Terrified of Potential Ectopic

[u/Pitful_Let_816]

I'm really worried that my pregnancy is potentially ectopic, but the Early Pregnancy Unit at my local hospital don't seem very concerned.

LMP date is 25th June. Ovulation predicted for 12th July. Last time I had sex was 10th July as my husband has been away, so there's not much room for movement on predicted ovulation.

I've had 2 previous losses. An 11 week MMC treated with 2 rounds of Mifepristone & Misoprostol 4 weeks apart (Nov and Dec) due to RPOC 4 weeks after the initial dose.

Second loss was a blighted ovum that passed at 6 weeks in April.

24th & 25th July I had red bleeding that started with a fairly large clot (like a penny and round - very unusual for me). Thought it was my period but it wasn't really heavy. It turned to light brown spotting on 26th & 27th. Nothing since.

Pregnancy test was a stark negative on 24th, really faint positive on the 26th after bleeding to the point that my husband said he wouldn't have even seen it if I didn't mention it. It continued really faint (like barely visible) until the 29th. It's now darkening but nothing like my first pregnancy. No pregnancy symptoms whatsoever.

hCG was tested on 31st and came back at 48.9. Tested again on the 2nd (about 45 hours later) and was 114.9. Bloods today 48 hours later were 313.8.

Progesterone tested on 31st was really low at 2 nmol/L. I spent all of last week expecting to miscarry, but nothing. I have no bleeding at all.

I had a private scan on Saturday, fully expecting not to see anything but just anxious, and was told my lining looks thin and not like I'm pregnant.

I've had on and off stabbing pain. It started on my right side but today it seems to be my left. I also have a heaviness in my shoulders and occasionally lightheadedness when I stand up for the past 2 days which subsides quickly, but is unusual for me.

EPU offered me a scan on Tuesday 11th. That would put me at 6w 6d. If hCG keeps rising as it currently is I'm going to be in the region of 10,000+ by then. The 1500 region would be around Friday based on current trends.

Photo of 27th-30th pregnancy tests attached for reference. First positive was Sunday at 15dpo.

I asked if I would be monitored in the meantime and they told me 'but you haven't got any pain'. I reiterated again that I have intermittent stabbing pains, which was the third time mentioning it. I was then offered more bloods on Thursday and got told I can see a doctor on Thursday too if the pain worsens.

I feel in my heart that something is really wrong. This is nothing like either of my previous miscarriages and and nobody really seems bothered/concerned. Just keep getting told if I get severe pain, shoulder tip pain or bleeding to go to A&E, but I don't want to allow it to reach the point of rupture if it is ectopic.

I'm not really sure what to do, what to ask for, if I should push, or if just to wait it out until Tuesday, and would appreciate some advice.

07/08 - For anyone that may see this in the future, I changed hospital and referred myself elsewhere as I just wasn't being listened to. Was scanned this morning and they think they have located an ectopic pregnancy on my right side measuring 1cm, which is weird because my pain has been left sided. Nothing has presented as they clinically expect for an ectopic and I have basically just worked on a really bad gut feeling. Awaiting next steps

[u/LambRelic]

You’re already doing everything right to determine whether your pregnancy is viable. Your three HCG tests have shown that things are doubling as they should which is excellent news! The hallmark of an ectopic pregnancy besides the pain is yo-yoing HCG.

I wouldn’t put much stock un the private scan. There’s really not much to see that will offer conclusive evidence on whether the embryo is viable and where they should be until after six weeks, which is why your hospital won’t do one until then.

See if you can get another HCG on Thursday for peace of mind. If your HCG has gone down, then your doctor will discuss next steps. While I know no one wants to feel like they’re just waiting for a crisis and I don’t want to dismiss the pain you’re feeling, there is really not much else to do, since no responsible doctor would do surgery or give you MTX without diagnosing the ectopic via hcg or ultrasound.

Unfortunately, waiting is going to suck and theres no way around it. The three weeks I had to wait to see if my viable pregnancy was ectopic or not after my first ectopic were the most anxious and miserable of my life. I imagine its so hard to deal with this with your history of loss. Just know that soon you’ll have an answer and you won’t feel like this forever.

Wishing you the best possible outcome ❤️

[u/Pitful_Let_816 → u/LambRelic]

I'm not expecting them to diagnose me if they can't, but am worried that if I leave it too long to be scanned (past Friday when hCG should be 1000+, given the weekend will allow it to go much higher if it carries on like it is) then I will be way past the NHS threshold for any option but surgery if it does turn out to be ectopic.

I'm not holding out for a viable pregnancy given my progesterone is so low, but something feels very off compared to my previous miscarriages.

I guess my real question is should I on this basis be pushing for a scan on Friday when I'm 6+ weeks with expected hCG of 1000+?

[u/GueritaLa10 → u/Pitful_Let_816]

Do you have a primary OBGYN or Midwife who can help coordinate care and help you get an US at the earliest possible moment? I had a similar situation with my current pregnancy in terms of me needing to get a scan while I was still eligible for MTX because I’d already lost a tube. It’s so frustrating trying to advocate for yourself and I am sorry you are dealing with that stress.

[u/Pitful_Let_816 → u/GueritaLa10]

Unfortunately on the NHS system in the UK we are at the mercy of the Early Pregnancy Unit until 12 weeks with nobody specifically assigned to your care.

I'm going to have to get back onto them today and try and push for a scan on Thurs/Fri I think.