Brief Answer:
follow up with scan 2 weekly, fibroids are small..

Detailed Answer:
Hello,

Thanks for contacting health care magic.

I have gone through your ultrasound report and it says live intrauterine fetus with h125 bpm heart beat. Also there are two fibroids - one intramural and the other subserosal. Both are harmless to the pregnancy as the intramural is very small 9mmx8mm in size and in anterior uterine body and not indenting the endometrial lining or the pregnancy. Moreover with growing pregnancy it is likely to thin out. The subserosal one is outside the uterus and not interfering pregnancy in any manner.

The concern about PRIMOLUT-N is genuine about causing congenital anomalies; but no large studies have been conducted which establish the fact and association. So if you plan to continue the pregnancy , just wait and follow up the progress of fetal growth with 2 weekly ultrasound as advised to you. In case there is any anomaly then nature has its own way of causing a terminating it naturally else the pregnancy would continue.

Also , if the pregnancy was unplanned, then also it is safe to terminate with medical methods at present under your gynecologist's supervision . The intramural fibroid should not be a problem, only concern would be slightly excess bleeding which can be controlled with antifibrinolytics if required.

So, option lies with you. Incase of further clarification , send me a direct query at:-
http://doctor.healthcaremagic.com/doctors/dr-sameer-kumar/68814

Regards,
DR XXXXXXX XXXXXXX

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Brief Answer:
pros and cons explained..possibilities explained

Detailed Answer:
Hello,
Thanks for the follow up.

yes abortion is possible at 5weeks -6 weeks by medical method.
Unfortunately we cannot detect by any means not earlier than 9-11 weeks , if the baby has any chromosomal anomalies ( by chorionic villous sampling) , but anatomical anomalies cannot be commented upon till 18-20 weeks. If the baby has anomalies and if it is not compatible with life then nature itself would take care of it.
tumour are fibroids , they are benign , not malignant. they are small and need no intervention at this size and location.

well if you guys were keen on pregnancy , then i suggest you keep the pregnancy as there are various check points in an obstetric mangement which can detect any anomaly or chances by screening methods...
NT SCAN AT 11-13 WEEKS.,
TRIPLE SCREENING AT 15-18 WEEKS.
ANOMALY SCAN AT 18-20 WEEKS.
if any defect is found then pregnancy can be legally aborted till 20 weeks as per law safely.
So, if the fetus survives to 9-10 weeks and the heart beat remains , then it means that pregnancy is compatible with life and anomalies are unlikely and it can be safely continued.

Presently you can opt for continuing unless its an unplanned pregnancy and you both feel strongly for abortion. you just have to decide whether you both want it or not, dont bother about anomalies now, leave it to the obstetrician. be sure about your own feelings for the child.

regards,
Dr.Sameer Kumar

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Brief Answer:
MTP limit is 20weeks as per law....

Detailed Answer:
Hello.
thanks for follow up.
As I mentioned earlier abortion is legal till 20 weeks period of gestation. so if you take a decision to continue then whenever at the checkpoints any anomaly is found MTP can be initiated before 20 weeks.
Secondly, regarding D&C, it is possible that there may be excessive bleeding due to inability of the uterine wall where myoma is present to contract and bleed, but with smaller gestation and small intramural fibroid it can be considered and if bleeding occurs it can be controlled by antifibrinolytics. The decisionis purely individual.
Thirdly , a scan after 2 weeks can establish viability of the fetus and if heart beat is present and growth adequate then pregnancy is likely to sustain.
Fourthly, continue folic acid and systen tabs along with balanced diet. Avoid much of dry fruits and papaya.

regards
dr XXXXXXX XXXXXXX

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