no sac? no fetus?

Ok so I thought I was about 5 weeks pregnant. I went to see my doc because I was having some bleeding. It wasn't very heavy but it was red. When he did a vaginal ultrasound there was no sac no fetus. He could not see anything except two VERY VERY tiny dots that he said could represent a pregnancy. They did a blood test and said my HCG levels were low at 43?? I think this means I am only about 3 weeks along. Is this normal? Or I am worried that during the bleeding I miscarried.

[Dr. Kokil Mathur]

Hi
Welcome to the MedHelp forum!
If HCG levels are of three weeks, you could be having implantation bleeding. It could also be that you are actually not pregnant. Also 5 weeks is too early to detect pregnancy at times.
A prolonged bleeding of any kind from the vagina can be due to a sore or ulcer in vagina as you see in Herpes or otherwise, endometritis or infection of endometrium of uterus, cervicitis or infection of cervix, fibroids, vaginal infections, vaginal polyp, endometriosis and cancer of either cervix, uterus or ovary. It can also be due to a hormonal contraceptive of any kind or due to hormonal imbalance due to withdrawing it. Sometimes PCOS also presents with prolonged vaginal bleed. It can also be a miscarriage—since you feel you are about 5 weeks pregnant. This you can confirm by taking a pregnancy test since the test remains positive for a month after miscarriage—then repeat after a week—dropping hormone levels confirm miscarriage while increasing levels confirm pregnancy. If it is miscarriage you will have to go for a D and C.
You would need to get some investigations done including hormone analysis, PAP smear, ultrasound and maybe CT scan of pelvis.
Consult a gynecologist regarding this. Take care!