### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi, may I answer your health queries right now ? Please type yAround 3 weeks ago, I had a positive pregnancy test on a Saturday, Sept 11th. Went to the doctor that Monday...they did a Serum ChatDoctor and it came back negative, but took another home test and it still showed positive. Monday night I started cramping and bleeding bright red blood....went to ED on Tuesday Sept 14th to be positive that I was miscarring bc I had positive test and negative ChatDoctor serum, my levels at the ED were at a 7 for ChatDoctor. Bleeding stopped Tuesday...was asked to repeat Beta ChatDoctor on Tuesday. I was curious so over the weekend took another test...still showed positive?? Had my labs done Tuesday Sept 21st and they increased from 7 to 101. Set up gyn appt. and went for my appt Sept 29th, they did a ultrasound and no gestational sac or signs of pregnancy are apparent. I still have the symtoms of tiredness, frequent urination, metal mouth, and increased appetite. They said maybe i miscarried three Tuesdays ago at the ed or maybe im early in pregnancy and couldnt see it being my levels were so low. Repeated ChatDoctor Sept 29 and and levels increased again to 204. What im confused about is why would my Beta ChatDoctor go from 7-101-204 in a 3 week toime span if nothing is there? Im confused...any answers??our query here...

### output:

Interesting case. Not a frequent one too. In short, pregnancy test is positive but since levels of BChatDoctor are below the discriminatory levels nothing is seen at the Transvaginal (endocavitary) scan. You need about 2000 mid/DL BChatDoctor for a pregnancy to be seen in a high resolution scan. You have a condition called PUL (Pregnancy of Unknown Location) and serial measurements of BChatDoctor can lead to the right diagnosis, options are: in this order of frequency1.- Normal intrauterine pregnancy (UP), 75%2.- Miscarriage (spontaneous abortion, SA), 25%3.- Ectopic pregnancy (EP), 1%Since BChatDoctor duplicate its levels every 72 HS and considering 7 as the initial level by Sept 29th your BChatDoctor levels should have been about 400-500, this means that:1.- no normal duplication pattern is seen, pregnancy might not be right and there might a miscarriage or an ectopic pregnacy2.- discriminatory levels are not met and that explains why a gestational sac GS is not seen3.- there is still the possibility of a normal pregnancyWhat would I do? Wait, repeat BChatDoctor in about a week and perform another scan with the new resultsLevels fall, no GS on scan: miscarriageLevels rise, duplicate and GS seen: Sublevels rise but do not duplicate or reach about 2000, no GS is seen: considering EP and new levels are measured and scan performed about a week later if more than 2000 units are measured, and no sac is seen, I would consider / perform a laparoscopy