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Pregnancy Bliss | Reproductive Health Hub

Threatened miscarriage at 9 weeks

Question:  I had a small painless bleed that stopped within 8 hours, the hospital gave me a scan that showed that my baby had a healthy heartbeat and was the right size for 9 weeks. I went in the next day for some blood tests and the doctor rang and told me that my hormone level had dropped slightly and it did not look good and to prepare myself for a managed miscarriage. I've not had any more bleeding and there has been no pain, am I still miscarrying? F.C. (UK)

Answer: I am not sure why the blood test for the pregnancy hormone, presumably beta-hCG was done in the first place. I am also unsure what they mean by the hormone level dropping. That will require doing the test twice, usually two days apart. Was this what happened? If the scan showed normal expected findings with the baby at the normal size for gestation and a normal heartbeat, there should have been no need to repeat the hormone test. This is therefore puzzling for me. I  would say however that, on the face of it, a normal original scan a few days ago and absence of any further bleeding would tend to bode well for the pregnancy. I would expect that your doctors intend to perform another ultrasound scan, probably a week after the last one, to assess fetal wellbeing. My best wishes.

Expressing milk for the baby

Question:  should expressed milk be used at same time it was expressed. ie if expressed morning should it only be only given in the morning? D.M. (UK)

Answer: Expressed milk, if stored properly, can stay fresh for up to 5 days. Most women who are keen to breast-feed express milk for use at times when they may be away from the baby so somebody else can feed the baby using the expressed milk. Milk can also be expressed and kept in deep freeze and this storage is effective for months. Ways of expressing and storing milk is discussed in more detail here:

Does Isotretinoin (Accutane) have effect on sperm?

Question:  my partner has HS and has been on a combination of antibiotics for over 2 yrs we are now wanting to start a family. He is currently on co-amoxiclav but then has to change to isotretinoin. Will these affect our baby? M. (UK)

Answer: I am assuming by ‘HS’ you are referring to hydradenitis suppurativa. Co-amoxiclav, a common antibiotic more popularly known by the brand name Augmentin is a combination of AmAccutane (Isotretinoin) and pregnancyoxicillin and Clavulanic acid. It is completely safe to use by the male partner during the time of trying to conceive. Isotretinoin, usually used for severe resistant acne but also occasionally used (for a short duration) in hydradenitis suppurativa is completely contra-indicated for a woman trying to conceive or one who is already pregnant. It is strongly associated with birth defects. However, this advice does not extend to the male partner. Studies have shown that it does not affect the sperm. Moreover, even though some of the drug does find its way into the semen, this is in exceptionally minuscule quantities, less than a millionth of the normal dose. This is believed to be safe.

Ascard use in pregnancy

Question:  Can i use pregnacare plus with ascard 75 mg throughtout my pregnancy???i had a missed misscarriage my doc has prescribed to take ascard from the very starting of pregnancy. N. (United Arab Emirates)

Answer: You can indeed use Ascard safely in pregnancy. Ascard, as you may know, is a brand name for Aspirin. Low-dose Aspirin at 75mg daily is recommended for mothers who may be prone to early pregnancy loss or who are known or suspected to have anti-phospholipid syndrome (APS) or thrombophilia syndrome.

As your doctor advised, you should ideally start taking this immediately after confirmation of pregnancy which should be around 5 or 6 weeks gestation. You should not take this before conception. Pregnacare is, of-course, a combination of nutritional supplements and nothing more. There is no harm in taking this.

Trying to conceive; irregular periods

Question:  was on Noristerat 4 2yrs,last jab in Feb 2011. Used an iucd til sep 2011,have been trying 2 get pregnant since then. My periods r varying cycles every month varying from 21 - 35 days. Its been 9 months trying 2 conceive,what could b the problem?

Answer: There isn’t necessarily a problem. You have not said whether you have been pregnant before. In any case, nine months of trying would not be regarded as an excessively long time. The only aspect of the brief details provided that could be significant is the pattern of your periods. There does appear to be a wide variation in the length of your cycles. That may potentially signify that you do not ovulate regularly. It may be an area that you could look at yourself using ovulation kits now widely available. If I had more information about you such as previous pregnancies, age, weight and general health I might have been in a position to be more helpful. In any case, with the little that you have provided, there does not appear to be any significant problem.

The warning for female patients using Accutane (Isotretinoin) is explicit. This does not apply to male patients