Confused about ultrasound results

[confused329]

I had a trans vag ultra sound at 6 weeks 2 days yesterday to check on some light spotting I had a week before.  The ultrasound revealed a lot of coagulated blood in my uterus according to the tech, so much so that she couldn't see anything else.  My hcg from 3 days before was 14,440.  They paged the Dr on call and she said that it is probably a miscarriage. They took another HCG blood test to be sure.  I won't have the results until Monday.  It is killing me because I don't understand.  They made it sound as though there was no sac or anything, but then why would my hcg have gotten so high? I have not been able to find any story online of a similar experience.  The tech did say it could be left over implantation bleeding, which I did have for 9 days.  Could the blood be hiding the sac?

[Elaine Brown, MD]

Hi!
I sure wish I had the films to look at myself!  What they have told you IS confusing!
With an HCG that high, I would certainly expect to see something somewhere!
One concern for me, would be an ectopic (tubal) pregnancy.  If the pregnancy is not in the uterus--where is it?!

If you had had a miscarriage with an HCG level like that, I would expect you to have symptoms of more than just spotting.  And with a missed abortion (the medical term for a pregnancy that has stopped developing but has not passed through the cervix yet) a sac should be pretty obvious in addition to the blood and clots.

I wish I could give you the answer you want, but one thing that is going to be VERY important is for you to follow up on you HCG results.  Until they figure out where the pregnancy IS, you have to be vigilant for signs of an ectopic pregnancy.  You should report any new pain symptoms right away to your doctor!

If it truly is a miscarriage, the HCG level should drop fairly rapidly.  If the level is going UP--you should have another ultrasound done ASAP  ( different tech? ).  If the level is staying stable, that is the most concerning for an ectopic pregnancy. Be sure your doctor discusses methotrexate therapy with you if you do have an ectopic pregnancy.  Be sure they don't forget your rhogam shot if you have Rh negative blood.

I hope this information is useful to you! I wish your ultrasound had shown better news!

Best!
Dr B

[Sammy905]

Oh that's great news - congratulations, wish you all the best : )

[armommy]

hi i am 17 weeks now but when i was 6 weeks i went to the hospital for cramping they saw a sac and nothing else i was devistated i went to my ob he sent me to a real ultrsound office and there was a baby and a heartbeat my ob told me that when your only a couple of weeks hospital ultrasounds arent that detailed you think they would be but they arent so they wouldnt pick up the baby that little so dont worry :)

[Sammy905]

Hi, Just wondering how you got on with your next ultrasound?? I am a couple of weeks pregnant myself and was getting like a brown bloody discharge - I went to the hospital straight away where they done both an internal and external scan but could only see a pregnancy sack, nothing inside it - I am also very very worried about this but have to wait ten days to go back for another scan to find out more.
Is so frustrating waiting around - I hope all worked out for you