What causes very high hCG levels in pregnancy?

Q. hCG level is high in a pregnant patient. What can it be?

Answered by
Dr. Richa Agarwal
and medically reviewed by Dr. Sneha Kannan
This is a premium question & answer published on Jan 19, 2016 and last reviewed on: Jun 21, 2023

Hi doctor,

I am 31 years old. I had two miscarriages around 9 and 8 years ago. My last 6-7 periods were heavy and had a lot of pain. A lot of my family members had fibroids. So, I thought the same in my case too. Two months back, I got my last period, and as usual, it lasts 5-7 days, 28-29 days cycle. Last month I missed my period, felt unwell, had very sore breast that got bigger noticeably. Most of the time I had a nauseous feeling and became moody (mostly sad and irritated), certain smells irritated me a lot, urinated a lot, started eating a lot, felt the need of eating sour things, weird taste in my mouth, my tummy felt full or bloated in a very uncomfortable way and I slept a lot.

One month back, I had 2 pregnancy tests, and both were positive, but the positive pregnancy test was very dark. I used the double pack of ultra blue. After three days, I went to the doctor for a checkup, they withdrew the blood sample to check the hCG levels. I got a call from the hospital asking me to come to see the doctor because my hCG levels are very high. Next day the doctor examined me and then did a transvaginal ultrasound, the doctor told me that the placenta is empty and it is not a normal pregnancy, but it is in the uterus. The doctor told me that no baby would be a result of this pregnancy and he also told me that my only option was the surgery where they remove the cells or tissues like scrapping the uterus. My hCG before the surgery was 28,671. I had the surgery on the same day. The nurse inserted 4 Cytotec pills into my vagina a couple of hours before the surgery. They said it was successful and they removed all of the tissue. They sent the tissue to the laboratory to test it. They said they suspect a molar pregnancy.

What is your opinion? They have not told me if it is a partial or a complete molar. It is 2 days after the surgery, and I am not bleeding a lot just spotting. Today I almost had no bleeding. I thought I am supposed to bleed more, should I be worried? I feel tired; I have this weird taste still. My breasts are less sore, but they are not back to normal. Are those good signs? I read that this condition might develop some sort of cancer. Since my hCG levels were quite high to start with, does that mean I have a higher risk of developing cancer? If there were complications and the levels did not lower down, in this case, how strong is the chemotherapy? Will it have strong side effects like losing hair?



Welcome to icliniq.com.

I have gone through your history and understand your concerns. I feel sorry about your loss.

It is most likely a molar pregnancy (benign tumor developing in the uterus) because hCG levels are quite high (human chorionic gonadotropin) and it is inside the uterus. Most likely a complete mole if the placenta has also involved. No need to worry, bleeding decreases when products come out and they are considered to be good signs. Sometimes, it can turn into cancer called trophoblastic disease. In your case, we have to go for a biopsy of the tissue and checkup of hCG levels after six weeks. If the levels are persistently high, then it is suggestive of cancer. Chemotherapy is quite effective in your case but the side effects of the drug could be there.

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