Pg related - input, advice, prayers needed PLEASE!!

[StaceyinLA]

This is long and probably confusing. I have tried to explain it as best I can.

 

 

Here’s a scenario I would love some input on.

 

This is dd’s third pg. She had two miscarriages when she was 17; one pretty early, and one that was probably technically a chemical pg - her HCG levels were probably never over 30. She is engaged now, and just recently found out she is expecting again.

 

Here is the insane scenario that now has her, and me, in panic mode (even though I know there is nothing we can do about it but pray).

 

LMP started the Monday or Tuesday before Easter, so March 25th or 26th. Had a positive test late April early May, along with some negative tests. Because of that, she went for an HCG on May 7th, which came back negative. She had an exam, and the NP that saw her did say there was a little (sorry if it’s TMI) blood around her cervix, so she might be about to start. She never started.

 

FF to 2 weekends ago (so 2 weeks and a few days) and she gets 7 VERY positive pg tests over a couple of days. She has bloodwork the Wednesday after and her levels were 624. 2 days later on the Friday they were 913. The following Monday, they were 2400. Everything was going pretty well so they didn’t do them for a few days, but she was really crampy and getting nervous, so she had them drawn again yesterday and the levels were 16,023.

 

Today she was feeling more crampy and felt like she might have seen spotting, so we went to the ER. At this point she had not had any ultrasound (one scheduled for next week) and had no idea how far along she was though the midwives’ estimate would’ve made her about 8 weeks now.

 

They see nothing on the abdominal so they do a vaginal. They are able to see a yolk sac and estimate she is about 6 weeks - to my knowledge they didn’t look for a heartbeat, or didn’t find one if they did. Her HCG level today was only 19,000, so it only went up 3,000 since yesterday (although the tests were run at a different location so Idk if their machines could be different in getting results).

 

She has had no more spotting at this point, but I truly believe another loss is going to send her over the edge. She’s been taking progesterone since she got the positive tests.

 

Any opinions? Input? I’m just at a loss, and need positive thoughts and prayers for her, the baby, and myself.

 

ETA: I'd appreciate it if the issue of her being unmarried and pg again after 2 losses as a teen didn't come into play here. She has grown to be quite responsible, though I do think the fact that she has experienced loss affects her desire to have a successful pregnancy tremendously.

[Starr]

Count me in on the prayers and good thoughts. :grouphug: In some ways it was easier before they started testing you every day or two.

[freeindeed]

Praying.

[StaceyinLA]

Thank you. I guess I just wonder if the rising over the 72 hours is necessarily going to be an even rise, or if this could be normal and it would still go up a normal amount over the next 48 hours?

[Annie]

Augh, I'm sure she's a wreck. The poor thing. The uncertainly of it all combined with the fact there's nothing you can really do is terrible. I spotted on and off up until a few weeks into my second trimester this time around, and it was so discouraging. I kept thinking the worst. :hugs:

[mumto2]

:grouphug:Praying

[fairfarmhand]

Is there any way that she can get in with a really good OB/GYN in the next day or two? I have miscarried and (nothing against midwives) really needed intense pregnancy support during my next pregnancy.

 

(again...I have nothing against midwives at all, but personally I'd prefer a MD if I was experiencing this.)

 

Hope everything goes well and the pregnancy continues.

[jewellsmommy]

prayers said! :grouphug:

[celticmom]

:grouphug:

[HS Mom in NC]

I'm typing the details of my very similar situations to show that they can be followed by a normal pregnancy and delivery and a complicated pregnancy and delivery and still have a good outcome either way. If she does miscarry, it doesn't mean she will miscarry the next pregnancy. If it doesn't result in a miscarriage, it could be normal from here on out. If she doesn't miscarry and it's a complicated pregnancy and delivery odds are it can be managed by her midwife and/ or an OB for a successful outcome. BTDT. (Please God, help us to find ways to get that technology to every pregnant woman on the planet.)

 

I had 3 miscarriages all between 6 and 13 weeks gestation. Then I had a normal pregnancy and delivery at home with a midwife. Then I was pregnant again. I had cramping and bleeding and thought I was having another miscarriage. The hormone levels were progressing high enough that the midwife said, "I've never seen levels this high not go full term." She asked it it was possible I could be farther along than I thought. That's always a possibility even though I had taken a pregnancy test that came back negative 3 weeks earlier.

 

We had a sonogram that showed our daughter 11 weeks along instead of the 8 I thought I would be (nursing can throw cycles off for some people, and no, it does not increase the risk of miscarriage in pregnancy) and a small part of the placenta had detached from the uterine wall and caused the bleeding. It happened again at 14 weeks but she was still alive and well. The back up OB ( a high risk specialist) told my homebirth midwife I should be on bedrest for the rest of the pregnancy and odds were, a homebirth would be an option. Being the pain in the butt I am, I demanded he cite and explain the research to prove the bedrest advice (I had a toddler after all.) He had to admit, to his surprise, that the research showed no difference in outcomes between the bedrest groups and the non-bedrest groups. Some did fine in both categories. Others in both categories lost the baby. Bedrest in that situation is policy as psycho- therapy.

 

There was a very small chance that the placenta could detach completely at any point in the pregnancy. (The risk of complications in a scheduled c-section were far more likely than a complete placental abruption-I made him look that up too.) To put that in perspective, it's about once a career for an OB to have a client experience a complete placental abruption. So, we planned a homebirth and had a plan for a hospital transfer. It happened to us at 40 weeks in early labor so we transferred to the hospital, had a c-section and both recovered completely. That's why we have back up OBs, hospitals and c-sections in addition to midwives-about 10% of the time we need that kind of intervention. There are very few situations that can't be handled these days between all these things working together.

 

Several years later research was released indicating that some (not all) people with a medical condition I have are at increased risks for what I experienced. We are supposed to be tested for another blood clotting disorder.

 

Now the other thing. What do you actually mean by, "I truly believe another loss is going to send her over the edge." ? Do you really think you daughter will have a psychological reaction so severe that her mental health will be ruined? Do you think she'll harm herself or someone else? Do you think she'll actually lose touch with reality? Do you think after a time of intense grieving and mourning she'll be unable to continue functioning normally? If that's what you really mean then you need to find counseling by a qualified medical professional who has experience treating this type of problem.

 

If you're using the phrase "over the edge" to convey that this would be intensely sad for her like the loss of any pregnancy would be to any woman who wanted to have the baby she lost, then be prepared to support her through the normal grieving process. You may need to grieve too. Different people grieve differently. Some prefer to put together a meaningful act or ceremony. My mother was a florist and did flowers for a couple of small, simple funerals for miscarried babies. Some people release balloons, read/write poems, go into seclusion and weep and wail for a designated period of time, etc. Other people grieve alone for a while. Let her know it's perfectly OK to grieve however she chooses, and that you'll do as little or as much to help her as she chooses.

[IdahoHomeschooler]

Has she had her progesterone levels checked? Had any sort of work up for a clotting disorder? Had her thyroid checked? If not, you might consider looking into that.

[Stayseeliz]

The dates sound very strange and confusing. Is there any way she might have had a chemical or early MC in April/May? 6 weeks puts the conception around a month ago so the positive tests in April/May are confusing. If she's 6 weeks finding a heartbeat would be iffy on US. I had one experience at that point where they didn't find a HB with DS and one where they did with DD2. I'm thinking she had a chemical or tubal a couple of months ago and this is a "new" pregnancy. Hope that makes sense. Hoping things work out. It's so hard to be in limbo with this type of thing!

[StaceyinLA]

I absolutely don't think this pg is based on conception after a normal period in late March. I guess a chemical is possible; the negative bloodwork in early May certainly implies that this pg began AFTER that. I guess the only reason I put the timeline is that there was never bleeding either from an early loss or a cycle.

 

After doing some reading, it appears that the levels don't continue to double as quickly after the HCG level has reached over 6,000. If that is the case, going from 16,000 to 19,000 in 25 hours is certainly within a normal range.

 

As of now, the midwives are feeling confident that her hormones are rising normally. They do work with physicians and consult with them when necessary. She has an ultrasound at their office next week, along with her first ob appt. They may also do another HCG late this week.

 

And she has been taking progesterone since the day she found out; my nephew (a dr) did some consulting with an ob friend and they said it wouldn't hurt her if she didn't need it, so it would be good for her to talk it.

 

At this point all we can do is wait and pray for a sticky little bean!

 

And to add, I don't think dd will harm herself or anything; by go "off the deep end," I just mean I think her grieving would be very difficult.

[Stayseeliz]

If she did have a chemical or early pg a couple of months ago that can do crazy things to someone's cycle. I've heard of many women who get pregnant again after a mc before they should even ovulate, etc. Sorry that you all have to wait to figure out what's going on. That's an awful feeling!