Is it possible to get pregnant following family planning operation or ligation?
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Hello docter My Name is XXXX, age 36 years. I have 2 children aged 13 years & 6 years. I have done Family Planning Operation in the year 2008. My LMP was 20-11-2013. After that i had no mensus period. Went to doctor and she gave harmone tablet. Tablets are Gynaset, Vitagal for 3 days and asked to wait for 5 days for gettimg Mensus. After 5 days also i did not have mensus cycle. Since I had stomach pain, I visited docter again, she said that there may be a chance for Pregant in the tube and adviced to me to take Urine Pregnance Strip Test. It showed positive. Further she asked me to take scan & Beta HCG Test. Beta HCG test showed a count of 13948.6 mIU/ml and CT scan of Abodoment report shows "Thickened Endometrium - Entometrial Hyperplasia & No Evidence of Gestational Sac / Free fluid noted in the Endometrial Cavity/Adnexa" Can you please suggest whether it is possible to get pregant after family Planning Operation also. Can you give what treatment can be given for this problem. Whether it can be cured with tablets or to undergo surgery.
Posted Sun, 2 Feb 2014 in Women's Health
Answered by Dr. S Patra 2 hours later
Brief Answer: ECTOPIC PREGNANCY. CONSULT WITH GYNECOLOGIST. Detailed Answer: Hello, Thanks for writing to us. YES, it is possible to get pregnant following family planning operation or ligation. But, chance is extremely low (0.04%). In this case, abnormal rise of Beta-hCG test (13948.6 mIU/ ml) following missed period with lower abdominal pain and empty gestational sac on CT scan is mostly suggestive of ECTOPIC PREGNANCY (commonly tubal type). It is a life threatening emergency condition and occurs in range of 4 to 8 weeks. Here, you need to consult with your GYNECOLOGIST at the earliest to avoid risk of internal bleeding (due to rupture ectopic pregnancy) and other complication to save your life. You should undergo one TRANS VAGINAL ULTRASOUND SCAN and repeat the blood beta-hCG test for monitoring. TREATMENT: METHOTREXATE is the drug of choice for early ectopic pregnancy with some criteria like 1) beta-hCG value less than 5000 mIU/ ml, 2) No fetal cardiac activity, 3) Ectopic mass less than 3.5 cm and 4) Hemodynamic stable. It terminates the growth of the developing embryo and may cause an abortion, or the developing embryo may be either absorbed by the woman's body or pass with a menstrual period. Follow up examination and tests are required. Surgical treatment like Salpingectomy (removal of the affected tube with the pregnancy) through laparotomy or laparoscope procedure may be required in this case. Kindly, consult with your GYNECOLOGIST for proper management. Hope, it will be helpful for your information. 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
Follow-up: Is it possible to get pregnant following family planning operation or ligation? 24 hours later
Dear Doctor, I consulted the Gynaecologist, she went through the CT Scan & Blood test report. In CT Scan since there is no indication of Gestational Sac anywhere in the Uterus, tube, etc and only Beta HCG count is more, she said that she cannot take any decision now. When i asked whether it will be serious if it burst, she replied that since there is no indication any sac it is not possible to burst. She also said indicated that since the Endometrium is thickened, there may be a chance of pregnant formation in the uterus. She has asked to take Beta HCG test again, if there is any increase in the count and indication of development of baby in the uterus then decision can be taken. Also she said that if there is severe pain, can get admitted in the hospital. Request your advice on the same.
Answered by Dr. S Patra 57 minutes later
Brief Answer: DO TVS SCAN AND REPEAT SERUM BETA-HCG. Detailed Answer: Hello, Thanks for follow up query. Positive pregnancy test with abnormally high rise of serum beta-hCG level is more suggestive of ECTOPIC PREGNANCY. Thickened endometrium with empty gestational sac on CT scan after missed period is another observation. Here, I suggest to undergo one TRANS VAGINAL ULTRASOUND scan (TVS) and repeat the blood test for beta-hCG to confirm the diagnosis. Proper treatment can be done on early detection of the case. TVS scan is more relevant in this case in comparison to CT scan. Hospital admission may be required in urgent case with moderate to severe abdominal pain and vaginal bleeding. Please, consult with your doctor following above investigations. Hope, I have guided you properly. Kindly, close the discussion. Good luck and all the best. Regards, Dr Soumen