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Pregnancy Bliss | Reproductive Health Hub

Wrong dates or evolving pregnancy loss?

Question:  31st of December was my LMP but I only got a positive pregnancy test confirmed on 27th of Feb after weeks of testing. I went for an early scan yesterday and was told my dates must be wrong as all that was showing was a gestational sac & yolk sac so more likely 6 weeks. I am to go back in a week’s time for a re-scan. I had an early miscarriage in November 2009 and am concerned the same thing is happening again. Please advise. Thank you. S. (UK)

Answer: This is a situation where it is extremely difficult to be sure as to what is going on until you have had that second scan. Working on the assumption that yours is a regular 4 week menstrual cycle; by your dates, you are supposed to be well over 10 weeks gestation and a scan should have no difficulty in picking up the fetus at such a relatively advanced stage. On the other hand, you may have conceived much later that you assume hence the previous repeat negative pregnancy tests and the findings on the scan. It will not be helpful for me or anybody else to speculate and despite your understandable anxiety, the most reliable source of clarity has got to be that planned repeat scan. My best wishes.

Coming off heroin during pregnancy

Question:  If heroin abuse is stopped at the fifth month and no other drugs or medication are taken, what are the major effects on the baby and what is to be done so that the risk gets minimal? L. (Albania)

Answer: Like all opioids, heroin use in pregnancy can be a major problem for the baby especially after delivery. Withdrawal symptoms can be quite severe and distressing. In many countries where management of abused drugs is handled with the help of specialists, a controlled substitute is used instead of heroin. Methadone is the commonest drug used instead. If it is found to be possible and ideal to wean the individual off this in pregnancy, this is done within the second trimester. Five months (22 weeks) is right in the middle of the second trimester and, with the right overall circumstances, it will be the right time to come off the drug. Whenever possible, the woman in question should have an expert in this field helping her so that the project is handled properly and is successful. A successful wean off heroin can only be positive for the baby. On the other hand, should she fail to come off in the second trimester, a complete stop late in the third trimester is not advised as withdrawal symptoms for the baby in the womb could be quite severe.

Pregnancy after a miscarriage

Question:  I had miscarriage in November (4 months ago) and had to evacuate the baby. Since then i have been scared cos i don’t know my chances of getting pregnant again and what to do next. C.B.

Answer: Following a miscarriage, the body can be ready to carry another pregnancy in less than a month. For most women who have a miscarriage, ovulation resumes within 4 - 6 weeks. You said you had to have an evacuation of the womb as treatment. This is probably the commonest form of management of any incomplete miscarriage in hospital. The form of management you receive is not important in deciding the timing of your trying for another baby. Your body is ready and has been for sometime. If, emotionally, you feel ready, you can start trying. There is absolutely nothing to stop you.

Pregnancy symptoms without a pregnancy

Question:  After 14 weeks of pregnancy, a scan was conducted but the result states that there is not obviously pregnant view.and almost all the pregnancy symptoms are noticed such as broad areola, abdomen shooting out,frequent urination etc. What is the cause of this? U.T.

Answer: You have started your question by stating that “after 14 weeks of pregnancy...”. This indicates to me that you are still convinced that you are/were pregnant. Yet, a scan has shown no evidence of pregnancy. You have not said whether a urine (or blood) pregnancy test was done at any stage. If it was, what were the results? If a pregnancy test was negative, this could very well be a case of a ‘phantom pregnancy’ which we have discussed in detail here: Another possible explanation of absent periods could be excessive production of a hormone called prolactin. Prolactin is responsible for milk production.  

If a pregnancy test was positive, then there is a distinct possibility we could be dealing with a pregnancy outside the womb which can conceivably be missed on the scan at this relatively early stage of pregnancy as the person scanning will be looking in the ‘wrong’ place. Abdominal pregnancies are rare variants of ectopic pregnancies but we should always be aware of their possibility.

Ampicillin and Ampiclox and breast feeding

Question:  Can I use Ampicillin and Ampiclox while breastfeeding? S.A. (Nigeria)

Answer: Both ampicillin and ampiclox belong in the broad group of ‘Penicillins’. Penicillins are safe to use whilst breast feeding. You can use either with peace of mind.

Mallory Weiss syndrome complicating pregnancy

Question:  Can Mallory Weiss syndrome occur in pregnancy? If so, what is the line of treatment? N.A.H. (Saudi Arabia)

Answer: Mallory Weiss syndrome can certainly occur in pregnancy and case reports have appeared in the medical literature from time to time. However, it is quite rare. Any condition that can cause violent retching or vomiting could lead to Mallory Weiss syndrome and these conditions can and do occur in pregnancy. In some cases, a woman may have an underlying condition such as scleroderma with gastrointestinal involvement. This could predispose to Mallory Weiss syndrome. If this complication was to occur in pregnancy without an apparent predisposing factor, management will be supportive only since the bleeding from an otherwise healthy oesophagus is mild and self-limited. The lacerations causing the bleeding tend to be quite superficial in the absence of varicosities.

Aching legs; swollen ankles in late pregnancy

Question:  I have a dull ache in my legs and is lasting all day. I’m 30 weeks pregnant and have been getting swollen feet/ ankles too, is this ok? G.C. (UK)

Answer: What you are describing is a fairly common occurrence in late pregnancy. When the ache is in only one leg, that can be a cause for concern as conditions such as deep vein thrombosis (DVT) need to be excluded. However, if you feel the ache in both legs, more or less equally, chances of a DVT being the cause are practically zero. The swelling of feet and ankles are usually a result of the slowed blood flow in the lower limbs. You may find that wearing support stocking helpful in this regard.