Unknown pregnancy location - possibly ectopic

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1

Hi all,

Looking for some advice at this extremely confusing time.

I’m 7 weeks pregnant today, although I know I ovulated later than normal so I think a little less than that. I have been brown spotting all the way through since implantation but never any pain aside from the odd small cramping. Until a few days ago when it suddenly turned pink/red. Got an appointment at the Early Pregnancy Unit yesterday and the nurse couldn’t find the pregnancy. She wasn’t the most patient of nurses and was rushing through with lots of terminology. Apparently there is a sac of fluid, probably blood at the bottom of my uterus. Possibly 2. At one point she said, “that could be the gestational sac there” but it was small and hiding behind the other other sac of fluid. She said she couldn’t see anything in the fallopian tubes or ovaries.

Then I was left waiting for my hormones bloods to come back at they were super high. My previous HCG results were:

October 31st - 2200

November 2nd - 3600

Yesterday they were over 40,000!

They sent me home and have to return on Monday for another scan. They suspect Ectopic but also mentioned Molar.

Can anyone tell me these HCG figures are normal in Ectopic? I thought they should be lower. After crying for 2 days Im slowly getting my head round it but there is a tiny bit of me that cant get the unclear scan out of my head, where she mentioned something hiding behind he sac of blood. I know this doubt is probably there for everyone though. Any advice would be greatly appreciated. Today, brown spotting has returned and still no pain.

Thanks

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Dear Shonzee,

I am so sorry to hear of the worrying time you are going through. It can be very overwhelming when we have no clue what is going on with our bodies and you have friends here who understand.

If scans are also 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. As you can see, it is difficult to suggest what is going on in individual cases. You have had a very large rise in your hCG levels so It is possible that you ovulated late and it was difficult to see on the scan.

Whilst I do not wish to alarm you, until the location of the pregnancy is known definitively, there is a risk of complications associated with an as yet undiagnosed ectopic pregnancy. 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.

We would gently remind you to not undertake any strenuous exercise or lifting or housework while you are being investigated. While I do not want to alarm you, there remains the risk of rupture until the location of your pregnancy is known and you should seek urgent medical advice with any bleeding or abdominal pain or you feel dizzy and unwell.

I am sorry that I cannot provide you with more precise details but I hope all becomes much clearer over the forthcoming blood tests and scans.

We are here for you for as long as you need,

Sending much love,

Karen x

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