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Pregnant. Having bleeding. Sonography showed no heart beat. Prescribed tranexamic acid and progesterone. What can be done?

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6w pregnant. have one 26 month child. Prev pregnancy was fine. Tho C Section. This time have started bleeding/spotting. Did sonography today. Intra-uterine preg. Sac seen. No heartbeat yet tho. Was asked to repeat sonography after 2 days. Am prescribed tranexamic acid and progesterone. Pls advise is it safe? History: first preg was medically terminated due to fetal anomaly. Second was fine... Thru c section. Some bleeding after c section due to particles left inside. Had to undergo d&c to clear that. Now pregnant after 26 months.

Am worried about fetal anomaly due to side effects of medicines. First pregnancy (that was terminated) was very painful physically and emotionally. Do not want to repeat that. So, want to know should i take the medicines or not. And should i worry about the bleeding?
Posted Sun, 14 Jul 2013 in Pregnancy
Answered by Dr. Shanti Vennam 36 minutes later

Thanks for writing to us.

Studies have not revealed any untoward effect on the fetus when Tranexamic acid was used in pregnancy, yet, the drug should be used only when deemed necessary by the attending doctor. As you seem to be experiencing a threatened abortion, your doctor may have felt the necessity to add the drugs.

Hormone replacement is suggested whenever the cause of the bleeding is suspected to be hormonal deficiency. Certain other precautions should also be taken like abstinence, avoidance of stress of any sort and taking absolute bed rest.

At this stage of pregnancy, the fetal pole is usually seen along with a fetal heart. Sometimes, due to poor visualization, fetal heart may take a few more days to appear in the sonogram. This may be clubbed with serial serum beta-hCG titres for better assessment. A healthy pregnancy shows doubling up of titres every 48 hours.

The history of the check curettage may not be of significance now if the uterine lining had healed well. The placental position later on should be carefully followed.

So, for the time being, I feel that your doctor has the better discretion on using the medication prescribed and there is no documented evidence of any harmful effects on the fetus.

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

Above answer was peer-reviewed by
Follow-up: Pregnant. Having bleeding. Sonography showed no heart beat. Prescribed tranexamic acid and progesterone. What can be done? 2 days later
Thank you so much for your advice, Doctor. Also, instead of plain folic acid(folvite), i was advised folic acid with DHA. Can you please guide me regarding the same? I took only folic acid(folvite) in my previous pregnancy.
Answered by Dr. Shanti Vennam 2 hours later

Thanks for writing back.

DHA or Docosahexaenoic acid is an omega-3 fatty acid and is an essential component of the central nervous system, sperm, retina, testicles and skin. Cold water oceanic fish oils are XXXXXXX sources of this nutrient. It has been considered to improve attention and visual activity when given to pregnant women. Of late, it has been proposed that this component may be added as a nutritional supplement during pregnancy and in infants and children. About 200-300 mg/day is recommended in pregnant women. Studies are still going on to note the several other benefits of this essentially nutritional supplement.

You may follow your doctor's advice and consume this drug. As this is a recent development, you may not have had it in your earlier pregnancies.

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

Above answer was peer-reviewed by
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