Miscarriage/Pregnancy Loss

Bleeding for 4 weeks straight & HCG levels not dropping

Found out I was pregnant and was Due August 24th 2018, went for an ultrasound at 7 weeks 2 days with a healthy baby! Came back exactly a month later and our sweet baby had passed away shortly after my first initial appointment. I was diagnosed with a missed miscarriage and had a D&C the following morning. 
I bled and had cramping like my doctor told me for about 2 weeks and I stopped. Saw him for my follow up and everything was good! Scheduled another appointment for 3 weeks later. Well the following week I started bleeding and have yet to stop a month and 1/2 later. It’s gotten so bad that I’m having to wear a tampon and a pad. Way worse than the post D&C bleeding. I mentioned this to him at my appointment and he said my HCG levels were too high and it wasn’t my period, so we started weekly HCG testing. I’m finally down to 38 but still bleeding excessively. Could he have missed something? Has Anyone else experienced this? I’m literally puzzled at what’s wrong with me and he doesn’t seem to concerned about the bleeding! Help guys! 

Re: Bleeding for 4 weeks straight & HCG levels not dropping

  • I’m so sorry for your loss.  I don’t have any experience with this but I would definitely get a 2nd opinion.  It doesn’t seem right 
  • I'm sorry for your loss.

    I bled lightly for a couple weeks straight,  then a few days off and then on and then by end of week 3 after surgery, I wasn't bleeding at all. My HCG levels were low enough that I got a - HPT 2 days prior to the 4th week mark. I know everyone is different, but that does sound like excessive bleeding to me. I would get a second opinion.
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  • ble1ble1 member
    I'm sorry for your loss. If you're bleeding that much I would definitely see another doctor. My doctor had said bleeding off and on up until the first af is normal, but she said spotting and it coming and going. Your doctor maybe right that it is normal, but I would speak with another doctor. I would try getting an ultrasound  to see if anything was possibly missed. 
  • How long have they been tracking your hcg? 
  • They have been tracking my HCG for about 3 weeks now since he was concerned at it being so high during my follow up appointments. 
  • @dssmith_, have you gotten the pathology report back from your D&C?  It sounds a bit like a molar miscarriage, but sometimes hcg can just take a while to drop.  After my D&C with mine, I barely bled, then it would get heavier, stop and start again.
  • He said on my first follow up that everything was normal, but then contradicted himself at the following apppointment when he said something about it possibly being a partial molar. I’m so puzzled, I don’t know what it could possibly be. I have also been bleeding heavier than usual the past 2 days. It’s beggining to be hard to go anywhere because of the amount! I’m desperate for answers! 
  • I would question him further about the partial molar.  My first pathology was questionable, and they had to send it to a larger hospital for further testing.  I probably had choriocarcinoma. But, in the meantime while waiting for the results, I was treated as someone who had a molar pregnancy.  My bleeding became so severe, I had a 2nd d&c.  Have you had any ultrasounds?  
  • holly321holly321 member
    edited April 2018
    Also, unless I am misunderstanding, when my bleeding would get heavier, the bad tissue was growing back. Are you have "clots?". We thought my uterus was full of clots (which can happen after a d&c) but it was actually tumors and I would have periods of heavy bleeding where I would , I guess it is best to describe it as delivery the clots then bleed heavily to the point I could not leave the house. 

    ETA , my molar was partial and never showed on any ultrasounds, the tissue was not physically visible during the d&c either.   I would contact the hospital younhad your D&C at tomorrow for your results of yuor pathology.  While molar pregnancy is scary, it does often self resolve, but you need to know for sure before becoming pregnant again, and to verify if it is molar it is going away, it can metastasize quickly if it is a persistent mole   Also, grape like clusters are not common with partial molars.
  • ble1ble1 member
    Pathology diagnosed my mc as partial molar. I agree with @holly321 call the hospital where it was done at. Pm usually dont turn into something really scary, but if it is a pm you need a doctor on your side. He should be working for you and doing anything he can to ease your mind and make sure nothing serious is going on.

    If the bleeding is impacting to your life, to where its hard going places. Please get some answers, either from your doctor, the hospital or another doctor.
  • I have not had any ultrasounds done! He said he would do one but never did. 
    @holly321 I have been experiencing clots! It is so relieving to read that you’ve had such a similar experience! I’m going to call him tomorrow and demand he see me! Along with call the hospital! 
  • It absolutely baffles me that your doctor has let it go this long. Please do get seen, ask about methetrexate as a supplemental treatment to D&C if your liver function is solid. It's an injection as opposed to surgery and will disrupt further cell growth. 

    Also, read and take this article with you if possible. This should not have been allowed to continue this long without better follow up with your beta quants. 

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3279094
  • If it is molar and HCG is dropping, even with bleeding, no treatment may be necessary.  Most molars, 99% of partials do not require chemo.
  • @dssmith_, I hope everything is going well today and you are getting answers!
  • @holly321 Understood. However, low chances are still chances.

    Personally, I've been on the receiving end of "less than 1% of women get this" so many times with different issues, that I'm now in the habit of not playing odds anymore.

    Hopefully it's as simple as waiting, but it's also weird that they have done an ultrasound. I just don't get why they haven't done more. >.< It would drive me crazy. 
  • @kathrenne, I was the 1% and had to do chemo.  I just don't agree with going in saying, "give me methotrexate and not a d&c" when 1st, it may not be molar, and 2nd if it is, it may not be persistent.  Most partial molars self resolve.    And partial molars rarely show on ultrasound. 
  • I didn't say demand, I said "ask about," and I certainly didn't say not to do a second d&c if necessary. I also bring up the ultrasound because it hasn't been done, the doctor already said it should be, and it's standard practice as a non-invasive potential means of diagnosis.

    I have had uterine surgical procedures and I have had methetrexate; I can only say on my own end which was easier to recover from (definitely the methetrexate), but I would not ever recommend someone expect a specific treatment unless medically warranted, which is why I linked research info.

    It is a starting point to ask questions, that's all. 
  • @katherene, it is not usually just one shot of MTX, it is usually a minimum of 4 rounds of chemo strength MTX.  However many rounds to get HCG negative, and pending the oncologist 2-3 rounds of preventative, so it is best to have at least a reason to feel the molar is malignant.  If HCG is down to 38, in a relatively short period, the odds of it being malignant are pretty low.  I think it is an average of 3 months before most people's numbers are negative. 

    I also don't think d&c is necessarily the starting point, there are bleeding risks when you have a molar pregnancy.  Although, they can be necessary.  In my case, I was hemorrhaging and my uterine lining was incredibly thick, so it wasn't stopping any time soon.  
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