Early Pregnancy Concerns: What to Do When You Experience Symptoms

Thank you, doctor?

I had my period on March 11 and 12.
After having intercourse on March 26, I took emergency contraception but still ended up pregnant.
I'm unsure about the exact date of conception.
I visited a doctor who confirmed the pregnancy, but we couldn't see the embryo yet.
The doctor estimated that I was about four weeks along.
My boyfriend and I are not familiar with pregnancy care, and we had intercourse again on April 22, after which I experienced bleeding similar to a menstrual period and abdominal discomfort.
What should I do? Is there a risk of miscarriage? Should I take emergency contraception again? Why shouldn't I take emergency contraception? What is the likelihood of an ectopic pregnancy and the risk of miscarriage? I won't be able to see a doctor until Friday.
Will this situation worsen? If I choose to pay out of pocket for a blood test, what is the approximate cost? Why is it necessary to have two blood tests? Thank you for your response, doctor.

Niming, 20~29 year old female. Ask Date: 2017/04/23

Dr. Huang Jianzhong reply Obstetrics and Gynecology

My period started on March 11 and 12.
I had intercourse on March 26 and took emergency contraception, but I still became pregnant, although I'm unsure of the exact date of conception.
I have seen a doctor, but they couldn't detect the embryo yet.
The doctor estimated that I am four weeks along.
My boyfriend and I are not familiar with pregnancy care methods, so we had intercourse again on April 22, but afterward, I experienced bleeding similar to a menstrual period and abdominal discomfort.
What should I do? Is there a risk of miscarriage? Should I take emergency contraception again?
1.
Why shouldn't I take emergency contraception?
Answer: Emergency contraception is ineffective at this point.
2.
What is the likelihood of an ectopic pregnancy?
Answer: The probability is unclear.
3.
What is the likelihood of miscarriage?
Answer: The probability is unclear.
4.
Since I can only see a doctor on Friday, will this be a problem?
Answer: If there is no abdominal pain, it should be fine.
5.
How much does it typically cost for a blood test if I pay out of pocket?
Answer: It depends on the doctor's assessment before the blood test.
6.
Why do I need to have two blood tests?
Answer: For differential diagnosis.

Reply Date: 2017/04/23

More Info

It sounds like you are experiencing a lot of anxiety and uncertainty regarding your early pregnancy, which is completely understandable given the circumstances. Early pregnancy can be a time filled with mixed emotions and concerns, especially when symptoms arise that may cause worry. Let's break down your concerns and provide some guidance.

Firstly, it’s important to note that early pregnancy can come with a variety of symptoms, including light bleeding or spotting, abdominal discomfort, and changes in mood. The bleeding you described, especially if it resembles a menstrual period, can be concerning, but it is not uncommon for some women to experience light bleeding in early pregnancy. This can be due to a number of factors, including implantation bleeding, hormonal changes, or even cervical irritation after intercourse. However, if the bleeding is heavy or accompanied by severe pain, it is crucial to seek medical attention immediately.

Regarding your question about the possibility of miscarriage, it is true that the risk of miscarriage is higher in the first trimester, particularly within the first 12 weeks. The estimated risk of miscarriage varies, but it is generally accepted that about 10-20% of known pregnancies end in miscarriage. Factors such as maternal age, health conditions, and lifestyle choices can influence this risk. If you are experiencing significant bleeding and pain, it is advisable to contact your healthcare provider as soon as possible for an evaluation.

As for the use of emergency contraception (the "morning-after pill"), it is typically not recommended once a pregnancy has been confirmed. Taking it during pregnancy can lead to complications and is not effective in terminating an existing pregnancy. If you suspect you are pregnant, it is best to avoid taking any additional hormonal medications without consulting your doctor.

You also mentioned concerns about ectopic pregnancy, which occurs when a fertilized egg implants outside the uterus, often in a fallopian tube. Ectopic pregnancies can be serious and require immediate medical attention. Symptoms may include sharp abdominal pain, shoulder pain, and heavy bleeding. If you experience any of these symptoms, it is critical to seek emergency care.

In terms of blood tests, your doctor may recommend serial blood tests to monitor your hormone levels, specifically hCG (human chorionic gonadotropin). This hormone is produced during pregnancy, and measuring its levels can help determine the viability of the pregnancy. Typically, doctors will check hCG levels about 48 hours apart to see if they are rising appropriately, which can provide insight into the health of the pregnancy.

As for the cost of blood tests, this can vary widely depending on your location and whether you have insurance. In the United States, a single hCG blood test can range from $20 to $100 or more, depending on the facility. It’s best to check with your healthcare provider or local lab for specific pricing.

In conclusion, while early pregnancy can be filled with uncertainty and anxiety, it is important to communicate openly with your healthcare provider about your symptoms and concerns. They can provide you with the necessary evaluations and support to ensure your health and the health of your pregnancy. If you are feeling overwhelmed, consider reaching out to a trusted friend or family member for support, or even a mental health professional who can help you navigate these emotions. Remember, you are not alone in this journey, and there are resources available to help you through it.

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