Confused on HCG levels and growth

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Hello, new here.

It’s nearly been a week post op for my ectopic pregnancy.

I had some questions that I had hoped the ward may have answered but they couldn’t give them I’m hoping I might be able to get some clarity here.

Two weeks ago it was assumed I was having a miscarriage, my HCG level was at 223 and then two weeks after I had the most terrible pain with HCG levels 40 luckily they took my pain seriously and I was taken to theatre to have my left tube and mass/foetus removed.

The thing I am struggling to understand is if my levels were so low does it mean the foetus was not alive or growing? But then why did I rupture so I assume it was still growing.

We have the chance to pick up the remains but in our minds we said goodbye two weeks ago when I was 5 weeks and thought it was a miscarriage telling myself it was cells and nothing that resembled anything baby like but at 7 weeks when they realised it was ectopic I have no idea if the remains will be baby like given the low HCG levels. The nurse has agreed to look at the remains and report back on what they look like for us to then decide how to proceed.

Am I to assume it was growing normally?

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Dear LTQKVS,

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

This is a slightly difficult question to answer as we do not have access to your medical and scan results. I would assume that the foetus stopped growing and so your blood hCG levels started to decline. This would not mean that the foetus would shirk in size as quickly and it is likely that it remains the size of was when it stopped growing as masses can take some months to be reabsorbed and reduce in size. It may have caused slight damage to your tube which then decided to rupture at the last minute.

We often wrongly assume that we cannot rupture with low or declining hCG levels, but as you have experienced, this is not the case. I’m sorry you have had to go through this often frightening experience, please take things easy. He kind to yourself and take time to heal both physically and emotionally.

We will be here for you for as long as you need,

Sending much love,

Karen x

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Thank you this was really helpful x