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What are the findings from the pregnancy report? Advise?

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Practicing since : 1989
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hi Doctor, i have doubts about my wife pregnancy doctor report, the doctor mentioned in the ultrsound scan report :
saying : uterus shows single intrauterine gestational sac which is irregular in shape and small in size, cannot be measured. no cardiac activity noted, tiny fetal pole
CRL Measures 7mm(6weeks +5days) and GA by LMP : 7Weeks+5days.
please advice doctor. please
Posted Fri, 6 Sep 2013 in Pregnancy
 
 
Answered by Dr. Shanti Vennam 28 minutes later
Brief Answer:
It could be a case of missed abortion.

Detailed Answer:
Hello,

Thanks for writing to us.

If your wife had regular 28-30 day cycles prior to this pregnancy and is sure of her dates, then the sonogram picture is suggestive of an unhealthy pregnancy, a missed abortion. An irregular gestational sac points to an unhealthy sac; added to that fetal heart is not visible which should have been seen by now and the findings show a lag of gestational age by dates.

With this current picture, if there are no other symptoms like pain or bleeding, watchful expectancy can be maintained until another high resolution sonogram is taken usually after another week; simultaneous measurement of serum beta-hCG levels on alternate days can be useful to assess the prognosis as doubling titres indicate good progress of pregnancy. If there is an abortion, the titres show a decline.

Absolute bed rest, avoidance of all forms of stress including sexual intercourse and healthy diet should be followed. Please have a follow up with your consultant to discuss further management.

Hope I have answered your query. Please feel free to contact if you need further clarifications. I will be happy to help.

regards,
Shanti.V.
Above answer was peer-reviewed by
 
Follow-up: What are the findings from the pregnancy report? Advise? 13 minutes later
thanks doctor, as you mentioned she is not having any symptoms like pain or bleeding and i want to be an more clear. you are suggesting me to wait one more week to take one more ultra scan to confirm,
whether any chances of growth ?
or this stage abortion is good for my wife health ?


what is this mean doctor : simultaneous measurement of serum beta-hCG levels on alternate days can be useful to assess the prognosis as doubling titres indicate good progress of pregnancy. If there is an abortion, the titres show a decline

further doctor reports added : i missed to mention earlier query

Right ovary and adnexa normal, left ovary contains 19mm corpus luteal cyst.
impression : embryonic demise

LMP : 23-06-2013, EDD 30-3-2013, GA by LMP 7weeks+5days.

plesae advice me doctor. please
 
 
Answered by Dr. Shanti Vennam 1 hour later
Brief Answer:
early evacuation is good for missed abortion

Detailed Answer:
Hello,

Thanks for writing back.

If the ultrasound findings and your doctor's clinical opinion suggest a missed abortion, it is indeed good to proceed for abortion without waiting any further. If the diagnosis is doubtful, you may wait as suggested for one more week to see if the pregnancy is progressing as sometimes there is a failure to detect the fetal heart in very early stages. Measurement of serum beta-hCG titres helps in doubtful cases; it is the pregnancy specific hormone and its declining levels suggest a missed pregnancy while doubling titres on alternate days indicate a viable pregnancy.

As the sonographer has opined that it is a missed pregnancy, you should discuss with your consultant on further management; a clinical opinion is necessary to plan further treatment. Meanwhile, you can get the blood counts, bleeding time and clotting time as a precaution. A missed abortion may lead to abnormal bleeding and clotting times and this has to be monitored.

Hope I have answered your query. Please get back if you have any more queries. I will be ready to help.

regards,
Shanti.V.
Above answer was peer-reviewed by
 
Follow-up: What are the findings from the pregnancy report? Advise? 7 hours later
hi doctor, as per you reply i asked my wife to give the blood test for alternative days to measure the serum beta hCG level for growth of the pregnancy.

currently she is taking following tablets daily.
Melmet sr 500MG : 1-0-1
duphaston 10mg : 1-0-1
Ecosprin 75 : 0-1-0
solic acid 5mg : 1-0-1

is that all the tablets are good to continue during the pregnancy time. as per my web search melmet sr 500mg is not good for pregnancy woman.

please advice me doctor. please
 
 
Answered by Dr. Shanti Vennam 1 hour later
Brief Answer:
Metformin is a category B drug used when needed.

Detailed Answer:
Hello,

Thanks for writing again.

Melmet contains Metformin, used to treat insulin resistance and thereby induce ovulation in polycystic ovary disease. It is a category B drug and this means that the drug may be given during pregnancy if absolutely necessary as studies do not show any untoward effects. Rest of the drugs are safe to use.

If your wife had been treated for PCOD prior to conceiving she would need Metformin throughout pregnancy; Duphaston is given as a precaution in such cases when progesterone deficiency is suspected. Folic acid is given to prevent neural tube defects while aspirin is given to prevent pregnancy induced hypertension (PIH).

Hope all your queries have been answered. Please feel free to contact if you have any more queries.

Wish you good health.

regards,
Shanti.V.
Above answer was peer-reviewed by
 
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