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Pregnancy Bliss | Reproductive Health Hub

Missed period; negative pregnancy test

Question: My period is 8 days late done a test which is negative been getting a pink reddy mucous stuff when i go the toilet. Just hoping you could let some light on this for me thank you. K. (UK)

Answer: If there are no other symptoms such as abdominal pain etc., my advice will be to wait and see. It is possible you could still be pregnant despite the earlier negative pregnancy test. If no proper period has arrived, I would suggest that you repeat the pregnancy test a week after the last one. If that too is negative , then you are unlikely to be pregnant. If the repeat test is positive, even if faintly so, you will need to see your doctor promptly especially if there is still this brownish vaginal discharge.

In some cases, that is an early sign that there is something wrong with the pregnancy and that could include such conditions as an ectopic pregnancy or a missed miscarriage. I hope it all turns out well for you.

Implanon reliability

Question:  Last year I conceived with the pill and had to have an abortion. I have been advised to try the implant as the coil is not agreeing with me. How reliable is it? P.H. (UK)

Answer: I am sorry to hear of your failed contraception. I am not sure what you mean by the coil “not agreeing” with you. If you have been having menstrual irregularities with the intrauterine device (coil), you may need to think carefully about going for the implant which I think is Implanon. This too can be associated with erratic, sometimes heavy, vaginal bleeding.

There is no question about its reliability as a contraceptive. Implanon is one of the most effective long-acting contraceptives out there. However, for a woman with a history of menstrual problems, it may not be the ideal choice. In such a situation, Mirena intrauterine device is arguably a better option. Both these are discussed in more detail here:

Identical twins

Question:  My scan shows that the twins I am carrying have separate sacs. Does it mean they are not identical?  S.R. (India)

Answer: That scan does not answer that question one way or another. If the scan shows that they are in separate sacs but are sharing a placenta, something that will be termed ‘monochorionic’ in medical parlance, then they are definitely identical. If they have separate placentas, they could still be either. That is, unless they are found to be of different sex, in which case they are obviously non-identical.

Superficial pain during sex

Question:  I had a baby five months ago. Since then, I experience sex every time. There is this sharp pain at penetration which makes it difficult to continue. I never used to have this problem even during pregnancy. Do you think there was damage down there? Please help! K.C. (Bahamas)

Answer: I am assuming you had a vaginal delivery. You probably had an episiotomy or a tear that needed to be repaired; you have not said. If that was the case, it may be that the scarring that resulted from the repair has changed the anatomy somewhat and created a rigid area that does not give as normal during coitus. You clearly need to be examined by your doctor. If what I am suggesting here is the cause of these problems, it is normally easy to correct with a small operation. You do need that physical examination.

Echogenic bowel on 20 weeks ultrasound

Question:  Hi, I’ve just had an ultrasound at 20 weeks and 4 days and the report says there is Grade 2 echogenic bowel. What is this? They were really non-committal and I can’t see my OB till Monday. Should I worry? S (USA)

Answer: A detailed scan in the mid-trimester, usually around 20 weeks, is meant to assess the state of all major organs and limbs and bowel falls in this group. Roughly 1% of all babies are found to have what is described as ‘echogenic bowel’. This is a descriptive term meaning that the bowel is appearing almost white (like bone) rather than the normal grey. The majority of these babies will be normal without any problem.

However, echogenic bowel has been associated with several conditions which include chromosomal anomalies such as Down’s syndrome, viral and other infections including cytomegalovirus (CMV) and Toxoplasmosis. Other conditions associated with echogenic bowel are cystic fibrosis, growth restriction, thalassemia and even bleeding. It is therefore vital that you see your obstetrician for a proper look at these findings and assess the likelihood of them being significant. If that is judged to be the case, further tests will be recommended on the basis of what the most likely explanation is. Best wishes.

Early pregnancy painless bleeding

Question:  I'm 7 weeks pregnant now and I've been to the doctor, the baby has a heart beat and everything was fine. But I'm experiencing a very light bleeding something similar to a mucous membrane from the vagina without any pain from today and I'm a little bit worried. Can you tell me what that might be? S. (Macedonia)

Answer: Early pregnancy vaginal bleeding, typically light and painless, is unfortunately fairly common. In the majority of cases, it resolves quite quickly within hours or a day. This type of bleeding is usually innocent and does not affect the well-being of the pregnancy. However, if the bleeding is persistent and/or accompanied by abdominal cramps or localised lower abdominal pain, that is likely to be more significant. In any case, the significance of any early pregnancy vaginal bleed cannot be definitively judged unless an ultrasound scan is done to check the status of the pregnancy. This is the case even if an early scan showed everything to be normal as is the case with you. Balance of probability here suggests your pregnancy is OK. However, final confirmation can only come from a scan.

Implanon insertion. The contraceptive implant is very effective but some women do experience an erratic vaginal bleeding pattern especially in the first few months.

An episiotomy repair scar can cause pain during intercourse (dyspareunia).  Such a problem is relatively easy to correct.