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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Thickened Endometrial And No Sac. Why Was There Bleeding? Have I Had A Miscarriage?

4 weeks pregnant, had red bleeding yesterday (very light) went to ER and all they saw was a thickened endometrial and no sac (that she could see, she didnt seem to know much though). The hormone count in my blood was 590. The ER dr was not informative at all and just told me it could be a threatened miscarriage . I have very very slight cramping every once in a while and usually its just a little cramp and thats all. blood is no longer red its brown. No clots. not heavy like i said not even soaking a pad a day. My question is does this sound like a miscarriage? I have an appointment on Wens at OBGYN Thanks
Thu, 3 Apr 2014
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OBGYN,  's  Response
Hello and welcome,

I understand the query and there are 2 possible explanations for this:
1. The bleeding was due to an threatened abortion.
2. It was an implantation bleed secondary to a delayed conception.

In both cases, management is similar. It is based on the principal that if it is a threatened abortion then try to prevent it.
Even and ultrasound after 2-3 days may show a similar picture as a gestational sac is difficult to visualise before 5 weeks. So until your appointment take bed rest, get a prescription of progesterone and HCG if possible along with folic acid. Sexual contact is to be avoided.

If the bleeding recurs, then it indicates that this is a progression towards inevitable abortion. However if it stops with treatment [ or if it was implantation bleed it will stop by itself] then pregnancy may continue and the baby will be well. So please do not worry. Take care.

Hope this satisfies your query.
Thanks for using HCM.     
Feel free to ask any more questions that you may have.
Dr Madhuri Bagde
Consultant Obstetrician and Gynecologist
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Thickened Endometrial And No Sac. Why Was There Bleeding? Have I Had A Miscarriage?

Hello and welcome, I understand the query and there are 2 possible explanations for this: 1. The bleeding was due to an threatened abortion. 2. It was an implantation bleed secondary to a delayed conception. In both cases, management is similar. It is based on the principal that if it is a threatened abortion then try to prevent it. Even and ultrasound after 2-3 days may show a similar picture as a gestational sac is difficult to visualise before 5 weeks. So until your appointment take bed rest, get a prescription of progesterone and HCG if possible along with folic acid. Sexual contact is to be avoided. If the bleeding recurs, then it indicates that this is a progression towards inevitable abortion. However if it stops with treatment [ or if it was implantation bleed it will stop by itself] then pregnancy may continue and the baby will be well. So please do not worry. Take care. Hope this satisfies your query. Thanks for using HCM. Feel free to ask any more questions that you may have. Dr Madhuri Bagde Consultant Obstetrician and Gynecologist