Very confused. PUL / Ectopic …

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1

Hi ,

I am happy I found this forum.

I am currently going through the worst time. I found out I was pregnant which was a shock due to taking plan B then having the most heavy period ever. I didn’t think much of it as apparently plan b can do that. I also shed a lot of tissue which didn’t concern me.

I then started to still have cramps after my period and decided to check for pregnancy. I saw faint lines but thought it was false , I took them for a few days and they got darker. After that I spoke to my GP as I didn’t know how I had faint lines after having my usual period which was very heavy. I was referred to early pregnancy.

Yesterday they confirmed my pregnancy via urine and took a blood sample in which I will take another one tomorrow to compare HCG levels. They did an internal scan which showed completely nothing , no sac or signs of miscarriage. I did a clear blue which shows I would be around 4 weeks. The hospital think it’s a pregnancy of unknown location or ectopic.

I have very dull right side pain in my hip , lower abdomen and shoulder. I have an appointment tomorrow but will go to a&e if it gets much worse over night.

Has anyone else gone through this?

I feel bad as I didn’t want a child right now but over time I have started to accept that maybe I could be a mother as I had to do a termination in the past and can’t possibly go through a similar experience.

Sorry for the long paragraph. Apart from

My partner I haven’t told anyone … x

2

Hi im so sorry your going through this the worry is something else to say the least!

I had a PUL but sometimes it’s just far to early to see anything in the scan. I’d advise you to push for more ultrasounds and if you do get any severe pain head straight to your local A&E! It could be a miscarriage love is you’ve bled already! But I’m no doctor or midwife I just know what it’s like to be in limbo and worry!! Anyways… my inbox is open :sparkling_heart: take care and take each day for now

3

I had a pregnancy in an unknown location too. I had a dull ache in my left hip and shooting sensation at 5 and a half weeks. I put it down to wind and wind trapped in my hip. Loads happened like a pointless trip to A and E being told its likely nothing. In the end my bloods showed my hcg went up and no signs of a baby in the uterus so had methotrexate injection which I was given a choice and had only a few minutes decide between that and surgery. This was all in December and March I was back to normal as hcg was 0. Hope everything goes OK for you.

Barbiedollx:
Hi ,

I am happy I found this forum.

I am currently going through the worst time. I found out I was pregnant which was a shock due to taking plan B then having the most heavy period ever. I didn’t think much of it as apparently plan b can do that. I also shed a lot of tissue which didn’t concern me.

I then started to still have cramps after my period and decided to check for pregnancy. I saw faint lines but thought it was false , I took them for a few days and they got darker. After that I spoke to my GP as I didn’t know how I had faint lines after having my usual period which was very heavy. I was referred to early pregnancy.

Yesterday they confirmed my pregnancy via urine and took a blood sample in which I will take another one tomorrow to compare HCG levels. They did an internal scan which showed completely nothing , no sac or signs of miscarriage. I did a clear blue which shows I would be around 4 weeks. The hospital think it’s a pregnancy of unknown location or ectopic.

I have very dull right side pain in my hip , lower abdomen and shoulder. I have an appointment tomorrow but will go to a&e if it gets much worse over night.

Has anyone else gone through this?

I feel bad as I didn’t want a child right now but over time I have started to accept that maybe I could be a mother as I had to do a termination in the past and can’t possibly go through a similar experience.

Sorry for the long paragraph. Apart from

My partner I haven’t told anyone … x

4

Thank you for the comments and advice. Very grateful.

Currently bleeding as I woke up with light brown discharge which has darkened over the hours. Slight cramps which have become more dull over time. HCG test taken again to compare it to the last ones and will see what they say. Not sure what’s going on x

5

Once they can compare your HCG levels they will be able to tell you if they believe it really is an ectopic pregnancy. Then depending on your levels, if it’s really high, they will say surgery, if it’s moderate they may let you choose surgery or the methotrexate injection and if it’s dropping and quite low they will do expectant management where they let the body naturally work to expel the pregnancy.

Have they told you to take pain relief if it gets bad? I was told I could have Paracetamol or codeine that had paracetamol in the capsule. Try not to worry.

6

Hey ,

They called me today and my HCG levels barely increased. It was 273 and now only 313. I am booked in for another blood test in 4 days to see if it has got any better. They didn’t give me much advice on pain killers , just told me to call if I get heavier bleeding or pain. Luckily I live close to my local hospital. Thank you for your reply. Hope you are coping ok xx

7

A slow rise doesn’t always mean its an ectopic. That’s why I think they are continuing to monitor your HCG. It could be the first signs your hcg is slowing down to get to a stage of decreasing and may be a miscarriage which wouldn’t be a complication like an ectopic. Although I know your side does hurt. Your HCG counts are in the 100s so at least if it is ectopic it shouldn’t be a long drawn out ordeal. Keep us updated.

8

Dear Barbiedoll,

I am so sorry to hear of your ectopic pregnancy loss,

Whether a planned pregnancy or not, It can still take its toll on us emotionally and physically and you have friends here who understand.

If no pregnancy can be seen in the uterus, or there is a small gestation sac in the uterus without a yolk sac or embryo, the pregnancy will be medically labelled as a Pregnancy of Unknown Location or PUL. It is important to understand that 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. For every 100 pregnancies labelled as a PUL about 10 will subsequently be found to be ectopic; and not all of these will need treatment.

If you have not been told what pain killers to take, I would advise on speaking to a pharmacist about over the counter medication. As you have been informed, It is important to seek urgent medical advice with any worsening bleeding or pain or you develop shoulder tip pain or feel dizzy and unwell.

I hope all becomes clearer in the next few days,

We will be here for you for as long as you need,

Sending much love,

Karen x

The Ectopic Pregnancy Trust

Registered Charity Number: 1071811

The EPT is awarded the PIF TICK as a Trusted Information Creator, the UK-wide quality mark for healthcare information

If the information provided here or through the EPT website has helped you, you can donate towards our support services, volunteer, or fundraise to raise awareness.

Further information is available on our website.

Email us: ept@ectopic.org.uk

We provide a call-back support line: 020 7733 2653. We are able to provide support in multiple languages including British Sign Language.

Take a look at our newsletters and subscribe to our mailing list.

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

9

Just wanted to give an update.

Ectopic pregnancy was ruled out and I’ve ended up having a miscarriage as I found out my levels dropped to 118 today.

Thank you for the advice given during the hard time. X

10

Dear Barbiedoll,

I am so sorry to hear of your loss,

Sending lots of love and warm hugs.

Whilst we will be here for you for as long as you need, the miscarriage association also have a lot of information and support on their website.

https://www.miscarriageassociation.org.uk/

Please be kind to yourself and allow time to grieve and heal both physically and emotionally.

Karen x

The Ectopic Pregnancy Trust

Registered Charity Number: 1071811

The EPT is awarded the PIF TICK as a Trusted Information Creator, the UK-wide quality mark for healthcare information

If the information provided here or through the EPT website has helped you, you can donate towards our support services, volunteer, or fundraise to raise awareness.

Further information is available on our website.

Email us: ept@ectopic.org.uk

We provide a call-back support line: 020 7733 2653. We are able to provide support in multiple languages including British Sign Language.

Take a look at our newsletters and subscribe to our mailing list.

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

11

Hello,

Sorry to hear your news!

I have recently had similar. I had some pain in my right side last Monday and on Wednesday I went to the GP who confirmed my pregnancy. Due to the pain I was seen in the hospital for a transvaginal ultrasound and blood tests.

This confirmed pregnancy in an unknown location. On the scans there was a poorly defined mass in one of my fallopian tubes. My levels were 480 and today are 500.

I am so anxious as they have increased since Thursday and although by not much, I am still worried. The pain is subsiding and only present when I press on my tummy.

Has anyone had this and then there been a viable pregnancy? My last period was the 27th July as well.

This is my first pregnancy & im so confused with all of the terminology and medical information.

<3

12

Dear Jadelouise,

I am so sorry to hear of the worrying time you are going through. It can be extremely overwhelming not knowing what is going on with our bodies.

When diagnosing an ectopic pregnancy, doctors use a combination of transvaginal ultrasound scanning and blood tests to check HCG levels. Usually scans take place at around six weeks gestation as there is a reasonable chance of seeing an embryo at around this time. 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.

I hope this explains a little why we do not rely on hCG numbers alone are not used to diagnose ectopic pregnancy. I hope it all becomes clearer with your next blood tests or scans. Although I do not wish to alarm you, I just advise you to seek urgent medical advice with any worsening bleeding or abdominal pain, shoulder tip pain or you feel dizzy and unwell.

Sending much love and warm hugs,

Karen x

The Ectopic Pregnancy Trust

Registered Charity Number: 1071811

The EPT is awarded the PIF TICK as a Trusted Information Creator, the UK-wide quality mark for healthcare information

If the information provided here or through the EPT website has helped you, you can donate towards our support services, volunteer, or fundraise to raise awareness.

Further information is available on our website.

Email us: ept@ectopic.org.uk

We provide a call-back support line: 020 7733 2653. We are able to provide support in multiple languages including British Sign Language.

Take a look at our newsletters and subscribe to our mailing list.

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