Hello, it's been a long time. Need help with HCG levels.

Specialties Ob/Gyn


Hi there,

It's been a while since I've been on this board. I miss discussing my delivery room experiences with you all and reading all of your experiences. I am in a pickle, and I could think of no where better to go. I hope you don't mind. :o

My neighbor came to me on Saturday to say she went to the hospital for a pain in her right lower abdomen and into her leg, and a doctor thought it may be because her ovarie is sitting too close to her hip or something? And thought she might be pregnant. She didn't know she was, her HCG came back at 94. She told the doctor the last time they had sex was 2-3 weeks ago, but the doctor thought she may have conceived 2-3 *days* ago.

Anyways, she started cramping on Sunday, and then bleeding. She went to the hospital and her HCG was down to 30something. She had an ultrasound yesterday, it was not a vaginal ultrasound (I figured it would be vaginal since it was so early?? but she was bleeding). And they didn't see anything. This morning she called me crying, because she passed a quarter-size clot with white in it and she is convinced she is seeing a sac. She thinks she may have been farther along than she even thought.

Here is my question.. Anyone have any idea what is going on??? If she passed all this stuff today, why wouldn't they have seen anything on ultrasound yesterday? I am just trying to figure out what is going on to give her an answer of some sort. I am walking around scratching my head because nothing fits. I think I agree with the doctors because she was so early.. that HCG count would be huge if she was farther along right? She says clumping that bad isn't normal for her periods, so she was pretty devistated to see that and think it was a sac.

Please help, sorry to disturb your board but I was trying to think of the best place I can get answers. Thank you!



20,964 Posts

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

sounds like very early miscarriage to me. the hcg numbers prolly never rose cause the pregnancy was doomed from conception. numbers are only valuable in series to tell what is going on, not to judge how far along one is....unless u/s correlates w/the numbers. i hope she is ok. did she save the tissue for examination?

Specializes in Telemetry, Case Management.

I don't have it in front of me, and I'm not an OB nurse, but I have noticed at work on the labs, the HCG levels come with corresponding "normal" levels for how many weeks pregnant the pt is.

Smilingblueeyes, do these numbers really not mean that? I am confused.


20,964 Posts

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

NO even "normals" VARY pretty wildly. By person, by many situations, such as multiple gestation. Just consult ANY Hcg chart....the numbers vary even in same periods of gestation and alone, they don't tell the story as to HOW pregnant a woman is. Falling numbers, however, USUALLY spell doom for an early pregnancy. U/S remains the GOLD STANDARD for gestational dating, in early pregnancy. Trust me on this, after two pregnancy losses in one year, I know what I am saying here, having seen some WILD numbers in my own case.:o

Jolie, BSN

6,375 Posts

Specializes in Maternal - Child Health.

As a very general rule of thumb, hcg levels should double about every 3 days. So, If her initial value on Saturday was 94, then it should have been about 188 on Tuesday and 376 on Friday, etc.

If hcg levels rise, but at a significantly slower rate than stated above, it may be an indication of a tubal pregnancy. If hcg levels drop, that may indicate demise of an embryo and impending miscarriage. Levels should be checked a few weeks following a miscarriage or D&C, in order to insure that all tissue has been removed from the womb. If hcg levels rise at a substantially higher rate than stated above, that may indicate a multiple pregnancy or a hydatidiform mole (sp?).

Levels peak at about 16 weeks, then begin to drop somewhat.

I'm sorry for your friend's loss.


108 Posts

Thank you very much for all of the information! Very helpful as always :)

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