Ectopic pregnancy - my symptoms
Hi all,
I feel like I should post my experience of my ectopic pregnancy here in case it may help anyone in the future with similar symptoms to mine. I've presented this as a timeline as I feel this is important. I was noting absolutely everything this past month which is why I can present you with accurate dates. Please be aware that I'm from the UK and I rely on the NHS for treatment, so treatment pathways would be different if you're from outside the UK.
Nov 19-20: Pre-AF brown spotting (very normal for me).
Nov 21-24: AF.
Nov 25: Post-AF brown spotting (again, this is normal for me).
Dec 5: Confirmed ovulation; tracked by BBT and OPK.
Dec 12: A triphasic temperature was observed, which looked promising.
Dec 19-20: Pre-AF brown spotting observed, which was to be expected if I wasnt pregnant.
Dec 21: Still spotting, but no AF. Spotting remains brown.
Dec 22: Took a HPT, came back with a BFP. Lovely Christmas news! At this stage, my pregnancy was considered to be at 4 weeks from my LMP, or 2 weeks gestational age. Still spotting brown blood.
Dec 23-24: Still spotting brown. Occasional small 'bits' observed, definitely not tissue material but perhaps small clots. Some cramping felt and mild nausea, but this was associated with typical pregnancy symptoms.
Dec 25: Spotting bright red blood. Not considered a true bleed because this is defined as enough blood to soak a pad within an hour (I believe), but it was fresh, bright red blood. Some tissue observed. I thought this may have been a miscarriage so I took another HPT, but still came back positive.
Dec 26-27: Brown spotting, small 'bits' observed still.
Dec 28-31: Heavier brown spotting, cramps still felt. Never painful, but definitely noticeable. Cramps were diffuse and never felt on one side. Mild nausea occasionally felt.
Jan 1: Bright red blood, still not considered a heavy bleed. Observed some stringier material this time, possibly tissue but possibly mucus. Cramps were mostly diffuse, but occasionally felt on my left side.
Jan 2: Brown spotting. Decided to just have it checked out on a hunch, so I walked into my local hospital that has an early pregnancy and gynaecology unit. They took my blood pressure, urine sample and was booked in for a transvaginal ultrasound that very morning. Three sonographers had to check me and all three observed a mass on my right fallopian tube measuring at 22mm. They could not observe a sac in my uterus (note that I'm just under 6 weeks LMP/4 weeks gestational age, so they should be able to see something at this stage), but my uterine lining was thickened. They didn't want to confirm it was ectopic until my blood was assessed, so a blood sample was taken to measure hCG levels after my scan, which measured at ~500 IU/L.
Jan 4: A second blood test was undertaken to measure how my hCG levels were changing over 48h. It rose to ~700. As this was not doubling, and was rising <66% over 48h, its confirmed that its an ectopic pregnancy.
Due to my low initial hCG levels, I'm now waiting until Jan 9 to see how my hCG levels are changing. If they are still rising, I will be given a small dose of methotrexate. This is with the caveat that unless things drastically change in the meantime (i.e. my symptoms get a whole lot worse). It feels strange as I feel like I have a ticking timebomb in me, but expectant management can work so I'm keeping a very close eye on things.
Few things I want to point out.
Firstly, the most important point, is that I was spotting brown blood from the beginning. Every article you read online seems to say that brown spotting = normal, red bleeding = abnormal. I had persistent brown spotting, and occasional red spotting, but never a true bleed. I passed this off as normal.
My one-sided cramp was on my left side, but the ectopic was confirmed on my right. Please dont rely on the location of your cramps to indicate that something is wrong.
I never felt pain. I know everyone has a different threshold of pain, but at best I felt discomfort which can be passed as a typical pregnancy symptom.
This was my first pregnancy and I'm TTC #1. Not the best start to my journey but I hope this isn't a taste of the journey ahead! I'm assured that many women conceive after having an ectopic pregnancy, but that the risk of subsequent ectopics are increased. In the future, I will get my butt to the clinic a week earlier to confirm if there's an ectopic mass. It may not be visible on ultrasound so early on, but at least my blood can be checked to see if hCG is rising as it should.
I hope this helps, happy to answer any questions.
Edit 1: (Jan 05)Thank you all who replied with your well-wishes and with your experiences. Hopefully our symptoms can help someone with similar red flags to get themselves checked as early as possible.
Edit 2: (Jan 06) my symptoms got worse. I felt a weird ache on my right shoulder blade (not tip) as if I slept on it funny, I had frequent stabby pelvic pains followed by bright red spotting. I was admitted overnight as the team wanted to keep an eye on me. In the morning they performed another ultrasound scan which showed that my tube was intact, the mass didnt grow but there was some bleeding. I was given a choice of methotrexate or surgery as I was in a grey area that both routes were suitable for me and I opted for surgery to remove the tube. Surgery (laprascopic salpingectomy) went very well and post-surgical pain was minimal. I think because I had surgery before the tube burst it minimised complications or pain. I was discharged on Jan 08.
Fun fact: removal of one fallopian tube does not mean that the ovary on that side is ‘wasted’ and that you must rely on the other ovary that still has the fallopian tube to get pregnant. Please look up ovum transmigration, the fallopian tube-less ovary can still ovulate an egg and the other fallopian tube can pick it up. There’s an interesting study on this which suggests that after removal of the fallopian tube due to ectopic pregnancy, one third of pregnancies are due to the egg transmigrating from the fallopian tube-less ovary and picked up by the other tube.
https://academic.oup.com/humrep/article/28/4/937/653121
when does ectopic pregnancy pain start reddit?
