question-icon

What does my blood test report indicate?

default
Posted on Fri, 24 Mar 2017
Question: Hello, My wife is pregnant with our second child. Our first child is healthy and is 2.5 years old. My wife is 38 and went in for her first appt with obgyn last Monday, Feb 27. On that date she was supposedly 6.5 weeks (dated from the first day of her last period 1/11/17).

The Dr. did a vaginal u/s and everything looked normal except she did not find a heartbeat. Dr. started talking about the possibility of miscarriage and percentages/probabilities, etc. She had my wife take a blood test on that day (2/27/17) and again yesterday (3/1/17). Her hcg level on 2/27 was 60,000 and yesterday (48 hours later) was 75,271. Dr says that the number should have gone up by 50% in that 48 hour period. Dr. emailed my wife that miscarriage is possible. My wife is scheduled for another ultrasound on Friday March 10.

Are the numbers not good? Should we be worried at this point?
doctor
Answered by Dr. Timothy Raichle (33 minutes later)
Brief Answer:
Sorry but this is likely a miscarriage

Detailed Answer:
The earliest that you can see a heart beat on an ultrasound is at about 6 wks. At this point it is easily seen at 100 +/- 10. So, based on this fact alone, this is a miscarriage. If the fetus actually measured at 6.5 wks, then this would be further confirmation. But, I am sorry, but this does not sound like good news.

Second, with regard to the HCG level. Yes, in early pregnancy the number DOUBLES every 48 hours but by about 6 wks this increase starts to slow down. So I disagree and don't believe that this is really helping to figure out what is going on. The ultrasound is your best tool for sorting this out.

My main suggestion to you is this:
1. Do NOT wait until 3/10 for the follow up scan - that is a Friday and lets say that your wife wants a D&C - now this gets pushed into the next week
2. Get the followup ultrasound earlier in the week so that if she wants to do something about this it could be done next week
3. By early next week, a repeat scan would reliably tell you what is going on.

Does this help?
Dr. Tim
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
default
Follow up: Dr. Timothy Raichle (19 hours later)
Thank you for your reply. Is it possible that maybe she ovulated later than thought? The obgyn did say that even a day or two can make a difference.

Not trying to cling to hope, but hoping for a possible positive outcome.

Thanks again
doctor
Answered by Dr. Timothy Raichle (18 hours later)
Brief Answer:
Yes that is possible in some cases

Detailed Answer:
Thank you for the follow up and I am sorry about the delay. In the ultrasound, if all they saw was a gestational sac and a yolk sac, then I would say that they might have been scanning too early. If they actually saw a fetus with no heartbeat, then it is likely a miscarriage.

So, I could probably give you the best answer if you can find out - did they see a fetus or not? Did they see a yolk sac or not?

I think given the fact that they put the follow up ultrasound so far out may mean that the doctor themselves might be cautiously hopeful that they were just earlier than they thought.

Dr. Tim
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
Answered by
Dr.
Dr. Timothy Raichle

OBGYN

Practicing since :1999

Answered : 1687 Questions

premium_optimized

The User accepted the expert's answer

Share on
What does my blood test report indicate?

Brief Answer: Sorry but this is likely a miscarriage Detailed Answer: The earliest that you can see a heart beat on an ultrasound is at about 6 wks. At this point it is easily seen at 100 +/- 10. So, based on this fact alone, this is a miscarriage. If the fetus actually measured at 6.5 wks, then this would be further confirmation. But, I am sorry, but this does not sound like good news. Second, with regard to the HCG level. Yes, in early pregnancy the number DOUBLES every 48 hours but by about 6 wks this increase starts to slow down. So I disagree and don't believe that this is really helping to figure out what is going on. The ultrasound is your best tool for sorting this out. My main suggestion to you is this: 1. Do NOT wait until 3/10 for the follow up scan - that is a Friday and lets say that your wife wants a D&C - now this gets pushed into the next week 2. Get the followup ultrasound earlier in the week so that if she wants to do something about this it could be done next week 3. By early next week, a repeat scan would reliably tell you what is going on. Does this help? Dr. Tim