PUL - possible ectopic

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Hi all! Not sure why I’m writing this post, just need to put it into words I think and maybe some of you lovely people will have a bit of advice.

So I am supposed to be 6 weeks+2 today according to my last period but I’m not convinced I am that far along due to irregular cycles. I was referred to a&e last Friday due to light bleeding after bowel movements and they took my hcg levels - it was 162 and I was told this was too low and I was going to miscarry. They booked me an appointment for the epu on Sunday and obviously I was devastated.

Went to epu and they said they couldn’t know for sure if I was miscarrying, did a scan but the lady said she would be v surprised to see anything and took more bloods. Unfortunately hcg came back at 178 - a very minimal rise and said I have a “pregnancy of unknown location” which could possibly be ectopic and I have to go back tomorrow morning for more bloods.

I havnt had any bleeding since, it’s only ever been when I wipe then it goes away. I’m stuck in this weird middle ground where I havnt miscarried but I know the pregnancy isn’t likely to be viable. Every symptom i still have is reminding me that something is still there but that something won’t ever be a baby

Sorry for the rant but feeling quite alone and need to get it off my chest xx

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Dear HMarshall90,

I am so sorry to hear of the difficult time you are going through. You are so right, the not knowing and waiting is so difficult.

A Pregnancy of Unknown Location or PUL, is not a diagnosis but a label until the final location can be identified with certainty, which is why your Dr’s are requesting further blood tests.

As an overview for hCG blood tests. If scans are inconclusive, doctors would normally 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 to carry out scans and tests.

Whilst I do not wish to alarm you, sadly I do have to remind you that if you begin 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.

Importantly, you are not alone. We are all here for you and will be for as long as you need,

Sending much love and warm hugs,

Karen x

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