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Preganancy 16th Week . Last Night While Urination I Had Two Small Spots Of Brown Discharge Radiolosgt Said OS Is Closed But There Is Some Fluid Collection In Retrochorial Plane Over Internal OS ( In Cervical Canal ) Measuring 4mm . Other Than This Nothing Else Was Detected And The Baby Is Developing Normally. Please Let Me Know What To Think Of This ?
Question: preganancy 16th week .
last night while urination i had two small spots of brown discharge , after which have'nt had any spotting other than usual colorless discharge . this morning went to see my gynecologist who sent me for an ultrasound(external) in which the radiologist said that the internal OS is slightly open. After reading the report we went for a second opinion and this time the ultrasound was transvaginal and the radiologist reported that OS is closed but there is some fluid collection in retrochorial plane over internal OS ( in cervical canal ) measuring 4mm . Other than this nothing else was detected and the baby is developing normally. Please let me know what to think of this
last night while urination i had two small spots of brown discharge , after which have'nt had any spotting other than usual colorless discharge . this morning went to see my gynecologist who sent me for an ultrasound(external) in which the radiologist said that the internal OS is slightly open. After reading the report we went for a second opinion and this time the ultrasound was transvaginal and the radiologist reported that OS is closed but there is some fluid collection in retrochorial plane over internal OS ( in cervical canal ) measuring 4mm . Other than this nothing else was detected and the baby is developing normally. Please let me know what to think of this
Brief Answer:
Precautions explained
Detailed Answer:
Hello ,
I have gone through both ultrasound scans. The first one is definitely wrong. The internal os does not appear to be open.
However, as the second report rightly mentions, there is a small collection over the opening of the uterus, which is the internal os.
This could indicate a miscarriage that might happen if you are not careful. Again, do not panic as the collection can get absorbed and disappear on its own.
It is important for you to follow a few precautions.
Take rest.
Avoid any kind of mental or physical stress, climbing stairs, bending, lifting weights, intercourse, travelling, constipation.
Ask your doctor to prescribe progesterone supplements to prevent miscarriage.
Get a Repeat scan done after two weeks.
Is this your first pregnancy?
To which city do you belong?
Any other medical complications in this pregnancy?
Looking forward to hearing from you.
Take care
Thanks.
Precautions explained
Detailed Answer:
Hello ,
I have gone through both ultrasound scans. The first one is definitely wrong. The internal os does not appear to be open.
However, as the second report rightly mentions, there is a small collection over the opening of the uterus, which is the internal os.
This could indicate a miscarriage that might happen if you are not careful. Again, do not panic as the collection can get absorbed and disappear on its own.
It is important for you to follow a few precautions.
Take rest.
Avoid any kind of mental or physical stress, climbing stairs, bending, lifting weights, intercourse, travelling, constipation.
Ask your doctor to prescribe progesterone supplements to prevent miscarriage.
Get a Repeat scan done after two weeks.
Is this your first pregnancy?
To which city do you belong?
Any other medical complications in this pregnancy?
Looking forward to hearing from you.
Take care
Thanks.
Above answer was peer-reviewed by :
Dr. Prasad
Thanks a lot for your reply Doctor . This is my second pregnancy running the 16th week . I have mentioned in medical history that the first one ended in a miscarriage at 8 weeks in dec.2015 due to monosomy of chromosome 18 .Karyotyping results normal for me as well as my husband.
I am from Haldwani (Uttarakhand ).
No other medical complications in this pregnancy . I was on progestrone supplements with 10 mg duphaston twice a day and Macgest SR300 oral once every day . it was only after reducing my intake to one tablet dupaston 10 mg after 14th week that this has happened .
I am on total bed rest , please do suggest the needful that is to be done.
thanks again.
I am from Haldwani (Uttarakhand ).
No other medical complications in this pregnancy . I was on progestrone supplements with 10 mg duphaston twice a day and Macgest SR300 oral once every day . it was only after reducing my intake to one tablet dupaston 10 mg after 14th week that this has happened .
I am on total bed rest , please do suggest the needful that is to be done.
thanks again.
Brief Answer:
As below
Detailed Answer:
Hello again.
I would suggest not reducing the dosage of progesterone.
Continue the dosage at Duphaston twice a day plus Macgest 300 oral.
I have great faith in a brand called Miprogen SR, it is also a substitute for Macgest, see if you get it in Haldwani.
Continue with the bedrest till this collection reabsorbs ( mostly that would happen in 2 - 3 weeks ).
Rest of the precautions as I explained.
Haldwani is a very small centre, do you plan to stay there until delivery ?
If it is possible to have medical care at a tertiary city, in view of this complication, that is a better option.
Take care.
Please feel free to discuss further.
As below
Detailed Answer:
Hello again.
I would suggest not reducing the dosage of progesterone.
Continue the dosage at Duphaston twice a day plus Macgest 300 oral.
I have great faith in a brand called Miprogen SR, it is also a substitute for Macgest, see if you get it in Haldwani.
Continue with the bedrest till this collection reabsorbs ( mostly that would happen in 2 - 3 weeks ).
Rest of the precautions as I explained.
Haldwani is a very small centre, do you plan to stay there until delivery ?
If it is possible to have medical care at a tertiary city, in view of this complication, that is a better option.
Take care.
Please feel free to discuss further.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks a lot Doctor for your prompt reply. I have started taking progesterone tablets as i was doing before and will surely look for the tablet that you have suggested .
As i am on complete bed rest travelling is just not on the cards , otherwise would have preferred for my delivery to happen in XXXXXXX .
One thing i would like for you to clear for me is where exactly is this 4mm fluid located . Is it between my placenta and chorion or in the cervical canal as the image shows , I am confused as the report has mentioned it under placenta as well as cervical canal . But , during the ultrasound radiologist clearly showed and pointed it out to be in the canal and rest of the areas being blood free.
Please do elaborate on this.
thanks a lot for your advice once again.
As i am on complete bed rest travelling is just not on the cards , otherwise would have preferred for my delivery to happen in XXXXXXX .
One thing i would like for you to clear for me is where exactly is this 4mm fluid located . Is it between my placenta and chorion or in the cervical canal as the image shows , I am confused as the report has mentioned it under placenta as well as cervical canal . But , during the ultrasound radiologist clearly showed and pointed it out to be in the canal and rest of the areas being blood free.
Please do elaborate on this.
thanks a lot for your advice once again.
Brief Answer:
As below
Detailed Answer:
Hello again.
I would advocate you to move to a bigger city once you are fine.
you are welcome to XXXXXXX :)
The fluid is located between the placenta and chorion ( retro - chorionic ), but in the area that rests just above the cervical canal, near the opening of the cervical canal ( the portion that connects with the uterus ).
It is a small collection, and the rest of the canal is free of blood, and the opening is closed too.
IF the internal orifice of the cervical canal opens up, there is a chance of a miscarriage.
Right now, that is not there, hence there are very good chances of the fluid ( blood ) being reabsorbed into the body.
You can confirm this by an ultrasound scan done after 15 days.
Meanwhile, follow the precautions and take care.
As below
Detailed Answer:
Hello again.
I would advocate you to move to a bigger city once you are fine.
you are welcome to XXXXXXX :)
The fluid is located between the placenta and chorion ( retro - chorionic ), but in the area that rests just above the cervical canal, near the opening of the cervical canal ( the portion that connects with the uterus ).
It is a small collection, and the rest of the canal is free of blood, and the opening is closed too.
IF the internal orifice of the cervical canal opens up, there is a chance of a miscarriage.
Right now, that is not there, hence there are very good chances of the fluid ( blood ) being reabsorbed into the body.
You can confirm this by an ultrasound scan done after 15 days.
Meanwhile, follow the precautions and take care.
Above answer was peer-reviewed by :
Dr. Remy Koshy
Hello again Doctor ,
Yesterday went for my revaluation ultrasound and thankfully the collection has been absorbed completely , the baby is developing normally and no other issues were detected . After going through the report my gynecologist has suggested stopping the progesterone supplements ( at once not waning off ) , as told before i am on Macgest SR300 one tablet and duphaston 10 mg two tablets a day . Now, my query is should i just stop taking these supplements as suggested or as i am in my 19th week of pregnancy or should continue with them as this situation did creep up last time i waned myself off them .
thanks a lot
Yesterday went for my revaluation ultrasound and thankfully the collection has been absorbed completely , the baby is developing normally and no other issues were detected . After going through the report my gynecologist has suggested stopping the progesterone supplements ( at once not waning off ) , as told before i am on Macgest SR300 one tablet and duphaston 10 mg two tablets a day . Now, my query is should i just stop taking these supplements as suggested or as i am in my 19th week of pregnancy or should continue with them as this situation did creep up last time i waned myself off them .
thanks a lot
One thing i forgot to add doctor is that i am on lupi hcg 5000 one injection per week as well, had a chat regarding this with my gynecologist and she said no harm in continiuing with it . Please do suggest regarding it and progesterone supplements.
Thanks again
Thanks again
Brief Answer:
As below
Detailed Answer:
Hello again.
Yes, you should continue with the injections.
Take them for a week or two more, and then stop them if no spotting.
Regarding the progesterone, continue with macgest one daily and duphaston once daily ( instead of two ) once a day.
Continue this for 15 days.
Then stop the duphaston and continue macgest for a fortnight more.
Then you can stop the macgest also.
So taper off the progesterone support within the next month gradually, being alert for any complications meanwhile.
Take more rest than usual and precautions too.
Take care.
As below
Detailed Answer:
Hello again.
Yes, you should continue with the injections.
Take them for a week or two more, and then stop them if no spotting.
Regarding the progesterone, continue with macgest one daily and duphaston once daily ( instead of two ) once a day.
Continue this for 15 days.
Then stop the duphaston and continue macgest for a fortnight more.
Then you can stop the macgest also.
So taper off the progesterone support within the next month gradually, being alert for any complications meanwhile.
Take more rest than usual and precautions too.
Take care.
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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