The hCG level is falling. Definition of hCG. Frozen pregnancy: is an analysis for hCG needed

15.05.2019

A laboratory study of the content of chorionic gonadotropin (hCG) will help diagnose a frozen pregnancy at an early stage.

When a pregnancy ends in miscarriage or fetal growth arrest, the hCG level should decrease, returning to the minimum. The time it takes for the amount of the hormone to return to normal depends on the gestational age. If the embryo froze at 8-10 weeks, when the content of human chorionic gonadotropin in the blood is maximum, it will take more time for the indicators to come to their natural value.

Usually, the concentration of the hormone decreases to a minimum level within 1-1.5 months.

If hCG increases after fetal death

Not always the desired pregnancy ends with the happy birth of the baby. In order to exclude possible complications, it is important to track the content of the hormone, the amount of which is systematically changing. But there are situations when hCG remains elevated for a long time during a frozen pregnancy. This condition may be due to the following:

Not all tissue of the ovum came out.
The embryo is not alone. When pregnant with two or more fetuses, hCG exceeds normal values, and it takes more time for it to fall.
when an egg is implanted outside the uterus, sometimes in the fallopian tubes.
Fetal malformations may be accompanied by increased hormone production. Therefore, it will be excreted by the body longer than usual.
Trophoblastic disease or hydatidiform mole. This disease is associated with abnormal growth of fetal tissue in a woman's uterus. The disorder can range from a benign tumor to a malignant tumor. In this case, the level of hCG is several times higher than the norm and continues to grow after a miscarriage. This condition requires mandatory medical supervision and an appropriate course of treatment.

During pregnancy, you have to take a large number of tests in order to detect problems in time. An essential indicator is the amount of chorionic gonadotropin. The value of hCG in a frozen pregnancy differs significantly from the required indicators. Knowledge of the norms will help a woman to suspect a problem in time, and timely diagnosis can prevent the occurrence of possible complications.

HCG definition

Human chorionic gonadotropin is a hormone produced by the chorion and the placenta after the ovum is attached to the uterine mucosa. In the absence of pregnancy, its content is normally up to 5 mIU / ml.

From the moment when the fertilized egg reaches the walls of the uterus and begins to implant, the hCG value increases exponentially. By the first day of delayed menstruation (about 14 days from the moment of conception), the content of this substance in the blood is already 29-170 IU / ml. The effect of all pregnancy tests is based on this fact, most of which have a sensitivity of 25 units, hence the recommendations on the timing of home studies.

Chorionic gonadotropin (hCG) is a special hormone that begins to be produced after the fertilized egg is attached to the wall of the uterus. By the level of hCG, experts can judge how well the pregnancy is proceeding.

It is called chorionic because it is produced by the chorion - a structure that is subsequently converted into the placenta, and gonadotropin - because it affects the reproductive organs.

HCG is much more potent than maternal steroids on the ovaries and uterus. Thanks to him, the corpus luteum begins to produce progesterone in large quantities - a hormone that supports pregnancy and creates all the necessary conditions for the development of the child.

In addition, chorionic gonadotropin increases stress resistance and suppresses the immune system, as a result of which the body does not allow the body to reject the fetus.

A decrease in hCG during pregnancy, as well as an increase in its amount, in some cases may be normal. However, sometimes this indicates the presence of a pathological process.

Every woman who wants to become a mother should know why hCG drops in the early and late stages. This will help her understand what is happening to her body and prevent unnecessary anxiety.

If you count from 1 day of the last menstruation, then the amount of chorionic gonadotropin should double every 2 days, up to 4 weeks of obstetric pregnancy. To be more precise, the doubling of the amount of the hormone happens every 2.2 + \\ - 0.8 days. Thus, it turns out that 2 days is the average value. For some women, doubling occurs within 3 days, and for some in 1.5 days.

Subsequently, the increase in the amount of hCG occurs smoothly. Its greatest indicator is observed at about 9-10 weeks of gestation. If during this period, instead of growing, hCG falls at an early stage, then the woman has a pathology that needs to be treated.

Starting from 9-10 weeks of pregnancy, there is a gradual decrease in hCG. This should in no way frighten the patient. This phenomenon is considered completely normal. As a result, throughout the entire period of gestation, the amount of the hormone in the blood is kept at the level of 6-7 weeks.

After childbirth, the level of hCG decreases even more and after a month it reaches the level of a non-pregnant woman.

How the hCG rises and how quickly the hCG falls can be understood by familiarizing yourself with the norms of chorionic hormone at different stages of pregnancy:

before pregnancy: 0-5 IU / ml;
1 week: 16-56 IU / ml;
2 week: 101-4870 IU / ml;
3 week: 1110-31500 IU / ml;
4 week: 2560-82300 IU / ml;
5 week: 23100-151000 IU / ml;
6 week: 27300-233000mIU / ml;
7-10 weeks: 20900-291000 IU / ml;
11-15 weeks: 6140-103000 IU / ml;
16-20 weeks: 4720-80100 IU / ml;
21-25 weeks: 2700-35000 IU / ml;
26-39 weeks: 2700-78000 IU / ml.

Decline

Often patients are interested in: "If hCG falls, what does it mean and what to do about it?" First of all, you need to calculate the date of conception again.

In most cases, the inconsistency of the hormone level with the norm is the result of an error in calculating the gestational age. This is especially true for women who have an irregular menstrual cycle, as it is very difficult to determine the day of ovulation in this case. At the same time, deviations from the true date of conception at 5-7 days will already be quite noticeable.

Traditionally, a decrease in hCG in early pregnancy is observed in patients with hormonal disorders. Also, a low level of chorionic hormone can indicate abnormalities in the development of the fetus. As a rule, this is a delay in its development. In this case, the growth of hCG will be present, but it will be weak and will not correspond to the norm.

Placental insufficiency or impaired blood circulation between the woman's body and the embryo often causes low levels of human chorionic gonadotropin.

If hCG falls at the end of the term, then this may indicate that the woman is walking over the pregnancy, and the chorionic functions begin to gradually fade away. At the same time, if hCG fell by half in the early stages, then the patient has a high risk of placental abruption and spontaneous abortion.

Implantation

Sometimes the ovum is attached not to the lining of the uterus, but to the ovary, fallopian tube, cervix, or abdomen. The cause of this pathology is still not known to doctors. However, it is known that such a condition is extremely dangerous for the health and life of a woman.

With an ectopic pregnancy, the level of the hormone at first may correspond to the norm, however, after the analysis, experts may find that the woman's hCG fell early in pregnancy. In some cases, the hormone stops being produced at all.

That is why it is so important that the doctor monitors the dynamics of the growth and decline of hCG from the earliest possible date.

Doom

Some patients are interested in: "Can hCG grow and then fall." This usually happens with intrauterine embryo death.

In the early stages of pregnancy, the hCG level increases in accordance with medical standards, but after a while it decreases sharply. This increases the risk of miscarriage. It is worth noting that in some patients, even after the final death of the embryo, false growth of the uterus may occur. This is directly related to the fact that the rejection of the ovum did not occur.

Moreover, even if hCG has fallen very much, the woman will still feel the characteristic symptoms of pregnancy all early on for some time. Only with time will they decrease and eventually disappear completely.

In most cases, fetal freezing can be confirmed with a routine home pregnancy test. If earlier two stripes were clearly visible on it, and then hCG fell, and now they are not, then the problem exists. In this case, you need to seek medical help as soon as possible.

Mistake

If hCG fell, but the pregnancy persisted, then this may indicate that the test results were erroneous. This happens quite rarely (no more than 0.01-2% of cases), but this probability must be taken into account.

A decrease in hCG during early pregnancy can be if the woman did not adhere to the rules for donating blood. Also, in this situation, the human factor should not be excluded.

Treatment

It is important to understand that with a low level of chorionic gonadotropin, it will be difficult to carry a pregnancy. However, medicine knows cases when, even in this state, a woman successfully carried and gave birth to a child. In this case, it all depends on why hCG falls in the early or late stages, as well as on the individual characteristics of the organism.

If hCG falls, only a qualified doctor can tell why this is happening. After evaluating the results of the analysis, he will prescribe additional diagnostic procedures, including ultrasound. In the future, based on the cause of the violation, he will offer the most effective treatment.

So, if hCG fell at an early date due to improper implantation of a fertilized egg, then the woman will undergo emergency surgery.

If the drop in hCG is not associated with a risk to the health and life of the patient and the fetus, then specialists draw up a special program for the management of pregnancy. In this case, medications will be prescribed, including those containing gonadotropin. The dosage of the medicine and the duration of its use will be determined by the attending physician on an individual basis. After the end of the course of therapy, the hormone test is repeated.

In some cases, if hCG has decreased at an early stage, treatment may not be required at all. For example, this may be the case if the amount of gonadotropin decreased after a stressful situation. After stabilizing the emotional state, the amount of hormones in the woman's body quickly returns to normal.

In cases where the drop in hCG in the early stages is associated with fetal freezing, a woman is usually prescribed drugs that provoke a miscarriage, or curettage of the uterus is performed. After that, the treatment will be carried out with anti-inflammatory drugs and antibacterial drugs.

Already in the first days of pregnancy, the body begins to actively prepare for the successful bearing of a child. One of the factors that ensure the development of the embryo is the hCG hormone (chorionic gonadotropin). It is produced by the shell of the embryo; the amount of this substance grows exponentially during the first trimester. With a frozen pregnancy, hCG stops its growth.

What is HCG?

HCG is a hormone that is present in the body of every person. The level of this substance in men and non-pregnant women is in the range of 0-5 mU / ml. During the period of gestation, the amount of gonadotropin increases rapidly. The concentration of the hormone is checked using a venous blood test.

An active increase in the indicators of chorionic gonadotropin is observed in the first three months of gestation. What indicator is considered acceptable? There are norms for the concentration of hCG in the early stages, which is reflected in the following table:

It is important to study the indicators of gonadotropin in dynamics. If you suspect a fading pregnancy, the test results are compared with normal values.

Why is it necessary to measure hCG during pregnancy?

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A blood test for hCG should be routinely taken by every expectant mother who is being observed in an antenatal clinic. Controlling the concentration of the hormone is necessary, because gonadotropin performs a number of important functions:

stimulates the production of estrogen, progesterone;
affects the mother's immune system, preventing fetal rejection;
affects the activity of the corpus luteum during the first two months of pregnancy;
helps to produce testosterone in male babies;
participates in the process of accumulating nutrients for the embryo.

It makes sense to carry out a test for the concentration of hCG in the first 12 weeks of pregnancy. After the 1st trimester, the hormone levels become lower and stabilize until the period of labor. If you suspect a non-developing pregnancy, the analysis should be taken at any time.

Diagnosis of a frozen pregnancy

There are a number of signs that may indicate fetal freezing. These include:

pulling pain in the uterus;
bloody issues;
underestimated levels of hCG;
sudden cessation of toxicosis;

the disappearance of pain in the mammary glands;
basal temperature is below normal (36-37 ° C);
cessation of fetal movements (with a period of more than 12 weeks).

To diagnose an undeveloped pregnancy, you will need to retake a venous blood test. It is advisable to do this 3 times with an interval of about a week.

Before taking blood, you must adhere to the following rules:

the last meal should be at least 7 hours before the procedure;
before taking the analysis, you need to drink water to improve the fluidity of the plasma;
delivery of biomaterial should occur at least a week after ovulation.

To study the material, you must contact one laboratory. If the results of repeated tests also show an underestimated level of hCG, this is a sign of a missed pregnancy. To clarify the diagnosis, the doctor will send a pelvic ultrasound scan, listen to the child's heartbeat.

The causes of fading can have different etiologies. The following factors cause pathology:

Hormonal imbalance. If the expectant mother has problems with the thyroid gland, ovaries, this leads to insufficient or excessive production of certain hormones. Hormone therapy is required to preserve the fetus.
Infectious diseases of the genital organs. Chlamydia, toxoplasmosis, cytomegalovirus can provoke a child's developmental arrest. Infections such as rubella and herpes also negatively affect the health of the fetus and can cause freezing.
Rhesus conflict. If the mother has a negative Rh factor, and the baby has a positive one, this can cause rejection of the fetus or its freezing.
Drinking alcohol, smoking. Both high and low doses of alcohol and nicotine can cause intrauterine death of the embryo.

Unfavorable environmental conditions, a profession with harmful working conditions are also fraught with the sinking of pregnancy. To prevent this pathology, it is worth saying "no" to bad habits, choosing a region of residence and a field of activity that is safe for health.

How does the hCG level change during a frozen pregnancy?

HCG with a frozen pregnancy is characterized by a decrease in hormone levels. The following changes indicate pathology:

the results of several studies of hCG show a dynamic decrease in gonadotropin;
indicators are 3-9 times lower than normal values.

The level of hCG with a frozen pregnancy decreases every day after the freezing of the embryo. Depending on the term, the indicators will differ from the norm by a certain number of times:

A decrease in hCG can also signal the development of the embryo outside the uterine cavity. In 26% of cases, a decrease in hCG was observed with the child's viability.

Is hCG growth possible after fetal death?

In medical practice, there are cases when the hormone indicators do not fall, and sometimes even continue to increase.

The reasons for this situation are:

The membranes continue to function, although the embryo is already dead. Chorion can produce a hormone for several days after the death of the embryo, then the concentration of gonadotropin decreases.
Anembryonia, characterized by the absence of the embryo in the presence of the ovum. In this case, hCG is produced by the ovum, and the increase in the hormone is insignificant. Anembryonia is often accompanied by toxicosis and other indirect signs of pregnancy. To make an accurate diagnosis, you will need ultrasound diagnostics. A similar condition had to be experienced by about 15% of pregnant women.
Tubal pregnancy. In a situation where the embryo did not descend into the uterine cavity and remained in the fallopian tube, hCG also grows. At the same time, the concentration of gonadotropin does not correspond to normal indicators: the increase in the substance per week only doubles.

In non-developing pregnancy, artificial termination is indicated. After this procedure, the hCG level should gradually return to normal, which will take about a month.

If the level of the hormone is higher than normal a few weeks after the abortion, the reasons lie in:

preservation of the elements of the ovum;
multiple pregnancy (one embryo was removed, and the other was left);
incorrectly set period of pregnancy.

An increase in the concentration of gonadotropin may not be associated with bearing a child. This situation is possible when taking hormonal drugs or the presence of hCG-producing tumors.

Most pregnancy tests are used in the early stages, and are based on the phenomenon of determining the hCG excreted in the urine of a woman during this period. A girl can conduct such a study at home to confirm her guesses. In a hospital or maternity hospital, a more accurate method is used - the determination of gonadotropin in the blood serum. This procedure is used by doctors if they suspect a pathological course of pregnancy.

HCG is an abbreviation for the full name of human chorionic gonadotropin, formed from the first letters. Normally, it is found in large quantities in early pregnancy. This substance, which resembles a hormone in action, is responsible for the correct formation and development of the membranes of the fetus. The growth of the placenta and the subsequent - temporary organs, which are responsible for nutrition, respiration and protection of the growing child, depends on its level.

On conventional pregnancy tests sold at the pharmacy, it is impossible to determine the amount of the hormone - they only indicate the threshold level of the substance in the urine. Therefore, with any suspicion of a complication, the woman's blood is examined. Normal values \u200b\u200bof the hormone are important, since any increase or decrease indicates various diseases.

The most noticeable decrease in the level of hCG during a frozen pregnancy.

What is Chorionic Gonadotropin?

It belongs to the actively working hormones of pregnancy - its level directly depends on the development of the child. It is secreted by the cells of the placenta - the organ that provides the baby's breathing and nutrition. Chorionic gonadotropin is an analogue of brain hormones responsible for changing the phases of the menstrual cycle. Unlike them, it performs several functions that ensure the preparation of the mother's body for bearing the fetus:

It allows you to preserve the corpus luteum - a small gland that remains in the ovaries at the site of the release of the egg. It releases gestagens - active substances - until the placenta is finally ripe.
Provides continuous growth of the placenta in the early stages - up to 12 weeks. By this time, it normally finishes its maturation, and begins to secrete gestagens on its own. The amount of hCG in the blood rises to and reaches a maximum during this period.
Influences the activity of the adrenal glands, providing the release of "stress hormones" - corticosteroids. They ensure a normal relationship between the mother and the growing fetus, which is a foreign organism. This is achieved by a slight suppression of the woman's immune system - the release of antibodies decreases.
Improves blood flow in the vessels of the uterus and prevents them from contracting, reducing their tone. This is necessary for the germination of placental villi into their lumen, through which the exchange between the mother and the baby takes place.
It inhibits the onset of the next menstruation and ovulation, as it replaces the brain hormones (gonadotropins) with its activity. A favorable background for pregnancy is created, since there are no sharp jumps in their activity in the blood.

The activity of gonadotropin during pregnancy has a certain character, a change in which indicates the formation of a complication. The level of hCG during a frozen pregnancy is not low, since until a certain period of time the child's growth can proceed normally.

A decrease in chorionic gonadotropin before 12 weeks indicates a delay in fetal development.

Change in hCG indicators

In a woman, chorionic gonadotropin may be absent only in three cases - in the absence of pregnancy, its ectopic localization, or an early test. After the first week, the hormone rapidly gains activity in the blood. Its increase depends on the development of the placenta, since it is its main source. Normally, it is completely formed after 12 weeks from conception, therefore, during this period, there is a gradual increase in gonadotropin.

Then a decrease in activity is possible, which has a gentle character, and gradually decreases by the time of childbirth. Changes in the early stages, indicating the development of complications, are low levels of gonadotropin. If the level was normal and then falls rapidly, then this indicates a risk of miscarriage.

Frozen pregnancy

This complication of early gestation is very similar in its mechanism to miscarriage. Under the influence of various reasons, the development of the membranes is inhibited, which leads to intrauterine death of the child. On this path, complications diverge, since a miscarriage occurs suddenly and is accompanied by the removal of the baby and membranes from the uterine cavity. If this process develops gradually, then it has less pronounced signs:

A frozen pregnancy develops as a result of a slow malnutrition and respiration of the fetus, which causes its death.
The girl's body does not react so violently to this process, so the membranes and placenta remain intact.
They continue to secrete gestagens, and the mother's brain and immune system "decide" that gestation is proceeding normally.
At the same time, hCG during a frozen pregnancy decreases slightly, and then remains at a consistently low level.

Non-developing pregnancy is a formidable complication, since it is almost not felt subjectively. In the early stages, even mild symptoms can be recognized as signs of toxicosis. Persistent changes in the uterus, formed as a result of complications, can lead to the development of infertility in a woman.

The task of the doctor is the timely appointment of diagnostics - ultrasound examination and determination of hCG in the blood during a frozen pregnancy.

What Happens When Pregnancy Does Not Develop?

The modern theory about the causes of this disease puts infection first. Any microbes entering the mother's bloodstream easily end up in the baby's circulatory system and amniotic fluid. In the early stages, the exchange processes between mother and baby are still imperfect, so they easily penetrate the barriers of the membranes.

The most dangerous in this case are viruses, since they are small in size, and the immune system reacts slowly to them. If these microbes do not cause the death of the fetus, then they will completely lead to the formation of congenital abnormalities in the child. Even a common cold is caused by viruses that can enter the bloodstream. They initially affect the membranes of the fetus, which interfere with its breathing:

Getting into the vessels of the uterus, microbes provoke the development of inflammation.
The membrane of the fetus and placenta reacts to this process, which leads to their enlargement due to edema.
If the inflammation affects them and moves to the amniotic fluid and the baby, then a miscarriage develops. This happens as a result of many hemorrhages, which leads to oxygen starvation of the baby and detachment of the membranes.
If the inflammation is sluggish, then this gradually leads to the replacement of the membrane tissue with scars. The new tissue does not have metabolic properties, which causes impaired nutrition and breathing of the child.
From a lack of essential substances, the baby stops growing and eventually dies. The woman's body reacts weakly to this, and begins to replace it with connective tissue.

Chorionic gonadotropin reacts most accurately to this pathological process - damage to the membranes and placenta reduces its release into the blood.

HCG for a frozen pregnancy

The concentration of this hormone in the blood depends on the growth and development of the placenta. In the early stages, when its formation is in progress, its amount turns out to be maximum. Therefore, with any damage to the membranes, a decrease in gonadotropin is observed, since the tissue of the placenta is damaged.

An undeveloped pregnancy leads to a drop in hCG, although it usually rises continuously during this period. After a gradual decrease, a stabilization of indicators is observed when the damaging effect of microbes ceases. The placenta continues to secrete a small amount of the hormone, despite the development of starvation and fetal death.

A miscarriage is also accompanied by a drop in gonadotropin, but is characterized by severe symptoms and a sharp drop in the amount of the hormone in the blood.

To confirm the diagnosis, a blood test for hormones is used in dynamics.

HCG index during early pregnancy: low, high. What does the decrease in level indicate?

What else does low hCG say? It is not excluded. This means the following: fertilization took place, but for some reason, the body recognized the fetus as unviable and rejected it even before the delay in menstruation. A woman most often does not even suspect that a new life was ripening in her. True, in some women, in this case, menstruation somewhat changes its character (due to the onset and failed implantation):

discharge becomes profuse;
there is soreness in the lower abdomen;
discharge takes a little longer than usual.

There is no need to regret the termination of such a pregnancy: the body was able to recognize the defects of the future fetus that are incompatible with life and eliminated everything without consequences for the life and health of the mother.

Decreased hCG in early pregnancy

An unfavorable sign is a decrease in the hCG indicator to 11 weeks. HCG drops in early pregnancyfor reasons:

incipient miscarriage;
violations of the blood supply to the fetus.

If hCG is more than half the norm, this is a reason to observe a woman for a week. If there are signs of a spontaneous abortion, the woman is admitted to a hospital for conservation.

Elevated hCG during early pregnancy

It would seem that increased hCG during early pregnancy is a good thing. The fetus is successfully entrenched, the hormone is actively released, it increases rapidly - everything is fine. Indeed, more often than not, the body can increase hormone levels during pregnancy with twins or triplets. In this case, upon confirmation of multiple pregnancy by ultrasound, the woman can rejoice - a physiological increase.

But large hCG also occurs in other circumstances:

the development of tumors (including malignant);
down syndrome in a developing fetus;
other developmental anomalies - in particular, neural tube defects;
cystic drift.

What level of hCG is considered really high - in each specific situation you need to ask your doctor. It is unacceptable to diagnose yourself on your own.

It is imperative to track hCG over time, since this hormone is a marker of normal, progressive pregnancy. If you want to make sure that everything is in order, periodically get tested before 11 weeks, and then you will have much less reason to worry. And if the mother is calm, everything will be fine with the child too.