High hcg levels 20 dpo with hcg at 6100, and u/s showing 1 baby.

[MyZoo]

We recently found out we were expecting again. DH and I have 5 wonderful children. We lost our son Landen in Sep 2008 he was only 20 wks Gestation (Trisomy 13 or 18). We conceived again (way to soon) in Jan 2009 resulting in a miscarriage. It was a long and drawn out miscarriage. Both pregnancy losses were handled very poorly by my OB. So when we took a HPT on Mon Oct 12th. The BFP sort of freak us out a little (okay a lot).  I had my Primary Doc order a blood hcg to confirm pregnancy on Wed Oct 14th hcg was *198* This time we contacted a new OB.  I mentioned a little history to the nurse and she had me come in the next day, that was Friday Oct 16th my hcg was 589 and gesterone was 14g. On Thur Oct 22nd the U/S only showed a gestational sack and my hcg was 6100. We came back in on Tue Oct 27th and sure enough we saw our diamond ring. Gestational Sack, Yoke Sack, Baby and Heartbeat. So far so good. But......Thur Oct 22nd when I had my labs drawn I was only 20 DPO and my hcg was **6100**.. Could he have missed a possible twin? Has anyone had anything simaliar? Please Advise

[martikadragoon]

First off my condolences for your losses. My first son has trisome 21 and that was hard enough to handle, I couldn't imagine a fatal trisome. You and your husband sound like a very strong couple!

IT sounds like your numbers are alright. The numbers can double anywhere from 24-72hrs.... (which is why they usually say 48hrs)... you had 6 days in between your betas being drawn.

589x2= 1178

1178x2= 2356

2356x2= 4712

so it looks like your numbers doubled about 3 1/2x.... which would make you on track.  I wanted to congradulate you on this baby. I know from experience the worry that naturally comes after experiencing a tough pregnancy. We went through it with this baby. Since our first had 2 genetic problems (t21 AND my genetic skin condition) and we were only 21 when he was born... we wondered if this baby would be healthy.

Well, Due Dec 25th we expect a healthy baby boy!..... If you plan to have any genetic testing or anything and want someone to talk to who's gone through that a couple times feel free to send me a private message or email me at

martikadragoon **  @ ** msn.com  (no spaces or ** marks)


Cindie

[MyZoo]

BFP: 10/12 dpo 9
1st hcg: 10/14 198     dpo 11
2nd hcg: 10/16  589   dpo 13
3rd hcg:  10/22 6100  dpo 20 u/s only showed gestational sack nothing in it...
10/27: Diamond Ring...

Referrencing Betabase.org my levels are high. I'm just worried....I would like one last time to successfully help God out in a miracle....Single or Twins...My next u/s is 11/10..We'll clarify everything then I guess..

[martikadragoon]

well going off all your numbers, it does look like they're doubling a bit fast and it's always possible that there would be a twin involved. I haven't had a twin pregnancy myself and can only go off what I can research.

I'll be praying that your next U.S. is normal!!!  only a few more days. I know it probably seems like an eternity. Please keep me updated on things.

from your last 2 U/S it seems like things are progressing well. My U/S were similar but at about 5 1/2w showed only a small sac, nothing in it. Then 8 or 9 days later another u/s showed baby, heartbeat and everything. :) the relief that we had at finding out this lil guy was healthy is immeasurable. Hubby looked at me about an hour after we found out our genetic testing results and said "is he really ok? is he really healthy?". lol we couldn't stop smiling all day.

[MyZoo]

Could you share with me a little about your genetic testing, all they did for my DH and I was lab work to test chromosomes and it came back normal.

[JoyRenee]

A higher than normal HCG doesn't always mean multiples but regardless of how many blessings you are carrying, CONGRATS!

[30something13]

I want to comment on your progesterone. 14 is low for a pregnancy! It should be like 15- 20 none pregnancy and over 30 for pregnancy. I have low progesterone and was put on Prometrium before so I could gt pregnant. i know there are some doctors who do not "believe" in it but you can read all about it all over the net. I ahve had multiple mc adn this was is fine as far as mc. So you need to ask your docotr about getting you on some meds. Best of luck and my HCG levels are extreemly high also. I am being watched for twins but so far they only seee one. It is very easy for one to hide! They should see it by 8-9 weeks if you have mroe then one in there.

[thickm]

my hcg was 5122 at 5 weeks and ultrasound showed empty sac, 2 days later hcg was 11266 (great doubling time) i had another u/s one week later at six weeks and within a week there was a baby and a heartbeat!!!

[LuvAbaby]

I also had high hcg early on. At 5w2d my hcg was 11728! I am now 14w2d and u/s at 12w5d showed only one baby.Congrats!

[martikadragoon]

Sorry that I took so long to reply. They were probably seeing if you or your DH had any recessive genetic traits that could be passed on to your children causing the trisome or maybe the miscarriage.  This is going to contain alot of information for you, so if you need me to repeat or rewrite anything at all just ask.

Since I have a genetic skin condition they did a blood test to determine where my mutation is (in what chromosome and on what gene).... They didn't test for anything else.
Then I had the amnioscentesis done at 16 weeks pregnant. This test has a 1:200 rate of miscarriage.

The amnio procedure is where a needle is inserted into the mothers abdomen and through the bag of waters surrounding the baby. the needle is guided by ultrasound and then removed with a catheter left in place (like an iv catheter but longer). They then withdraw some fluid.

Later they culture the cells from the fluid which are the same cells the baby has, usually skin that has shed which is normal.  They will grow more of the same cells and may do something called a
FISH test. basically a FISH test is where they break open a cell (usually several just to be certain of results) and dye the chromosomes. They separate and count the chromosomes. The FISH test will tell you if there is a trisome, or a translocation where one part of a chromsome is attached to another. it can also find a "deletion" where part of a chromosome is missing. Itll also say if baby's chromosomes are normal.

the FISH can be gotten back anywhere from 48hrs if rushed, to 7-10 days which is normal for most labs. If your insurance doesn't cover it it can cost a few hundred dollars out of pocket for the FISH.

They can then do the final testing on the cells they culture checking for any chromosome abnormalities or specific mutations (they have a whole list they look for). Those results can take up to 6 weeks to get back.


There's another test done anywhere from 11-13 weeks which is CVS or Chronic Villus Sampeling.  this test has approx. a 1:100 rate of miscarriage. Basically they do the same thing as an amnio except they get a small piece of the placenta to test. This test does come with a little more risk, since the fetus is so small they can rarely cause damage to the arms or legs with the needle. also, there's the chance they'd need to repeat the test or wait for a later amnio if the first sample they get doesn't grow the cells well enough.  

If you aren't wanting to risk a miscarriage at all, and if you don't plan to abort or terminate no matter your results of the amnio you can always wait til later in pregnancy to get it done when baby is viable. it can be done up until baby is born. There's always the option of getting a level 2 ultrasound which can check for "soft markers" of any known trisome condition or any syndromes.

ultrasound is about %60 accurate at catching a case of a visible genetic or congenital abnormality.


PERSONALLY~ Since you did miscarry for unknown reasons once I'd suggest going with the amnio rather than the CVS if you HAVE to know for certain... otherwise I'd suggest the level 2 ultrasound.

I hope your aware... the normal testing/screening like the NT scan can have inaccurate results if it's not done right at about 12 weeks. the triple screen blood test can also be inaccurate and is ONLY an indicator of risk, not an actual positive or negative test..

[MyZoo]

Thank you for the break down, my DH and I only had the basis markers checked. They stated that the Trisomy was random and we feel the 2nd pregnancy was just to soon and wasn't able to stabilize. Our new OB is referring me to a Perinatologist. I'll first go around 12wk for the Nuchal Translucency testing, more to have him check for things that we know were wrong during Landen's pregnancy. He only had 1 artery and 1 vein in he's umbilical cord among a few other things we want looked at. The OB did mention that he recommend an amino, however, we haven't decided on that yet. I guess we'll see what the 1st level 2 u/s shows before we decide..I diffently won't have the AFP Screening done. I've heard on people having a false positive before but we had a false negitive. Our test came back completly normal and we lost Landen 3wks later.. Well I have my next appt tomorrow afternoon I hope all is still well. I'll post a follow up then..

[martikadragoon]

MyZoo~ Thank you for updating. I agree about not having an AFP..... I can tell you from personal experience the Amnio isn't too horrible. It's a bit painful sometimes (my first was, the second wasn't until he put the catheter inside and accidentally poked the side of my uterus, lol).

if you have any questions I'll try to answer them. if I dont know the answer I'll research it and find one for you. :)

[MyZoo]

Thank You....