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ObGyn/Pregnancy issues/Could this be a tubal pregnancy?


I had my tubes tied March 21,2011 after having my 3rd child via C-section. I was feeling strange and on June 15,2013 I took a hpt that came back positive within 25 seconds. I took 2 more which were also instantly positive. These were not faint positives they were obvious. My Dr confirmed the pregnancy Monday morning but said that my HcG was 835 and I was probably less than 4 weeks which is why the u/s didn't show anything. My uterus lining was thickened but that was about all that they could see. They said there was no free fluid which was a good sign. I have no cramping, no spotting or bleeding. The only thing that I do have is mild low back pain but that is fairly normal for me. I am terrified that this is an ectopic because I had tubal ligation. Any advice?


This is probably an ectopic. Having free fluid in the Douglas pouch is a sign that the ectopic have rupured inside the tube with a possibility for internal hemorrhage. Therefore, absence of fluid in the Douglas pouch can be cnsidered as a good sign but this does not mean in anyway that you should wait till the tube ruptures then they interfere. You already complained at any early stage so why would they wait till the ectopic ruptures??

My advise is to have an immediate laparoscopy done (examination of your abdomen with a scope) and if ectopic is confirmed, immediate interference and extraction of the ectopic can be performed immediately through the scope with repair of the tube if needed. However, not every obstetrician is familiar with the use of operative laparoscopy and you should ask your doctor if he/she can do it or you may seek another one.

Good Luck

ObGyn/Pregnancy issues

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Mohamed Kandeel


I can answer questions about antenatal care, medical problems associated with pregnancy, labor and delivery and postpartum care.


Currently I am working as a Professor of Obstetrics gynecology, Menofyia University, Egypt. Since 1987, I worked in many university and private hospitals with a high load of pregnant population averaging 7-9,000 deliveries/year. This exposed me to all problems associated with pregnancy, labor and delivery. I had my doctorate degree in Obstetrics and Gynecology in 1996 in the use of Doppler ultrasound in high risk pregnancies.

Menofyia University, Egypt

-British Journal of Obstetrics and Gynecology (Kandil M) -Egyptian Journal of Obstetrics and Gynecology (Kandil M) -Ain Shams Journal of Medicine (Kandil M)

-Master's degree in obstetrics and Gynecology 1989 -Doctorate degree in Obstetrics and Gynecology 1996

Awards and Honors
Editorial advisor: Fetal monitoring section of the international website

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