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Methotrexate and surgery - advice re recovery please

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tangledaurora
Posts: 6
Joined: Thu Apr 16, 2020 9:05 pm

Methotrexate and surgery - advice re recovery please

Post by tangledaurora »

Hi all,
I have struggled to find any advice regarding my situation because of the current Pandemic and wanted to see if anyone could offer any advice please.

I suffered pain and bleeding the day after my positive pregnancy test. Ended up calling 111 due to the pain who sent me straight to a&e. Bloods confirmed pregnancy but was sent home and asked to do more bloods two days later. This continued for 3 weeks, as bloods were rising but not doubling and four internal scans could not locate the sac anywhere at all.

After four weeks of this [heck], I was given methotrexate and diagnosed with pregnancy of unknown location. Further sets of bloods showed my levels were still rising. Another scan and the Consultant located my baby in my right fallopian tube. Emergency surgery was scheduled for the next day (7 days after methotrexate) and they removed my right tube.

I haven’t read much about anyone having the injection and surgery and was curious to see how others recovered? I had three days of very light bleeding after surgery which I was surprised with and am worried about the side effects of having both surgery and the injection.

I am very lucky to already have a beautiful 10 month baby girl but this lost baby was planned for and so wanted. I am so shocked that this happened to me, no pre-existing conditions and the fact that it took four weeks of going to the hospital every 2 days with nobody having a clue what was going on, has really affected me.

Sorry to waffle on!

EPT Host 22
Posts: 659
Joined: Fri Nov 20, 2015 10:26 am

Re: Methotrexate and surgery - advice re recovery please

Post by EPT Host 22 »

Hi TangledAurora,

I'm so very sorry to hear of your ectopic pregnancy and loss. Right now, the most important thing to do is to look after yourself. There is no set recovery or set timeframe for recovery. As every woman is unique, we all process it in different ways. Your well-being is the most important thing right now. These boards are full of men and women who understand the challenges of ectopic pregnancies. It's important to remember that there is nothing you did to cause or could have done to stop an ectopic pregnancy.

Many people experience receive both methotrexate shot, but go on to have surgery. 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. Usually, as soon as you know you are pregnant, you can 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.

However, in the current climate with coronavirus, the UK’s National Health System is seeing a reduction in resources and capacity and there is the aim to minimize hospital attendance. In light of this, guidance by the UK’s Royal College of Obstetricians and Gynaecologists states:

“Unfortunately, early pregnancy units will not be able to offer ultrasound scans to provide reassurance to women who have no symptoms. This will also be the case even if you have a previous history of miscarriage or ectopic pregnancy.”

This means that is a woman is pregnant again after an ectopic pregnancy, she would not be able to have an early scan in the current pandemic.

There is no official guidance in the UK about trying for a baby at this time and whether to start trying to conceive is a personal choice. A key consideration is certainly your medical history and getting the care that she would need with any future pregnancy. The UK’s Association of Early Pregnancy Units suggests that women consider waiting until the pandemic is over before trying to conceive. This is to minimize the burden on the health service and to ensure women have full access to early pregnancy and maternity care.

As a gentle reminder regarding conceiving again, we and many medical professionals advise waiting for two menstrual cycles. 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.

I hope this provides you with some answers to your questions. Please continue to post here whenever you need and for as long as you need. These boards are a safe space for you.


With good wishes,


Michele

The Ectopic Pregnancy Trust
Registered Charity Number: 1071811
Ectopic pregnancy patient information suite: Highly Commended in the 2019 BMA Patient Information Awards

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J_russell
Posts: 7
Joined: Fri Apr 03, 2020 10:15 pm

Re: Methotrexate and surgery - advice re recovery please

Post by J_russell »

Hi TangledAurora

Your experience sounds similar(ish) to mine, my pregnancy was found to be ectopic and I was given methotrexate but on my day 4 check up I was admitted for surgery. Due to the pandemic the hospital was not performing any keyhole surgery so i had a laparotomy.

I am not sure how far along in recovery you are, I am now 2 weeks after my operation so I might not be able to give you much advise on what to expect as it’s still very early days for me but if you have any questions let me know.

Physically I am recovering well, my wound is healing and I am pretty mobile. If anything I worry I might be doing too much but I also would go crazy if I did nothing. .

This was our first pregnancy, we had been trying for a while and I was so excited, the emotional side is still taking a while. . I have only really just started to properly process as everything happened so quickly.

Good luck with your recovery, sending lots of love x x x

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