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Pregnancy Bliss | Reproductive Health Hub

Bleeding after a miscarriage

Question: I had  two miscarriages, i  had  second miscarriage  recently. I want  to  know if it is normal  i had  a  bleed  only  3 to 4 days but  i  get  a  pain. So  could  u  tell me,  shall  i tell GP why i  got  a bleeding  only  3,4 days? I was  pregnant only  4 weeks.  Thx.  Waiting  for ur  reply. S. (UK)

Answer: Bleeding after a miscarriage can certainly last only a few days. Three or four days is not unusual especially after such an early miscarriage. When miscarriage is complete, meaning there is no pregnancy tissue retained inside the womb; bleeding should last no longer than a normal period. If you are getting lower abdominal or pelvic pain or you are having an abnormal discharge, that will be a valid reason to see a doctor and that should happen promptly. In the absence of that, there is nothing to worry about.

Late period; brown vaginal discharge

Question:  I had a miscarriage 2 months ago. i got one period after it but i am 3 days late this month and for the past 5 days I’ve been getting brown discharge. What does this mean? J. (Ireland)

Answer: I am not sure I understand the train of events correctly. You say your period is late by 3 days, yet you have been having a brown (vaginal) discharge for 5 days. I take it this means the discharge started 2 days before your period was due. It is difficult to say for certain whether this is just a change in the pattern of your periods or whether you have conceived again and this (the discharge) is a symptom of threatened miscarriage. My view is that, if you have not seen any menstrual flow, your first action should be to do a urine pregnancy test. If that is negative, at least you will know you are not pregnant and you can wait and see what happens. If it is positive, you will need to get seen by a doctor promptly.

Metformin dose in early pregnancy

Question:  Please advise... I'm 12 wks pregnant; type 2 diabetes, on metformin 500mg 2x a day and insulatard 3 units at night. I think I double dose my metformin this night because I dont remember if I already took my tablet, then later on I took another 2 tab, but i did not take my insulin. Any effect to my baby? E.P. (UK)

Answer: It is only in the last few years that Metformin has been used in pregnancy. This was after extensive studies showed that it is actually safe to use in pregnancy. This was a major boost for pregnancy care for women with diabetes since the condition can sometimes be fairly problematic to manage. Yes, Metformin does cross the placenta but this is rather complicated. There is no passive transfer. What this means is that, the dose you take does not directly reflects what gets to the baby. In fact, concentrations of Metformin tend to be higher in the mother’s circulation compared to the baby’s. This is because there is an active mechanism of pumping this back from baby to the mother. There is also the fact that you are actually on a fairly low dose anyhow. Most pregnant women on Metformin tend to be on between 1500 and 2000 mg daily (in divided doses). To answer your question; even if you have inadvertently taken double your evening dose of Metformin, it is exceedingly unlikely that any harm has been done. You can relax.

Scan and dates discrepancy

Question:  I had my Mirena removed on the 27th Jan, had my period 29th Jan, found out i was pregnant 5th March. My dates came to 6wks 3days when i went for my scan on 15th March but the measurements came back I was 5wks 5days. Only sac and yolk was seen. I go back 25th March for repeat scan but im terrified something will be wrong as i have no pregnancy symptoms anymore, sickness has passed, not peeing as much! Haven’t had any bleeding though. Do you think everything will be ok for me? This will be my 4th child but 6th pregnancy. M. (UK)

Answer: The discrepancy between your dates and the scan findings are not a cause for a great deal of concern. There is only a five day difference and that is well within expectations. What concerns me a little is that at nearly six weeks, there is no mention of a ‘fetal pole’ or a fetal heart pulsation. That will be expected to be seen, especially if a vaginal scan was performed. If there was a gestational sac and only a yolk sac identified within, it raises the possibility that we are looking at a blighted ovum (anembryonic pregnancy) as explained here: it is, however, important to be cautious in making firm pronouncements since this is very early pregnancy and there could be other explanations for these findings including the possibility of the gestation being less than your dates suggest. The logical thing therefore is to wait for that repeat scan which should give you clarity. My best wishes.

Vitamins in pregnancy for the skin

Question:  What are the best vitamins to take for the fetus and mom's skin? L. (Albania)

Answer: Modern medicine can be very prescriptive. There are no specific vitamin or nutritional supplements that you need to take specifically for your skin and fetal wellbeing during pregnancy. That’s a fact. The most honest advice you can get to ensure optimal all-round health when pregnant is to ensure you have a well-balanced diet and of course avoiding noxious things like alcohol and certainly smoking. Any preparation that is promoted to improve skin health in pregnancy cannot be based on solid scientific evidence and may be an out-and-out rip-off. Vitamins and other nutritional supplements and their roles in pregnancy are covered in their specific section here:

Blood in the urine during pregnancy

Question:  I am 12 wks pregnant I have seen a spot of blood in my water this morning. Is that normal? B. (UK)

Answer: Passage of blood in urine at any time cannot be said to be normal. However, it does not always mean there is a serious underlying problem. Often times it is due to an innocuous lesion known as a urethral curuncle right at the outlet of the lower urinary tract (urethra). This little pimple-like lesion which is entirely innocent can bleed quite easily and urine may appear blood-stained as a result. If there are no other symptoms and this turns out to be an isolated event, then it is reasonable to be reassured. On the other hand, were it to happen again, you should bring it to the attention of your doctor or midwife.

‘Avoiding’ a phantom pregnancy

Question:  what can I do to avoid a recurrence of ‘phantom pregnancy’? Secondly, is real conception possible immediately after one has experienced a ‘phantom pregnancy’? This is because I observed my normal menstrual period the following month I experience what the doctor referred to as threatened abortion, of which I had come to realise according to the answer you supplied to my last question that the pregnancy was not a real one but what you referred to as ‘phantom pregnancy’.The reason for this question is because I am presently observing some symptoms of early pregnancy again such as vomiting,spitting of saliva frequently etc. I am also experiencing gradual uterus pain. U.T.

Answer: In phantom pregnancy, the most important milestone in avoiding a similar problem in the future is to realise and acknowledge you have had one. That is the most effective antidote against the risk of being tricked by your mind again in the future. If you are getting symptoms suggestive of early pregnancy and you have missed a period then the best thing to do is to perform a urine pregnancy test. You are clearly keen to get pregnant but, should the test results be negative, don’t ignore or disbelieve the results. This tends to be the case with phantom pregnancy victims. Instead, try to seek medical help to find out why you are getting those symptoms which are, of course not specific to pregnancy. To answer your earlier question; yes, it is possible to get pregnant immediately after the diagnosis, acceptance and therefore end of a phantom pregnancy.

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