Brief Answer:
explained all the details

Detailed Answer:
Hello and welcome,
I am Dr Madhuri a Consultant Obstetrician and Gynecologist and will be helping you with your queries.

I am not sure if about the history. Gartners cysts are common in the vagina and do not occur in the uterus. So can you please reconfirm that it was in the uterus and not the vagina. Also I assume that your daughter underwent a cesarean section as the baby was obstructed.

So if it was a vaginal cyst and the baby was not able to get past it, a cesarean section was justified.

Also it seems that now you are worried about the bleeding that your daughter is having and she is also on contraceptive implant [ needle].

Please do not worry at all. The implants are known to cause bleeding. It may be irregular spotting, intermittent bleeding or heavy bleeding in a few women. Some women eventually develop absence of bleeding or amenorrhea.
The nausea may be due to the implant and oral hormones or due to infection. It is difficult to comment on this now as she is having abdominal pain as well as dysentery along with nausea. Both oral hormones and infection produce similar complaints.

Another rare cause of bleeding after childbirth is a tumor called trophoblastic tumor or retained bits of placenta in the uterus during childbirth.

So the plan for you now is first to get a urine pregnancy test. If it is negative it will rule out trophoblastic disease. An ultrasound will help detect retained products or placental bits. Ask her to take a soft diet mainly clear soups with just salt and no spices, oats or thin gruel. This will remove the strain on her digestive system. Use probiotics and low fat yogurt to aid digestion.
Using oral hormones is not a good idea to control bleeding from implant. It will more likely not get controlled as hormones are the one that may be causing this bleed. So discuss with your doctor regarding stopping them. Antacids like digene will help in the stomach pain and a tablet of ondesetrone will control nausea. Bleeding can be controlled by drugs like tranexamic acid twice daily for a few days.

If the symptoms still persist, she may need to get the implant removed.

Do not worry these symptoms are seen in many women after implant and most will get adjusted to them after a few months.
Hope this satisfies your query.
Thanks for using HCM.     
Feel free to ask any more questions that you may have.
Dr Madhuri Bagde
Consultant Obstetrician and Gynecologist

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Brief Answer:
If cyst is big, needs removal

Detailed Answer:
Hello and welcome back,

The bleeding may come from the cyst if it has grown big [ the upper layers may slough off and cause bleed, but this is usually accompnied by foul smelling discharge so check if she has it]. However implants also cause bleeding. And she is on hormones for the bleeding which may well be either due to the hormones or the cyst. These cysts usually do not cause abdominal pain as they are way low down. In either case, oral hormones may not help at all.

A cyst of the size of a tennis ball is big and needs removal. I suggest that you discuss this issue with your GP [ you may accompany her or get some one else to accompany her] and convey it to him that the problem is an acute one and needs to be addressed urgently. Another way is to try and see another doctor if possible. The cyst may grow during pregnancy and then decrease in size later. A scan and a vaginal examination are needed. In any case it is best to get it removed. So please see and talk with your doctor as soon as possible as your daughter is in agony.

I understand that you are concerned. Please do not worry as worry does not help. The cyst is causing symptoms but it is non cancerous and removing it will help her. You just need to impress her agony so that the doctor will realize the gravity of the issue. You may discuss all my previous suggestions as well as the current ones with your doctor and it may help.

Hope she recovers soon.

Take care.
Dr Madhuri

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