Help-Pregnancy of Unknown Location fears

[squizita]

Hi
I was wondering if anyone could help or advise because Dr Google just contradicts himself and is terrifying.
Basically, last week my locum GP & secretary booked me in for my reassurance scan far to early in error, everyone at the EPU explained it would most likely create a PUL as the bean would be too small to see (4 weeks 6 days) - and it did. They saw a tiny dot which could be a sac or maybe not...
However, they also did 48 hour bloods to be on the safe side.
My 1st day bloods were 5800 hcg
My 48hr bloods were only 7500 hcg - so not a big enough increase!
My progesterone however is 180, which is apparently very healthy.

I just don't know where I stand and the (Sunday night) registrar who gave me my results was really vague. She said to try more bloods Tuesday but didn't even tell me the time to come in, I think she was busy.

As far as I can see online my progesterone puts me at low risk of ectopic, but the low rise in hcg places me at very high risk!! I am not in any of the risk factor groups either (I am 34 so getting on for 35 but in good health, no coil, no STI history etc').

I have NO symptoms (no bleeding etc') the only symptoms I have are ones which you would also have in a normal pregnancy or (backache) ones I have all the time pregnant or not.

I am going to ring the EPU for some better analysis of my results than yesterday. But this has all spiralled out of control from an admin error to something really terrifying, and as it is STILL too early to definitely see anything I can just see things rolling on and on until I end up in A&E in agony or something...

Has anyone had this (the high HCG rising slowly with good progesterone) and can they advise?

Well I haven't had that but I am not sure it's as exact a science as "HCG doubles every 48 hours." In fact I have just had a very quick google and the first click got this which says that it doubles every 48-72 hours.

I remember having a miscarriage years ago that they thought might be an ectopic pregnancy. This was because although I was bleeding they couldn't see anything on the scan yet pregnancy tests were still positive.

They made me keep having blood tests then because of the "doubles every 48 hours" thing - if it HAD doubled then it would have indicated an ectopic pregnancy. Which seems to be the opposite of what you have been told.

My advice would be to stay optimistic. HCG is going up, you feel well!

Have you tried one of those fancy poncy pregnancy tests that tells you how many weeks pregnant you are? I'd have a go of one of those, if it comes out with the right sort of date then that'd be a good sign that levels were good.

Chin up!

Hi Squiz,

I had serial HCG levels done last week and gp said to expect doubling in 48-72 hours. Looking at yours if they continued at same rate they would more or less have doubled in the 72 hour window.

Completely agree. Up to 72 hours doubling time is fine. Your prog sounds great and they saw a dot at 4 weeks +. Be hopeful.

SQUIZ

Please listen to me... And save yourself ALOT of heartache.

"My progesterone however is 180, which is apparently very healthy"

It is statistically VERY unlikley, read impossible (according to my OB), that you are having an ectopic pregnancy with a progesterone reading of 180.

I was in this situation 26 odd weeks ago and it was a hugely traumatic time. Now my baby is happily kicking away. I wish I had know then what I know how about progesterone levels and ectopics. I was basically told by my OB that anything over 25 for a progesterone can effectively be used to completely rule out an ectopic pregnancy.

Please PM if you want to talk.

This is sounds totally positive. Do not let it mar the start of your pregnancy.

They now have me under observation and going in daily- not the HCG that is the worry ( you were all correct there!) But they can only see a loose, empty sac which flops around - very likely to be a pseudo sac. My progesterone has also fallen (only by 20 or so). 2 consultants fear miscarriage with lagging hormones. So, until they rule out ectopic 100% (high progesterone ectopics are very rare they said but better safe than sorry) I am going in daily for a scan 1 day bloods the other.

Any news squizita?

Hope you're ok.

Well I got further downgraded to a PUL.

Had the runs this afternoon ... argh ectopic symptom!! But I rang the gynie on call at the hospital who said ONLY the runs = wait till morning. She felt that given I had a scan with NO tube blockages 24 hr ago it was unlikely something was severely amiss now.