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Pregnancy Bliss | Reproductive Health Hub

Contact Answers In the News Hot Topics

Trying to conceive after a miscarriage

Question: Since i had a miscarriage 3 months ago my periods have not been regular only last month i had a normal period on time. Is it now possible i could conceive? Also i was told to have intercourse every other day to conceive and now i have done that i am now waiting for my period because my periods are 34 days long. N.J. (UK)

Answer: It is possible that your irregular periods signify that you are not ovulating regularly. This tends to be a feature of a condition called Polycystic Ovarian Syndrome. It is also seen in most women once they get into their late 30’s. It is a problem that is relatively easy to overcome but let’s not get ahead of ourselves. It is still possible that you could conceive since you are having regular sexual intercourse. This is particularly important in a case like yours where the cycles are irregular and you cannot pinpoint the mid-cycle, the so-called ‘fertile’ part of the cycle.  I am assuming you conceived spontaneously, without medical help last time. You may need to wait and see whether that happens in the next few months. If the periods remain irregular and you don't conceive, it will be advisable to seek your doctor's assistance.

Fetus ‘smaller’on scan than my dates

Question: Just had early scan dates say I should be 7+3 but scan shows size at 6wks heartbeat was present but consultant seemed quite negative i have to wait 2 wks for a re-scan what is the hope for my pregnancy its still another 10 days before my next scan and i feel like I’m going out of my mind. PS: i have had no bleeding at all. B. (UK)

Answer: I am rather puzzled by the apparent reaction of your consultant. Unless there is more to the picture, such as a slow fetal heart rate, I cannot understand why a viable early trimester scan finding can provoke a negative prognosis. I know you are not bleeding but did the scan show a possible bleed? Dates are not strictly reliable unless it is an IVF pregnancy. If there is no bleeding and the scan shows a fetus with ‘normal’ cardiac activity at 6 weeks, I cannot see why an apparent discrepancy of the dates should cause such gloom on the part of your doctor. If this is the whole picture then I think you can breathe easier.

A possible phantom pregnancy

Question: Hi; how long do phantom pregnancies last? My friend thinks she's having one and has all the pregnancy symptoms and hasn't had a period for 6 months even though her own GP says its all in her head .. Hope you can help. Thank you ..R.H. (UK)

Answer: You will have read on our section on the subject of Phantom pregnancy that this type of ‘pregnancy’ mimics the real thing in most ways. That includes the duration of the pregnancy. The most important hallmark of a phantom pregnancy is that, the expectant mother is completely convinced that she is really pregnant. That means her periods stop, there is abdominal distension and she gets a variety of pregnancy-like symptoms. She will also perceive what she considers to be fetal movements. Now, if your friend’s GP has really reacted that way, that is disappointing.

It is easy to diagnose a phantom pregnancy. All objective ways of confirming a pregnancy will of-course be negative. That includes a pregnancy test and an ultrasound scan which will confirm a normal-sized empty uterus. Now, even if your friend’s situation does not quite fit the bill (for instance if she is not convinced she is pregnant), an absence of a period for 6 months needs to be investigated. Yes, if you want to put it crudely, a phantom pregnancy is all in the patient’s head but it is a medical condition that requires proper management. I hope she gets the appropriate help soon.

Severe pain with fibroids in pregnancy

Question: I have pregnancy for 10 weeks. During 4th week i feel sharp pain that continued all the day. I visited doctor. Then on ultrasound doctor had seen MYOMA [pedunculated fibroid]. Now surgical and therapeutic treatment is not possible due to pregnancy. My question is  i have severe pain all the day what should i do? I. (Germany)

Answer: Fibroids in pregnancy cause pain in two distinct ways: A fibroid can undergo degeneration. This can cause quite severe pain. This complication does not normally threaten the well being of the pregnancy but the pain that comes with it can be truly awful and sustained. The only thing available for it is pain-killers such as Paracetamol and codeine or a combination of these. Sometimes a short course of opiates such as diamorphine becomes necessary.

The second fibroid complication, (and this only affects a pedunculated fibroid) is torsion. A pedunculated fibroid means the fibroid is separated from the main body of the womb by a thin stalk. That means it is mobile and therefore can twist on its stalk. If this happens, there is no choice but to operate and cut off the fibroid. There is a small risk of provoking a miscarriage when surgery is performed but there is really no choice. You need to get an urgent review with your doctor to establish exactly what is going on.

Using ultrasound to ascertain gestation

Question: Do ultrasounds always check to see if your LMP is the correct due date? Would a tech know if you were 15 weeks further along than thought? D. (USA)

Answer: An ultrasound is very accurate at calculating gestation especially in the first of the pregnancy. Accuracy in this regard starts to go down as the pregnancy advances towards the third trimester. This is where babies diverge in their rate of growth. However, even at its weakest, that’s, towards the end of the pregnancy, the calculation can be out by, at most three weeks or so. A scan will definitely  be able to tell if there was a discrepancy of 15 weeks between your ‘dates’ and the true gestation. Take this example:

Thigh bone (femur) length: At 15 weeks: 18mm;  At 30 weeks:  59mm

Head circumference:          At 15 weeks: 111mm  At 30 weeks: 280mm

You can clearly see the massive difference in the measurements, meaning the error will be quite obvious.

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