Beta-HCG monitoring What is it for?

Transcription

1 Beta-HCG monitoring What is it for? Brooke Building Early Pregnancy Unit All Rights Reserved Document for issue as handout.

2 Introduction This booklet aims to give some information and advice about the purpose of serial Beta HCG monitoring. Beta-HCG is a blood test that monitors the hormones in pregnancy. These hormones are produced in large quantities during early pregnancy. Its full name is Human Chorionic Gonadotrophin. By monitoring the hormone level in the blood, we can determine if there is a continuing pregnancy. If you have any questions regarding this booklet please do not hesitate to ask a member of staff. l That you have a continuing but very early pregnancy l That you have sadly suffered a miscarriage l That the pregnancy has become lodged in the tube. This is known as an Ectopic pregnancy. The test is performed by taking a sample of blood and measuring the level of Beta- HCG in it. The test may be repeated several times to monitor whether the hormone level rises or falls. Who should I contact? If you have any worries, concerns or symptoms you wish to report, contact the Early pregnancy unit on: You will be able to speak to the nurse who will refer you to the duty doctor if necessary. If you simply require advice, speak to the staff on the early pregnancy unit who will do their best to help you. The Early Pregnancy Unit is open 8am-5pm Monday to Friday. erica.wilson.@srft.nhs.uk What symptoms do I look out for? If you feel unwell or if there is any change in your condition you must contact the Early pregnancy unit at once. If out of hours you must attend Accident and Emergency. l New or increased abdominal pain l The bleeding increases l Feeling of dizziness, light headedness or pains in the tip of the shoulder l You must come into hospital immediately if you faint or pass out. Your ultrasound scan today has not given a clear answer as to what is happening with your pregnancy. At the moment we are considering three possibilities. 1 2

3 What is an ectopic pregnancy? Ectopic pregnancy is a common condition. If undiagnosed it can be a life threatening condition. It occurs in pregnancies and is due the embryo implanting in the fallopian tube. This is the tube that connects the ovary to the womb. If the pregnancy continues to grow, it can cause pain and irregular bleeding. If not diagnosed and treated, it can rupture the tube and cause abdominal bleeding, which can lead to a deterioration in the mothers well being. If an early diagnosis can be achieved before rupture of the tube and the appropriate facilities are available, less invasive treatment can be offered, which may aid to a speedier recovery and may increase the chance of the women s chance of future fertility. We can sometimes recognise an ectopic pregnancy straight away, but it can be difficult and may require a number of blood tests and repeat scans to confirm the diagnosis. During this time we are happy for you to remain at home. Key Hole Surgery: Before rupture of the tube, it may be possible for the surgeon, to remove the tube using laparoscopy. This may mean you will be discharged home the following day. It is more common for key hole or open surgery (laparotomy) to be performed to remove the effective fallopian tube. Treatment With Drugs: Alternatively the drug Methotrexate could be used. This drug is injected into the outer part of your muscle on your bottom and will destroy the pregnancy tissue without the need for surgery. This will leave the tube intact and will heal, allowing a pregnancy in the future. Laparotomy: If the tube ruptures, or the ectopic pregnancy is difficult to remove you will need a laparotomy (opening into the abdominal wall). This is an open surgical operation through a bikini line incision and the tube is removed. What should I do over the next few days? Please try to observe the following points until we are able to give you a better idea of what is happening to your pregnancy: l You must be contactable and within easy reach of the hospital at all times l You should avoid strenuous exercise although you are not confined to bed l Contact the hospital at once if there is any change in your condition. 3 4

4 Possible outcomes There are three possible outcomes in this situation: l If the concentration of the Beta-HCG in your blood rises quickly, then this may signify a continuing pregnancy. Once a certain level is reached you will have another scan when we hope to see more clearly how the pregnancy is progressing. l If the concentration of the Beta-HCG in your blood is low or goes down quickly then, unfortunately you have probably miscarried. This will be explained to you and further information given. Sometimes the level starts off high and then falls. If the level does rise, but only slowly we suspect an ectopic pregnancy or a non progressing pregnancy. l If the scan shows an empty womb and the Beta HCG is high, then there is a strong possibility of an ectopic pregnancy and further investigations are required. You will be asked to return to hospital and may need to stay in. Useful contacts and further information? Contact the Early Pregnancy Unit if you have any queries or questions. Opening hours Monday - Friday 8:00am to 5:00pm Notes 5 6

5 G Design Services Salford Royal NHS Foundation Trust All Rights Reserved 2014 This document MUST NOT be photocopied Information Leaflet Control Policy: Unique Identifier: SURG39(14) Review Date: September 2016 For further information on this leaflet, its references and sources used, please contact Copies of this information are available in other languages and formats upon request. If you need this interpreting please telephone In accordance with the Equality Act we will make reasonable adjustments to enable individuals with disabilities, to access this treatment / service. Under the Human Tissue Act 2004, consent will not be required from living patients from whom tissue has been taken for diagnosis or testing to use any left over tissue for the following purposes: clinical audit, education or training relating to human health, performance assessment, public health monitoring and quality assurance. If you object to your tissue being used for any of the above purposes, please inform a member of staff immediately. Salford Royal operates a smoke-free policy. For advice on stopping smoking contact the Hospital Specialist Stop Smoking Service on Salford Royal NHS Foundation Trust Stott Lane, Salford, Manchester, M6 8HD Telephone If you would like to become a Foundation Trust Member please visit: for-members If you have any suggestions as to how this document could be improved in the future then please visit: for-patients