Ectopic pregnancy-- how (and when) did you know?

[Anonymous]

So if a lot of ectopic pregnancies don't have symptoms before a rupture-- and if most OBs don't do ultrasounds (where they'd notice an ectopic) until at least 8 weeks-- and if many ectopic pregnancies cause ruptures before 8 weeks-- how are you supposed to avoid surgery and losing a fallopian tube and maybe even worse? Seems pretty risky to me to wait 'til 8+ weeks to check... sure, ectopics aren't that common, but they're not super-rare either, and tubal ruptures are pretty serious.

Or am I wrong about one or more of these things?

If you had an ectopic pregnancy, when and how was it found? Were there symptoms beforehand?  If it ruptured, when did it rupture? 

(And are there doctors who'll do ultrasounds before 8 weeks if you don't have risk factors? Who?)

[Anonymous]

I haven't had one but I know that erratic betas as well as bleeding (even way before before a repture) are signs. I get what you're saying though. I had bad cramping in my side at the beginning of my prenancy so my doctor just gave me an early ultrasound to rule it out.

[Anonymous]

I started bleeding went to doc she checked betas and ordered ultra. Ultra showed empty uterus she thought miscarriage but was worried I was in pain and still bleeding.. So ordered another. They rushed me to ER. Said beta was not multiplying normal but beta too low to see something in ultra so I waited 2 days. Redid beta, high enough to see but ultra emory. They assumed pain, blood and beta and ultra it was etopic. Got the MTX shot. No burst or surgery

[Anonymous]

Anonymous wrote:I started bleeding went to doc she checked betas and ordered ultra. Ultra showed empty uterus she thought miscarriage but was worried I was in pain and still bleeding.. So ordered another. They rushed me to ER. Said beta was not multiplying normal but beta too low to see something in ultra so I waited 2 days. Redid beta, high enough to see but ultra emory. They assumed pain, blood and beta and ultra it was etopic. Got the MTX shot. No burst or surgery

Week 4-5 for me

[Anonymous]

I had pain and spotting around 5 1/2 weeks. I called my doctor first thing in the morning and they squeezed me in; ultrasound showed the ectopic, and they fit me in for emergency surgery that afternoon. (Fortunately I had skipped breakfast.) I did not rupture but came very very close to it - the doctor said I was incredibly lucky and waiting a few more hours might have been a disaster. I lost the tube. Got pregnant again after a couple months of healing and two months trying.

[Anonymous]

I've had two ectopics. In both cases there was bleeding and pain before the ectopic was identified.

First ectopic was pretty much a disaster. Began bleeding only a few days after my + home test. Went to OB for an u/s, it showed nothing, they decided it was an "incomplete miscarriage" and did a D&C. 1.5 weeks later I went to the ER with sudden and very severe pain. Two more ER visits and an overnight hospital stay before they determined I had an ectopic pregnancy, on the basis of my betas and the fact that the path report on the D&C found no products of conception. Got a methotrexate shot, was back in the ER that night with extreme pain (by far the worst pain in my life). Had surgery the next morning that started out laparoscopic but turned into a 4 hr laparotomy due to rupture and hemorhaging. Lost the tube, obviously. I'm not sure when the rupture actually occurred, but I am guessing it was when I went to the ER the first time for the pain - so 5.5 days before the surgery. The abdominal scans they did that night showed fluid (blood) in my abdominal cavity, I remember, but no one suggested ectopic. I still don't quite understand why no one put the pieces together sooner, but I guess it's because the pregancy was never seen on u/s until the last ER visit/a few hours before the surgery. I think I was probably about 7.5 weeks pregnant at the time of the surgery, but obviously the embryo wasn't developing anything close to normally.

Second ectopic was not nearly as dramatic. Actually didn't take a test or realize I was pregnant until I'd been having my "period" for nearly 2 weeks. Went to the Dr, ultrasounds again showed nothing, pattern of betas over the course of 3 were unusual and indicative of ectopic, and again I was having pain (enough to have me pacing and trying to breathe through it, but nothing remotely as severe as with the prior ectopic). One methotrexate shot resolved the pregnancy, no rupture. I would guess I was about 6 weeks at the time of the shot, but again - development wasn't anything close to normal.

[Anonymous]

Like others, bleeding was the first indication for my ectopic. I knew something was wrong when, after what I thought was a perfectly normal period, my waking temperatures didn't go down (I was temping a la Taking Charge of your Fertility). So I took a pregnancy test and it was positive. I called my OB, she ordered betas. Second beta didn't double so it was presumed to be a miscarriage. Ultrasound was inconclusive so she ordered more betas. They climbed slowly... during this time I had some more bleeding... then they became erratic and, on the same day as the erratic beta results, it showed up on an ultrasound as ectopic. This was at about 6.5, maybe 7 weeks. I was treated with methotrexate, my tube never ruptured. The crazy part is I never had any pain.

For subsequent pregnancies, I have gotten betas every 48 hours starting the moment I got a positive on home pregnancy tests (about 9-10DPO on really sensitive ones) until an ultrasound confirms there's something in my uterus at about 5 weeks.

If you're worried, ask for betas.

[Anonymous]

Mine was discovered at a routine ultrasound. Had absolutely no symptoms. In retrospect, I had some spotting around 4 weeks, but at the time no one thought it was a big deal. There was never even a mention of ectopic until I went for my first ultrasound and they they told me to go immediately to the ER. Treated with methotrexate and no rupture and no lost tubes. Based on the beta results in the hospital, they think it was probably resolving naturally, but of course they treated it anyway).

2nd pregnancy, I had spotting at around week 6 and the ob's front office staff blew me off even after I told them about the history of ectopic. I became totally paranoid and ended up in the ER where an ultrasound confirmed a normal pregnancy.

3rd pregnancy, went in for a blood test to confirm at 6 weeks and the midwife looked at my chart and made them do an ultrasound for peace of mind. It confirmed that it wasn't ectopic, but they couldn't find a heartbeat so it was a nervous week for me until they did a followup and all was fine.

[Anonymous]

PP, how many weeks along were you at that ultrasound the first time when they sent you to the ER?

[Anonymous]

Bleeding at 5 weeks which led to an u/s.

[Anonymous]

Anonymous wrote:I've had two ectopics. In both cases there was bleeding and pain before the ectopic was identified.

First ectopic was pretty much a disaster. Began bleeding only a few days after my + home test. Went to OB for an u/s, it showed nothing, they decided it was an "incomplete miscarriage" and did a D&C. 1.5 weeks later I went to the ER with sudden and very severe pain. Two more ER visits and an overnight hospital stay before they determined I had an ectopic pregnancy, on the basis of my betas and the fact that the path report on the D&C found no products of conception. Got a methotrexate shot, was back in the ER that night with extreme pain (by far the worst pain in my life). Had surgery the next morning that started out laparoscopic but turned into a 4 hr laparotomy due to rupture and hemorhaging. Lost the tube, obviously. I'm not sure when the rupture actually occurred, but I am guessing it was when I went to the ER the first time for the pain - so 5.5 days before the surgery. The abdominal scans they did that night showed fluid (blood) in my abdominal cavity, I remember, but no one suggested ectopic. I still don't quite understand why no one put the pieces together sooner, but I guess it's because the pregancy was never seen on u/s until the last ER visit/a few hours before the surgery. I think I was probably about 7.5 weeks pregnant at the time of the surgery, but obviously the embryo wasn't developing anything close to normally.

Second ectopic was not nearly as dramatic. Actually didn't take a test or realize I was pregnant until I'd been having my "period" for nearly 2 weeks. Went to the Dr, ultrasounds again showed nothing, pattern of betas over the course of 3 were unusual and indicative of ectopic, and again I was having pain (enough to have me pacing and trying to breathe through it, but nothing remotely as severe as with the prior ectopic). One methotrexate shot resolved the pregnancy, no rupture. I would guess I was about 6 weeks at the time of the shot, but again - development wasn't anything close to normal.

I'm so sorry