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Positive pregnancy test at the Dr office both urine and

Dear Dr. JA: When was your...
Dear Dr.
JA: When was your last pap smear? Have you ever had an irregular pap?
Customer: No
JA: Anything else in your medical history you think the doctor should know?
Customer: Positive pregnancy test at the Dr office both urine and serum, on the 15 May
JA: Have you been keeping a personal medical record?
Customer: Yes
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Answered in 6 minutes by:
6/27/2017
Dr Anil Kumar
Category: OB GYN
Satisfied Customers: 9,779
Experience: M.D with over 30 years of experience in practice.
Verified

Hello and thanks for trusting me to help you. I am a board certified consultant with over 30 years of experience.
Please provide more information regarding your question so I can help you in detail.

What is your age?

When was your last menstrual period?

Any symptoms?

Please explain your question.

Thanks.
Waiting for your response.

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Customer reply replied 5 months ago
I had a positive pregnancy test both urine and serum on the 15. may. On that day the hCG was 298. First date of lmp very uncertain.Went for a sonography yesterday , nothing could be found. No gestational sac. Thickened endometrium walls.
Took a new serum hCG yesterday, still awaiting the results.I have not had any bleeding.
How long can an ectopic pregnancy last without symptoms?
Is there any chances that there is a foetus somewhere which could not be seen at that moment? I understand there is a correlation between the level of HCG and the ability to see something on scan, is that true?
Customer reply replied 5 months ago
Lmp is very uncertain, because I had a miscarriage on 24 March, stopped bleeding on 7 April. Tested positive on the 15. May. No menstruation since then.I am 41 years, I have two children. The youngest is 14 years old.No bleeding. Symtoms are; tiredness, often urination, tingling feeling in the breasts.I sonography showed no gestational sac or yoke. HCG was 289 on the 15 May.
Taken a new HCG sample yesterday, awaiting results. Urine test yesterday was positive.

Sorry for late reply and inconvenience.
Thanks for all these additional information.
I understand your concern.

Well as you describe,most ectopic pregnancies can be detected using a pelvic exam, ultrasound, and blood tests. An ectopic pregnancy is likely if there are no signs of an embryo or fetus in the uterus as expected, but hCG levels are elevated or rising above 1500 mIU/mL.

So if your new HCG levels are above 1500 then ectopic pregnancy should be ruled out.

If it's lower or same as your previous HCG result then it's possible that the HCG is from a small piece of placenta still inside the uterus.

If so, it will generally go away with time. There is also something called persistent trophoblastic disease, where the placental tissue survives and keeps growing.

Usually serial HCG levels should be done.

Some remaining placental tissue and elevated HCG can also be treated with a drug called methotrexate.

Let me know if you have any further query so we can discuss it thoroughly in every aspect.
Please use the REPLY/SEND BUTTON to reply back to me. It’s request to avoid poor/bad rating.
Please provide a positive rating by clicking on 5 stars.
It’s my pleasure to continue this conversation until you satisfy.
Waiting for your response.
Thanks.

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Customer reply replied 5 months ago
Thanks for the clarification, part of my question was, how long can an ectopic pregnancy last in the falopian tube?
Methotrexate is known to have serious side effects? Is it advisable when the diagnosis is so uncertain?
Customer reply replied 5 months ago
Pls, you did not mention anything about the thickened endometrium.

Thanks for the follow-up.

Ectopic pregnancy can be screened in fallopian tube after 8 weeks.

And methotrexate should be only advised after determine underlying cause.

The thickness and sonographic appearance of the normal endometrium changes with the menstrual cycle.

In a premenopausal women a mean thickness would be 8-10 mm.

In the secretory phase of the period cycle, the endometrial stripe thickens can go up to a mean of 14-16 mm in AP width.

So just on the basis of endometrial thickening, with no other symptoms like abnormal uterine bleeding,pain, you should not be worried.

Just on the basis of the endometrial thickening, the diagnosis are not based usually. The diagnosis is based on the symptoms, clinical findings, investigations.

Hope this helps.
Use reply to let me know if you have further queries.
Please provide a positive rating by clicking on 5 stars and avoid poor/bad rating.
Bonus is highly appreciated.
We are here to help you until you satisfy.
Waiting for your response.
Thanks.

Dr Anil Kumar
Category: OB GYN
Satisfied Customers: 9,779
Experience: M.D with over 30 years of experience in practice.
Verified
Dr Anil Kumar and 87 other OB GYN Specialists are ready to help you
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Customer reply replied 5 months ago
Thanks for the reply. Going for a scan tomorrow and will get the reply of the S-hcg tomorrow. And will have to take a new s-hCG tomorrow. Will keep you posted.
Was great to have additional facts.

I wish for your good health.
Welcome.
Kind Regards
Dr.Anil

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