Dear Susie-J,
I am so sorry to hear you are going through this, it is such a difficult and confusing time.
It is important to understand that Pregnancy of unknown location - (PUL) 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. Dr’s usually carry out a transvaginal (internal) scan, to find the location of the pregnancy. You have not mentioned that you have been offered any scans, if you haven’t, I would ask your Dr’s as to why they haven’t offered you a scan and if they are planning to do so.
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.
Can I also remind you that if you experience any shoulder tip pain, worsening abdominal pain, bleeding or feel dizzy and unwell, please seek urgent medical advice.
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 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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