Pregnancy ‘symptoms’ with negative pregnancy test

Question: I have all the symptoms of pregnancy, i.e. sickness, breasts are getting bigger and very tender, getting tired more often, mood swings, eating more, going to the toilet more, lower back pain at times, my belly is starting to swell into the shape of a bump and more. But i have took a pregnancy test and it was negative and my doctor sent me for an ultrasound which showed nothing except from a big of pressure on my kidneys (not sure why though) but i still have all the symptoms and I’m not going onto my 3rd week of being overdue my period. i haven't been stressed either so that cant be why its held back.do u think I’m pregnant and maybe it just didn’t show up? maybe it was hidden away. I dunno but what do you think ?

The ultrasound was over a month ago and i should be about 3 months if i am pregnant, but i had been taking my period which can still happen whilst pregnant but now my period has stopped which can also happen. I’m 14 years old. N. (UK)

Answer: Thank you for a very clear and detailed query. It is very unlikely that you are pregnant. You are at a stage of life where rapid changes to your body are taking place. This may explain many of the ‘symptoms’ you describe especially the breast and mood changes. You mention that you are eating more and feeling more tired. That combination may actually make you gain weight and the ‘swelling of the belly’ that you mentioned may be a combination of the weight gain and hormonal changes. It is something that you will need to have a firm handle on before it runs away from you and becomes difficult to manage. Erratic periods are a very common feature in the early teens and I think this is what you are experiencing. Your contention that ‘periods’ can happen when you are pregnant is actually a myth. It is not true. However, if you have continued having unprotected sex since your test and scan, it may be worthwhile doing another pregnancy test.

Since you are already sexually active and, my guess is that you do not want to become a mother at such a tender age, I would advice that you discuss with your mother and/or doctor about the possibility of going on the contraceptive pill. This will allow you to have regular periods, eliminate many of the symptoms you mentioned and, of course, prevent unwanted pregnancy.

HELLP Syndrome

Question: I had a condition called H.E.L.P'S during my pregnancey and things were quite stressful at the end, I was just wondering if you had anymore information about this condition as I am planning to have another baby but just want to know all about it first. Many thanks M. (UK)

Answer: The actual name of this condition is HELLP syndrome. The word HELLP is derived from a combination of the three main features of the condition namely Hemolysis (the breakdown of red blood cells) leading to anaemia, Elevated Liver enzymes and Low Platelets. It is a condition which can occur together with pre-eclampsia as it does in 1 in 5 cases. Having gone through it you will recognise the clinical features which will include some or all of these:

Abdominal pain mainly in the right upper part (location of the liver)
Headache, sometimes quite severe, with or without blurring of vision
Nausea and vomiting
Pins and needles or a tingling sensation in the limbs
Seizures

A blood test on a patient will confirm the HELLP syndrome diagnosis by showing falling platelet count and elevated liver enzymes. The reason there is usually right upper abdominal pain is because of the changes in the liver whereby the organ swells up and the capsule is stretched.

The destruction of the blood cells (hemolysis) could lead to acute renal (kidney) failure. A close eye is therefore kept on the kidney function. Because of the depletion of platelets, there could be serious haemorrhage at delivery.

A platelet count test is done every few hours to keep track of what is happening. A platelet transfusion is sometimes required.

Delivery is really the only cure of the condition unless it presents after delivery (this occurs in 1 in 5 of cases). Postnatal HELLP syndrome requires close supportive measures until the storm has passed. This may involve anti-hypertensive medication, pain-killers, steroids, intravenous fluids and, if necessary, platelet transfusion.

HELLP syndrome is a very serious pregnancy complication and around 1 in 100 women affected die. The infant mortality is higher with at least 1 in 10 of the babies being lost depending on the severity of the condition and the gestation at which it presents.

Roughly 1 in every 4 women affected by HELLP syndrome will experience a recurrence in a subsequent pregnancy. The chances of recurrence are increased by degree of severity as measured by the platelet count. For those patients where the platelet count falls below 30,000; the risk of recurrence is highest. (Normal platelet count ranges from 150,000 to 450,000).

The cause of HELLP syndrome is not known.

Establishing ‘cause’ of Down’s Syndrome

Question: What kind of questions the doctor should ask us (the couple) to help us determine the cause of Down syndrome in our baby? N. (UK)

Answer: You will be aware that, in the majority of cases, the occurrence of Down’s syndrome is spontaneous and has nothing that can be described as an underlying cause. This is why we talk of predisposing or risk factors rather than ‘causes’. The main risk factors are advanced maternal age and family history of Down’s syndrome.

The only exception to this rule is where there is what is known as balanced translocation of parental chromosomes. This is a rather complex phenomenon where one of the parents has chromosomes swapping places (translocation). Let me explain briefly: Each of the 46 chromosomes are in pairs. That means there are 23 pairs of chromosomes. In some cases, one of the chromosomes on Pair No. 21 (this is the relevant pair for Down’s) exchanges places with another one, let’s say No. 8. This individual will be perfectly healthy because he or she has the correct number of chromosomes and genetic material, even though some of them are located in the ‘wrong place’. The problem comes when this person wants to have children. The risk of the chromosomal balance being upset in the offspring is dramatically increased. If the father was the one carrying the translocation, the chances of ending up with an affected baby is almost 10%. If the mother is the one that is affected, the risk could be as high as 50%.

So, coming back to your question, your doctor does not have much to ask you on that issue. If you are young parents with no family history, an offer may be made to perform a blood test to look for possible chromosomal translocation.

There is more details on this subject here:

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