Brief Answer:
Pregnancy scan must be repeated after 2 weeks to confirm if it is favorable

Detailed Answer:
Hi XXXX,
Thanks for writing in to us.

I have read through your query in detail.
As I do ultrasound scans regularly, I would like to explain your ultrasound report findings to you in simple language.

I guess you have got ultrasound scan done through the lower abdomen.
1. The uterus is bulky with a well defined gestational sac

It means that the uterus shows the earliest signs of a pregnancy as can be noted from the presence of a well defined intrauterine gestational (pregnancy) sac.


2. No obvious fetal pole or activity is seen within the sac yet.

This means there is no visible sign of the fetus or any fetal heart activity yet. In early pregnancy it can still take time for fetal parts to show up.


3. The pregnancy gestational sac diameter (gsd) measures 10.6 mm and estimated gestational age (ega) corresponds to a pregnancy age of 5 weeks 1 day.

This is giving the age of the pregnancy as 5 weeks 1 day.


4. Conclusion reads early single intrauterine cyesis.

Cyesis means pregnancy and this line says the presence of a single pregnancy sac in the uterus.


5. Repeat pelvic USG in 2 weeks to ascertain VIABILITY.

This suggests that the ultrasound scan should be repeated again after two weeks to know if the pregnancy is VIABLE or favorable. The pregnancy age will be 7 weeks 1 day and by that time the fetus should be visible with the presence of heart beat. VIABILITY is a term used to say that the pregnancy is favorable and will progress in a normal way.



You must wait for two weeks and get the ultrasound scan repeated to know if your pregnancy is favorable and growing as expected in a normal way. This is because still the fetal part is not visible and also heart beat of the baby is not appreciated. At 5 weeks and 1 day it might be too early to see the fetus and heart rate. However at 7 weeks and 1 day (after two weeks) the fetal pole will be clearly visible and this will tell that your pregnancy is normal.

Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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Brief Answer:
Please find details below

Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.

I have read through the updated information provided by you. Please find my observations below.

1. It looks like you had a failure of medical termination of pregnancy resulting in an incomplete abortion. However patients are told to wait for at least 1 week but you got scan done earlier. Right now you have a persistent gestational sac with no cardiac activity as written in report findings.

2. Every country has its own legal methods of medical termination of pregnancy. Please check this with your local doctor and confirm the rules for treating an incomplete abortion. Please make sure you follow the laws in your country.

3. Guidelines vary for women who have a persistent gestational sac on ultrasonography without evidence of embryonic cardiac activity or continuing development.

(i) Patients with a persistent gestational sac 1 week after treatment can safely receive another dose of medical termination pills or continue with expectant management (wait for uterus to empty by itself).

(ii) Studies indicate that even with a retained sac 2 weeks after medical termination pills, intervention is unnecessary and that expulsion will typically occur in the ensuing weeks.

(iii) Women who prefer not to wait longer may choose to have a surgical evacuation at any time.

In conclusion, (iii) going for D and C is your personal choice and you can go for it at anytime after discussing with your doctor.

If you want to avoid D and C then (i) repeating medical termination pills is advised.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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Brief Answer:
D and E is a safe and recommended procedure, wishing you a quick recovery

Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.

If your gynecologist has examined you and recommended a D and E then please go ahead with it as you are in discomfort. It is a good decision by your gynecologist and will reduce your pain and discomfort instantly. It is a short procedure and you can go home few hours after the procedure. Please do not worry.

Wishing you a quick recovery.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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Brief Answer:
Welcome and wishing you good health

Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.

Good to know that the D and E is over and you are alright.

Please watch for any pain, bleeding or fever over next few days and if it happens then consult your doctor.

Take any medications given to you by the gynecologist.

Take rest for 3 days and then you can continue with normal work.

Avoid heavy physical activities for a few days.

Wishing you a quick recovery.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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Brief Answer:
Please find details below

Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.

Please do the following

1. You can take something cold or iced.

2. Some cramping or mild abdominal discomfort is considered usual for a day or two.

3. You should take any pain medication after food as ordered by your doctor.

4. A short course of antibiotics is also given and you should take it.

5. Please avoid having sexual intercourse for a week.

6. Do not insert anything into your vagina, including tampons or douches, for at least one week or preferably two. Maintain genital hygiene.

7. If you experience any signs of infection (such as fever, pain or discharge) see your doctor immediately.

8. Do not lift heavy weights for a month.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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Brief Answer:
Mild cramps are expected for 5 days after the procedure

Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.

Painful cramps are expected in most women after D and E and is due to the uterus getting back to normal size. This might happen till 5 days after the procedure. Please take antispasmodic medications as given by your doctor. You can also use a heating pad to make you comfortable.

Mild bleeding might also happen for about a week. If you do not have bleeding then that is also normal.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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Brief Answer:
Take medications and precautions

Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.

Please take your medications on time. Use a heat pad if that makes you comfortable. Avoid lifting heavy weights. Eat healthy meals and drink lots of fluids and juices.

The fleshy products should stop soon and with it the pain will also disappear.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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Brief Answer:
Please follow instructions below and if painful then consult doctor

Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.

Please apply ice over the area on the hand and do not scratch the skin. It is not a concern and should heal in few days.

If it is paining in the area then it might be inflammation of the vein in which drip was given and known as superficial thrombophlebitis. Please consult your doctor. If confirmed, you doctor will most likely give you a prescription for HEPARIN OINTMENT. This comes in a tube and is to be applied over skin. Please check with your doctor.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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Brief Answer:
You can use the same ointment after confirming with your doctor

Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.

Please do not worry then. Ask your doctor and use the same ointment.
It will get better in a week.

Wishing you a quick recovery.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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