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Dr. Norm S.
Dr. Norm S., Board Certified OB/GYN
Category: OB GYN
Satisfied Customers: 11252
Experience:  Over 30 years of experience in OB/GYN practice, including teaching students. Fellow of American Board of Obstetrics and Gynecology.
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How is scar ectopic pregnancy diagnosed

Resolved Question:

Hi how is scar ectopic pregnancy diagnosed
Submitted: 2 years ago.
Category: OB GYN
Expert:  Dr. Norm S. replied 2 years ago.
What do you mean by scar ectopic pregnancy?Could you tell me something about your circumstances? Thank you.
Customer: replied 2 years ago.
I'm 41 hrs old and have 18 yr old son from previous marriawge. It was a c-section. My husband is 50. We have been trying for a baby for close to 3 years and had given up hopes that we will ever get pregnant.I had my last period towards end of July. I thought it was my period when I started bleeding on 21st August. It was very light, don't feel like the regular period at all. It lasted for 10 days. I the first week of September I took a pregnancy test and it was positive indicating I was 2-3 weeks pregnant. After 2 days I took another test and got same results. I saw a gp, told him about the bleeding. He brushed it off saying it must have been the implantation that caused the bleeding. I registered with the midwife, had my first appointment with her. We were over the moon that I was pregnant and started planning our lives around the baby.Last week I started bleeding again. Very light and last for 2 days. Spoke to the gp, since I was booked for regular us scan 2 days later she asked me to wait for the scan.Had my scan on Thursday, the sonographer couldn't find the baby so did a vaginal scan still no luck. All we could see was an empty sac, no yolk or embryo. The sac was 20 mm. She arranged for me to speak to the consultant immediately. The consultant told us I was having a scar ectopic pregnancy (implantation in c-section scar) and that our only option was to go through a miscarriage. They took my blood for hcg test on the same day, I went again yesterday to give blood for the second test. I have another scan tomorrow where they will decide the best way to manage the miscarriage.We are devastated. I need some advice - is the diagnosis of scar ectopic pregnancy is as simple as one scan showing empty sac? Is the position of the empty sac that defines it? Can this diagnosis be wrong? Can my dates be off and baby may appear in a few weeks if we wait it out? Should we get Second opinion? Please help.
Expert:  Dr. Norm S. replied 2 years ago.
Was the empty sac located in the c-section scar (in the wall of the uterus)?
Customer: replied 2 years ago.
The consultant wasn't sure but she said it might be
Customer: replied 2 years ago.
Is it a possible that it is located close to it so it looks like it is located inside the c-section scar? What options do I have to make sure thief diagnosis is right?
Expert:  Dr. Norm S. replied 2 years ago.
I've never heard of that.As long as the sac was inside the uterus, it's not an ectopic.If it was actually in the wall of the uterus, that would be an ectopic, but it would be extremely rare.If it were located in the scar, most likely it will act like a miscarriage. Since you had a positive pregnancy test the first week of September, and now we're more than a month later, I don't believe there is any possible chance that you have a viable pregnancy. If it were viable, there would be a fetus with a heartbeat now.A follow up scan will show whether the sac is disappearing or growing. It's possible for a pregnancy to continue to grow without a fetus. However, if it's growing in the uterine scar, it's very unlikely to cause much problem.
Expert:  Dr. Norm S. replied 2 years ago.
A repeat scan will help to know whether the diagnosis is right, which I doubt.If the sac disappears, or if you develop some bleeding, then it can be treated as a miscarriage. You would be unlikely to need any treatment, such as for an ectopic in the tube.
Customer: replied 2 years ago.
I will get a picture of the scan tomorrow, would that help you with providing me some advice?
Expert:  Dr. Norm S. replied 2 years ago.
Yes.
Customer: replied 2 years ago.
Thank you I will be in touch tomorrow
Expert:  Dr. Norm S. replied 2 years ago.
I'll be waiting.You can attach a picture using the paper clip.
Customer: replied 2 years ago.
Will do
Expert:  Dr. Norm S. replied 2 years ago.
:-)
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Expert:  Dr. Norm S. replied 2 years ago.

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