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Has hyperthyroidism, PCOD, infertility. Trying to conceive. Now has burning sensation in vagina, pain in abdomen. What is wrong?

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Medical History of Mrs. Nigar Bano, Age – 36 Years.
Married in XXXXXXX 2001, continuous trying to conceive.
Under treatment from 2004
1.In 2006 diagnosed Hypothyroidism, PCOD, Hypertension & Infertility
2.In 2007 March suffered with Endometrial infection (Tuberculosis), Treated with full coarse of anti tuberculosis drug, re-biopsy done no infection repeated.
3.In 2008 January HSG done as per advice of Dr. Sohani Varma - Apollo Hospital Delhi. Diagnosed as Left fallopian tube with hydrosalpynx and right side tube with cornual block.
4.In 2008 XXXXXXX IUI performed – UN success.
5.From 2010 to 2011 continuous treatment under Dr. Sohani Varma – Apollo Hospital Delhi.
6.In 2011 April as per the advised of Gynecologist – Dr. Sohani Varma, HYSTEROSCOPY + LAPAROSCOPY WITH CHROMOTUBATION & RIGHT SIDE OVARIAN DRILLING Done on 15 April 2011. By Dr. XXXXXXX Badhwar, Delhi.
OPERATIVE FINDINGS: Hysteroscopy – Cavity – Normal. Endometrium – Normal. Right cornu – Normal. Left cornu seemed covered by flimsy adhesions- broken with hydrostatic pressure.
Laparoscopy: Uterus – Normal. Bilateral Tubes apparently healthy. Bilateral Ovaries polycystic. POD Clear. Chromotubation done . Right Tube showed partial Hydrosalpinx with free glow of XXXXXXX When the XXXXXXX was pushed, there was a spontaneous perforation of the uterus in the posterior wall near the Fundus & another pinpoint hole seen next to that (? due to previous intervention). The perforation was sutured and hemostasis assured. Right sided ovarian drilling done.
From 2004 to 8 August 2011 treated with following medicine
•Bigomet SR -500mg (Metformin Hydrochloride Extended release tablet) 1 tab. X 2 time daily.
•Rabium 20mg ( Rabeprazole ) 1 tab. X 2 time daily.
•Thyronorm (50 to 100 mcg.) 1tab. daily (as per dose advised by Endocrinologist)
•Zaart – H 50mg ( Losartan potassium ) 1 tab. daily.(up to 7th August 2011)
•Vitamin C 500mg 1 tab. daily
•Folvite 5mg (Folic acid) 1 tab. daily (From January 2008 till continue )
•Aldactone and Pioglar also used up to 2010.

7.In 2011 8 August Pregnancy conformed in Zulekha Hospital Sharjah (Dr. Geetu Motwani)- US – Pelvis ( Trans Vaginal) - 6 weeks 3 days of gestation with cardiac activity heart rate is 123 bpm, Pathological test on 9th August 2011 Glucose (fasting) – 112.3 mg/dl, TSH - 6.96ulU/ml. Medicine prescribed as Duphastone 10mg 1 tab. x 2 times daily, Aldomet 250mg 1tab. X 2 times daily, Aspimed 75 mg 1tab. daily with all other previous medicine Bigomet,Thyronorm 100mcg, Vitamin C and Folvite.
8.On second visit to Dr.Geetu Motwani on 23th August 2011, US – Pelvis ( Trans Vaginal) impression was cardiac activity is absent and suggestive of intrauterine fetal demise, Correlate clinically. Advised DNC.
9.DNC done in Apollo Hospital Delhi under guidance of Dr. Sohani Varma on 30 August 2011.
10.In November 2011 Suffered with Typhoid Fever and Febrile UTI – Ecoli infection and treated in Zulekha hosp. Sharjah under Dr. XXXXXXX XXXXXXX XXXXXXX and Dr. Amer with antibiotics and other medicine.
11.LMP – 5th Feb. 2012, Pregnancy confirmed through Pregnancy kit and HCG test on 11th of March 2012 in Zulekha hosp. Sharjah (Dr. Betty John). TSH value on 11 March 2012 is 3.459uIU/mL ,TT3-77.90ng/dL,TT4-9.51 ug/dL.


Medication continue with following medicine as on 18th Feb. 2012
•     Bigomet SR -500mg (Metformin Hydrochloride Extended release tablet) 1 tab. X 2 time daily.
•     Thyronorm 125 mcg. 1tab. daily (as per dose advised by Endocrinologist)
•     Duphastone 10mg 1 tab. X 2 times daily (From 11th March 2012)
•     Aspimed 75 mg 1 tab. daily (from 11th March 2012)
•     Vitamin C 500mg 1 tab. daily
•     Folvite 5mg (Folic acid) 1 tab. daily
•     Calcium 800mg 1tab.daily.

Now concerned, dr. advised to do TVS on 26th march 2012.
NOW SHE IS feeling burning sensation in vagina some times for last two days-when feeling burning sensation in vagina also feelig heat in her body,feeling temperature change in body,,some time little pain in lower abdomen portion. so please advise,cause and medication.
Note;She is 2nd time pregnant after 12 years of marriage, 1st preganacy in XXXXXXX 2011 ,misscarriage happened




Posted Tue, 22 May 2012 in Infertility Problem
 
 
Answered by Dr. Chetna Jain 3 hours later
Hi,

Thanks for your query.

Congratulations on conception. Please do get Ultrasound as advised by treating Doctor on 26th March. The prescription provided is fine. The vaginal burning is most probably due to vaginal infection, which could have led to burning in urine and urine infection. Pease do urine routine microscopy and culture sensitivity.
You can use vaginal cream for immediate relief. They are available over the counter and should work well till you see your doctor. Drink plenty of water. For fever tablet paracemol 500 mg can be used upto three times daily. The chances of this pregnancy being successful is about 97%. Keep the faith.

Hope I have answered your query. Let me know if I can assist you further
Best Wishes

Dr Chetna
Above answer was peer-reviewed by
 
Follow-up: Has hyperthyroidism, PCOD, infertility. Trying to conceive. Now has burning sensation in vagina, pain in abdomen. What is wrong? 20 hours later
DR XXXXXXX
Is there in special treatment or medicine to control misscarriage which happened with me in last year august 2011.
pl's advise in detail

rgds
mrs,nigar bano
 
 
Answered by Dr. Chetna Jain 21 hours later
Dear Nigar,
Thanks for writing back.
There are no specific medications to prevent miscarriage but a lot of them are in use for this reason.
You are already taking bigomet, duphaston and aspirin. A couple of others are Injection Hydroxy progesterone caproate, capsule natural micronised progesterone, dexona tablets etc.
Not all miscarriages can be prevented.
Just believe and keep a positive attitude as this has been shown to improve outcome.
I hope I have addressed your concerns.
Regards
Above answer was peer-reviewed by
 
Follow-up: Has hyperthyroidism, PCOD, infertility. Trying to conceive. Now has burning sensation in vagina, pain in abdomen. What is wrong? 6 days later
Dear DR XXXXXXX XXXXXXX
Good noon mam,
My TVS performed on 26th march 2012(Report in pdf format aattached) and as per dr advise some pathological test done regdg. sugar,lipid profile,Rubela etc.(report attached.
Concerning dr. started one injection (PRIMOLUT Depot 250mg,1ampoule weekly for 4 weeks from 27th march 2012and Endocrinologyst also increased the dose of THYRONORM from 125 to 150 mcg/day.
Detail of current Medication as below.......
Bigomet SR -500mg (Metformin Hydrochloride Extended release tablet) 1 tab. X 2 time daily.
• Thyronorm 150 mcg. 1tab. daily (as per dose advised by Endocrinologist from 25th march 2012)
• Duphastone 10mg 1 tab. X 2 times daily (From 11th March 2012)
• Aspimed 75 mg 1 tab. daily (from 11th March 2012)
• Vitamin C 500mg 1 tab. daily
• Folvite 5mg (Folic acid) 1 tab. daily
• Calcium 800mg 1tab.daily.
>>>>>PRIMOLUT Depot250 mg once in a week started from 27th march 2012 for 4 weeks.
NOW u r requested that please advise me regdg above .
thanking u
With best regds.
mrs. nigar bano
 
 
Answered by Dr. Chetna Jain 22 hours later
Dear Nigar
Thanks for writing back.
As of now, your thyroid function, blood sugar and rubella are ok. I would suggest that you get the rubella vaccination after delivery. Your ultrasound is also fine.
I would suggest you continue with the same treatment.
However, to measure thyroid function, it is better to do a free T3 (free thyronine), T4 (free thyroxine level) and a TSH ( thyroid stimulating hormone level) done.
Additionally, a repeat ultrasound should be done to detect the fetal heart. At 12 weeks, an early anomaly scan or a level 1 scan is required.
I hope I have addressed your concerns. I will be available for follow ups. Please close this discussion if you have no more queries.
Regards
Above answer was peer-reviewed by
 
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