Confusing opinions on possible ectopic - help :(

[krisztalszl]

Hi all, I need your help.

My periods are usually anywhere between 27 and 33 days and I believe I ovulate rather late, around d21 instead of usual d14. On day 33, when I suspected I'm missing my period, I tested at home. It was a Monday and a very very very faint positive. Two days later, Wednesday my digital test said positive, 1-2 weeks. Then Friday morning tested again, positive again and much stronger line than on Monday. I was super happy.

However, because of horrible one sided cramps on Friday I talked to my doctor who sent me for an ultrasound. On the scan, the private doctor was 100% sure he is seeing an ectopic pregnancy, a 7mm gestational sac in my left fallopian tube. Nothing in my uterus. He sent me to emergency and said I either have to have the Methotrexate or surgery.

Then I arrived to emergency, and here on the scan they said they are not sure at all that it's ectopic. I had two scans that day in the hospital with several professionals, they all saw something on the tube, maybe a myoma, but they say they wouldn't say it's a sac and they are not sure. I also can't believe I would have a 7mm sac as I do believe I only actually became pregnant two weeks ago.
On the same Friday (so 5 days after the faintest positive ever seen on a pregnancy test), my beta HCG was 144, and today, on Sunday, in actually just 40 hours, it is 270. They are unsure.

Can someone help me with suggestions, opinions? I do believe it is too early and on my tube that is something else, and that a healthy sac will show up in a weeks time, when my HCG is above 1500, in my uterus...

Thank you so much for any thought!!!!

[Sunflower89]

Hi,

Sorry to hear about your experience, I know having this uncertainty is very stressful. Are you in the UK? If so, an early pregnancy assessment unit should be able to monitor and scan you, and I believe will only offer methotrexate once two people have confirmed the presence of an ectopic pregnancy. This was the case for me anyway.

My ectopic was suspected when I had pain on one side, and a scan showed no sign of anything in the uterus and something unclear near my right ovary. A few days later a scan showed that the presence was actually a corpus luteum cyst, and the ectopic was actually in my left fallopian tube - the ectopic had been too small to be seen on my left side during my first scan, and the pain on the right side was unrelated. I think generally you will be offered methotrexate once ectopic is definitively confirmed, but scans and hCG levels will need to confirm best course of action. I hope you have been told this, but in the meantime please make sure you are aware of the symptoms of rupture and go to hospital if you experience any sudden pain or symptoms of rupture.

Wishing you all the best and I hope you find comfort and support here.

[krisztalszl]

Hi there,

Thanks so much for your reply and I'm so so sorry for your experience and all that you were going through. It must have been traumatic. I wish you the best recovery and I hope soon you will have a healthy one growing in the right place

How far into pregnancy were you when it all happened? My whole idea is that I'm just very very early as based on my bHCG they are not supposed to see anything anywhere.

I'm in Budapest now, just moved here last week from the UK. Thanks God they're taking me very seriously and actually keeping me here in the hospital until they know for sure what is going on. One more ultrasound down, still they're unsure and do not agree with the first guy who saw the sac in my tube. They seem hopeful, just like I do, that I am earlier than thought. Every two days they will do the blood test and the ultrasound until they either see something 100% pregnancy-related inside or outside my uterus, or until my bHCG gets to a point (above 1500 according to my research) when they should see something and they do not... so if my bHCG keeps doubling ok, that will be in 6 days... Of course, if my bHCG doesn't keep doubling, then my situation will look worse. But I have high hopes.

I am just so so confused how the first, private ultrasound guy could say he is 100% sure he sees a sac in my tube, and no one agrees. I have never seen anything like this on any forums, any website - no one really came back from suspected ectopic.

Thank you again for sharing your experience with me and I wish you all the best going forward!!!!!!!

[Sunflower89]

That does seem strange that he is so certain and the others aren't...

I was around 5.5 weeks when I had the first scan and they could see cyst but not ectopic. That was on Tuesday and I'd had bloods that day. At that point consultant warned that based on what they could see and my numbers that it could be ectopic pregnancy, or it could be a miscarriage as nobody could see anything in my uterus. Had second blood test on Thursday to monitor hCG levels and could see they were rising - was immediately booked for a second scan and told it could be ectopic, although there was a chance that I may have ovulated late and the pregnancy was not as far along as I thought. On the Friday I had another scan where they were able to diagnose the ectopic, but at the time it was quite small. Had a second scan and more bloods the following Monday and a second person confirmed the ectopic, and because my hCG was rising they booked me in for methotrexate injection later that day. So things changed quite quickly.

Have you got follow up bloods and scans booked?

[krisztalszl]

Yes, every second day bHcg and ultrasound is booked in, and in the meantime I stay in the in-patient bed in case there's an emergency. Did your bHcg double for you every two days and do you know what level was it?
I officially should be 5 weeks but I think I'm 4 (now 4 and a half). For me the fact that bHcg was so low on Friday and Sunday it doubled makes me hopeful that I'm early. But yes indeed, very very weird that that guy was so sure. And apparently he is the country's best ultrasound guy. But here 5 different people checked since, no one seeing anything they would call an ectopic. Such a strange strange situation to be in... uncertainty is not easy but at least it means there's still hope I guess...

[EPT Host 20]

Dear Krisztalszl,
Not knowing what is happening to our bodies can be extremely overwhelming and you have friends here who understand. When nothing definitive on scans is seen, they label the pregnancy a Pregnancy of unknown location - (PUL). It is important to understand that the term 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. Whilst I do not wish to alarm you, for every 100 pregnancies labelled as a PUL about 10 will subsequently be found to be ectopic; but not all of these will need treatment. If treatment is required, (methotraxate injection or surgery) this will depend on the results of blood tests and scans and I would discuss this further with you Dr.

We would gently remind you to not undertake any strenuous exercise or lifting or housework at this time as while I do not want to alarm you, if it is an ectopic pregnancy, there remains the risk of rupture even with low or declining hCG levels. Signs of rupture for ectopic pregnancy include shoulder tip pain, abdominal pain, vaginal bleeding, bowel problems or feeling dizzy and feel unwell, and it is important to seek urgent medical advice with any of these symptoms.

I am sorry that I cannot provide you with more precise details but I hope all becomes much clearer over the forthcoming blood tests and scans.
We are here for you for as long as you need,
Sending much love,
Karen x

The Ectopic Pregnancy Trust
Registered Charity Number: 1071811
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