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What Does" Sub Chronic Bleed Pole Measurement - 13X4 MM" Mean And How Can It Be Treated ?
Question: THIS QUERRY IS FOR MY WIFE NEEVITHA.
IT HAS BEEN 1.5 YEARS SINCE MARRIAGE.
WE ARE TRYING FOR A BABY FOR THE PAST 8 MONTHS IN THE MEAN TIME SHE WAS DIAGNOISED FOR PCOD AND TOOK TREATMENT FOR THE SAME I.eTWO MONTHS ON BIRTH CONTROL PILLS FOLLOWED BY CROMINAC TAB AND LETROZE TAB AND THEN PROGESTRONE AFTER 14TH DAY.
AFTER 4 CYCLES NO RESULT.
30TH MAY SHE GOT HER PERIODS AND THIS TIME DOCTOR ADVISED TO STOP ALL MEDICATION AND GIVE A CASUAL TRY,WE TRAVELLED A LOT HOLIDAY AT SRILANKA AND LUCKILY GOT PREGNANT WHEN WE WENT TO DOCTOR ON 8TH JULY. DOC ASKED US TO TAKE SCAN ON 22 JULY,AND PRESCRIBED FOLIC ACID TAB AND PROGESTRONE 300MG.
BUT TODAY MORNING (13 JULY) SHE HAD CRAMPS AND UN BEARABLE ABDOMEN PAIN IN THE MORNING. WE TOOK A SCAN AND I HAVE UPLOADED THE SCAN AND REPORT ALONG WITH THIS QUERY.
DOCTOR HAS ADVISED COMPLETE BED REST.
WHAT IS THE CHANCE ?
WHAT DOES IT MEAN BY SUB CHORIONIC BLEED POLE MEASU: 13X4 MM.
IS THERE SOMETHING ELSE ANY NEW TECHNIQUE OR OTHER MEDICAL TREATMENT APART FROM TAKING REST AND WAIT?
XXXXXXX
IT HAS BEEN 1.5 YEARS SINCE MARRIAGE.
WE ARE TRYING FOR A BABY FOR THE PAST 8 MONTHS IN THE MEAN TIME SHE WAS DIAGNOISED FOR PCOD AND TOOK TREATMENT FOR THE SAME I.eTWO MONTHS ON BIRTH CONTROL PILLS FOLLOWED BY CROMINAC TAB AND LETROZE TAB AND THEN PROGESTRONE AFTER 14TH DAY.
AFTER 4 CYCLES NO RESULT.
30TH MAY SHE GOT HER PERIODS AND THIS TIME DOCTOR ADVISED TO STOP ALL MEDICATION AND GIVE A CASUAL TRY,WE TRAVELLED A LOT HOLIDAY AT SRILANKA AND LUCKILY GOT PREGNANT WHEN WE WENT TO DOCTOR ON 8TH JULY. DOC ASKED US TO TAKE SCAN ON 22 JULY,AND PRESCRIBED FOLIC ACID TAB AND PROGESTRONE 300MG.
BUT TODAY MORNING (13 JULY) SHE HAD CRAMPS AND UN BEARABLE ABDOMEN PAIN IN THE MORNING. WE TOOK A SCAN AND I HAVE UPLOADED THE SCAN AND REPORT ALONG WITH THIS QUERY.
DOCTOR HAS ADVISED COMPLETE BED REST.
WHAT IS THE CHANCE ?
WHAT DOES IT MEAN BY SUB CHORIONIC BLEED POLE MEASU: 13X4 MM.
IS THERE SOMETHING ELSE ANY NEW TECHNIQUE OR OTHER MEDICAL TREATMENT APART FROM TAKING REST AND WAIT?
XXXXXXX
Hello,
Thanks for the query. I have gone through your wife's reports.
She is having threatened abortion. In this, there is danger of miscarriage. But the situation can be prevented. The following information should be of help to you.
1. She should undergo quantitative beta HCG levels as well as progesterone levels in blood.
2. As you mentioned that she is on progesterone 300 mgm which means it is micronised progesterone.
It's doctor's choice but I would prefer duphastan instead of progesterone. You may discuss about it with your gynecologist.
3. She can be put on HCG injections 5000 IU weekly but after knowing the HCG levels.
4. Folic acid and strict bed rest needs to be continued.
5. For abdominal cramps she may take duvadilon (isoxsuprine hydrochloride) tablets or Injection.
Tranexamic acid also controls the bleeding and prolongs the pregnancy. You can get these medications prescribed by your gynecologist.
6. Repeat the scan after 15 days if there is no bleeding , hoping everything is going to be fine.
7. I hope your doctor have got the thyroid profile and TORCH test done. If not you may get these done too.
I will be able to continue this discussion if the results of these test are known.
Hope this answer is helpful to you. Should you have any more queries, I will be available for follow ups.
Regards
Thanks for the query. I have gone through your wife's reports.
She is having threatened abortion. In this, there is danger of miscarriage. But the situation can be prevented. The following information should be of help to you.
1. She should undergo quantitative beta HCG levels as well as progesterone levels in blood.
2. As you mentioned that she is on progesterone 300 mgm which means it is micronised progesterone.
It's doctor's choice but I would prefer duphastan instead of progesterone. You may discuss about it with your gynecologist.
3. She can be put on HCG injections 5000 IU weekly but after knowing the HCG levels.
4. Folic acid and strict bed rest needs to be continued.
5. For abdominal cramps she may take duvadilon (isoxsuprine hydrochloride) tablets or Injection.
Tranexamic acid also controls the bleeding and prolongs the pregnancy. You can get these medications prescribed by your gynecologist.
6. Repeat the scan after 15 days if there is no bleeding , hoping everything is going to be fine.
7. I hope your doctor have got the thyroid profile and TORCH test done. If not you may get these done too.
I will be able to continue this discussion if the results of these test are known.
Hope this answer is helpful to you. Should you have any more queries, I will be available for follow ups.
Regards
Above answer was peer-reviewed by :
Dr. Prasad
Dear mam,
as advised checked with my gynac and she gave my wife one HCG ingection,and asked to continue bed rest ,along with routine progestrone tablet and folic acid.
she also gave her injection of TREMADOL and OVERON to subside pain.also advised to take buscospan if there are cramps,which my wife took only twice
we took follow up scan on 14th and 27 july.it is showing some improvement.
kinldy have a look at the report and suggest.
she is suffering from very very severe back pain every morning.asked the gynec even she too told me that the reason is not known even she has not heard about any other severe back pain case during 2nd month.
kindly advice
as advised checked with my gynac and she gave my wife one HCG ingection,and asked to continue bed rest ,along with routine progestrone tablet and folic acid.
she also gave her injection of TREMADOL and OVERON to subside pain.also advised to take buscospan if there are cramps,which my wife took only twice
we took follow up scan on 14th and 27 july.it is showing some improvement.
kinldy have a look at the report and suggest.
she is suffering from very very severe back pain every morning.asked the gynec even she too told me that the reason is not known even she has not heard about any other severe back pain case during 2nd month.
kindly advice
Hello,
I saw the reports.
Congratulations as there is no subchorionic collection and it is 8 weeks intrauterine gestation.
She should take strict bed rest till 12-14 weeks.
Mattresses should not be very hard.
Apply some local ointment like Volini gel on the back, do not massage, apply gently.
It is better to give injection duvadilan or isoxsuprine hydrochloride in IV fluids slowly.
One has to monitor BP with this drip and should be administered after hospitalisation at least for 24 hrs under gynaec supervision.
Buscopan is a good drug , you can also give injection meftal spas or tablet meftal as and when required.
Injection Corion biweekly along with progesterone.
Progesterone injection can also be given instead of tablets.
If you can not admit her to hospital then give tablet Suprox SR 40 mgm daily at bed time after dinner.
Duvadilan causes slight tremors and fall in BP for a short while but they subside within 10-15 minutes.
Do not worry.
Tell her to have good diet and proper sleep.
Best wishes
I saw the reports.
Congratulations as there is no subchorionic collection and it is 8 weeks intrauterine gestation.
She should take strict bed rest till 12-14 weeks.
Mattresses should not be very hard.
Apply some local ointment like Volini gel on the back, do not massage, apply gently.
It is better to give injection duvadilan or isoxsuprine hydrochloride in IV fluids slowly.
One has to monitor BP with this drip and should be administered after hospitalisation at least for 24 hrs under gynaec supervision.
Buscopan is a good drug , you can also give injection meftal spas or tablet meftal as and when required.
Injection Corion biweekly along with progesterone.
Progesterone injection can also be given instead of tablets.
If you can not admit her to hospital then give tablet Suprox SR 40 mgm daily at bed time after dinner.
Duvadilan causes slight tremors and fall in BP for a short while but they subside within 10-15 minutes.
Do not worry.
Tell her to have good diet and proper sleep.
Best wishes
Above answer was peer-reviewed by :
Dr. Manju M
Dear Mam,
we tooka scan on 29 oct and things were fine then.
on 10th nov my wife had some bleeding and some blood clot in the morning.
we took a scan asadvised by Gynac report attached.
she is again on progestrone 300 mg tablets as advised by Gynac.
she feels heavyness below her stomach.
can any thing be done to prevent placental bleeding.but after 10th nov she didnt have any bleeding.she has stopped daily walking and taking bed rest now.
Kindly advice,
warm regards, XXXXXXX
we tooka scan on 29 oct and things were fine then.
on 10th nov my wife had some bleeding and some blood clot in the morning.
we took a scan asadvised by Gynac report attached.
she is again on progestrone 300 mg tablets as advised by Gynac.
she feels heavyness below her stomach.
can any thing be done to prevent placental bleeding.but after 10th nov she didnt have any bleeding.she has stopped daily walking and taking bed rest now.
Kindly advice,
warm regards, XXXXXXX
Hello again XXXXXXX
Thank you for writing back.
I saw the reports, she is having 23 weeks pregnancy with placental clot.
The placenta is posterior and away from the XXXXXXX os which is a positive finding.
If it is anterior and covers the XXXXXXX os then it is called placenta praevia.
In this case it is called an antepartum haemorrhage.
The causes can be various , the most common is high blood pressure or toxaemia of pregnancy.
Another cause can be any fall or injury on the abdominal wall.
You should get her regular BP check up and watch for the swelling on feet and get her urine albumin done.
She should take complete bed rest.
Isoxsuprine hydrochoride should be given in tablet or injectable form under your doctor's guidance and prescription.
Progesterone which she is taking is ok.
She should take iron supplements and you can give trenaxamic acid if your doctor feels like giving it.
Repeat ultrasound after 15 days to see the amount of blood inside as it is a concealed type of bleeding.
Wait and watch is the only answer for this problem.
Any further query is most welcome.
Take care.
Thank you for writing back.
I saw the reports, she is having 23 weeks pregnancy with placental clot.
The placenta is posterior and away from the XXXXXXX os which is a positive finding.
If it is anterior and covers the XXXXXXX os then it is called placenta praevia.
In this case it is called an antepartum haemorrhage.
The causes can be various , the most common is high blood pressure or toxaemia of pregnancy.
Another cause can be any fall or injury on the abdominal wall.
You should get her regular BP check up and watch for the swelling on feet and get her urine albumin done.
She should take complete bed rest.
Isoxsuprine hydrochoride should be given in tablet or injectable form under your doctor's guidance and prescription.
Progesterone which she is taking is ok.
She should take iron supplements and you can give trenaxamic acid if your doctor feels like giving it.
Repeat ultrasound after 15 days to see the amount of blood inside as it is a concealed type of bleeding.
Wait and watch is the only answer for this problem.
Any further query is most welcome.
Take care.
Above answer was peer-reviewed by :
Dr. Yogesh D
Dear mam,
This is XXXXXXX again.now my wife neevitha has completed 39 weeks.attached here with her scan report taken @ her 38 week 2 days.
The doctor told me that baby's weight is very high.and babies head is still floating.
she told me that the head normally does not float after 36 weeks.
weather weight of the baby is abnormal
what is the probability of normal delivery?
she has slight pain in the abdomen area but no cramps.
if the babies weight is more and normal delivery is not possible at what point it will be decided to take the baby out.what are the symptomps to watch out for?
warm regards, XXXXXXX
This is XXXXXXX again.now my wife neevitha has completed 39 weeks.attached here with her scan report taken @ her 38 week 2 days.
The doctor told me that baby's weight is very high.and babies head is still floating.
she told me that the head normally does not float after 36 weeks.
weather weight of the baby is abnormal
what is the probability of normal delivery?
she has slight pain in the abdomen area but no cramps.
if the babies weight is more and normal delivery is not possible at what point it will be decided to take the baby out.what are the symptomps to watch out for?
warm regards, XXXXXXX
Hello XXXXXXX
As neevitha is having 39 weeks with floating head so chances of LSCS (Lower segment caesarian section) are more
Normally the head is fixed at 36 weeks in Primigravida
It is called CPD or cephalopelvic disproportion
The doctor who is examining is the best judge as she is doing the per vaginal examination and judging the pelvic cavity and position of the head
If your doctor feels like C - section then go for it , there is no point waiting for the normal delivery or labour pains
Best wishes
Waiting to hear the good news
Good luck once again
As neevitha is having 39 weeks with floating head so chances of LSCS (Lower segment caesarian section) are more
Normally the head is fixed at 36 weeks in Primigravida
It is called CPD or cephalopelvic disproportion
The doctor who is examining is the best judge as she is doing the per vaginal examination and judging the pelvic cavity and position of the head
If your doctor feels like C - section then go for it , there is no point waiting for the normal delivery or labour pains
Best wishes
Waiting to hear the good news
Good luck once again
Above answer was peer-reviewed by :
Dr. Raju A.T
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