Pregnancy of unknown location

Other Pregnancy and Baby Loss
1

Hi all

I found this amazing website after surfing on internet for the past few days… I thought of posting my experience just in case this might help someone one day and to get some moral support as i feel totally confused, sad, guilty… and I couldn’t stop crying…

I’m 35 years old and my DH is 39 yrs, We have been trying since 2021 and on January 04th when i saw the bfp we were over the moon… So happy but it didn’t last 48h… I started to get brown discharge and cramps (which i didn’t have in my previous pregnancy) so i knew that it is not normal to have these… I rushed to the emergency unit they tested my hcg level and did a transvaginal ultrasound… For them technically based on my last period i was 5 weeks 3 days on 8th January and no gestational sac visible which was alarming for them. They asked me to come back after 48h to check how far my hcg rises…

08 jan -1514

10 jan - 1920

12 jan - 2459

14 jan - 3624

16 jan - 5543

With >5000 they must have seen a gestational sac but nothing was visible in my uterus, fallopian tubes or ovaries… So they rule this out as an ectopic pregnancy or a miscarriage non-scalable (moderate growth of hcg without doubling)… It was totally devastating… I had no other choice but to accept the methotrexate injection…

I had my 1st shot yesterday… My spotting stopped and no cramps so far thankfully.

I have my next appointment this Friday, i really hope the injection will do the deed and my hcg level declines if not i will have my second shot or a surgery…

A roller-coaster experience just in a week period… I can’t stop thinking of the baby I lost and just can’t believe this is happening and all the whats if’s are killing me. … I might sound stupid but i really believe I’m wrong with >5000 hcg level could they have missed the gestional sac? should I waited another 48h? How is my hcg rising but nothing is seen in the ultrasound??? This really makes me wonder how is it possible?!! … I feel guilty… No words to express my feelings and thoughts… I feel empty… Has anyone experienced the same thing? Thank you

2

Dear BB3,

I am so sorry to hear of your loss,

When we experience loss, it is very common to have feelings of guilt. From the bottom of my heart, there is nothing you could have done to prevent this from happening and I am so sorry you are going through this.

Although it can be difficult to see any pregnancy at lower hCG levels, your hCG levels weren’t rising as expected and sadly, I don’t think you would have had positive news of you had waited another 48hours.

You mention you may need another injection if your hCG has risen, however the hCG level often rises on the day four blood test because the action of methotrexate is not instantaneous, so the cells will have continued to divide for two or three days after the injection was given, and some cells release more hCG when they start to disappear. Your doctors are looking to see a drop in your hCG value of at least 15% between days four and seven. If there has not been a 15% drop, this is when the doctors will consider a second dose of methotrexate or surgery.

Diagnosis of baby loss, going through treatment and the loss of our babies can be very overwhelming and your feelings are completely normal. He kind to yourself and allow time to grieve and heal physically and emotionally.

We will be here for you for as long as you need,

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

If we have been able to help you, are you able to help us with a small donation or by volunteering or fundraising?

Further information is available at ectopic.org.uk

Email us: ept@ectopic.org.uk

We provide a call-back helpline service: 020 7733 2653

Take a look at our newsletters and subscribe to our mailing list here: https://mailchi.mp/986bdd6091ee/ectopic-matters

Detailed medical information can be found on our website. Please remember online medical information is NO SUBSTITUTE for expert medical advice from your own health care team

3

Thank you very much Karen. I’ll keep you posted.

4

Hello

Update: So my hcg level didn’t go down after the first methotrexate injection that I had on Jan 16th, and to my surprise it went up by +2K!!

20 Jan- 7464

23 Jan- 8444 - 2nd Metho shot

27 Jan- 7970

30 Jan- 6130

I was spotting and didn’t have heavy bleeding…but on the 31st jan, technically, after a week after the 2nd shot, I had heavy bleeding, lots of blood clots and cramps. I have adenemyosis, I usually have strong cramps during my period, but this was extremely painful. I rushed to the emergency, they checked and everything seemed normal.

So I had heavy cramps and bleeding for the next 6 days and I really think I got my period. CD5 SEVERE cramping and I think I had decidual cast came out after that, cramping stopped but I bled for the next two hours, then slowly stopped.

I had my visit this morning. The intern who examined me told me that I shouldn’t bleed like I did if it was an ectopic pregnancy! However in my case we never found anything I probably think I miscarried not completely as my hcg wasn’t doubling (one of the doctors who examined me did propose this theory). I was actually sick before Christmas and took some antibiotics (I wasn’t aware that I was pregnant/will get pregnant that cycle) I feel like it had something to do with it…I really don’t know and will never know.

I got the call from the doctor…Finally my hcg levels have dropped!!

06-Feb - 1360

I feel relieved at the same time I will never have an answer if it was a normal pregnancy but I had a miscarriage or a PUL…

I will need to follow up until my hcg is below 5.

Thank you for reading.

5

Dear BB3,

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

It is good to hear that your hCG levels are finally reducing, I know this has been such a long drawn out process for you and you must feel exhausted.

In your circumstances, with never having a positive identification of an ectopic pregnancy, it is difficult to say what was your actual diagnosis, and I’m sorry you haven’t had the closure in this.

For any future pregnancies, I would follow the guidance we usually give and request an early pregnancy scan at around 6 weeks, you can do this by self referral to your local EPU if you are in the UK, or by speaking to your GP surgery or medical team who can arrange this for you.

Sending positive thoughts that those hCG levels continue to drop quickly and you get to pre pregnancy levels very soon.

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

If we have been able to help you, are you able to help us with a small donation or by volunteering or fundraising?

Further information is available at ectopic.org.uk

Email us: ept@ectopic.org.uk

We provide a call-back helpline service: 020 7733 2653

Take a look at our newsletters and subscribe to our mailing list here: https://mailchi.mp/986bdd6091ee/ectopic-matters

Detailed medical information can be found on our website. Please remember online medical information is NO SUBSTITUTE for expert medical advice from your own health care team

6

Dear Karen,

After 2 shots of methotrexate and all those blood tests every other day and the wait, I finally had my salpingectomy last night. I had severe abdominal pain on the right side and lost consciousness. Thank goodness I was on wfh yesterday and my husband was there at the time. We called the pompiers aka Fire Brigade (we live in France) and I was rushed to the emergency. I was pale, the fact that my blood pressure had dropped a lot, and they could see blood in the abdomen they arranged for an emergency operation. I was under general anaesthesia, I panicked a lot as everything happened so fast from the relief of having the hcg to drop around 1360 then alas I was in the operating theater so hard to digest.

They found my right fallopian tube ruptured, they had to remove it. Fortunately it did not affect the right ovaries and my left fallopian tube and the ovaries apparently were healthy. They told me that I arrived at the right time so they were able to deal with it appropriately and that everything went well. I left the hospital tonight.

To be honest, I feel relieved, because I kinda feel like I have a closure now. Ironically, my first ER visit was on January 08, and on February 08, it all came to an end!

I have post op pain but somehow, I feel relieved that the bleeding has stopped. It will definitely take time to start TTC again as we will need to prepare emotionally and physically.

Thanks for your help,

Kind regards.

7

Dear BB3,

Oh my gosh, I’m so sorry to hear that you had to have surgery after everything you have been going through. I totally understand the feeling of relief and being able to draw a line in the sand.

Generally speaking, you should take it very easy 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 so please do be kind to yourself. Recovery can take time and some days will be better than others. One day you may be okay and the next you may be 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 signals. Pain and feeling tired are your body signals to tell you to rest. We suggest keeping a healthy diet drinking lots of water and resting.

Above all be kind to yourself and allow time to grieve and to heal both physically and emotionally

We will be here for you for as long as you need,

Sending much love,

Karen x

The Ectopic Pregnancy Trust Registered Charity Number: 1071811 **************************************************************************

If we have been able to help you, are you able to help us with a small donation or by volunteering or fundraising?

Further information is available at ectopic.org.uk Email us: ept@ectopic.org.uk

We provide a call-back helpline service: 020 7733 2653

The latest EPT newsletter is out now! You can take a look at the Winter edition and subscribe to our mailing list here: https://mailchi.mp/986bdd6091ee/ectopic-matters

Detailed medical information can be found on our website.

Please remember online medical information is NO SUBSTITUTE for expert medical advice from your own health care team

8

Thank you very much for your kind words and moral support Karen.

Love X