Ectopic Pregnancy Concerns: Understanding Symptoms and Testing

Question
I have been going back and forth to the doctor to see if i could have a etopic pregnacy . I have had one in the year of 98 but had a child after then in 2001 .I am pregnant again my level is going up normal like it should the clinic thought that i was 6 weeks but i just found out that instead of my period coming on during Oct 21 it could be later , The pregnancy center stated that I had a negtive pregnacy test on Nov.11 but a postive one on Nov.24 Could this be another epotic if my level has risen to 3900 and rising ok but they see no sack , I am stable in no pain and they want to wait things out to be sure it is a normal pregnacy before during anything but they seen fluid around my uteris and bladder is this normal . May i ask you opinion?

Answer
What was the date of the first day of your last period? If you are less than 6 weeks from the first day of your last period, a sonogram will only show an empty gestational sac or no sac at all. After 6 weeks, we usually will see a fetus and a fetal heartbeat. Fluid around the uterus may indicate an ectopic pregnancy, but it may merely be from a corpus luteum cyst. It all depends on your gestational age and your symptoms. A rule of thumb is that if your HCG values are doubling every 48 hours, it indicates a viable pregnancy. If the HCG values halve every 48 hours, it indicates a miscarriage. If the values remain constant (plateu) in 48 hours, it may indicate an ectopic pregnancy. I would continue taking HCG values and repeat the sonogram at the correct time. As long as you are not having any pain, you can safely wait.