My husband & I have been trying to conceive our second child. My last menstrual period began on September 2, and on September 26 I tested positive for pregnancy. The hCG levels were rather high, however, at 81,879 mUI/ml for a theoretical conception date of September 16. In addition, I experienced light spotting for a few days in the middle of September. During my first pregnancy I experienced no bleeding at all, and my hCG levels were normal.

Because of the high hCG levels, my doctor and I suspected that maybe the pregnancy had actually begun in August. On November 5 I had an ultrasound to find out, but the doctor who performed the ultrasound informed me that the embryo did not have a heartbeat and, since it measured only 4.8 mm, it had stopped developing 6 weeks after my last period began. I went back to my doctor with the news, who sent me to a gynecologist. The gynecologist examined me and did another ultrasound, and he concluded that the egg did not even contain an embryo. He prescribed medication to induce uterine contractions and sent me home with no instructions about follow-up (unless the medication failed to work or I had excessive bleeding). None of the three doctors I visited could give me an explanation for the high hCG levels.

Reading up on miscarriage in a maternity book, I came across a brief paragraph on hydatidiform moles, which mentioned the fact that they caused elevated hCG levels. Should I ask a doctor to screen for this even after I take the contraction-inducing medication, or would it have been obvious just from the ultrasound if it was a mole, even that early in the pregnancy?

Thank you for your time.