Well, the “a little bit pregnant” saga continues. Yesterday, I went in for blood work, and got a call late morning with my updated HCG levels. 1200. That’s a 77% rise in 48 hours, which again is within normal limits. The overall number is generally lower than expected for being 5 weeks 3 days (my RE said she’d like to see numbers “2 or 3 times higher than that”).
Given this rise (and probably just the fact that it went over 1000), they wanted me to come in right away for an ultrasound to rule out an ectopic pregnancy. I ended up literally rushing over to their office immediately, because it was 11:15 and I had patients scheduled all afternoon (1-4:30). It’s such a hassle to cancel/reschedule patients, so I’m glad they were able to see me right away, but it also definitely got my blood pressure up for the whole situation.
They did an ultrasound – both abdominal and transvaginal. My RE was in the room for the ultrasound, which was good (no waiting around for results). They pretty immediately saw that there was a “small sac” in the uterus, and were able to confirm that it was not an ectopic pregnancy (thank goodness). And there was indeed a pregnancy to be seen in my uterus – right in the center. At 5 weeks 3 days, they saw a sac and a faint yolk, and mentioned a couple of times that it was small. At the end I asked the actual size of the sac, and the ultrasound tech said she thought around 3mm, though she didn’t have the numbers in front of her. (I’ve read that 5mm or greater would be “normal”)
Before we even started, my RE said that she wasn’t going to “do anything until nature decides what’s what.” I took that to mean she would recommend a chemical abortion or D&E unless it was a clearly nonviable pregnancy. At that point, she felt like it was likely not viable, but that I was “still in the ballgame.” So honestly, at this point, I was feeling about the same as I was previously. I knew that it wasn’t ectopic and really wasn’t worried about that, because I hadn’t had a single twinge of anything on one side or another that would indicate a possible ectopic. My RE also mentioned that she was worried it could have possibly implanted in my C-section scar and been just as bad, which was something I hadn’t considered at all.
My sense after leaving the ultrasound was that I’m still likely to be having a non-viable pregnancy, but that there’s a tiny chance it’ll pull through. The follow up plan was to return for another ultrasound in 2 weeks. My RE said that she could have me back in 1 week, but that we would possibly see a fetal pole and low heartbeat, and then return a week later to have no heartbeat, which she feels is probably more devastating. I think it’s weird that she shared that, but also tend to agree.
Within about 15 minutes of leaving the ultrasound, I felt a gush. I assumed it was the ultrasound goo, but after feeling 1 or 2 more gushes I hit the restroom as soon as I got back to work. Turns out I was bleeding – bright red blood and at a pretty good clip. I put a pad on and ate my lunch while feeling a couple more gushes. By the end of lunch, I had confided the whole sordid tale to 3 of my colleagues/friends. I went to the bathroom again and felt myself pass what felt like a large clot (my only comparison for this sensation was the clots I passed post-birth in the first handful of days). I came back into the office we were eating in and said, “I think it might have just happened?” Of course this is all happening at 10 minutes to 1, and my 1:00 patient (a new evaluation) was already in the waiting room. One of my colleagues was so wonderful and offered to take that patient for me as she had the early afternoon spot open for writing, and they all encouraged me to go home. I was able to quickly cancel the rest of my day and head home. I got home around 1:30 or so, and when I went to the bathroom again had the same “clot passing” feeling. Oddly, after that the bleeding totally stopped. I had minimal spotting for a couple of hours but only when I wiped. I think I probably bled for a total of 1.5-2 hours? And there was minimal mild cramping.
Soooo I am guessing that that was the miscarriage I’ve been kind of waiting to happen. To be honest, if it was, I’m pretty relieved that it means I won’t have to make a decision about a D&E or Methotrexate. I know that there’s always the chance that the bleeding (and even clots) were just the result of the ultrasound kind of “shaking loose” blood that was pooling somewhere up there. But given all of the information, I’m thinking that’s not too likely. I messaged my RE because there’s no way in hell I’m waiting 2 weeks to find out if that was “it,” and they put in orders for me to have blood work again tomorrow to see if my HCG starts to drop. After all of that, we’re still in a very “wait and see” place. I’ll be back tomorrow to report what happened to my HCG.