27 y/o female with multiple abortions and amenorrhea

 DR.NAVYA(INTERN)

DR.CHETANA(INTERN)

DR.ABDUL RAHEEM (INTERN)

DR.ASHFAQ(INTERN)

DR.SRAVYA(INTERN)

DR.GNANADA(INTERN)

DR.CHARAN(PG1)

DR.VAMSI(PG1)

DR.SUSMITHA(PG2)

DR.ADITHYA (PG3)

DR.PRANEETH(PG3) 

DR.PRAVEEN NAIK (ASS.PROF)

DR.RAKESH BISWAS(HOD)

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Here is a case i have seen:

27 y/0 female arrived from West Bengal with chief complaints of Amenorrhea since 10 months and Multiple abortions.

 Patient got married in 2016, before marriage she used to have delayed or early menstruation by 3-4 days. After marriage(in 2016) she had Menstruation twice in one month and this reoccurred after 3 months. Between 2017-2018 in a span of 1 year she took oral contraceptive pills thrice ( Unwanted 72). The couple tried conceiving in 2018 and due to failed attempts visited a Gynaecologist in 2018 , she was advised medications for 2 months and then try conceiving . On follow-up after 2 months, the patient was asked to continue medications. Soon after that, In August 2019 she was tested pregnant 1st time and then they didn’t take the previous medicine prescribed. In October 2019 , she started bleeding per vaginal and underwent abortion and were advised to conceive 3 months later by the Gynaecologist.

In April 2020 she was tested pregnant again and after 2 months similar bleeding happened and underwent abortion.

After 1-1.5 months , she complained of Amenorrhea, and was tested for Pregnancy 3rd time. The couple denied that they didn’t try conceiving. However , they were told by the Gynaecologist that she was pregnant. After 1 month pervaginal bleed reoccured and was advised to undergo abortion. The couple refused and were prescribed Unwanted - KIT.

After 1 month she complained of Pain abdomen and visited an RMP. Following further investigations she was Suspected of gestational Trophoblastic disease and was started on injection Methotrexate on 29/10/2020 and on 2nd Line Actinomycin D on 11/12/2020. 

She had also tested positive for IgG Rubella Virus and CMV. 

She’s not a k/c/o HTN, DM or Thyroid diseases

No c/o allergies.

No significant family history, no history of Cancers in the family.

Appetite mixed , but decreased since 1 year. No addictions.

Investigations :

 USG Report

                                  
                                     

 Biochemistry results:

                                     

Hematogram :

 Liver Function Test Results :

Immunology / Serology results :

Management Summary: