Ectopic Pregnancy: Symptoms, Diagnosis, and Treatment Options

Ectopic pregnancy

Last month, my period started on the 7th.
This month, I had my period again from December 8th to December 15th.
A week later, on December 22nd, I experienced abdominal pain and light bleeding.
I initially thought it was ovulation pain since I was still breastfeeding until December 23rd.
I continued to have intermittent abdominal pain, so I visited a gynecologist who performed an ultrasound and found internal bleeding.
A pregnancy test showed two lines, and the doctor diagnosed me with an ectopic pregnancy, advising me to transfer to a larger hospital.

At the larger hospital, my blood test showed a level of approximately 6600, and I was immediately scheduled for laparoscopic surgery.
After the surgery on December 24th, the doctor informed me that during the procedure, they removed a blood clot from the abdominal cavity, but there was no embryonic tissue present, suggesting it may have already been expelled.
They also removed a cyst from my ovary.
The doctor checked the fallopian tubes, which appeared clean with no bleeding, and both samples were sent for pathology to check for any embryonic tissue.

Before being discharged on December 25th, my blood test showed a level of about 1100.
Could it be possible that I am not experiencing an ectopic pregnancy but rather a miscarriage? Does this mean the surgery was unnecessary? What could be the possible scenarios?

Ms. Zhou, 30~39 year old female. Ask Date: 2023/12/26

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, internal bleeding is not normal.
Please follow up at the original unit.
Wishing you good health.

Reply Date: 2023/12/26

More Info

Ectopic pregnancy, or tubal pregnancy, occurs when a fertilized egg implants outside the uterus, most commonly in the fallopian tubes. Understanding the symptoms, diagnosis, and treatment options for ectopic pregnancy is crucial for timely intervention and to prevent severe complications.

Symptoms of Ectopic Pregnancy
The symptoms of ectopic pregnancy can vary, but common signs include:
1. Abdominal Pain: This is often one of the first symptoms. The pain may be sharp or cramp-like and can occur on one side of the abdomen.

2. Vaginal Bleeding: Light spotting or heavier bleeding may occur, which can be mistaken for a normal menstrual period.

3. Shoulder Pain: This can occur due to internal bleeding that irritates the diaphragm.

4. Weakness or Dizziness: This may indicate internal bleeding and potential shock.

In your case, the abdominal pain and bleeding you experienced could align with the symptoms of an ectopic pregnancy. However, these symptoms can also be indicative of other conditions, such as a miscarriage or a ruptured ovarian cyst.

Diagnosis of Ectopic Pregnancy
Diagnosis typically involves:
1. Ultrasound: A transvaginal ultrasound is the most effective way to visualize the location of the pregnancy. In early pregnancy, a gestational sac should be visible in the uterus. If it is not, and there are signs of bleeding, an ectopic pregnancy may be suspected.

2. Blood Tests: Measuring levels of human chorionic gonadotropin (hCG) can help determine the status of the pregnancy. In a normal intrauterine pregnancy, hCG levels should rise significantly every 48 hours. In an ectopic pregnancy, the levels may rise more slowly or plateau.

3. Clinical Symptoms: The combination of symptoms, ultrasound findings, and hCG levels helps in making a definitive diagnosis.

Treatment Options
If diagnosed with an ectopic pregnancy, treatment options include:
1. Medication: Methotrexate can be used to terminate an early ectopic pregnancy if there are no signs of rupture and the hCG levels are not excessively high. This option is less invasive and preserves the fallopian tube.

2. Surgery: If the ectopic pregnancy is ruptured or if there is significant internal bleeding, surgical intervention is necessary. This can be done via laparoscopy or laparotomy, depending on the severity of the case. In your situation, it appears that surgery was performed to remove the blood clot and assess the fallopian tubes.

Your Situation
Based on your description, it seems that the medical team suspected an ectopic pregnancy due to the ultrasound findings and elevated hCG levels. The surgery you underwent was likely a precautionary measure to prevent complications from a potential rupture. The absence of embryonic tissue in the blood clot suggests that the pregnancy may have resolved on its own, which can happen in some cases of ectopic pregnancy.
It's understandable to feel concerned about whether the surgery was necessary. However, given the risks associated with ectopic pregnancies, including rupture and internal bleeding, the decision to operate was likely made to ensure your safety.

Conclusion
While it’s possible that you may have experienced a miscarriage rather than an ectopic pregnancy, the medical team's decision to proceed with surgery was likely based on the need to rule out any immediate threats to your health. It is essential to follow up with your healthcare provider for further evaluation and to discuss the results of the tissue analysis. They can provide clarity on your specific situation and any implications for future pregnancies. Always remember that early detection and treatment are key in managing ectopic pregnancies effectively.

Similar Q&A

Understanding Ectopic Pregnancy: Diagnosis and Treatment Options

Hello, I would like to inquire about ectopic pregnancy as I am not very familiar with the condition. 1. How long after conception can an ectopic pregnancy be diagnosed? 2. What methods can be used to diagnose an ectopic pregnancy? 3. Is it necessary for the fallopian tube to ...

Dr. Huang Jianxun reply Obstetrics and Gynecology
Dear Chen Shichang, Firstly, early diagnosis of ectopic pregnancy can be challenging and requires consideration of symptoms (such as lower abdominal pain and vaginal bleeding), gestational age, a series of ultrasound examinations, or a series of blood tests measuring the pregnan...

Understanding Ectopic Pregnancy: Causes, Symptoms, and Treatments

What is an ectopic pregnancy?

Dr. Lü Lizheng reply Obstetrics and Gynecology
Hello, what is an ectopic pregnancy? An ectopic pregnancy is also a type of pregnancy that presents with pregnancy symptoms; however, the embryo is not located in the uterus. It typically implants in the fallopian tube. An embryo that grows to seven weeks can potentially rupture ...

Understanding Ectopic Pregnancy: Treatment Options and Dietary Considerations

Hello Doctor, last week I went to the obstetrics and gynecology department due to abdominal pain and bleeding. They performed a pregnancy test and it came back positive. The doctor also conducted a transvaginal ultrasound but did not see a fetus, so I was advised to have two bloo...

Dr. Tian Yiwen reply Obstetrics and Gynecology
If you are concerned, it is advisable to seek a second opinion from another doctor. Your condition cannot be assessed solely through online articles; a direct consultation and examination are necessary to determine if you have an ectopic pregnancy. Excessive bleeding could pose a...

Signs and Symptoms of Ectopic Pregnancy: What You Need to Know

What are the signs of an ectopic pregnancy? How can one know if they have an ectopic pregnancy?

Dr. Zhan Deqin reply Obstetrics and Gynecology
Ectopic pregnancy can cause vaginal bleeding and abdominal pain. A doctor needs to perform an examination, which may include an ultrasound and blood tests.