Low hCG 4 Weeks, Cramping/Spotting + ER Visit Scare. Help?

BabyCub2015

I got my bfp a week ago (12dpo) on 11/20.

Today I started having some low uterine cramping and when I went to the restroom I noticed light pink spotting when I wiped (was not enough to even get on my underwear) 20 minutes later I had to pee again, went to the restroom apprehensively and sure enough, noticed a little spotting again when I wiped and the cramps were getting a bit more noticeable.

DH drove me to the ER. They immediately did a blood draw and set up for a transvaginal and a transabdominal u/s and started pumping me with fluids. I advised them that I was only a little over 4 weeks (4w2d), judging by my LMP. (My first prenatal appt isn't until 12/17).

Here is where I got confused: The Dr. came back in after reviewing the ultrasounds and blood work and said, 
"Your hCG levels are extremely low for you to be 4 weeks along. They're only at 565 and they should be somewhere around 3000 right now. The second problem we're having is that we could not locate a gestational sac through either ultrasound. This means one of two things: Either you've had a miscarriage already, you are having a miscarriage now, or you're having an ectopic pregnancy."

I asked if there was still a chance for this to turn out to be a healthy pregnancy, in the proper place, and he said yes but did not seem very optimistic about it. 

He referred me to a see an OB/GYN in 3-5 days and have my hCG levels rechecked to see if they've doubled or if they are going down. He said if they go up they'll have to do another u/s to find out exactly where the pregnancy has taken place. 

My confusion is... At 4 weeks & 2 days, is 565 actually low? From everything I've seen online it's within the normal range... And are you even guaranteed to see the gestational sac at 4 weeks? I was under the impression that they wouldn't be able to see the GS until after 5 weeks.

Maybe the Dr. is just concerned because I am experiencing a small amount of spotting accompanied with cramps? I'm just so wound up and terrified now because he literally said, "Don't get your hopes up."

Any thoughts, ideas, or has anyone had a similar situation? What was the outcome? 

I'm so lost right now, we've prayed and prayed for this child and have been so excited for this sweet baby and after hearing from the doctor tonight it's taking everything in me right now to stay positive and hold it together.

mmur76

At 4w, my hcg level was 35.  I am now 32 weeks pregnant with a healthy baby. Your levels seem completely fine.  Plus, it's not the actual number that matters much at this point, but if your numbers are doubling every 48 hours.  I would wait to see your OB and have them check levels 48 hours apart.

Amstreagle

For future reference, call your OBs after hours line for spotting don't go to the emergency room. First of all regardless of what's happening there's nothing anyone can do and ER docs' field is not in obstetrics so they won't be of much help.

brittc624

https://americanpregnancy.org/pregnancy-complications/early-fetal-development/
Check this link out for some info. I am currently 5 weeks and 6 days my levels at 4 weeks were 51. They are supposed to double/triple every 48-72 hours. My second appt my levels were 400. Sounds like your levels are fine. Also some light cramping and spotting are completely normal. Hang in there.

taahira

I agree with everyone else. ER isn't the place to be in early pregnacy they aren't set up to really give you correct advise. Your OB is always the best place to contact even after hours.
My HGC at 4 weeks was 72, it's not the actual number you should be concerned with, but whether your numbers are double every 48 hours. I would follow up with your OB. Good luck!!!

MeganRusticBarn

I had spotting and severe cramps my first couple weeks pregnant and had to have emergency ectopic surgery! LISTEN to
Your body!!!! If you think there's a problem, seek professional help. I was days say from having a ruptured tube. Oh, and by the way... My OB nurse suggested ME NOT to get a early U/S because my levels were doubling. Tests were normal... I needed clarification... I had cramps and spotting and just felt like something was wrong. If we would of waited, God knows if i would still be here! EP is dangerous!!! Always listen to your body, not just the web or Google

BabyCub2015

Thanks, ladies! I thought something sounded totally wrong with everything he had said, then when I started researching it and reading your comments it calmed me down.

My spotting and cramping seems to be gone today, I'm getting my blood drawn tomorrow to recheck my hcg levels. I took another clearblue advanced digi yesterday on a whim of curiosity. On 11/20 when I got my bfp it said "pregnant 1-2", today it seemed to come up "pregnant" really fast, a minute later it said "2-3". I'm going to take that as a good sign and just relax until tomorrow morning! Fingers crossed!

MeganRusticBarn

@Sunshinelady15‌ did your doc say that your tube would grow back after partial removal? I have my OB follow up next week and was going to ask. I too suffered what you are going through 10 days ago. I am finally starting to feel better. My stiches have bruises around them though, but I guess that's normal.
How long do you have to wait to TTC?

@BabyCub2015‌ let us know. I went in for blood work as well to check my levels and they doubled. Cramps went away and I felt fine. Just listen to your body, severe cramps is nothing to hold off on. Knowing now for next time, every little symptoms I have, I will be calling my OB nurse on

MeganRusticBarn

@BabyCub2015‌ when are you getting your U/S at your OB office? They should of scheduled you one right away, especially if the doc said you could possibly have a EP pregnancy

MeganRusticBarn

I continued to pee on a stick during my EP for the two weeks I was pregnant and sure enough the tests came back positive. Even blood work at my OB office confirmed my pregnancy. Nurse recommended me not to have a U/S early because everythjng seemed fine. OB nurse blamed my cramps on my constipation. I am glad I listened to my body!

LuvLoveXo

This doctor is an idiot and this is exactly why you DO NOT GO TO THE ER unless you are hemorrhaging. Everybody's levels are different and the number isn't so much important as the fact that they are doubling. Cramping and light spotting can be totally normal. As PPs have stated those pregnancy test with the indicators are a gimmick and totally unreliable. I'm sure they'll be pulled from the shelves sooner or later.
I wish you the best of luck in your pregnancy!!

ShuShubee

There are many reasons for cramping and/or spotting in early pregnancy, and it does not always equal a miscarriage. My first pregnancy was a chemical, but with my second, current, pregnancy, I had pretty bad cramps around 4 weeks for a day or so. It is just the uterus stretching. My first beta was a 14, and then it jumped to the 80s about 36 hours later. Like PPs said, it is not the number, but the fact that is should double. I am now 34 weeks along.

The ER doc has no clue what he is talking about. You will not see anything on an ultrasound this early - there is nothing to see. And, HCG levels vary woman to woman. Going to the ER this early, unless you are heavily bleeding, is only going to make you feel worse. Always, always, always consult with your OB office first, no matter how far along you are (unless it is a dire emergency).

zokorro

Hope everything goes well. Keep us posted. 

ttcfor2015

When I was 3.5 weeks my HSG test were 41 then 2 days later my numbers were 100. I haven't tested in 2 weeks.