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10 weeks no fetal heartbeat
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10 weeks no fetal heartbeat

my first day of LMP was aug 6, 2008.  im about 10-11 weeks pregnant. on october first, my Hcg quantitative level was around 28 thousand.  i went for check-up on monday (Oct 20) and had a transvaginal ultrasound and fetal heart tone could not be found. my OB suggested I do a D&C or wait for a miscarriage.  I went to check my Hcg on Oct 21 and it went up to 50 000.  Can anyone tell me what it means?  Is there a possibility that my pregnancy is viable?  What other tests can be performed?  
Im due for another ultrasound on monday.  Please respond ASAP.  This is so depressing.

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I am sorry to hear you are going through a tough time.  It is very likely that you have had a missed miscarriage if there is no fetal heartbeat found on ultrasound at this stage in your pregnancy.  The hcg level isn't really relaible in making a diagnosis at this point, because it had been almost 3 weeks since your last level, and you can't really determine the rate of rise with that, and you also don't know at what point the fetus stopped developing.  Also, in a normal pregnancy, hcg peaks around 10 weeks, and then may decrease before hitting a plateau for the remainder of the pregnancy.  Ultrasound is more reliable at this stage.

There are no other tests to perform aside from the ones you have had.  There is always a small possiblilty that they just couldn't find the heartbeat for some reason other than there being none, but please prepare yourself for the likelihood that your ultrasound on Monday will show the same thing. If this is the case, you will have to decide whether you want to go ahead with a D&C or to wait until the products of conception pass on their own.  I'm sorry not to have more positive thoughts for you at this point.

Good luck and I'll be thinking of you.

I had my ultrasound done today.  As much as I want to share good news, unfortunately  this baby is not meant to be.  The ultrasound showed the fetus is still 8 weeks and 1 day. no change from a week ago.  Its hard to accept, its painful but....
I will schedule a D&C since just thinking about having a complete miscarriage at home is
not something I want to go through..

thank you for responding to my question

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University of California San Francisco
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