After some light spotting in W5 we arranged a private ultrasound to ensure everything was proceeding normally. GP told us not to worry about the spotting but thankfully we did as the scan at W6D6 suggested an ectopic. We were rushed to A&E where blood test showed β-hCG levels around 4000. Wife was admitted and eventually given methotrexate about 24 hours after arriving at A&E. However, it doesn't seem as if any other blood tests were done in those 24 hours or immediately prior to MTX injection.
The hospital has brought us in for follow-up blood tests but doesn't seem to be following the usual day 0, day 4, day 7 schedule.
I can't tell whether this is a conscious choice or if they are getting mixed up with the blood draw dates and the MTX treatment date. I understand that the days are somewhat arbitrary, but if we are going to be recommended surgery at the start of day 5 post MTX we are nervous that the medication hasn't been given sufficient time to work.
- Monday evening (day -1) - ultrasound suggests gestational sac 2cm in size in right fallopian, blood β-hCG 4000
- Tuesday evening (day 0) - MTX administered, no further bloodwork carried out, no bleeding or blood pressure issues
- Friday morning (day 3, but really only about 66 hours post MTX, rather than expected 96) - β-hCG 7800 (a significant step up!). Ultrasound shows no change to sac.
A few questions for the forum:
- Am I calculating the days post-MTX correctly?
- Is it strange that the hospital isn't following the typical routine?
- Would we be out of our minds to push to wait until day 7 before making any decisions about surgery? Can we even do this in the NHS?