low hcg in early pregnany, is the doctor wrong?

[monkeymoma]

My GP referred me to the womens health unit 2 days ago because I had spotting (never a flow, never red blood) combined with R sided pain

I kept explaining to the doc at the womens unit that although on the day my dates by LMP were something like 5+3, I was actually 4+0 (based on OV dates, same situation as when I had DS) - he didn't really listen

had bloods taken at 4+0 MY dates (5+3 by LMP dates), the result was 288, doc says this is too low and is a MC

I'm wondering if anyone can shed any light because I don't think the doc listened to me re dates

Is 288 low for 4 weeks EXACTLY or is it low for 5+3 which he is insisting on going by (despite me repeatedly telling him I was 4+0 on the day the bloods were taken), I asked him to clarify what it should be at FOUR weeks, he was vague and said for 4-5 weeks it shoudl be >1000

Thanks! I'm not trying to be in denial if it IS too low for my actual dates, I just want to know if its low for what I REALLY am x

[Haggisfish]

Fingers crossed for you Monkeymama. We had our second scan, and saw a 2mm foetus with beginnings of a pulsing heart and foetal pole. So, we ae out of the ectopic realm and (hopefully) into happy pregnancy. I am just much earlier than I thought (currently about 6 weeks pg, when I thought about 8 or 9 by now). Hope it goes well for you, too.

[monkeymoma]

thanks batteryhen

had a bit of a whinge at DH and feel better now, I think the doc is trying to prepare me for the worst emotionally just incase, rather than giving me a balanced view of the possibilities/likelyhood, IMO it COULD still be ectopic but it is looking less and less likely right? It's a bit patronising because I KNOW a full term bouncing bubba is not a definite given at this stage, but for the moment things are looking good IMO and I would like to enjoy this stage now that things are looking okay-ish - not in an unrealistic way, I'm still vigilant for any signs that I need to seek urgent attention, just also want to be able to say I'm pregnant and happy about it right now!

he didn't even say "you ARE pregnant" when he gave me today's result, he was still non commital about it and said I should book in with the MW INCASE I am having a viable pregnancy

[batteryhen]

I am still with you on the pregnancy front. My Dr told me the numbers don't really matter, if its if they are rising sufficiently. For today you are pregnant -until proven otherwise!

I hope you get that scan and prove them all wrong!

[monkeymoma]

although despite still being somewhat up in the air and not yet quite having a licence to celebrate, at least now I have proof that I'm not some crazy woman insisting I'm still pregnant when the doc says I'm not!

[monkeymoma]

hCG was over 5000 yesterday, doc not sounding particularly positive though, he still wants a scan, hopefully then if that's okay I'll be allowed to be officially pregnant and happy about it!

[monkeymoma]

:-( what a roller coaster Panda!

appointment was uneventful, got a blood form, going to get the blood taken this afternoon

[AitchTwoOhOneTwo]

oh bloody hell that must have been particularly gutting for you, Panda. They really are bastard things to diagnose.

[Panda1234]

My last ep appeared to double at first (the dr was really surprised when it turned out to be an ep), then went down, then went up again. They really are unpredictable things.

But hopefully you're going to be ok. Fingers crossed everything is fine at your appointment.

[monkeymoma]

thank you all! this thread has been really useful/informative/supportive
I'll update when I've seen the GP
xx

[Sastra]

Fair enough. Still, it's all sounding positive at the moment! Got everything crossed for you!xx

[FoxyRoxy]

*Monkey I'm really pleased things seem to be progressing for you, good luck at the doctors tomorrow :)

[AitchTwoOhOneTwo]

fingers crossed. yes, roughly speaking what you say is correct, the blood supply in the tube isn't going to be as nourishing as if it were in the right place.

[monkeymoma]

thanks for sharing your results batteryhen!

sastra, when my GP originally referred me to womens health he first tried the other EPU nearby but they refused me and said I had to go to my nearest one so unfortunately I don't think I can choose my EPU, they're all referral based.

[monkeymoma]

I have an update

at 6am this am my CBD was still 2-3, just now it's 3+
(last tues morning it was 1-2, last wed afternoon after I left hospital it went up to 2-3) - (CBDs tell you weeks since conception not weeks pg so add 2!)
Based on OV I should be between 4+4 and 4+6 today (by LMP I'm 5+6)

I know it's not the same as blood tests, but it does seem to be showing that my levels are doing what I think they should be doing roughly by MY dates

and from what I understand about ectopics (please DO correct me if I'm wrong about this!), in ectopics the levels rise but not as fast, so by that rationalle if it was an ectopic I probably wouldn't be "graduating" on CBDs on time every week?

anyway I do have an appointment with my GP tomorrow morning, but I'm feel pretty positive!

[Sastra]

Do, Monkey.

Sorry, when I said private scan I meant could you get bloods done privately. Or could you even try a different EPU (I'm on London and several of the big hospitals have them).

But call your GP and see the lay of the land tomorrow. Hope you're managing to get some rest.xx

[batteryhen]

I know nothing about ectopics, but do have experience with low HCG. A Dr can not possibley say if you are having a miscarriage from one HCG reading - you have to be abe to compare it withanother reading.

I know this because I am now 26 weeks pregnant witha pregnancy, and my hcg started off lower than yours. At 4+4 my hcg was 58. 2 days later it was 85. 2 days later it was 156. So mine was low and didn't double. Not once did the Dr say I was going to miscarry. And it doesn't have to double every day - as long as it increases by 60% or more than that is Ok apparantly. I was concerened this was another MC as I already had 3.

Some pregnancies are just slow starters :) Good luck xx

[monkeymoma]

hi, I will phone my GP tomorrow x

[Soontosplit]

Name change fail... I was Charliechoc!

[Soontosplit]

Hi monkeymoma, I hope everything has been ok for you today. It sounds as though your immediate symptoms had abated by yesterday. I just wanted to say please please do get to the doctors tomorrow and ask for the serial blood tests.

I know bleeding and some pain is common in early pregnancy. Unfortunately this led to my GP not even considering an ectopic. As your GP was concerned last week, and you have had bleeding and pain, I think it's best to rule out any possibility of an ectopic.

Think of it as just being on the safe side. I really hope you come back this week and say everything was fine with your tests!

[AitchTwoOhOneTwo]

every time i've said it could be absolutely fine, and pointed out that my 'classic' ectopic symptoms actually turned out to be DD1, but there is just no point in saying that x or y is unusual to someone who may not actually 'get' how serious this could be.
this isn't the ept website, where people go when they've had or might be having an ep, this is mn, there are heaps of lurkers who pick up info that they might need to use later on, so we need to be careful about what we say is usual or unusual, especially as we are aware how sneaky eps can be.
you can already see on this thread that people have picked up erroneous info and are advising MM wrongly. and as for the doctors...
have buzzed izzie on FB, anyway, am curious to know how rare it is to have pain so early, as i most definitely did and they weren't CL cysts. perhaps there is a difference between comforting someone who you know is already seeking treatment, and quoting proper stats.

[libelulle]

don't 'oh god, honestly' me aitch - a lot of us have been through ectopic here and I know as well as anyone that it usually doesn't present in a standard way - but all the same, if you look at the advice on the EPU site and message boards, then the inimitable Izzy (who has adviced many 1000s of women with ectopics) will also tell you that pain is unusual at 4 weeks for an ectopic. That is what she told me, anyway.

If you are seriously worried monkeymoma then obviously go to a&e - as aitch points out, ectopic is sneaky in lots of ways - BUT all the same don't lose sight of all the other much more likely possibilities for what this might be.

[bringonthetrumpets]

Spotting can be really normal as the embryo is implanting and burrowing in. Cramping is also really normal as your uterus is getting used to having something in it. hCG levels really vary woman to woman, and as long as you're not experiencing heavy bleeding and really painful cramping, you should be fine. If they are going to do your bloods again, I would ask them to check your progesterone. Often times low levels are the culprit for cramping and spotting as the pregnancy progresses.

I know it sounds a bit patronizing, but really try to not get stressed out, it can make things much harder to deal with.

Fingers crossed for you, monkeymoma. Sending healthy pregnancy vibes your way!

[AitchTwoOhOneTwo]

oh god, honestly. it's not unusual to have pain at this stage. i did. there really is no point in speculating as to what's normal regarding ep. nothing's normal. some things are just more common, that's all.

good that you're on the alert for any change, MM, i bet you're right about the doc today. the ept site is great, it's a total lifesaver for a lot of people.

[libelulle]

sorry, CL - corpus luteum

[libelulle]

Sounds like you are getting typically rubbish treatment from the EPU, sadly. Mine have decided in their wisdom that they don't do scans before 8 weeks, even though a lot of ectopics (mine included) will have ruptured/needed emergency surgery by then.

BUT what I would say is that if you really are only 4 weeks by LMP, then that IS very early for ectopic-like pain, and that a CL cyst sounds a much more likely possibility. With both my children post-ectopic, I ended up in A&E with pain and bleeding just before 5 weeks, thinking I was having a repeat ectopic, and in both cases a cyst was responsible and baby was growing fine in there.

However, if I were you I'd give the ectopic pregnancy trust helpline a ring, as you can get through to someone both medically qualified and with specific expertise on ectopic pregnancy. Their forums are also great, though I have issues with their moderation rules which treat women like rather dim 4-year-olds.