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What Do These Following Lab Reports Indicate?

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Posted on Mon, 26 Dec 2016
Question: Hello Doctor,

I had a planned cervical cerclage done yesterday. I had no such complications before the surgery but since i had a history of previous miscarriage my doctor decided to put the stiches. I had an Ultrasound done yesterday morning right before my cerclage was done & that measured the cervix length as 3.5 cm. But after the surgery doctor told me that while operating she found the cervix shorter (approx 2-2.5cm) & soft.
Now she has advised for a bed rest of 15 days & put me on a dose of Susten 400mg twice a day along with other supplements.
I have attached all my reports herewith.
I am still concerned that if the Ultrasound showed it as 3.5 cm then how can it be shorter in real ?
Cant we rely on Ultrasound results then ?
And if this is something expected , then please advise what precautions should i take now ?
And are there any risks involved even after cerclage ?
I have got really worried now.

Thanks,
XXXX
doctor
Answered by Dr. Aarti Abraham (35 minutes later)
Brief Answer:
As below

Detailed Answer:
Dear XXXXXXX
I understand your anxiety.
Manual measurement of cervical length with the hands ( done by your doctor during the surgery ), is more reliable than measurement of the cervical length with ultrasound scan.
So what showed as 3.5 could have been actually shorter.
You cannot rely on scan results as much as on digital actual exam.
But one cannot do digital exam everytime, so ultrasound scan is second best.
A cervical length of 2 cm carries high risk of miscarriage dear.
So yes, there are risks involved with such short cervical length.
Precautions include -
1. Abstain from sexual activity.
2. Bedrest ( only necessary tasks for yourself , nothing else )
3. Take medications as explained.
4. Avoid stress, travelling, jerks, anxiety, exercise, bending, stretching, lifting heavy weights, standing for prolonged periods of tie.
5. 15 days measurement of cervix with ultrasound scan.
6. Report immediately to your doctor in case of pain, cramping, bleeding, spotting etc.

You have a long route ahead of you, and you will have to be very careful now with this pregnancy.
In which city do you reside , XXXXXXX ?
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Aarti Abraham (13 minutes later)
hi Doctor,

Thanks for your quick response.
I stay in XXXXXXX and i am working.
I have couple of more questions :
Does Bed rest mean that i cannot continue my office work as well ?
Can i still walk after dinner or i should just be lying on the bed everytime ?
Also, will the cerclage done help with the complications ?

Thanks,
XXXX
doctor
Answered by Dr. Aarti Abraham (11 hours later)
Brief Answer:
As below

Detailed Answer:
Hello again dear.
Bed rest does mean that continuing office work is difficult.
Walking after dinner has to stop.
You should lie down or sit or recline all the time.
How is your work profile at office ?
Yes, the cerclage will help to a great extent , if done well.
Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Aarti Abraham (7 minutes later)
hello doctor,

My work profile includes mostly sitting at my desk. But at the same time the route to my office has got a lot of speed breakers so avoiding jerk will be difficult.
In addition to that my work also permits me working from home. So, is it fine if i can lie down on my bed and continue working on my laptop ?
Does constantly working on laptop harm ?
Apologies for asking these many questions.
I was really hopeful with this pregnancy with all my reports coming normal but this sudden finding has really shocked me.
Thanks for your guidance.

XXXX
doctor
Answered by Dr. Aarti Abraham (24 hours later)
Brief Answer:
As below

Detailed Answer:
Hello Dear XXXXXXX
Please do not hesitate to ask any questions.
I am honoured that you trust me and choose me with your doubts.
I will always be happy to answer any number of them.
It is perfect, and best, if you can work from home.
There is no problem in lying down or propping yourself up while sitting with pillows and working from home on your laptop.
Yes, constant laptop use has side effects, but it will not lead to a miscarriage.
You can take a break every couple of hours while working on the laptop.
I can understand that you would be restless with the sudden reports having come out.
But please relax, if you take due care, you should be fine.
Atleast you had a warning this time !
God bless you, will pray for you, and keep in touch.
Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Aarti Abraham (23 minutes later)
hello doctor,

Thanks for your kind words. Really appreciate it. I will try not to strain myself.
Just one more concern. After my stitches..i did not have any significant pain or bleeding.
But i am having white discharge. Sometimes it is watery & sometimes it is dry an flaky.
Specially with the urine, i always see white flakes like substance.
Is it normal to have this kind of discharge ?
Could it be because of increased dosage of Susten (400mg twice) ?
There is no itching, burning or pain associated with this discharge.

Thanks,
XXXX
doctor
Answered by Dr. Aarti Abraham (24 hours later)
Brief Answer:
As below

Detailed Answer:
It could be because of susten .
Are you taking it vaginally , or orally ?
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Aarti Abraham

OBGYN

Practicing since :1998

Answered : 6004 Questions

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What Do These Following Lab Reports Indicate?

Brief Answer: As below Detailed Answer: Dear XXXXXXX I understand your anxiety. Manual measurement of cervical length with the hands ( done by your doctor during the surgery ), is more reliable than measurement of the cervical length with ultrasound scan. So what showed as 3.5 could have been actually shorter. You cannot rely on scan results as much as on digital actual exam. But one cannot do digital exam everytime, so ultrasound scan is second best. A cervical length of 2 cm carries high risk of miscarriage dear. So yes, there are risks involved with such short cervical length. Precautions include - 1. Abstain from sexual activity. 2. Bedrest ( only necessary tasks for yourself , nothing else ) 3. Take medications as explained. 4. Avoid stress, travelling, jerks, anxiety, exercise, bending, stretching, lifting heavy weights, standing for prolonged periods of tie. 5. 15 days measurement of cervix with ultrasound scan. 6. Report immediately to your doctor in case of pain, cramping, bleeding, spotting etc. You have a long route ahead of you, and you will have to be very careful now with this pregnancy. In which city do you reside , XXXXXXX ?