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Developed Hypothyroidism After First Child, Taking Thyronorm. Had Missed Abortion. Have Delayed Period, Diagnosed PCOS And Taking Metformin

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Posted on Thu, 10 Oct 2013
Question: I am 32 year old and developed hypothyroidism after the birth of my first child who is 4 years old. I am taking Thyronorm 75 mcg in consultation with my Endocrinologist. I also had a missed abortion (7 weeks) last year (Sept 2012).



I had my last period on 28th July 2013. When my period get delayed by one week then i conducted UPT on 3rd Aug, it showed weakly positive.Then, I consulted my gynaecologist who advised me to go for Beta HCG test which came 14mlU/mL. I also had mild unilateral pain in my abdomen. My gynaecologist advised me to take Corion 5000 IU injection. On 10th Aug, I again went for beta HCG test and it was 37.95. My gynaecologist advised me to go for TV Ultrasound. In ultrasound my central endometrial echoes measured 18.1 mm in thickness and right ovary had 2 small follicles and left ovary had 4 small follicles, measuring 5mm each. No evidence was found for intrauterine pregnancy.

on 11th Aug 2013, after consulting US report my doctor told me that i have PCOS and she advised me to take"Metformin 500 mg" twice a day along with "Primolut-N" (twice a day for 5 days) to regularize my Period. I have consumed 10 tabs of primolut N and waiting for period to occur. In between, I had unprotected sex with my husband.

I also had a Beta HCG test on today (16th Aug) and it was surprisingly came to 363. Today, I have consulted to my gynaecologist and she has advised me again to go for TVU.

Now, i am in dilemma whether i am pregnant or suffering from PCOS. If i am pregnant, then consuming 10 tabs of primolut-N is going to harm development of foetus? Please advise.
doctor
Answered by Dr. Monika Choudhary (52 minutes later)
Brief Answer:
You can have extra-uterine pregnancy

Detailed Answer:
Hello XXXXXXX
Thanks for posting your query.
Getting serum Beta HCG more than 10 is an indication of pregnancy, it can be intra-uterine or extra uterine.
As your serum beta HCG was not doubling up in 48 hours, on urine pregnancy test you were having faint line, complain of pain abdomen & on TVS scan-no evidence of intra-uterine pregnancy.
In conclusion you can have extra-uterine pregnancy(abnormal pregnancy).
Get one trans vaginal scan done to rule out extra-uterine pregnancy.
If it comes extrauterine it will be better to terminate it as soon as possible otherwise problem can be catastrophic.
I will be available for your further queries.
Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Monika Choudhary (1 hour later)
Dear Ma'am,

Thanks for your reply. I went for TVS today and its showing endometrium echo of 22.6 mm and a tiny intrauterine G-sac measuring 2.5 mm suggesting possibility of early pregnancy. Both ovaries have multiple small follicles.

I have been advised by my doctor to take HUCOG 5000 IU I/M twice weekly along with folifit, Ecoaspirin 75 MG, Duphaston 10 MG and Complamina Retard for 15 days.

There are three questions striking to my mind and need your guidance to answer these:
1. I had consumed 10 tabs (last taken on 16th Aug) of Primolut-N as I mentioned in my previous query. So, whether it will affect the development of foetus?
2. I have been detected with PCOS, so is it going to complicate my pregnancy, g and growth of baby?
3. Being Overweight (BMI 29.5), what precaution should i take during pregnancy?

Kindly respond.

Regards,
XXXXX
doctor
Answered by Dr. Monika Choudhary (25 hours later)
Brief Answer:
you can continue pregnancy

Detailed Answer:
Hello XXXXXXX
First of all I will congratulate you for your expectant motherhood.
Ideally primolut -N is contraindicated in pregnancy.
However chances of fetal malformation are very rare so you can continue your pregnancy & get ultrasound scan done regularly to detect fetal growth.
PCOS can increase risk of miscarriage or preterm delivery, so keep in touch with your doctor & take precaution for not gaining excess weight by avoiding heavy & fast food.
I hope your query has been answered.
Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Monika Choudhary

OBGYN

Practicing since :2004

Answered : 816 Questions

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Developed Hypothyroidism After First Child, Taking Thyronorm. Had Missed Abortion. Have Delayed Period, Diagnosed PCOS And Taking Metformin

Brief Answer:
You can have extra-uterine pregnancy

Detailed Answer:
Hello XXXXXXX
Thanks for posting your query.
Getting serum Beta HCG more than 10 is an indication of pregnancy, it can be intra-uterine or extra uterine.
As your serum beta HCG was not doubling up in 48 hours, on urine pregnancy test you were having faint line, complain of pain abdomen & on TVS scan-no evidence of intra-uterine pregnancy.
In conclusion you can have extra-uterine pregnancy(abnormal pregnancy).
Get one trans vaginal scan done to rule out extra-uterine pregnancy.
If it comes extrauterine it will be better to terminate it as soon as possible otherwise problem can be catastrophic.
I will be available for your further queries.
Regards,