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Pregnancy Bliss | Reproductive Health Hub

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Your Questions; Your Answers

Questions sent in by Pregnancy-Bliss visitors are answered here

Severe morning sickness in early pregnancy

Question:  My daughter is 6 weeks pregnant with her second baby and is having great difficulty coping with the severity of the sickness experienced.  She was not this bad with her first baby, but she is also experiencing more or less constant dizziness and fatigue.  Could she possibly be anaemic and is there anything she can do? C.L. (UK)

Answer: Anaemia does not cause sickness. The fatigue and dizziness is most likely due to some degree of dehydration that is a common feature of pregnancy associated sickness. This is because the nausea would prevent the pregnant woman from drinking adequately and the little that she manages to force down is brought right back.

Most cases of excessive early pregnancy morning sickness occur in otherwise straight-forward singleton pregnancies. However, in a few cases, this could be a symptom of a multiple pregnancy (twins etc.) or even, rarely, a pregnancy abnormality  by the name of hydatidform mole (molar pregnancy).

The way it sounds, it is worthwhile that your daughter is assessed by a doctor who may suggest at least a short stay (a couple of days or so) in hospital. This will allow her to get more powerful anti-sickness medication as well as intravenous fluids. These are measures that can only be applied in hospital and the relief obtained is always quite welcome.

Phantom Pregnancy presentation

Question:  I was wondering about the phantom pregnancy.  On **/**/**** (about 7 weeks ago) I had a miscarriage.  I bled like after you have a baby and everything.  I have four children.  I know when I am pregnant.  I keep taking tests, they are all negative.  I feel something moving in my stomach,  like when you first feel the baby moving.  I have a doctor’s appointment in a week’s time.  I still have periods and everything.  Is it possible to be pregnant right now? My breasts even still leak. N. (USA)

Answer: It is very unlikely that you are pregnant. A few reasons for me to come to this conclusion. Pregnancy tests are consistently negative, that would be unlikely if you had a viable pregnancy still. You have had a period or two since your miscarriage; exceedingly unlikely in an ongoing pregnancy and, third; your breasts are leaking. That shouldn’t happen in an ongoing pregnancy.

That visit to your doctor in a few days time should solve a few puzzles, the most pressing of which is why your breasts are leaking. That is unusual because, even if you had had a Term delivery, without breast feeding, the milk would have long dried by now. I think the ‘baby-like movements’ are probably bowel in origin. They can be quite similar in a situation like yours.

The only remotely possible explanation for some of your symptoms would be if you had a missed miscarriage (explained here). With that, the pregnancy test would revert to negative and you can have leaking breasts especially if the pregnancy was fairly advanced, towards the half-way mark (20 weeks). However, even with a missed miscarriage, contrary to your experience, you would not have any vaginal bleeding.

You started your question by wondering whether this is a phantom pregnancy. No; it does not quite fit the description. Absence of periods is an essential part of a phantom pregnancy and milk leakage is not. With an ultrasound scan and some blood hormone tests, your doctor should be able to provide clarity.

Situs inversus and pregnancy

Question:  I was born with a condition called abdominal versus situs. It is where al my organs are the opposite side of every one else’s, could this effect my chances of getting pregnant? N. (UK)

Answer: The condition is actually called situs inversus. This is an inherited condition which can be passed on to offsprings. For this to happen, both parents will have to carry the responsible gene. It is what is known as an autosomal recessive type of inheritance. Situs inversus does not have any bearing on an individual's ability to conceive. One of the notable individuals with the condition is Canadian actress Catherine O'Hara who has two healthy children.

Bleeding within days of having sex

Question: If i start bleeding 6 days after having sex could i still be pregnant as my period is not due for another week? N. (UK)

Answer: Bleeding within a few days of having sex means it is very unlikely that you have conceived. However, it is not impossible.

Factor V Leiden and pregnancy

Question: my daughter has factor v leiden. she takes on average between 10 and 16 mg Warfarin per day depending on her INR. she is 19 and is about 5 weeks pregnant. Warfarin has discontinued, and an urgent haematology referral made. 18 months ago she had a massive dvt, beginning in the thigh down to her calf. she was put on Warfarin for 6 months, then had a further dvt in the popliteal veins. she is now on long term Warfarin. this dvt has not fully dissolved due to the size, will it now get bigger due to the pregnancy, and will heparin be as effective as Warfarin? what are her chances of carrying this baby full term and problem free.

Answer: The measure to stop your daughter's Warfarin was the correct one. The risk posed by Warfarin to the baby is considerable. Heparin (and I would suspect she has been put on the newer low molecular weight heparins such as Fragmin, Clexane or similar) is perfectly safe for the baby (it does not cross the placenta) and just as effective as Warfarin provided the dose is got right. She will most likely be on twice daily injections throughout.

Pregnancy is a thrombogenic (promotes clot formation) condition so it is important that treatment is adhered to religiously. Should this be the case, the clot shouldn't get any bigger and should in all expectations continue to resolve. If this is found to be difficult to achieve, she might be offered a filter to prevent pulmonary embolism. This is rarely necessary.

I think with appropriate expert input, that is both the haematologist and obstetrician, her chances of successful conclusion of this pregnancy are as good as any other woman's.

My best wishes to her.

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