PUL experiences please (pregnancy unknown location)

[DieCryHate]

Hello all. Hope this the best place to post this.

I was given likely prognosis of miscarriage due to a large empty sac last Tuesday. That Thursday I started bleeding (I posted on here about it). My bleeding was mainly brown and hasn't been much. The follow up scan this Tuesday showed my uterus now empty. Sonographer was happy no medical intervention needed but due to lack of cramps or heavy blood loss the midwife took my bloods and did the 48 hour comparison today as a precaution.

Midwife has called me and my hcg levels have increased by 200 in 48 hours (I would be 7 weeks today). She has said I'm high risk ectopic, and it's somewhere other than my uterus but not sure where. I need to go to the larger hospital in 48 hours again (Saturday morning) for repeat scan, hoping it appears, and more bloods.

I was coping brilliantly with the miscarriage news as there didn't seem to have ever been a "baby", just the sac, but this has completely floored me. I feel so scared this could be dangerous if they don't know where the pregnancy is and also the news that actually, technically I'm still pregnant.

I think I just need a handhold and hopefully some positive stories. Sorry for rambling. X

Hi - I was just coming on here for some advice on the same subject. Started bleeding on 29/4 - should have been 6w then - hcg level was 156 - I thought that would be it and was ok with it really - repeat test 48hrs later was 181 and this mornings had gone up to 193. The bleeding was quite bad with cramping too but now it's all kind of stopped.
I had a scan yesterday and they couldn't see anything either in the uterus or the tubes except some fluid.
I am freaking out about EP and we're meant to be going on a mini honeymoon tomorrow which we've already rearranged once due to childcare. The nurse said today before my results came back that if they had risen at all I would not be allowed to travel.... now I am waiting for a doctor to call me to let me know what's going on and what happens next.
It's so hard isn't it - I feel like I was ok with a miscarriage and trying to stay logical but this is just dragging that on and now if I have to cancel our weekend away well that just sucks.
Hope you're ok OP.....

Ps . Sorry for not posting anything positive though - just feels so frustrating doesn't it - plus there's the added feeling of still being pregnant which is not really helping - are you still having symptoms? My boobs are still as sore as ever and I still feel 'pregnant'

Hi @Castledweller sorry you're stuck in the same shitty limbo as me. I really hope you manage to have your mini honeymoon.

I know what you mean, I was quietly confident all was okay as my nausea and heartburn went over a week ago but the sore boobs have crept back in a few days ago which I thought was a bit odd. My hcg seems high to me, it's gone from 1262 to 1436, so nowhere near as much as a viable pg would but still seems so high to me. I'm the same in that logically I got my head around a MC surprisingly well but the likelihood of EP has really given me a wobble. Hopefully we'll hear some positive stories and get some good (at least, as good as it can be!) news soon.

Hi @DieCryHate, sorry your going through this it's really rubbish. I went through the same over Xmas

(full story:
Pregnancy of unknown location/raising HCG treatment www.mumsnet.com/Talk/miscarriage/3450970-pregnancy-of-unknown-location-raising-hcg-treatment)

Have you taken some time off work to process this? Taking time out at this point is the best thing you can do and build up your support network through friends and family. Be prepared for lots of hospital visits and waiting for answers you may never get. Because your HCG is above 1000 they maybe able to pick it up on the scan and find out where it is. When do you have your scan?

So sorry, it’s really tough. I had a similar experience three years ago - I thought I’d had a miscarriage and was coping really well with it then I had odd stomach pains three days later so I thought I’d better get them checked out. Turns out it was EP, they gave me methotrexate to clear it without removing the tube - it worked, but was painful for several weeks because I got blood pooled in my abdomen (as a side point, women who have endometriosis are absolute warriors!!). My employer was very supportive, so I had about 4-5 weeks off work, and kept going back into hospital to get checked, they would’ve whipped out the tube if it hadn’t cleared but I wanted to avoid the surgery if possible. In the end, it was all ok. We couldn’t TTC for 6 months afterwards, so we went and did some exotic travel then started TTC... Three years later, the EP has had absolutely no long term impact and we have two beautiful boys!! :)

Good luck! When I look back on my EP compared to the other two miscarriages I had around the same time, I think about it more as me overcoming a health problem rather than losing the baby - maybe because the baby was always in the wrong place, so not viable from the get go. Mostly, be kind to yourself! EPs are a big thing for your body to cope with, get some time off work and rest up!

Thanks @undomesticgodde55 I've just read your thread, thank you for sharing. How are you feeling now?

Thanks @JimmyJazz that's really encouraging to read and I'm pleased you have your two lovely boys. I also have a son who is wonderful. This pregnancy happened very quickly for us, less than 2 weeks after finally deciding we'd start trying for #2 I got the positive test so it's been a hell of a rollercoaster. We almost didn't TTC again because my son and I didn't have a great time of it in labour ("unlucky 1%") which really put my DH and me off trying for another one. Then this happens!

My next scan and blood test will be on Saturday morning. The midwife says they'd expect to see something on a scan at hcg levels of 1500 and mine has gone to 1436 today so I'm hoping nothing scary happens in the next couple of days, they find it on screen on Saturday and I can get this all dealt with.

Thanks for sharing your experiences, makes it all seem much less scary.

@DieCryHate hope you get some answers on Saturday - keep us posted

I got called from the emergency gynae unit about 3 and they said I should come in to speak to the consultant about interventions - especially since I'm going away tomorrow (supposedly). They have said it's definitely a PUL and that they will do another blood test tomorrow at 7am and hopefully the hcg will have plateaued or gone down a bit which will make me more confident about going on a flight.

They also did bloods to check for internal bleeding etc

Consultant said that if I did go anyway that I would have to come back ASAP when back in the UK on Monday and if hcg hasn't dropped then I will have to have the injection. I asked about having it today instead but she said that you definitely cannot go anywhere soon after the injection so that's not an option.

It's so shit!!! I am trying to be positive about it all but it does make the recovery from the miscarriage a lot harder with all this lingering on.
I have pretty much completely stopped bleeding now too.

I have 2 dc already and never experienced anything as weird as this before.

for everyone in this shitty situation

@DieCryHate honestly, now it feels like the whole episode happened to somebody else. It sucked waiting three months TTC again, but we were lucky and I'm now 8 weeks. We had a reassurance scan on Monday, it's in the right place this time and has a little heartbeat .

Don't get me wrong though, at the time I was devastated, had a good 3/4 weeks off work as I did have sever cramps and was constantly crying. It's a very emotional time especially as your hormones are still hanging around. I felt a lot of guilt at the time as I felt I was killing my baby, I thought it was my fault because it was my body that caused it etc. But of course that just isn't the case. The baby would have never survived and would have made me really poorly in the process if I'd have left it there. And my body was just doing what it thought it should be doing, it's no ones fault unfortunately it's just one of them things. I really hope you get some support and keep us updated

@Castledweller I will keep everything crossed for your blood test tomorrow and for going away, sounds like a much deserved break!

@undomesticgodde55 that's wonderful news, congratulations! Very pleased for you.

I'd like to fast forward to Saturday morning now and hopefully get some treatment sorted. I've not had a response from my boss so I hope they're not annoyed. It's my husband's birthday next week too, poor sod. I don't think we'll even consider trying again now for a while. It took so much soul searching and positivity to start TTC #2 I don't think we're up to it mentally.

I've had both a PUL and a ruptured ectopic- if your levels have continued to increase it does sound like there is pregnancy tissue somewhere which is causing the release of hcg?
Heterotropic ectopics is rare but can also happen where you have one in the uterus - which is why they saw a sac there and also one in the tube which is causing the hcg rises
Just be aware if they give you methotrexate that you can't ttc again for 3 months as it is really dangerous to have in your system in early pregnancy x

Looks like I can't risk going away - my levels have gone up to 221 now so that's the biggest increase and in only 24 hours too.
ah well.
We're going to stay local but still go somewhere nice since we're kid free! The hospital said they would give us a letter for the insurance company so we get the money back

@Castledweller sorry you can't take your original holiday but glad you can hopefully get your money back and still have a nice break together.

@itwasalovelydreamwhileitlasted thank you!

I ended up in A&E Yesterday with the pain. I've been transferred to a different hospital now. Ultrasound confirmed ectopic pregnancy in a tube so I'm now on a drip, nil by mouth hopefully into theatre as soon as possible to have it removed.

Shitting a brick!

@DieCryHate oh no, can't you have the injection rather than going for the surgery?

You must be pretty nervous.... don't worry - at least this will hopefully be over soon... thinking of you

 all the best @DieCryHate, it's a horrible situation but you are obviously in the right place and being looked after

Thanks all. No mention of the injection, I think the pregnancy was too large and unstable to risk it. I am out now Yupik, yippee. As long as I carry on in recovery okay I can go home later today. Thanks for all of your support - all the best for your pregnancy @undomesticgodde55 and best wishes and positive vibes for you @Castledweller

Ahh well done @DieCryHate! It's all over now. How do you feel?
I have to be at the hospital at 9:30 for another scan/bloods then they'll decide what to do next....

@Castledweller good luck for 9.30! If you end up having the keyhole surgery and tube removal that's what I've had and honestly i felt scared but they were so reassuring and it's so routine to them. Last thing I remember was looking at the clock and it was 9.35 when they put the oxygen mask on me and I groggily said my hand hurts, remember them saying "that's the painkiller travelling up from the cannula" then I woke up and it was 11.15am all done and I was in recovery!

I feel sore but I managed to get home early hours this morning so I slept in my own bed which made a world of difference.

I really hope you get some answers today and a treatment plan in place which you're happy with. There was a girl on opposite me in the same position as us, it's frightening when you don't know what's going on but you'll be in the best hands. Let me know what they determine x

@DieCryHate glad it's over for you and it seems like the surgery went well - how are you now?

My levels had stayed the same on Sunday but yesterday they'd gone up a little again - the doctor said that it had gone on long enough already (about a week monitoring hcg levels) and I needed to have the methotrexate - had it yesterday at 2pm ish - feel ok so far.....