Q. Had D and C before a month. Should I continue Primolut?
Hi doctor,
I had D and C before a month and I bled for five to six days after that. I was given Xamic for three days and Primolut N for 21 days. I had brownish discharge 18 days after my D and C and then had bleeding for seven days. I am still spotting. My hCG three days prior to periods came 21 and my ultrasound while in periods came normal. The reason of my D and C was hydropic villi in placental tissue. Should I continue the tablet?
Hi,
Welcome to icliniq.com.
I understand your concern.
As per me you should discontinue tablet Primolut (Norethisterone) as you have already taken for 21 days. After 7 to 10 days you will have normal periods. Now you do not need any hormonal tablets. If you have any abnormal bleeding in next period then do let me know.
Hi doctor,
I still have two tablets. My concern is that is this not my periods? I have had light bleeding for a week this is precisely 18 days after D and C. I was scared of hydropic degeneration, so I am monitoring my hCG levels. Is there any other tests or issues I need to worry about?
Hi,
Welcome back to icliniq.com.
I understand your concern.
- In your case the main reason for worry is hydropic degeneration and recurrence. You have to get serial hCG (human chorionic gonadotropin) level monitoring as well as repeated ultrasound estimation.
- As you said your hCG was 21 it appears to me as non-pregnant level. You have to get beta hCG again after six weeks post pregnancy.
- You should get ultrasound pelvis done at the same time. You can update me the report.
- You can take Primolut for two days as dosage is of total 21 days.
- You can get your complete blood count, liver function test, kidney function test and chest x-ray to rule out any rare chances of metastasis.
- In your case you have to use contraceptive for at least one year. It means that you do not have to get pregnant for the next one year.
- You can get your complete blood count, liver function test, kidney function test and chest x-ray to rule out any rare chances of metastasis.
- You can take Primolut for two days as dosage is of total 21 days.
- You should get ultrasound pelvis done at the same time. You can update me the report.
- As you said your hCG was 21 it appears to me as non-pregnant level. You have to get beta hCG again after six weeks post pregnancy.
Investigations to be done:
1. Beta hCG.
2. USG - ultrasonography pelvis.
3. CBC (complete blood count).
4. LFT (liver function tests).
5. RFT (renal function tests).
6. Chest x-ray.
Gestational trophoblastic disease.
Preventive measures:Contraceptive advice.
Regarding follow up:Revert back with the investigation reports to an obstetrician and gynaecologist online.---> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist
Hi doctor,
I was tested negative for gestational trophoblastic disease. My cardiolipin and liver kidney tests everything came out normal during D and C. The only two tests remaining are chest x-ray and hCG. If the hCG count goes to zero then do I still need to follow up for regular hCG test?
Hi,
Welcome back to icliniq.com.
Thanks for the update (attachments removed to protect patient identity).
- As you said you have been tested negative for gestational trophoblastic disease. But, hCG follow up is necessary just to detect recurrence. As, recurrence of this disease is very high.
- If hCG goes to zero you need to get it repeated after six months as this is the best test to detect recurrence.
- Chest x-ray should be done just to be on safer side.
For further information consult an obstetrician and gynaecologist online --> https://www.icliniq.com/ask-a-doctor-online/obstetrician-and-gynaecologist
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