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Dr. Andrew Rynne

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Had an ectopic pregnancy. Took methotraxate shot. Small mass seen in ultrasound. What's wrong?

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Dr. S Patra

OBGYN

Practicing since :2011

Answered : 4047 Questions

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Posted on Thu, 31 Jan 2013 in Abortion and Stillbirth
Question: I had an ectopic pregnancy on my right side, I took a methotraxate shot on Nov - 1st - 2012, my beta HCG as on 12 - 17 - 2012 was at 5. Yet the Ultrasound showed a mass measuring around 2-3 cm, how long does it take the mass to reabsorb?
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Answered by Dr. S Patra 1 hour later
Hello XXXXXXX,

Thanks for your query.

I have gone through your medical history in detail.

You took one shot of Methotrexate following detection of Ectopic pregnancy. Last Beta hCG measurement was 5 as on 17th December and it seems to low enough to suggest that the pregnancy has safely ended.

Now Ultrasound reveals small mass around 2-3 cm and it will be gradually resolved over the time period.Also there is no risk of tubal rupture (mass less than 3.5 cm) or internal bleeding which are the most aggravating complications.

It may be spontaneously absorbed or come out as miscarriage.Time duration for complete resolution varies from one to three months and it is not predictable.

You should undergo serial Ultrasonography with 4 weeks interval to check or assess mass size for complete resolution. Please do consult with your gynecologist regarding this and take suggestive measures.

Do following things also:
-Avoid mental stress/anxiety regarding this
-Take healthy diet and drink lots of water
-Maintain personal hygiene properly

Hope I have answered your query. If you have any further questions I will be happy to help.

Wish your good health and risk free life.

Regards
Above answer was peer-reviewed by : Dr. Mohammed Kappan
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Follow up: Dr. S Patra 49 minutes later
Hi Doctor,

Thanks for the reply. When can I start planning to conceive, what are some precautionary measures I should take? Any specific tests that should be done?
doctor
Answered by Dr. S Patra 1 hour later
Thanks for Follow up Query.

You can start planning to conceive only after complete resolution of the ectopic mass. It can be assessed by serial ultrasound only as previously said.

There is no as such precautionary measures to prevent ectopic pregnancy in the future. But early diagnosis & treatment is helpful to prevent grave complications. You do practice safe sex by using CONDOM only & only and Quit Smoking (if you have habit) to decrease the risk of such ectopic pregnancy.

Early diagnosis can be done through Trans Vaginal Sonography (TVS) and it is superior to Trans Abdominal Sonography (TAS/USG) for early detection. Also closed monitoring is needed following being conceived by your doctor as you have the risk factor.

If you do not have any clarifications, you can close the discussion and rate the answer.

Wish you good health.
Regards,

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. S Patra 40 hours later
I am still getting pain on my right side when I do physical activity? I don't understand why when my hcg is 0? Any explanation on that?
doctor
Answered by Dr. S Patra 4 hours later
Thanks again for follow up query.

1) Mild lower abdominal pain on right side may be present sometimes till complete resolution of the ectopic mass. You may take some anti spasmodic medication for temporary relief of pain. You may do light work but not strenuous or heavy work.

2) HCG level at 5 mIU/ml suggests that ectopic pregnancy has safely ended as previously described. HCG level is less than 5mIU/ml or undetectable among non pregnant healthy women. In your case, it is almost low and it will be less than 5 mIU/ml over time period. You may undergo for current Beta HCG Level Assay as previous one was almost 4 weeks ago. Further follow up to your doctor may be needed.

If you do not require any further clarifications, you can close the discussion and rate the answer. Please do leave a feedback.

Regards
Above answer was peer-reviewed by : Dr. Mohammed Kappan
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