The article is professionally consulted by Specialist Doctor I Nguyen Thi Man - Department of Obstetrics and Gynecology - Vinmec Danang International General Hospital. The doctor has over 10 years of experience in diagnosing, advising, and treating in the field of Obstetrics and Gynecology.
hCG is an important hormone secreted when a woman is pregnant. Monitoring hCG levels provides valuable information about the status of the pregnancy. Many pregnant women are concerned about whether low hCG levels are a problem and the risks associated with low hCG levels.
1. hCG Hormone
1.1 What is hCG Hormone?
hCG (Human Chorionic Gonadotropin) is a hormone released early in pregnancy, right after the fertilized egg attaches to the uterine lining. hCG is produced by the placenta and plays a critical role in maintaining the production of progesterone, preventing menstruation, protecting the uterine lining, and thus safeguarding the pregnancy. hCG also helps stimulate sex hormones that determine the fetus's gender and helps regulate the mother’s immune response to the fetus.
Since hCG only appears during pregnancy and appears early in pregnancy, it is essential for detecting pregnancy early. Pregnancy tests detect the presence of hCG in urine at low concentrations, which is usually accurate. However, only a blood test can provide an accurate hCG concentration in the body.
1.2 hCG Levels During Pregnancy
hCG levels vary widely between pregnant women, so there is no specific reference value for hCG levels, only a range with significant variation. The table below provides data on hCG levels by week of pregnancy (hCG concentration is measured in mIU/ml, and pregnancy age is calculated from the first day of the last menstrual period):
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hCG levels typically increase continuously from the beginning of pregnancy, and generally, hCG levels double approximately every 2-3 days. hCG levels peak around the 10th-12th week of pregnancy and then tend to stabilize and decrease. Since hCG is responsible for pregnancy symptoms like tenderness, nausea, and dizziness, pregnant women often experience more severe symptoms in the first trimester compared to later stages.
2. Is Low hCG Level a Concern?
If a pregnant woman's hCG levels are lower than the normal range, the doctor will usually recommend a series of hCG tests every two to three days to compare the results. A single test result is not enough to draw conclusions. Sometimes, low hCG levels may not be a cause for concern because hCG levels can increase after 2-3 days. Since hCG levels can vary widely among individuals, what matters most is whether the hCG levels are increasing or decreasing over time during the pregnancy. Many women may have low hCG levels but still have a healthy pregnancy.
However, in many cases, low hCG levels can indicate certain risks such as:
2.1 Incorrect Pregnancy Dating
Pregnancy is typically dated from the first day of the last menstrual period. If a woman has irregular menstrual cycles or cannot remember her exact menstrual dates, there may be errors in determining the pregnancy's age. If the pregnancy date is calculated incorrectly, the hCG test results might be lower than expected for that pregnancy stage.
2.2 Miscarriage
Sometimes, low hCG levels may indicate that a woman has had a miscarriage or is at risk of having one. A miscarriage usually occurs before the 20th week of pregnancy. Since hCG is produced by the placenta, when the pregnancy does not develop properly, hCG levels will decrease. After a miscarriage, it typically takes 4-6 weeks for a woman's hCG levels to return to normal, usually below 5 mIU/ml. Common signs of a miscarriage include vaginal bleeding, cramping or dull pain in the lower abdomen or pelvis, fever, chills, fatigue, sweating, and the disappearance of pregnancy symptoms.
2.3 Blighted Ovum
A blighted ovum is a condition in which the fertilized egg attaches to the uterus but does not continue developing into an embryo. When the gestational sac develops, hCG hormone may be released, but the level does not increase because the embryo is not developing. A blighted ovum typically occurs very early in pregnancy, and women may not even realize they were pregnant. Symptoms may resemble a normal menstrual cycle, with slightly heavier bleeding.
2.4 Ectopic Pregnancy
An ectopic pregnancy occurs when the fertilized egg implants outside the uterus, such as in the fallopian tube, ovary, or cervix. This is a dangerous condition that can threaten the life of the mother. In ectopic pregnancies, hCG levels are usually lower than normal. Common signs of an ectopic pregnancy include delayed menstruation, abnormal vaginal bleeding, persistent abdominal pain that gradually intensifies, and increasing pain. To diagnose an ectopic pregnancy, in addition to measuring hCG levels, the doctor will perform an abdominal ultrasound or transvaginal ultrasound to locate the gestational sac.
3. Can Low hCG Levels Be Treated?
Low hCG levels cannot be treated directly, although in some cases, low hCG levels are not a cause for concern.
If the cause of low hCG is a miscarriage, treatment is needed to remove any remaining pregnancy tissue. This can be done through natural expulsion, medication to expel the tissue, or a surgical procedure such as dilation and curettage (D&C). The doctor will choose the most appropriate method based on the specific case.
In the case of an ectopic pregnancy, if the pregnancy is small and has not ruptured, the patient may be given medications to allow the pregnancy to self-resolve. If the pregnancy has grown larger, laparoscopic surgery or open surgery may be necessary.
Vinmec International General Hospital is one of the hospitals that not only ensures high medical quality with a team of expert doctors and modern medical equipment but also excels in providing comprehensive, professional medical services. The hospital offers a civilized, safe, and sanitized environment for consultations and treatment. Patients can fully trust the accuracy of test results when choosing to have tests done here.
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Article reference source: Heathline.com
