question about a sac

[stellav]

Hi Dr. Wisot

I had an ultrasound today (at 4.5 weeks of pregnancy), which showed the gestational sac inside the uterine cavity, but somewhat laterally positioned. They told me that it is not moved too far to the side, though. My HCG level was more than 6600 units, while the last measured one (on Dec 4) was 216. What are the possible explanations? Is the high level of HCG indicative of ectopic?

Thanks,

[Dr. Wisot]

Ectopics usually have a low hCG level. Laterally positioned usually does not mean anything as long as it's in the uterine cavity and surrounded by endometrium. At 4.5 weeks that's all one is going to see.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California

[stellav]

Thank you.
I was told afterward that because the U/S showed the sac "kind of on top" (?), there is some possibility of a cornual pregnancy (the sac "looks like it is inside the cavity, only laterally situated"). They are not sure, and want me to repeat the U/S in a week. What are your recommendations regarding this? I have been having stomach cramps (on and off) for the last 3-4 days, which is why I requested an U/S in the first place. Can ultrasound reveal internal bleeding?
Thank you.

[Dr. Wisot]

I can't make recommendations here except to tell you to make sure they are aware of how you are feeling so that they can make the proper recommendations. Collections of blood may be seen on ultrasound.

Let us all know what happens.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California