Dr. Sameer Kumar
Obstetrics and Gynecology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I had unprotected intercourse and received periods in the same month and the next month. However, due to the ectopic pregnancy scare, I went for a TVS scan and beta HCG blood test, 49 days after unprotected intercourse. My beta HCG blood test value came as 0.46 ul, and I am attaching my TVS report.
Kindly see and guide if everything is normal or there is any risk of normal or ectopic pregnancy.
Thank you.
Hi,
Welcome to icliniq.com.
I have reviewed the attached reports (attachments removed for the patient's identity), and they indicate no pregnancy inside or outside the uterus. The hCG levels of less than 5mIU further confirm that there is no pregnancy at all and you are not pregnant.
However, the presence of fluid in the pouch of Douglas with an adjuvant finding of corpus luteum in the ovary indicates that you have recently ovulated. However, fluid in the pouch of Douglas also suggests pelvic infection, but you need to complain of pelvic pain for that, which I believe you do not have.
You are not pregnant for sure, and there is no ectopic at all.
Thank you.
Patient's Query
Hello doctor,
I have had lower abdomen pain for seven to eight days. Could you suggest some medicines for that?
And seeing the reports, can I be confirmed that there is no pregnancy, normal or ectopic, or it can show up later?
The last unprotected intercourse was two months back. If there is a pregnancy, then how many weeks in maximum can it happen from one time unprotected intercourse?
I am really scared.
Thank you.
Hi,
Welcome back to icliniq.com.
You need to get further investigated for pelvic inflammatory disease before I can prescribe any PID medicines.
As far as pregnancy is concerned, there is no pregnancy as evident in ultrasound. Moreover, you have had your menses twice post Intercourse, which also rules out pregnancy. Ideally, you would have missed your periods if you would have been pregnant.
Thank you.
Patient's Query
Hello doctor,
I have only abdomen pain and no other complaints of fever or discharge. The pain began from the left side of the abdomen's lower part but is not constant. But now I feel pain in my entire abdomen. The discharge is normal. There is no fever. And the pain is also not constant but is there. I have attached my CBC report done on the eighth of this month. There is also no burning sensation in passing urine or itching in the vagina. I only have pain in the abdomen.
Can pregnancy from that one-time unprotected intercourse happen now or later?
I am just so scared of it. Sorry for the repeated bother of the same query, but I seek your guidance and support. The TVS is done mid-cycle, 10 to 12 days after menses get over
Thank you.
Hi,
Welcome back to icliniq.com.
This is unlikely pelvic inflammatory disease (PID). The pain is likely spasmodic and not related to the uterus per se or fallopian tubes or ovaries.
You may opt for a pain killer like Combiflam, one tablet twice daily for two days. If the pain is relieved, then it is likely intestinal or spasmodic. There is no pregnancy at all. USG confirms that and also the HCG. If the HCG is less than 5mIU after eight days post-last intercourse, then it is conclusive that you are not pregnant as this is the gold standard to test for pregnancy, and the earliest it can be done is eight days post intercourse, and one needs not to wait for the periods to be missed.
Thank you.
Patient's Query
Hello doctor,
I read somewhere that if it is ectopic, then in some cases, it does not show on the HCG blood test. That is why I am puzzled and repeatedly asking the same query. The sonographer said that there was some infection near the uterus while doing the scan. Other things she said were normal, only she spotted some infection near the uterus.
I asked about tubes, to which she mentioned that they are not visible unless there is some swelling.
The TVS is done mid-cycle, 10 to 12 days after menses get over
Thank you.
Hi,
Welcome back to icliniq.com.
In that case, you need to see a gynecologist and get a per vaginal and per speculum examination done to confirm PID before treatment can be started. Online consultation has its constraints with regard to examination.
In ectopic pregnancy, HCG levels are very high and cross even 1 lakh. So you have either read wrong and misinterpreted, or you have been offered the incorrect information.
Thank you.
Patient's Query
Hello doctor,
Do I have to repeat any TVS or beta HCG blood test for confirmation, or can I be relaxed that there will not be any kind of pregnancy from the intercourse that happened?
Thank you.
Hi,
Welcome back to icliniq.com.
There is no need at all, as the HCG report is negative.
Thank you.
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Obstetrics and Gynecology
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