Static HCG expectant management for PUL

[Lucy141018-]

Hi all,

Desperate for some reassurance. Has anyone had a story like mine?

I found out I was pregnant 25/10/23 but had some spotting a few days later. I went to EPU, had an early scan and diagnosed with pregnancy of unknown location. We agreed expectant management would be OK due to low HCG levels and was told I was miscarrying. I had 3 weeks of heavy bleeding and thought it was over. 2 weeks later my HCG had dropped from 147 to 39. I was told to retest in a week and call if it was positive.

A week later my test was positive. Bloods drawn which showed HCG levels of 91. Had a scan which showed I had ovulated from the other ovary but also had some internal bleeding into my pelvis. Spotting continuing. Saw a consultant who told me to continue with expectant management and recheck HCG in 2 days. The levels came back at 74. Told to come back in a week.

A week later, HCG is now 82. I’ve had constant niggling pain, on and off bleeding, and to be honest I am completely fed up of the waiting game.

I have an appointment on Tuesday with the consultant. I am driving myself mad with constant questions and I am just so afraid I’m going to rupture. The trouble is they haven’t actually found the cells yet

Hopefully one of you lovely ladies can help put my mind at rest?

TIA xxx

[Jc798429]

I’m so sorry you are going through such a hard time! I completely understand how you’re feeling- especially feeling like you’re in a waiting game, because my story is somewhat similar!

I had a positive pregnancy test on Aug 30, but started with heavy bleeding on Sept 8 (would have been 6 weeks pregnant). I went to ER and my HCG was 75 and they were unable to find anything on ultrasound (did vaginal ultrasound as well, but found nothing).
I was told I was having a miscarriage and to return every 3 days to check my HCG levels.

I had heavy bleeding with clotting from Sept 8-14

Sept 11 - HCG 92

Sept 14 - HCG 77 (they assumed this confirmed a miscarriage because the number was decreasing and so low, so they said get hcg checked again in 7 days)

Sept 21st I started with light spotting - HCG 151 (doctor believed there was a chance I had conceived after my “miscarriage” and my light spotting was potentially implantation bleeding.. I wasn’t having any pain or discomfort at this point, just spotting. I had asked about chances of ectopic, but doctor didn’t think that was the case as i was having no abdominal pain or other signs of ectopic aside from fluctuating hcg.

But then on Sept 28th, bleeding turned heavy and I was having cramping. I couldn’t wait any longer to find out what was going on, so I went back to ER and that’s when finally with vaginal ultrasound, they were able to see the ectopic in my left tube (would have been at 9 weeks pregnant) with my HCG at 131. I was treated with the methotrexate injection and was told I was a good candidate for that because of my low hcg and the ectopic mass was under 4cm. (I think mine was 3.5)
I only needed 1 dose and it took about 3 weeks for my HCG to return to 0.

If I’ve learned anything through this, it is to trust your gut and advocate for yourself! You know your body best. I’m so happy I listened to my gut (and my body) and went to ER multiple times to be checked (even though at the time, I thought I could be overreacting).

I know how scary it is constantly worrying and wondering what is going on in your own body. The fear of rupture while waiting to find out what was going on, took over all my thoughts and was probably the most terrifying experience I’ve ever gone through. My husband and family were such great supports during that time, but I don’t think anyone fully understands those feelings and thoughts unless it’s happening to you. Please reach out if you need someone to chat to!
I hope you get your answers tomorrow!

[Lucy141018-]

Thank you so much for your reply. I’m sorry you had such a rough time.

I’m glad the methotrexate prevented you needing surgery. Did you suffer many side effects? I’m hoping the dr will prescribe it tomorrow. I asked for it a week ago so I am just so frustrated I’ve been left for so long

Xx

[Jc798429]

I didn’t have many side effects from the methotrexate! I was already bleeding when I was given the injection and my bleeding lasted for about a week after that.
I was exhausted for the first couple days and had some cramping/abdominal pain.
After the methotrexate, they take your hcg levels on day 4 and day 7 post injection. On my day 4, my HCG increased which can be expected, but was very scary to hear. Thankfully on day 7, my hcg dropped by 40%. From there I had to weekly blood draws until my HCG went to 0

I completely understand your frustration
I really hope you are able to get your answers and treatment started tomorrow! I’ll definitely be thinking of you!

[Lucy141018-]

Interesting!!

So I’m no longer PUL - they’ve found it in my right tube my HCG has dropped to 47 so they’re hopeful I might not need methotrexate. I wish they’d just hurry up and treat it as theres still a chance it could go up again right? It’s all just very stressful. Had horrific pain and bleeding last night so maybe that’s the end of it. Will find out on Thursday.

Thanks for your well wishes x

[Jc798429]

Im sorry to hear that it’s finally confirmed

Hopefully you will continue to see your numbers drop without needing treatment! I hope for good news for you Thursday!
Fingers crossed for you!