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Pregnant. Started spotting, feeling constipated. Am I miscarrying. What else could it be?

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Hi. I am (or was) just shy of 5 weeks pregnant. I ovulated on XXXXXXX 24th. I had an IUI with monitoring so I am sure of the date. I had a positive pregnancy test on 7/9 (14 DPO) and a blood confirmed with a low HCG of 15.7. I had HCG tested again on 7/11 and it was 39.8. I had a third HCG test on 7/13 and it was 79. I've also been on 100 mg progesterone suppositories 2x a day since a couple days after I ovulated. I have an appointment for an ultrasound this Thursday and we were not contemplating further blood tests since the numbers were doubling, although low. The hope was that the ultrasound would provide more insight.

I have had brown spotting every day since I got my positive pregnancy test. It's varied from very light spotting to medium spotting and at for a few days was more like a very light flow. It's very light brown with small flecks of tissue. A couple times when I've wiped there's been pink or a dark red/brown but never consistently. I've also had very mild cramping on and off the entire time which seems to get a little worse in the evenings (I do have a CL cyst on my right ovary but the cramping hasn't been confined to either side, sometimes on one side, sometimes on another, sometimes right below my belly button).

Today I've had cramps that I'd rate at a medium level - substantially lighter than cramps at the start of my period. I've also been a bit constipated today so presumed that was contributing. I tried to make a bowel movement this afternoon and was not able to move much but when I wiped there was a 3 to 4 inch white/red stained tissue about 1/4 -1/2 inch thick (from my vagina - not my rectum). There was about a teaspoon or two of dark brown/red blood that followed. Since then I've been back to light spotting. My abdomen has remained tender.

I will call my doctor tomorrow but am presuming this was a miscarriage. Is there anything else it could be?

Thanks very much.
Posted Sat, 4 Aug 2012 in Menstruation and Miscarriage
Answered by Dr. Chetna Jain 1 hour later
Yes your beta hCG levels are very low
An ultrasound at these low level is unlikely to show pregnancy
Since you have been spotting and having brown discharge almost daily the chances are slim that the pregnancy could be healthy
You may just take paracetamol tab if not allergic for pain control
Whitish discharge may be due to infection
Please take it easy. I can understand your worry.
Drink plenty of water to avoid constipation
Best wishes
Above answer was peer-reviewed by
Follow-up: Pregnant. Started spotting, feeling constipated. Am I miscarrying. What else could it be? 27 minutes later
Thanks very much. The white/red stained tissue did not seems like discharge - it seemed like actual bodily tissue - it was solid - looked almost like a thick piece of cold/solid chicken fat with blood. It was solid but it did tear when pulled at. I've never seen anything like it before. Could it have been a miscarriage? Would there have been more blood or would the progresterone supplements have stopped further bleeding? I'm just wondering if what I experienced could be anything other than a miscarriage.

I am not worried about taking pain medication - the pain is not too significant and does not interfere with my daily activities - I just note it as a symptom.

Thanks again.
Answered by Dr. Chetna Jain 11 hours later
The fleshy piece that you passed could be a part or complete products of conception. If you have saved it we can do a histopathological exam to determine the exact nature of the piece/s. Yes progestrone support may halt further bleeding.
If a miscarriage is complete the bleeding may stop.
High probability is that, in the ultrasound no pregnancy will be seen and a further monitoring with beta hCG levels will be required till it drops below 20 or if it rises above 1000 then an ultrasound may show pregnancy.
The status of this pregnancy will become clear with time but what is assuring is that you conceived and if not this time, you have good chances of a subsequent healthy pregnancy.
Good wishes and best of luck
Above answer was peer-reviewed by
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