Miscarrige or not?

[uglybunny]

I feel like I am in such limbo.  I got a BFP on feb 7th at home and a faint on the 8th at dr office. I went to the dr for tonsillitis/strep and she put me on antibiotics because of the baby. Problem is I have been spotting and light cramping since Jan 18th. First is was brown and now it is pink/red.  It is never very much and it does come and go. I haven't had any spotting since yesterday but I have been having period like cramps this morning and some this afternoon.  But I also have fatigue, low back pain, pain with nursing, mild nausea and increased hunger. I also still nurse my 22 month old but she went to grandma's on Friday so I haven't nursed her since. This will be my 3rd child but I am still unsure if is going to last. Is this a miscarriage or not? I posted a similar question to cafemom and they all said to go to dr or er.  Which to me seems premature to go to the er. Thanks for your thoughts.

LMP Jan 12 cycle length 26 days

relations Jan 22 and 26th

first spotting Jan 29th and everyday since

Positive test Feb 7 and 8th and today

[yellow73]

I don't think you will know for sure unless you get a true period or go to the doctor for an ultrasound or lab work.  Doesn't sound like you need an ER unless you think you have an infection. Seems like one of those things that you would decide based on how you like to handle things,:  a wait and see approach, or go now and figure it out.  

The bleeding could be nothing, or something, just no way to know.

Personally, I'd probably go in to rule out ectopic pregnancy. There are other reasons you could have bleeding, even significant amounts, that still do not mean miscarriage, e.g. subchorionic hemorrhage (although this would probably happen a bit later than you are).  A friend of mine had this and bleed for months!  It was crazy, but she now has a very healthy little boy.    

[Jaimee]

Welcome to MDC!!    Congrats on your pregnancy!

You definitely do not need the ER unless you're experiencing alarming symptoms.   A m/c by itself this early is not dangerous.  Many women spot and cramp while pregnant and go on to have perfectly healthy pregnancies.  If the bleeding does not increase to full red flow, accompanied by more intense cramping, I would not worry about a m/c yet.  I know, easier said than done! 

Let's see..

CD1 January 12th

CD11 and 15 DTD

CD13ish possible O

CD18 spotting started

CD26 expected AF

CD26, 27, and 32 HPT+

CD32 today

With this information we could assume you O'd somewhere between CD10 and 20 in order to catch that egg.  With your shorter cycles, we might assume you typically O somewhere between CD12 and 14.  So the spotting could be associated with implantation, but more likely it is hormonal in nature.  My first mw told me that about 50% of women will spot during pregnancy and only half of those will m/c. 

Do you suspect low progesterone?  Since you are breastfeeding, this is a possibility.  You could talk to your care provider about getting a blood test for progesterone and getting on a progesterone supplement if necessary.  Usually, though, this would cause a chemical pregnancy, which would have happened more like a couple weeks ago, around the time of your expected AF.  You could get betas drawn to see how your hCG levels are doubling, which can be reassuring.  You could also opt for an early u/s around 6-8 weeks to see the heartbeat.  Once the heart starts to beat at an appropriate rate, your chances of m/c are much, much lower.

You might find additional support in the I'm Pregnant forum and your due date Social Group (click on the Group tab on the navibar to find the October 2012).  Good luck and keep us posted!

Edited by Jaimee - 2/13/12 at 6:49am

[uglybunny]

I don't know if this makes a difference but my HPT+ were CD26, 27 and 32

[Jaimee]

Oops, miscounted that somehow!  Sorry!  It means you're not as far past the time of expected AF as I originally counted.  So a chemical pregnancy is still technically possible, if you had later O than suspected.   Any thought on getting betas done?

[uglybunny]

I am sorry I am new to this.  Are betas hcg?   I called my dr and the nurse told me if it wasn't bleeding like a full period it was fine.  She said I could go to the er to rule out a m/c just for reassurance. So I asked to have my hcg levels checked instead of going to the er.  I went and had my blood drawn and I am waiting for the results.

[Jaimee]

No problem... yes, beta hCG testing is when they do an hCG quant test to see your actual level and then repeat 2-3 days later to see how your levels are doubling.  Doubling in 24-48 hours is a good sign of viability.  The doubling time is what matters- the actual level varies GREATLY woman to woman, pregnancy to pregnancy.  You can check out this site for fun (or to drive yourself crazy!) 

http://www.betabase.info/showBasicChart.php?type=Single

[uglybunny]

I think it is going to be a very long night if I don't hear back about the betas today.  I was doing better I thought. No bleeding for almost 24 hours until just now.  Now the spotting is back and the cramping has backed off.  I was on antibiotics which totally messed up my probiotic levels and caused a lot of bowel problems (sorry tmi) and a yeast infection.  Could any of this contribute to the cramping/spotting? Thanks for your support!

[Jaimee]

Well, I know that I get nauseous from abx.  Intestinal cramping can cause uterine cramping, so maybe that is it?  FX!  Call you doctor before they close!

[uglybunny]

I did call before they closed but they hadn't received the results from the lab.  I will update tomorrow!  Thanks!

[Jaimee]

Bummer!  Sorry!

[uglybunny]

I got the lab results back.  My dr said my progesterone levels don't look promising.  And my hcg levels where in the 360s.  I go back tomorrow to get a repeat hcg.  I am sad but the fact that it is taking so long is heartbreaking.  Over a week to have a miscarriage is really hard.

[Jaimee]

    So you're CD34 today?  And perhaps 23DPO?  Your hCG is on the lower end for 23DPO, BUT remember that it is the doubling time that matters the most.  Plus we are not positive of your DPO, so the hCG number is really not indicative of anything right now.  What was your progesterone level?

[uglybunny]

Are you saying that if the hcg level doubles then the pregnancy is viable despite a low progesterone?  Then a supplement might be needed to prevent m/c?

[Jaimee]

I'm not a doctor, but if your hCG is doubling nicely there really is no reason to suspect the embryo is not viable.  The spotting could be a low progesterone issue or not.  What was your level?  My understanding is that anything above 11 is just fine and if it is borderline then yes, a supplement could help.  You could also pick up some natural progesterone cream (NPC) and supplement yourself if you feel comfortable doing that.

[uglybunny]

Ok called the dr back.  My hcg was 396 and my progesterone was 3.53.  I asked them about a supplement and the nurse is going to call me back.

[Jaimee]

Yes, that progesterone level is not great.  Many women on here use NPC.. you can search the threads if you'd like to try that.  Otherwise your dr. will hopefully give you a prescription for prometrium or something like that.

You could also try making a new post asking about progesterone levels and supplements.

[uglybunny]

2nd hcg came back at 317 so this time is a loss.  Thank you so much for your kind words and wisdom.

[Jaimee]

I'm so sorry!    Please don't hesitate to post in the Pregnancy Loss forum for support.  Those ladies have been through it (sometimes several times).  Did your doctor say anything about your progesterone levels for your next cycle?