Normal hCG levels (mIU/mL) by week:
4 weeks: 5 – 426
5 weeks: 18 – 7340
5 weeks: 18 – 7340
6 weeks: 1080 – 56 500
7–8 weeks: 7650 – 229 000
9–12 weeks: 25 700 – 288 000 (PEAK)
13–16 weeks: 13 300 – 254 000
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Seen in the ED Quiz: 6 Weeks Pregnant with Vaginal Bleeding
The patient is 42-years-old, G2P1 and presents with 1 week of vaginal spotting, 4 days of pelvic pain. Review the ultrasound and lab findings. What's your diagnosis?
Patient history. A 42-year-old woman who is G2P1 and approximately 6 weeks pregnant is sent from her clinic to the emergency department for 1 week of vaginal spotting and 4 days of pelvic pain. She denies any fever, dysuria, vomiting, or other complaints.
Exam. Vital signs all are normal. Exam is normal except for mild suprapubic tenderness.
Initial Concerns:
- Ectopic pregnancy
- Threatened abortion
- UTI
- Sexually transmitted disease
Testing:
- CBC: normal
- Beta hCG: ~270,000 mIU/mL (see normal values, by week of gestation, at right)
- Pelvic ultrasound: see image
What does the case image show?
Molar Pregnancy fromThe Emergency Medicine 1-Minute Consult Pocketbook
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