Hi, I just had the methotrexate shot 5 days ago, but etopic ruptured and I had to have the Laparoscopic surgery two days ago. Online it says to go back to ER if clots are over a quarter sized but I’m not filling up a pad of blood or anything, just regular light bleeding and these clots. Did anyone else experience anything similar?
Dear Tbayless,
I am so sorry to hear of your ectopic pregnancy loss.
It can be common to experience bleeding with clots.
The bleeding that follows an ectopic pregnancy, particularly when treated with methotrexate, can be very heavy and clotty and result in the passing of what we call a decidual cast. This decidual cast can cause confusion and worry and it can often be mistaken for the tissue of their baby.
The lining of the uterus when we are pregnant, other than that which is taken up by the placenta, is called the decidua. The appearance of the normal lining of the uterus by the presence and action of progesterone (hormone that prepares the uterus for a fertilised egg) becomes decidualised. When an area of the decidua is shed we call it a decidual cast. It is thought to occur as a result of the lack of stability of the integrity of the lining and this lack of stability is because the hormones aren’t functioning properly in an ectopic pregnancy.
The sudden drop in hormones can cause the pregnancy tissue inside the uterus to be shed in layers and the material that is passed can be grey, pink or white as well as appear like a clot or dark or frank red blood.
We are unable to provide individualised medical advice so if you are concerned about the clots or bleeding, especially if you need to change your sanitary pads more than every 30minutes please seek urgent medical advice.
General advice following surgery is that you should take it very easily for about six weeks after surgery. Your body will be using its energies to heal internally. It is normal to feel physically and emotionally exhausted during this time and please do be kind to yourself. Recovery can take time and some days will be better than others, one day you maybe ok and the next you maybe in discomfort or more emotional. This is perfectly usual and the healing process will go back and forth in this way for however long you need. It is important to listen to your body’s signals and pain and feeling tired are your body’s signs to tell you to rest. We suggest keeping a healthy balanced diet, drinking lots of water and resting. Once your wounds have healed, very gentle exercise such as a short walk can help, but please do take this slowly.
Best wishes,
Karen x
The Ectopic Pregnancy Trust
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