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Expectant Management

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KatAdams12
Posts: 1
Joined: Sat Jan 09, 2021 3:21 pm

Expectant Management

Post by KatAdams12 »

I recently found out I had an ectopic pregnancy. Around the 6 week mark I started bleeding and went in for a scan which couldn't detect a pregnancy. I had blood tests to check my hormone levels and 2 further scans, which eventually revealed an ectopic pregnancy in my right fallopian tube. The early pregnancy unit are encouraging me to deal with this with expectant management, which I'm happy to do as I'm in very little pain and the bleeding is slowing down a lot. It's been 11 days since I started bleeding and I've had 4 blood tests in that time. My start hormone level was 727, then 2 days later was 780, 2 days later was 680 and 4 days after that was 620. But now I'm already getting frustrated with this method as I feel I'm leaving it all up to fate to resolve this problem and I'm doing nothing to resolve it myself and get back to normal, as I'm told to rest rest rest! My last blood test I was hoping for a big drop in the number but it was the smallest yet. If this doesn't resolve naturally then I will need surgery (assuming it doesn't rupture in the meantime). I don't know how long I can just wait around for it to pass. Has anyone else had a similar experience with their hormone levels and has any success (or otherwise) stories to share to help me get my head around it?

NikiA1992
Posts: 2
Joined: Sat Jan 09, 2021 4:15 pm

Re: Expectant Management

Post by NikiA1992 »

I presented to A+E with HCG levels of 2667, 2 days later they had dropped to 1885, then down to 1227 and now down to 1000.

I was due to have surgery because they discovered my ectopic in my left fallopian tube and it's quite big but due to the drop in my HCG levels i am on expectant management and also because im having very little symptoms, ie small amount of vaginal bleeding and very little pain etc..but there is still a chance of rupture.

The important thing to remember is if your symptoms worsen or you pass out or anything like that then get to the hospital straight away x

Elle11
Posts: 6
Joined: Mon Jan 04, 2021 1:00 am

Re: Expectant Management

Post by Elle11 »

Hi Kat,
I’m going through something similar at the moment and agree with you that it just feels like we are in limbo, waiting for the unknown and fearing the worst.
I’m keen not to have MTX or surgery so am hoping this self resolves, but understand the anxiety around what might happen if the levels stop dropping, and with the fear it can rupture even if HCG is low and dropping.
I’ve read a lot into expectant management and it seems that a large proportion of selected patients do well. I think units will offer it if your levels are dropping, minimal or no pain, and if the ectopic is small. Do you know the size from your scan?

Elle11
Posts: 6
Joined: Mon Jan 04, 2021 1:00 am

Re: Expectant Management

Post by Elle11 »

Niki can I ask what the bleeding for you has been like? And what the size of your ectopic was?

I feel for you both going through this... this is such an awful situation, hope you are doing okay

Thanks for sharing xx

lolly2481
Posts: 38
Joined: Wed Dec 23, 2020 8:33 pm

Re: Expectant Management

Post by lolly2481 »

I am going through expectant management and it is a long game and in the beginning my anxiety levels were high. I started with light spotting at 5 weeks which was heavier bleeding by 6 weeks but no pain above a slight ache on my left side. On the 9th of December a scan showed a pregnancy on my ovary a couple of centimetres (honestly, the hospital have been a bit vague about it and I only saw a doctor once on the first day). Initial hCG levels were low at 189 and after going for blood tests every 48 hours over 8 days it dropped to 139 with a slight increase on the 3rd blood test. Once it dropped to 139 I was allowed to go back after 10 days (should have been 7 days but it was Christmas and I needed a break as the cycle of going backwards and forwards to the hospital and waiting for results). After 10 days hCG levels had dropped to 29. I'm now 2 weeks into a 3 week wait to do a HPT. The hope being I should be negative by then. Bleeding wise..I had bleeding for about 2.5 weeks which got lighter towards the end.

No-one tells you how hard the limbo of expectant management is. But I prefer this to surgery. I am terrified of needing surgery. Everyone wants to tell you how lucky you are that you don't need surgery or methotrexate, and yes we will hopefully come out of this with tubes intact etc but it's not EASY.

EPT Host 20
Posts: 2078
Joined: Thu May 31, 2012 9:58 pm

Re: Expectant Management

Post by EPT Host 20 »

Dear KatAdams12,
I am so sorry to hear of your ectopic pregnancy and loss,
Whilst expectant management has the least physical side effects of all treatment methods, it can be a drawn out process and I'm sorry you are having to go through this.
There is no set pattern for how quickly hCG levels fall and I appreciate how frustrating it can be.
Have your medical team mentioned methotrexate? This can be used as an alternative to surgery. We have more information on our website here-
https://ectopic.org.uk/patients/treatment/

I would discuss through all options, including how it is affecting you emotionally to your medical team.

Sending much love,
Karen x

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