Unfortunately, it sounds like a miscarriage- I'm so sorry! With the bleeding and the HCG levels going down- that is usually pretty clear indicators that a miscarriage is occurring. One of the really hard things about this situation though, is that, you do have to hang in there and wait and see for a little bit in order to be sure. Do you have a doctor or just visiting the ER? If you don't have a doctor, make sure you have one lined up that can advocate for you and explain what's happening a bit better. Are they going to check your HCG levels again? Do you have a follow up for another ultrasound? Those are two things that they can do- in about a week or so. The follow ups are going to give you the best idea of what is happening- but I know it's very hard to just wait to know for sure what is happening. Keep us updated on how you are doing.