Pregnant after ectopic and very worried

Pregnant After Ectopic Pregnancy
1

Hello,

I had a miscarriage/PUL in January last year, and an ectopic pregnancy in August which was surgically managed and resulted in the loss of my left tube. The surgeon told me my right tube was healthy.

I have been having twinges on both sides for a couple of days, and thought my body was just doing it’s pre-period routine, but then yesterday there were really only twinges on my right side, and a dull tense ache in my hip (like when you’ve been holding your leg a bit funny when sitting down or something) so did a test and it was positive. I was due to start my period today. The dull ache is how the pain began with my previous ectopic and I’m absolutely terrified that it’s happening again on the side with the remaining tube.

I’ve tried to get hold of the EPU after being told by the hospital switchboard last night that they were open 8am-6pm daily - apparently this isn’t the case and they’re not open until Monday.

I’ve been advised to go to an out of hours gp but they will surely all be full? This is also what happened in August as my pain became unbearable on a Saturday morning. I spent all weekend in the out of hours, a&e and a ward and nothing actually was done until the Monday morning - and that was with severe abdominal and shoulder tip pain.

I’m at a complete loss as to what to do, particularly want to avoid a&e if possible given the current circumstances, but extremely scared that this is another ectopic and will destroy my remaining tube if left over the weekend.

Any thoughts greatly appreciated as we are feeling completely abandoned at the moment.

Thanks

C

2

Hi Emufarm,

I am so sorry to hear you are going through this worrying time. It is very normal to feel anxious about pregnancies following our ectopic experiences. I know how challenging it can be in this early stage of pregnancy, and it’s easier said than done to attempt to relax and distract yourself from the sensations.

What I can offer is that it is important for you to continue to monitor your symptoms and take it easy. You may find that recording the symptoms helps, and these writings can be used when you see your GP. However, If you are feeling increasing pain, especially shoulder tip pain and/or heavy bleeding, it is important to be seen by a doctor or at A&E. Do not let the current COVID19 situation prevent you from getting any help you require.

Please take it extra easy this weekend and look after yourself, and make sure you reach out for the medical assistance you require if your symptoms increase or cause you concern.

With good wishes,

Michele

The Ectopic Pregnancy Trust

Registered Charity Number: 1071811

Ectopic pregnancy patient information suite: Highly Commended in the 2019 BMA Patient Information Awards

During the coronavirus outbreak, The EPT team is still working hard to provide crucial information and support to women and families experiencing ectopic pregnancy as quickly and efficiently as we can.

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

Hi Michele,

Thanks so much for replying so quickly!

I’m keeping track of symptoms and trying to take it easy. I finally got through to 111 who called back and advised waiting until Monday unless things get worse so will keep everything crossed that we’re able to do that.

Thanks again

Catherine

4

Just come back from epu after having to convince them to let me be seen. Apparently they can see something in the uterus but not conclusively, my remaining tube is full of fluid and the fluid in the pouch of Douglas? So it doesn’t look great I would say. I have shoulder pain and more constant abdominal pain as if this morning. They took bloods and are going to phone when they have results. I’m absolutely devastated to be in this situation again, particularly when they told me my remaining tube was healthy. It just feels like they’re waiting for a serious problem before anything will be done and I’m going to lose my tube Feeling very anxious and really not sure what to do.

5

Dear C,

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

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.

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.

Sending much love and positive thoughts,

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

6

Hi Karen,

Thank you for replying!

I did go back to hospital and was examined - they seemed to not be too worried and were happy for me to go home. I know I’m probably being overly anxious because of my history. I went back to EPU for a second HCG and the level has risen by 173%, so they have booked me in for a scan on Tuesday when I should be just over 5 weeks, and have told me I still have open access to SAU and should ring them or the EPU if things get worse. The pain is more of an achy discomfort but this is how it began last time, which is why I’m so concerned along with the scan showing fluid in my remaining tube and abdomen.

Is the hcg rise a likely indicator of it not being ectopic or is there still a risk - if so is there any information on how much of a risk? I understand if it’s not something that can be worked out, just curious as to whether an ectopic would still cause a level rise like that as the nurse I spoke to wasn’t very clear - she just said it could suggest an intrauterine pregnancy.

Also is there anything I should be doing to give this the best possible chance of not rupturing if it is ectopic - avoiding lifting etc I’m guessing but no one has been very clear on that either. I’m trying to rest a bit and a do sort of pottering about rather than anything too strenuous - is this what I should be doing in this situation?

Thanks so much for all your help and sorry for all the questions!

C x

7

Dear C,

Never apologise for asking questions that’s what we are here for.

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 really have friends here who understands how you are feeling.

To provide an overview - with a healthy pregnancy, hCG levels typically double every 48-72 hours. If levels rise normally, they can suggest (but not give a certain answer) that the pregnancy is implanted in the uterus. HCG levels that rise by less than 66 per cent over 48 hours can mean the pregnancy may be ectopic. So while hCG levels can rise with an ectopic pregnancy this isn’t necessarily at the “normal” rate. Declining levels can indicate that the pregnancy has ended - possibly a miscarriage or an ectopic pregnancy that is “self resolving”. It is difficult to predict what is happening with hCG levels alone and I hope your next scan will provide some answers and positive news.

Sadly there is nothing you can do to prevent ectopic pregnancy, but taking things easy, pottering about and not doing any heavy lifting won’t cause any harm and may help you to relax a little.

I wish I could give you more advice on how to count down the days to your scan on Tuesday. I truly understand what a nerve wracking time it is. Try to keep your mind busy, I know the current situation of social isolation may not help this, but anything you can do to pass the time, work, box sets, reading will all help.

I am sending so much love and positive thoughts,

Again, never apologise for asking questions on these boards, a lot of us have been in a similar situation and we do understand how you feel. We’ll be here for you for as long as you need.

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

Hi again, thanks for your kind words.

My scan today has shown that what they saw in my uterus has grown, and they might be able to see a yolk sac but aren’t sure. The fluid in my tube is still there, but they think slightly less. The fluid in my pouch of Douglas has gone apparently. I’ve got a collapsing corpus luteum in my left ovary?

They still can’t rule out an ectopic and I’m booked for another scan next week.

I’m really struggling with the uncertainty and every little twinge and every time I go for a wee I’m so scared of seeing blood. :frowning:

In the meantime I’ve been carrying on taking my boots conception vitamins as I haven’t got any pregnancy vitamins? Is this ok? The pregnancare ones I had said in the leaflet they were fine to continue with into pregnancy but the boots ones don’t say. I’m finding it so hard not to worry about every tiny thing. :frowning:

9

Dear Emufarm,

Not the definitive news you wanted but not completely bad news either. Hang on in there. It maybe just too early to see anything on the scan yet.

Sadly I am not medically trained so cannot give you specific advice on the vitamins you are taking. I know you have to be careful of so e vitamins during pregnancy and I have added a link on advice the NHS suggests regarding pregnancy vitamins.

https://www.nhs.uk/conditions/pregnancy … -pregnant/

If you have you have concerns over what you are taking please speak to your GP who may be able to advise you further.

Sending much love and I’m keeping everything crossed for next week.

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

10

Hi Karen, thanks for your reply.

I changed vitamins in the end, and at my scan yesterday they saw it’s not another ectopic, and there’s a tiny little heartbeat! I’m so happy and relieved, but still terrified that something will go wrong. I still have fluid in the tube and a bit in my abdomen, and the nurses I spoke to couldn’t tell me if this was a risk to the pregnancy, which I don’t find at all reassuring. Having suffered two losses I’m finding it very hard to not worry about everything, and they initially weren’t very understanding of that - telling me to just stop worrying as too much stress is bad for the pregnancy, which now makes me feel like if anything does go wrong it will be my fault for worrying!

I’m trying really hard to focus on the huge positive that everything is in the right place and they have a heartbeat but worries always find a way to creep in. I had a terrible dream last night that I was bleeding and had to run to the loo to check straight away.

I’ve still got an ache in my right hip which they told me was nothing to do with the fluid but I can’t see what else would cause that?

Sorry for the rambling/unanswerable questions - I’m just anxious and the nurses I saw although obviously trying to be helpful did very little to reduce this or even validate it as a normal feeling in my situation. I know how lucky I am and am really really happy, but all the previous worry that this could be an ectopic seems to have effortlessly morphed into fear of miscarriage.

C x

11

Dear C,

I’m so sorry that the scans weren’t as reassuring as you would like. It is great news that they were able to identify a heartbeat.

Are they planning on any further scans to check the fluid or are they hoping it will slowly be reabsorbed into your body?

I think it’s only natural to worry so don’t beat yourself up about it. I certainly worried throughout the early stages of my pregnancy, I think it’s normal when we have experienced loss.

I wish I could give you ideas of how to fill your days. With the current lockdown this is increasingly hard, but try to read books, watch box sets, anything you can do to take your mind off things for 5 minutes will help.

Plus keep in contact with us, we are here for you.

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