Prolonged Blood Loss Accompanied By Abdominal Pain After A Positive Testpack?

Greetings, I am Dessy aged 34 1year, my last mens 24 nov’19 (my men are irregular, always back from 2 days, 10 days, up to 14 days) on 9/01 I test packs with 2 clear lines, breast pain and stomach also feels painful just like menses, I am only a midwife not USG (this is the 3rd pregnancy, normal child 1, child 2 cesarean) on 11/01 I have contact with my husband, g da complaints, on 12/01 afternoon brownish mucus comes out and still abdominal pain just like menses, on 13/01 a few drops of blood came out in my pants, I went straight to the hospital for an ultrasound with a gynecologist, I had a transvaginal ultrasound, the fetal pouch was not visible, sent back next week, pain and the blood comes out what medicine “only d suggest if severe pain / severe bleeding directly to the emergency room .. ok I go home, blood still dripping sometimes “, not continue “an and stomach pain still feels a little, date 14 / 01 in the middle of the night when there is a pee tucked in the middle “my vagina took like blood rather thick like the shape of something but I don’t know what, n Yeri, there is no stomach pain, but the breast pain is gone, on 15/01 because of concern that the fetus is out, I am a doctor again, but what is the doctor’s response to the thick blood, direct ultrasound tranvaginal again, the results are visible fetal pockets in the womb but the fetus has not been seen, and in the right side there is a “mass ” but not yet know what, hrs d have to do a fetomaternal ultrasound but have not scheduled that I will only send it back another week (22/01), long time ago how are you waiting for date 22/01, just thinking about it, what’s going on naturally? “What mass ” is this on the right? Is that a cyst or miyom? And why isn’t the fetus visible? Did I have a miscarriage? Thanks doctor if you are willing to answer

1 Answer:

Hello Dessy Muliasari,

Examination to diagnose a pregnancy can use a test pack (detecting an increase in the hormone HCG in the urine), examination of HCG hormone levels in the blood, and ultrasound examination. Transvaginal ultrasound (a device inserted into the vagina) can more easily detect a pregnancy at an early gestational age <6 weeks and its accuracy is better than an abdominal ultrasound (a tool placed on the abdomen).

Based on the first day of your last menstrual period (HPHT), 24 November 2019, today the womb should be around 7 weeks old. At 7 weeks gestation, the expected NORMAL results on USG examination are:

 Visible gestation sac (pregnancy) in the uterus Visible fetus in gestational sac, can be measured the distance from the head to the buttocks (crown rump length) for the estimated age of the fetus Placenta in the uterine fundus The clear amniotic fluid When at 7 weeks the fetus does not appear at Your case is likely:

  Blighted ovum / anembrionic pregnancy. Fertilization does not develop into a fetus, only the gestational sac continues to enlarge. Generally, a blighted ovum pregnancy will experience a miscarriage (exiting before 20 weeks gestation). After a complete miscarriage, generally the results of the test pack will turn negative after 2 weeks. The HPHT calculation is incorrect because the menstrual cycle is irregular (actually the fetus is still <7 weeks). The mass on an ultrasound examination can be located in the uterus, in the tissues around the uterus, or in the ovaries. Transvaginal ultrasound or abdominal ultrasound both can help to detect the presence or absence of an abnormal mass (which should not be present in normal conditions) associated with the reproductive organs. Generally abdominal ultrasound has a wider field of examination to determine the location of the mass. From the location, echogenisity (black and white) mass picture, edge mass, mass size obtained from ultrasound can help doctors to distinguish diseases that might cause the mass. Cysts or myomas for now can not be distinguished, because both can provide an abnormal mass picture on ultrasound examination. Please re-examine according to the time determined by the doctor.

Thus the explanation from me, hopefully useful.

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