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What Does The Pelvic Ultrasound Report Indicate?

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Posted on Mon, 8 Jun 2015
Question: Hi I had a termination, 10 days after I had a plevic ultrasound which found moderate retained poc. So went back to have a d & c now 4 days after I have a constant bright red bleeding its not heavy , however its constant. I have had another pelvic ultrasound and the doctors comment was "probable retained poc" I am unsure and stressed about what I am supposed to do? Any thoughts or recommendations?
doctor
Answered by Dr. Ramadevi Wani (44 minutes later)
Brief Answer:
If bleeding is not reducing, Consult Gynecologist. Details below

Detailed Answer:
Hi,
Welcome to Healthcare Magic.
I am Dr Ramadevi Wani. I will be answering your concerns.
You are changing how many pads per day? What was the D&C product histopathology finding? Do you have pain? Is there fever? Is there any foul smelling discharge?
It is a bit strange to find probable retained POC even after second D&C. What is the size?
The reason for the bleeding you have could be due to any of the following reasons.
1.     It could be the normal bleeding after D&C. This reduces in severity day by day and stops by 7-10 days. So if the bleeding is decreasing and you have no other complaints, just wait for few days. Things will settle down.
2.     Infection- Uterine tenderness, fever and vaginal discharge are usually present. Sometimes you may not experience these symptoms. Get a pelvic examination and CRP and white cell count done to find out if it is infection.
3.     Rarely it could be due to gestational trophoblastic disease. It occurs when the pregnancy does not develop normally due to imbalance in the chromosome number of egg or sperm. It can be detected by microscopic examination of D&C tissue or by measuring pregnancy hormone which shows a unusual rise.
It is not perforation or injury to cervix. In that case you would have had bleeding since the day of D&C and there would be pain too.
If the bleeding is not reducing, then most likely it is due to infection. Consult your Gynecologist for examination and for investigations written above. In that case you need to take antibiotics.
I hope this helps.
If you have further queries, do write to me. I will be happy to answer.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Ramadevi Wani (16 minutes later)
ill be home tomorrow and ill tell you the findings onlf the ultrasound. thank you for your time speak soon
doctor
Answered by Dr. Ramadevi Wani (3 minutes later)
Brief Answer:
Will be waiting.

Detailed Answer:
Hi,
Welcome back.

I will be waiting.
If the bleeding is not reducing, do follow what I have suggested.

With best wishes,
Dr Rama
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Ramadevi Wani (34 hours later)
tonight I suffered 8/10 in painful cramps followed by heavier bleeding when I went to the bathroom. my cramps lasted about 30-40mins I was almost going to go to the ER but they have calmed down to about a 4/10 pain.
doctor
Answered by Dr. Ramadevi Wani (2 hours later)
Brief Answer:
Please consult your doctor tomorrow morning. Details below.

Detailed Answer:
Hi,
Welcome to back.
Noted the contents of your notes. You had told me that you would go home and write the ultrasound findings. But you did not write to me . Could you please write to me the ultrasound report?
Since you have not mentioned about fever, persistent pain or discharge infection is unlikely.
It seems like there may be remnants of conception in the uterus. That must have caused the cramps and severe bleeding. Please take Mefenamic acid 500mg three times daily with food for cramps for 1-2 days.
Retained products of conception after the second curettage is very rare. Please follow the microscopy result of the curettage product . Gestational trophoblastic disease must be ruled out.
Please see your doctor for the follow up even if you are feeling better now. It is important to clarify the cause of this bleeding (retained products of conception or Gestational trophoblastic disease).
I hope this helps.
If you have further queries, do write to me. I will be happy to answer.

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Ramadevi Wani (4 hours later)
sorry I attatched the pics but they didn't go through ill try again. either way I shall go to the doctors today. on the report it says: Findings- scans ta and tv. it then talks about my uterus saying it's anverted and normal in size 74mm.
endometrium heterogeneous and thickended up to 13mm sagittal . no significant fluid.

both ovarys some follicular cysts biggest being about 10mm. right ovary is 1.2cc and left is 3.2cc

no free fluid in pouch of XXXXXXX

COMMENT
probable retained POC
doctor
Answered by Dr. Ramadevi Wani (5 hours later)
Brief Answer:
Good news is that retained product is not large

Detailed Answer:
Hi,
I saw the uploaded ultrasound film and report. It looks like retained product of conception. Good news is that it is not large. Things should settle down on its own without any further intervention.
Please do follow up the histopathology report.
If possible Keep me updated about the histopathology report.
Best wishes,
Dr XXXXXXX
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
Answered by
Dr.
Dr. Ramadevi Wani

OBGYN

Practicing since :1985

Answered : 1457 Questions

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What Does The Pelvic Ultrasound Report Indicate?

Brief Answer: If bleeding is not reducing, Consult Gynecologist. Details below Detailed Answer: Hi, Welcome to Healthcare Magic. I am Dr Ramadevi Wani. I will be answering your concerns. You are changing how many pads per day? What was the D&C product histopathology finding? Do you have pain? Is there fever? Is there any foul smelling discharge? It is a bit strange to find probable retained POC even after second D&C. What is the size? The reason for the bleeding you have could be due to any of the following reasons. 1. It could be the normal bleeding after D&C. This reduces in severity day by day and stops by 7-10 days. So if the bleeding is decreasing and you have no other complaints, just wait for few days. Things will settle down. 2. Infection- Uterine tenderness, fever and vaginal discharge are usually present. Sometimes you may not experience these symptoms. Get a pelvic examination and CRP and white cell count done to find out if it is infection. 3. Rarely it could be due to gestational trophoblastic disease. It occurs when the pregnancy does not develop normally due to imbalance in the chromosome number of egg or sperm. It can be detected by microscopic examination of D&C tissue or by measuring pregnancy hormone which shows a unusual rise. It is not perforation or injury to cervix. In that case you would have had bleeding since the day of D&C and there would be pain too. If the bleeding is not reducing, then most likely it is due to infection. Consult your Gynecologist for examination and for investigations written above. In that case you need to take antibiotics. I hope this helps. If you have further queries, do write to me. I will be happy to answer.