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Dr Ted Manos
Dr Ted Manos, Board Certified OB/GYN
Category: OB GYN
Satisfied Customers: 727
Experience:  40 years experience; Board certified Ob-Gyn
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I had an ultrasound at 8 weeks, baby looked good and

Customer Question

I had an ultrasound at 8 weeks, baby looked good and measured 8 weeks but no heartbeat. I am going to have a vaginal ultrasound done. My doctor wants to do a DNC he says my hormones are too high (100,000) so it could be a complete mole pregnancy. I've been told it's ok if a heartbeat isn't detected yet and to get a vaginal ultrasound also, can't the pregnancy hormone be as high as 200,000 at 8-9 weeks? I feel like I'm having a normal pregnancy (this is my third) spotting or cramping.
JA: The Expert will know what to do. Is there anything else the Expert should be aware of?
Customer: The baby looked normal on the ultrasound, no cluster...
Submitted: 1 month ago.
Category: OB GYN
Expert:  Dr Ted Manos replied 1 month ago.
Hello, thank you for choosing Justanswer about your concern. I'm Dr Ted Manos M.D., Board Certified obgyn for over 35 years and I can respond momentarily.
Expert:  Dr Ted Manos replied 1 month ago.
From my experience of ordering serum HCG levels on countless pregnancies I can't recall an HCG level of over 100,000 in any case. Many levels came in less than 50,000 units in normal pregnancies. The closer it gets to 100,000 or more, the more likely it's a molar pregnancy. Ultrasound, particularly transvaginal, can show increased evidence of a molar pregnancy and either there are no fetal echoes or if a fetus is seen, there is no fetal heart activity. You would have to trust your doctor but the diagnosis is dependable in this day and age. The longer a molar pregnancy continues, the risks for hemorrhage increases. I hope you understand my information as this type of molar pregnancy is not common but certainly not rare. Treated properly can keep future pregnancies possible that can be normal again. You can rate your satisfaction with my response.
Customer: replied 1 month ago.
Ok, standing by...
Customer: replied 1 month ago.
With a mole pregnancy doesn't the ultrasound look fetus, a cluster, etc? With my ultrasound they thought the baby looked good and measured at 8 weeks.
Customer: replied 1 month ago.
this information I found isn't accurate?..."The hCG hormone level in the human body doubles approximately every 2.2 days during the first trimester of pregnancy. Detectable levels of hCG start at 5 mIU/ml during the first week of gestation and rise to 100,000 mIU/ml at 2 to 3 months."
Expert:  Dr Ted Manos replied 1 month ago.
Hopefully, the lab is accurate about the HCG level or did they miscalculate 20,000 to be 200,000. The proper ultrasound should pick up heart activity one way or the other.
Customer: replied 1 month ago.
Iy just says at 8-9 weeks hormone levels can raise to 100,000. I don't believe it's a mole pregnancy because on the ultrasound the fetus looks great and measures at 8 months. I thought with a mole there is no fetus or cluster type tissue, right?
Customer: replied 1 month ago.
Would you order a DNC if at 8 weeks there wasn't a heartbeat and hormone levels were 100,000?
Customer: replied 1 month ago.
even if the fetus looked great?
Customer: replied 1 month ago.
I'm not cramping or bleeding...this feels like a normal pregnancy and this is my 3rd.
Expert:  Dr Ted Manos replied 1 month ago.
I've seen 30+ years of HCG levels where 100,000 units is uncommon particularly with a normal pregnancy. Most HCG levels are between 20,000 to maybe 50,000 and normal pregnancies don't need the HCG level when there is a viable pregnancy. I wouldn't consider a D&C if it is a normal looking gestational sac with a fetus without heart activity. A patient may abort spontaneously and avoid [email protected] If there is evidence of molar changes then D&C would be in order.
Expert:  Dr Ted Manos replied 1 month ago.
On transvaginal ultrasound the heart is readily seen if it is beating or not.
Customer: replied 1 month ago.
Thank you...We have requested a vaginal ultrasound. Hopefully that will happen in the next day or two.I don't trust this doctor because of his lack of sensitivity and demanding a D&C when it's only been two business days since my ultrasound. I will more than likely change doctors! Thank you for your help.
Expert:  Dr Ted Manos replied 1 month ago.
When transvaginal ultrasound came available in the early to mid 1980's it was a simple tool for seeing the pelvic organs and pregnancies that made my life easier. I and some of my colleagues did our own ultrasounds which didn't let situations like yours arise. Very few ob's followed that philosophy and even today it's talking to deaf ears. The fear of making a mistake was an excuse. Who better to visualize the pelvis but the doctor who will take care of the fetus for many months. Whatever your outcome, proper handling should keep you safe.
Customer: replied 1 month ago.
Right! I'm really hoping a heartbeat shows up because the ultrasound looks completely normal otherwise.
Expert:  Dr Ted Manos replied 1 month ago.
Good luck