CLINICAL MANAGEMENT OF BLEEDING IN FIRST TRIMESTER
Dr. Pratik Tambe (ICOG GCM 2020-25) addresses the challenges faced by gynecologists during early pregnancy.
WEBINARS
Key Takeaways:
Bleeding <12 weeks’ gestation discussed. Bed rest (empirical) & progesterone (evidence based) remain the most common therapeutic approach.
Progesterone is also required to create immunomodulation so that mother’s body allows it to implant & grow for 9 months.
Better compliance for oral route and higher efficacy seen because immunomodulation theory tilts evidence towards oral dydrogesterone.
Which progesterone to choose will also depend on clinical evidence in the Indian population.
The evidence holds strong for oral dydrogesterone in clinical practice with decades of experience in millions of women.
Dydrogesterone dosage in case of bleeding during early pregnancy is 40 mg stat, followed by 10mg three to four times daily till 13-14 weeks.