Can pregnancy occur despite having low hCG levels?

Question

Hello doctor,

I am a 27 years old normal healthy woman. I have one child who is six years old and when I was pregnant with her I did not find out until I was 19 weeks as I had periods Lately, I have been having pregnancy symptoms and then got really sick with what was diagnosed as malaria. After my first round of antibiotics I was still having the pregnancy symptoms and my period was almost a month late. I had a faint positive home urine test, went for a blood test and my HCG level was 10. I also have Prolactinoma and I explained how my first pregnancy was hidden and demanded an ultrasound. The transvaginal ultrasound showed a sac of fluid but the doctor told me that since my HCG was low it is probably not a pregnancy and could be PID. He gave me four Tinizandole tablets since he didn't have Flagyl on hand and made me take them as one single dose since I was still on Ciproflaxcin from my malaria. A week later I started mild cramping on my right side and then my period started two days ago. It seems to be finishing today, however, I am still having symptoms of pregnancy. Extreme tiredness, food and I are usually friends but now I get full easily, frequent urination, and tingly boobs. My question is could a low HCG level cause pregnancy symptoms? I am also concerned about the sac of fluid in my uterus. If it is in fact PID and not pregnancy what if the treatment I got is not sufficient? Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understand your concern. That is quite a lot of conditions you are having at the time. Okay let's address it one by one

1. That sac in the uterus is definitely not a pregnancy sac. Only when the Beta hCG (human chorionic gonadotropin) level is more than 1500 miu/ml, pregnancy is seen in the scan, not before. You might have got pregnant, but this was the way of not allowing the malaria infection and also the antibiotics you used to affect the baby and have a baby with lots of anomalies. Now if you check Beta hCG again, levels would have reduced. Such low levels do not cause such symptoms. The features you mentioned could be due to the weakness caused by malaria, fever and it is secondary infections. also the side effect of the antibiotics. Due to fever and as side effects you will lose sugar, salt, and water. So you will have neck ache, backache, heavy headedness, just have lots of lime juice with sugar and salt or coconut water or ORS (oral rehydration solution) for the next few days.

2. PID (pelvic inflammatory disease)- This infection starts in the vagina when your partner has an infection in semen or penis or urinary tract. The infection will enter the uterus and then into the tubes. Symptoms are discharged like white or yellow or brownish or grayish, with or without itching and foul smell, increasing around sex and periods, throbbing pain in the lower abdomen before periods, and pain increases during periods.at the end of sex, spotting after periods and sex, periods bleeding more than normal, darker, thicker with clots and fleshy masses. After completing malaria treatment you can get reevaluated and both you and your partner can have a course of antibiotics with antifungals.

Treatment would be:

You and your partner can have:

1. Tablet. Fluconazole (Dibasic calcium phosphate anhydrous, Povidone) 150 mg stat (only one tablet, no repetition) after lunch.

2. Tablet. Azithromycin (Azithromycin dihydrate)1 gm stat (only one tablet, no repetition) one hour before food.

3. Tablet Secnidazole forte two tablets stat (no repetition ) after dinner.

All these on the same day by both of you. Later you have capsule. Doxycycline (Lactose monohydrate, Yellow iron oxide) 100 mg twice a day for one week. Vaginal wash or similar cleanser twice a day and vaginal pessary - Capsule. Clingen forte or Candid -CL or Cansoft CL once at night for five nights. Your partner can have the local application of any antibiotic and antifungal cream. (Candid B or Candiderma or Lobate GM ) on the penis twice a day after washing it for seven days. Do not have sex till the infection is fully gone. Do treat it as delay may send the infection inwards and may affect both your and your partner's future fertility. I hope I have clarified your query, do write back if any more queries.

Thank you.