Expectant Management

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I was recently told that I am having an ectopic pregnancy and my treatment is currently expectant management. I’ve been in and out of hospital having blood tests and scans over the past week. I had to stay in overnight at the weekend due to pains but was discharged as the pains and bleeding has decreased. I’m not due back for another blood test until next week but just feel like I am a ticking time bomb and am just waiting for pain to appear.

Please can someone tell me what I should be expecting over the next week? Every time I feel a slight twinge I get scared and think I need to go back into hospital. Is this normal? Should I still be getting pain and bleeding as long as it’s not too severe?! Terrified that I might need to have surgery as this was looking likely at the weekend.

My latest HcG was 98.

Thank you

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Hi! I went through the same treatment and my initial levels were 980. In 4 weeks they went down to 220 after which no blood was drawn and I was supposed to take pregnancy test in 3 weeks time, which I did and it came negative. That meant I was all clear and didn’t need to do anything else. When my levels were around 220, they were decreasing by almost 40 % every week. Thats when I started to have stabbing pain on my right hand side ( upper back and breast) which usually would go away with 2 paracetamols. Sometimes it won’t but I was told this is likely to happen as that mean the tissue is trying to absorb itself in body. I had spotting all this while and yesterday I started bleeding which doctors think is my periods ( just 5 days after negative pregnancy test, which was a bit confusing for me but again I guess its norma because it does feel like periods). All my stabbing pain has gone and I am just having periods pain, not enough for me to take any painkiller. In your case, with your level, it should be okay. If your hcg is decreasing, thats a good sign and minimal chance of rupture. You will have pain as this could be a sign that tissue is absorbing itself. My doctor said, any pain that won’t go away with pain killer or will not reduce after one is when you would worry. Also, I started going back to work as soon as my levels were down to 480 as wanted to keep myself occupied. I liked talking about whats going on as it helped take away my stress and to realise that many have gone through the same. So I would say, keep yourself occupied so time can pass quickly and in no time you will heal.

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Dear A1893,

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

I understand how worrying it is when we don’t know what is going on with our bodies. Pain and bleeding is normal following ectopic pregnancy and as long as the pain can be managed by over the counter pain relief and isn’t worsening and you are not bleeding to heavily, this is normal. If the pain is increasing or you are bleeding so you are soaking a lad every 1/2 hour, please seek urgent medical advice.

Although expectant management can be a long drawn out process, it doesn’t have the side effects of methotrexate and isn’t as invasive as surgery and can work well as a treatment for a lot of women.

For now, be kind to yourself and allow time to grieve and heal both physically and emotionally,

Sending much love,

Karen x

The Ectopic Pregnancy Trust

Registered Charity Number: 1071811

Ectopic pregnancy patient information suite: Highly Commended in the 2019 BMA Patient Information Awards

During the coronavirus outbreak, The EPT team is still working hard to provide crucial information and support to women and families experiencing ectopic pregnancy as quickly and efficiently as we can.

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Further information is available at ectopic.org.uk

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Thank you for your replies.

I have found them both really helpful and reassuring. Sending love to anyone who goes through this.