WOMENS-HEALTH Messages for October, 2007: CHRONICPAIN: Painful miscarriage diagnosis doesn't add up

CHRONICPAIN: Painful miscarriage diagnosis doesn't add up

From: Concerned and in Pain (anonymous@obgyn.net)
Thu, 25 Oct 2007 19:25:11 -0500 (CDT)

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Please forgive long post, thought I'd explain what I've been through in hopes someone can shed some light. Maybe you have an idea of what is happening to me, or maybe you've had similar symptoms?

33-year-old married female, never had children. Menstrual cycles are normally 35-40 days, 7-day periods with mild nauseousness and mild cramps.

Normal period in early July. In late August, I got my period. On the 2nd day, I awoke to extremely crampy feeling in my abdomen. I felt nauseous and every movement activated abdominal cramping (mostly right-side pain). My bowel movements became extremely painful. Every gas bubble moving through my intestine was painful and like cramping. Sitting down on a hard chair was impossible as it seemed to put pressure on my inner organs. I bled for 10 days and then was normal 10 days.

Then on 9/15, I started bleeding, but it was light flow and dark color. One week later, I started bleeding more heavily. The abdominal pain, gas and BM pain returned. I visited my dr on 9/25, and she did a pregnancy test, which was positive. My dr was concerned about ectopic pregnancy, so I had an ultrasound that afternoon (abdominal and vaginal), which showed no evidence of pregnancy. No endometrial fluid or gestational sac was identified. Ovaries appeared to be within normal limits. No free pelvic fluid identified. No evidence for adnexal mass or torsion. I followed up with bHCG tests, and my levels went to 0, indicating miscarriage.

Stopped bleeding from 9/26 – 10/4. On 10/7, started bleeding heavily and again, the pain returned. Abdomen very painful to the touch. Saw my dr 10/9, she thought apendicitis and ordered abdominal/pelvic CT. CT showed the following: Uterus shows the appearance of small amount of endocervical fluid. There is a heterogeneous appearing right adnexal mass, which measures approximately 7.5cmx4.6cmx6.1cm. This appears to be confluent with dense free fluid in the lower pelvis suggesting possibility of hemoperitoneum (bleeding into abdomen). Blood tests were normal.

I then visited OB/GYN on 10/10 ultrasound showed healthy-looking ovaries but showed mass which looked dark and heterogeneous on the monitor. Her conclusion: Ruptured corpus luteum cyst bled into abdomen. Blood in abdomen causing pain, should resolve itself within 1-2 months. After that I had 10 days of relatively normal life. Then, on 10/20, I started feeling abdominal pain again, gradually increasing. The same symptoms returned.

I am concerned that the pain is returning. How can the pain be explained by the masses when the pain started before the masses showed up? Does this kind of pain happen during a miscarriage? I'm told to "wait and see" if the masses get reabsorbed by my body, but does this seem advisable? Can blood in the abdomen cause pain that comes and goes? Could these symptoms not be related at all to the miscarriage, but rather indicate something else?

Any thoughts or ideas would be greatly appreciated.

Next message: missyhelly: "Re: GYNECOLOGIC: Unsatisfactory pap with inflammatory exudate"
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