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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Could Persistent Bleeding Post Positive Pregnancy Result Indicate Miscarriage?

I took a pregnancy test 7 weeks ago and it came back positive. I took an other 5 weeks ago just to make sure and it came back positive. My last period was feb 11th so I should be 13 weeks. I have been bleeding every day for a week when I pee and today I had blood in my underwear. I had 2 ultrasounds done 2 days ago and both say I am 5 weeks or less. The doctor says my cervix is closed and they see a sac but nothing in there, that I should go back in 2 weeks for an other ultrasound. Is it possible that I had a miscarriage?
Tue, 30 Mar 2021
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General & Family Physician,  's  Response
Hi,

It seems you are having incomplete abortion. in which a part of the products of conception is passed out thru the open cervical OS. The presence of incomplete abortion can be diagnosed by:
1. Absence of fetal heart rate
2. Pelvic examination which usually shows an open OS, however, in some cases the OS may be closed after bleeding stops, but part of products of conception is still inside uterus, as is present in your case
3. Trans vaginal or trans abdominal ultrasound will show some products of conception but no fetal heart
4. Low HCG level is present after an incomplete abortion; usually a decline of at least 50% is there after 24 hours in HCG level

Surgical management by curettage of the uterus is generally employed. However, manual vacuum aspiration is also a known safe method. In your case, as the OS is closed, therefore, the doctor may perhaps want to be doubly sure that the fetus is not developing and has advised you for a repeat ultrasound after 2 weeks.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Satnarain Bansal, General & Family Physician
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Could Persistent Bleeding Post Positive Pregnancy Result Indicate Miscarriage?

Hi, It seems you are having incomplete abortion. in which a part of the products of conception is passed out thru the open cervical OS. The presence of incomplete abortion can be diagnosed by: 1. Absence of fetal heart rate 2. Pelvic examination which usually shows an open OS, however, in some cases the OS may be closed after bleeding stops, but part of products of conception is still inside uterus, as is present in your case 3. Trans vaginal or trans abdominal ultrasound will show some products of conception but no fetal heart 4. Low HCG level is present after an incomplete abortion; usually a decline of at least 50% is there after 24 hours in HCG level Surgical management by curettage of the uterus is generally employed. However, manual vacuum aspiration is also a known safe method. In your case, as the OS is closed, therefore, the doctor may perhaps want to be doubly sure that the fetus is not developing and has advised you for a repeat ultrasound after 2 weeks. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Satnarain Bansal, General & Family Physician