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Help - Possible Ectopic Pregnancy

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Mark
Posts: 1
Joined: Mon Jun 14, 2021 1:50 pm

Help - Possible Ectopic Pregnancy

Post by Mark »

Hi,

I wonder if I could get some advice or guidance on others personal experiences.

My girlfriend is pregnant which is estimated to be 6 weeks and a day today.

Last Wednesday we went for a scan and nothing could be seen, two scans were performed and there was a hcg reading of 1250.

Two days later on the Friday we went for a repeat blood test and the hcg was 2800, no scan was performed.

Two days later on the Sunday (yesterday) which could be around 6 weeks we had a reading of 5100 and still nothing could be seen.

The hospital is suspicious of a ectopic pregnancy but nothing can bee seen anywhere after the internal scan, my girlfriend is anxious that she may have to have surgery, she would prefer the mtx injection. Tomorrow is the next scan and blood test. Is there a cut off point or criteria for when the injection can or cant be take? I read 5000 but some have it up to 16000 however some people say its based on the pregnancy time or size?

Its seems to be dragging and we are both very anxious that something could be growing in the wrong place which could potentially cause her a serious medical issue.

Symptoms wise, no pain or cramping. Just a light spotting now and again.

Any help or advice would be appreciated.

Thanks

EPT Host 20
Posts: 2276
Joined: Thu May 31, 2012 9:58 pm

Re: Help - Possible Ectopic Pregnancy

Post by EPT Host 20 »

Dear Mark,
I am so sorry to hear of the worrying time you are both going through.

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 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. This is possibly the reason why your doctors are waiting to carry out further scans and tests.

Methotrexate is most effective in the earlier stages of pregnancy, usually when the pregnancy hormone ‘beta hCG’ level is below 5000 mIU/mL. The risk of rupture is higher in pregnancies with levels greater than this. Early pregnancy units will also have their own criteria on suitability for the injection, we have more information on our website and I have added The link here-
https://ectopic.org.uk/treating-an-ecto ... hotrexate/

What I would say is that methotrexate has been developed as a less invasive method of treatment than surgery, although it can be a drawn out process with hospital visits for blood tests. Also, studies suggest that the chances of successful pregnancy are not significantly different between treatment methods ie. whether having a tube removed of methotrexate.

I hope you both get some answers soon. We Are here for you both for as long as you need.
Sending much love,
Karen x

The Ectopic Pregnancy Trust
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