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Pregnancy Bliss | Reproductive Health Hub

Unsure whether pregnant

Question: Hi, after missing my periods for seven days, i got terrified by a noise n started bleed with a mild lower abdominal pain. the bleeding was unusually little. i have had few symptoms of pregnancy like fullness n paining of breasts, skin is very sensitive, craving for food, vaginal discharge, tiredness, n vomiting. i still have some of those symptoms. I did a USG test and was told that nothing can be seen. i appreciate if you could tell me whether I’m pregnant or had an early abortion or am i still pregnant. what advice can u give regarding this? When i did home pregnancy test, though it wasn’t positive, a well defined pinkish area was seen below the control line. If hcg hormone is absent will there be any pinkish area like that? I’m so confused. Please help me on that. S. (Bangladesh)

Answer:  I have read your details carefully and my firm impression is that you are not and most probably have not been pregnant. In other words, you have experienced a variation in your periods pattern but this was unlikely to have been due to pregnancy. All the symptoms you have described are not specific to pregnancy and are not unusual in cases of an unusually prolonged cycle. You said you had an ultrasound (USG) which showed nothing. You are probably aware that if a pregnancy is less than 5 weeks gestation, nothing will be seen. Regrettably, I am unable to comment on your urine pregnancy test strip because I do not know which type you used. Some of these are not specific enough to the pregnancy hormone and there could be some mild cross-reactivity with other hormones you have in your body. If you are convinced that you are very likely to be pregnant despite this evidence to the contrary, the best thing to do is to ask your doctor for a blood test to check levels of the pregnancy hormone beta-hCG. If this is negative, you can be certain you are not.

Worried about possible toxoplasmosis infection

Question:  I am 6 weeks pregnant and recently had to stay in a farmhouse that was pretty infested with mice - lots of droppings in evidence and a noticeable smell of urine. The place was very dirty and dusty and, whilst I tried to be careful with hygiene, I did sleep over night there and ate food prepared in the kitchen. I am now highly anxious about having contracted toxoplasmosis or LCMV, but will have to wait 3 weeks until they show in my blood. Am I likely to be infected and should I immediately take spiramycin as a preventative measure? Any advice gratefully received. H. (UK)

Answer: It is probably unlikely that the conditions you describe would have put you at increased risk of toxoplasmosis infection. Even though the presence of rodents may appear grim, it is not really the risky situation as far as toxoplasmosis is concerned. Members of the cat family are the main host of this infection and the most likely way of getting it for humans is to handle cat-litter and failing to observe proper hand hygiene or eating undercooked (or raw) meat that happens to be contaminated. It does not appear that any of those risk factors were present here. You should certainly not take Spiramycin.

Lymphocytic choriomeningitis Virus (LCMV) infection is a different matter. Rats are certainly the main culprit when it comes to LCMV. However, it is also the case that this infection in pregnancy is quite rare. In fact it is so rare that when it happens, it is usually published as a ‘case report’ in medical journals. Odds are therefore that you and your baby are OK.

A baby at 41?

Question: I’m 41 and would like another baby. Am I too old? K.B. (UK)

Answer: This is not a yes or no question. Every individual’s circumstances are different and you cannot give a blanket advice. If we were to take just the narrow view of age alone, it is certainly not uncommon and imminently possible to aim for motherhood at 41. You will need to be aware that conception may not come as easily at that age because of the expected less than regular ovulation at this age. There is also the quality of eggs. Once you go into your late 30s and beyond, the eggs produced are not of the best quality and the risks of both pregnancy loss and chromosomal abnormalities are increased. It is important to have a proper perspective of this information: Chances of having a healthy baby still far outweigh the possibility of the mentioned complications. As I said before, this is just a narrow look at age alone. You should take into consideration your other circumstances such as general health and your previous pregnancy history.

Severe anaemia in late pregnancy

Question:m  My niece is 38 weeks pregnant has iron level 7.3 she is "allergic" to iron but has found one supplement that she can take. Midwife has said she will have to have a blood transfusion, how can this affect the baby, how is it done, when is it done (before or after birth)? she is very worried please advise, thanks. M. (UK)

Answer: Your niece’s anaemia is quite severe and, for a person about to have a baby, even life-threatening. With a haemoglobin level of 7.3g/dl, any substantial blood loss at delivery could provoke a major crisis. This is no exaggeration.

She should certainly heed the advice of her midwife and have that transfusion. At 38 weeks it is already too late to correct the anaemia using iron anyway, even if she did not have issues with the supplements as you seem to suggest. The transfusion will be offered as soon as possible, ready for delivery. In any case, her iron deficiency will need to be corrected since the transfusion is a stop-gap measure to tide her over the forthcoming labour/delivery. She should therefore continue taking the iron supplement that she has found tolerable as a long-term measure. Blood transfusion is given through a vein and, in her case, the process may last a whole day because, I suspect, she will be given a minimum of 4 units. The baby is perfectly safe.

Bleeding in early pregnancy

Question:  If you are pregnant for the first time and you start bleeding in the 9th week is it normal?The bleeding is not continuous it alternates. A.B.S. (Ghana)

Answer: No bleeding in pregnancy, at any stage, is normal. What you are experiencing is what is generally termed as threatened miscarriage until proved otherwise.  In the vast majority of threatened miscarriage cases, the bleeding resolves spontaneously after a variable length of time. To know what exactly is going on you will need to have an ultrasound scan done. If such facilities are not immediately available, it may take up to 14 weeks gestation before the fetal heartbeat can be heard abdominally.