A 25 yr old pregnant women with 16 weeks of gestation came with bleeding p/v since 3days..no pain abdomen.. no h/0 vomitting and no fever....associated with bleeding gums while brushing...h/0 intercourse 4days back,...all blood investigation and scan is normal in relation to implantation... foetal heart ...possible diagnosis and management



I can see a small pocket of clot(subchorionic hemorrhage), low lying placenta edge just near the os.. adv strict bed rest. inj aq susten 25 mg stat I'm can be given for 5 days tab duphaston 10 mg bd for 15 days or nat progesterone 200 to 400 mg TDs. tab tranexmic acid 500 mg bd for 3 days Tab isosuprne (duva retard) bd for 10 days Folic acid 5 mg od Avoid constipation, so laxatives strict abstinence. Repeat USG after 10- 15 days.

25 yrs / 16 weeks pregnancy / bleeding pv/bleeding gums. this is a case of threatened abortion where patient experiences bleeding pv and scan shows a viable pregnancy. few causes of threatened abortion : * sub chorionic hematoma. * vanishing twin pregnancy. placenta previa. * associated fibroids. * Cervical issues. *vaginal issues. here in the scan film the edge of placenta appears near internal os. bleeding gums can be due to gingivitis hypertrophy during pregnancy. advice her rest and abstinence. give inj aq sustenance 25 mg daily for 5 days. add tab dydrogesterone 10 MG bd for a month or so. routine antenatal care with iron, calcium. there is a chance for preterm labour. proper antenatal care is necessary.

injectable progesterones daily..it's gonna be too painful..they r oil based preparations.we juz give 250mg once a week or put patients on micronized progesterones for vaginal insertion

when associated with bleeding gums.. I think we should think of bleeding diathesis first. of course a speculum examination to rule out local causes including erosion or cervical polyp. USG to look for any placental causes of APH.

Possibly it's a case of 'Bleeding Disorder'. Management :1.Blood for CBC, PT, APTT, BT, coagulation factors, vit k, Vit C 2.H/O any anti coagulant intake to be excluded 3.Iron /Folic acid /Natural micronized progesterone to be given before reports come in hand 4.Must exclude local causes for gum and cervix/vagina separately

check for platelet count,aptt,and pt,as pt has bleeding gums , spontaneous bleed is seen in the scan,cpuld be post coital,placenta low lying strict bed rest,abstinence,tranexa tb bd,inj maintain stat,add antibiotic azithral 500 mg od for 3days with tid flagyl

Rule out placenta previa.do p/s.based on which , if erosion of cervical lip ruled out. If placenta previa., adv. Bed rest. Tab. Ethasylate given

Placenta previa or low lying placenta. It is threatened abortion. Exclude bleeding diathesis . Complete bed rest. Abstinence Progesteron duphastone Tab tranexmic acid 500 mg BD. Tab duvadilan Repeat usg after one week .

it may be threatened abortion advise admission Rx with inj maintained 500mg stat , or inj system 25 much daily for 5 days , tab duphaston 10mg bid complete rest , avoid intercourse ,for bleeding gums tab vit C

large chorio decidual separation seen with low lying placenta. adv complete bed rest .no intercourse progesterones in form of inj and tablets haemostatics and antibiotics. rpt scan after 48 hrs.

patient should be investigated for some bleeding diathisis. ..which me leads above symptoms. ..ofcorse placenta previa is most common couse of antenatal p/v bleeding but how we explained gum bleeding Mx .. sent for all profile investigation for related bleeding diathisis start iv tranexa bedrest vit c supplement supportive treatment if needed

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