Slow HCG Rise & Early Pregnancy Concerns: Ultrasound & Potential Outcomes

Question
Here it goes:
LMP-Dec.31/05
Age - 31
1st Pregnancy

Started to see light beige mucus spotting on 2/08/06 when I urinated at night.  Repeated every day since but only once a day and only when I wiped. HCG count is rising but slow (which inevitably is a bad sign)  First HCG - 104 on Jan 31st 2nd Feb.10th HCG 1692  - 1st ultrasound indicated gestational sac at 5wk 2days no fetal pole visible.   3rd HCG Feb 13 1952, 4th HCG Feb 15th 2375.  With HCG not doubling at all I fear the worse but on Feb 15th they ordered a 2nd ultrasound because of these low blood results.  U/S indicated gestational sac and yolk with fetal pole and heartbeat and normal development of 5wk6 days.  As you can imagine this broke my heart as I expected horrible news (or at least a blighted ovum with these numbers!) and the technician shows me this! Low slow rising HCG normally indicates that the embryo is not developing properly and I should probably expect a miscarriage.  I have another appt. with the OB on Friday Feb.17.  Is this a lost cause? Has there ever been a favourable outcome?

Answer
If your last period started on December 31, you probably ovulated around January 14 and could have conceived if you had sex on January 13,14,15, or 16. The best time to start taking a pregnancy test is seven days after missing your next period.  Since your HCG values are rising steadily and since the sonogram did show a fetus and a fetal heartbeat, it is most likely that all will be well. Although we like to see HCG values double every 48 hours, it is not always the case and does not necessarily indicate an abnormal fetus. Since they did see the fetus, it is most definitely not a blighted ovum. Usually, at less than 6 weeks (from your last period) we only see an empty gestational sac but no fetus or heartbeat. After 6 weeks, we usually can see the fetal pole and the heartbeat.It is also common to have some brownish staining in early pregnancy. I would repeat the sonogram in a week or two to see if there has been adequate growth of the fetus. If there has and there still is a heartbeat, you should not worry, unless the HCG values are dropping.