hCG Plateau After Positive Pregnancy Test: Understanding Potential Outcomes

Question
My hCG levels have plateaud and I am wondering when I can expect a miscarriage. My last period started October 16th, I ovulated October 29-31 (I did the ovulation testing), and I had a positive HPT on November 6th.  My hCG on November 7th was 70 then I started bleeding on November 14th and the hCG level on the 15th was 127, the 17th it was 140 and the 21st it was 149.  So a miscarriage is going to happen, but I only bled 1 morning and then had some borwn blood off and on. Since I wasn't very far along, could the miscarriage already have happened? I have had no cramping, but after more than a week I am sick of waiting for this to happen. Should I request a D&C?
Thanks for the advise.

Answer
If you started your last period on October 16, and  had a positive pregnancy test, you should now be 5 weeks 2 days pregnant. If the HCG values have not been doubling and you are bleeding, you may be undergoing a miscarriage or may have an ectopic pregnancy. If you are not having severe crampinig or heavy bleeding, you should wait until 6 weeks gestational age and get a sonogram. If, at that time, there is no fetal pole or fetal heartbeat, then it confirms a non viable pregnancy and you should have a D&C. If there is no evidence of any fetus or tissue in your uterus, you may not ned a D&C and may merely need some Methergine to contract your uterus. Discuss it with your gynecologist.