
Ectopic Pregnancy
Q. I had sex one day after my period and then my period came, but it only lasted two days and was very light. Now I'm having lower abdominal pains and all kinds of symptoms. Could I be pregnant?
-Anonymous, West Virginia
A. Most women ovulate12 to 14 days after the first day of a period, which would mean you are probably 10 to 12 days off from the time you could have gotten pregnant... unless, of course, you have an irregular cycle. If this is the case and you did conceive at that time, the abdominal pains could be from egg implantation. When I was first pregnant, I remember thinking that I was going to have my period any day because of the cramping I was experiencing.
If your cramping becomes severe, it could be an ectopic pregnancy. (An ectopic pregnancy is when the egg implants itself somewhere outside the uterus, most often in the fallopian tube.) If you experience extreme crampy pain with tenderness that starts on one side and then spreads throughout the uterus and worsens with movement, coughing or having a bowel movement, then you should contact your doctor ASAP.
Unless you have very irregular cycles, you are probably not pregnant and are just experiencing PMS.
Q. I am around seven weeks pregnant with my first pregnancy. I have been having more severe cramping the past couple of days (I originally was having mild cramps for quite a while when I first found out I was pregnant). Also, just this morning there was some light spotting. It was light pink in color, and there was very little. It looked about the same as what you would see at the very end of a period, except it was pink. Also, I've been having some pain in my shoulder, but it mainly feels like my shoulder is out-of-joint. I've been concerned about an ectopic pregnancy. Is the pain I'm feeling in my shoulder typical of ectopic pregnancies? I realize the pain in my shoulder could simply be a coincidence and I'm really hoping that's the case.
-Anonymous, New York
A. All of the symptoms you've described could indicate an ectopic pregnancy. The most common signs are: extreme crampy pain with tenderness that starts on one side and then spreads throughout the uterus, possibly worsening with movement, coughing or having a bowel movement; spotting or bleeding; nausea or vomiting; shoulder pain (yes, this is a symptom); and rectal pressure.
Since you are experiencing quite a few of these symptoms, you should report them to your OB/GYN just in case. If the pain becomes sharp and severe, get yourself to your doctor's office or an emergency room ASAP.
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Q. I am/was seven weeks pregnant. I've had quite a bit of bleeding. I went to the doctor and she did an ultrasound and a transvaginal ultrasound. She saw that my uterine lining was thickened, but there was no sac, no baby and no heartbeat. She said my next option would be to check my blood in case I am still pregnant, but it's just not showing on the sonogram. I've read almost every question on your site. I have noticed that you said that you bled for nine days with your second pregnancy. Were your ultrasounds okay during this time? I am looking for any glimmer of hope, and I am prepared for any answer you give, whether or not it's good news. My doctor also said it could be ectopic, but I am not experiencing any shoulder pain, severe cramps or backaches.
-Anonymous, Washington DC
A. I can sympathize with your situation, but I'm afraid it doesn't look good. If your doctor did both types of ultrasound and saw nothing, then you are probably no longer pregnant.
When I had an ultrasound after my bleeding episodes, my OB/GYN was able to visually confirm the pregnancies almost right away.
It looks like you have already had a miscarriage or you have an ectopic pregnancy. If your blood work still tests positive for pregnancy, it could be ectopic and the sooner you know the better. The pain can start and your fallopian tube can burst within hours. You need all the tubes you can keep if you want to continue trying for motherhood.
Q. How soon do the signs of ectopic pregnancy begin to really appear? Is it within the first month or two with the severe cramping and bleeding?
-Katie, Connecticut
A. Most ectopic pregnancies are diagnosed between six and seven weeks (but some as early as four weeks) as the embryo begins to grow and stretch the fallopian tube to its breaking point. If you are three months pregnant or less and are experiencing any of the following symptoms, you should contact your OB/GYN ASAP: extreme crampy pain with tenderness that starts on one side and then spreads throughout the uterus and possibly worsens with movement, coughing or having a bowel movement; spotting or bleeding; nausea or vomiting; shoulder pain; or rectal pressure.
If the ectopic is ruptured, you may also have signs of shock like a weak, racing pulse; pale, clammy skin; and dizziness or fainting. In this case, you should get yourself to an emergency room immediately.
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