Patient's question:
Doctor, my last menstrual period was on October 6th, and on December 2nd, I had a weakly positive urine test with a blood HCG level of 545.3. The ultrasound examination did not show any signs of a gestational sac either inside or outside the uterus. The doctor suspected an ectopic pregnancy and recommended a re-examination after one week. On December 7th, my blood HCG level was 592.2, but the ultrasound still did not show any signs of a gestational sac. On the 8th, I experienced bleeding and passed two pieces of tissue-like material. Pathological examination confirmed it was decidua and chorionic villi. On the 14th, my blood HCG level was 19.8, and the ultrasound examination showed no abnormalities in the uterus or adnexa. The vaginal bleeding has now stopped. In our case, can it still be suspected as an ectopic pregnancy, or is it a normal intrauterine miscarriage? Do I need any further examinations? Thank you in advance.Doctor's answer:
Hello, ectopic pregnancy. This includes tubal pregnancy, early pregnancy in the cervix, ovaries, and other abdominal sites. Rupture or miscarriage of ectopic pregnancy is most common around 40 days of gestation, accompanied by severe lower abdominal pain. If the ectopic pregnancy ruptures, it can lead to acute massive bleeding, resulting in hypotension, fainting, or shock. Your condition does not seem to be ectopic pregnancy. Radioimmunoassay measurement of BhCG can help diagnose early, non-ruptured ectopic pregnancy. MRI can detect the absence of a gestational sac within the uterine cavity while identifying one outside the uterus, which is beneficial for early diagnosis.