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

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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.

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.

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

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
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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

hello doc, dont worry for gum bleedings.. these r very common symptoms in this stage due to hormonal change n local irritants.. pt adv to keep maintain oral hygiene by regularly brushing n using .2% chlorhexidine mouth wash rinse for 16sec n expil twice daily. hope i help u regarding dental point of view. all the best.

Hello doc, provided informations are very much helpful to us but every gum bleeding cases in pregnancy doesn't necessarily mean that it's a physiological change. Though it's true in 99 %cases but remaining 1%may be gingivitis, vit c Def., bleeding disorder, local trauma etc. So should exclude them I think.
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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

had a similar pt given tab duphaston 40mg stat then 20mg after 12hrs then 10mg bd for a month.shes at term now without any other complications. .

good
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homoeo medicine are given in this case.. hamamalis q 15-15-15 drop tds or hamamlis 200 tds.4-4-4 pills 5 day....

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