Does my ultrasound report show extra-uterine pregnancy?

Question

Hello doctor,

Please read the ultrasound and provide feedback. I was advised by a midwife that based on the imaging from my ultrasound, it looks like I have an extrauterine pregnancy. Seems as if the fetus is behind my bowels. My current symptoms are nausea, amenorrhea, weight gain, pelvic pressure, food aversions, night sweats, etc.

I am currently on Lamictal, Propranolol, and Prenatal vitamins.

Answer 1

Hi,

Welcome to icliniq.com.

I can understand your concern. Upon carefully reviewing the images (attachment removed to protect patient identity), I agree with the diagnosis.

The uterine cavity is empty, and there is an extra-uterine baby/pregnancy. The problem with extra-uterine pregnancy is rupture and internal bleeding, which may lead to hypovolemic shock.

In the first three months, they usually try medical treatment (Methotrexate). After the first trimester, the treatment is almost always surgical. An ectopic pregnancy occurs when a fertilized egg grows outside of the uterus. Most ectopic pregnancies occur in the fallopian tube. As the pregnancy develops, it can cause the tube to burst (rupture). A rupture can cause major internal bleeding. This can be a life-threatening emergency that needs immediate surgery.

The risk factors for ectopic pregnancy include the following:

1.Previous ectopic pregnancy.

2. Prior fallopian tube surgery.

3. Previous pelvic or abdominal surgery.

4. Certain sexually transmitted infections (STIs).

5. Pelvic inflammatory disease (PID).

6. Endometriosis.

Other factors that may increase a woman’s risk of ectopic pregnancy include cigarette smoking, age older than 35 years, history of infertility, use of assisted reproductive technology such as in vitro fertilization (IVF).

Please let me know if you have any further questions.

Answer 2

Hello,

Welcome back to icliniq.com.

You are welcome. Keep in tpouch for further doubts.

Answer 3

Hi,

Welcome back to icliniq.com.

I really do not do video conferences. There are many requests, and I am not able to answer them.

Please let me know any written questions you have. I will be happy to help you.

Answer 4

Hi,

Welcome back to icliniq.com.

As far as I know obstetrician decide the treatment by looking at blood hCG (human chorionic gonadotrophin) level and ultrasound. They all may start with Methotrexate if there is a continued drop in hCG level, it may work. If not, they do laparoscopic surgery. It is not my area of expertise but I do not think it is absolute contraindication to start with medical treatment. As a patient, you may always choose surgical treatment. You do not need to travel anywhere to see doctors, most of the institutes have video patient visit opportunity, you can easily get an appointment and ask their opinion. You will not lose anything asking about their opinion. If all or most of them suggest the same treatment, then it is most probably the best way to go. I wish I could help you more but I am not familiar with obstetricians in my area. Please do not be late, the more you wait, the more your risk for internal bleeding increases.