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Are Sore Breast And Nausea Signs Of Ectopic Pregnancy?

Posted on Sat, 21 May 2016

Question: Hi

Im 30yrs old and a mother of 2 boys with 2 normal vagainal deliveries.

My last period was 11/2/2016.

I had a positive pregnancy test on the 9th of march. Having sore breast and nasuea.

I just came from my gyno but the suprising thing is that no sac is seen at all !!!

Then we did a BHCG which came out 981mil/ml.

What do you think? Should it be ectopic pregnancy?

Please give me your suggestions.

Answered by Dr. Dr. Soumen Patra (54 minutes later)

Brief Answer:
Repeat beta-hCG after 2 days and TVS after 3 days.

Detailed Answer:
Hello,

Thanks for writing to us. Followings are my comments:

1) You are currently on the 5th week of pregnancy and beta-hCG level varies from 18 to 7340 mIU/ ml. Your level 981 mIU/ ml is quite NORMAL at this stage of pregnancy.

2) It is too early to comment on Ectopic pregnancy with above clinical features and test report. An ultrasound is highly unlikely to show anything in the uterus until your hCG levels are between 1000-2000.

3) Beta-hCG doubling time is 48-72 hrs. I suggest you to repeat blood test for beta-hCG after 2 days and check the trend whether it is rising or falling. Do one Trans Vaginal ultrasound scan after 3 days (completed 5th week). It will confirm the nature of pregnancy (tubal or intrauterine).

Review with all test reports. Hope, I have answered your query. Wish your good health and take care.

For future query, you can directly approach me through

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=63326

Regards,

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr. Soumen Patra (30 minutes later)

My next vt scan is due 1 week from now.
Do you think i should do the bloodtest in 2 days from now or its ok to wait until my appointment.

And with this level of hcg can it be chemial pregnancy? Since i had one before having my first baby. That was in 2011

Answered by Dr. Dr. Soumen Patra (20 minutes later)

Brief Answer:
Yes, you can do TVS scan on next visit.

Detailed Answer:
Hello Dear,

Thanks for follow up query.

1) Yes, you can undergo Trans Vaginal Ultrasound scan after 1 week, on next visit to your doctor. It will confirm viability of pregnancy.

2) However, you should repeat blood test for beta-hCG after 2 days to check for rising pattern. It will give a gross idea overall.

3) According to above features, it could be a chemical pregnancy. But, it CAN'T be confirmed at this stage without above tests.

Hope, I have clarified the things. Get back to me with beta-hCG test result.

Good luck and take care.

Regards,

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr. Soumen Patra (47 hours later)

Hi again

I just repeated the Hcg today
48hrs ago was 981
Today 2,475

What do think? Im still worried that it might be ectopic pregnancy since no sac was seen earlier!!

My coming v scan would be after 5 days from now.

If it was an ectopic pregnancy does the hcg level increase?

Answered by Dr. Dr. Soumen Patra (6 hours later)

Brief Answer:
Do TVS scan to confirm healthy pregnancy.

Detailed Answer:
Hello dear,

Welcome back again.

Ectopic pregnancy has several clinical features like sudden lower abdominal pain, vaginal bleeding, cervical tenderness and pelvic pain.

Raised beta-hCG alone is NOT a specific criteria to diagnose ectopic pregnancy. It should be combined with clinical symptoms and Trans Vaginal Ultrasound scan.

Level 2475 mIU/ ml is quite NORMAL for healthy pregnancy as it is more than double after 48 hrs. In ectopic pregnancy, rising pattern will be less than 65%.

I suggest you to undergo Trans Vaginal Ultrasound scan as early as possible (as beta-hCG level more than 2000) or after 5 days when you have the appointment.

Hope, I have answered your query. Good luck and take care.

Regards,

Above answer was peer-reviewed by : Dr. Naveen Kumar