thread: Pregnancy Symptoms in the First Trimester

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  1. #1
    Registered User

    Aug 2009
    Glasshouse Mountains
    263

    Oh no Delphmoon, sorry to hear that you're being stressed out. first don't panic as that's more likely to do harm than anything else..

    Ok, apparently HCG levels can start falling at 9-10 weeks, here's a piece from a medical journal:

    Family physicians often use quantitative human chorionic gonadotropin (HCG) testing to assess first-trimester bleeding. While we anticipate a range of normal results for any given week in the first trimester, we predict an approximate doubling over 48 hours in a normal pregnancy during the first trimester. Human chorionic gonadotropin tends to peak at about 10 weeks’ gestation before declining and stabilizing. When HCG levels plateau prematurely or fail to rise as expected, we consider that the pregnancy might not be viable. The average doubling time for HCG levels during the first 6 weeks from conception (8 weeks gestational age) is 1.94 days.1 This increases to an average of 4.75 days between 6 and 8 weeks from conception (8 to 10 weeks gestational age)1; HCG levels then begin to plateau, reaching an average peak of about 100 000 IU/L before declining and stabilizing at approximately 20 000 IU/L.2 This generally occurs at 10 to 14 weeks gestation, at which point HCG levels become less helpful in the evaluation of first-trimester bleeding.

    Here's a case stated in his journal, it's a bit long but may be useful:

    Case description
    Mrs S.C., a 28-year-old primiparous woman, was diagnosed at a walk-in clinic with a 6-week pregnancy. She was referred to our clinic for prenatal care, and an appointment was made for about 12 weeks’ gestation. Several weeks later, however, she returned to the walk-in clinic because of postcoital spotting that had lasted 1 day. There was no associated cramping. Her estimated gestational age (EGA) by confident dates was 8 weeks, 5 days. Her examination revealed blood in the vaginal vault, but was otherwise normal with no cervical dilation or pathology. Quantitative HCG test results showed her HCG level was 167 343 IU/L. She was asked to repeat the test the next day; results showed a level of 131 681 IU/L.She was asked to come to our clinic for further evaluation. While awaiting her appointment, her HCG test was repeated again, 48 hours after the second test (EGA 9 weeks, 1 day). Results showed a further drop to 115 104 IU/L. She was seen in our clinic several days later (EGA 9 weeks, 5 days) with no further bleeding or pain. Results of examination were normal. Results of a follow-up HCG test, however, showed her levels had dropped yet again to 104 177 IU/L. Prenatal laboratory workup also determined that she was Rh-negative.Based on the 3 consecutive HCG drops, I initiated a difficult discussion with the patient. I discussed the progressive decline in HCG as representing, in all likelihood, a nonviable pregnancy. As usual in these circumstances, I addressed the issues of guilt, blame, and grief associated with miscarriage. We discussed management options, including chemical induction, dilation and curettage, and watchful waiting. The patient opted to wait for spontaneous completion of her miscarriage. Finally, I referred her for treatment to suppress the immune response, in light of her Rh-negative status.Before receiving treatment the following week, a confirming ultrasound was obtained. At 10 weeks, 6 days EGA, ultrasound scans revealed a viable 11-week pregnancy. This experience understandably resulted in an emotional roller coaster for my patient, who graciously but decidedly transferred her care to another physician.


    If you're still a little concerned, here are some suggested by Francesca Naish in her 'the natural way to a better pregnancy' book: have best rest, avoid intercourse (!), ensure continued good nutrition with extra supplementation of zinc (40mg 2x daily), vitamin C (2g 2x daily), bioflavanoids (especially from cherries & citrus) & B6 (with B-complex), 100mg daily.

    I'm not sure if this info helps but I know sometimes it feels better to be doing something..

    most of all rest, and don't worry about the blood results, according to the medical journals it definitely doesn't mean that anything is inevitable & shame on your docs for worrying you

    Keep us up to date

  2. #2
    Registered User

    Nov 2009
    Vic
    1,292

    Question

    Thankyou HC for your reply. I managed to get an urgent ultrasound and read your reply while waiting in the room for an ultrasound...it gave me a glimer of hope.

    The doctor told me the ultrasound would be more for me and DP to see the foetus before it 'departs'...I thought it was all over...

    But...we have a strong heartbeat (167bpm), and no noticable bleeding in the uterus. The sonographer said its a very normal ultrasound result!! sOO WOOHOOO

    but..what do I do now? Am I still awaiting a miscarriage even tho I have no symptoms other than this falling hCG? I contacted the doc and have made an appointment for tomorrow- I intend to keep a close eye on my levels!

    Thankyou sooo Much HC for your reply- I feel abit more empowered now!

  3. #3
    Registered User

    Aug 2009
    Glasshouse Mountains
    263

    Hey Delph, I'm not a doctor but if the sonogram is healthy and HCG levels tend to start dropping between week 10-14 naturally, i'd say the chances you're about to MC are slim, slim, slim. Tell that doctor of yours off for worrying you, decide everything is normal and have a relaxing weekend

    (by the way, how come they even checked your HCG levels so far along? most docs don't check it after the initial confirmation unless you have bleeding..)

  4. #4
    Registered User

    Feb 2009
    Brisbane
    1,070

    (by the way, how come they even checked your HCG levels so far along? most docs don't check it after the initial confirmation unless you have bleeding..)
    I was just wondering the same thing. I was never told my hcg levels with either pregnancy and didn't have blood tests except to confirm pregnancy. My gp wasn't even going to do that test with DS2 as he said the urine tests are accurate enough.

    Try not to worry now. The ultrasound showed a healthy baby and pregnancy.

  5. #5
    Registered User

    Aug 2009
    Glasshouse Mountains
    263

    Hey Delphmoon

    Just thought I'd check in and see how you are? I hope that everything went well over Christmas and the scary phase is over?

    Healthychick

  6. #6
    Registered User

    Nov 2009
    Vic
    1,292

    Hey Delphmoon

    Just thought I'd check in and see how you are? I hope that everything went well over Christmas and the scary phase is over?

    Healthychick
    Hi HC,

    Wow- thankyou for inquiring about me~!
    What a massively scary time. Bubbles is still rolling around in me and kicking occasionally.
    I have educated quite afew women on hCG levls so they will be better informed than what I was.
    I still worry but I think thats normal- DP bought me a foetal heart monitor for Chrissy which has come in handy!

    Cheers !

  7. #7
    Registered User

    Aug 2009
    Glasshouse Mountains
    263

    Hi Delphmoon

    what great news :-) I was thinking about you and hoping all was good! I hope you're feeling well.. it took me to 16 weeks to feel bubs move (and for the sickness to go!) so it's great you're feeling little one already.. I think I really calmed down and worried less after 16 weeks so I'm sure it'll all get less scary, and at least you have the monitor.

    wishing you a healthy happy pregnancy