Brief Answer:
DO ONE TRANS VAGINAL ULTRASOUND SCAN.

Detailed Answer:
Hello,

Thanks for writing to us.

Vaginal bleeding in the 2nd trimester (after 20 weeks) may be due to Placenta Previa, Placental abruption and Vasa previa. These are the most common cause of antepartum hemorrhage. Effective management is required to avoid maternal and fetal complications.

In this context, we need to rule out Placenta previa (painless vaginal bleeding). Therefore, I suggest to undergo one ultrasound scan to confirm the diagnosis. Trans vaginal ultrasound is superior as compared to trans abdominal one, thus allowing measurement of distance between placenta and cervical Os.

Baseline laboratory tests include hematocrit, platelet count, fibrinogen level, coagulation studies, blood group type and antibody screen. Continuous fetal monitoring is also recommended.

The main therapeutic strategy is to prolong pregnancy until fetal lung maturity is achieved. Tocolytic agents may be used safely to prolong gestation if vaginal bleeding occurs with preterm contractions. Corticosteroids can be administered to women who have bleeding from placenta previa at 24 to 34 weeks' estimated gestation.

Kindly, consult with your OBSTETRICIAN regarding this and take suggestive treatment accordingly.

In addition, you should AVOID heavy work/ long journey/ too much bending/ up & downstairs/ sexual intercourse; take complete bed rest; drink more water to stay hydrated & better feto-placental circulation and maintain genital hygiene properly.

Hope, this information is quite helpful to you. Kindly, close the discussion if you don't have any other query.

Wish your good health and take care yourself.

Regards,
Dr Soumen

For future query, you can directly approach me through

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=63326

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Brief Answer:
DETAILS ARE GIVEN BELOW.

Detailed Answer:
Hello,

Thanks for follow up query.

1) At first, you have to undergo one Trans Vaginal Ultrasound scan to know the current status of pregnancy along with fetal well being. It also helps to detect cause of vaginal bleeding at this stage.

2) Bed rest and your day to day activity (including office) depend on ultrasound scan (TVS) report. You should take minimum 7- 10 days bed rest and continue Naturogest 200mg according to your doctor's recommendation. In addition, you would follow previous advices which I have described in last paragraph.

3) You would take protein rich diet (extra 350 Kcal/ day) including egg, salmon, beans, sweet potatoes, Popcorn and other whole grains, Walnuts, Greek yogurt, Dark green, leafy vegetables, Lean meats, Colorful fruits and vegetables.

Drink more water 2.5-3 Lit/ day or fruit juice to stay hydrated and for better feto-placental circulation.

Hope, I have answered your query. Kindly, close the discussion.

All the best and good luck.

Regards,
Dr Soumen

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