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Old February 19th 04, 05:33 PM
Dagny
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Default Still pregnant or not? hcg level only decrease by 100? miscarry twin only?


Well I'm no expert, but here's what I think ...

"SLC" wrote in message
om...
Is it possible to miscarry a twin at 6 weeks and have another aged 5
weeks survive the whole process?


Yes.

Sometimes I naturally ovulate from
both sides in a cycle and intercourse did happen 8 days after the
first so it may be a possibility. Friday spotting began, Saturday an
exam showed HcG at 7600. I should have been at 6 weeks 5 days but the
ultrasound aged a sac 5 weeks 2 days high in the uterus and the cervix
was slightly open with membrane like tissue near it.


OK, not sure what membrane like tissue near the cervix means. You think
this was your lost twin?

The next day
Sunday I really think I miscarried and passed a quarter size piece of
tissue. Monday the ob/gyn saw me and did no examination of any kind.
He said he did think the tissue was a product of pregnancy but didn't
send it to lab. He only said to wait and that many women bleed and
cramp in early pregnancy. I am scheduled for an ultrasound in 11
days. Wednesday I begged for at least an HcG test. The results
showed that in the last 4 days past what I believe was a miscarry the
level went from 7600 to 7500. This doesn't sound right to me.
Shouldn't the level go down farther by now?


I would think so, but I am not sure how to factor in things like tolerance
on the lab work (is it +/- 100 or 1000?) and things like your state of
hydration -- that if you were slightly dehydrated you might show higher hCG
concentrations than if you were very well hydrated on a particular blood
draw.

Could there be a chance
the sac on the ultrasound is still there and another embryo not
visible on the ultrasound had passed?


Yes.

Wouldn't the HcG go up in that
4 days if there was still a pregnancy and if not why only go down 100?


Well, because the hCG is produced by the embryo. If you had two embryos
when your hCG was 1000, for example, and each was at the exact same stage of
development, I'd think each was responsible for roughly 500 units (although
in reality it would just be A+B=1000). In your case, the living embryo
would be doubling production approx every 48 hours but the dead or dying
embryo would at some point stop producing altogether.

If there is still a progressing pregnancy why did my symptoms like
breast soreness lessen?


Either because you had a temp dip in hCG (maybe you went, 7600, 5000, 6000,
7500), or just because. Not all of us have consistent breast soreness in
early pg.

I should just be patient and wait until next
week but it is driving me crazy not knowing if I already lost the baby
or not. In the mean time I continue to spot and cramp intermittently.


There's no reason to go crazy waiting unless you desire to limit your
ultrasound exposure. If I was going crazy, I'd call up the doc and ask for
another scan -- and if he said no, I'd go ahead and switch doctors, which
would probably garner you a scan in and of itself.

Is it unusual for the doctor to not do an ultrasound now to at least
confirm the sac is gone or still there?


No, because the risk to your health of not doing it is very very tiny, it's
expensive, the doctor may not want to overscan any little embryo living in
you (and wants to just scan it when the sac would be expected to have a
heartbeat by its current size), and there's nothing the doctor can do with
the information to help any embryo you've got.

Anyone hear of this kind of
experience happening?


No, but if it helps here was my exp. When I actually passed tissue, I had a
five something week sac, and my hcg was already down to nothing (under
25) -- BUT my hCG levels in that pregnancy were always low which I took in
hindsight to mean the embryo was "sick" from the early on. I don't think I
would ever have had a lab at 7600. I had one quant about five days before I
started bleeding, which was about 250. Maybe if you lost one embryo, that
embryo was doing fine and thus chugging out hCG and then had some
catastrophic event at a later point in development than my embryo did. My
tissue was about the length of a quarter but not as big because it wasn't
round.

HANG IN THERE. Miscarriage sucks big time. -- Dagny