QuestionI am 38, have 4 children, 15, 14, 12, and 2. I had a missed miscarriage in June, at 10 weeks, I should have been 12 weeks. I had a D and C. I got pregnant a couple of months later. My dr did some blood work and found that my hcg levels were low. She has me on Prometrium 600 mg a day. She checks my levels every week and they have been increasing. I started bleeding 2 weeks ago. I should be 7 weeks, my lmp 9/3/04, but the u/s showed 5 weeks. My dr says not to worry that I may just be a little behind because of early low hormone levels, but doesn't have an explanation for the bleeding. She hasn't even checked me vaganally since the bleeding started. The dr that read the u/s told me that I was either 5 weeks pg or I was going to miscarry, because of the bleeding. I don't know whether to get a second opinion from a dr that will physically examine me. What do you suggest? My dr doesn't want to see me till next Monday when we do blood work again.
AnswerIf the sonogram only showed a 5 weeks gestation, you may merely be off on the date of your last period or the date that you ovulated. If your last period started on September 3, then you are now 7 weeks 5 days from your last period. However, your doctor is correct in that your hormone level can be low. There is no reason to have a physical exam at this point. It will show nothing and the uterus, at this point, appears merely top normal size. A sonogram in 1-2 weeks should show a fetus and a fetal heartbeat at that time and you should definitely get a sonogram in two weeks. Then you will know. It is common to have somje mild bleeding in early pregnahcy, but if it gets heavier than a normal period, you may, indeed, be miscarrying. Another way is to repeat a quantitative HCG twice, 48 hours apart. If there is a doubling of the results in 48 hours, it inicates a viable pregnancy. If there is a halving of the results iin 48 hours, it indicates a miscarriage. Good Luck to you.
