1st Trimester

Spontaneous Triplets

Hello! It is my first pregnancy and I am very nervous. I went to the ER out of state because I was spotting. It turns out I have 3 implants! The ER doctor was not helpful AT ALL and was very vague when she said “there’s 3 implants but no heart beat detected. You should go and get your hcg levels drawn to make sure they’re increasing.” I went and got my levels check and they are increasing. Has anyone experienced trouble with detecting heart beats? I’m trying to look on the bright side and think maybe I’m not far along enough.

Re: Spontaneous Triplets

  • Hello! It is my first pregnancy and I am very nervous. I went to the ER out of state because I was spotting. It turns out I have 3 implants! The ER doctor was not helpful AT ALL and was very vague when she said “there’s 3 implants but no heart beat detected. You should go and get your hcg levels drawn to make sure they’re increasing.” I went and got my levels check and they are increasing. Has anyone experienced trouble with detecting heart beats? I’m trying to look on the bright side and think maybe I’m not far along enough.
    1st of all how far along are you?  We can not tell you whether a heartbeat can be seen, unless we know how far you are in pregnancy.  

    2nd NEVER go to the ER because you are spotting. Even out of state, still call your doctor.... The best is to call your doctor if spotting.  The ER has minimal OB training and always are erroring on the side of caution and always say follow up w/ OB - Hence why you call OB first.  

    Best of luck!

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  • First of all, do not tell me what to do when it comes to the emergency room. I am a nurse. I am not sure of my due date because my LMP does not add up to my ultrasound. That’s why I am worried.
  • Thank you @paytonpedro

    @triplet_mama
    As a nurse, you should know that the ER doctors are NOT highly trained in OB. Do not go off on me when you are asking untrained internet strangers for advice if you don't want to hear what we have to suggest. 

    Unless you are heavily bleeding there is no reason to go to the ER for spotting.  You should know that calling your doc would be the thing to do, even if out of town.  If they tell you to go to the ER, that's a different ball game.  

    How far along you are according to your LMP? Is it off by a few days vs the ultrasound? A week? Two weeks? You are leaving out key information here.

    Also, you are asking untrained internet strangers w/ no medical background so our advice may not be as good as the info you can get from your  NURSE friends or colleague DOCTORS, OR better yet your OB.


  • My doctor advised me to go to the ER because it is my first pregnancy. Especially being over 1,000 miles away from home. And yes, the ER was helpful in determining my blood levels and gave me the news of triplets. Im simply not asking any “strangers” questions. I was simply asking if anyone had an experience of not detecting heart beats.
  • @triplet_mama you are in fact asking strangers questions lol. As for the experience of not detecting a heart beat, yes. This happened to me. I was 6+2 with my first and we couldn’t see the heartbeat yet. We had to go back a week later where we very happily enjoyed seeing his heart beating away. But my experience does not dictate in the least what yours will be. Especially with still having no clue about how far along you are. My current pregnancy we saw the heartbeat at 6 weeks exactly, which still does not help you at all. 
  • @triplet_mama I am surprised your obgyn would even send you to an ER with spotting.  Not sure why first pregnancy matters?  At least around here, the ER is so full, they are redirecting true real emergencies,  so it seems like a waste of everyone's time.  Even yours, since you got absolutely no answer.  Honestly, if I were you, I wouldn't even put money on the fact there are 3 implants based on everyone's experience I have ever heard with ERs and pregnancies. 


    And the ER giving you one HCG level is also not helpful, as one blood draw means nothing.  Again, Honestly, in my experience even good betas can mean nothing, as can good ultrasounds.  Heck, I have even had very unpromising ultrasounds turn out with healthy pregnancies.   Unfortunately,  there is so much uncertainty in early pregnancy. 

    As to answer your question,  yes. I have had ultrasounds were heartbeat wadnt detected, as a stage were it could be expected, and I have an 8 year old from that.  But, again, I have had ultrasounds at 8+ weeks have a beautiful heartbeat and I don't have a 9 year old from that.
  • I ended up going back a couple days later for blood draw because they advised me to. The good news is that my hcg levels have increased. 
  • Glad your levels increased, but still haven't answered any questions.  Can't "help you" about detecting heartbeats if you won't say how long you think you are based off of LMP vs. What ultrasound is.  So honestly I don't know why you posted this.

    I guess that you got a few personal experiences of other people, but don't know how you expect us to give our opinions when you refuse to give the most basic info - as a nurse you should know this also.  
  • I did not reply to you for a reason. Thanks though.
  • @triplet_mama. If you are more than 7 weeks along (by LMP), and there is no HB, and the baby(s) are measuring small, the most likely thing (unfortunately, even if hcg is rising) is that you re experiencing a miscarriage. If you are *supposed* to be more than 7 weeks along, and your HCG is doubling appropriately (not just rising) it is possible that you ovulated late (especially if you typically have irregular cycles), and you are really actually only 6 weeks or so, too early to see HBs. But the window for seeing "implants" (like actual embryos) and no HBs is pretty short-- maybe only like a week. Before that it's too small to see anything but a sac, and after you should see a HB. Also-- multiples are more likely to miscarry, particularly identicals. 

    Agreed 100% on going to the ER for spotting in first tri. Yes you can get an US there but they are really bad at it, and ultimately if you are miscarrying in the first tri, there is nothing they can do. Usually if there is no HB, they will schedule you for another US in a week, and if there is still no HB, then they will confirm that you are having a miscarriage. 
    TTC History
    TTC #1 Sep 2017-Sep 2018 
    BFP 11/30/2017 | MMC 12/31/2017
    BFP 6/22/2018 | CP 6/27/2018
    BFP 10/5/2018 | EDD 6/14/2019
    Baby girl born 6/19/19

    TTC #2 May 2020-November 2021
    BFP 7/18/2020 | MonoDi Twins | MMC 9/10/2020
    BFP 11/7/2020 | CP 11/9/2020
    RE Consult January 2021 | Dx "borderline DOR"/RPL
    IVF with PGT:
    Standard Antagonist:
    ER #1 3/27/2021 7R | 5M | 3F | 2B | 1 PGT-A Normal, 1 low-level mosaic
    ER #2 4/22/2021 10R | 7M | 3F | 2B | 0 normal, 2 aneuploid
    ER #3 5/19/2021 2R | 1M | 0F
    Estrogen Priming Antagonist:
    ER #4 7/10/2021 5R | 4M | 3F | 1B | 1 PGT-A Normal
    Duostim  (Standard Antagonist):
    ER #5 9/22/2021 13R | 11M | 8F | 5B | 2 PGT-A Normal, 1 low-level mosaic, 2 aneuploid
    ER #6 10/9/2021  9R | 6M | 4 F | 1B | 1 aneuploid
    FET #1  11/5/2021 | EDD 7/24/2022
    Baby boy born 7/19/22

    TTC #3 since May 2023 (ntnp)
    IVF Started Fall 2023 (Standard Antagonist)
    ER #7 10/6/2023 | 9R | 6M | 5F | 3B | 2 aneuploid, 1 high-level mosaic
    ER #8 10/31/2023 | 5R | 4M | 3F | 1B | 1 PGT-A Normal
    FET #2 11/27/23 | CP (bHCG = 8)
    FET #3 planned Jan 2024



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