AN INTRAUTERINE PREGNANCY
An intrauterine pregnancy occurs when a yolk sac or fetal pole is present in the gestational sac. During an intrauterine pregnancy, a fertilized egg implants and develops inside the uterus, where it is supposed to be. An ultrasound finding of an intrauterine pregnancy indicates that the pregnancy is developing appropriately.
MEANING OF INTRAUTERINE IN PREGNANCY
Intrauterine pregnancy means within the uterus. The fertilized ovum is implanted within the uterus.
The uterus is a small, pelvic shaped hollow organ in which the fetus develops.
HOW DO I CONFIRM AN INTRAUTERINE PREGNANCY?
An ultrasound scan is the most common way to determine whether a pregnancy is intrauterine.
Yolk Sac Visibility
An intrauterine pregnancy can be verified when an embryo develops and can be seen through ultrasound at 5.5 weeks of pregnancy.
The activity of the fetal heart
A fetus’ heart rate increases every week after six weeks of pregnancy, and the average heart rate is 100-120 beats per minute.
IS INTRAUTERINE PREGNANCY BAD OR NORMAL?
The intrauterine pregnancy is normal when seen in the right place in the womb (the uterus), and the fetus has a normal heartbeat. A heart rate of less than 80 beats per minute before 6.3 weeks is associated with a higher risk of complications throughout the first gestation. Between 6.3 and 7 weeks, 120 bpm is associated with a wrong diagnosis, while less than 100 bpm is associated with a higher risk of miscarriage.
During intrauterine pregnancy, what is the level of human chorionic gonadotrophin?
In a normal viable intrauterine pregnancy, a gestational sac should be visible under ultrasound after an hCG level of 1500mlU/L is noted. If the transabdominal approach is preferred, the threshold is up to 6500mlU/L.
ULTRASOUND DIAGNOSIS OF INTRAUTERINE PREGNANCY
The following terms can describe pregnancy inside the uterus:
In the case of a live intrauterine pregnancy
An intrauterine pregnancy is considered live when the gestational sac contains either a yolk sac or an embryo/fetal pole with fetal heart activity.
Pregnancy with a single-live fetus
Typically, at this stage of pregnancy, there is only one fetus, and the scan has identified either a single yolk sac or fetal pole with heart activity.
An early intrauterine pregnancy
A gestational sac exists in a woman’s uterus, but an embryo or fetal heartbeat cannot yet be seen. Further information (perhaps another ultrasound scan) is needed to determine the progression of the pregnancy.
IS COLOR DOPPLER USEFUL IN EARLY CONFIRMATION OF INTRAUTERINE PREGNANCY?
A positive pregnancy test usually diagnoses IU pregnancy. An intrauterine gestational sac can be seen by a transvaginal scan as early as 4-5 weeks (2-3 weeks embryo). Sometimes, early pregnancy problems create confusion because of uncertainty about the site of the pregnancy, leading to further investigations and interventions.
These often increase patients’ anxiety and the cost. With the advent of expectant and medical treatment of ectopic pregnancy, early confirmation of the site of pregnancy has become more relevant. Color Doppler may be used to investigate uteroplacental circulation in early pregnancy and early pregnancy problems. It might be instrumental in managing early pregnancy problems if it were successful.
WHY DO EARLY INTRAUTERINE PREGNANCIES FAIL?
Various factors can cause early intrauterine pregnancy failure or miscarriage.
Chromosomes or Genes that are abnormal
The majority of miscarriages are caused by abnormal fetal growth. Approximately 50 percent of miscarriages are caused by missing or extra chromosomes, an entirely random phenomenon. Chromosomal abnormalities occur during embryo division and development, not from either parent.
Chromosomal abnormalities can lead to
Fetal death in utero
The fetus would cease to develop and die before any symptoms of pregnancy loss appeared.
An ovum that has been blighted
Embryos never begin to develop.
Pregnancy with molars (and partial molars)
An embryo’s chromosomes are both handed down by the father. Abnormal placental tissues and inadequate fetal development can also characterize a molar pregnancy. In partial molar pregnancies, the mother’s chromosomes remain, but the father still passes on two sets of chromosomes.
Health of Mothers
Occasionally, a preexisting medical condition can trigger a miscarriage. Contributing factors include:
Your and your baby’s safety is at risk when chronic conditions like diabetes go untreated.
An imbalance of hormones can produce irregularities in your uterine lining, which can interfere with the implantation and nourishment of a fertilized egg.
Infections like malaria, cytomegalovirus, listeriosis, toxoplasmosis, syphilis, or HIV can cause significant complications for a mother.
Diseases of the thyroid
When your thyroid is overactive or underactive, it disrupts hormone levels and interferes with the proper development of your embryo.
Problems with the cervical or uterine region
There is an increased risk of miscarriage when the cervix is incompetent (with fragile cervical tissues), and the uterus has specific abnormalities.
The age of the mother
At age 35, women have a 20 percent higher chance of miscarriage than women under 35. By age 40, the risk doubles to 40 percent, then double again to 80 percent.
Miscarriages in the past
It’s important to note that previous miscarriages do not necessarily prevent you from being able to become pregnant again in the future.
Use of alcohol, tobacco, and drugs
Miscarriage and congenital defects are dramatically increased for pregnant women who smoke, drink heavily, and use drugs.
The weight of the person
It is also dangerous for mothers and children to be overweight or underweight.
A common misconception is that the following activities increase your chances of losing your baby:
Intercourses with sexual partners
A mucus plug and amniotic fluid protect your baby
As long as your doctor approves, you may continue exercising if you have always been active.
STEPS TO REDUCE CHANCES OF AN EARLY INTRAUTERINE PREGNANCY
You and your baby-to-be can stay healthy and happy by considering the following lifestyle variables:
Be sure to eat a well-balanced diet rich in fruits and vegetables.
Quit smoking, drinking, or doing drugs.
Before conception, maintain a healthy weight.
A weakened cervix or antiphospholipid syndrome (APS) should be treated before pregnancy.
AN ICD 10 CODE FOR INTRAUTERINE PREGNANCY
Intrauterine pregnancy with abdominal pregnancy
Billable/specific ICD-10-CM code O00.01 indicates a diagnosis for reimbursement purposes.
On October 1, 2022, ICD-10-CM O00.01 became effective for the 2023 edition.
CONSULTATION WITH AN OBSTETRICIAN OR GYNECOLOGIST
You should consult your doctor as soon as you receive a positive pregnancy test result. If you observe vaginal bleeding and spotting, seek medical attention immediately.
The suspected presence of ectopic pregnancy should be addressed by referral to an obstetrician.