I had an ultrasound because I was pregnant and the doctor did not know exactly how far along I was. They did both the vaginal ultrasound and the abdominal one. The doctor said that the baby was eight weeks along, but that the baby had no heartbeat -- that basically I was having a miscarriage. I had a D&C today and I am still recovering emotionally. My doctor said that what caused the miscarriage was that my body had stopped producing a hormone to help the baby grow and progress -- is this true? Can you tell me more about this?

T.P.

I am sorry for your loss; I, too, have experienced the pain of miscarriage early in pregnancy and understand the emotions you are experiencing. While it may be of little comfort, miscarriages are very common. In fact, 20 percent of pregnancies we are aware of end in miscarriage, and research shows that almost 50 percent of all conceptions terminate on their own, most of them before the woman knows she is pregnant.

Sometimes, the ovaries do not produce enough of the hormone progesterone to sustain an early pregnancy, and a miscarriage results; some doctors prescribe progesterone supplements to try to take care of this problem. The vast majority of the time, early miscarriages are due to chromosomal abnormalities and nothing you did -- or didn't do -- caused this to happen. The good news is that one miscarriage does not increase the odds of having another.

Ultrasound, especially transvaginal ultrasound, is very good at determining how far along you are and -- if you are more than six or seven weeks pregnant -- whether the baby is alive or not. On transvaginal ultrasound, a heartbeat is usually seen around six weeks; sometimes if the uterus is severely tilted back (retroverted) it may be more difficult to see. If the measurements are consistent with eight weeks, a heartbeat should be seen. Sometimes an ultrasound will be repeated several days later, especially if you are difficult to scan. If there is any question about how far along you are, a blood test called hCG may be ordered; if the hCG level is greater than 2,500, a heartbeat can usually be seen (with the same caveats as above). If the hCG level is less than 2,500, it will be repeated until it is high enough to suggest that a heartbeat should be seen.

If your doctor had any doubts about how far along you were or if there was a heartbeat, she would not have suggested a D&C. One of the most unpleasant things I have to do is to tell someone she is not going to have a baby. Your doctor would not have done anything to disrupt a pregnancy unless she was certain that the baby had already died.