Brief Answer: DETAILS ARE GIVEN BELOW. Detailed Answer: Hello, Thanks for writing to us on healthcare magic. Followings are my comments: 1) Abdominal ultrasound scan can detect fetal pole and heart beat around 7 to 8 weeks. However, Trans Vaginal Ultrasound (TVS) reveals Fetal Heart Beat around 5 to 6 weeks of gestational age. Here, I suggest her to repeat the ultrasound scan (TVS) after 7 to 10 days for confirmation. Sometimes, late conception may be the cause of late detection of fetal heart beat. If it is not detected on next ultrasound scan, then possibility of pregnancy loss or MISCARRIAGE is quite high with above clinical picture. 2) Mild spotting is quite common during early weeks of pregnancy. DUPHASTON contains Dydrogesterone as active ingredient (progesterone supplement) which supports her pregnancy and prevents natural miscarriage or pregnancy loss. It is not harmful to growing fetus also. Therefore, she can take this as per her doctor's recommendation. In addition, she must avoid heavy work, long journey, lifting heavy objects and take complete bed rest. Take healthy protein rich diet with vitamin & Folic acid. Hope, I have answered your query. Kindly, close the discussion if you don't have any other query. Wish her good health and take care yourself. Regards, Dr Soumen For future query, you can directly approach me through WWW.WWWW.WW

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Brief Answer: DETAILS ARE GIVEN BELOW. Detailed Answer: Hello, Thanks for follow up query with detailed scan report. Recent Ultrasound report is quite good with POSITIVE fetal cardiac activity. However, I want to comment on two things - intramural fibroid and subchorionic bleeding and its relation to current pregnancy. 1) Intramural (within uterine muscle) is the most common type uterine fibroid. But, chance of miscarriage or pregnancy loss is quite LOW. Periodic follow up with ultrasound scan is mandatory. 2) Subchorionic bleeding or hematoma (SCH) is seen in some percentage of early pregnancies. It is located between chorion & endometrium (on gestational sac). It can cause vaginal bleeding or brown discharge occasionally. However, most patients remain asymptomatic with small or mild hematoma and few are present with threatened miscarriage. Most of them regress naturally. Current statistics shows that chance of pregnancy loss or miscarriage is near about 1-3% with SCH after 12 weeks & mostly associated with large hematoma. Most of them resolve within 20 weeks of gestational age without any further complication. But few percentage has greater risk of development of placental abruption in later months. In such case, urgent medical attention is required. There is NO useful treatment for SCH pregnancies. Wait and watch with serial ultrasound scan and avoiding strenuous activity are the key element in such case. Here, she would need to take all prescribed medication by her doctor. It helps to support pregnancy and prevents possible miscarriage. Kindly, proceed follow-up visit to your OBGYN in periodic manner and do next scan after 4 weeks for assessment of pregnancy status. 3) In addition, she must follow these advice strictly: a) Avoid heavy work/ long journey/ lifting heavy objects/ too much bending/ high heal shoe/ walking on uneven surface/ more ups & downs etc. b) Take complete bed rest till the problem is resolved. Non-prescribed medication should be avoided. c) Take healthy protein rich diet and drink more water for better feto-placental circulation. Maintain genital hygiene properly. Hope, it helps for your information. Kindly, close the discussion. All the best and good luck. Regards, Dr Soumen

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