Saturday, March 28, 2015

High hCG and No Baby Seen? FORGET THE hCG! It's All About the Size of the Gestational Sac!

If you are being diagnosed with a blighted ovum just based on your hCG levels and no baby being seen, your doctor is wrong.

Let me repeat...

Your doctor is wrong!

If your doctor has not been telling you the size of your gestational sac, you need to ask.

Going to repeat again...

Blighted Ovum scare?  Ask the size of your gestational sac at each appointment.

If this is a blighted ovum scare, you don't need ultrasounds every two to three days.  This is self-defeating.  It'll leave you worried.  Gestational sacs need time to grow.  They don't grow much in two to three days.   If your pregnancy is indeed viable, your baby needs time to grow and be seen.  Give it a week. 

You can wait longer but, really, the waiting is torture, a week is fine.  Please, keep in mind, I had to go almost a month before finding a baby in my gestational sac and the sac measured 28.5mm.  At only 21.5 mm, it still looked empty.

I know you are worried but if there are no serious complications (i.e. threat of ectopic, infection, etc...) make sure your ultrasounds are scheduled one week apart. 

Also, so important, once that gestational sac is seen, hCG levels do NOT need to be taken.  They can rise, plateau or drop and this can still be a viable pregnancy.  I have talked to women whose hCG levels were over 100,000 before they found their babies.  I've talked to women whose hCG numbers seemed to plateau around 30,000 to 40,000 and then went on to find their babies.

So what should the size of the gestational sac be before a blighted ovum is suggested?
I love the UK's new guidelines.  I oft repeat them because these guidelines would do away with the majority of misdiagnosed miscarriages.

The gestational sac should measure at least 25mm before a blighted ovum diagnosis is even suggested. 

Want to know more about these guidelines?  I blogged on this last year:

Misdiagnosed Miscarriage? The UK Has Changed their Guidelines. Your Doctor Needs to Take Note

If you are in a pregnancy forum here online, share this page!  Yes, some women will miscarry but you may prevent somebody from ending their pregnancy while there still might be a viable pregnancy. 

The take away from this blog post.  If you have seen the gestational sac, stop focusing on the hCG levels.  Focus on the growth of the gestational sac

- and -

just to throw another wrench into the works...

And, Even More on the Unreliability of Ultrasound Measurements During the First Trimester

Your ultrasound tech may get a different measurement than another ultrasound tech.  For absolute certainty, if there are no complications, you may want to wait one week after the gestational sac reaches 25mm to verify the empty sac.

Yes, a blighted ovum diagnosis is one of the most miserable diagnoses you will ever receive.  The waiting is torture but a number of women have waited it out and found their babies.

27 comments:

  1. I am 5w4d and I went to the ER yesterday with heavy bleeding. My hcg level was 20000. The doctor told me it was a possible blighted ovum. I am going back in 1 week for another u/s. This is my 2nd pregnancy and I am so nervous. I hate the waiting game!

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  2. I am 5w4d and I went to the ER yesterday with heavy bleeding. My hcg level was 20000. The doctor told me it was a possible blighted ovum. I am going back in 1 week for another u/s. This is my 2nd pregnancy and I am so nervous. I hate the waiting game!

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    Replies
    1. Much too early to diagnose a blighted ovum. This may or may not end in miscarriage. Stay monitored but you should see the sac growing from week to week for there to be hope. (((hugs)))

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  3. Hi - I am hoping that I am in the same position as all you ladies.
    My last period was January 16, 2016, it lasted for only 1.5 days. I was having pregnancy symptoms so I took a home test 10 days before my next period was due and it came back positive. I had blood work done Feb. 25 and my levels were at 169. This is my second pregnancy and I started showing very early. March 17 I had an ultrasound (8+ weeks) but it came back saying they could not detect a pregnancy. I am being sent tomorrow for blood work. I am still having pregnancy symptoms, some nausea, vivid dreams, an expanding belly...my doctor thinks I have miscarried.... Could she be mistaken?
    Thank you, I appreciate any comments OE feedback

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    Replies
    1. I am so sorry you are going through this scare. Let us know what your hCG levels show. They really should see the sac and if your levels indicate that you are pregnant, this may be ectopic. (((hugs)))

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    2. Thank you for replying so quickly, I will let you know what I find out.

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    3. Hi Kay Suzanne - got my results back and my hcg levels are at 13, 099...which would mean I am only 5-6 weeks pregnant rather then the 9 weeks the doctor thought. What do you think?

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    4. I am being sent for additional bloodwork on Thursday to see if levels are increasing or decreasing

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  4. Hi, I went in for a ultra sound on Feb 29th and was told i was 5w4d gave me a picture if the sac with a little bean in it.. I had slip and fell yesturday and although only my back is hurting no sporting no cramping I decided to go to the e.r and have everything check out being in the safe side because I've had complications in the past. At first they did a reg ulta sound then went vag. They kept asking me are you sure your 8 weeks?? Finally the e.r doc came in and ask me the same question wanting to know why I thought I was 8ws. When I explain I had a picture he said that my sac measured 6weeks and They couldn't find a heart beat but my level were 20,000. That either I was earlyer then I think or I'm having a belighted ovum. I'm following up with my o.b. I've had a belighted ovum so I'm very aware what that means. But when I had on I bleed and cramped on and off. This pregnacy I haven't had any problem. Please give me some insight.

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  5. Hi, I went in for a ultra sound on Feb 29th and was told i was 5w4d gave me a picture if the sac with a little bean in it.. I had slip and fell yesturday and although only my back is hurting no sporting no cramping I decided to go to the e.r and have everything check out being in the safe side because I've had complications in the past. At first they did a reg ulta sound then went vag. They kept asking me are you sure your 8 weeks?? Finally the e.r doc came in and ask me the same question wanting to know why I thought I was 8ws. When I explain I had a picture he said that my sac measured 6weeks and They couldn't find a heart beat but my level were 20,000. That either I was earlyer then I think or I'm having a belighted ovum. I'm following up with my o.b. I've had a belighted ovum so I'm very aware what that means. But when I had on I bleed and cramped on and off. This pregnacy I haven't had any problem. Please give me some insight.

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  6. I am so sorry you have been going through this scare. Time is the only test of a blighted ovum. I do hope you've received your answer by now. (((hugs)))

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  7. Hello everyone.
    So I went to the Dr today for another ultrasound and was told I'm measuring 6 weeks and 2 days and it looks like I have a blighted ovum because they only see the gestational sac. I'm also measuring 2 weeks behind my LMP.
    They scheduled me for another ultrasound next Thursday and I also did more blood work.
    Last week I went on Wednesday the 6th and was told I was 5 weeks and 6 days.
    I also did blood work that following Friday.
    On Wednesday my HCG levels were 19,699 and Friday it was 24,902. They said that since my levels were not doubling that I probably did not have a viable pregnancy.
    They also did not test progesterone because they said that really did not matter.
    Has anyone experienced anything similar and had a successful pregnancy?
    I'm 31 years old and this is my 1st pregnancy.
    Thank you for the feedback.

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  8. Need help! So I'm 100% certain of ovulation date as I triggered and temped. Last week at what should be 6w6 we went, had a vaginal ultrasound and while hubby and I swear we saw something, dr said all there was was a gestational sac measuring 7w1 or 2.12 cm and a yolk sac, no baby. Just went today and I'm 8w0 and they found a baby but only measuring .53cm max which he said is like 6w2 with no heartbeat and a gestational sac of 7w3 or 2.32 cm. the presence of a baby gives me hope, but the slow growth makes me think the dr is right and I should have a dnc... What do you think? He's stopping my progesterone and baby aspirin which scares me if this is misdiagnosed miscarriage...

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  9. my daughter has had 2 u/s she was told at the first- twins each in a separate sac....no pole no heart beat...one gestational sac measuring a. 5 weeks b. 6 weeks...hcg ...5683...this week (2 weeks from first one) told 2 sacs..no change...both sacs at 5 weeks...hcg 55270.....told blighted ovum..expect to miscarry over the weekend? no signs? no spotting? no pain? no fever? she should be about 6 weeks..both u/s were vag ones

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  10. Hello. I'm going through the exact same thing. My last period was 3/11/16. So I went in last week for an ultrasound and they said I had a blighted ovum. They drew hcg levels first one resulted at 71,000 two days later it resulted at 79,000. They said that confirmed it was a blighted ovum. I've had no signs of miscarriage and I feel extremely pregnant. I decided to wait a few weeks to have another ultrasound. I was wondering how it turned out for you?

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  11. Is it rue that blighted ovum can only happened once?

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    Replies
    1. Not true at all but if you are having D&Cs before nine weeks, you can't be sure they are truly blighted ova.

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  12. Hello Ms. kaye, I am more than 8 weeks pregnant based on my LMP April 1,2016. I visited my OB on June 1, i had the UTS with a gestational sac of 1.22cm but no yolk sac and heartbeat,my hcg is 18,681 mIU/ml. I had an ongoing medication with cyclogest and crinone 8% BID to increase my progesterone coz i had spotting for 2 weeks with a brownish color,but after 2 wks medication my spotting is gone and my progesterone increased to >40ng/ml.My First UTS on May 10 was no gs seen,only 3 fibroids are seen. On May 15, my OB found gs measuring 0.53cm via transvaginal uts, after 3 days May 18 another trans Vaginal uts had been made with 0.61cm. Its difficult for them to find out gs through abdominal uts, but when i came back after 2 weeks June 1,2016..My ob can able to see clearly the GS via abdominal uts,but not yolk sac and heartbeat yet.I have an appointment after a week for another uts.I am so much worried because 2 years ago I suffered from a blighted ovum and it made me scared a lot. My OB told me maybe I miscalculated, I guess I just ovulated late and having an early pregnancy,and not exactly 2 months pregnant that I thought. My hcg keeps on doubling every 3 days. When I read the stories here in your site,I feel hopeful for a viable pregnancy, no signs of miscarriages, a little bit nauseous but morning sickness is gone. Im still keeping a good faith, and hoping for the best,in Jesus name.

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  13. Hi,

    Had first ultrasound at what should be 7 weeks yesterday. GS measured 6w5d. Sac looked normal but no fetal pole or yolk sac. Got told to take blood test and another ultrasound in a week.

    Hcg came back 75000 which seems strong and doctor told me not to stress out yet.

    I've had no bleeding and light cramping here and there.

    Anyone experience anything like this and have hopefully a positive outcome.

    Trying not to stress.

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    Replies
    1. Hi going through ough exact same thing. What was th e outcome of your pregnancy?

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    2. Hi going through ough exact same thing. What was th e outcome of your pregnancy?

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  14. Hello and sorry for my english.
    In few words: i am pregnant in 7w 3d. (hope i still am) LMP 25.12.2016
    31 days HCG 1500
    34 days HcG 4900
    6w ultrasound: emty gestational sac- dr diagn. blighted ovum.
    6w4d Ultrasound again: emty gestational sac- again diag. blighted ovum and prop urgent D&C
    6 w3d HCG: 38400
    2 days after HCG: 47400, dr. said it didnt double, not even 60% procent, again prop. urgent D&C.
    since 6w brown spotting.
    i received treatement with utrogestane and duphastone, folic acid and vitamins.
    7w1d: ultrasound with another dr: little embrio, not beeing sure about fetal cord.
    i have to wait another few days to repeat US.
    Is there any hope for me?

    ReplyDelete
  15. Hello and sorry for my english.
    In few words: i am pregnant in 7w 3d. (hope i still am) LMP 25.12.2016
    31 days HCG 1500
    34 days HcG 4900
    6w ultrasound: emty gestational sac- dr diagn. blighted ovum.
    6w4d Ultrasound again: emty gestational sac- again diag. blighted ovum and prop urgent D&C
    6 w3d HCG: 38400
    2 days after HCG: 47400, dr. said it didnt double, not even 60% procent, again prop. urgent D&C.
    since 6w brown spotting.
    i received treatement with utrogestane and duphastone, folic acid and vitamins.
    7w1d: ultrasound with another dr: little embrio, not beeing sure about fetal cord.
    i have to wait another few days to repeat US.
    Is there any hope for me?

    ReplyDelete
  16. At 7 weeks 4days g.sac measures 25 mm with no fetal pole and hb doc said it is blighted ovum

    ReplyDelete
  17. Hi there,

    I had a miscarriage last August so was over the moon to find out in March that i was pregnant again. I should be 8 weeks and 1 day pregnant today.

    However, I went for an ultrasound on Thursday (should have been 7 weeks, 6 days then) but only an empty gestational sac was found, no baby, fetal pole or heart beat. I was told then that they should see something that far along so it was most likely a failed pregnancy.

    Went to my doc the next day who told me that the sac measurement put me at 5 1/2 weeks pregnant, which is almost impossible as i know when my last period was. She had my hcg checked and my levels came back at 38,000, which is normal for 6-8 weeks pregnant. But at that level they should have seen something in the sac. She said it was all very strange, and because of the small size of the sac (20mm-from memory), the date of my last period and the high level of hcg she told me its most likely a molar pregnancy. Its an extremely rare condition, but the numbers dont add up and its the only explanation.

    She also said my hcg levels wouldnt be that high with a blighted ovum or normal miscarriage. I never thought Id be sitting here today hoping that it is 'just a miscarriage':(

    I have had more blood tests done today and go back monday to find out the results. If my hcg levels havent doubled, she said she would need to refer me to King Edward hospital to have a D&C and testing done to check that its not malignant (as a molar pregnancy is a tumor)!

    On top of that I also wont be able to try for children again for another 6 months to a year which is absolutely devastating as time is not on our side.

    I had a laparoscopy at the end of last year to have endometriosis on my appendix removed...could this have something to do with it? Ive read stories about scar tissue and a tilted uterus affecting ultrasound results?...

    Has anyone been through anything like this that can give me a little bit if hope or advice? Has anyone experienced an empty sac at their 8 week ultrasound
    And gone on to have a healthy pregnancy?

    I suffer from an anxiety disorder as it is and this is almost unbearable. Absolutely devastated :(

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    Replies
    1. My gestational sac looked empty at 8 weeks. If the gestational sac is growing from week to week and not yet measuring more than 25mm, it is too early to diagnose. (((Hugs)))

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  18. This site is helpful but the size of the sac makes me nervous. My LMP was March 13 but my periods are 31-36 days. Husband and I took ovulation test on our honeymoon, I got a positive March 31. I got a positive early pregnancy test April 10. Went in for our first ultrasound April 25th and only saw a gestational sac. My HCG was 8K. HCG two days later was 13K. Second ultrasound was May 10 and were told the baby was only measuring 6w but they did see a fetal pole and yolk sac. We were told to get a D&C as it was 100% miscarriage. I just couldn't wrap my head around doing that since we had seen growth.

    Got a second opinion yesterday (May 15) and a heartbeat was visibly detected but could not be heard yet. Sac again measuring around 6w (one tech said 6w5d, one said 6w0d). HCG 65K, progesterone 21.5. Baby was .33cm. Dr said he is not optomistic but we should wait it out another week.

    This is challenging because the baby should be 8 weeks but is measuring 6 weeks and has continued to measure 6 weeks for a week. BUT we are seeing growth and we now see a heartbeat. Sigh. Anyone had something similar to this?

    ReplyDelete