How to manage post-coital bleeding during pregnancy?

Question

Hello doctor,

I am in the 13th week of my first pregnancy. I had two episodes of postcoital bleeding after which USG was done which showed a low lying placenta (lower placenta is covering the os). I have been on bed rest and pelvic rest for the past one week and I am taking Susten 200 BD apart from Folvite. Is it fine for me to go to my workplace? I am a pathologist and I have to sit for three to four hours only. Should I take any other precautions? Please help.

Answer 1

Hi,

Welcome to icliniq.com.

I can understand your concern.

If there is no active bleeding, then you can safely go to work provided the roads are smooth and it does not involve a very long drive. Please avoid intercourse and vaginal douching. Repeat USG (ultrasonography) after six weeks for a level 2 scan and to look for placental migration. I suggest you continue taking the tablet Susten (Progesterone tablet).

I hope this helps. Do get back if you have any further queries.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

Glad to have you back.

Folic acid supplements can be stopped now. The tablet containing Ferrous ascorbate, folic acid, and zinc sulfate (Livogen-XT) can be taken once a day which is enough as it contains 1.5 mg of folic acid. Also, take the tablet Shelcal (calcium with vitamin D3) 500 mg twice a day, as it has both calcium and vitamin D. Iron is preferable to be taken on an empty stomach. If however, you get nausea or acidity, then you can take it with food though the absorption will be compromised. If your initial Hb is 11.5 or more, then this treatment is enough.

I wish you good health.

Thank you.

Answer 3

Hi,

Welcome back to icliniq.com.

Congratulations. The scan is good (attachments removed to protect the patient's identity). A cervical length of 1.57 inches is very good. The placenta has also moved up.

Continue taking the tablet Progesterone (Susten) for four more weeks.
Take HIV (human immunodeficiency virus), HBsAg (Hepatitis B surface antigen), HCV (Hepatitis C virus), and TSH (thyroid stimulating hormone) tests. These are blood tests. Around 21 weeks, go for a level 2 scan. Level 2 ultrasound scan is a must.
For your history of PCOS (polycystic ovary syndrome), I suggest you control sugars in your diet. Take full fruits instead of juices. You should not take sweets and sugar. This is a precaution as PCOS patients may develop diabetes in pregnancy.
Repeat oral glucose tolerance tests (OGTT) at 24 weeks.

Be happy and stay safe.

Thank you.