Q: I’m about a month pregnant. I just had an ultrasound and they didn’t see a heart beat. Is this normal at this stage of my pregnancy? Could it just be too early?
A: On transvaginal ultrasound, you can usually see the heartbeat by about four weeks after conception. So the answer to your question really depends on what you mean “a month pregnant.”
In obstetrics, we traditionally count weeks from the last period. For a woman with 28-day cycles, a month pregnant is about two weeks after conception, and you would not expect to see a heartbeat. But by a month after conception, you’d be right around the time a heartbeat is expected.
Unless you are certain you conceived over a month ago, it just may be too early to see the heartbeat yet. Sometimes the sonographer can get a sense of whether the pregnancy looks normal for an earlier gestation or whether something seems wrong (like it is the right size to see a heartbeat but none is seen, or the gestational sac seems irregular). If they think it looked normal but too early, they will probably recommend a repeat scan in a week or so. I hope your repeat scan yields good news!