Re: Ectopic pregnancy

Posted By LAURIE on March 16, 1999 at 21:35:04:

In Reply to: Re: Ectopic pregnancy posted by hfhs.md.rcs on March 16, 1999 at 17:47:19:






I have a question about ectopic pregnancies. lmp12-20-98. On 1-24-99 experienced spotting which lasted three days. 1-27-99, had moderate bleeding, few very small clots. Talked to OB on phone, he said HCG level was 725 and that I was probably miscarrying. He said no need to be seen in office even though I was having pain in lower left side. Three years ago I had a tubal ligation reversed. I switched to a different doctor at this time because of his lack of concern. Second doctor saw me right away and ordered ultrasound. US showed no sign of pregnancy anywhere. follow up HCG levels have been 350 on 2-4-99, 170 on 2-11-99 and 30 on2-18-99.Saw doctor again on 2-20-99 because of worse pain on left side.He said I had an infection and prescribed antibiotics.Seen again 2-25-99 ,still in pain ,was sent for second US which showed soft tissue mass in left fallopian tube. Radiologist thinks it is a tubal pregnancy, my doctor says it can not be one because my HCG level is now 0.He thinks it is residual infection in tube. Can anyone please advise me ? Should I take his word for it or should I seek a second opinion ?




Dear Laurie:
Ectopic pregnancy is a very challenging diagnosis and there are more unusual presentations of this problem than there are patients who have symptoms and signs as printed in the textbooks.
Although the hCG level has dropped, that tells us only that there is no hormone production from the trophoblast (early pregnancy tissue). There is a condition termed chronic ectopic pregnancy in which the tissue stops growing, but does not get quickly resorbed and is an ongoing source of discomfort and irregular bleeding.
A thoughtful physician welcomes a second opinion and it is very satisfying to patients.
Keywords: ectopic pregnancy
This information is provided for education purposes and is not a medical consultation. If you have specific questions, please speak with your physician.