Complications in First Weeks of Pregnancy

QUESTION

I just found out I am pregnant a week ago. Because I've been diagnosed with Endometreosis and Polycystic Ovaries, I contacted my doctor right away. I went in and she did a test and confirmed that I was pregnant. She estimated that I was about 6 weeks along.

However, when she did my hCG level, she concluded I am only about 2 weeks pregnant. I had a pap two days later and after the pap I started bleeding and it hasn't stopped and it's been four days. So I went in to another doctor who did an ultrasound, and you can see the gestational sack, but nothing in it.

Is it just too early to see it or is there something wrong? At this last appointment my hCG level was 33,900. I have no clue how far along I am, or when I'm due, or if I'm having a miscarriage, or if this could be normal, or anything? Nobody is telling me anything.

What should I be worried about and what should I expect? Should I prepare myself mentally for a miscarriage?

ANSWER

It kind of depends on what you mean by "bleeding for four days." If you mean bleeding like a period, then chances are you have lost the pregnancy, and your hCG level will begin to drop. But if you mean spotting that is turning brown, then that may just be from the pap and everything with the pregnancy is fine. Most women bleed more with a pap when they are pregnant due to all the extra capillaries on the cervix.

I know this isn't much of an answer, but it is very likely that within two weeks you will know one way or the other. It will take another ultrasound to be sure, but by then if it is a viable pregnancy, there will be a heartbeat visible on ultrasound.

HCG levels are a notoriously poor way to date a pregnancy, so I would just ignore the level for that purpose. If it is continuing to rise, chances are you have a viable pregnancy.

Good luck!
~Cynthia

Cynthia Flynn

Cynthia Flynn, CNM. PhD, is the General Director of the Family Health and Birth Center which provides prenatal, birth, postnatal, gynecological and primary health care to underserved women and their families in Washington, D.C. Recently Cynthia served as Associate Professor of Nursing at Seattle University. There she not only taught, but remained in full scope clinical midwifery practice at Valley Medical Center where she cared for pregnant and birthing women, and practices well-woman gynecology, family planning, and treatment of sexually transmitted diseases.

Cynthia founded Columbia Women's Clinic and Birth Center, where she took care of pregnant women and infants up to two weeks of age and attended both birth center and hospital births. Before Cynthia earned her CNM, she worked as a registered nurse in labor and delivery and postpartum and is a certified Doula and Doula trainer.