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Wednesday, November 30, 2005

Persistent positive pregnancy test

Dear Dr Amy,

As you recommend I pressed my doctor for a scan as I havent had a period for three months and had four faint positives now. I saw a different doctor who listended for a heart beat and said he may be able to hear something and felt my tummy and said he could feel what felt like my womb and called the hospital for a scan.

I had a scan done Monday and they didnt find any sign of a baby or any sign of any complications. I didn't have a full bladder. In fact, I was told to empty my bladder since they were going to perform a transvaginal scan, but they read the notes and it said abdominal ultrasound and proceeded with an abdominal ultrasound.

Would an empty bladder stopped them seeing anything if I was 14 weeks pregnant? Surely they could see something with or without a full bladder.

Really appreciate your reply as all this messing around is driving me crazy!


Dear Stephanie,

This is a serious situation and should have been sorted out long ago. You need to see a gynecologist (or a more competent one, if you've seen one already). You may have an ectopic (tubal) pregnancy, and that is a potentially life threatening problem.

You need to have HCG levels checked twice at least 24 hours apart and you need a transvaginal ultrasound. Both of these things should be done as soon as possible.

It is extremely unlikely that this is a normal pregnancy. A baby would be clearly visible on an abdominal ultrasound by 14 weeks.

In a normal pregnancy, the HCG levels will double approximately every 48 hours. By 14 weeks, the HCG level should be in the tens of thousands. If it is low and not rising appropriately, there is a very high chance that this is an ectopic pregnancy. An transvaginal ultrasound may show pregnancy tissue in the fallopian tube, but if it does not, it is still possible to have an ectopic pregnancy.

If you have an ectopic pregnancy, you need to be treated with medication or, less commonly, with surgery.

If you cannot get an appointment with a doctor, you may need to go to your local emergency room.




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