Advice on PUL/possible ectopic appreciated

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1

Hello,

I wanted to post on here as I’ve found other people’s stories about PUL/ectopic really helpful and I’d be really grateful if anyone might be able to share a similar experience or provide any advice to my current situation.

I started what I thought was my period on 20th Jan and thought nothing of it until I realised I had been bleeding for 8 days. That evening I stood up and had quite a lot of blood and I don’t know why, but I took a pregnancy test and it was positive. Due to the bleeding I assumed I was miscarrying and scheduled a doctors appointment the next day. I had two positive tests at the doctors and a scan was arranged at EPU the following Wednesday when I would be approx 6+1 to either confirm miscarriage or if it is a viable pregnancy.

I continued to test positive on pregnancy tests but was also continuing to spot, and at the scan they confirmed they couldn’t locate any pregnancy so assumed it was a miscarriage, but she did notice a very small swelling on my right fallopian tube so to be safe she arranged bloods to be taken. I had bloods that day then another in 48 hours. My levels so far on my blood draws have been:

140 HCG

237 HCG

317 HCG

I have had another scan where they are now classifying it as PUL, but have another blood draw this Friday, so five days since my last blood test. I feel completely anxious about the prospect of an ectopic pregnancy and possible rupture. Should I go to EPU prior to Friday and explain my nerves? Any advice or similar experiences would be really appreciated.

I also feel like nothing more has been discussed in relation to expectant management or medical management and I feel like I’ve been really badly handled in the process so far.

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Dear Tweetiepie,

I am so sorry to hear of the worrying time you are going through.

Not knowing what is happening to our bodies can be extremely overwhelming and you have friends here who understand. Whilst I was not diagnosed with a pregnancy of unknown location, I was admitted to hospital with a ? ectopic pregnancy on a Friday evening of a bank holiday weekend so I had to wait until the Tuesday to be informed that I was indeed having an ectopic pregnancy and it really was the most anxious wait.

It is important to understand that Pregnancy of unknown location - (PUL) is not a diagnosis; it is a label given until the final location of the pregnancy can be identified with certainty.

In the event of a PUL, blood will be taken to measure serum progesterone and hCG and the hCG test repeated 48 hours later. The doctors would also want to repeat the scan. Until the location of the pregnancy is known definitively or the serum hormone levels have decreased to below pregnancy levels, there is a risk of complications associated with an as yet undiagnosed ectopic pregnancy.

Whilst I do not wish to alarm you, for every 100 pregnancies labelled as a PUL about 10 will subsequently be found to be ectopic; but not all of these will need treatment. If treatment is required, (methotrexate injection or surgery) this will depend on the results of blood tests and scans and I would discuss this further with you Dr.

Although I do not wish to alarm you, please seek urgent medical advice if you experience worsening pain or bleeding, shoulder tip pain, or dizziness or feeling unwell. We would gently remind you to not undertake any strenuous exercise or lifting or housework while you are waiting further tests.

I am sorry that I cannot provide you with more precise details but I hope all becomes much clearer over the forthcoming blood tests and scans.

We are here for you for as long as you need,

Sending much love,

Karen x

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3

Heyyy

I had a PUL in November and diagnosed last week as an EP. Both times I had to ask for next steps dependant on upcoming hcg results and scans.

Hopefully you have answers by now but if not it might be worth explaining you would feel calmer if you know some possible outcomes. I think sometimes they prefer to take it one step at a time. But for me, heck, I’d like a flow chart.

Thinking of you!