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Missed miscarriage?

A woman coming in weakly presses a clammy hand to me. "I'm nervous," she says. She is alone and sits down on the chair. "What's the matter?" I ask. "I had a miscarriage three months ago." She grabs a paper handkerchief from her handbag and dabs up the tears running down her face. "Sorry," she says. "I want a baby so badly. My mother lives abroad and my husband works on an oil rig. He just left again. I'm alone a lot and very emotional because of this miscarriage." "It doesn't matter," I say and look at her compassionately. I pour a glass of water and set the filled glass down on the table in front of her. "Now I haven't had my period again so I took a test and it's positive. I am so scared that it will go wrong again."

"Come let's have a look together," I say and point to the examination couch. "I'll do an ultrasound first because then we'll know more." She lies down on the couch and exposes her belly for me. I see a bulged belly up to her navel. "How long do you think you are pregnant?" I ask. "I have no idea, my cycle has always been very unpredictable and irregular. My last period was 2 months ago but it was very short so I guess 8 weeks?" She sounds tense "Okay, then I'll start with an external ultrasound just to be sure. But if I don't see anything, don't be alarmed because the pregnancy may still be so early that I need to do an internal ultrasound." She nods in approval.

I smear a little warm gel on her and feel her abdominal muscles relax a little as in glides over her belly with the toner. Slowly I move over the belly hoping to get a good view of the screen. Thinking about eight weeks pregnant, I look at the images. To my surprise, I see quite a large baby on the image. I quickly measure the baby's growth to get an idea about her term. The first measurement already indicates over 22 weeks.  

"Who said you had a miscarriage?" I ask. "I had blood loss and went to the GP, who said it was a miscarriage." I look at her for a moment. "Didn't anyone do an ultrasound or a pregnancy test then?" I ask. "No...," she says and looks questioningly in my direction. I look and take the rest of my measurements. "I see a baby sitting at 22 weeks gestation," I say. Quickly in my head, I calculate her gestational age based on the data she gave me earlier. "You haven't had a miscarriage." She immediately puts her hands in front of her mouth. "Really?" she asks. "You're not a little pregnant, you're very pregnant," I say. She laughs. "Really?" she asks again. I nod. "Really!" 

"I told my mother that I felt something moving. She said, 'That's in your head because it can't be that early at all.' No one is going to believe me." She can hardly stop laughing in disbelief. "Can you call your husband?" I ask, laughing. "No, it's not so easy on that rig, but tonight I can call video."

"Can I even call my mother in front of you? Otherwise she won't believe it!" she looks questioningly in my direction. "Fine," I say. The woman calls her mother. I heard the cheerful Surinamese voice on the other end of the line and the phone are not even on speakerphone. "She doesn't believe me." The woman hands me the phone. "Yes, it's really true," I say to a voice. "Thereby I can tell you that your grandchild is doing well!" "What kind of grandchild am I getting?" asks a the friendly voice on the other end of the line. "I don't know if your daughter wants to know," I say looking at her. "Am I getting a girl?" I nod. The woman looks at me and screams. Immediately afterwards, woman on the other end of the line does exactly the same.

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