My report shows retroplacental haemorrhage.I have a prior history of miscarriage.Please help.

Hello,

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Considering your history and bleeding on and off from the 16th week, and now at 24th week of gestation, you are presented with an old and mild retroplacental hemorrhage over the anteriorly placed placenta grade 1 maturity. (as per attached reports). One needs to understand that retroplacental clot means that there is a part of placenta which got detached from uterus and got filled with blood at the 16th week. Luckily the bleeding did not continue and got stopped and hence the size did not increase, thereby causing complete separation and fetal loss called abruptio placentae (placental abruption). Now what happens is, as the fetus grows, the uterine wall is stretched and the placental attachment tends to get stretched as well and definitely there would be some bleeding occurring, as it has been in your case. Initially the bleed was concealed, then now it has started to reveal. The main fear is abruptio placentae which is an emergency where due to bleeding, the whole placenta separates from uterus and there is heavy bleeding. It is accompanied with severe pain and uterus is board like hard in consistency. It is dangerous for the fetus and causes death in minutes. Hence you have been given Tidilan retard 40 which is a uterine relaxant and would prevent any form of undue contraction or stretch to affect the already hemorrhaged site. However, the present aim would be to carry the pregnancy till 34 weeks till the lungs of the baby matures and you have to be on complete bed rest and if possible in the hospital only. The reason is, what you have been experiencing has been the warning bleed. It may so happen that suddenly you may have an accidental antepartum severe hemorrhage where immediate attention or probably cesarean may be required to save the child, hence hospital stay where you would be better observed is preferable till delivery. In our practice, this is a high risk pregnancy and abruptio placentae is one of the dreaded diagnosis which often leaves very less time for the doctor and the fetus, hence complete rest, uterine relaxation and hospital stay is warranted. I do not intend to scare you, but it is indeed necessary to be vigilant and careful for a safe future.

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