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Miscarrying a twin ?

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I am 29 years old and Have four children. My last pregnancy was identical twin boys. I have two daughters that are 2 years apart. I have had a miscarriage and a D & E before my twins. Last week I discovered I was about a week late for my pd, and was having pregnancy symptoms. I pretty much know my body so I decided to take a pregnancy test at home. It was positive. I took a second the next morning to be sure and it was positive as well. But later on that night I began to spot a brown discharge. I figured it was implantation bleeding until it started to turn pinkish and then soon red. I went to the emergency room only because this happend with my twins, I bled badly for three weeks with them and they turned out to be a normal healthy pregnancy. I never did the HCG beta trend with them. Anyway (i'm trying to keep this short), When I went to the emergency room ( 1/9) they told me that the OS was closed, beta was 1100 and ultrasound confirmed a gestational sac at about 4 weeks old. No fetal pole yet, but they said it was too early for that. So I followed up with my OB (1/11) and she did another Quant. Count was 1,984 and I had another one on 1/13. Also another ultrasound confirming a normal healthey 5 week gestational sac. However my beta on 1/13 went down to 1,936. I would normally think i was miscarrying if it wasn't for the positive ultrasound news. So my question is, is it possible that I might have miscarried a twin and that's the reason for the slight dip? I dont know what to think. Anybody have some insight. I was also told that if I miscarried, the ultrasound would not have turned out the way it did. Advice, Please:) Good or bad.
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replied January 17th, 2010
Hi,
Welcome to the ehealthforum and I am really glad to help you out. HCG can first be detected by a blood test about 11 days after conception and about 12 - 14 days after conception by a urine test. In general the hCG levels will double every 72 hours. The level will reach its peak in the first 8 - 11 weeks of pregnancy and then will decline and level off for the remainder of the pregnancy. But the hCG levels should not be used to date a pregnancy since these numbers can vary so widely. The results from an ultrasound after 5 - 6 weeks gestation are much more accurate than using hCG numbers. Since you are having a history of miscarriage, routine checking of hCG levels is required. Low HCG levels may indicate possible miscarriage or an ectopic pregnancy. But low HCG levels are not the only indicator for a possible miscarriage. A perfectly healthy pregnancy may have low hCG levels also. So many things like state of uterus and cervix, maternal health and environmental factors should also be considered. I sincerely hope that helps. Take care.







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