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Pregnant, mild blood clot leaks at intervals, low abdominal pain. USG shows Placentomegaly with subchorionic hemorrhage, mild IUGR. Best solution now?

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General & Family Physician
Practicing since : 2005
Answered : 436 Questions
Dear Doctor,
My wife is at 24th week of pregnancy. Last week her amniocentesis result is come and it is normal. She had an early pregnancy complication and it is quite normal up to 2nd trimester. But from the last week she again leaks a mild blood clot at intervals. The last USG reports on 11th Nov says that she has "Placentomegaly with subchorionic hemorrhage and a mild IUGR". Right now she is suffering from acute low-abdominal pain. My doctor is helpless. He told me that in this situation there is nothing to do except 'wait & watch'. He also told that if she carries 32 weeks then he might try to pic up the baby.
I am in at frustration point and really don't know what to do. How come I out with this situation.

Please advice me thanks in advance.
Posted Sat, 28 Apr 2012 in Pregnancy
Answered by Dr. Radhika 27 minutes later
Thanks for the query.

Placentomegaly is an abnormally enlarged placenta.
The common causes of unusually large placenta are maternal diabetes mellitus, severe maternal anemia, fetal anemia, congenital syphilis, chromosomal anomalies, and large intervillous thrombi.

A subchorionic hemorrhage is caused when blood collects between the chorionic membrane (a membrane that develops around a fertilized egg) and the wall of the uterus. These bleeds, or clots, can cause the placenta to separate from the uterine wall if they get too large. The outcome of the fetus depends on the size of the hematoma, the mother's age, and the fetus's gestational age.

More than half of women who bleed during their first trimester go on to have perfectly healthy pregnancies.

Depending on the findings, she must take strict bed rest, refrain from lifting heavy objects, and avoid exercise. In most cases, you’ll be asked to avoid sexual intercourse.

Also she should take ultrasounds frequently as advised by her physician to monitor her condition. Do not worry, but, she needs maximum care possible.

Hope I have answered your query. I will be available for follow up queries if any.


Above answer was peer-reviewed by
Follow-up: Pregnant, mild blood clot leaks at intervals, low abdominal pain. USG shows Placentomegaly with subchorionic hemorrhage, mild IUGR. Best solution now? 17 hours later
Hello Doctor,

Thanks for your response. My wife age is 29 and the fetus's gestational age is 24 week and 1 days as on 11/11/11.

She has 1:15 risk in her Triple test but in Karyotype the report is normal. So, is that risk makes the Placenta become large? Is there any way (medicine) which controls the increasing rate of the placenta?

Also, is there any medicine for the bleeding and the acute pain which she suffers. Yesterday someone told me about MAA PREG & LRZIN. Which may helpful for the IUGR. Can I go for that?

Another question is, does frequent ultrasound make any harm to the newborn?

Answered by Dr. Radhika 3 hours later

Thanks for the query.

You have mentioned 1:15 risk in triple test but karyotype as normal, so there are fewer chances for chromosomal anomalies.

As I said earlier bed rest, refraining from lifting heavy objects, and avoiding exercise will prevent the placental enlargement from progressing. There is no specific medication to prevent the same.

It is important to remember that screening tests are not diagnostic of a fetal abnormality; they indicate a normal or increased risk. Of all women who have positive triple screening results, only a very small number of them have babies who actually have a neural tube defect or chromosomal abnormality.

Triple test is done in pregnancy in the second trimester to classify a patient as either high-risk or low-risk for chromosomal abnormalities (and neural tube defects such as trisomy 21 or Down's syndrome).

MAA PREG & LRZIN are ideal medical nutrition therapy during pregnancy. It contains Albumen, which is used as protein source for preterm, anemia, low Birth Weight and miscarriages. This will cause no harm to pregnancy.

Frequent ultrasound scans will sometimes be needed to monitor the growth of the baby. It does not cause any harm.

Wishing you good health.

Above answer was peer-reviewed by
Follow-up: Pregnant, mild blood clot leaks at intervals, low abdominal pain. USG shows Placentomegaly with subchorionic hemorrhage, mild IUGR. Best solution now? 21 hours later

Can you please suggest any medicine for the bleeding which is leaking frequently and the acute pain which she suffers a lot.

Thanks in advance.

Answered by Dr. Radhika 1 hour later

Thanks for the follow up.

While there is no specific treatment available, few medications may be tried depending on the general condition and obstetric condition. Medicines such as Magnesium sulfate, progesterone, nifedipine will be normally used in bleeding due to Sub chorionic hemorrhage.

Magnesium sulfate is sometimes used as a tocolytic medicine to slow uterine contractions during preterm labor.

Nifidepine are frequently used during pregnancy for pregnancy-induced hypertension and to inhibit pre-term labor. These agents are helpful in the treatment of pre-term labor because they decrease myometrial contractility in the uterus.

17-a-hydroxyprogesterone caproate (17P) have long been considered important agents in the maintenance of uterine quiescence and have been used extensively in primary and secondary prevention of preterm delivery.

Again for her pain NSAID like Ibuprofen can be given.

Discuss about these option with her gynecologist. They can be prescribed to her by her treating gynecologist after careful examination and evaluation.

Wish you good health.

Above answer was peer-reviewed by
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