Hello
Thanks for posting yur query at DoctorSpring.com
Can you please upload the exact ultrasound scan report ?
That would help me to make a diagnosis , instead of just reading the typed inference.
Looking forward to hearing from you.
Regards.
Patient replied :
Thanks for replying doctor.. I already added one of the scan, which shows the problem in question, and also the summary report. Adding all of the other scans too. We need a second opinion about the problem diagnosed & medicines prescribed (in case our doctor has missed something). During the Pregnancy, my wife had some bleeding in the 18th week (in the scan, Clotting was found in low lying placenta), when she was admitted in hospital for 5 days, and then took complete bed rest for about 1 month. Then in the 29th week scan, placenta had moved up with no signs of clotting. She has had mild constipation, gastric issues almost throughout the pregnancy till now.
LMP is 12/05/2014. Today is 33.4 weeks and this scan was done on 33.2 weeks (31/12/2014).
Was not able to upload all the scans. They're accessible here:
http://www.mediafire.com/download/o2x6ppd9c9r5dn9/Scans.zip
Hello,
Yes I have gone through all the images.
It is clear that there is some infective / inflammatory lesion in the lower abdomen just beneath the skin and muscles.
There is pain , and she is pregnant, so nothing apart from conservative medications can be tried at this point in time.
The treatment being given is perfect, and she should respond to it within 24 - 48 hours.
How many hours back was the treatment started ?
Since when did the pain start ?
Did she ever have similar symptoms in the past ?
In my opinion, intravenous antibiotics and intravenous painkillers should be the mainstay of treatment , and it is already being given.
She should have bedrest and wait for 24 - 48 hours.
If she is not relieved , more intensive imaging would be required.
Hope this helps, feel free to discuss further
Patient replied :
Thank you Doc.
Q. How many hours back was the treatment started ?
The Intra-venous treatment was started about 48 hours back.
Q. Since when did the pain start ?
Pain started about 72 hours back. We saw the doctor the next day morning, and started the treatment the same day evening.
Q. Did she ever have similar symptoms in the past ?
No she didnt have any such symptoms ever.
Doc, can you also help us understand why something like this would happen? Also, are there any chances that even while the treatment is on, this infection/inflammation may increase? Would it in any way impact the baby?
Doc, you said Bed-rest. She was asked to lie down on her left side, while sleeping. But right now, she can't lie down at all. She's not sleeping at nights either. It is paining continuously, so bedrest is actually out of question. Is there any other position you can suggest? is sitting fine?
Thanks for all your help.
Hello,
It is very strange that she has not responded to 48 hours of IV therapy.
She needs to be examined by a Gastro Surgeon, and the ultrasound scan should be repeated also, at the best possible centre, to see whether the lesion (the anatomic structure) is resolving / decreasing in response to treatment.
Which city are you based and at what centre is all this happening , maybe I can suggest a better centre ?
During pregnancy, it is uncommon to see such lesions, it will not impact the baby in all possibility since the lesion is outside the uterus.
She needs to find a position that suits her, if it is not possible to lie down, it is alright to sit with pillows propped up.
Hope this helps, feel free to discuss further