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Ask DR PRABIR KUMAR DAS Your Own Question
Category: OB GYN
Satisfied Customers: 1886
Experience:  MBBS(CAL)MD(G&O)
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I'm 30 years old woman currently 10 weeks pregnant. I

Customer Question

Hello, I'm 30 years old woman currently 10 weeks pregnant. I have had 3 miscarriages before, 2 chemicals and 1 loss at 5-6 weeks. Have been tested for thrombophilia and APS and ANA, all good (except heterozygous for MTHFR A18..). This pregnancy has been
going great until 10 days ago when after a perfect ultrasound at around 8 1/2 weeks (173bpm), I've started mild cramping. I've cramped for days, then on Monday I've started bleeding and have been bleeding every day since then. Some days heavy with clots, red
blood, other days brown or dark red blood. Cramps have continued usually only on my left side and very localized and very intense. This left side pain alternates between acute when it feels like something ripping off the uterus to more chronic when it's just
a dull ache like a horrible sqeeze. Every time that left pain becomes acute I bleed more intensely. I also have occasional cramps in all the uterus which have become more intense over the last days. I went for an ultrasound this Friday expecting to have lost
the pregnancy but it was still there, the baby measuring correctly and good hearbeat 168. I have a big subchorionic hematoma, blood in my uterus, a 3.6cm fibroid on the left side of the uterus right where I feel that intense pain/cramp and possibly a septum
or arcum of the uterus. I will attach a photo of the fibroid (upper picture) and the baby. The problem is ever since yesterday's prodding and poking at the doctor's the pain on the left has become very intense (8/10) and continuous, I've started having occasional
30mins contractions and cramps in the whole uterus around 6/10 and I'm feeling overall extremely unwell. I've started bleeding fresh blood again and filled a large pad overnight. I could barely sleep because of the pain. The doctor recommended I take antispasmodic
(drotaverine) but I've been taking it for a few days now and it's not helping much. Neither does paracetamol. I've read online that when fibroids undergo red degeneration they can bleed and release prostaglandins into the uterus which can cause contractions
and eventually miscarriage. I've read that ibuprofen is effective against this but there are also conflicting studies whether it causes miscarriage or not. The truth is with how increasingly horrible I'm feeling I can't imagine not ending up miscarriaging...
should I take ibuprofen, is it an option? I can't speak to my doctor as he is out of town until next Wednesday and I feel my situation is progressing quite quickly. I can't get out of bed and my pain is not subsiding only increasing. Please advise me, is ibuprofen
useful in this case?
Submitted: 1 year ago.
Category: OB GYN
Customer: replied 1 year ago.
Adding the picture of the fibroma and baby.
Expert:  DR PRABIR KUMAR DAS replied 1 year ago.


If the pain is due to red degeneration of fibroid uterus ,it will be relieved by paracetamol (drug of choice), but as it is not working in your case I it is due to the contraction of uterus due to presence of fibroid and to avoid the miscarry any uterine relaxant like duvadilan or utodine is the best choice for you.Ibuprofen is nothing special ( it is non steroidal anti inflammatory drug) and if paracetamol does not work it will not give you greater result.This drug will not increase the chance of miscarry as such but may increase the retroplacental hematoma and in my opinion you should not take it.

Thank you

Customer: replied 1 year ago.
Thank you so much, I've sent my partner looking for them.In your opinion looking at the photo and the symptoms, would you say this fibroid is undergoing red degeneration and that is probably the culprit of my bleeding and cramping? This fibroid was not seen on ultrasound until Friday (and I've had ultrasounds almost every week) so perhaps it has changed its composition making it more visible, due to this degeneration, does that make sense?By taking Duvadilan are there good chances of saving this pregnancy from being miscarried?
Expert:  DR PRABIR KUMAR DAS replied 1 year ago.

Yes presence of fibroid is one of most common anatomic cause for recurrent loss of pregnancy.I think the pain is due to combination of degeneration of fibroid and uterine contraction.

Thank you

Customer: replied 1 year ago.
Doctor, the only uterine relaxant drugs I could find are Salbutamol 4mg and Nifedipine 20mg. Are these useful? I could not find Duvadilan or Utodine (or their main components).
Expert:  DR PRABIR KUMAR DAS replied 1 year ago.

salbutamol and nifedepine have uterine relaxation action but they are not used for this purpose.

duvadilan and utodine are used clinically for this purpose.

Please you google for ritodrine(utodine) and isoxsuprine (duvadilan) and you will get your answer.

Thank you