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Pregnancy Bliss | Reproductive Health Hub

Using hormones after a miscarriage

Question:  After suffering consecutive miscarriages, how about taking estrogen and progesterone before you think it is advisable. I really want to do my bit in preventing future miscarriages since i have already had 3 in the past. O. (Nigeria)

Answer: Whilst completely understandable, desperation is the last thing you want to allow following what you have experienced. That can make you do things which actually make the realisation of your goal even more difficult. Using either of those hormones before conception will achieve exactly that. Remember, estrogen is the hormone that is used in the standard contraceptive pill. It will prevent ovulation and therefore, effectly, prevent conception. Likewise, progesterone is the hormone that is used in the so-called ‘mini-pill’. It is likely to have the same effect. Stay away from any hormonal preparations whilst trying to conceive. Once you have conceived successfully you can use low-dose (daily 75mg) Aspirin and/or low molecular weight heparins such as Clexane or Fragmin. This may be useful even if there is no laboratory proven anti-phospholipid syndrome or Thrombophilia syndrome. Artificial hormones have no role to play. My best wishes.

Spotting in early pregnancy

Question:   My wife has been spotting for about 5 days. Her doctor saw her and recommended a scan which was done and the result revealed viable fetus. However, the bleeding though not regular but accompanied by lower abdominal pain. Please, what is your advice? D.I. (Nigeria)

Answer: What your wife is going through is what is generally termed as ‘threatened miscarriage’. Once a scan has confirmed viability, there is nothing for the mother or doctor to do other than wait and see. There is no intervention of any kind that can influence the eventual outcome of a threatened miscarriage. The positive in all this is that the vast majority of all cases of threatened miscarriage do resolve their own and the pregnancy carries on as normal. Your role is just to be supportive and hopefully everything will be alright.

Anaemia and home birth

Question:  I am a vegetarian. Baby due on aug 23 (just over 2 weeks away). I was diagnosed with anaemia 2 months ago.  Taking iron tabs but have had very loose stools since being on them; what can I do ? Doc says anaemia has not improved . Should I still have a home birth ? D.H. (UK)

Answer: It does indeed sometimes happen that oral iron supplements fail to correct anaemia and this appears to be the case with you. It is now really too late to correct the anaemia before the baby arrives as you should be delivering by 42 weeks at the latest which is a month away. It means you have to work on the premise that you will be anaemic when you go into labour. One of the cardinal rules of a home birth is that it should only be undertaken when there is no identifiable risk factor. You have not mentioned how low your blood count is but I would assume it is significantly low. If that is the case I would certainly firmly advise against a home birth. Delivery does not necessarily result in significant blood loss but were this to happen when you are away from the hospital and ready availability of blood, it can be truly life-threatening. Have your situation assessed by your obstetrician at the hospital. If they advise hospital delivery, please heed that advice.

Late period; negative pregnancy test

Question:  how do I know if i am pregnant? I got my periods 8 to 9 days late so i m worried if i m pregnant. Did my pregnancy test, it was negative.   T.D. (India)

Answer: You are, most probably, not pregnant. Your period did arrive albeit late and the pregnancy test is negative. Both these facts point strongly to your not being pregnant. Late periods may be uncommon for you but many women do experience these from time to time. Moreover, modern pregnancy tests are quite sensitive and therefore rarely give negative results. If you are still concerned just do another pregnancy test, maybe using a different brand. However, from the facts given, I am firmly convinced you are not pregnant.

Termination of pregnancy for fetal abnormality

Question: sister is 5 months pregnant and her ultrasound reports shows that her baby's brain and spinal code are not developed and her doctor suggested her to do abortion she is in hospital. They gave her some medicine in glucose but from last 30 hours her labour pain is after 10 min.

Now she is very tired and axausted..can you please tell me if she can do any exercise or can eat something that can help in getting close towards her labour.if there is any danger in this stage of abortion .... J.

Answer: This reply will probably get to you when the issue has already resolved. I certainly hope so... A very distressing situation for the mother and her family. Termination of pregnancy at that stage which is just after the mid-way stage of the pregnancy can sometimes be a protracted process. It is difficult for anybody remote from the patient to advise relatives on what should be done to expedite the process. Every hospital will have its protocol on how to deal with this sort of situation.

I would therefore want to leave it with your doctors as they will know best on how to help her. Hopefully the ordeal will be over soon so she can start grieving for her baby without being in physical distress. Just as a matter of academic discourse, in most western hospitals, late terminations of pregnancy such as this are performed using prostaglandin preparations, given orally or vaginally. This is, in fact, preceded by a single dose of an oral tablet of an anti-progesterone medicine called Mifepristone administered 48 hours before. Typically, a woman will go home after she has taken Mifepristone and come back to the hospital for the Prostaglandin preparation. Once the prostaglandin preparation (usually Misoprostol) has been given, the abortion will be expected to complete in 12-24 hours. Mifepristone is also known by brand names Mifiprex and Mifegyne in some countries.

Light vaginal bleeding at 12 weeks pregnant

Addendum:  i am 12 weeks pregnant and having a light bleeding... i cannot go to doctor or any there any home remedy for this??please answer me as soon as possible.. I'll b grateful.. A. (UK)

Answer: OK, this sound like threatened miscarriage. As a rule, there is nothing that needs to be done in threatened miscarriage as you cannot influence what happens eventually. The bleeding does eventually stop but unfortunately for 1 in 10, this sort of development is a prelude to pregnancy loss. If this was going to happen, nothing can be done to change the course of events. I am, however, a little concerned about your comment that you cannot go to a doctor or any hospital. I would not want to pry as for the reasons for this but this suggests to me that you probably have not even had a booking scan and therefore do not have the basic information about your pregnancy. Information such as confirmation of the gestation, number of babies, viability etc. If that is the case< I would strongly urge you to find a way of getting medical attention. My best wishes.