Confused. Low hCG 4 Weeks. Miscarriage, ectopic, or ??

[melissa850]

I got my bfp a week ago (12dpo) on 11/20.

Today I started having some low uterine cramping and when I went to the restroom I noticed light pink spotting when I wiped (was not enough to even get on my underwear) 20 minutes later I had to pee again, went to the restroom apprehensively and sure enough, noticed a little spotting again when I wiped and the cramps were getting a bit more noticeable.

DH drove me to the ER. They immediately did a blood draw and set up for a transvaginal and a transabdominal u/s and started pumping me with fluids. I advised them that I was only a little over 4 weeks, judging by my LMP. (My first prenatal appt isn't until 12/17).

Here is where I got confused: The Dr. came back in after reviewing the ultrasounds and blood work and said,
"Your hCG levels are extremely low for you to be 4 weeks along. They're only at 565 and they should be somewhere around 3000 right now. The second problem we're having is that we could not locate a gestational sac through either ultrasound. This means one of two things: Either you've had a miscarriage already, you are having a miscarriage now, or you're having an ectopic pregnancy."

I asked if there was still a chance for this to turn out to be a healthy pregnancy, in the proper place, and he said yes but did not seem very optimistic about it.

He referred me to a see an OB/GYN in 3-5 days and have my hCG levels rechecked to see if they've doubled or if they are going down. He said if they go up they'll have to do another u/s to find out exactly where the pregnancy has taken place.

My concerns are... At 4 weeks & 2 days, is 565 terribly low? And are you guaranteed to see the gestational sac at 4 weeks? I was under the impression that they wouldn't be able to see the GS until after 5 weeks.

Any thoughts, ideas, or has anyone had a similar situation? What was the outcome?

I'm so lost right now, we've prayed and prayed for this child and have been so excited for this sweet baby and after hearing from the doctor tonight it's taking everything in me right now to stay positive and hold it together.

 

[bee lady]

That's avery normal number and you would not expect to see anything at 4 weeks. I am almost to 6 weeks and had an ultrasound on Wednesday. They did not see anything except for a thickened uterus and normal overies for a pregnancy. I am supposed to go back on sat. To get an ultrasound and I'm hopping to see something this time.

 

[BeautifulRose]

At 4w0d I had HCG of 89 and 4w4d they went to 414 and I'm now 9 weeks. Saw healthy baby at 8w3d

 

[melissa850]

Thank you so much, ladies! Huge sigh of relief!


I just looked up the normal hCG levels for 4 weeks online. I'm wondering if he was looking at gestational age for some reason instead and had it wrong.

I hope to see the OB on Monday and hopefully he'll have some better news (and more answers) for me than the ER doctor did today.

Fingers crossed! I'll update again if anything changes before then and definitely come back to update after I get another blood draw on Monday.

 

[too_scared]

My hcg was 68 at 4+0. I didn't have over 3000 until 10 days later. At 4 weeks I don't think you would see anything on an ultrasound.

My ob told me 68 was exactly what it should be at 4 weeks so I think 565 is awesome!!

 

[smoore]

I agree those are not "bad" numbers for 4 weeks and that you wouldn't be able to see anything at 4 weeks anyway. The doctor sounds like he doesn't actually know much about early pregnancy. The most important part would be that your numbers can double in 24-48 hours... not the exact number really. There is a large LARGE range of numbers that are normal.

 

[greats]

You typically don't even see a speck on an u/s until your hcg is over 1,000!!! Remember to be careful with ER doctors... Even though they've had some OB training they are not OB/gyns. You are only 4 weeks along, just wait till your appointment with your doctor, re-draw bloods, and check to see if they've doubled. I never saw anything on my u/s with my daughter until 5.5 weeks

 

[Jenny Bean]

OMG I am so frustrated for you and the system.

The same thing happened to me I had my HCG measured at 4+1 day and my levels were 685, the walk in clinic said "well your levels are pretty LOW". I was freaking out so worried only to find this actually is well within normal range, at 3 days later I was at 2100.

I am 10 weeks now (I haven't had a scan yet but there is no reason to since everything seems to be progressing normally).

Don't let them give you bad ideas.

My first exposure with this pregnancy left me very nervous and scared even now.

 

[tubs]

I don't think ER doctors know a whole lot about pregnancy, especially early pregnancy. Your numbers sounds normal. How is the spotting now?

 

[traylee01]

Wow 14 dpo mine 153. 16dpo 381 20dpo was 1960 I had a scan 1.5 weeks ago at 6 weeks showed 5 weeks 6 days heart beat 102.

 

[Pinkee]

@greats Right, er physicians go off of most common ranges. I had been in the ER with a pregnancy and my hcg levels were so high they told me I was pregnant with twins.

Freaked me out.

 

[Shilo]

What?! I wouldn't listen to anything that doctor said. Spotting around 4 weeks is pretty common since it's when your period usually comes. At 3 weeks 6 days, my HCG was 63. At 4 weeks 2 days, it was 300. I'm 13 weeks 3 days now and everything is going fine. Your HCG at 4 weeks is awesome! You also wouldn't see anything on an ultrasound at 4 weeks. I'm sure everything is fine. Hopefully a repeat HCG check will show your HCG rising and you'll be able to see your baby in a few weeks.

 

[jacksonl8805]

I got my bfp a week ago (12dpo) on 11/20.

Today I started having some low uterine cramping and when I went to the restroom I noticed light pink spotting when I wiped (was not enough to even get on my underwear) 20 minutes later I had to pee again, went to the restroom apprehensively and sure enough, noticed a little spotting again when I wiped and the cramps were getting a bit more noticeable.

DH drove me to the ER. They immediately did a blood draw and set up for a transvaginal and a transabdominal u/s and started pumping me with fluids. I advised them that I was only a little over 4 weeks, judging by my LMP. (My first prenatal appt isn't until 12/17).

Here is where I got confused: The Dr. came back in after reviewing the ultrasounds and blood work and said,
"Your hCG levels are extremely low for you to be 4 weeks along. They're only at 565 and they should be somewhere around 3000 right now. The second problem we're having is that we could not locate a gestational sac through either ultrasound. This means one of two things: Either you've had a miscarriage already, you are having a miscarriage now, or you're having an ectopic pregnancy."

I asked if there was still a chance for this to turn out to be a healthy pregnancy, in the proper place, and he said yes but did not seem very optimistic about it.

He referred me to a see an OB/GYN in 3-5 days and have my hCG levels rechecked to see if they've doubled or if they are going down. He said if they go up they'll have to do another u/s to find out exactly where the pregnancy has taken place.

My concerns are... At 4 weeks & 2 days, is 565 terribly low? And are you guaranteed to see the gestational sac at 4 weeks? I was under the impression that they wouldn't be able to see the GS until after 5 weeks.

Any thoughts, ideas, or has anyone had a similar situation? What was the outcome?

I'm so lost right now, we've prayed and prayed for this child and have been so excited for this sweet baby and after hearing from the doctor tonight it's taking everything in me right now to stay positive and hold it together.

At 4 weeks even my HCG was 330. It was my third blood draw and I am doubling every 35 hours. My Doctor (infertility specialist) said my number was great. She also said we could most likely do an early scan, but not until I am over 2000. She said otherwise you can't see anything.

Sorry to hear the ER doctor made it sound so horrible! Let us know how things go; hoping you have a very H & H 9 months!!

 

[alternatedi]

My HCG at 4w3d was 98. 2 days later it was 238. I'm 8 weeks along and I've seen my baby and his lovely beating heart twice now.

Also, I spotted all of week 4 - I thought it was a chemical but my baby kept chugging along. I think you're absolutely fine!

 

[melissa850]

Thanks everyone! Your comments give me hope!

Still having some mild pinchy-feeling cramps on and off, the spotting only happens when I wipe and is still very light pink. I had one instance of a teeny-tiny speck of red blood on the TP when I wiped yesterday.

The only thing that is making me nervous is my nausea has gone away and my pee frequency has decreased. I'm sure it's all in my head though, that Dr. planted a seed of doubt in my head and it's been hard to shake it - it feels like Monday is so far away!

I tried to call the OB today to set up an appointment for Monday but they were closed. Hopefully they'll be able to get me in for blood work! The wait is killing me.

 

[skyesmom]

i agree with all the pps - those numbers are great for 4 weeks and you're not supposed to see a gestational sac at 4 weeks, it becomes visible around the 6th week (sometimes even 5 weeks are way too early as in the early stages of pregnancy even a day can make a huge difference!).

i don't know what that doc had in his head when he told those levels are low and that you are having an ectopic or have/are miscarrying. the embryo is SO tiny at 4 weeks that it CAN'T be detected by any ultrasound AND your hcg levels are great for 4 weeks!

 

[mummyconfused]

At 4weeks my hcg was like 300 and even at my 5weeks ultrasound they saw nothing. Dr is an idiot

 

[ace28]

ER drs and nurses specialize in one thing- emergency medicine. They don't know much else about anything. OB protocols and HCG levels are definitely best left in the hands of an OB doctor- I'm excited for you to see yours on Monday. Sounds like there is definitely a reason to hope!

 

[melissa850]

Thank you, ladies!

I've had a few more instances of spotting and cramping today but I guess the good news is that it's not getting any heavier or any more painful.

I took another clearblue advanced digi today on a whim of curiosity. On 11/20 when I got my bfp it said "pregnant 1-2", today it seemed to come up "pregnant" really fast, a minute later it said "2-3". I'm going to take that as a good sign and just calm down until Monday!

It feels like forever away, still. It could also be that my job scheduled me to work 6 days in a row this week and today is normally my Friday, but I've got a whole day to go before my actual day off.

 

[skyesmom]

that with clearblue digi is defo a positive sign! fingers crossed for you for tomorrow!