Dear upanddown,
Whispered congratulations on your pregnancy.
After an ectopic pregnancy, finding we are pregnant again can be a mix of emotions and I can completely understand your feeling nervous. It is perfectly normal to feel scared after the ordeal you have endured. I also felt twinges and aches after my ectopic pregnancy, particularly when I next felt pregnant. My mind started racing and I was only really able to relax to some degree after my early scan. It is a nerve-wracking time and you have a friend here who understands how you are feeling.
Speaking from UK medical practice and standards, usually doctors carry out an internal transvaginal scan at around six weeks with subsequent pregnancies after an ectopic. This is because there is a reasonable chance at six weeks of seeing an embryo around this six week mark.
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.
It is very encouraging to hear that your hCG levels are rising. I am afraid it is not possible for me to draw firm conclusions from limited readings and also I am not medically qualified. I wish I could give you the comfort that you need but I am afraid it is not possible to say whether or not a pregnancy is ectopic from stand-alone hCG reading.
Having said this, I do think that if you are currently feeling pain which seems unusual and is concerning you and, in particular, if you experience any bleeding or spotting, it is better to get checked out to be on the safe side. As pain is unique to each person and I have such limited information, it would be better to get professional medical assistance by someone who can examine you. Visiting the hospital would give you peace of mind and, if you explain your previous ectopic pregnancy and the pains you are experiencing now, they would be able to check your symptoms and assist you.
To answer your question, symptoms for an ectopic pregnancy can show as early as four weeks gestation. However it may be of some comfort to be aware that the chances of a further ectopic after a first in UK is 10%. So thats 90% chance of the embryo being in right place next time.
I wish I could give you advice on how to ease your worries but I know for me, it was the first thing I thought about in the morning and the last thing I worried about at night. Take each day as it comes and try to take things easy.
Sending much love,
Karen x
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