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Pregnancy Bliss | Reproductive Health Hub

Dropping hCG level in early pregnancy

Question: I have just found out that i am 2 weeks pregnant because i suffered a small amount of blood loss. The docs think i could have miscarried as my hcg level have dropped slightly but my cervix is tightly closed? They have also said that this could be due to dehydration can u help? I’m so confused? C.K. (UK)

Answer: I think you have got your number of weeks (gestation) wrong. There is, technically, no such thing as a 2 week pregnancy. Medically, we only start making a reference to pregnancy when the gestation is at least 4 weeks. You have not said when your last period was and whether, indeed, you have missed a period. I take it you had the blood test for hCG levels because a scan did not show anything in the womb. In any case, the fact that the blood hCG levels are dropping is not a good omen. It almost certainly indicate a failed or failing pregnancy. This could be an evolving miscarriage. An ectopic pregnancy is also still a possibility. In a viable early pregnancy you never ever have hCG dropping. The exception to this is, if the pregnancy has advanced beyond 9 weeks, levels of the hormone hCG will start going down as a natural phenomenon. However, at 9 weeks and beyond, the pregnancy status is easily established using an ultrasound scan.

Chlamydia and miscarriage

Question: Can  chlamydia or an infection be the cause of the miscarriages I've had? I was once diagnosed to have had chlamydia though it was later treated. I got pregnant almost immediately and lost it after which i was given some antibiotics. I now got pregnant the second time and was blessed with a baby girl. After that birth i got pregnant again and had another miscarriage. Now the doctor says he will have to give me antibiotics before i can start trying to conceive. What do u think? O. (Nigeria)

Answer: No; chlamydia is unlikely to have been the cause of the miscarriage. As we have stated in the relevant section, chlamydia pelvic infection, especially if unrecognised for a long time, can cause significant damage to the female reproductive system leading to sub-fertility. This is mainly through making it difficult to conceive or increasing the risk of ectopic pregnancy. You do not appear to have any problem conceiving. There is very little evidence that active chlamydia infection can lead to a miscarriage but even this evidence is weak and patchy.  

If there is any suspicion that you may have got re-infected with chlamydia, the best thing to do is to have the diagnostic test, either using the cervical swab (best) or a urine sample. Chlamydia infection is easy to diagnose. Unless facilities are not available, blind treatment is not really ideal.

Probability of child having sickle cell

Question:  I have Hb A and C. My partner has A and S. I’m 31 weeks pregnant. What are the chances that our baby will have sickle cell? T. (UK)

Answer: You have a mixture of Hb A (which is normal) and Hb C. You therefore have what is known as Haemoglobin C trait (Hb C trait). People with Haemoglobin C trait are usually healthy and I would think that is the case with you also. Your partner has got Haemoglobin A and S. That makes the combination AS which is also called Sickle Cell trait.  With you two coming together, there is a chance that you could have a baby with the combination SC. That is a variant of sickle cell disease. The probability of your child having sickle cell disease (haemoglobin SC) is 1 in 4 or 25 %. The other permutations are like this:

Sterilisation at caesarean section

Question:  I want to be sterilised at caesarean section. It will be my third child and I don’t want any more. However, the doctor says sterilisation done at caesarean section has a higher probability of failure. What should I do?  R.C.M.(UK)

Answer: It is true that the quoted figures of the possibility of female sterilisation failure show that this is modestly higher when performed at caesarean section as opposed to when it is an isolated procedure in a non-pregnant state. It is also the case that the methods of sterilisation are somewhat different even though they all achieve the same result. At caesarean section, the fallopian tubes are divided and tied. When done as a stand-alone procedure, the commonest method is to occlude the fallopian tubes using clips. In fact this, in the medium to long term results in the same thing which is division of the tube into two parts at the site of the clip application.

Having said all that, there is consensus among doctors and other experts that, the difference in the failure rate is, for practical purposes, so insignificant, that it is unjustifiable to subject a woman to a second operation just for that. This is why, for those women who are sure they have completed their families and are having a caesarean delivery, sterilisation is performed at the same time. If you are having a caesarean section, don’t let this piece of information deter you from having a planned sterilisation at the same time. This will save you a lot of hassle.

Omega 3 and pregnancy test results

Question:  Can pre-natal drugs like pregnacare and omega 3 affect ovulation test readings?

Answer: No; these can’t. We have discussed some of the causes of false positive pregnancy test results as well as false negative results here: However, it is important to be aware that most modern kits have become extremely specific and sensitive and are not susceptible to these pitfalls.

Mephedrone use in pregnancy

Question:  My friend has just found out that she is pregnant at 9 weeks. She has been using meow meow  while clubbing. Will the baby be alright? J.A. (UK)

Answer: Even though ‘meow meow’ or Mephedrone, to give it its proper name, is currently not illegal in the UK, it is banned in many countries around the world. Mephedrone is a type of amphetamines. Amphetamines use in pregnancy have been associated with a range of problems including miscarriage, antepartum haemorrhage and even some types of birth defects, some serious.  Now that she knows she is pregnant, your friend should definitely refrain from using this or any other illicit drugs, for the remaining part of the pregnancy. It is not possible for me to state whether the baby will be alright or not. Hopefully when she has the detailed anatomy scan at 20 weeks, she will be reassured.