Ectopic Pregnancy: Symptoms, Diagnosis, and Concerns

Ectopic pregnancy

1.
I would like to ask, my last menstrual period started on October 11, I received the BNT vaccine on October 13, had sexual intercourse on October 27, and began experiencing brown discharge around October 29.
I tested positive for pregnancy on November 1.
The brown discharge lasted for about a month, during which I visited an obstetrician and took medications and injections to support the pregnancy.
After about five weeks, I still could not see the embryo, so the doctor recommended a blood test to check the HCG levels.
After three tests, the levels were all around nine hundred.
The doctor then confirmed an ectopic pregnancy and administered methotrexate (MTX).
However, I started bleeding the day before the MTX injection.
I continued to receive injections weekly for a total of two weeks, and my HCG levels have now dropped to below 50.
Is it normal to still be bleeding at this point?
2.
Is there a connection between ectopic pregnancy and receiving the vaccine?
3.
The doctor suspects that I should not have been able to test positive so early and even questions whether I was pregnant in October.
However, on October 11, I tested my urine and noticed some bleeding.
The first test showed faint double lines, but the second test only showed one line.
The bleeding was similar to my menstrual flow, so I did not consider the possibility of being pregnant and did not pay much attention to it.

4.
In my first pregnancy, there was no heartbeat around seven weeks, and in my second pregnancy, it was an ectopic pregnancy, but the fetal development was also poor.
Should my husband and I undergo health checks to investigate potential chromosomal issues?

Han, 20~29 year old female. Ask Date: 2021/12/15

Dr. Chen Zhiyu reply Obstetrics and Gynecology

Hello, Ms.
Han! Regarding your concerns, it is recommended that you discuss them further with a specialist in obstetrics and gynecology.
Thank you!

Reply Date: 2021/12/15

More Info

Understanding ectopic pregnancy is crucial for any individual experiencing symptoms or concerns during early pregnancy. Ectopic pregnancy occurs when a fertilized egg implants outside the uterus, most commonly in the fallopian tubes. This condition can lead to serious complications if not diagnosed and treated promptly.

1. Symptoms and Diagnosis: The symptoms of ectopic pregnancy can vary, but common signs include abdominal pain, especially on one side, and abnormal vaginal bleeding, which may be brown or coffee-colored. In your case, the presence of coffee-colored discharge for about a month, along with the inability to visualize the embryo on ultrasound, raises concern for ectopic pregnancy. The HCG (human chorionic gonadotropin) levels you mentioned, remaining around 900, are indicative of a potential issue, as they typically should rise significantly in a normal intrauterine pregnancy. The decision to administer methotrexate (MTX) is a common treatment for ectopic pregnancy, as it helps to stop the growth of the pregnancy tissue. It’s not unusual to continue experiencing some bleeding after treatment, as the body expels the tissue.

2. Relation to Vaccination: There is currently no evidence to suggest that receiving the BNT vaccine (Pfizer-BioNTech COVID-19 vaccine) has any direct correlation with the occurrence of ectopic pregnancies. Vaccines are rigorously tested for safety and efficacy, and while they can cause temporary side effects, they do not influence the implantation of a fertilized egg.

3. Early Pregnancy Testing: The timing of your pregnancy test results can be confusing, especially with the presence of bleeding. It is possible to have a positive pregnancy test even when experiencing bleeding, as some women may have implantation bleeding or other forms of early pregnancy complications. The faint line on your first test could indicate a very early pregnancy, while the subsequent test showing only one line suggests that the pregnancy may not have been viable at that time.

4. Genetic Factors: Given your history of a previous pregnancy loss and now an ectopic pregnancy, it is reasonable to consider genetic factors. Chromosomal abnormalities can lead to pregnancy complications, including miscarriage and ectopic pregnancies. It may be beneficial for both you and your partner to undergo genetic counseling and testing to rule out any hereditary issues that could affect future pregnancies.

5. Ongoing Concerns: It’s important to monitor your symptoms closely. While some bleeding can be normal after treatment for ectopic pregnancy, you should contact your healthcare provider if you experience severe pain, heavy bleeding, or any other concerning symptoms. Regular follow-ups are essential to ensure that your HCG levels continue to decrease and that there are no complications.

In summary, ectopic pregnancy is a serious condition that requires careful monitoring and management. Your symptoms and history warrant close attention from your healthcare provider. If you have ongoing concerns or experience any new symptoms, do not hesitate to seek medical advice. Understanding your body and the changes it undergoes during early pregnancy is vital for your health and future family planning.

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