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Hi, My Sis In Law Is Pregnant For The First

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Posted on Thu, 16 Jul 2020
Question: Hi,
My sis in law is pregnant for the first time,got married in march 2020,her age is 35 years,her last lmp was april 28,2020.she has developed some complications in pregnancy .she had continuous spotting and sometimes light bleeding.today she had vaginal ultrasound and after ultrasound bleeding started.doc said dead baby is inside the left felopine tube,it can burst anytime and there is a threat to mothers life on immediate basis she has to go for surgery and her one felopine tube will be removed.as we know there is very less chances for conceiving on one felopine tube.she was on inj. Hcg and inj.maintain.as far as I know first ultrasound is vaginal ultrasound but doctor advised her abdominal ultrasound ,she developed pain and spotting from that point of time.
We took second opinion and other doc said there is one more way that tomorrow morning hcg test should be taken and if hcg levels are low and she will be given some injection and her felopine tube can be saved and the remainings will be flushed out.

We don’t want to go for operation,if we can save the felopine tube there will be bright chances for conceiving again.

Please find attached reports and advise .
thanks
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Follow up: Dr. Soumya (0 minute later)
Hi,
My sis in law is pregnant for the first time,got married in march 2020,her age is 35 years,her last lmp was april 28,2020.she has developed some complications in pregnancy .she had continuous spotting and sometimes light bleeding.today she had vaginal ultrasound and after ultrasound bleeding started.doc said dead baby is inside the left felopine tube,it can burst anytime and there is a threat to mothers life on immediate basis she has to go for surgery and her one felopine tube will be removed.as we know there is very less chances for conceiving on one felopine tube.she was on inj. Hcg and inj.maintain.as far as I know first ultrasound is vaginal ultrasound but doctor advised her abdominal ultrasound ,she developed pain and spotting from that point of time.
We took second opinion and other doc said there is one more way that tomorrow morning hcg test should be taken and if hcg levels are low and she will be given some injection and her felopine tube can be saved and the remainings will be flushed out.

We don’t want to go for operation,if we can save the felopine tube there will be bright chances for conceiving again.

Please find attached reports and advise .
thanks
doctor
Answered by Dr. Soumya (9 hours later)
Brief Answer:
Medical management of ectopic pregnancy is an option only if feasible

Detailed Answer:
Hi,

I understand your concerns.

Following is my reply:

1) Condition you are describing is called ECTOPIC PREGNANCY.

2) Baby is growing inside the fallopian tube rather than inside womb.

3) This is non viable condition where baby cannot be saved as it is not in the womb.

4) Waiting for long time with baby in fallopian tube is dangerous to health of mother. If this baby grows, it bursts the fallopian tube leading lot of bleeding inside the abdomen and leads to life threatening situation for mother.

5) I understand you dont wish to undergo surgery at this moment. Medical management of ectopic pregnancy with Inj. Methotrexate is possible in early stage of ectopic pregnancy. There are few conditions which will be decided by your doctor if pregnancy can be treated medically without surgery.

6) Please attach ultrasound scan report and beta hCG blood test report to assess further and advice if medical management is feasible.

7) Even if surgery has to be done, fallopian tubes can be attempted to be spared by salpingostomy surgery instead of removing tube, but this decision will be done by surgeon as this is not always possible.

Let me know if you need anymore help.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Soumya (0 minute later)
Brief Answer:
Medical management of ectopic pregnancy is an option only if feasible

Detailed Answer:
Hi,

I understand your concerns.

Following is my reply:

1) Condition you are describing is called ECTOPIC PREGNANCY.

2) Baby is growing inside the fallopian tube rather than inside womb.

3) This is non viable condition where baby cannot be saved as it is not in the womb.

4) Waiting for long time with baby in fallopian tube is dangerous to health of mother. If this baby grows, it bursts the fallopian tube leading lot of bleeding inside the abdomen and leads to life threatening situation for mother.

5) I understand you dont wish to undergo surgery at this moment. Medical management of ectopic pregnancy with Inj. Methotrexate is possible in early stage of ectopic pregnancy. There are few conditions which will be decided by your doctor if pregnancy can be treated medically without surgery.

6) Please attach ultrasound scan report and beta hCG blood test report to assess further and advice if medical management is feasible.

7) Even if surgery has to be done, fallopian tubes can be attempted to be spared by salpingostomy surgery instead of removing tube, but this decision will be done by surgeon as this is not always possible.

Let me know if you need anymore help.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Soumya (11 hours later)
Brief Answer:
Dont wait

Detailed Answer:
Hi,

I saw the attached ultrasound report which shows ectopic pregnancy.
Beta hCG level is low at 171 and medical management can be attempted which should be finally decided by your gynecologist.

It is not wise to wait. It is difficult to predict when ectopic pregnancy can burst in tubes. Self flushing out is rare, and dont wait for it.

Inj. Methotrexate regimen has to be prescribed by gynecologist after examination.

Repeat beta hCG blood test everyday to know the progress.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Soumya (0 minute later)
Brief Answer:
Dont wait

Detailed Answer:
Hi,

I saw the attached ultrasound report which shows ectopic pregnancy.
Beta hCG level is low at 171 and medical management can be attempted which should be finally decided by your gynecologist.

It is not wise to wait. It is difficult to predict when ectopic pregnancy can burst in tubes. Self flushing out is rare, and dont wait for it.

Inj. Methotrexate regimen has to be prescribed by gynecologist after examination.

Repeat beta hCG blood test everyday to know the progress.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Soumya (3 minutes later)

Thanks you very much for reply!
LMP-28 APRIL 2020, EDD-FEB.4,2021.age-35years,weight-70 kgs
I fully understand Waiting for long time with baby in fallopian tube is dangerous to health of mother. If this baby grows, it bursts the fallopian tube leading lot of bleeding inside the abdomen and leads to life threatening situation for mother.
Please answer My further queries:

1)is bhcg level is low?
2)if bhcg level is low can we wait for the remainings to be flushed out on its own?if yes till what time we can wait so that tube does not get burst?
3) Medical management of ectopic pregnancy with Inj. Methotrexate is possible in early stage of ectopic pregnancy. can we start Inj. Methotrexate,if yes what is the frequency and till what time we can continue that?
4) Please find attached ultrasound scan report(previous and new)and beta hCG blood test report (previous and new) to assess further and advice if medical management is feasible?
default
Follow up: Dr. Soumya (0 minute later)

Thanks you very much for reply!
LMP-28 APRIL 2020, EDD-FEB.4,2021.age-35years,weight-70 kgs
I fully understand Waiting for long time with baby in fallopian tube is dangerous to health of mother. If this baby grows, it bursts the fallopian tube leading lot of bleeding inside the abdomen and leads to life threatening situation for mother.
Please answer My further queries:

1)is bhcg level is low?
2)if bhcg level is low can we wait for the remainings to be flushed out on its own?if yes till what time we can wait so that tube does not get burst?
3) Medical management of ectopic pregnancy with Inj. Methotrexate is possible in early stage of ectopic pregnancy. can we start Inj. Methotrexate,if yes what is the frequency and till what time we can continue that?
4) Please find attached ultrasound scan report(previous and new)and beta hCG blood test report (previous and new) to assess further and advice if medical management is feasible?
default
Follow up: Dr. Soumya (36 minutes later)
Hi, I have provided some attachments. Please review them.
default
Follow up: Dr. Soumya (0 minute later)
Hi, I have provided some attachments. Please review them.
default
Follow up: Dr. Soumya (0 minute later)
Hi, I have provided some attachments. Please review them.
default
Follow up: Dr. Soumya (0 minute later)
Hi, I have provided some attachments. Please review them.
doctor
Answered by Dr. Soumya (1 hour later)
Brief Answer:
Medical management of ectopic pregnancy is an option only by gynecologist

Detailed Answer:
Hi,

I have seen the attachments.

1) Beta hCG levels are low.

2) There is no definite limit to say when it will burst. You should never wait when ectopic pregnancy is diagnosed as it is life threatening. Flushing out does not happen always.

3) Inj. Methtrexate can be tried. Frequency, dose and other details will be explained in person by gynecologist as self medication is not advisable in situation like this.

4) Medical management can be tried. But only after examination and prescription by a qualified gynecologist.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Soumya (0 minute later)
Brief Answer:
Medical management of ectopic pregnancy is an option only by gynecologist

Detailed Answer:
Hi,

I have seen the attachments.

1) Beta hCG levels are low.

2) There is no definite limit to say when it will burst. You should never wait when ectopic pregnancy is diagnosed as it is life threatening. Flushing out does not happen always.

3) Inj. Methtrexate can be tried. Frequency, dose and other details will be explained in person by gynecologist as self medication is not advisable in situation like this.

4) Medical management can be tried. But only after examination and prescription by a qualified gynecologist.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Soumya

OBGYN

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Hi, My Sis In Law Is Pregnant For The First

Hi, My sis in law is pregnant for the first time,got married in march 2020,her age is 35 years,her last lmp was april 28,2020.she has developed some complications in pregnancy .she had continuous spotting and sometimes light bleeding.today she had vaginal ultrasound and after ultrasound bleeding started.doc said dead baby is inside the left felopine tube,it can burst anytime and there is a threat to mothers life on immediate basis she has to go for surgery and her one felopine tube will be removed.as we know there is very less chances for conceiving on one felopine tube.she was on inj. Hcg and inj.maintain.as far as I know first ultrasound is vaginal ultrasound but doctor advised her abdominal ultrasound ,she developed pain and spotting from that point of time. We took second opinion and other doc said there is one more way that tomorrow morning hcg test should be taken and if hcg levels are low and she will be given some injection and her felopine tube can be saved and the remainings will be flushed out. We don’t want to go for operation,if we can save the felopine tube there will be bright chances for conceiving again. Please find attached reports and advise . thanks