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Miscarriage and high Hcg levels

Posted by Deb on April 24, 1999 at 14:41:49
I had a blighted ovum at 10 weeks in Sept '98 requiring D&C. Progesterone levels never returned to normal even though I was ovulating. Started Clomid at 50 mg and it didn't work. Did Clomid at 100mg for 2 months. On second month, my temps stayed high, I had spotting (I had this with previous preg) but (-) urine tests. Went to MD on 4/12 (day 35 of my cycle) and blood test showed HCg level of 12. Next day, temp dropped, spotting got heavier. On Wed, 4/14, Hcg level still at 12 but started heavy bleeding with clots. Tested Hcg level on Fri 4/16 and it was 28.  Didn't get this info until next Wed 4/21. Hcg level that day was 217 and on Friday 4/23 my MD told me my Hcg level went up again but did not double.  My MD says she's never seen this before and we just need to keep monitoring my quant levels. My question is how come my Hcg level is going up if I had such heavy bleeding? Is there any chance a normal pregnancy could come out of this?  Thanks in advance for any info.   Deb

Posted by HFHS.MD.RCS on April 26, 1999 at 23:05:55
Dear Deb:
hCG is produced by trophoblast. These cells form the placenta, membranes, and baby portions of a pregnancy. Early trophoblast is very hearty and can burrow into the wall of the uterus, continue to make hormone, and the surface lining can be shedding because there is not a healthy, developing pregnancy. Less often, there is bleeding from one area of the uterine lining and the pregnancy is safely attached to a distant area. Rarely trophoblast cells take on a life of their own in a process called hydatidiform mole.
The quantitated hCG levels should be followed. Continued rise in the face of no evidence for a healthy pregnancy may require ************** (methotrexate). Resolution of the hCG level will show that the trophoblast has undegone self-destruction.
Keywords: hCG, early pregnancy

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