My hCG has not doubled properly. Do I still have a chance at normal pregnancy?

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There is a good chance that you may continue the pregnancy, simply because the initial doubling of hCG from 664 to 2002 was evident and indicated adequate placentation. Ideally, the serum beta hCG levels should rise by 63 to 65 % in 46 hours. So, as can be seen, that they are and to add further, the fetal heart rate has arrived. The heart rate is low with known standards (140-160 bpm), but nevertheless, this is an ongoing pregnancy and you should be placed on Progesterone support for the next four weeks to allow better placentation. You may get a repeat scan done after two weeks to check for fetal viability and growth.

Regards.

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Yes, that would be sufficient. Avoid any exercises, brisk walking, or lifting any weights.

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If the rise seen is in a week, then it is low indeed, and hence you were advised Progesterone support. If the previous two pregnancies ended in miscarriage with less than 10 weeks gestation, then there may be a chance that this may too, but now that heartbeat has arrived, the next best thing remains to follow up with scans and repeat hCG levels to monitor the pregnancy. If God forbid, there starts any bleeding, then you would be labeled a case of recurrent miscarriage and the possible cause could be thrombophilia. You would then need to get an inherited and acquired thrombophilia screening done.

I feel you should be placed on Ecosprin 75 mg daily and tablet Sildenafil 10 mg twice a day during this pregnancy to support pregnancy further to tide over if at all you are a case of thrombophilia, just to safeguard this pregnancy now that the heartbeat has arrived. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. Best would be to get a thrombophilia screening done. Anyhow, as it is a blood test and depending on the results, pregnancy can be further managed by considering LMWH (low-molecular-weight heparin) injections if required.

You may discuss it with your provider and make an informed decision.

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If they were chemical pregnancies, the cause is unknown. But, you can still continue on Progesterone, Sildenafil, and Ecospirin for next two weeks and the result and further assessment can be made after the next scan. You may send your investigations for my purview as an attachment.

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Sildenafil is Viagra. As per the latest guidelines, it is used even during pregnancy for increasing local blood flow to uterus assisting in better implantation and results. 10 mg once or twice a day can be taken. This is available on prescription. Hence you need to discuss with your treating obstetrician and take the medicine with his/her consent. I am here to suggest.

Regards.