Could I be having an ectopic pregnancy?

[Charltonboo]

I’m concerned that I might be having an ectopic pregnancy.

After recently trying to conceive, I got a strong, positive pregnancy test on the 8th of January, after being late for my period. Everything progressed normally, I didn’t have a lot of pregnancy symptoms or morning sickness but didn’t think much of it as I had a very easy pregnancy with my last baby. I started having spotting on the 14th that lasted around half a day so got in contact with my GP who told me this was common and to do a pregnancy test in 2 weeks time.

I stopped bleeding completely until the 20th when it restarted and I have had light bleeding since (now on day 6). On the day it restarted I had a lot of nausea, headache and had numerous dizzy spells, at times I was concerned that I was going to faint. I called 111 the next day and managed to get an out of hours appointment. At the appointment the doctor did a urine sample and confirmed I was pregnant and told me I shouldn’t be concerned as she had heavy bleeding throughout her pregnancy. She told me to go to the EPU the next day if I was still concerned and that it’s walk in only. Low and behold I turn up the next day and it’s appointment only so I get turned around at the door I’d started getting a lot of backache that morning so I headed down to A&E instead who referred me to urgent care, where the doctor finally referred me for a scan the next morning (23rd).

With an ultrasound and vaginal scan they confirmed that there was no sac present and they are assuming I have fully miscarried the pregnancy which was very upsetting. They then took my bloods and arranged for me to have more taken in 48 hours time. When the results came back the HCG levels have decreased much less than they would have expected. Obviously at the time I didn’t know what the numbers meant at all so didn’t take note of them but I have another blood test booked in tomorrow and the nurse mentioned that they need to confirm it’s not ectopic.

I feel like some of my symptoms are correlating with what I’ve researched (backache, bleeding, dizziness, lack of sac on scans) but I guess I’m just wondering whether anyone has had an ectopic pregnancy where there was no pain or heavy bleeding and HCG was decreasing but very slowly? I feel like the doctors haven’t taken me too seriously because I’ve been lacking the more worrying symptoms but I’m starting to get impatient and a little concerned!


Thanks for reading this far x

[EPT Host 20]

Dear Charltonboo,
I am so sorry to hear of the worrying time you are going through.
The problem with ectopic pregnancy is that although bleeding and pain can be signs, everyone will experience them differently. Some people will bleed very heavily, or just spot, or it may look like a brown loss (a bit like prune juice). Some people will have severe pain, some people just a slight niggle. There really is no set pattern.

You did exacted right thing seeking medical advice for your symptoms and I'm so sorry to hear that you've had such a difficult time getting answers. Although I do not wish to alarm you, I can't stress enough how important it is to seek urgent medical advice with any worsening symptoms (pain, bleeding or dizziness) and if you can't get into your early pregnancy unit, please attend A&E and advise them that you are waiting for tests to rule out an ectopic pregnancy. Possible ectopic pregnancies should be treated as a medical emergency, especially if the woman is feeling unwell.

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.

When diagnosing an ectopic pregnancy, doctors use a combination of transvaginal ultrasound scanning and blood tests to check HCG levels.
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
You will get more answers with tomorrow's bloods, but I cannot stress enough that you seek urgent medical advice if you are concerned about your level of pain or bleeding or dizziness or if you start to feel more unwell in any way.

We have more Information on ectopic pregnancy on our website about diagnosing ectopic pregnancy and treatment options as well as supporting you,
https://ectopic.org.uk/

Please continue to lean on us for as long as you need,
Sending much love,
Karen x

The Ectopic Pregnancy Trust
Registered Charity Number: 1071811
The EPT is awarded the PIF TICK as a Trusted Information Creator, the UK-wide quality mark for healthcare information
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[Charltonboo]

Hi Karen,

Thank you so much for all the useful information! If I begin feeling worse I will 100% go down to the hospital. The results have come back and show that it’s decreased from 797 to 646 so still decreasing but still slower than they would like. Due to me not having any pain they’ve booked me in for another set of bloods on Monday but to contact them if I have any pain so hopefully all goes well

[ChaoticBlues]

Hey,

Sorry you are going through this.

My ectopic pregnancy experience, I was 5 and a half weeks, it felt like trapped sharp wind in my left hip, I felt sick, then was a surge of blood that came out. The hospital said they believed it was a miscarriage. Then two weeks later said it was ectopic because my hcg went down back up, they saw no fetus in the womb.

It's quite tricky as ectopic there's a combination of things they look at. It's only really clear if they actually see the baby in a tube, ovary, etc. If not it is guess work and based on other factors, so if your hcg decreases and goes up that's a sign of an ectopic. If your hcg just decreases they class that as a miscarriage. If they see no baby past 6 weeks in the womb and there's high levels of hcg then they may say its ectopic, if its low levels they may say its a miscarriage.

So as you can see it's a combination of things they look at. Sounds like you're being monitored so that's something.

[ChaoticBlues]

Meant to add ectopic pregnancy symptoms are different for everyone. I bled for 1 sec, so no I didn't have heavy bleeding, as I said I had pain in my side. Not everyone has pain or heavy bleeding early on. The bleeding got heavy later on.

My experience was the doctors don't take miscarriages or suspected ectopic pregnancies as serious. Miscarriages are seen as normal, common and not serious, I was told to go home and take paracetamol. At A and E I told them I'm having an ectopic and they didn't look me over told me to go home and that its probably a miscarriage. Just because they don't take it serious you should.

[Charltonboo]

Hey Chaotic,

Thanks for sharing your side of things, it’s so helpful to know from the perspective of people who have actually been through it! The bleeding is easing off today and I’ve been having quite a bit of back pain but my HCG has only gone down to 607 from 646 in the last 48 hours so they’ve booked me in for more scans and my 5th lot of blood tests hopefully that should give some more answers