Very confusing ER vist!

[mrs.pennyapple]

So, I believe I'm four weeks along. I went to the doctor yesterday, and they gave me Zofran, and did another pregnancy test, which came out positive. I ended up going to the ER last night, I felt faint and extremely dizzy. They give me an iv, and take blood and urine samples. The doctor came back, and told me that my urine test was negative, and that the blood test had extremely low levels of hcg, so I must have miscarried, and needed an ultra sound. I asked if anything would show up, since I'm only at four weeks, but he seemed to think I really needed to do it, because it could also be an ectopic pregnancy. Of course, it showed nothing.
Next round, he comes in, I ask questions, he didn't give very satisfactory answers. My HCG is 164, which he said should be 400 at four weeks. Which, according to him, means that I either had a miscarriage, or an ectopic pregnancy. There are no signs or symptoms for either of these. I had a slight fever, that wasn't there when I was at the drs office, and went down within half an hour after getting fluids.

I've never had blood tests, and only had a positive test at the doctors on Saturday.
I'm so confused! My lmp was I thought, June 08th. My fiance seems to think it may have been the 12th.
According to the lab sheet, if I'm interpreting it right (i dont see how i could be wrong?)
Pregnant Women Full Weeks Beginning with Start of LMP Median:
3 - 18, 4 - 141, 5 - 1398

So, me being at four weeks, 164 would be correct and consistent, right?

My fiance and I are so confused, stressed, and worried. We aren't sure what to think. We know we won't find out for certain until another blood test is done, but were wondering if this makes sense, or if we are misunderstanding how it works?

[MaerynPearl]

Originally Posted by mrs.pennyapple

My HCG is 164, which he said should be 400 at four weeks.

WTF I would question it being 400 at only 4 weeks! That is an extremely high number for only being 14 days past likely conception! 14dpo median is about 100. So 164 is a great healthy number. And this is assuming LMP of 8th June with a very average cycle (ovulation on cd14)... but if thats the case and you had the blood test last night, 13dpo, median then is around 60.

Of course, I would not worry about twins either, your numbers are right where they should be... but I definitely would say there's no reason to suspect that you are miscarrying or have an ectopic pregnancy.

I think you just had one really ignorant-in-the-subject-of-pregnancy ER doctor (they are not all specialists at these things, after all... and if he does not generally work with pregnant women he may have ignorantly thought that you saying you were 4 weeks means that you got pregnant 4 weeks ago... which would translate to the rest of us as being 6 weeks along)

and as for the lab sheet... 18 at 3 weeks is extremely abnormal levels... which either means the woman had extremely early implantation (3/4dpo) or is further along than she thinks.

[Lousli]

I'm agreeing on Mae with this one. I am also 4 weeks (and 1 day) and I don't know my levels this time around, but my last pregnancy, 13 DPO I had an hCG of 46 and then 2 days later (15 DPO) 108. So your numbers seem great to me.

I think the doc was confused about how far along you are or being an ER doc is used to the worst case scenario since he only sees the bad stuff happening. I think it would be best to call your regular OB and ask for a repeat blood test to see if your numbers are rising appropriately.

BTW, Mae, I wonder if the number for 3 weeks is for 3 weeks 0 days or for the entire third week. I think if it is for the entire 3rd week it would make sense. I mean if it includes 3 weeks 6 days, that would be 13 or more DPO for a lot of women.

[forest~mama]

Chiming in to say I'm glad you got meds- I've been following your other thread.

[MaerynPearl]

Originally Posted by Lousli

BTW, Mae, I wonder if the number for 3 weeks is for 3 weeks 0 days or for the entire third week. I think if it is for the entire 3rd week it would make sense. I mean if it includes 3 weeks 6 days, that would be 13 or more DPO for a lot of women.

yeah... that would make much more sense... but being 3w0d would make no sense at all!

[mrs.pennyapple]

Thank you for your responses! I feel better now, knowing that someone else would think the same thing I was. I'm not sure what that doctor was thinking. I'm still nervous, but hopeful that the numbers will have doubled when I go for another blood test on Thursday!

[kalamos23]

At 3w3d, I had a beta of 46, and at 4w0d, I was at 564 with the last pregnancy, and then with DD, at 4w2d I was at 1555, so for me, 400 would be consistent - BUT I get really high HCG fast. 164 for 14dpo is PLENTY good! Especially since you have been having such strong symptoms, I would not be worried in the least.