A woman in her 30s suffered a ruptured ectopic pregnancy despite having a negative pregnancy test.
A new BMJ case report explained how the mother of three headed to a UK hospital with symptoms of severe bleeding when she was around six weeks pregnant.
At the time, a blood test confirmed that she was pregnant, but the ultrasound did not detect a gestational sac.
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Doctors then kept an eye on the woman to see if her pregnancy was earlier than initially thought, or whether she was suffering from a miscarriage or ectopic pregnancy.
After a few days, the woman’s beta-human chorionic gonadotrophin (bHCG) - a hormone present in pregnancy and detectable with a pregnancy test - had decreased, indicating that she may be suffering from a miscarriage.
Clinical staff monitored the woman every 48 hours with blood tests and ultrasounds, but did not offer further treatment as her vitals were normal, she was not suffering from pain, and her bHCG levels were low, according to an Insider interview with Dr. Louise Dunphy, the case report's lead author and gynaecologist at Leighton Hospital, Crewe, Cheshire.
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Around four weeks later, when the woman would have been around 10 weeks pregnant, she came back to the hospital with severe pain in her right side.
Her urine pregnancy test was negative, despite now showing signs of an ectopic pregnancy - which, according to the NHS, can include unusual vaginal bleeding, abdominal pain which typically occurs on one side, pain in the shoulder tip, pain when going to the toilet, and feeling faint or collapse.
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However, a blood test showed that the woman was still positive for pregnancy, whilst further testing showed that she had suffered a ruptured ectopic pregnancy, despite the initial negative test.
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Meanwhile, ‘an urgent anaesthetic and gynaecology review was requested’, according to the study, where the woman had surgery to remove her right fallopian tube and the pregnancy tissue.
The study also indicated that the woman had lost around 2,050 millilitres of blood (115 tablespoons) and therefore required a blood transfusion.
She soon recovered from the ordeal and was discharged after three days.
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The NHS also noted that those capable of conceiving may have an ectopic pregnancy if they miss a period, have a positive pregnancy test or other signs of pregnancy, in addition to ectopic pregnancy symptoms.
However, you may be still suffering from an ectopic pregnancy if you have a combination of any of the above symptoms and have had a negative pregnancy test.
If you are worried about ectopic pregnancy, contact your GP or call NHS 111. In an emergency, always dial 999. To speak to The Ectopic Pregnancy Trust for non-medical support, you can request a call-back within 24-48 hours on 020 7733 2653 or email [email protected]
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Gabriella Ferlita