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Pregnancy Bliss | Reproductive Health Hub

Previous blighted ovum

Question:   Hi, I recently had a miscarriage two months ago due to a blighted ovum at 6.5 weeks. I also have PCOS which makes it very difficult to conceive. I have now found out that I am pregnant with baby no 2. I have not had a period in between my pregnancy and miscarriage but believe I am around 4 weeks. However I'm really concerned as I'm not really experiencing any pregnancy symptoms apart from feeling tired. When I was pregnant with my daughter I had severe all day sickness and couldn't handle any smells, which would indicate a level of pregnancy hormone. However just a bit worried that I'm going to be told I have another blighted ovum as I didn't particularly get any severe pregnancy symptoms two months ago either before I had the miscarriage. Do you think this is normal or could there be a high chance that I have another blighted ovum in this pregnancy as well due to my PCOS and that the immature eggs that this creates due to hormone imbalanceis not able to sustain cell division at conception accordingly. Many thanks. V. (UK)

Answer: Pregnancies can behave in completely different ways even for the same individual. One’s experience of a pregnancy can differ markedly from the next. It is actually not true that an anembryonic pregnancy (blighted ovum) does not exhibit the common early pregnancy symptoms. Even though no baby develops in such a pregnancy, the rest of the pregnancy unit is there and it is this tissue that produces the pregnancy hormone responsible for the symptoms. Now, you may have had little or no symptoms in your last pregnancy affected by this but that does not mean the experience was because of it being a blighted ovum. it is possible things may have been the same even if everything was normal.

You are right in saying that women with polycystic ovarian syndrome (PCOS) are, on average, at higher risk of early pregnancy loss. This is therefore a significant factor in your case rather than the previous blighted ovum. Blighted ovum does not have predilection to recurrence. Seeing as you are uncertain about the dates and as you are understandably anxious, it would be worthwhile to see your doctor so an early scan can be arranged. This should ideally be in 2 weeks time when, by your reckoning, you should be around 6 weeks gestation. An earlier scan is possible but should it turn out to be too early to define what is going on, that will only heighten anxiety.

Novamox (Amoxicillin) in early pregnancy

Question:   Hi, I am 22 weeks pregnant and my doc had put me on NOVAMOX 500 and DICOLIN NOSE DROP for upper respiratory infection. Dose is for 7 days, 21 caps.But I am really worried to take those medicines but I had started the course. Any suggestions about its effect on unborn baby? B.G. (India)

Answer: Novamox is a brand name for a common and popular antibiotic the generic name of which is Amoxicillin. Amoxicillin is a completely safe antibiotic at any stage of pregnancy. You can therefore take this with peace of mind. I am not familiar with the other preparation you mentioned (Dicolin nasal drops) nor could I find it mentioned anywhere in the appropriate pharmaceutical literature. I am therefore not in a position to comment on that.

Brownish vaginal discharge in early pregnancy

Question: I am 6 weeks pregnant today. Last saturday i had a slight change in the colour of my discharge (light brown) it lasted about an hour this then happened again yesterday. This morning i was constipated and as a result i had a light bleeding from my vagina which stopped almost straight away. I have no abdominal pain. This is my second pregnancy. At 5 to 6 weeks in my first pregnancy i had a very short spot bleed and waited for 1 week t find out if we had a heart beat via ultra sound. Should i contact the early pregnancy unit at my local hospital as before or should i just wait? R.(UK)

Answer: There are features here which, though apparently mild, would inevitably cause some degree of anxiety on your part. Vaginal bleeding in early pregnancy, however light or brief, should ideally be actively investigated. Seeing as you are already at a stage (6 weeks) where an ultrasound scan will give clarity of what is going on, I would advise that you arrange to have  this done straight away.

From conception to implantation

Question:  How long after intercourse does implantation take place? O. (Nigeria)

Answer: As long as the egg is already released, fertilization will take place within seconds of ejaculation into the vagina. The process of the fertilised egg undergoing multiple divisions starts within about 24-30 hours after the fertilization.

This fast dividing ball of cells travels along the fallopian tube towards the womb cavity. Implantation starts taking place within approximately seven days of fertilization and will take about another week to complete.

Endometriosis, fertility and cancer

Question:  I have been found to have endometriosis and doctor says I need to have this treated before trying for a baby. What’s your opinion? Is it true that endometriosis can cause cancer? Thanks. E. (UK)

Answer: The doctor’s advice is sound. However, this cannot be generalised. You have not said how the diagnosis of endometriosis was reached. Whilst you can suspect endometriosis on the basis of the signs and symptoms, the only way you can confirm the diagnosis is by having a laparoscopy and actually visualising the endometriotic lesions. Scans are helpful but not confirmatory. When endometriosis is severe (as seen at laparoscopy), that can negatively impact on the ability to conceive and carry a pregnancy successfully. In such a case, surgical treatment will help improve fertility. Medication used to treat endometriosis is very good in alleviating associated symptoms but, significantly, does not improve fertility. It is therefore important to be very clear about what you want and the type of treatment offered. This is particularly important because a course of medical treatment takes an average of 6-9 months. The benefit from surgical treatment is instant.

Regarding the second part of your question, it is arguably a bit of a stretch to say ‘endometriosis causes cancer’. It is, however, true that there is a slight increase in the lifetime risk of some forms of ovarian cancer. This increase has been observed when endometriosis is severe and directly affecting the ovaries. The overall absolute risk remains small and, it is important to make it clear here that there is no firm evidence of a direct cause-effect relationship between endometriosis and cancer.