no fetus at 6 wk 4days

  I had a miscarriage last October and became pregnant again in February 99.  I was having pains so my doctor ordered blood test. On 3/3 my level was 794, on 3/5 it was 2015.  By this time the pains had stopped.  I went for an ultrasound on 3/9 - at which time I was 6wks and 4 days LMP. They saw a gestational sac which registered 4.6 weeks since conception.  They said either the baby wasn't developing or I was not as far along as they thought.  They also said the fact that the blood levels more than doubled doesn't necessarily mean that the pregnancy is progressing.  I am having another ultrasound next week, but this is really upsetting me.  I have absolutely no signs of being pregnant - no nausea, no breast tenderness, and I'm not even urinating as frequently as I was.  Is this a bad sign?  I am convinced that I have lost this baby too.  Please give some advice.
  Lynn

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Dear Lynn:
You have been given good information: a rising hCG level means only that the early placental cells are functioning and it does not assure that the fetal cells are forming. An ultrasound can be misleading if it is done too early and the only resolution is a second imaging study after one to two weeks. Although one can have a healthy pregnancy in the absence of any symptoms, most women do notice some of the changes you describe.
This information is provided for education purposes and is not a medical consultation. If you have specific questions, please speak with your healthcare provider.