24yrs old with primary infertility 3yrs with pcod conceived after induction of ovulation in the 2nd month.LMP--18/9/16.Came c/o spotting p/v on 25/10/16.UPT was positive. Progesterone support , Folicacid given nd adv rest nd abstinence.Adv to come after 2wks for fetal viability scan.But she came late c/o pain lower abdomen, no spotting. Scan is showing subchorionic bleed.Wt-40kgs.Taking min dose of Eltroxin 12.5mcgms.Now TSH is normal. Discuss about the management.

8 Likes

LikeAnswersShare

24 yr //treated for primary infertility.//PCOD //LMP 18 -9-16 //bleeding pv.//Hypothyroidism. If there is a -viable fetus ,then advice her rest and abstinence as earlier. Give injection -HCG 10,000 units stat. followed by weekly in -HCG 5,000 till 16t week. Give tab duphaston 10 mg bd till 16th week. Add folic acid.Sub chorionic hemorrhage gets absorbed.Repeat scan after two weeks. Once stabilized continue your antenatal care,iron,calcium supplements,scan and blood tests as usual.

Proluton depot needed wid hcg inj?
1

View 2 other replies

A case of precious pregnancy as she conceived after 3 yrs,with k/n PCOS. TVs suggestive of threatened abortion. But subchorionic bleed is small. So can be managed conservatively. Strict bed rest. Abstinence Inj hcg 5000/units stat & Wkly Inj vit k im stat Nat progesterone found be far effective in such cases So put on inj ACU susten 25 mg daily Im for 5 days Susten 300mg daily bd Folic acid daily Repeat scan after a week.

Mam size of sub chorionic bleed small. 2.explain the risk of threatened abortion.to pt. 3. Inj Huchog 5000 you now. 4.followed by inj Huchog 5000iu Billy. 5 cap progesterone supports 200 mg bd 6. Tab. Duphaston 10 mg od. 7. Adv bed rest. and abstinence. 8. Adv scan after 10 days 8.

if fetus viable then Rest Abstinence Continue progesterone support Inj hucog 10000iu im once weekly Continue eltroxin as before Repeat scan again after 2 weeks fr fetal viability nd to compare d size of sch

It is Th aobotion. Continue previous treat .Add injHCG10,000 UIT ST&repeat 5000unit wkly till16 wks preg, Tab Duphaston10mg bd upto 16 wks.Repeat scan after 2wks.onc stablised ,continue Nat progestron support, calcium, iron, protein supplementation . Regular ANC & Reviews.

Iron not needed untill 20 wks
0

I agree with @Dr. Suvarchala Pratap I adv ecosprin 75 mg od till edd

Not to worry as pregnancy continue subchroionic bleed will clear continue progesterone folic acid regular usg to see progress of pregnancy

It's a case of threatened abortion.. subchorionic bleed... Requires just observation... Support with inj.maintane 500mg weekly once till 12 weeks, folic acid.

Continue folic acid n progesterone support Micronized progesterone upto 400mg bd per vaginally can be given Abstinence to be continued plus avoid heavy work Subchorionic bleed mostly dissolve with time To be followed with usg

SC bleed observation and absolute bed rest. Natural micronised progesterone 200mg IM weekly and duphaston BD Review Usg after 15 days.

Load more answers

Diseases Related to Discussion

Cases that would interest you