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Expectant management

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Xamy88x
Posts: 2
Joined: Sat Dec 25, 2021 9:53 pm

Expectant management

Post by Xamy88x »

Hi everyone
I found out I had an ectopic pregnancy 2 days before Christmas 😢 my hormone levels were initially 1500 and they dropped to 500 48 hours later so was told I would have expectant management as it looked like my body was dealing with it and could return a week later for another blood test.
A week later my levels had dropped to 250
A week after that my levels had only dropped to 225.
Whilst this is still a drop it’s not as big a drop as I was hoping for and as I was feeling better I expected more of a drop in all honesty. The doctor said to leave it another week and if there was only a small drop I would have the injection. I’m hoping that the drop will be bigger next time and I won’t need the injection.
Just wondered if anyone had gone through anything similar and managed to continue with expectant management?
Thanks

EPT Host 20
Posts: 3155
Joined: Thu May 31, 2012 10:58 pm

Re: Expectant management

Post by EPT Host 20 »

Dear Xamy,
I am so sorry to hear of your ectopic pregnancy and loss,
Although expectant management doesn't have the side effects of methotrexate injection or surgery, it can be a drawn out process. There is no set pattern for how quickly the hCG drops as we are all unique and it can seem to plateau on occasion.
I hope you receive more positive news at your next blood test.
We will be here for you for as long as you need,
Sending much love,
Karen x

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Sam_X
Posts: 2
Joined: Tue Jan 11, 2022 12:26 pm

Re: Expectant management

Post by Sam_X »

Hi Amy,
I have recently been under expectant management for an ectopic pregnancy. I had initially decreasing hcg but then it plateaued for a while and I was left with the option of either having methotrexate or waiting a little longer with the hope my body would start to reduce the hcg and rebasorb the pregnancy. This is week 8 for me and I have only just been discharged today as my bloods have finally reached 8.9.
So sorry this isn’t probably that helpful but as long as you’re well enough then you could continue with the expectant management but it is a long process 😞. Hope you’re feeling ok and your next bloods decrease!

Xamy88x
Posts: 2
Joined: Sat Dec 25, 2021 9:53 pm

Re: Expectant management

Post by Xamy88x »

Thank you for replying.
I am back at the hospital this weekend so hoping for a bigger drop. Not in any pain at the minute so I’m hoping I can continue with expectant management but like you say it really is a long process.
I hope you are feeling better, I’m sure it’s a mixture of both relief and sadness when your levels do actually reach zero

Sam_X
Posts: 2
Joined: Tue Jan 11, 2022 12:26 pm

Re: Expectant management

Post by Sam_X »

No worries! I know what a lonely place this whole process is so I wanted to reach out.
I really hope your levels have decreased so you do not need the methotrexate.
You’re right about the mix of sadness and almost relief but I guess that’s normal.
Fingers crossed for you!

Lyn_K
Posts: 36
Joined: Fri Mar 18, 2022 12:48 pm

Re: Expectant management

Post by Lyn_K »

Hi Xamy88X,

I hope you managed to stay on the expectant management. I only just found out yesterday that I had an ectopic pregnancy. Because my HCG levels are so low at the moment (37.4 on Monday and Wednesday and 39.0 on Friday), my doctor is hoping for expectant management although she did give me the option of surgery. She refused to give me the Methotrexate until we see what my blood says on Monday.

I am very torn between expectant management and surgery. Part of me want the expectant management as I don't like the idea of going under the knife. But I feel that surgery would be the only way to give me the full reassurance that this nightmare will be done soon.

What was the outcome of your situation (or anyone else's situation)? Did you end up needing the medication? Or did you still have to go for surgery?

Hopeful2
Posts: 5
Joined: Sat Apr 23, 2022 1:52 pm

Re: Expectant management

Post by Hopeful2 »

Hi lyn_k

I am going through expectant management at the moment ….can I ask how your recovery has been?

Lyn_K
Posts: 36
Joined: Fri Mar 18, 2022 12:48 pm

Re: Expectant management

Post by Lyn_K »

Hi Hopeful2,

Of course you can ask.

My HCG luckily never went above 40. The following HCG were 32, 19 and then under 1.

As I waited and went back and forth for more bloods, I did have a lot of abdominal pain and not just on my ectopic side. At one point, I ended up in hospital with severe abdominal pain and spotting which turned into a lot of bleeding with some clots. I stayed in hospital overnight and then was discharged home. There was no sign of rupture or internal bleeding in my scans. The heavy bleeding lasted for about 2 days and stopped. From the 2 medical reports I received, it also looked like the mass was decreasing in size. I have an appointment in about 6 weeks time to follow up on my progress.

I have now returned to work after 3 weeks on sick leave and am still trying to recover emotionally. I am very aware that despite my unfortunate diagnosis, I 'had it easy' compared to some other women as I had a choice and a lot of time to process everything. But it was my first pregnancy, a pregnancy I wanted since forever so it was still really hard to take.

Today will be about 4 weeks since my HCG hit under 1 and I am still waiting for my first period. On top of that, I have been having cramps here and there on my left side but also occasionally on my right side. I am not sure if it's the body reabsorbing the tissue, ovulation cramps, or just me being hyperaware. But it is still very anxiety provoking as it takes me back to when I first felt the symptoms of ectopic.

My recovery is still in progress. I heard that it can take a year to really recover fully emotionally.

I hope this helps. How are you doing?

Hopeful2
Posts: 5
Joined: Sat Apr 23, 2022 1:52 pm

Re: Expectant management

Post by Hopeful2 »

I’m going into my 3rd week now and levels are now down to 42, so I’m now able to get my bloods done every 4 days now rather that every two days.

I’ve never had pain on the ectopic side, it’s always been the other (it turns out I have a cyst on the other side) but the bleeding has slowed down a lot which is a relief….well I think it is, then I worry that the mass isn’t clearing itself! But one of the midwife’s said that could take months to disperse.

A nurse last week said I could try to conceive if I felt ready, but surely levels need to be zero, or it could show a false positive….who knows!
I’m keeping everything crossed my body manages to get back to ‘normal’ as the thought of any treatment really scares me x

Lyn_K
Posts: 36
Joined: Fri Mar 18, 2022 12:48 pm

Re: Expectant management

Post by Lyn_K »

I am glad to hear that your levels are going in the right direction.

They actually also found a cyst on my left tube (where my ectopic is or was). I wonder if that's the reason I've been having pain. I did ask my doctor but she was very dismissive about it and didn't even answer my question.

The mass should be reabsorbed by the body. I read an article that found that for some women, it can take up to three month. I might speak my GP in 3 month's time for another scan. Just to make sure that I am in the clear before I try again.

I will follow the Ectopic Pregnancy Trust recommendations to wait at least 2 periods or 3 months (whichever is the soonest) before you try again. It only makes sense to me. It'll give my body time to heal and reabsorb any remaining tissue. And also allow my mind to recover from everything.

Fingers crossed for you!! x

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