Dear OlgaM,
I am so sorry to hear of your ectopic pregnancy and loss and 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. Whilst I was not diagnosed with a pregnancy of unknown location, I was admitted to hospital with a ? ectopic pregnancy on a Friday evening of a bank holiday weekend so I had to wait until the Tuesday to be informed that I was indeed having an ectopic pregnancy and it really was the most anxious wait.
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. For every 100 pregnancies labelled as a PUL about 10 will subsequently be found to be ectopic.
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.
Methotrexate does generally work well with low hCG levels as yours so although we cannot guarantee your levels will not increase, it is more likely to work with lower levels.
You should be having another blood test in the next few days. Do not worry as 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.
Your hCG levels will then continue to be monitored every 3-7 days to ensure that they are falling appropriately. Most women only need one injection but in up to a quarter of cases a further injection may be required if serum hCG levels are not decreasing.
I am sorry that I cannot provide you with more precise details but I hope all becomes much clearer over the forthcoming blood tests.
We are here for you for as long as you need,
Sending much love,
Karen x
The Ectopic Pregnancy Trust
Registered Charity Number: 1071811
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