I’ve been diagnosed with PUL and possibly ectopic pregnancy, a tiny substance was found under my right ovary. My hormones have started decreasing rapidly after blood tests and scans were done. It’s currently 107 as at 8 weeks. I was meant to be on methotrexate but due to the hormones rapidly decreasing I’ve been put on wait and watch and was told if I’m having sharp pains on the shoulder, etc etc. I should ring the EPU. I’ve not experienced any sharp pain but I do get tingling pins and needles sensations on the right shoulder. It’s not painful at all I can move my shoulder but how do you explain it. The sensation is felt at the top shoulder and occasionally at the tip but no pain. Should I be worried? I’ve got a numb pain on my right stomach which settles after I take paracetamol. I have rang EPU and they are yet to ring me back.
Does anybody have the same symptoms? What should I do? :?
Your EPAU should be able to advise you when they call you back. I got a similar pain. In the end it felt like an ache in my shoulder and I got pins and needles all down my arm and in my fingers.
Although I had some free flowing blood, they weren’t majorly concerned as my levels were going down. Because I wasn’t in loads of pain they didn’t think I had ruptured but scanned just in case.
If it settles with paracetamol they might still want to wait and see but it’s always best for to check just in case
I later received a call from the EPU. I explained my situation and she explained it’s nothing to be worried about. Since the paracetamol I’m taking is able to keep it under control, it’s ok. A rupture would be certain if I have acute worsening pains that paracetamol can’t seem to stop, in that case I would need to come in immediately. I’m due to go back this week, hopefully my hormones have gone down.
I am so sorry to hear of the difficult time you are going through.
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. The doctors would also want to repeat the scan.
Until the location of the pregnancy is known definitively or the serum hormone levels have decreased to below pregnancy levels, there is a risk of complications associated with an as yet undiagnosed ectopic pregnancy. Whilst I do not wish to alarm you, for every 100 pregnancies labelled as a PUL about 10 will subsequently be found to be ectopic; but not all of these will need treatment. If treatment is required, (methotraxate injection or surgery) this will depend on the results of blood tests and scans and I would discuss this further with you Dr.
Unfortunately I am not medically trained and I know you have been told to return if you get any shoulder tip pain but I would advise to also seek medical advice if you experience worsening pain or your tingling in your shoulder does not ease.
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.
Sending much love,
Karen x
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