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Severe cramps in lower abdomen, fluid in the cul de sac, chances of ectopic pregnancy? - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Pregnancy
Answered by

General & Family Physician
Practicing since : 2009
Answered : 681 Questions
Doctor :   HI
User :   HI
User :   hELLO
Doctor :   Please proceed with your query.
User :   CAN U HELP
Doctor :   I am a general physician and would help you within my expertise and if required would suggest you a specialist.
Doctor :   Ok
Doctor :   Ok
Doctor :   Ok
Doctor :   Ok
Doctor :   Ok
Doctor :   I would like to know few more things before suggesting you: User :   YA
Doctor :   May i know your age?
User :   28
Doctor :   Are you following any family planning methods?
Doctor :   Ok
User :   I am having continuos pain in right lower abdomen on pressing it hurts .Plus i have in right shoulder since two months .I am an acidity patient but since 3-4 months my togue is almost white .My periods have become from 5-6 days to 3-4 days and is a bit different than normal a bit wattery and dark.I feel tired and had a back pain fw days back .Thanks for the reply sir My dates have been like this .I had physical relation with my partner on 4th and 5 th of feb (my dates were due but i had tablets to delay them) I had i pill after that.My dates lasted from 7th to 10 th feb (not as heavy flow as i normall have) Then dates were 5th to 7th march normal flow. I had a relation on 18 march .19 march and had a ipill on 19 th .then 21 and 23 had a relation and again a ipill. I had light periods that lasted from 26 th march to 29 march. Since march i feel nausea and pain in abdomen ,acidity and at times bad taste . In april dates were 24 to 27 april(first three days heavy flow) in may 16 to 19 (heavy flow) June dates were from 8th to 11 and July 2-5 and a little spotting on 6th. can it be ectopic as i have pain in lower abdomen right side increased after this month periods,pain in lower back and right shoulder .Still having pain i right abdomen ,the reports said (ultrasound on 27.06.11) small fluid in cul di sac . i have pain in right shoulder and right side lower abdomen. CAn it be ectopic ,please tell as though my periods are begular they have shifted from 24 days to 21 days cycle and from 5-6 days to 4 days .Although first threedays flow is heavy.
Doctor :   Please give me few minutes to go through the history.
User :   OK
User :   DOC U THERE
Doctor :   After going through the history, I feel that the fluid present in the cul de sac which is a pouch in between the uterus and the rectum could be due to ectopic or any infection in the pelvic region.
User :   ya i told u that
User :   but i have had periods
Doctor :   Ok
User :   i took medicines for infection put pain has increased
Doctor :   Ok
User :   did u go through the entire history
Doctor :   Yes, i did.
User :   can it be ectopic
User :   its more that 3 months
Doctor :   Ok
Doctor :   There are very low chances of being a ectopic pregnancy but has to be ruled out.
User :   dint get u
Doctor :   You need a repeat ultrasound as now its already 3 months and if there any mass it would be visible in the ultrasound.
Doctor :   I meant that there are very low chances of ectopic pregnancy.
User :   in case of ectopic will an ultrasound detect nething
User :   my ultrasound was done on 27 of this month
User :   it said small fluid in cul de sac
Doctor :   The ultrasound has to detect mass in the fallopian tubes but as your ultrasound was normal but there is presence of fluid in cul de sac, that is why it is important to rule out ectopic.
User :   i recently only got a ultrasound done
Doctor :   Yes, I understand but along with this a beta hcg test from laboratory is required to know the levels of HCG.
Doctor :   Yes, Let me please explain it to you: User :   ok
Doctor :   The fluid present in cul de sac could be due to ectopic or ovarian infection or pelvic infection.
Doctor :   Now as the most common cause is ectopic it is very important to rule out this cause and it is life threathening too.
User :   ya the pain now is stabbing me
User :   plus the shoulder pain tha i have
User :   both on right side
User :   but the sonologist specified
User :   small fluid in cul de sac
User :   will an ectopic also have small amount of fluid
Doctor :   As your ultrasound was done on 27 june and as it only says about fluid in the cul de sac it is important to get the HCG levels in between 24 hrs to know whether the levels are dropping or not and this would help us in confirming ectopic pregnancy.
Doctor :   Please do not panic.
User :   i cant visit doc before monday
Doctor :   OK
User :   and till then the pain wont be bearable
User :   what does hcg level specify
Doctor :   The pain in the right side of the abdomen and in the shoulder could be due to irritation of the diaphragm as this is supplied by same nerves.
User :   is that a point of concern too
User :   in necase what are the chances of ectopic
Doctor :   HCG is a pregnancy enzyme seen only in pregnant females and if this level is constantly low and is not reducing completely to zero that means you are pregnant and as the usg states your uterus is empty there are chances of having an ectopic pregnancy.
User :   since i have had regular periods although instead of 5-6 days for 4-5 days
Doctor :   Yes, there are chances of having normal periods as implantation is not in the uterus.
User :   will a home pregnancy test detect if i am pregnant or not
Doctor :   Yes, it might.
User :   if the result is negative then am i safe
Doctor :   But some times the levels are low which can't be detected by the home pregnancy test.
Doctor :   Yes, it is possible.
User :   even after 3 months
Doctor :   Yes, in ectopic the levels would constantly stay low.
User :   the level will be low
Doctor :   Yes.
Doctor :   But I suggested you before I feel that being a ectopic is very low and the other causes like ovarian infection or pelvic infection could be a major cause.
User :   my doc gave me tab ornio for infection
User :   but dint help
Doctor :   Ok
Doctor :   I can't state in percentage but I can only state it is very low chance but very important to rule it out.
User :   shall i go for us again
User :   if the fluid is not present then what are the cahnces of ectopic
Doctor :   Yes, It would be better to get a repeat US and along with this please get a Beta HCG too to know the levels and repeat after 24 hrs if HCG is present.
Doctor :   If fluid was not present it could be initial stages of pregnancy or no ectopic.
User :   i cant go for hcg as i am nt married nd my fiance will return from uk in nov
User :   nd i cant tell the doc all this
User :   ne other way to find out
User :   as the pain is increasing
User :   u there
Doctor :   Yes, i feel you can see a gynecologist and get an internal examination.
Doctor :   Along with this an ultrasound and beta hcg test needs to be done.
User :   i will go on monday
User :   how long can an ectopic survive
Doctor :   Ok.
Doctor :   It depends on the size of the mass, but as i explained you before please do not worry about ectopic and stay clam.
Doctor :   Did you follow my suggestions?
User :   i did
User :   but this made me more tensed
Doctor :   Please relax and do not worry about the ectopic pregnancy and see your doctor.
User :   as i was informed by the websites that even an ectopic has a missed period
User :   which i had
Doctor :   yes, that is also possible.
User :   but ya all the other symptoms like nausea tiredness exist
Doctor :   That is why I am suggesting you that the chances of ectopic are very low. and please do not worry about it.
User :   ok
Doctor :   this could be due to infection present in the pelvic region.
User :   can i repeat the dosageof the antibiotic will it have ne negative effect
Doctor :   The antibiotic could increase your nauseating feeling.
User :   it was tab ornio
Doctor :   you can take a dose along with antacids as this would help in healing the gastric lining.
User :   neither side effects
User :   with tab pantoacid
Doctor :   yes, you can take it with pantacid.
Doctor :   this would reduce your nauseating feeling.
User :   what are the symptomps if ectopic bursts out
Doctor :   The symptoms would be loss of excess blood and excess sweating. but i feel you shouln't worry about this.
User :   u mean vaginal bleeding
Doctor :   yes, excess vaginal bleeding which would be continuous.
User :   like i just had my periods and then this pain
User :   so how do i differenciate whether its due to rupture or normal cycle
Doctor :   No, this would be for long and continuous not as periods.
User :   for how many daays
Doctor :   It would be continuous and would require medical intervention to stop it.
User :   one more thing i got the us done before my periods were abt to start can the fuid be bcoz of that too
Doctor :   Yes, there are chances of having fluid because of infection during periods.
Doctor :   I would again request you to stop thinking of ectopic as ultrasound has not read anything about it and please get a repeat ultrasound and beta hcg levels and please see your doctor on monday.
User :   ok
Doctor :   Did you follow my suggestions?
User :   i cant assure of beta hcg as this is done only for pregancy
User :   but yes will visit the doc and get a us done again
User :   yes i did follow yur suggetions
Doctor :   No problem, please get a ultrasound done and see your doctor on monday.
User :   ok
User :   tilll then i will repeat the medicines
Doctor :   Yes, please with pantocid.
User :   actualy when i got my us done and saw the doc she was a physician not a gyno with 15 years of experience she suggested its a pid
User :   but she dint knw the entire history
Doctor :   Ok, did she do a internal examination?
Doctor :   Ok
User :   no
User :   just pressed my belly
Doctor :   Ok
Doctor :   you can speak about this with your doctor.
Doctor :   Thanks for consulting me
Doctor :   Take care
Doctor :   Bye for now.
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