Brief Answer:
Please get ultrasonography performed

Detailed Answer:
Dear XXXXXXX XXXXXXX

Pregnancy is a state when there is no vaginal bleeding neither is there any pain arising from the uterus. This is a state of normal pregnancy.

If your wife is having lower abdominal pain, it is likely to be due to the contractions of the uterus which is trying to abort the pregnancy. The bleeding that she has got is next step of the abortion process. Usually threatened abortions where uterine contractions (perceived in the form of lower abdominal pains) precede the uterine bleeding, it is very difficult to salvage the pregnancy.

Please subject her for ultrasonography. It will reveal whether the baby is still viable or jeopardized. If it is viable, some Progestational medicines like Susten 200 may be tried which will help to stabilize the pregnancy. Also ultrasonography will reveal from where the bleeding is coming. The management of the pregnancy will vary depending up on the source of bleeding.

However, if the baby is not viable, the pregnancy will have to be terminated. In such cases, please do not take Progestational medicines which may stop the bleeding (where you feel abortion has been stopped) but will lead to missed abortion (non viable baby not getting aborted). Then the pregnancy will not grow but may lead to some serious complications like bleeding. infections, etc..

Pregnancy test on urine will be of no use at this juncture for knowing the status of the baby since it takes about 8-10 days after the baby has become non-viable for the hCG hormones to go down to the level when they cannot be detected by test; thus giving negative results.

Please report to your Obstetrician without delay. At this stage, till the diagnosis is made, please restrict her to the bed. Ask her to use the pads and save all the pads for doctors inspection. You may post the pictures (high resolution) for my review. The clots of blood stick to the edges of the pad while the products of conception stick to the centre of the pad. This helps diagnosing whether it has become incomplete abortion. Keep a count of the pads. In case of alarming bleeding, please shift her to the hospital ASAP.

Please upload the reports and the images for my review to finalize the advise.

For any more information or advice, I am always available for you XXXXXXX XXXXXXX

Dr. Nishikant Shrotri

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