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Had continuous periods, feeling tired, loss of appetite. Urine test showed faint pregnancy positive. Had miscarriage. Suggest?

Mar 2013
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Practicing since : 1998
Answered : 5621 Questions
my mense came on the 6th september 2013 and ends on the 12th. then on the 14th sept, it came again. but this time its very light reddish.. concerned, i went to the doc. telling him i have been feeling very tired and appetite wasnt that good. he got me to test for urine. and it showed a very faint positive. i was told to come back the following day. another urine test and it came out a very light positive, Ultrasound showed a very thick lining but with no sac. I have had 2 miscarriages before. is this the very early stage of pregnancy? or i have actually experienced a spontaneous miscarriage? i am still down with lethargicness and under the weathers.. the doctor told me to come back next month for a review. I am not sure if i shud be happy coz it showed a positive or sad that its a miscarriage..
Posted Wed, 9 Oct 2013 in Pregnancy
Answered by Dr. Aarti Abraham 20 minutes later
Brief Answer:

Detailed Answer:

Thanks for writing to us.

Would you let me know the date of your last menstrual period BEFORE 6th of September, and the normal length of your menstrual cycles ?

Judging from the information provided, to me, this sounds to be a miscarriage. By the time a urine pregnancy test is positive, a gestational sac should be seen inside the uterus if the pregnancy is proceeding normally. Unfortunaely it is not seen, and the spotting you experienced on the 14th makes this diagnosis most likely. I agree with your doctor, that you need to repeat ultrasound scan after a month.

An early pregnancy is less likely. But if there is any suspicion about early pregnancy, you need to get blood beta HCG test and a repeat scan after a week or two. Had the doctor even suspected an early pregnancy, medications to support the pregnancy would have been prescribed, and you would have been asked to come for a repeat scan after a week, not a month.

Besides those two, a rarest possibility is an ectopic pregnancy. This means that the pregnancy is in the tubes or ovaries, instead of the uterus. This can also present with spotting, a positive pregnancy test (generally faint) and no sac seen on scan. An ectopic pregnancy also would be diagnosed by a blood B HCG test done serially. Also, I hope the ultrasound was done transvaginally, as abdominal ultrasound would not be very helpful at this stage.

If I were to be your treating doctor, I would not consider the scan report as sign of early pregnancy. I would order a blood beta hCG level after confirming your last menstrual cycle date and then based on the report will order you to report back after a week / month.

Discuss about blood beta hCG levels with your treating doctor. That can help your doctors differentiate.

All the best.
Please feel free to ask any further follow up questions.
Above answer was peer-reviewed by
Follow-up: Had continuous periods, feeling tired, loss of appetite. Urine test showed faint pregnancy positive. Had miscarriage. Suggest? 35 minutes later
Last mense before this mth was 8th august.
Answered by Dr. Aarti Abraham 3 hours later
Brief Answer:

Detailed Answer:
In that case, if your cycles were regular, you should be 6 weeks pregnant by now, and the absence of a gestational sac clearly points towards the diagnosis of a spontaneous miscarriage.
Above answer was peer-reviewed by
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