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Re: High HCG Levels

From: Lynn D. Montgomery, MD (anonymous@obgyn.net)
Thu, 4 Jan 2001 13:13:47 -0600 (CST)

At Thu, 4 Jan 2001, Tasha wrote: >
>I recently switched doctors after my 10th week of pregnancy due to a
>relocation. I'm now in my 15th week and yesterday had my first appt.
>with the new doctors, with the results of a battery of tests given to me
>by the first doctor, who had not gone over any of them with me.
>
>I notice when I looked at the test results that I had an "abnormal"
>reading for HCG levels taken at 9w1d of approx. 315,000. Everything
>else is normal. I had an ultrasound that same day that showed one
>intrauterine pregnancy, with a normal heartbeat (167 bpm), measuring
>normal for how far along I was. I have had no bleeding or other
>visible/noticeable signs of trouble. Some manageable morning sickness.
>
>When I raised concern about the HCG level, the nurse practitioner I was
>seeing (who evidently had missed the result when reviewing the chart)
>just said, "we don't do that kind of test that early here, and I can't
>imagine why they would have done it there. She had no other input.
>After I asked a few times whether it woudl be a good idea to test again
>now to see if it were normal now, she consulted their perinatologist,
>out of my presence, and reported back that he didn't think it was "that
>high" and that retesting would just confuse things. So, they scheduled
>me for the AFP in 2 weeks (when I'll be 16w4d) and said we'll schedule a
>Level I ultrasound for the normal time.
>
>I am deeply concerned about this test result and the NP's reaction to
>it. It doesn't appear that it's a molar pregnancy, as there's a
>thriving fetus, but I know it could be a partial molar pregnancy or an
>indicator of Down's or some other major defect. I am debating insisting
>on a repeat test, because living with this fear, with no way to get any
>peace about it, for 2 weeks is extremely stressful. I don't know enough
>about HCG to be able to feel comfortable that 315,000 where the max.
>normal should be 289,000 is not "that high," and I don't see any reason
>to delay finding out if there are serious problems with the baby.
>
>Is there any way to get some perspective on this and the HCG levels?
>Should I insist on a consultation with a doctor and/or additional test
>now, rather than later?

There is sooo much variability in the peak values of HCG from pregnancy to pregnancy. I have been involved in more chases of "high" HCG's for molar or partial molar pregnancies than I care to think about. NEVER has one actually had a problem. I would await the testing in the mid-second trimester for reassurance. I think things will be fine... Lynn 

--
Lynn D. Montgomery, MD
Director, Maternal-Fetal Medicine
Rocky Mountain Perinatal Center
Missoula, Montana


**Note:  Opinions expressed here are for educational purposes only and, as such, do not constitute a physician-patient relationship.  This information is not intended to supplant the need for you to consult with your physician prior to choosing therapeutic options and/or interventions.


**Private e-mails cannot be entertained due to time constraints, consequently no private e-mails will receive a response.


**Thank you for your understanding ;-)



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