PREGNANT BUT NOTHING IS SEEN

I have an issue with my health and wish to have your advice. I am 30 years and a mother of 2. After my last pregnancy in 2013 I went for family planning (implanon) for 3 years. Last month I took in but still bleeding. Below is the scan result I did on the 15-10-2016. PELVIC SCAN REPORT: Real time transabdominal scan with additional transvaginal views reveal a normal size uterus. The AP measures 4.8cm. the outline is smooth. There is no focal mass in the myometrium. The endometrial plate is normal size and uniform in echo. It measures about 14mm. The POD is empty. Both ovaries are normal in size. There is no abnormal adnexal mass. Assessments: Normal Scan. I am worried because I don’t know why I should be bleeding. Just scared of losing the pregnancy. Amina, Kaduna

I am happy that not only abdominal scan was done but also transvaginal scan. Did you do pregnancy test? Was was the result? If the pregnancy test was negative now, then with this scan you have no problem. Most likely the pregnancy has been aborted as evidenced by the vaginal bleeding.

If you are still worried do another pregnancy test now. If it is positive there are likely possibilities. Could it be early pregnancy that could not be picked with scan yet? In this case repeat scan in a week’s time. Or it can still be complete miscarriage because pregnancy test becomes negative between one to two weeks after miscarriage.

Another possibility is ectopic pregnancy. In which case close monitoring is required because of danger of ruptured ectopic which is a life threatening condition if this is suspected you have to be admitted and supervised by a Gynaecologist until the situation is resolved. Part of the investigations to be done include the PCV, another transvaginal scan, serum beta hCG, and laparoscopic.

Also gestational trophoblastic disease is a possibility. Serum beta hCG quantitative assay is diagnostic. In places where this is not available urine pregnancy test in neat and serial dilution is diagnostic.

I will suggest you see a Gynaecologist for proper assessment