hCG & Its Role In Miscarriage (Part-2)

In part-1 of this article, we got to know about how hCG plays a role in miscarriage along with knowing the value of serial hCG test. Let’s now read more…

What does a low serial hCG level indicate?

If your hCG doubling time in a serial hCG test is slow, or if it decreases over time than expected, this may indicate a miscarriage or an ectopic pregnancy. In about 15 % of pregnancies, the hCG doubling time is slower than usual, and may actually turn out to be a normal pregnancy. So, speaking to your doctor would be advisable.

When can hCG levels indicate a miscarriage?

Your doctor would explain what your hCG levels mean, as normal hCG levels vary significantly in each pregnancy. The information from your serial hCG test results along with your medical history, the presence of miscarriage symptoms and an ultrasound may be needed to make a confirmatory diagnosis.

Globally, however, if the dropping of hCG levels is seen in the first trimester, it is a sign of impending miscarriage. In the opposite scenario, slow-rising hCG levels can also occur in a normal pregnancy.

Moreover,  hCG levels may remain for up to a few weeks after a miscarriage. In other words, you may continue to have a positive HPT even after a miscarriage has occurred.

When can hCG levels indicate an ectopic pregnancy?

Slow-rising hCG levels (quantitative), in most early pregnancy, can be a sign of an ectopic pregnancy. Since it is life-threatening, especially a ruptured ectopic pregnancy, you may need a transvaginal ultrasound to look for confirmatory signs of an ectopic pregnancy.

If your hCG level has at least a minimum value of 1,500 to 2,000 mIU/ml and there is an absence of a gestational sac (no visualization on ultrasound), it may be an ectopic pregnancy.






Dr. Aishwarya Rajeev has completed her MDS degree and is currently pursuing her PhD. She is an avid reader and loves to teach and write!

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