QuestionI am currently 5 weeks pregnant. I started having pain in my lower abdomen and groin area over a week ago. I was extremely concerned with ectopic pregnancy. I called my doctor and they did a transvaginal ultrasound. The US tech said she couldn't see much and that is was too early. The nurse practitioner came in later and told me that I was ok and that is was intra-uterine. I am still paranoid that something is wrong. Should I be concerned? Was she able to tell at this early in the pregnancy?
AnswerHello, Kristie,
I don't know why the technician told you 5 weeks is too early to tell. However, the majority of tubal pregnancies cannot be detected by vaginal ultrasound. This information may be helpful:
"By 5 to 6 weeks of pregnancy (1 to 2 weeks after the missed period) all normal pregnancies in the uterus should be seen by vaginal ultrasound.
"20-30% of ectopics have no detectable sonographic abnormality.
"The usual finding for ectopic is a mass on one side, some fluid in the pelvis, and no normal pregnancy structures in the uterus.
"Conclusive diagnosis of ectopic by ultrasound can only be made if fetus or fetal cardiac motion is seen outside the uterus. This is only seen in about 20% of ectopics with vaginal probe ultrasound."
http://www.advancedfertility.com/ectopic.htm
This article may also be helpful:
http://kidshealth.org/parent/pregnancy_newborn/pregnancy/ectopic.html
Did the doctor say you should come back? Are you experiencing any weakness, fainting, spotting or bleeding, or low blood pressure? Are your hormone levels low?
One point of confusion may be the way the length of pregnancy is calculated. Sometimes it is calculated from a woman's last menstrual period because of the difficulty of telling when fertilization occurred. The other is to make a guess at when fertilization occurred and then calculate from there. So are you calculating from your last menstrual period, or from the probable date of conception?
Do you have a reason to suspect tubal pregnancy other than the pain? Do you have a history of abortion or sexually transmitted disease? Tell me more about this pain. Is it on one side, or both sides? What do you mean by your lower abdomen? Well below your belly button? Obviously, any pain needs to be tracked down. It could be due to another problem, but pain is always an indication that there is some kind of abnormality. Be persistent. Don't take an "everything's fine" for an answer. If the pain stops abruptly, it is almost certainly a tubal pregnancy that has ruptured. At that point, surgery becomes an immediate emergency. A woman can bleed to death from that situation. If you have to, seek a second opinion.
That's about all anyone can tell you over the internet. Good luck finding an answer, and please let me know how it turns out.
