Been told I may have an ectopic pregnancy

Hi

I am 6 weeks pregnant and had an early scan yesterday due to having a lot of brown bleeding. I was told they could see the gestational sac but no yolk sac or fetus. I had to have a blood test that is to be repeated again tomorrow and they will have a better idea on friday. I have been told to rest and wait. I am so worried. Nothing was really explained to me just that if I have severe pain or dizziness to go straight to a&e. Does anyone have any advice for me and what I can expect to happen next if it turns out to be ectopic?

Dear Sarah012,

I am so sorry to hear you are going through such a worrying time.

As you have mentioned that your scan showed a small gestation sac without a yolk sac or embryo, this is known as a Pregnancy of Unknown Location or PUL. This is not a diagnosis but a label until the final location can be identified with certainty. I cannot be sure, but it could be the case that it may be too early to see a pregnancy on the scan.

To provide an overview, if scans are inconclusive, doctors would carry out a series of blood tests to check hCG levels to see if the numbers are rising as expected. However, in isolation, hCG tests only provide a part of the picture - declining levels indicate that a pregnancy has ended and will be miscarried. It can also possibly indicate an ectopic pregnancy that is “self-resolving”. Also hCG levels rising by less than 66% over 48 hours means it is likely (but not certain) that it is ectopic. If levels rise normally, they suggest the pregnancy is implanted in the uterus. You may see from this that hCG levels only indicate certain possibilities and are not in themselves a definitive guide. A positive identification of an implanted embryo on a scan is usually needed before a final diagnosis/certainty that the pregnancy has implanted in the uterus. This is possibly the reason why your doctors are waiting until your appointment to carry out scans and tests.

Your early pregnancy unit, should have given you contact details should you experience any heavier bleeding, pain, shoulder tip pain, bladder or bowel problems or feel dizzy and unwell. If they haven’t and you start to experience these, please to to your nearest A&E department.

If you are sadly diagnosed with an ectopic pregnancy, treatment would depend upon your hCG levels and if there is any fluid seen in your abdomen on your scans. Options include surgery, methotrexate injection or expectant/medical management. These options will be discussed with you at the time but we have more information on treatment options here.

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

Please continue to rest, I will be thinking of you and am sending positive thoughts,

Much love,

Karen x


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