Many terms are used in medicine to explain a condition or a medical status and these terms are understood by the doctors but may or may not be understood by just anyone. Viable pregnancy and non-viable pregnancy are two of those terms. Now what do they mean?
A viable pregnancy is a condition in which the baby can survive the gestational period and birth. If you’re told that your pregnancy is non-viable, it means that either the baby cannot survive and won’t grow and develop or that the baby will not be able to survive outside the womb. Such news would definitely be devastating and many questions may run through your mind. You’ll want to know how the doctors are sure about it. You might think about taking second opinions and many other questions.
We’ll discuss the causes, the treatments, and how they may affect your fertility.
Vita in Latin means alive so, a viable pregnancy describes a pregnancy that is alive and the term can be used in for the same meaning in the different stages of the pregnancy such as:
- The normal increase in hCG levels before 6 weeks of pregnancy when even the heartbeat is not present can be termed as a “viable pregnancy”.
- Seeing a normal fetal heartbeat after about 6-7 weeks after pregnancy can also be called as a “viable pregnancy”.
- The term “fetal demise” can be used if a fetal heart can be seen but not a heartbeat.
- Even if a fetal heart rate in the uterus is observed but has no chance of survival if delivered before 22-24 weeks can be called as a “non-viable pregnancy”.
- If there is a chance that the baby delivered before 22-24 weeks of pregnancy has a chance of survival, it would be called as a viable pregnancy.
- “Missed abortion” is a term used for a fetal demise before 20-24 weeks of gestation.
- A baby born at 26-28 weeks in some countries or under some circumstances may not receive neonatal care, in such cases, the babies are considered non-viable.
- Babies born with conditions that may not allow them to live for long are considered “non-viable”. These include babies having lethal defects, such as heart or lung malformations and genetic condition that are untreatable.
The first trimester is the most delicate time period where organogenesis occurs which makes the diagnosis difficult to detect the viability of the pregnancy. Some guidelines can help define the ultrasound diagnosis which can help in detection of a non-viable pregnancy.
- The crown-to-rump length is more than 6 mm with absence of heartbeat.
- Mean sac diameter is more than 24 mm without an embryo.
- Absence of fetal heartbeat >=2 weeks after a scan showing the presence of a gestational sac but absence of a yolk sac.
- Absence of fetal heartbeat > 10 days after a scan showing the presence of a gestational sac along with a yolk sac.
The Baby/Fetus is Viable:
We just talked about viable pregnancy, now let’s about a viable fetus or also called as viable baby. This refers to a baby that is just born but does have chances of survival. Mostly, babies can be considered viable if born at about 24 weeks, but that does not mean that every baby that survives would not have any problems. Every day that the baby survives increases the survival probability and decreases the chances of complications.
A term “gray zone” is used for weeks 23-24 when most doctors do not intervene and after 24 weeks would in order to save the baby’s life. They may go for a caesarian section but under 23 weeks, a caesarian is not considered.
A baby born at 24 weeks would be a pre-mature baby and may need to be taken care of in a NICU in addition to a lot of medical attention. If the pregnancy progresses after 24 weeks, the odds of survival increase and comparatively, babies born at 37 weeks would be far better than those born at 28 or before that.
What is a Non-Viable Pregnancy?
If the fetus does not have a heartbeat or if there is no increase in the normal hCG levels, the pregnancy is termed as non-viable. It could be a missed spontaneous abortion or a miscarriage during early pregnancy. Long story short, the term “non-viable pregnancy” is used if a fetus doesn’t have a chance of being born alive or even if it is born, it has no chance of survival.
Symptoms of a Non-Viable Pregnancy:
Initially, the viability of a pregnancy is measured by the hCG levels, its presence can be detected in urine by a home pregnancy test but the accurate measurement can be found through a blood test. Normally, the hCG number doubles ever 2-3 days and embryonic development becomes visible in the ultrasound when the hCG reaches 2000mIU/ml.
In later gestation, if a pregnancy becomes non-viable, the following physical symptoms can be observed:
- Abdominal or back pains
- Mild to severe cramps
- Pink-white mucus
- Clot like material
- Symptoms of loss of pregnancy such as nausea, although they can occur in viable pregnancy as well.
Women may have no idea about their pregnancy being non-viable until they visit their doctor. The ultrasounds show an imaging of the present material like the gestational sac and yolk sac and then the fetal heartbeat is considered to determine the viability of a pregnancy. if everything is observed to be healthy, there is a drop in the risk for miscarriages and survival rates go up.
Causes of a Non-Viable Pregnancy:
There are many different factors that affect the viability of a pregnancy, these are as follows:
- Chemical pregnancy: Inability of a fertilized egg to embed itself in the uterus lining.
- Molar pregnancy: Development of a tumor in the uterus during early pregnancy due to some genetic error.
- Ectopic pregnancy: The implantation of a fertilized egg outside the uterus is called as an ectopic pregnancy.
- Abnormal chromosome count: Genetic defects or abnormal chromosome count can prevent a baby from surviving.
- Blighted ovum: After the formation of a gestational sac, if a pregnancy ceases, it is termed as a blighted ovum.
- Pre-mature birth: A premature birth of a baby may restrict it from surviving outside the womb.
In case of a non-viable pregnancy, either a miscarriage would occur naturally or would have to be carried out by surgical methods such as D&C. Medication might also be required in order to get rid of the remaining fetal tissue in the body.
You should keep in mind that a non-viable pregnancy cannot be saved by any surgical method or medication. A non-viable pregnancy would not affect your fertility in most cases as they usually occur due to chromosomal abnormalities or genetic errors. However, an ectopic pregnancy that is not diagnosed on time may result in a rupture of a fallopian tube which is a health risk. You should go for regular checkups during your pregnancy.
From the above-given information, we learned the difference between a viable pregnancy and a non-viable pregnancy. We know that there are no treatments for a non-viable pregnancy as they’re usually caused due to chromosomal abnormalities or genetic errors which are untreatable.
You should visit your doctor from time to time during your pregnancy to detect any arising complications in an early stage and to detect in case if the pregnancy becomes non-viable which can be possible at any stage.
Keep yourself updated with your doctor and follow the given guidelines. The news of a non-viable pregnancy can be devastating to the expecting presents. For the best care follow your doctors’ suggestions, however being the parents, you would make the best choice for your little one.