Possible ectopic / miscarriage - help with US report

lisac1818-2

Hi everyone. I’m so sorry for the long and confusing post. So I posted yesterday at 7w2d I went to the ER for light bleeding. It turned out that my baby was no longer there. They didn’t give me much info besides expect to miscarry in the next 3-4 days. But now I look in my test results and it says there a a right adnexal mass that wasn’t there on Tuesday.

I went on Tuesday to get my first ultrasound and my gestational and yolk sac, fetal pole all measured 6 weeks with heartrate of 112. (I should’ve been 7 weeks) and When I was getting my second US in the emergency room 2 days later it was obvious the tech was not able to find the baby. She found an empty sac in my uterus. She seemed to be confused and had to bring a dr in. He kept asking “are you sure they saw the baby in the uterus?” So do they think this mass is the baby? Is it a possible second ectopic? Molar? I told them I’m having little twinges of pain on my right side, but all the dr ended up saying was that I was going to miscarry and to return to OB to keep checking to make sure my hcg goes down. I also think my hcg was very high. What are all your thoughts?

My OB is closed til Monday and I didn’t want to call the emergency line for this if it means nothing. But I’m just confused as to what this means.

HCG

3/16- 415

3/22 - 7589

4/1 - 89,000

holly321

First, I am sorry for your loss.  The ER is not a good place to get answers for miscarriages.  I would think if the doctor had any concern about an ectopic pregnancy,  they would have discussed it, and suggested follow up ultrasounds, not betas. 
 As for molar pregnancy,  there is no indication of it.  High hcg levels (yours are within normal range for 7 weeks) are seen in complete molar, not usually in partial.   A complete would likely be very obvious on the ultrasound, there would be no baby, and tons of masses.   Partials will likely have a baby, and aren't obvious on an ultrasound. 

Whoever performed your ultrasound is not probably doing a ton of prenatal ultrasounds, and may not have completely known what to look for (and likely didn't have the best equipment) they may have not looked closely enough at your ovaries the first time.  My understanding,  is that there is often(?) A mass on one ovary during pregnancy. 

calliah

A radiologist will not come out and say ectopic pregnancy in an ultrasound report. They will say what’s in your report and it’s on your doctor or OB to follow up. Without seeing a fetus in the mass in the adnexa, it can’t be determined at ectopic anyway. 

I will say, as an ultrasound technologist, it’s weird that the mass wasn’t said to be on the ovary, making it a corpus luetum cyst. It could be something you’ve had for a while and your OB office just didn’t see it or care about it. Or it could be new. Heterotopic pregnancies are very rare, so the fact that there was an IUP is mostly reassuring. Follow up with your OB and make sure your betas are falling appropriately. If they aren’t, hopefully they do another ultrasound. 

I’m sorry for your loss.