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

### input:
Hi! i was 5 weeks and 5 days pregnant and i started spotting in my sixth week of pregnancy. It started off with bright red bleeding that lasted only for a very short time and then turned brown and very light. it stopped the very next day. A day after that i started bleeding heavily, bright red and also passed big blood clots followed by severe cramping, dizziness and nausea. i went hospital that day and had both transvaginal and pelvic ultasound and the doctor said they could not see the baby in there but the blood test for ChatDoctor hormone came positive indicating i am still pregnant. Its been two days now and i am still bleeding, cramping and feeling dizzy. What does this mean?

### output:

By 6 weeks of pregnancy, we should definitely be able to see a baby and a heartbeat on ultrasound. What you are describing is concerning for a spontaneous abortion (miscarriage). The fact that they couldn't see a baby is also concerning. We have a rule in the OB world- a positive pregnancy test without visualization of a baby is an ectopic pregnancy until proven otherwise. An ectopic pregnancy is a pregnancy outside the uterus, usually in the Fallopian tube-this can be life-threatening and needs to be treated either medically or surgically. I am not fazed by the fact that your blood hormone Chat Doctor was positive- it can take a couple of weeks for the hormone to disappear from your system after a miscarriage or during an ectopic. Your hormone level needs to be monitored every 48 hours until your doctor can clarify if this is a miscarriage, an ectopic pregnancy, or a normal pregnancy. With the amount of bleeding you are having, it sounds like you are miscarrying. However, I cannot rule out an ectopic pregnancy at this point. Please follow up with your doctor as soon as possible, especially if you are still bleeding heavily or having a lot of pain. Heavy bleeding can make you anemic, which may mean you could need a blood transfusion. Severe abdominal pain is concerning for an ectopic. Either way, please follow up with your doctor. Best of luck!