#ATGMissedAbortion.
Topic: Bleed in Early Pregnancy & Missed Abortion
#Case
I have been bleeding since on Saturday, the last time is saw my menstrual flow was 2nd of October and I tested positive for PT on the 27th October. I did a scan nothing was seen, and I returned after 2 weeks was told nothing was seen but my breasts are tender, feel weak at any little thing I do. Since the beginning of the bleeding I visited hospital and was discharged briefly, I went for another scan and was told nothing was still seen. 

I had to visit a general Hospital and after I was seen by a Doctor, I was told to go for another scan and the scan result stated that I have missed abortion contrary to the one I did a day before.

I went for another pregnancy test and it tested positive, however the blood is still dropping. It is not a heavy flow, just like a normal menstrual flow. Please I hope my baby is still OK. 

I don’t have any pain below, just little cramp briefly. I feel normal and my breasts are still tender, I hope my baby is OK and what can I do to stop this blood drop.

I will expect your reply soonest, thank you.
#Response
Bleeding in pregnancy can be very scary. Bleeding during early pregnancy (early first trimester) can be harmful or harmless. Harmless bleeding might be due to implantation bleeding, or it might also be due to some other hormonal changes following pregnancy. Majority of pregnant women experience bleeding at some time during the duration of pregnancy, these women still go ahead and have uneventful pregnancy and deliver their babies normally. 
However, some bleeding during the early stage of pregnancy might be a signal that the pregnancy is exposed to some dangers. It is very important to work with your doctor immediately bleeding is experienced. It is very good you did exactly that, and the scan can to an extent indicate the state of the pregnancy. Missed abortion is likely in this scenario.
What is Missed Abortion?
Unfortunately, in medical field, missed abortion refers to the termination of pregnancy before the fetus is capable of survival outside the uterus. The spontaneous loss occur pregnancy before the 20th week of pregnancy. This can be both physically and emotionally painful. The is the most common type of pregnancy loss. Majority of these miscarriages are often because the fetus isn’t developing normally and thus the body tries to expel the growing fetus.
Symptoms of Missed abortion include:

• fluid, blood, or tissue discharge from the vagina

• pain in the belly or lower back or pelvis

• uterine contraction

• nausea or vomiting

• cramping, irregular uterine bleeding, or fatigue
t’s a very heart breaking experience and it also common to feel sadness or grief. Unfortunately, once this unfortunate process starts it can’t be reversed or stopped. 

Having said all the above, is very important to confirm this diagnosis with your doctor.
However, medications or procedures such as a dilation and curettage can prevent certain types of complications. In addition, counseling and support is widely available.
#Diagnosis
 A missed abortion is usually diagnosed when the blood Hcg (pregnancy urine / blood test) fails to increase as expected, or when on ultrasound there is either no embryo (blighted ovum), or when there is an embryo or fetus but no heartbeat.  
To explain further, missed abortion is a silent miscarriage that occurs when a fetus dies, but the body does not recognize the pregnancy loss or expel the pregnancy tissue, and as a result, the placenta may still continue to release hormones, so the woman may continue to experience signs of pregnancy. This condition is usually, diagnosed during a routine checkup, where the doctor will fail to detect a heartbeat. A subsequent ultrasound will show an underdeveloped fetus.
#Treatment
Unfortunately, as stated above, once this process starts, it can’t be stopped. However, medications or procedures such as a dilation and curettage (D&C) can prevent certain types of complications.

 In addition, counseling and support can help, also Supportive care and monitoring for changes or improvement. Some medications can also be prescribed, for example, Progesterone blocker and 
A special medical procedure called, Medical abortion can be used in management. Vacuum aspiration can be used too.
#Advice and Recommendation
Please go back to your doctor and discuss their findings and the line of management. If it is confirmed you have missed abortion, you have to come to terms with that hurtful development. You must allow yourself grief and also recover, body soul and spirit. 
Dr. Chudi Godsons
Reference & Photo Credit
Mayo clinic

www.fertilityauthority.com

www.slideshare.ne


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