Ectopic Pregnancy Symptoms & What to Do - A Patient's Story

Question
this is my 11 pregnancy,nolive births. 8 ended up in miscarriages and i think this is my 3rd tubal. i have went to my ob and had 3 ultrasounds. i am only 4 weeks, nothing showing in my uterus but my hcg levels are going up and yesterday it was 7578 and so far are doubling normally. but i have been bleeding sometimes red sometimes old dark blood and hurting for a week now on my right side. myob keeps wanting to wait another week. keep repeating quants and do another ultrasound on monday. my ob is hoping this one is and iup and not in my tube. i am scared to death the 1st ectopic i had in 98 rutpured and i almost died. based on this info, do you have any suggestions or do you believe i should do as my ob wants.  

Answer
Unti 6 weeks gestational age, a sonogram will not show anything in the uterus. After 6 weeks, we usually will see a fetus and a fetal heartbeat.  After 5 weeks we can sometimes see an empty gestational sac. If we do see a sac, we know it cannot be an ectopic pregnancy. If, after 6 weeks you still do not have anything in the uterus, we have to rule out an ectopic and you may need a laparoscopy to take a look inside. However, if your HCG value keeps doubling normally every 48 hours, you may have a viable intrauterine pregnancy. If you start bleeding heavily with severe cramping, you may be pushed into the laparoscopy before you can do the sonogram.