Miscarried 3.5 weeks ago but still have hCG

[ZucchiniPie]

Just over 3 weeks ago I had a missed miscarriage at 12 weeks (pregnancy had probably stopped around the 6 week mark). I had an ERPC following very heavy bleeding and have been feeling really well (physically) since then - I felt so awful while I was pregnant that the contrast in my energy levels has been really marked.

However, on Thursday morning I woke up with really bad abdominal pain and went to the loo, where I passed out. When I came round the pain was absolutely excruciating - way worse than anything I experienced in labour with DD (now 18 months).

At the time of the miscarriage, the ultrasound technician saw something up near one of my ovaries, in addition to the pregnancy sac which had developed in the uterus. She mentioned that it could be a concurrent ectopic pregnancy, but the doctors all said this was so unlikely because of the fact there WAS an intra-uterine pregnancy they didn't follow it up. More likely to have been a cyst, they reckoned.

On Thursday when I went to A&E following my collapse and the pain, I told them this and they tested my blood for hCG. It was 29. I've just found out that the level in the bloods they then took on Saturday was 24, so has fallen slightly. They were looking for it to have doubled, which would have meant I was pregnant again (unlikely as we've only had sex once and used a condom!). But as the levels have dropped, I'm not pregnant, so now whatever the explanation is is going to be harder to find.

Has anyone experienced anything like this? The ectopic possiblity is very unlikely too, as could one ever get to what would be now 15.5 weeks without having terrible problems way before that point?

Or is an hCG level of 29, 24 and dropping actually quite normal 3.5 weeks after a miscarriage? (On the day of my ERPC, the levels were 1300.) Of course it doesn't explain the pain and the passing out...

I'm waiting for a call from a doctor at the hospital to analyse the results (all the nurse I spoke to could do was tell me the numbers) but it would be nice to hear from anyone who's been in a similar situation!

[batteryhen]

Hello :) I didn't want your post to go unanswered. I know your HCG levels can take a while to come down, - a lot depends on how far pregnant you were, and if your levels had already started to drop etc. And 24 is quite so low so I wouldn't panic too much. Has your consultant called back yet to give you any answers?

[exexpat]

Do you know if they checked the ERPC for signs of a molar pregnancy? That could cause elevated HcG (and pain and bleeding if the tissue was growing in a fallopian tube, for example), but if there was enough molar tissue remaining or regrowing to cause problems, I think you would expect the HCG levels to be climbing quite fast again. Worth asking if they have ruled it out?

[ZucchiniPie]

Thanks both of you. I haven't heard back from the consultant yet (really frustrating) but after a bit of googling this afternoon I did realise that 24 is pretty low so am not feeling as worried as I was before.

I'll definitely ask about the molar pregnancy though - the surgeon who did the procedure certainly didn't mention it at the time but I did ask her whether they'd checked out what it was in the tube that the ultrasound technician had seen and she hadn't as I don't think it was ever pointed out in the notes and she said they were just looking at the uterus.

[AitchTwoOh]

oh zucchini, you poor thing. i am so sorry that you lost your pregnancy, and hope that you get to the bottom of whatever is happening soon.

[hairyfairylights]

Sorry for your loss. I had a suspected ectopic in the Spring. They couldnt tell me for sure. but I had very slow rising HCG (highest was something like 170 at eight weeks).

After having medical management (methotrexate) It went down but seemed to stop temporarily at 30 and then went up by aobut three, then down again.

I've had a MMC this month, and fainted after the first ERPC (I needed two). They said sometimes there can be something stuck or something in the cervix. Have they looked?

[ZucchiniPie]

No, I haven't had a follow-up ultrasound since the ERPC. Basically I need to make sure I track down a doctor to speak to tomorrow as it's five days now since I was in A&E and three days since the follow-up blood test and they obviously don't see me as much of an emergency!

I've made an appointment to see my GP (again not possible till Thursday...) as a contingency because if all else fails at least I can probably get them to take some more blood so the levels can be compared again - if I knew they were still going down, even slowly, that would be reassuring!

[meltobe]

Hi zucchini I'm so sorry for your loss.

I had a miscarriage 3 weeks ago too and my hcg levels are dropping but are still at 500.

You did mention a cyst - I'm wondering if this could be the source of your pain? I too have a cyst which was picked up on a scan when I first became pregnant. I was told not to panic about it but that I should avoid exercise and sudden movements in case it twisted or burst.

This might not be the case for you but I just thought I'd mention it.

I do hope that your recovery goes well and I wish you all the best.

[ZucchiniPie]

Hi meltobe - really sorry for yours too. Hope you're feeling okay...

I finally got hold of a doctor just now and she said it probably was just a question of the levels taking a bit of time to come down. I'm going to have another blood test early next week to check the trend is still a downward one.

It sounds crazy but when I was in the ambulance on Thursday morning the paramedic told me that trapped wind can sometimes be so excruciating that she's had people who think they're having a heart attack. When I first woke up with the pain it did feel more digestive than gynaecological, but after coming round it was so extreme (and what with the fainting too) it did feel more likely to be connected to what had happened with the miscarriage than something as simple as the fact I ate lentils the night before!

Anyway, now I know HCG takes its time leaving your system like this, I'm more prepared to believe the two events might have been unconnected after all. Fingers crossed they're near to zero by next week.

[meltobe]

No probs zucchini, I hope you're feeling ok today. I'll be interested to know how your levels go as we're in similar positions both with when our mcs happened and our slow dropping hcg - hoping for a great plunge for both of us

[pink4ever]

I was going to suggest a molar pregnancy(as I have had one myself) as levels can appear to go down at first and then steadily climb back up.
I would def instist on some sort of follow up just in case.

[ZucchiniPie]

Well there's been an unexpected development today because when I woke up this morning I had what seemed to be my period! So I called the hospital to ask them whether I should be worried, as obviously a period shouldn't really be possible with the HCG still hanging around, so was possibly some other type of bleeding.

So they got me in for a scan really quickly and this time I was seen by the consultant who was very thorough and she could see that I had indeed ovulated and that everything looked completely fine. No retained products, ovaries moving around nicely, etc. So it is indeed a period, 4 weeks to the day since the ERPC! I actually did think a couple of weeks ago that I was ovulating (I'm usually pretty able to tell) but after the blood tests last week dismissed that idea. But I'm obviously proof that you can ovulate with HCG still in your system, and I'm wondering whether that's not so unusual - maybe lots of women still have hormones there when they ovulate again, but just don't get tested to see - the consultant agreed it was possible. I'm going back next week for a blood test to check the levels again.

I asked about molar pregnancy and she printed off the histology report for me which confirmed there were no indications of that.

The whole mystery of the fainting and the pain is unfortunately still unexplained. She said it could have been a cyst bursting, which can cause sudden pain, or something to do with the corpus luteum after ovulation (didn't quite understand why that would be) but there's no way of telling. She couldn't see anything on the scan which would indicate what had happened.

Anyway, hopefully this is the end of the saga. Thank you all for your supportive messages and meltobe, fingers crossed your levels come down soon xxx

[ZucchiniPie]

Oh and I forgot to say, the consultant also said there was no signs of any ectopic pregnancy either - agreed with the doctors at the time of the MC that it was a fimbrial cyst.

[AitchTwoOh]

good news, zucchini. the cl cyst can happen after ov, and can be very painful i believe, especially when it pops. i hope that this latest doctor put your mind at rest. that first period is a bittersweet time, eh?

[banana87]

zucchinipie I had my ERPC coming up to 7 weeks ago. Last week I had a positive HPT so rang my dr straight away. I've had two scans and a blood test, and they are not sure if its retained products or not. My HCG was 285 AND I have definately ovulated, so I guess bodies are clever and know when you are and are not pregnant!

[meltobe]

That's great news zucchini, i'm glad your body is back on track. I wondered if I'd ovulated at the beginning of the week but dismissed it as I knew I still had hcg but after reading your post perhaps I did! All the best for the future xx

[ZucchiniPie]

You're right AitchTwoOh, that's exactly what she said but I didn't realise the corpus luteum WAS the cyst. Makes sense now so thanks for clearing that up for me! Wikipedia says it can cause sudden, sharp pain - which is exactly how I'd describe it.

Also says that certain fertility drugs can increase the likelihood of one developing - I'm not on those, obviously, but it occurs to me that the anecdotal stuff about being especially fertile right after a MC might mean there's the same effect...