Concluded Case

AUB with CVA

50 yrs old female, P2 L2 with previous 2 lscs , tubectomised, along with she is diabetic and hypertensive, 3 days back she had acute stroke with right hemiplegia with aphasia...my concern is she is heavily bleeding since 6-7 yrs and her haemoglobin fallen upto 5...3 pi50nt packed cells were transfused corrected hb is 10..scan is mentioned as anterior wall fibroid of 10 cms..she is presently on clexane, clopidogrel and ecospirin ...since today she suddenly had bout of bleeding with 1 pad soakage.Current situation pause inj is been kept on hold as she may have chance of thrombus getting dislodged.she definitely requires hysterectomy after a biopsy..planning to get an endometrial pipelle in the ward before she gets discharged ... 1. Can I plz know wat is the medication for her present situation to reduce bleeding even after stopping ecospirin??? 2. Can I know the alternative options like mitena/ copper T/ 3. When can i operate early ??? Can I go ahead with endometrial pipelle biopsy for this case ??? Will that help .???

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thanks for all ur advices presently her bleeding is reduced as TVs pelvic scan suggests as submucosal fibroid finding the fundus with endometrial thickness mentioned as 5 mm ... planning to do a pipelle biopsy after 2 weeks .... depending on biopsy which would b mostly benign ... further to proceed for TAH+BSO 3 months down the lane...
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thanks for all ur advices presently her bleeding is reduced as TVs pelvic scan suggests as submucosal fibroid finding the fundus with endometrial thickness mentioned as 5 mm ... planning to do a pipelle biopsy after 2 weeks .... depending on biopsy which would b mostly benign ... further to proceed for TAH+BSO 3 months down the lane...
- Put her on High dose of Progesterone ( Normolan CR 10mg) BD, to prepare for surgery & stop blood loss - Alternative doesn't help much - fit patient for surgery with physician reference
Does mirena help her ????
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Get her Pap smear, endometrial sample for hpr ,do rule out CA endometrium, u can try inj leuprolide to delay hysterectomy till she is medically fit for surgery
Thank you doctor
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Better to operate as soon as possible Whenever fit by anaesthetist high dose progesterone can be tried
Thank you doctor
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Botrapase can be used to manage bleeding Hysterectomy can be done only after fitness by anesthetist
I agree
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Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!
Thank you doctor
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