Pregnancy of Unknown Location

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1

Hello

I went for an early private scan on Sunday ( I’m meant to be 7 weeks), this is my first pregnancy and the sonographer labelled it as a pregnancy of unknown location, which was obviously devastating news.

They could see a fluid filled sac in my uterus, but no masses or fluids on my tubes or ovaries. They advised it could be one of 3 three things: 1. i’m too early so can’t see anything on the scan, 2. miscarriage, 3. ectopic pregnancy.

I have had no bleeding or pain.

I wondered if anyone had any experiences of this?

I have been referred to the hosptial and I am booked for Thursday, but I’m worried and scared. What tests will they do to find out what has happened?

Are they usually quick at diagnosing?

If it is found it is ectopic, what tests to do they do for that specifically?

I am beside myself and also worried what this means in terms of if I can get pregnant again, or will it happen again! I’m 35 and terrified of what all this means. There has been no support provided so far and i don’t know who to talk to.

Any advice, experiences of this would be really appreciated

xxx

2

Dear Claire,

I am so sorry to hear your the worrying time you are going through.

Not knowing what is happening to our bodies can be extremely overwhelming and you have a friend here who understands.

It is possible that you ovulated late so you may not be as far along as you thought. This happened to me and I attended a week later to see a little heart beat in the correct place.

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.

When diagnosing an ectopic pregnancy, doctors use a combination of transvaginal ultrasound scanning and blood tests to check HCG levels. Usually scans take place at around six weeks gestation as there is a reasonable chance of seeing an embryo at around this time. 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.

Unfortunately I am not medically trained and I am sorry that I cannot be more precise but it is good that you aware having another scan on Thursday which will give you further information. Whilst I do not wish to alarm you, I would advise to seek urgent medical advice with any bleeding, tummy pain, or you feel dizzy and unwell.

Sending positive thoughts for Thursday,

Sending much love,

Karen x

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