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Pregnancy Bliss | Reproductive Health Hub

Pregnancy and miscarriage after sterilisation

Question:  Hi, I was sterilised 11 years ago and now I am 5 wks pregnant and had brown discharge, but then it turned into bleeding similar to a period. I miscarried in October last year at 4 weeks but I immediately bled. I have rang the EPU and they said my body probably thinks its having a period and it is normal. Could you please shed some light on this as I am very confused. S.A. (UK)

Answer: My answer may cause more confusion but please hear me out. My view is that you are not pregnant and in all likelihood you were not pregnant last October either.  You see, pregnancy after sterilisation is quite uncommon. Pregnancy a decade after sterilisation is even rarer. What makes me doubt the possibility of pregnancy on both these occasions is the mentioned gestation. You say in October you were “4 weeks” pregnant. In strict descriptive terms, there is no such thing as a 4 week pregnancy. This is because a normal standard menstrual cycle is 4 weeks, hence you can only talk of a pregnancy when there has been no menstrual period for more than 4 weeks. In other words, at 4 weeks you have not really missed a period and it appears your period in that instance arrived bang on time. I am just wondering whether you actually did a pregnancy test and if so what prompted you to do so in view of the fact that you had not missed a period.

In the latest instance, you seem to have gone a week over when your period should have arrived (assuming you have regular 4 week cycles). Again, this may just have been a delayed period and nothing more. You have not said whether you have done a pregnancy test and whether it was positive. If this is so then there is a case for doing a blood test to estimate the level of the pregnancy hormone (beta-hCG). This is because, even though uncommon, pregnancy after sterilisation could be ectopic. I have to say, I still think in your case the likelihood is that you have not been pregnant at all.

Dark line on a pregnant abdomen

Question:   I m in the 8th month of pregnancy and I have a vertical dark-lined sign through my womb.Is that going to be there even after the delivery? L. (Albania)linea nigra

Answer: Whilst not every woman gets this, it is, in fact, a fairly common development in pregnancy. It is what is known as linea nigra. It is a hormonal effect and will gradually fade and disappear within weeks of delivery.

Short femur and Down’s syndrome

Question:   I have been told that the thigh bone is short but that there is nothing to worry about. Before this somebody had mentioned the risk of downs syndrome. I am still worried. What do you think? I’m now 23 weeks. D.O. (UK)

Answer: It is true that a short thigh bone (femur) is regarded as a soft marker for chromosomal disorders including Down’s syndrome. However, when it is found in isolation, it tends not to be significant. I take it from the details that you have provided that  after a close and detailed  ultrasound examination, no other soft marker was identified. That may have been the basis of the reassurance your doctors have given you. You can see more datails about the so-called ‘soft markers’ by clicking here:

Water infection during pregnancy?

Question:   I'm 11 weeks pregnant and i've been having a severe abdominal pain; my doctor thinks it is an infection. I'm yet to confirm cos the urine test i did ,the result is not yet out. What do you think? R. (Nigeria)

Answer: The description of “severe abdominal pain” is making me wonder whether this is really a urinary tract infection (UTI). This type of infection does not tend to present this way. You have not said whether you have any other symptoms such as urinary frequency and urgency, burning sensation when passing water or loin pain. In any case, trying to rule out a UTI is a logical move on the part of your doctors since this is a fairly common infection in pregnancy. If you have other symptoms (apart from the pain) that are strongly suggestive, it would be reasonable to start you on a broad spectrum antibiotic even before your urine culture results are available.

Confirming miscarriage

Question:  I've been told that I've had a possible miscarriage due to bleeding for 3 days. However, they are unsure as yet and i have to go back in 2 days. I took a pregnancy test and it is positive still,does this mean anything? K.C. (Ireland)

Answer: If the clinical picture is suggestive of a miscarriage, that is most probably what has happened. A pregnancy test can remain positive and in fact will be expected to remain so for several days after a miscarriage has taken place as the pregnancy hormone (beta-hCG) is eliminated from the body. Current test kits are so sensitive that they can detect quite low levels of the hormone. This is why the test tends to remain positive up to a week and sometimes longer after a miscarriage. I would assume that a scan was performed and confirmed that miscarriage had taken place.

Methadone and heroin use and possible pregnancy

Question:   Hi, i am on methadone 80 ml and i still dabble with heroin (iv use). Recently my breasts have become very tender and look bigger also i have been sick every morning at around 6.30am to 7.00am. Around 4 weeks ago i was at hospital with my leg i have a DVT in my left leg and am on 12,500 units  of Fragmin it is since then really that all this has happened. My diet is poor and i rarely eat. Could i be pregnant? H.D. (UK)

Answer: You could very well be pregnant. The symptoms you describe are certainly suggestive. Now, I have to say, if I may, that if a pregnancy test confirms this, you will need to evaluate what you are doing and fast. Fragmin is safe in pregnancy and you will certainly need to continue with this throughout the pregnancy and beyond. The dose may be adjusted at some point but I will leave that to your haematologist and obstetrician. You absolutely have to try and stop the heroin use. This is critically important both for you and your baby (if you are pregnant). This will, in fact, help with your appetite as well and hopefully the diet will improve which is also vital. Methadone will need to be maintained but seeing as you are on a rather high dose, there may be an attempt to bring this down gradually in the course of pregnancy. That is, if this does not create the risk of you lapsing into the heroin dabbling. First things first: Do that pregnancy test.