Hallow Dear,
I would have appreciated had you mentioned for how many days your periods have been delayed.
Since you are off Mirena, your
contraceptive protection has been removed and you do stand chances of pregnancy. However, we never diagnose the pregnancy only on symptoms; it should be confirmed by pregnancy test and/or clinical examination.
The report of pregnancy test 'pregnancy cannot be rules out' is rather ambiguous. Does it mean that the pregnancy test is week? If so, the possible causes are :
1. Test is performed too early. Probably a repeat test after 4 days might confirm the diagnosis of pregnancy.
2. Ectopic pregnancy : In this condition the pregnancy is implanted somewhere outside the
uterine cavity - most commonly tube. Such pregnancy cannot grow and there is always a risk of rupture of the tube. This is bleeding emergency requiring many units of
blood transfusion and surgical intervention.
I would suggest you to opt for
ultrasonography. If the uterine cavity is empty in spite of the (?weak) positive pregnancy test, the chances of ectopic pregnancy have to be considered strongly.
Laparoscopy may help in confirming the diagnosis and also offering conservative management to save the tube.
If ectopic pregnancy is diagnosed before the rupture of the tube, it can be managed conservatively by either
Methotrexate or by
Microsurgery through Laparoscopy.
My advice to you is not to wait for few more days for the pregnancy test to become positive. Please get Ectopic pregnancy ruled out first.
Better to err on safer side!
If it is not ectopic pregnancy and turns out to be an intrauterine pregnancy, you can manage it safely. If it is an unwanted pregnancy and you want to terminate it, there are medicines available with Gynaecologist's advise to terminate it.
So, please do not waste time; report to your Gynaecologist ASAP.
Dr. Nishikant Shrotri