What causes heavy bleeding in a patient with ovarian cyst?

Question

Hello doctor,

I have an ovarian cyst on my left ovary that is 3.0×2.1x2.0 somewhat solid with no internal cystic structures or peripheral vascularity no free fluid. That is word for word on my documents. So my question is I have been bleeding dark blood for almost a month now. When I am more active throughout the day it is heavier than when I am resting. I fill a pad in six to eight hours. The reason for alarm is I also found out that I am pregnant. My hCG levels were 816. I am waiting to see the obgyn because the hospital did an ultrasound and said that I have a ruptured cyst. From what I just read there is no free fluid so how could this be. I am scared. I do not want to miscarry.

Answer 1

Hi,

Welcome back to icliniq.com.

With a beta hCG of 816 and a cyst in the left adnexa with bleeding from vagina the first probable diagnosis is ectopic pregnancy. However, it is likely that it is an abortion of the tubal ectopic pregnancy which means that probably there was an ectopic pregnancy in your tube and it slipped out on its own into your abdomen. That can give rise to the cyst in the left adnexa. There are 2 ways to deal with this:

1. If you are clinically stable and have good hemoglobin, you can do a serial measurement of beta hCG every other day and see for falling trends as a good sign.

2. Go for a diagnostic laparoscopy and let your doctor take a look inside your abdomen and he or she may proceed based on the laparoscopy findings. Above all kindly remain under direct supervision of your doctor. This consultation is only a second opinion and should not be used for primary treatment.

Thank you.