After injection and HCG dropping

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1

Hi all,

I was discharged by the hospital on Thursday after being seen for ectopic pregnancy, 1 dose of methotrexate. HCG dropped from 2000 to 25 within 3 weeks. I am happy things went well but I am still worried. Last Saturday, 2 weeks through the treatment, I had a horrible abdominal pain I thought the tube ruptured, but the pain eventually eased. I still went to A&E but they didn’t know what the problem was (note that they said they couldn’t perform a scan that night and that I had to wait until the following morning, what if I had been bleeding inside?).

Now my HCG levels are somewhere between 25 and 0 and I was told that there is no risk of rupture anymore, but I still feel pressure on my left side (the ectopic is sitting in the left tube and is still there as the last ultrasound scan showed 2 days ago, no internal bleeding). I feel pressure/discomfort while walking or sitting (today even when passing urine) . I am concerned but as the scan showed nothing was wrong, I don’t know what to do? Go back to the Unit and ask for another scan or just sit and wait. I guess I am horrified that I would experience similar pain and have to go to A&E again, so trying to anticipate!

I would love to hear from anyone with any info on this/ similar experience of pain/pressure/ discomfort even after HCG dropping very low (it could be even 0 by now)!!

How long does the mass take to disappear? I found it weird that the hospital requires no follow-up scan to check the state of the tube and the mass even in 3 months’ time). They said they don’t know how long it will be there!

2

If it were me, i’d be heading back to the early pregnancy assessment unit or equivalent. Better to be in and out the hospital for nothing, than sit at home and something is going wrong and no one knows!

3

Dear Micha,

I am so sorry to hear of your ectopic pregnancy and loss,

Sadly I am not medically trained so cannot give you specific advice on your symptoms however if you are concerned, we would always advise to seek a medical opinion.

It is usual practice for the hospital to complete regular blood tests to monitor your hCG levels until the tests are negative. This can take several weeks and this will be explained by your doctor. Your hospital will make arrangements for you to have the hormone level checked. We usually advise that you have bloods until levels have reached 5mIU/mL or below, so I would discuss this with your EPU.

It is not common practice to have scans following ectopic pregnancy in the UK. The ‘reabsorption’ you refer to can take weeks and sometimes months to be complete. I am afraid it can be difficult to be precise because our bodies are all unique and we respond differently physiologically with what is happening. In some instances, the fallopian tube may remain blocked by the pregnancy tissue which can take some time to shrink and, occasionally, it may not shrink and will leave a blockage in the tube by way of a small cyst. However, the treatment does not reduce the chances of successful future pregnancy, whatever the outcome in the affected fallopian tube.

We have further information on what to expect following treatment for ectopic pregnancy here-

https://www.ectopic.org.uk/patients/treatment/

Whilst I do not wish to alarm you if you experience any unusual bleeding abdominal pain, shoulder tip pain, bladder or bowel problems or feel dizzy and unwell please seek urgent medical advice.

Sending much love,

Karen x

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