Confused by hospital decision

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Hi, I was just wondering if someone could share their thoughts/insights about my situation as I am feeling very worried.

I had my copper coil removed at the start of my cycle, and had a positive pregnancy test several weeks later, but this was after several days dark spotting and some red bleeding. The spotting has reduced, but is still present daily. The GP and hospital took my bloods three times over 8 days, and HCG rose as expected (more than doubled over 48 hours). Due to the bleeding I went for early tests yesterday (GP estimated me to be at 6+2 weeks based on last period but I have irregular cycles), bloods came back as an HCG of 2500, but a trans-vaginal ultrasound on the same day showed no sign of pregnancy at all (no gestational sac, no sign at all). From what I understand, a normal pregnancy should have definitely shown at this HCG level, and therefore it is very likely something is wrong, and hospital told me it could well be ectopic.

What worries me is that they have now told me to come back for more bloods in 5 days, and another scan in 10-14 days. I just don’t understand the reason for making me wait this long, if it seems pretty evident this pregnancy isn’t viable? I am worried that this is just increasing my chances of serious complications and risk of tube removal? I already have fertility issues due to PCOS and am really frightened things may get worse. Did anyone else experience a similar situatiin, or understand why the hospital is waiting so long to scan again?

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Hi There, I’m sorry to hear your experiencing this as I went through a similar situation only a month ago so I can understand how you are feeling.

The only difference with my story was that the hospital didn’t mess around, they acted quite quickly.

I had the same as you, the constant bleeding and increasing HCG levels and absolutely no signs of a pregnancy after 2 scans (a week apart from each other).

The day of the second scan, my bloods rose again and they operated the next day as the ectopic was on my ovary I was 6 weeks 6 days).

All I’d say is if in doubt keep pushing them, it does seem like a long time to wait considering your bleeding and having rising levels and especially as they can not locate your pregnancy on the scan.

Go with your gut and make sure they look after you and get you some answers quickly xxx

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p.s also it can be sometimes too soon to see the pregnancy on the scan, but like you I knew that considering how far gone I was even at my 5 week 5 day scan they should have seen something even if it was tiny but they didn’t. All they saw on the second scan was something close to or ob my left ovary which ended up to be the pregnancy. Do keep faith though just in case xxx

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Hi stephanie,

Thanks so much for your reply .

I am really sorry to hear that you went through this, wishing you lots of strength to cope!

When I go for my next blood test I’ll try to press them for some answers. It’s still 3 days away and I am feeling sick with worry, I really don’t know how I will cope if they make me wait another week after that…

Thanks so much for your support.

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Dear Skyla,

I am so sorry to hear of the worrying time you are going through, I completely understand your concern.

Unfortunately I am not medically trained but I’m presuming the doctors are waiting to rescan as your hCG levels are doubling as expected.

When diagnosing an ectopic pregnancy, doctors use a combination of transvaginal ultrasound scanning and blood tests to check HCG levels. Usually scans take place at around six weeks gestation as there is a reasonable chance of seeing an embryo at around this time. 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.

Having said this, I do think that if your bleeding worsens or you begin to feel pain which seems unusual and is concerning you I would seek urgent medical advice through your EPU as it is better to get checked out to be on the safe side.

Sending much love and warm hugs,

Karen x

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Oh bless you, isn’t it just awful

It’s the waiting that is the worst.

Sending you lots of love and support and please do let us know how you get on.

Hopefully you’ll get some answers in a few days, keep going, you’ll get there xxx

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Hi all,

Just an update for ladies with similar worries who might want to know my outcome.

After coming back for more bloods 5 days after my last post, it was found that my HCG had again doubled every 48 hours. I was then asked to come back for a scan in another week, so 12 days after the initial scan. This was yesterday, and they found the ectopic on my left ovary. As it was large, alive and growing, I was operated on within a few hours, they removed the tube and am now at home recovering.

All the nurses and doctors were extremely nice and caring when I was very upset and frighted, so huge respect to the NHS staff for acting so quickly and compassionately on the day of the surgery.

I would say that if I could go back in time or give advice to ladies going through a similar thing, to really insist on wanting closer monitoring instead of a wait of 12 days. From my understanding, my “empty uterus” scan at an HCG of over 2500 was a strong indicator of ectopic, and I can see in some online medical guidances, that women should really be monitored very closely with follow-ups every 48 hours in those circumstances. I feel that because my bleeding was minor and had stopped, because my HCG doubled normally, and because I did not present with abdominal pain, the risk of ectopic was not taken as seriously as it should have been, given that the scientific evidence shows that at those HCG values and an empty uterus the chance of ectopic is much much higher than a viable pregnancy (I am a research scientist for work so couldn’t help myself looking up the facts in the medical literature). I can’t help but think that if they had monitored me more closely, they could have found it at a smaller stage with more chance of saving the tube and improving my future fertility chances (not to mention that I was lucky I did not rupture during the 12 day wait…) I wish I had been more insistent on getting closer monitoring, and would recommend other ladies to speak out more than I did!

Sending my thoughts to all of you going through ectopic worries or recovery at the moment, it is just horrible…