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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes an ectopic pregnancy?

Answered by
Dr.
Dr. Sameer Kumar

OB and GYN Specialist

Practicing since :2002

Answered : 1656 Questions

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Posted on Tue, 13 Sep 2016 in Pregnancy
Question: I am 36 and my wife is 32 planning for kids and had consulted gynaecolohist we both had gone all test scanning no cyst no Thyroid and my test too normal. so she had her last period on 9 July Dr. had advised Ubiphene and Omega G tabon 11 july and when had proper intercourse in her last period. on 9 she tried with HPT a light two lines positive. and later on 15 and 16 two positive HPT result. she started spotting whtie gel with bit red since 4 aug. on 15 aug she had right lower abdominal pain. so went to Dr. on her advice got abdominal scanning it was negative so got Beta HCG scanning it was positive. so due to spotting and pain Dr advice preatol plus 200 and meftal plus but she continued to have brown and red discharge and in scanning it was found that she has Ovarian Follicular Cyst 3 cm had been for a second scanning on 22/08 it was also negative. so we are confused as blood and urine tests are positive and scanning is negative what is exactly happening. and on 22 Dr advice and changed tablets cefix cerixime 200 mg and Aldigesic P and Pentop 40 is it safe to have Aldigesic P.
doctor
Answered by Dr. Sameer Kumar 33 minutes later
Brief Answer:
possible ectopic pregnancy.

Detailed Answer:
Hello,
Thanks for the query to HCM,
the fact that the serum beta hcg levels are positive and above 2711, indicates that there is a hcg production and likely there has to be a pregnancy. Now if the pregnancy is not inside the uterus then it can be an ectopic pregnancy anywhere outside the uterus even in abdomen or in the ovary itself, tubes, cervix, broad ligament anywhere.
The next step should be to undertake serial serum beta hcg monitoring 48 hrs apart and if there is an increasing trend in the two levels I.E doubling of hcg or a rise of more than 65% in the hcg levels, then there is for sure an ectopic pregnancy and one needs to find it.
The next step post that would be a USG ABDOMEN AND PELVIS or an MRI , if that fails.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sameer Kumar 22 minutes later
The Radiologists was saying that there is no ectopic Pregnancy so he advised to scan after 10 days. Doctor What about the cyst, if it would be ectopic then what can be done further. And one more consent was can she take those tablets Aldigesic P, Cerixime Ip 200mg & pantab 40. can we have a fake positive Beta HCG. Sir one more thing sir when earliest can Abdominal scan can be positive in case of normal pregnancy.
doctor
Answered by Dr. Sameer Kumar 6 minutes later
Brief Answer:
answered

Detailed Answer:
The antibiotics cannot cause beta hcg secretion, so that possibility is out. As the hcg levels are high, as good as 5th week pregnancy, so there has to be a hcg producing mass, likely pregnancy , so a serial serum beta hcg test 48 hrs apart is most important. If there is a rise in levels so there is a hcg producing mass somewhere if not in adnexa or pelvis then somewhere else, which needs to be searched, identified and operated upon and removed.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sameer Kumar 7 hours later
Sir can my wife have Aldigesic P tablet in this condition as our Dr. has given this for 5 days course. and Would the cyst create any problem. Sir in other patients how early can they diagnosis in Ultrasound Scanning.
doctor
Answered by Dr. Sameer Kumar 36 minutes later
Brief Answer:
answered

Detailed Answer:
Hello,
She can have aldigesic p, if she has any pain anywhere. The earliest an ectopic is detected usually in tubes is by 4-6 weeks gestation easily. I feel one can wait another week and observe the beta hcg serial levels as that shall give us an indication of the viability of pregnancy wherever it has implanted or there is a possibility that gestational sac may appear in uterus due to delayed implantation . So a repeat usg should be under taken after a week again.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sameer Kumar 31 hours later
Doctor Today I again got Beta HCG test done it's reduced I am attaching the report please go through it sir. what are the other reasons of High Beta HCG in previous report else then Pregnancy. are there any chance of false positive Beta HCG or due to overies cyst we get it.
doctor
Answered by Dr. Sameer Kumar 36 minutes later
Brief Answer:
answered

Detailed Answer:
Hello,
The beta hcg is 912 which has dropped drastically indicating a failing and non viable pregnancy at unknown location. The other possibilities are hcg producing ovarian tumours, but the hcg in them do not drop without treatment.
The most likely cause for the same still remains failing pregnancy.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sameer Kumar 49 minutes later
Dr. we visited our gynecologist so she termed it as Chemical Pregnancy. So if the Pregnancy is no more then we should wait for periods now and sir plz let us know that how much gap should we give now for our next planning for pregnancy. and what are the chances that she can conceive further. and sir why it happens like this any specific reason.
doctor
Answered by Dr. Sameer Kumar 11 minutes later
Brief Answer:
answered

Detailed Answer:
Hello,
There are no specific reasons for chemical pregnancy , usual being triploidies, congenital anomalies or chromosomal abnormalities.
The next pregnancy should be planned only after 3 months post the hcg levels are dropped below 3 mIU.
Yes menses should arrive next month once hcg levels drop below pregnant range.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sameer Kumar 2 days later
Doctor after this miscarriage how about the cyst do they need to be treated or it will go on its own any way we have scheduled for scanning again after 8 days. and my wife had some bleeding on 27/08 like period but it stoped on same day. when to expect her next normal period sir.
doctor
Answered by Dr. Sameer Kumar 1 hour later
Brief Answer:
answered

Detailed Answer:
Hello,
As the cyst is follicular and less than 4cm, it should reduce on its own after a course of ocpills for 3 months. Ideally she should be placed on oc pills for cyst resolution. Menses should ideally resume after a month if she is not on oc pills.
However a repeat beta hcg test should be done after 8 days again to check the hcg levels and scan as well to confirm the completion of miscarriage.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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