Post-Surgery Concerns: Bleeding and hCG Levels After D&C

Post-operative questions?

I underwent a dilation and curettage (D&C) for a molar pregnancy on June 17, but I have been experiencing bleeding for over ten days.
On June 28, my hCG levels had dropped to 1568.6, and my doctor was pleased, stating this was a good sign.
However, on July 1, my levels rose again to 1817.6.
I would like to know if this increase is normal or if emotions could also have an impact.
Thank you for your assistance.

Linlin, 20~29 year old female. Ask Date: 2021/07/04

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, based on your description, it is recommended to follow up with your physician for a few more blood tests and ultrasounds to determine if everything is normal.
Thank you! Wishing you peace and health.
Dr.
Zhang

Reply Date: 2021/07/04

More Info

After undergoing a D&C (dilation and curettage) procedure, especially following a molar pregnancy, it is common to have concerns regarding post-surgery bleeding and hCG (human chorionic gonadotropin) levels. Your situation, where you experienced prolonged bleeding for over ten days and fluctuations in your hCG levels, raises several important points to consider.

Firstly, it is essential to understand that after a D&C, some bleeding is expected as the body clears out the uterine lining and any remaining tissue. This bleeding, often referred to as lochia, can vary in duration and intensity. It is not uncommon for women to experience bleeding for several weeks post-surgery, especially if the procedure was performed due to a molar pregnancy, which can complicate the recovery process.

Regarding your hCG levels, it is crucial to monitor these closely after a D&C, particularly following a molar pregnancy. The hCG hormone is produced by the placenta, and its levels should ideally decrease to zero after the removal of any pregnancy tissue. In your case, the initial drop in hCG from a higher level to 1568.6 was a positive sign, indicating that your body was responding to the procedure. However, the subsequent rise to 1817.6 is concerning and may suggest that there is still some placental tissue remaining or that there could be another issue at play.

It is important to note that emotional stress can impact hormone levels, but significant fluctuations in hCG after a D&C typically indicate a physiological issue rather than an emotional one. If hCG levels continue to rise or do not decrease appropriately, further evaluation is necessary. This may include additional blood tests to track hCG levels over time and possibly imaging studies, such as an ultrasound, to check for retained tissue in the uterus.

In terms of treatment, if there is evidence of retained products of conception, further intervention may be required. This could involve a repeat D&C or medication to help expel any remaining tissue. It is crucial to maintain open communication with your healthcare provider and follow their recommendations for monitoring and potential treatment.

In summary, while some bleeding and fluctuations in hCG levels can be expected after a D&C, significant increases in hCG levels warrant further investigation. It is essential to work closely with your healthcare provider to ensure that any complications are addressed promptly and that your body can heal properly. Regular follow-ups and monitoring will be key to your recovery process.

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