Bleeding in Early Pregnancy: Causes, Risks & What to Expect

Question
I am 34, have a 15 mo old son and had a m/c 3 months ago.  My LMP was 8/26 and a HPT was positive 2 weeks ago.  On 9/28 I started bleeding (medium flow) which lasted for 2 days then slowed for a day or 2 (no cramping).  I had sonogram on 9/28 showing no sac/fetus yet and got a hcg level of 16.  I won't get results of followup hcg until next week, and am a basketcase.  Is hcg of 16 too low for 4 weeks 5 days? How common and risky is bleeding at this point?  Should I stay in bed?

Answer
At 4-5 weeks, the range of HCG should be 1000-50,000. A value of 16 is quite low for 4 weeks, especially since there is no gestational sac seen. Normally, at this stage we see an empty gestational sac. By 6 weeks, we see a fetus and a fetal heartbeat. See what the next HCG value is. If it has not doubled, it is a poor prognostic sign. If you feel more comfortable staying in bed while bleeding, do so. However, studies have shown that bedrest will not have any effect on the progression to miscarriage. Miscarriages occur in 15-20% of every pregnancy. There is nothing you can do to cause a miscarriage and there is nothing you can do to prevent a miscarriage.