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Pregnancy Bliss | Reproductive Health Hub

Could I be pregnant?

Question: I have a question. It has been a month now after everything happened...but I am very paranoid!!! The day after, I drank the morning after pill...and we also used a protection. Might there be a possibility that something did happen??? I know that there might not yet be signs but I want to be sure before I buy a pregnancy test... Is there any other way I can find out??? Feeling for a lump or something? Please help me, I'm desperate. M. (UK)

Answer: Let’s take a sober look at the whole picture. You used protection (presumably a condom) and you used emergency contraception (morning-after pill) the very next day, meaning it was in less than 24 hors. Emergency contraception is most effective the earlier it is taken after the act but is still protective for up to 72 hours. With your case, the possibility of pregnancy is really quite low. As for finding out for sure, now that it has been a month, I think you need to be a little more patient. If your period has not arrived, let’s say in the next one week, you will then have to perform a pregnancy test. That’s assuming you normally have regular periods. No, there is no other way of finding out yourself whether you are pregnant. A ‘pregnancy bump’ cannot be felt abdominally until you are over 12 weeks (almost 3 months).

Bleeding in early pregnancy

Question:  I had a scan at approximately 5/6 weeks, i was told that it was too early in the pregnancy to see and that the nurse could see a thick lining where the pregnancy could be taking place. So she sent me home to come back in a weeks time, my appointment is now in 2 days time however i have been bleeding like a normal period since last night but no serious pain or cramping. Is this a miscarriage? I was expecting to see large clots. M.R. (UK)

Answer:  The kind of bleeding you are describing is a cause for concern. That’s particularly so bearing in mind that your scan at a gestation of 5 to 6 weeks was inconclusive. A vaginal scan can and should, in most cases, show the gestational sac at 5 weeks. At 6 weeks you should certainly be able to see this as well as the so-called ‘fetal pole’ and the pulsation of the fetal heart. A combination of absence of any of these and the bleeding is certainly not a good sign. I am unsure, however, why you went to have a scan at such a supposedly early gestation. Were you having some symptoms even then? All in all, even though this is by no means a foregone conclusion, you should brace yourself for possible bad news.

‘Supplements’ taken in pregnancy

Question:  Now iam 14wks pregnant. I take progesterone 100mg twice daily,aspirin 75mg once, folic acid 500mcg once. For how long should i have these medications? Should i take iron, calcium? S. (Egypt)

Answer: The only time Progesterone supplements have any role to play in the first trimester is when they are used in IVF pregnancies. In spontaneously conceived pregnancy, progesterone supplementation has absolutely no benefit in early pregnancy. In the second and early third trimester, progesterone is employed in cases of threatened preterm labour. In such cases, there is strong evidence of benefit. Outside those described indications, there is no role for progesterone supplements.

Aspirin, where indicated, should be used ideally up to 36 weeks gestation.

Folic acid is advocated in early pregnancy to reduce the risk of neural tube defects such as spina bifida. When used for this purpose, it should be taken quite early and by 7 weeks gestation, it is no longer beneficial for this purpose. However, folic acid still has a role, albeit different, and that is in preventing folic acid deficiency anaemia. For this purpose it can be taken throughout the course of pregnancy. That is, unless you are confident your diet is supplying enough. The same advice applies to iron. Calcium supplements are not routinely required in pregnancy for most people who would have a generous component of dairy products. Calcium is also plentiful in fish and bread. However, if you feel your diet is not giving you enough then supplements in the tune of 1000mg daily could be beneficial. The subject of nutritional supplements in pregnancy is covered here:

Post-coital spotting in early pregnancy

Question:  i am due to have a six week pregnacy scan this coming Friday, this morning was the first time my partner and i had sex since we found out we were pregnant as we feared hurting our new baby in my womb.

I have had light spotting after sex and later today i had a bowel movement and started spotting again... Could i possibly be having a miscarriage? i have been in bed all afternoon resting with hopes of holding my baby safely in the womb. I can't stop crying because this is our first baby and we promised we would never have sex again until after the baby is born, i know this will probably be stressful on our relationship but having this baby is so important to us. Our scan is scheduled to Friday and i telephoned the doctor who advised i should rest and relax until i see him at the end of the week. C.W. (UK)

Answer: Your anxiety is completely understandable. However, I cannot stress  strongly enough how misplaced the blame on the sex you had is. Let me explain: The spotting you are experiencing may have been provoked by sexual intercourse.

However sex does not, cannot and would not cause miscarriage. When you experience bleeding after intercourse, typically light and painless, it is usually local; what will be known as contact bleeding. The source is usually cervical, usually because of presence of cervical ectropion (erosion), a condition particularly common in pregnancy. This is discussed in more detail here: This kind of bleeding has absolutely no bearing on the well-being of the pregnancy. I suspect this is what is going on with you. Of-course I cannot be sure and you will have clarity when you have that scan but that is the impression I’m getting here. Should you be staying in bed? The answer is a firm No. Bed rest has no role to play in true or perceived threatened miscarriage. It does not make any difference. In fact, there is a possibility it could be counter-productive by worsening the anxiety. I hope it all turns out alright with your forthcoming scan. I would urge you to re-consider your vow on sex and I’m sure your doctor will tell you the same thing.

Gestational sac disappeared

Question: i had a scan on the 11 of Feb they found 3.4mm gestational sac and 4.5mm yolk sac but no heartbeat.then on the 14 of feb i did a urine test which show the second line is not clear. And on the 3rd of March i had scan again which the doctor told me he could not see anything and the urine test is negative.what had happen i did not bleed at all. Thanks. A. (UK)

Answer:  That’s rather unusual. Your description of the initial scan findings suggested an early pregnancy failure, either as a ‘missed miscarriage’ or a blighted ovum (anembryonic pregnancy). In either case, unless a surgical evacuation is done, some degree of vaginal bleeding is expected as the miscarriage eventually concludes. I cannot therefore understand how the apparent gestational sac seen could have just disappeared. The only possible explanation for that I can think of is if the described sac was a false one, the so-called ‘pseudosac’ which can just resolve and disappear. In any case, the measurements you have given here are clearly wrong. The gestational sac (3.4mm)is given as being smaller than the yolk sac. That is not possible since the yolk sac is contained within a gestational sac and tends to be significantly smaller. Your second scan as well as the negative urine pregnancy test have certainly confirmed that you are no longer pregnant. It is however difficult to logically explain the earlier findings.