Ectopic or miscarriage

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1

Hi

I found out I was pregnant with my 3rd on the 9th august and thought I was about 5 weeks, I got a little bump and was considering and early scan but decided to wait. I started bleeding on the 19th sept. Had a weekend of hell of being fobbed off so on the Monday after chasing and chasing for a referral for early pregnancy and being told by my own midwife ‘she was driving and couldn’t deal with me and to be honest there wouldn’t be anything early pregnancy could do for me anyway’ I was seen by them on the Wednesday. Told I had no baby and they weren’t sure what they were looking at so sent for hcg blood tests. Things got really bad pain and bleeding wise on the Friday and with an Open access letter for gynie I went up there. Examined by a Dr who told me it can’t be ectopic because my cervix was open he removed something and sent it for testing and made me sign a form to say they’d cremate it. I had a blood test the following day and was told Monday by early pregnancy they still weren’t happy with my levels as they were going down so slowly. Another blood test still not happy come in for a scan. Had the scan this Thursday just gone the sonographer told me there’s still a lot left inside to come out, nurse said she’ll get consultant to look at everything and push for medication to speed things along. Consultant not happy with what they saw on first scan still can’t rule out ectopic and another blood test scheduled for Monday.

Sorry for long post but I just feel lost. It’s coming up for three weeks since this began I have no answers my head is all over the place is it ectopic am I at risk? Is it a miscarriage the longer this all stays inside me I’m at risk of infection? I just want this whole thing over and I feel like I’m getting no answers and the only time I’m going to get answers is if something bad happens to me.

Thank you for reading

Hannah

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Dear Hannah,

I am so sorry to hear hear of everything you are going through.

Not knowing what is happening to our bodies can be extremely overwhelming and you have friends here who understand.

If scans are inconclusive, doctors would normally 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.

If scans and blood tests are inconclusive, this is known medically as a Pregnancy of unknown location - (PUL). It is important to understand that this 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, (methotraxate injection or surgery) this will depend on the results of blood tests and scans and I would discuss this further with you Dr.

We would gently remind you to not undertake any strenuous exercise or lifting or housework while your hCG levels are dropping. While I do not want to alarm you, there remains the risk of rupture even with low or declining hCG levels. You should not resume exercise until your hCG levels are falling consistently and are in the low 100s.

I also need to remind you to seek urgent medical advice with any worsening pain, bleeding, shoulder tip pain or you feel dizzy and unwell.

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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Thank you for your reply,

I got called last Thursday and went in Friday to received the pessery tablets for medical management/retained products I asked what had changed from earlier in the week when I was told this absolutely wasn’t an option, and to be honest there wasn’t really an answer for it, there were no test results from the product I had removed. I did the medication on Saturday and have been bleeding since but not huge amounts and I’ve lost one clot, the bleeding is really brown and not heavy at all. I’m approaching 4 weeks of wearing pads now and feeling so sore and fed up. I’m struggling with the constant changes in hormones and some days can’t even concentrate through feeling miserable and anxious.

The hospital told me to do a pregnancy test after 3 weeks and that’s it I was never told where the pregnancy was located and once this is over I think I’m going to book a private fertility scan as I will always worry

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Poor you Hanaban. You’ve really been through the mill!!

I had to last just over a week not knowing if I was pregnant or had miscarried and it was so hard. The end result was that I had an ectopic (found this Monday and op on Tuesday).

My HcG levels were doubling nicely and my progesterone was as it should be. The HcG did not reveal a problem!! The empty uterus on the scans did though and luckily they found the ectopic!

I’m so glad that you are now getting treatment rather than being fobbed off. Keep aware of your symptoms and don’t feel daft for contacting the EPU with anything that feels not quite right!

Sending love x x