Abnormal pregnancy, D and C and Pathological report


#1

Dear Ladies,

The more I read about D &C, the more I get confused and curious.

After having been trying to conceive for 3.5 years, I felt that July became my lucky month (also my birth month) when in the third IUI attempt (1st with injectibles, previous ones were with clomid) I got the very first HCG reading of 147. Needless to say I was ecstatic, and looking forward to welcoming multiple kids (since I started with such high HCG just 2wpo). Within three days the numbers more than doubled to 475. I was scheduled for first U/s on 8/6 however, I started bleeding the night before. The U/s showed nothing but a blood clot and I was put on bed rest. My HCG now was 6768. Bleeding (bright red) stopped after 12 hours and spotting also ended the same day. I returned to RN for 2nd U/s on 8/9 and the same thing happened …no gestational sac yet, just the blood clot while the HCG stood at 19442 now. Progesterone levels were above 40 since the beginning. On 8/14 during my third u/s I asked the RN specifically that I needed answers. She could still not see a sac and because I persuaded to know what was happening and why wouldn’t there be a sac even at 20,000 HCG ( the last reading, it was around 39000 on 8/14) so I was re-checked by the doctor who concluded that it was an abnormal pregnancy, might be molar and recommended D&C. I was shocked and wanted to proceed with natural M/C but my husband decided to go ahead on the spot. He didn’t want my body to suffer for a child which was not there. I had D&C on 8/16 and to my dismay the U/S before the surgery showed that I was probably pregnant with twins (just what I had wanted!), the normal sac collapsed much before and the abnormal kept the HCG levels going up. Essentially there was no blood clot, it was the abnormal sac :frowning: now, I am desperately waiting for the diagnostic results and hoping it wasn’t molar. My levels have not gone down very much in last one week they stood at 28000 this Friday (8/23). This seems to be a slow fall.

  1. I would like to know if someone has come across any graphs that show normal rate of fall of HCG after D&C. Any ways to lower it faster?
  2. How many of us have had D & C with pathological results not showing any apparent reason why the pregnancy failed? How soon did the doctor permit to start to TTC in those cases.

Any other piece of information you may wish to share from your experience is more than welcome.

Appreciate your time & advice.


#2

I had similar thing happened with my last cycle (refer to my signature), HCG kept increasing but only a small gestational sac formed at approximately 6-7 weeks. If at 6.5 weeks there is a sac but no fetal pole and 7 weeks no heartbeat, unfortunately the pregnancy is not normal. How far along were you when they told you to get a DnC? In some cases when a gestational sac formed it continues to excrete HCG hormones because the body thinks that there is still an embryo in the sac when there is actually not. 1). I am not sure how far along you were but if there was only a gestational sac formed and you had a D and C, because the tissue was so small at that point, it was not feasible to remove them. Your HCG should be checked after D and C to make sure it has dropped if it has not, your doctor may recommend you take cytotec or methotrexate or just let you wait. I decided to take methotrexate because of the possibility of ectopic and because my doctor said she may not be able to remove the tissue since it was so small (12 mm when we discussed about ending it), and it took about 20 days for my HCG to drop to zero. If you take cytotec, it is a natural miscarriage takes about 24 hours to expel the tissue but it is very painful I heard. I think it is up to you and the doctor to decide what to do next… I hope you can miscarry naturally, as it is a very stressful process having to visit the doctor every week for HCG checks with methotrexate and it is toxic to the liver. 2) With my last nonviable pregnancy both embryos transferred were chromosomally normal. Everything checked out normal, immune issues, clotting issues, and i was on steroid to lower my immunity and lovenox for the entire pregnancy and the pregnancy was abnormal. My doctor thought it could be ectopic or blighted ovum. So it could still be possible to have a nonviable pregnancy with normal embryos.


#3

Hi Alexi,

Thanks for your reply. I was 6 weeks 4 days when I was told that the pregnancy wasn’t growing as normal and had to be discarded. I got D&C done just two days after ; waiting for natural miscarriage might have been much more time consuming and taxing emotionally & physically. When last checked before D&C my HCG was 38,930 and I would assume that it must have rose for the next two days until D&C. It came down to 27,966 one week after D&C i.e. on 8/23. I got my pathology reports as well today and thank fully it wasn’t a molar or any chromosomal abnormality. It was an unexplained miscarriage and I could start trying again from next cycle. I’m now desperately waiting for the HCG to turn negative & my periods to begin.

All the things that we read about what all could go wrong with pregnancies these days surprise me; there were no such problems during the times of our parents and grand parents. At times I feel that it’s stress & performance pressure to out do self in the current world that has brought all of such unheard of things into picture :frowning:

Thank you & my best to you!