Understanding Early Pregnancy Bleeding: Causes & What to Expect

Question
Dear Doctor,

I am 40 years old and I have 2 children. My prior pregnancies were completely normal and have had no prior miscarriages. The first day of my last period was September 28th. I took a pregnancy test and had a positive result; however, I started to spot (a brownish color) about a week ago and it has progressed to a light pink color and now bright red. I have been doing a lot of reading about the potential implications and I am still not sure of potential outcomes. I know that bleeding is a cause for concern and I now have at least a 50% chance of miscarriage. My understanding is that if the bleeding is "more than a period" there is a bigger cause for concern. My bleeding is bright red, like a period, but I am only using one sanitary napkin a day, which is less than my typical period and definately more than spotting. I do not see any clotting and I am not experiencing any big cramping although last week I did have some slight cramping similiar to pre-menstral cramping but not sharp pains.  I have been in contact with my OB/Gyn and I had my blood drawn for a Beta HCG titer quantitative test and another scheduled in two days. What can I expect from the results of this test? Is there ANY hope for a baby, or is miscarriage imminent?

Thank you for your help.  

Answer
If you are bleeding heavier than a period and also have cramp9s, that is a sign of miscarriage. However, spotting in early pregnancy is normal and does not necessarily mean that you are going to have a miscarriage. If the Beta HCG shows a doubling of the value in 48 hours, it signifies a normal viable pregnancy. If it halves in 48 hours, it indicates a miscarriage. There is always hope.