High hcg but empty gestational sac

Patient : LMP 1/7 had positive urine preg test 2/11 + beta hcg = 32000. 2/12 US showed empty sac - should I be concerned? Is this normal? I go back for repeat US 2/18 but am concerned if they will see yolk/fetal pole. Such high hcg should have shown something
Symptoms:  No pain or bleeding
Doctor :   Hi, Thanks for the query. I understand your concern. According to your last menstrual period, the gestational age by 2/11 will be 36 days or 5 weeks 1 day. Usually, Ultrasound can detect fetal pole with heart rate after six completed weeks of gestation. Generally in singleton pregnancy beta hcg levels at 5 weeks 1 day can range between 1,200-1,800 mIU/ml. But multiple gestations like in twin pregnancy, at this gestational age high beta HCG levels can be expected like around 2,400-36,000 mIU/ml. Another rare possibility is a molar pregnancy. To come to one conclusion please go for repeat ultrasound after 1 to 2 weeks as advised by your doctor, possibly by the time yolk sac with fetal pole can be detected. Hope this helps. Take care.

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