Please help need advice DNC?

[Violetasmom]

I posted this on other forums and recived no replies. Please help. I am at a loss.  I am 4o years old. I had two miscarriages last year one at 8.5 weeks and on at 5wks. I have had no prior pregnancies, This year i became pregnant again. LPM was Dec 13, 2007. I tested positive Jan 11 iwth an HCG level of 19. Jan 14 HCG level of 73 Jan 17 112. Jan 22 383 Jan 23 466 Jan 25 535. My first u.s on Jan 23 my doc thought he saw a small sac well we all saw a small oval black dot. Second u/s on Jan 25, nothing in the uterus. Doctor thought it may be ectopic. Today, Jan 28 third u/s vaginal and abdobinal showed nothing in the uterus. Doctor would like to do a DNC an wednesday and a posiible laporoscomy to rule out ectopic. I have never had a DNC. I waited to bleed naturally on my first two. My husband asked ifthere woudl be a risk to wait to bleed naturally and the doctor said no I coudl wiat because he had a hunch that this was not ectopic. Well, how dos a hunch work. If the HCG is going up even slowly ...isn't there a pregnancy somewhere? My husband would liek to wait and let me bleed naturally(he doesn't have to wait) I am scared and woudl liek to have children one day and want to do the best thing HEALTHWISE not emotion wise. Help?

[Keith Downing, MD]

Hello,

This is a highly desired pregnacy, so waiting is okay.  You are at risk of having an ectopic, so if you have abdominal pain, bleeding, nausea/vomiting, and/or lightheadedness/dizziness you should seek medical care right away.  In the meantime, close follow up with your ob/gyn will be necessary.

Another thing, checking a progesterone level can sometimes be helpful to discern if this is a normal pregnancy or not.  

Best regards,

Dr. Downing

[Violetasmom]

thank you for your reply. Well, I just got another twist. My military doctor finally called ( iwas seeing a German doctor who suggested the DNC)and said that a DNC is totally off mark right now. My HCG level was 893 today and she said that  I should wait and get a new HCG Wednesday and new u/s Friday. She is a new doctor for me and she said in 15 % of pregnancies HCG levels are low and don't double as they should and since mine was steadily increasing and I had no blood that I should not discount a viable and healthy pregnancy yet. I told her not to give me false hope and she said she wasn't and that a DNC could terminate a viable child. So, now I am waiting...cautiously waiting. thanks She is hopeful because she says my progesterone was at a good level. I'll wait...although I am a bit sore from teh u/s. Yes, this IS a highly desired pregnancy!

[rene67]

I am so sorry to hear about your losses, I am also 40, had 2 previous miscarriages around 6-7 weeks.  These were missed miscarriages (no symptoms but fetus stopped growing).  I am pregnant for the 3rd time, but likely not viable.  My LMP was Dec. 10, had U/S yesterday (Jan. 28), but low heartbeat and growth dating a week behind.  I have a followup U/S next week, but feel results won't be good.  My doctor says 50/50 but I think its #3.

From my past experience, seeing nothing in your transvaginal U/S at almost 7 weeks is not good. But definitely get the follow-up U/S.  Maybe check the HCG levels, but not really a good way to measure once U/S is confirmed.  Your doctor's "hunch" that this isn't ectopic is probably right, I think U/S should pick that up plus you'd be in pain.  If ectopic, it requires surgery (I don't think you can miscarry that naturally).

I had D&Cs both times, and all went well.  I would recommend it instead of waiting weeks until you miscarry naturally.  It is very stressful (at least to me) to be carrying a pregnancy around for weeks when you know its not viable.  You need closure as soon as possible.

Sorry if this is just bad news you don't want to hear, I honestly feel your pain.   This is an extremely trying time for me too right now.  I really hope that its all a mistake and your pregnancy turns out OK.  I'll think about you in my prayers.

[Violetasmom]

I am so sorry about your pregnancy. I HOPE all goes well..lets bank 50% positive side. I know hwta you mean the whole thing sound strange to me but my levels are increasing still . I am now up to 1400 so I don't know what to make of it. My military doctor is hopeful and says mt preg was just a late bloomer but I have never heard of this happening, She says it happesn to 15% of pregnancies..I am waiting til next week for my u/s on Feb 6...and praying for the best... I don't even know what to tell people anymore...I also caught a vicious cold and so I feel miserable...thanks for your post. keep me updated!

[rene67]

Well sounds like you could be OK, I'll hope for the best for both of us, my follow-up is a day before yours.  Funny, I also got a nasty head cold right before my Jan. 28 U/S, still have it a bit.  Seems we are in sync somehow, although likely on different coasts? (I'm in California).

[Violetasmom]

Hi Yep. very different coasts. I am in Germany. I will lokk fwd to hearing about how things go for you please post and let me know...this cold is really really a pian but still no blood or cramps everytime I sneeze I feel like it has to hurt the baby...Oh I hope there i s ababy..:)

[lawanb33]

If you don't have any cramp I would wait for another hcg  levels and U/S. In my case I had a ectopic pregancy. My DR insisted everything was okay when my hcg kept going up when he didn't detected anything in my uterus. I knew something got to be wrong since I bled entire time. At almost 8 wks I went to ER b/c of sever cramps came to find out I had a tubal pregnancy. My dr still insisted I wasn't having ectopic pregnancy till he saw my sonagram. Bleed flow from my right tube and went for surgery right away. I lost one tube and a ovary b/c of that. The pain of losing the baby what hurts the most. I hope your out come is bette then mine. Best wishes. I'll keep you in my prayers.

[Violetasmom]

Thank you for the best wishes! As wednesday becomes closer I am more anxius...my only solace is that I don't have any pain and not a drop of spotting...not a drop...I pray all is well...thanks for your thoughts...:)I'll post Wednesday...

[martikadragoon]

I think you'll be fine, just so you know, I had a U/S @ nearly 5 weeks and saw nothing but a tiny black spot. The dr. just said I wasn't as far along as my LMP said.

That may be the case for you too. I went back 1 week later and saw a heartbeat. I had another U/S a week after that at a diff. type of dr's office and we saw the heart beating like a real heart!

Please try not to stress yourself out, as it isn't good for the baby.

BTW I'm 8+ weeks right now.

Cindie

[rene67]

Well today was the confirmed bad news.  Should be 8w1d now, but only dating around 6w3d.  Heartbeat down to 70s (104 last week), which means "inevitable fetal demise".  Sux big time!  I DO hope all goes well for you, please let me know on this post.

After 3, you can get an auto referral to reproductive specialists (at least in my med plan).  I'm almost certain its just old eggs and I keep hitting every one, 'cause all else with me is mostly fine.  I'm so ready to just give up now, but my husband wants us to keep trying, go ahead and get the full workup.  Potentially they can "superovulate" me -- help me ovulate (w/drugs) more than one at a time and hope that one is good.  For now though, I just have to get through this...arghh.

[dej69]

i have been following your story. i am so sorry for your loss. i cant imaging losing 3 pregnancies. i had an ectopic rupture a couple of months ago and had to remove my tube. i was going to write to you earlier to tell you to be very careful and aware of ectopic symptoms. a rupture can be fatal you.  we tried for 3 years before getting pregnant with this