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

[monkeymoma]

I just hate not knowing how to FEEL! If I felt confident in the doc I saw at hospital I could face up to a MC head on and get on with preparing for "things to happen"

If I'm pregnant I want to be happy

I don't even know if I'm pregnant or not now it's wierd!

[sunnyday123]

if you are 5.3 from LMP then you are 5.3 weeks pregnant (but less from ovulation but thats not how pregnancy is dated in the medical profession). The doctor is right to dismiss your dates as LMP is what all their figures are based on- not ovulation date.

Thus when they give a figure for 5.3 weeks pregnant they mean 2-3 weeks after ovulation - thats just how they do it.

I had spotting with both my pregnancies (inc red blood and pain) and both were fine so dont worry too much. The hormone should double every 48 hours - thats how they tell thing are progressing normally - your GP can test for the hormone if you ask. Scans before 6 weeks are of no use - there's no heart beat so pregnancy can be seen but that doesnt mean it'll progress.

I'd pressure GP to repeat bloods again

[monkeymoma]

I'm not 5+3 weeks pregnant. With DS when I had a dating scan the HCPs adjusted how many weeks pregnant I was from weeks since LMP to amt of weeks since OV plus 2, which was considerably less pregnant, like this time

[monkeymoma]

and sunny they WILL adjust your weeks if your cycle lengh is long so that you are weeks since OV plus 2
but mine is not, mine is 4 weeks but I OV in week 3 so they calculate it on OVing at 2 weeks since LMP

but you are incorrect that they always date you exactly since LMP because if you have long cycles they date you differently, and I am LIKE someone with long cycles, just with normal ones

so when I said to the doc that I am 4 weeks, he repeated his question about my cycle lengths, then dismissed my claims of being 2 weeks since conception

[monkeymoma]

the scan my GP wanted was not for signs of a heart beat, it was for location of pregnancy

[sunnyday123]

with all my 4 pregnancies - all have been from LMP and correlated with scan (i used ovulation kits so know what day i ovulated with each, thus even scan showed 6 weeks pregnant when i was 4 weeks post ovulation etc). You may not 'technically' be 5+3 pregnant but in medical terms you are as thats how they date? presumably you are in theory 2-3 weeks from ovulation but drs still refer that to 5 weeks pregnant and thats what their figures are based on.

However peoples levels rise differently - some people are so low at this stage that they don't show on a test! i.e under 25! thus i would put your syptmoms to implantation which i had 2-4 weeks after ovulation - lots of pain/spotting but everything fine so good luck!

[monkeymoma]

"Thus when they give a figure for 5.3 weeks pregnant they mean 2-3 weeks after ovulation ."

a 5.3 weeks foetus is 3 weeks 3 days post ovulation

4 weeks foetus is 2 weeks post ovulation

quite different, as I imagine the hCG levels are too

so, are my levels okay for 2 weeks post ovulation or not?

[monkeymoma]

x post

I have had implantation pain/bleed before so I didn't worry about it for the first few days, it was only because it had gone on for over a week that I went to my GP to ask at what point it stops being normal, and he was concerned so sent me to hospital

[eurochick]

sunny I think you are missing the point a bit. They always date from LMP yes and you could not possibly have conceived for the first two weeks or so of that and that is the same for everyone. But the OP has a short cycle. They should adjust the dates to account for it.

[AitchTwoOhOneTwo]

sorry to be blunt but wasn't he concerned about ectopic pregnancy?

[monkeymoma]

nope I have a normal length cycle, but usually OV at day 20 or even later

they DO adjust for cycle length, so if someone OVed on day 20 or later, but had a long cycle, they would have been dated by the doc as being 4 weeks, but I wasn't.

[monkeymoma]

Aich, my GP was yes which is why he sent me straight to hospital (and told me to be Nil By Mouth), but the hospital doctor wasn't

[sunnyday123]

i would say yes - 288 sounds high - like i said some people test 2-3 weeks after ovulation and still have negative tests and so much lower than yours as most tests pick up levels >20. Plus hCG is only produced after its implanted which takes a minimum of 9 days usually- thus the hormone started at say 10 and has doubled every 48-72 hours since it implanted - to me that puts you spot on?! I bled with all my pregnancies and it got worse with each one - i had TERRIBLE pain with DD2 too (literally doubled over!) and still she was fine - think i literally felt every twinge of implantation!

Do you normally get period pain or ovulation pain? I did - every month and i think this was related to how my body reacted when pregnant.

Spotting 2 weeks after ovulation seems a classic sign of implantation to me so i'd try stay positive:)

[monkeymoma]

actually the spotting was how I knew I was pregnant before I even started getting +ive test, because the only time I'ld had early spotting before was with DS, so at first it was a good sign, it was only when it dragged on longer than I remembered with DS, combined with pain always on one side, that I went along to my GP for a chat to ask how long I should put it down to being normal for and when I should be concerned about it

so the GP sent me to hospital for a location of pregnancy scan/laporoscopy on wednesday, neither of which I had, instead I had a urine test and blood test, he said the urine test was a faint and inconclusive +ive and today told the hospital doc me on the phone that it was a misscarriage as the levels were too low (he was supposed to phone yesterday )

[monkeymoma]

the spotting stopped on wednesday BTW (typcial - symptoms always hide as soon as you see a doc ), so if I am having a MC nothing is passing yet
it was spotting not bleeding before that (pink or brown when wiping)

[monkeymoma]

"Do you normally get period pain or ovulation pain? I did - every month and i think this was related to how my body reacted when pregnant."

yes I feel ovulation every month

[AitchTwoOhOneTwo]

well... i understand why his thoughts turned to ectopic, unfortunately.

that being the case, the investigation you've been offered is utterly moronic. fair enough he doesn't want to scan you until 6 weeks (that's actually correct, according to the guidance) but they HAVE to give you serial hcg tests. that's a blood test every two days to check for levels rising, falling or remaining static.

you just cannot know anything from 288. my eldest daughter's figures were an absolute joke... it's how they behaved that made the difference in the diagnosis. doubling every couple of days (not an exact science in itself) suggests that the embryo is established somewhere with a good blood supply etc... so that's a positive sign.

[CharlieIsAChocolate]

Could you ask for a blood test to rule out anectopic pregnancy? I had similar symptoms - early bleeding and spotting. I was sent to a&e where the hospital doctor said everything was fine. It turns out I did have an ectopic pregnancy and it was only the fact that the hormones didn't double within the 24 or 48 hours (can't remember which) that picked it up. It was a midwife that insisted on the blood tests.

It probably isn't... But just to be on the safe side?

[monkeymoma]

I did ask for a repeat blood test Charlie

he said maybe next wednesday
so I asked if I could go in and pick up a blood form so I could get one done next wednesday and he said no, to wait and see till wednesday

(he also introduced himself as the reg, but when I phone up to chase my results the nurse asked who I saw, I said I didn't know the name but it was the reg, she asked was he black (no) because the only reg they have is black, the did however have a SHO who met his description who they chased to call me back with my results)

[monkeymoma]

oh I didn't just have a blood test and urine test, I also had a speculum exam to look for "proof of bleeding", which there wasn't any

wasn't expecting that, felt a bit.... "American", but the chaperone was a proper Level 3 permanent womens health member of staff not some clueless agency woman and she seemed to act like it was routine so I went along with it

[sunnyday123]

pain on one side though could be due to the corpus luteum which develops (after conception) on the side of the ovary which released the fertilised egg - i'm sure i read thats what caused my one sided pain?

[monkeymoma]

stupid weekends! I have to wait till monday to contact my GP, my head is spinning a bit now am unsure of what I'm even supposed to "push" for?

[CharlieIsAChocolate]

Ok, sorry I started to reply and didn't see the updates.

The reason I had serial blood tests was because I could feel that something was wrong- I just knew things weren't quite right. The midwife at the early pregnancy unit could see I was convinced something was wrong.

Could you ask your GP to refer you for blood tests? Just to rule it out? Sorry if I sound alarmist- I wouldn't want anyone to go through what I went through.

[monkeymoma]

hospital doc said it is not ectopic, but what's he basing that on? a poke of my tummy and my hormone results not being what they should be for someone a week and a half more pregnant than I am?

argh!

[CharlieIsAChocolate]

And sorry again- just read that you will go to your GP. Sounds like a good plan.