Aa
No heart beat yet
On 5/16 my HCG levels were 4603 and the DOC saw a sac. Today 5/24 no heart beat yet I think I can be about 6 weeks. They told me its a miscarriage. Can this be possible?
I agree with adgal re: the ultrasound. 6 weeks gestation (4 weeks fetal age) is the earliest a heartbeat would be seen and it isn't unusual to have it not show up until 7 or 8 weeks.
Keep in mind that gestational age is based upon the assumption that a women has a 28 day cycle and ovulates on Day 14 (and on Day 14, the date of conception, baby is considered 2 weeks gestation). But many women do not have a cycle that fits into this "norm" and thus pregnancy dating can be a little off...and for early benchmarks (such as heartbeat...which doesn't show until 6 weeks gestation) can cause concern when a pregnancy dated 6 weeks from LMP is actually the result of a later ovulation so baby is NOT as old as expected. Gestational age based upon LMP is used because it is usually the easiest date to calculate. Most women do not know when they ovulated and conception can take place days after ovulation...so doctors use gestational age which is not particularly precise.
Your hCG numbers don't mean much unless they take two separate samples 2-4 days apart. The important thing is the rate of increase. hCG levels double every 48-72 hours. On May 16 you were about 5 weeks (if you are 6 weeks now). Expected hCG range for 5 weeks is between 18 and 7340 (notice the HUGE range? that is why two tests are needed...the range is just too big to use a single test)
So...I would not say at this point it looks like a miscarriage based on the information you posted and I definitely would NOT agree to a d&c. Wait at least a week and have another ultrasound. Also see if your doctor will draw your hCG levels 204 days apart so you can see the rate of increase.
Keep in mind that gestational age is based upon the assumption that a women has a 28 day cycle and ovulates on Day 14 (and on Day 14, the date of conception, baby is considered 2 weeks gestation). But many women do not have a cycle that fits into this "norm" and thus pregnancy dating can be a little off...and for early benchmarks (such as heartbeat...which doesn't show until 6 weeks gestation) can cause concern when a pregnancy dated 6 weeks from LMP is actually the result of a later ovulation so baby is NOT as old as expected. Gestational age based upon LMP is used because it is usually the easiest date to calculate. Most women do not know when they ovulated and conception can take place days after ovulation...so doctors use gestational age which is not particularly precise.
Your hCG numbers don't mean much unless they take two separate samples 2-4 days apart. The important thing is the rate of increase. hCG levels double every 48-72 hours. On May 16 you were about 5 weeks (if you are 6 weeks now). Expected hCG range for 5 weeks is between 18 and 7340 (notice the HUGE range? that is why two tests are needed...the range is just too big to use a single test)
So...I would not say at this point it looks like a miscarriage based on the information you posted and I definitely would NOT agree to a d&c. Wait at least a week and have another ultrasound. Also see if your doctor will draw your hCG levels 204 days apart so you can see the rate of increase.
Dr.'s count weeks from last menstrual period (first day of), not conception. So when you say 6 weeks, are you counting from the first day of your last period? That would be a bit early for me to be comfortable agreeing to a d&c or anything.
One of the things they are looking for is a certain amount of growth between ultrasounds. If it isn't there, they may make an early diagnosis like that, although most Dr's don't until about 8 weeks from first day of last menstrual period. It is not uncommon for there to be no bleeding or physical symptoms. Sometimes it takes a bit of time for the body to realize the pregnancy has been lost.
If you are not comfortable with the Dr.'s diagnosis, it is best to request another ultrasound in a week or two. I wish you well, I know this is very hard.
One of the things they are looking for is a certain amount of growth between ultrasounds. If it isn't there, they may make an early diagnosis like that, although most Dr's don't until about 8 weeks from first day of last menstrual period. It is not uncommon for there to be no bleeding or physical symptoms. Sometimes it takes a bit of time for the body to realize the pregnancy has been lost.
If you are not comfortable with the Dr.'s diagnosis, it is best to request another ultrasound in a week or two. I wish you well, I know this is very hard.
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