Pregnant female with severe abdominal cramping

A 31 y/o G1P0 abortus 0, presented at 15 weeks gestation timed by intrauterine insemination, complaining of severe abdominal cramping. Transabdominal ultrasound showed a single live intrauterine pregnancy and a low lying placenta. A complex echogenic area within the endocervical canal suggestive of a mucus plug was noted. Two days later, the patient experienced severe vaginal bleeding with passage of numerous blood clots with an estimated blood loss of 200 milliliters. What next should be done?

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Funneling of the mem seen which goes more in favour of inevitable abortion Admit the pt Go for os tightening if cx is short ,I mean if cx length is less than 3 Support with Duphastone & Duvadilon Lft,CBC & coagulation profile. Strict rest Avoid constipation.
Inj. HCG 5000 IU weekly. Inj. Progesterone twice im weekly. Lupigest vaginal hs Adv. Bed rest.
- Rest - Progesterone support inj. Proluton depot 500 IM - Tab. Traneximic acid 500 tds
Get repeated fetal heart rate as low lying placenta may be separated with growth of fetus. Keep patient on rest and uterine relaxant. Give progesterone till placenta is formed and fixed completely. Treat anemia also
Do hemoglobin. Assess uterine activity. Inj hydroxyprogesterone 500 mg im stat and weekly Explain pt and relatives about risk of abortion Presently conservative management as described above as threatened abortion
Conservative with rest
INEVITABLE ABORTION