Shoukd I go to the ER?

[Trouble0705]

So roughly 2 years ago I had an ectopic pregnancy.  About 3-4 months later I became pregnant with my now 15 month old daughter.  I have had a huge amount of pretty much unexplained weight loss beyond baby weight so that has messed with my already abnormal periods.  I was having some weird cramping that didn't really feel like period cramps so last night I took a pregnancy test which came back positive.  In the last 3-4 days the cramping has been progressively getting more painful, and very similar feeling to the cramping that I started to have with my 1st ectopic pregnancy.  Another huge concern is that the field I work in is NOT safe for a pregnant woman due to x-rays and hazardous material I handle on a daily basis, so this means possibly miscarriage.  I don't know if I should just head to the ER or if I should just monitor the cramping and if so at what point do I know it's time to go to the ER?  

[Elaine Brown, MD]

Hi!
If any of my patients have a history of ectopic pregnancy, I have a very low threshhold for sending them to the ER.  In your case, unless you can get in to see your regular OB doctor (which would always be preferable to the ER) you should probably go to the emergency room.  If you were my patient, I would first check a quantitative beta hcg.  If the result was over 1000, I would do an ultrasound to try to determine where the pregnancy is located.
If under 1000, I would follow blood tests every other day until I could do an ultrasound.
Hope this helps!
Dr B

[Trouble0705]

Pain is still getting worse, it's not a super quick process but there is a noticeable difference every hour or so, I ask because I don't have insurance and would rather not incur a large medical bill for nothing.....