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What to expect...

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What to expect...

Postby Clarecuppycake » Thu Feb 06, 2020 4:49 pm

It's my first pregnancy and sadly it has turned out to be eptopic Iv really struggled to get my head round it all and feeling alot of anger and frustration with all the unknown things.
I was found to be eptopic and have just been monitored with bloods tests every few days to check my hcg levels are decreasing they originally started at 1000 and are now down to 92 four weeks later I have another blood test Monday but I have no idea what I should be expecting to happen to my physically...? I have no bleeding or pain so what happens now? The hospital staff haven't been great with given me many answers or advice so I would really appreciate anyone else's experience and what to expect now?
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Re: What to expect...

Postby EPT Host 22 » Sat Feb 08, 2020 7:55 am

Hi ClareCuppyCake,

I'm so sorry to hear you are experiencing an ectopic pregnancy and loss. This can leave us with many questions, and I will do my best to help answer your questions. Please take time reading my response and feel free to ask any further questions.

With treatment for ectopic pregnancy through expectant management, when the pregnancy is ended, the whole pregnancy sac including any cells that might have grown into a baby is usually reabsorbed by the body. This is normal and happens in many cases of miscarriage. This process can take weeks and sometimes months. In some cases, the Fallopian tube may remain blocked and take time to shrink, there is no time frame for how long this takes. Sometimes the tissue can separate and be passed through the vaginal bleeding that occurs.

The bleeding that follows an ectopic pregnancy can be very heavy and clotty and result in the passing of what we call a decidual cast. This decidual cast is the lining of the uterus when we are pregnant. The sudden drop in hormones can cause the material inside the uterus to be shed in layers and the material that is passed can be grey, pink or white as well as appear like a clot or dark or frank red blood. Women can often mistake it for the tissue of their baby which can cause worry but it is important to remember that it is a normal process for the uterus lining to be shed. This process involves vaginal bleeding - it can be clotty or like one of your usual periods and some women have bleeding/spotting for up to six weeks.

Many women experience changes to their menstrual cycles after an ectopic pregnancy and it can take some time to settle back into a rhythm that is more usual for you. Periods can be heavier or lighter or more painful than before - as we are so individual there isn't necessarily a set pattern. Doctors consider menstrual cycles of between 23-42 days to be within normal parameters and, if you find that you are not within these sorts of timeframes, it would be a good idea to speak to your doctors just to be on the safe side.

As a gentle reminder regarding conceiving again, we and many medical professionals advise waiting for two menstrual cycles once your hCG levels are back to pre-pregnancy levels. It is important to allow time for your body to recover and emotions to surface and be worked through. This is so that you have some comfort that your body is returning to its natural rhythm and you have a last menstrual period date from which to date a new pregnancy - key information in checking you are not suffering from an ectopic pregnancy in the future. The first bleed soon after surgery for ectopic pregnancy is not classed as a period as it is the body's response to falling hormone levels.

With regards to trying to conceive, the chances of a further ectopic after a first in the UK is 10%. So that's a 90% chance of the embryo being in the right place next time. While generally, it is possible to conceive after an ectopic pregnancy, the amount of time it takes varies from couple to couple. Factors include age, general health, reproductive health and how often you have sex, among other things. It may be comforting to know that 65% of women are successfully pregnant within 18 months of experiencing an ectopic pregnancy and some studies suggest this rises to around 85% after two years. In terms of chances of future successful pregnancies, studies do not show a significant difference between treatment routes, whether surgical, medical using methotrexate or expectant management (allowing time for the body to resolve the pregnancy itself).

Importantly early scans are available. As soon as you know you are pregnant, contact your local EPU to inform them and book in for an early scan at around six weeks. Remind them of your previous ectopic pregnancy. This self-referral route is the best route in our view. Hopefully, you will have some comfort to know you are under the radar of medical professionals right away.

I know waiting for hCG levels can be an anxious time, and while I don't want to worry you, there remains a chance of rupture until you are at the non-pregnant levels (below 5mIU/ml). For these reasons, it is important to stay alert to any symptoms of pain, particularly abdominal or shoulder tip pain, or heavy bleeding. In these cases, you will want to be seen at the A&E.

These boards are a safe space for you, and we here for you for as long as you need.

With good wishes,


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Re: What to expect...

Postby Bodhi81 » Thu Feb 20, 2020 8:39 pm

Hi Clarecuppycake
I’m going through something similar, my hcg started at 1150 after going to EPAU with bleeding, it had only dropped to 947 6 days later. I’m having to wait a week for repeat bloods as I had zero symptoms, however, yesterday afternoon and today I’ve had ‘niggles’ - the odd pang here and there, and achy shoulders - did you have anything similar? I’m not sure if I’m just imagining things or I’m just taking more notice, I’m not normally a worrier but this wait and see business is not sitting well with me (mines also PUL so not definite EP) x
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