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How to confirm pregnancy during irregular menstruation?

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Dr. Sameer Kumar

OBGYN

Practicing since :2002

Answered : 1657 Questions

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Posted on Tue, 15 Sep 2015 in Pregnancy
Question: Am I pregnant? If yes how many weeks have passed?
Can a PCOD patient get pregnant without having MC?
Whether I had miscarriage? if yes then why it was not detected in sonography reports ?.
doctor
Answered by Dr. Sameer Kumar 1 hour later
Brief Answer:
get a serum beta hcg test and an ultrasound pelvis ....

Detailed Answer:
Hello,
Thanks for the query to hcm,
As i can see that that I can test strip does show a positive result indicating that you may be pregnant, but considering your history of no intercourse since last 2 months this may be a false positive result. It is suggested that you should get a blood serum beta hcg test now to check for raised hcg levels which shall indicate confirmation of pregnancy or rule it out if the levels are less than 1ng/dl. Also get a transvaginal ultrasound to look for any intrauterine pregnancy in form of a gestational sac and it would also give an estimated size and weeks of pregnancy.
Considering that you had irregular menses and have not been on any contraception till date though you had been down with typhoid as well, the outcome is yet confusing with a positive result but the possibility does exist that there may be products of conception left inside uterus and you may have had an incomplete abortion. In any case a transvaginal ultrasound is a must and it shall give a clearer picture. Please meet your gynaecologist for the same and follow up with the reports.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sameer Kumar 20 hours later
Hello Dr. XXXXXXX

Thank you so much for your detailed reply.

Request your answer to below points please:
1. I did test again through a different instrument today and it turned to be positive. Now based on your reply I am worried about incomplete abortion? whether it has any serious concerns about my health and can it still show result event after 3months of miscarriage? I remember on 13th May night when I was hospitalised and during physical examination Dr.'s showed doubt of pregnancy they asked me to do pregnancy test which turned negative. and very next day I had that huge mass coming out (as shared in image). so still that possibility exist ???

2. As informed, whilst I was getting treated for Typhoid Drs. did several test along with sonography of whole abdomen wherein
Uterus report says : "Anteverted, normal sized, demonstrating normal endometrial echo complex and even echo textured myometrium"
while of Ovaries: Normally visualized, no retroperitoneum does not show any abnormally enlarged lymph nodes, no free peritoneal fluid or pleural effusion seen, bowel loops are unremarkable and both iliac fossae are normal".

So at this point of time Dr. informed me that everything is normal and nothing to be worried about, they just prescribed IRON tablets for month. Please help me with your views on this ?

3. I would like to know whether anyone can conceive without having MC cycle?

4. Lastly, I had MC on 10th May (miscarriage period) continue bleeding till 20th May) further we had intercourse on 23rd /24th /25th May and then regularly from 6th XXXXXXX till 23rd XXXXXXX from 24th XXXXXXX to 5th August there was no intercourse so can it be possible that I am pregnant for more than 2-3months???

Thank you for time and answers in advance , your views will really help me

Awaiting your reply
doctor
Answered by Dr. Sameer Kumar 13 minutes later
Brief Answer:
answered

Detailed Answer:
Hello,
I understand your concern here.
the fact that the repeat urine pregnancy test has come out to be positive indicates that there is hcg production still on in the body and most likely cause can be an ongoing pregnancy or a molar pregnancy or a gestational trophoblastic tumour which has been producing hcg.
Hence i suggested that you should get a serum beta hcg test done to check for levels. If the levels are more than 100000( 1 lakh) then it is likely molar or gestational tumour if not pregnancy.
If its pregnancy then a serial serum beta hcg test should be done on alternate days and if there is a rise in hcg levels by more than 65% then that indicates that there is a viable ongoing pregnancy.
A transvaginal ulltrasound is far more better than an abdominal ultrasound in detecting uterine contents/ pathologies/ pregnancy.
The chances that you had an ongoing pregnancy when you shed the clot is high simply because you never went for a follow up ultrasound.
My simple suggestion at present is to go to your gynecologist and get the serum beta hcg test and ultrasound done sooner rather than contemplating chances.
Investigation is a must in your case and we never know you may come out with with a surprising result.
I feel it can be an ongoing pregnancy / molar pregnancy/ even may be an ectopic if uterus is empty.
You should discuss these options with your gyne when you meet him/her and take an informed decision.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sameer Kumar 30 hours later
Hello Dr.

Thank you for all your valuable and detailed answers, highly appreciate it.

Today I went to my regular gyne in South XXXXXXX and she referred me to do normal sonography but Sonography Dr. could'nt not find anything so he did transvaginal (same as suggested by you) but he was again shocked he could'nt come to a conclusion of any specific observation. He too enquired about history and gave doubt of "too early pregnancy, so asked to come back after 2 weeks for Ultrasound". He clearly denied any chances of ectopic pregnancy and rest findings is attached in the report for your kind reference.

I asked several queries to my gynae but then she did not gave me any concrete answer and asked me to wait for 2 weeks, she said that since we had intercourse after 5th August there is possibility of too early pregnancy ( but then she was also doubtful that how PD kit showed +ve result?).

I would be very thankful if you can help me with all possible outcomes of this so that during my next check up I will be fully prepared. Once again thank you so much for all your help.

Regards
XXXX
doctor
Answered by Dr. Sameer Kumar 12 minutes later
Brief Answer:
answered

Detailed Answer:
Hello,
I am surprised to see that there were no contents which were found in the uterus and neither any ectopic evidence of pregnancy is seen. In this scenario, there is just one option left and that is blood serum beta hcg test which is 99 % sensitive and specific for hcg hormone.
if thats negative then there is no pregnancy and the PD kit is wrong and showing false positive result. But if hcg test is positive then the source of hcg has to be searched for , if it is not uterus and pregnancy then another source could be a hcg producing tumour or a gestational trophoblastic tumour which would have to be looked for with an MRI WHOLE BODY and if required a PET SCAN as well.
You can discuss these options with your gyn after 2 weeks if the USG still doesn't show any gestational sac.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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