Expert: Doctor Early Options - 8/3/2009

Question
I just found out i am pregnant and am seeking an abortion, i went in for an ultrasound (they did 2..one on my stomach and one vaginally) and saw nothing...they told me to come back in a week and that i might not be far along enough yet... can you explain what that means? can a pregnancy test read a false positive? (i have only done a hpt.... so far)

and, is it possible they dont see anything because it could be an ectopic pregnancy?
i have been having alot of cramping and thought that might be a reason... can you still have a normal abortion if you have an eptopic pregnancy? thank you.

Answer
Dear Marie,
This is an excellent question.  
Typically a pregnancy test turns positive 2-3 weeks after conception.  However, an ultrasound does not show anything until 3-4 weeks after conception.  
If you go to a doctor's office, and the pregnancy test is positive but the ultrasound is negative, there are a few possibilities:
1) you are too early, and in one week it should show up on ultrasound;
2) you are having a miscarriage or spontaneous abortion (SAB), and the pregnancy doesn't develop, and eventually you start to bleed;
3) you have an ectopic pregnancy (approximately 1/400, becomes much more of a concern if you are more than 6 or 7 weeks pregnant).

Depending on the date of your last menstrual period, the doctor's office can either follow QUANTITATIVE hCG (a blood test that shows a level of hormones, and that you can track every 48 hours).  If this number doubles, like normal, it is probably an early pregnancy.  If it stays the same or goes down, it is likely a spontaneous abortion or miscarriage.  If you are less than 6 weeks from your last menstrual period, they will likely assume it is an early pregnancy and just have you return in a week.  If you are more than 6 weeks and the ultrasound is still negative, they would have a stronger suspicion for an ectopic pregnancy, and should evaluate the situation sooner.  

Hopefully this is not too confusing!
For more excellent information on early abortion go to earlyabortion.com; and for information on miscarriage, go to ipaswomancare.com.

I hope this is helpful,
Doctor Joan
EarlyAbortionOptions.com
Early Abortion Specialist
New York City