Question: My last period was 21st Feb. As at 26th March, my period had not come. A pregnancy test kit result showed POSITIVE. From the 26 March to date, i have had severe abdominal cramps with dark brown discharge. The doctor did a scan an said the womb is empty but i will be doing another scan it two weeks’ time. He has prescribed Primolut depot and recommends bed rest. This morning, there was a heavy dark brown mucus discharge when i passed urine. What can be happening to me? M.P. (Ghana)
Question: I am 30 weeks Pregnant, I was 50kg till 4th month.now am in 8th month now my weight is 63kg. Why such rapid increase in weight? During 6th month in scanning baby was normal and the weight of the baby was 650g. My bp level is 100/60 and my blood sugar level is 54 before taking food and 105 after eating but i have some traces of sugar in urine. Some say that increase in weight shows the sign of girl baby.Is it true? How can i control my weight. Should i follow any diet? S. (India)
Answer: You have raised a number of issues here. A weight gain of 13kg in 4 months is certainly excessive. The most likely explanations is that your diet has been quite high in calories and therefore your intake is much more than what you are expending. There is sometimes a mistaken belief during pregnancy that a pregnant woman should ‘eat for two’. As a result, the person is encouraged to eat bigger quantities than normal and the food may be rich in fat. That is a mistake and can lead to excessive weight gain. There is no specific diet to recommend other than to ensure a healthy and balanced diet.
Question: My daughter had a postpartum abscess 24hrs after an emergency section. Her waters broke 4 days earlier but was leaking rather than a full break so was booked in for delivery on the fourth day but was delayed as delivery suite was busy and was sent to the delivery suite the following day. Things went wrong and a section was done. Everything seemed fine but about 48 hrs later was given a blood transfusion, This did not help and her health deteriorated suddenly and was sent for an urgent scan which showed a huge mass in the womb/pelvic area. She underwent an emergency operation and they found a huge abscess, the size of a melon. She lost her womb and cervix, but barely survived. She later had two other abscesses in her back. we need some feedback as to what was the possible causes, that is all as we are not getting any answers from the hospital. She is still suffering abdominal aches. She was in hospital for 5 weeks and her baby is now 12 weeks. I want to know if I'm worrying too much. Her baby needs her as does her partner. L.C. (UK)
Answer: This was, undoubtedly, a major complication following the caesarean section. From the details given here, it appears to me that there was concealed bleeding following the caesarean section. This would have led to the discovered anaemia, probably with falling blood pressure, leading to all those tests. The scan would have shown the accumulated blood in the pelvic cavity that prompted the emergency surgery. This is where it is rather difficult for me to know what transpired during the operation to lead to a decision to perform an emergency hysterectomy. It is possible they found that the haematoma (the accumulated blood) was massive with evidence of infection already. That may be the reason why this was described as ‘an abscess’. That being the case, they may have found that the uterus too was involved in the infection and it was deemed unrealistic or even risky to try to conserve the uterus.
Alternatively, they may have evacuated the infected haematoma and discovered that there was ongoing bleeding from the uterus which they could not control effectively, a situation which can ultimately be solved by actually removing the uterus because, at that stage, it is immediately life-threatening. I’m sorry if this appears non-specific but, in the circumstances, I have had to make a few assumptions as I do not have the fine details of what transpired. As for the future, bearing in mind that your daughter had just undergone two emergency major operations and survived a massive infection, it should not come as a surprise that, 3 months on, she is not back up to her old self. This is, in addition to the fact that she has an infant to look after. After 12 weeks she is almost certainly on her way to full recovery. One thing I would advise is that she should arrange to have a bllod test to ensure normal ovarian function. Following a hysterectomy and especially an emergency one, there is a small risk of getting premature ovarian failure within a few months of the procedure. It is therefore prudent to get that checked a few months down the line. It is a simple hormone profile blood test and her GP should be able to do that. My best wishes.