Understanding Miscarriage After Tubal Pregnancy: A Personal Story

Question
Hi -
I have a 22 months old son who was born after a 'perfect' first-time pregnancy.
About 6 months ago, December 2006, I was pregnant again for the second time - but was diagnosed with a tubal pregnancy which ended up removing my right tube. I was really sick and was traumatized by an emergency surgery after quite a bit of internal bleeding....But was able to be emotionally strong thinking it was an one-time accident. My husband and I were just hopeful to try again soon.

Last Friday I missed my period for 2 days and the pregnancy test turned positive. I went in for a blood test as advised by my doctor in December. My hcg level came back at 22....the nurse told me that the level is too low and they suspect that the pregnancy might not be viable. I told them I was spotting a little bit that day. The nurse told me I was going to have a miscarriage very soon and call back after the weekend.

Actually my spotting stopped completely after Friday. I went in for another blood work yesterday - Wednesday - now my hcg level is only at 39.....this time my doctor called and told me that I need to 'update' them on Monday whether I had a miscarriage or not. She also told me there is a low chance that it's going to be another tubal pregnancy.

I am so devastated that this is going to end up in a miscarriage. For some reason, it's so much harder to deal with than the tubal pregnancy I had 6 months ago...maybe because nothing is happening to me as of now and I know that it's going to end up in a miscarriage. I am pregnant but not going to have a baby!

Really, my question is what's going to happen...? If I don't have a miscarriage until next week - and my hormone level is still low - what does it mean...?  

Answer
Dear HJ,

I'm sorry to hear of your troubles. If you have not had any more bleeding by next Monday, your doctor will likely want to do another blood test to see what your hCG level is doing. In a healthy pregnancy, hCG levels will double every 48-72 hours.

Here's the thing... your doctor does not want to risk a repeat of December. If this would happen to be another ectopic pregnancy, he is not going to take any chances - and you don't want him to! You have one viable tube and you want to keep it viable.

So - if an ectopic is in any way suspected, it must be dealt with as soon as possible to avoid a rupture. If it actually is an intrauterine pregnancy that is simply not developing due to a chromosomal abnormality, then there is absolutely nothing you can do to help that. And there is absolutely nothing you could have done to have prevented it either. It is just one of those very unfortunate things that may have happened. You may have had more than your share recently, I know, but that does not mean that you are doomed to never have another successful pregnancy.

Try to keep your chin up. I'm sure this hasn't helped much, but I hope I've answered your question. I wish you well and will have a good thought for you.

Brenda