Brief Answer: Does not seem to be ectopic Detailed Answer: Hi and Thanks for the query. I understand you concern and also I appreciate them as you have had an earlier ectopic. First regarding the difference in dates: The first possibility is that ovulation occurred early in this cycle and hence the dates are ahead of the expected dates. The increase in hormone level may also be different in different women leading to minor error in dates. The kit is also not completely accurate and a margin of 1-2 days is expected. So this should not be a cause of concern. Another reason for the difference may be twin pregnancy or a condition called vesicular mole [very rare form of abnormal pregnancy and considering your symptoms almost unlikely]. Regarding the bleeding: It may be implantation bleeding that occurs during the time of the expected menses. It is harmless and slight in quantity and does not need treatment. The other cause is abortion. This needs urgent investigation and treatment. At less than 4 weeks it is difficult to diagnose abortion by any investigation. however for similar women in my clinic I still advise an ultrasound. It helps sometimes in women that may have wrong dates. Sometimes an intrauterine sac may be visible and helps to rule out an ectopic. Threatened abortion can be controlled by using weekly HCG injections and progesterone injections or tablets and repeating the ultrasound after 2 weeks to see for fetal growth. Regarding the ectopic: It is difficult to comment upon this at this stage. You have no symptoms, but they usually come around 5 weeks. The only sign indicating that ectopic is unlikely is the kit showing an advanced pregnancy. In ectopic pregnancy the hormone levels rise slowly as compared to an intrauterine pregnancy. So had it been an ectopic, the kit would have more likely shown less gestation rather than more than expected gestation. I suggest that you visit your obstetrician and get and ultrasound done. If an intrauterine sac is visible, start HCG and progesterone and take bed rest as it helps the most. Also start folic acid tablets to help in the babies brain development. Do not worry it does not look like ectopic, just start treatment early and you will be allright. Hope I was able to help you. Thanks for using Health Care Magic. I would be happy to answer any further queries. Have a nice day and take care. Dr. Madhuri Bagde Consultant Obstetrician and Gynecologist

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