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Monday, October 31, 2005

Nausea

I have been experiencing extreme nausea throughout the day, as well as extreme bloatedness and very painful wind. (I am 9 weeks pregnant).

My docter doesn't want to prescribe me anything - he says they 'try not to' unless the patient is hospitalised and not keeping anything down.

Do you have any suggestions? I have tried ginger nuts, peppermint tea, dry toast, etc. Nothing seems to work. Surely, a little medication can't do any harm just until the worst of this first trimester is over?

Regards,
Ludine

Dear Ludine,

The most sensitive time in a baby's development is the first trimester. Certain medications can cause severe birth defects. Most doctors (myself included) will not prescribe medication in the first trimester unless it is medically necessary.

The nausea and other side effects will go away by themselves, usually by the end of the first trimester.

Sincerely,
Amy

Fetal heart rate of 126

Hello,

A few moths ago I posted that we were tring to get pregnant. Well, we are! But Thursday I started lightly spotting ( brown) after attempting to have sex. I called my OB who ordered an ultrasound. The baby measure 1.24 cm(crl of 7w2d) my OB's only concern was the baby's heart rate was only 126. I am very aware this is low but need to know how concerned I should be. I am going to have another US this week after seeing the OB on Monday. All spotting has stopped. Any advice or informmation you could share?

David and Lee

Dear David and Lee,

Anywhere between 120-160 is considered a normal heart rate. While it is true that the heart rate tends to be higher in early pregnancy, 126 is not a sign of a problem.

There's no way to predict what will happen, though. Even after you see the heartbeat on ultrasound, the miscarriage rate for the average pregnancy is 10%.

Good luck.

Sincerely,
Amy

Sunday, October 30, 2005

Getting pregnant after tubal damage

Can I still get pregnant after a tubal pregnancy surgery and one of my tube is tied up because it was damaged? My husband and I tried for almost a year now and are still not pregnant. What should I do?

DV

Dear DV,

It is theoretically possible for you to get pregnant with one tube, but if you have been trying for a year without success, your other tube may be damaged as well. You should make an appointment to see a gynecologist or infertility specialist to find out about the other tube and whether you will need further treatment.

Sincerely,
Amy

Cat has worms

Hi,

I'm a bit concerned as my partner and i are trying for a baby and my period is late, i have a cat and have just discovered she has worms which will be treated immediately, can this harm me or my baby if I'm already pregnant?

Thank you for any advice,
Kellie

Dear Kellie,

Cat worms should not pose a danger. The risk of cats during pregnancy is that cats can carry the disease toxoplasmosis, which is dangerous to unborn babies. Toxoplasmosis is found in cat litter, so pregnant women should not handle cat litter or handle it only with protection (gloves).

Sincerely,
Amy

Neotigason

Dear Dr Amy,

My partner is taking Neotigason for psoriasis. Is there any side effects for me if we were to fall pregnant. I notice in the information sheets that women who are taking the drug are at high risk of having serious birth defects.

Thanks,
Leisa

Dear Leisa,

Neotigason affects the developing baby if taken by the mother during pregnancy. As far as we know, it should have no effect on the baby if it is being taken by the father.

Sincerely,
Amy

Friday, October 28, 2005

Does cervical mucus change when you conceive?

Dear Dr. Amy,

My husband and I have been trying to get pregnant since June. I have been observing my cervical mucus for ovulation signs. My question is as follows: during ovulation, my cervical mucus is stretchy like raw egg white. If conception occurred, will the vaginal discharge also be stretchy like raw egg white or will it be milky and wet?

Thank you in advance,
Karine

Dear Karine,

Cervical mucus does not change in response to conception, so you cannot tell if you conceived by the way that the cervical mucus looks.

Sincerely,
Amy

Thursday, October 27, 2005

Not pregnant yet

Hi Dr Amy,
My husband and I have been trying to get pregnant for over 9 months. I am 25 and he is 28. My periods have been very irregular since I went off the pill in January. When I was on the pill I had a normal 28 day cycle. Now I have 35 and sometimes 42 day cycles. My husband has only one working testicle so we decided to try having sex just on the day that I was ovulating. I purchased a home ovulation detection kit. Every morning I dip the stick into a cup of my urine to determine if I am ovulating or not. Well so far I've had not shown a positive test of ovulation. I had my last period on October 1st. Shouldn't I be ovulating by now? How can this be??! I don't understand what's wrong with me.

Very Frustrated,
Melissa

Dear Melissa,

When you stop the Pill, it can take months for your periods to return to normal. During that time, you may not be ovulating regularly, or you may not be ovulating at all.

Everyone is regular on the Pill. It's more important to know what your cycles were likely before you took the Pill. Did you always have irregular cycles? If that's the case, the underlying cause of the irregular cycles is still there. You should talk this over with your gynecologist to find out if you have a hormonal problem.

The fact that your husband has only one testicle should not limit his fertility. Every drop of semen contains 10s of millions of sperm and all you need is one. You do not need to restrict sex to the day that you think you are ovulating. In fact, it's probably better to have sex regularly since you can't predict when you are ovulating.

Sincerely,
Amy

Taking Provera every month

Dear Dr. Amy,

My doctor prescribed me Provera (10mg per day for 5 days) starting on November 1st. This would be my third time (May, August, and November) taking Provera. My doctor wants me to take it every month (the 1st to the 5th day of every month.) The reason my doctor prescribed this to me, because I wasn't getting my period. I actually didn't have my period in years. I was wondering, is it okay to take Provera this many times? I had a pap test done and blood work done, but everything came out good. I currently have high blood pressure and my weight is very high (371 pounds.) Can that be interfering with my period (me not having one?) Do you have any idea on why I haven't been getting my period? The only time I get a "period" is when I take Provera. That makes me have a period. I'm just so confused right now. Please help!!!!

Yours Truly,
Aleia

Dear Aleia,

It is safer to take Provera regularly than it is to miss many periods. That's because if you don't get a period for months at a time, you are at increased risk of eventually developing abnormal cells inside your uterus. Simulating regular periods with Provera reduces this risk.

Your weight could definitely be interfering with your periods. Fat cells can convert estrogen to androgens (male hormones) and these can suppress your periods. Losing weight will help get your periods back on track.

Sincerely,
Amy

Irregular period since I started trying to get pregnant

Hello Dr. Amy,

I am a 32 year old mom of a 2 1/2 year old. I am eager to get pregnant again and have been trying for 3 months now with no luck. Although I know it can take time, I am concerned because 1 month after I started "trying" my periods became irregular. I was getting my period every 28 days for as long as I can remember and now they are closer to 35 days. I am on day 32 now and am dreading getting my period. What could be going on?

T

Dear T,

It's not necessarily a bad sign. It could be that you have had one or more chemical pregnancies. A chemical pregnancy is another name for a very early miscarriage. You do get pregnant, but the pregnancy stops growing around the time you expect your period. You experience this as a late period. Chemical pregnancies are extremely common. In fact, that's probably what happens to many women in the months that they are trying, but haven't gotten pregnant. It has no impact on the getting pregnant in the future.

Sincerely,
Amy

Wednesday, October 26, 2005

Irregular periods

Dr. Amy,

I started my period when I was 11 years old, I am now 22 and I have yet to have a regular period. The only time I was able to regulate my periods were when I was on Birth control.

I am currently trying to get pregnant, so I have been off BC for about a year. I have been trying since Feb. 2005, with no luck. I have gone to my gyno and I have had all my hormones tested and everything has come back normal, my doctor put me on provera to jump start my period, and then he prescribed Metformin, I take 2 tabs twice a day every day that's 2000mg of metformin a day. The only problem is that I can't really afford the medicine every month it cost me $120 to get that prescription filled, so I have not been taking it.

My last normal period was April 2005, I have not had one since, and no I am not pregnant. My question is what could possibly be wrong? I don't have PCOS or endometriosis. I do however have herpes, but my doc said that would not interfere with my fertility. I also weigh about 270lbs and I have been heavy almost all of my life, but my doctor said that it should not play a big role in my fertility.

Do you have any suggestions of what I can do to regulate my cycle? I know all about timing of ovulation and everything I could possibly know about getting pregnant- I just can't seem to get my periods regulated. Please help!!

Thank You,
Rachel

Dear Rachel,

There are several things that you mentioned that suggest that you might have PCOS. You have a long history of irregular periods, you are overweight (a common side effect of PCOS), and your doctor prescribed metformin (a common treatment for PCOS). If you do have PCOS, it is not likely to get better on its own. The metformin may help you regulate your periods and may help you get pregnant, but there is no guarantee.

Another possibility is your weight. Fat cells can convert estrogen to androgens (male hormones). This can dramatically interfere with your cycles and make it difficult, if not impossible to get pregnant. If that is part of the problem, losing weight will help to start your periods again.

Unfortunately, there is nothing simple that you can do to regulate your periods. You will either need to pay for medication of some kind or start a weight loss program. The good news is that one or both are likely to be very helpful.

Sincerely,
Amy

Tuesday, October 25, 2005

Abdominal pain

For the last 2 weeks I have had pain where I would imagine my ovaries are (in the middle of my abdomen on each side). It happened the day after I had sex with my husband and it is continuing. We have had sex since its been hurting, but it will hurt during the day outside of sex. I can be sitting at my desk and start to get the pain. It doesn't last all the time, but every once in a while (quite a few times/day) its there. Also, during this time period my breasts have been very sore/tender.

I have also had weird digestive things happening. I had nausea for a couple of days and now my BM are not normal. Could all this be caused by stress/poor diet? I'm currently on birth control (the pill), and I have been for 9 years. It is a low estrogen pill. Last month my period was really short, it only lasted a day but I did bleed.

I'm just trying to figure out what all of this could be so that I can try to fix it. I really don't think I'm pregnant. Do you think any of this is worth a trip to my doctor? or do you think they'll just go away?

Thanks, Erin

Dear Erin,

I'm not sure what is going on. If you are faithfully taking the Pill, it is unlikely to be pregnancy or ovarian cysts. It is possible that you have an infection, but many infections are accompanies by fever. If it persists, you should definitely talk it over with your doctor. He or she may want to examine you.

Sincerely,
Amy

Monday, October 24, 2005

HPV

Dr Amy,

I have just been diagnosed with HPV. The thing is, I have only been with two men, one man with who I am currently, the other man was for the most part against my will. With my boyfriend, we have been together for almost two years. We have sex with a condom, have had anal sex once, and I performed oral sex on him once and he performed oral sex on me many times. With the other guy, he penetrated me anally one time, and put his penis in my mouth the other time.

Well now i have learned that I have HPV and the only symptom I have is precancerous cells in my cervix. Which man do you think I most likely got it from? It kills me to know i may have passed it on to my bf. And then again, I don't know if my bf already had it to begin with.

From what I know so far, I only have precancerous cells, and not warts. Could I have contracted that from anal or oral sex, or since it was in my cervix, could I have only gotten that from vaginal sex? I have only had vaginal sex with my boyfriend, but we used condoms. Is it most likely that I got it from him?

Please let me know what you think.

Sincerely,
Extremely Anxious

Dear Extremely Anxious,

It is most likely that you got it from your boyfriend. The fact that your only symptom is abnormal cervical cells suggests that you acquired it during vaginal sex. Condoms are only partially protective against HPV because the virus can be anywhere on the genitals, not just on the penis.

Most men never have symptoms of HPV, so they do not know they have it, and therefore do not know that they can pass it on. Anyone who has ever had sex can have HPV, since it is so common. It is not a sign of promiscuity.

Sincerely,
Amy

Pregnancy test positive, then negative

Dear Dr Amy,

I have missed my period by 4weeks. I did a pregnancy test a week ago and it was positive. I did another three tests a few days later and they were negative. How can that happen? I have booked in to see my G.P , but wondered whether this indicates a serious illness or could I be pregnant?

BH

Dear BH,

It sounds like you may have had a chemical pregnancy. A chemical pregnancy is actually a very early miscarriage. You got pregnant and the pregnancy implanted, but stopped growing at an extremely early stage. Most women don't know that they have had a chemical pregnancy. They just notice that their period has been heavier or a bit later than usual.

Sincerely,
Amy

Sunday, October 23, 2005

Novotrimel

I was told by the doctor that I have a bladder infection and she prescribed novo-trimel. Is it oky to take this if you're pregnant?

Thanks,
RA

Dear RA,

No, novotrimel is not a good medication to take during pregnancy. There are other, safer medications for bladder infections. Talk it over with your doctor as soon as possible.

Sincerely,
Amy

Rash during pregnancy

Dear Dr. Amy

I am 30 weeks pregnant and haven't had many problems, but I noticed today that I have a unusual rash across my stomach. Do I need to worry or is this common?

Thank you,
Becky

Dear Becky,

Only someone who examines you can tell you what the rash is, but some pregnant women develop a rash called PUPPP. This stands for pruritic urticarial papules and plaques of pregnancy. This rash is most common in women expecting their first baby and usually occurs in the third trimester. PUPPP is not harmful, but it can be very itchy. Talk to your doctor about it at your next visit, or sooner if it bothers you.

Sincerely,
Amy

Not pregnant after 2 years

Dear Dr. Amy

My husband and I want a baby very much. I had a miscarrage about 2yrs ago, just after i went off the pill (i was on the pill at 17yrs old till after i got married in 2000 - 21yrs old). We really haven't been trying, but on the other hand we want a child. My periods come on the 25day of each month for about 3-4days, so days 10 - 16, their the best days, right? If so, then what the hell am i doin wrong! My mum say that i want it to badly. Is that right?

M

Dear M,

If you are not pregnant after 2 years of unprotected intercourse, there may be a problem. You should make an appointment with a gynecologist for an infertility evaluation. He or she can figure out the problem and prescribe the best treatment.

Sincerely,
Amy

Saturday, October 22, 2005

Irregular periods after stopping the Pill

Dear Amy,

I had recently got off of the pill from being on it for over 2 yrs or so. I need to know since then, my period was off about a week or so. Then, when I started I was normal like before. Nothing too heavy and I was just on it for a week or less.

Then about two weeks later I started it again. Then on it for a week or less. Then two weeks later I started, again. This been happening for a month or more already. Now, I am on it again. This time I started three weeks, instead of two weeks later. I just would like to know if this is normal. I know that you may skip a month or so. Having starting my period for two weeks back to back, I am just confused. I haven't had my routine pap smear done. The last time, they said I was fine. Everything seems to be normal, just having my period like every two weeks instead of every month. I really would appreciate your help. Thanks!!

Respectfully,
Christina

Dear Christina,

After you stop the Pill, it can take months for you to ovulate (release an egg) again. During that time, many women have no period at all, but some women have irregular bleeding. You can talk to your doctor about this. He or she may suggests medication (Provera) to stimulate a normal period and that may get you back on track with regular periods.

Sincerely,
Amy

Irregular periods

Dear Dr. Amy,

I am 35 years old, married, with 3 children 12, 10 & 6. We don't want anymore children.
I have been using Encare Vaginal Spermicide suppositories, for the past two years. My husband doesn't want to get the vasectomy and i am still not thrilled with the idea of tubal ligation.

Since last March my menstrual cycle has been very irregular. Each month it is either 2-7 days early then it has been 2-12 days late. So far this month i am 8 days late from last months first day of the period which was sept 14th. I feel fine have no symptoms. I have been under enormous stress lately.

I just went to the doctor on Thursday Oct 20. However, she had to cut the visit very very short since there was an emergency at the hospital emergency c-section. However, she did give me a pap-smear test.

Would the pap smear test results be effected by my irregular periods or possibly even pregnancy? What effect does stress have on the menstrual cycle? I also have been skipping a lot more meals in the past 6 -8 weeks, so stressed not really that hungry, could that have an effect on menstrual cycle?

Thank you for your cooperation.

Sincerely,
Dianna

Dear Dianna,

The fact that your periods have been irregular for the last 6 months could be related to stress. It is also possible that you are in the early stages of peri-menopause and that is affecting your periods. Peri-menopause can last for 5-7 years or more before you actually go through menopause. During that time, your periods could become irregular, could be longer or shorter than usual, or heavier or lighter than usual.

Pregnancy does not sound likely, but only a pregnancy test can tell you whether you are pregnant.

A Pap smear is just a scraping of cells from the cervix. It would not be affected by irregular periods or a pregnancy.

Since your doctor had to cut the visit short, it seems reasonable for you to call her and talk to her at greater length about your concerns. Since she is familiar with your medical history, she may have additional ideas about what is going on.

Sincerely,
Amy

Friday, October 21, 2005

Sex after LEEP

I just had a LEEP done and the doctor said no sex for 3-4 weeks. Could climaxing set up an infection or would it be caused by the moving of the penis.

Thank you,
L

Dear L,

The concern is that any object in the vagina (a penis, a vibrator) could introduce bacteria that could cause an infection or could disrupt the healing of the cervix and cause heavy bleeding.

You should avoid sexual activity of any kind until the bleeding stops. After that, orgasm should not cause problems.

Sincerely,
Amy

Thursday, October 20, 2005

Conception date

I'm am 8w6d pregnant from my last menstrual period which was August 19th. When I went in for my u/s at 7w4d the baby read 6w1d, which would be 1w3d off. That means I got pregnant 3 days after my period ended. Could that be right?

In July my period never came so the doctor put me on provera on Aug. 11th to induce a period. From what the doctor says i conceived on the 29th. What do you think? Also i'm 9weeks tomorrow and already I'm showing a little in the front but losing weight everywhere else. Is that normal sinceI'm eating healthy? Thanks.

Stephanie

Dear Stephanie,

If the first ultrasound showed you were 1 week and 3 days less than expected, that would mean that you conceived 1 week and 3 days after you thought you did. So instead of conceiving on September 2nd as you might expect if your last period was on August 19th, you conceived around September 12th. That's not surprising since the reason you got Provera in the first place was because you were not ovulating regularly.

The fact that you haven't gained any weight yet is not a cause for concern.

Sincerely,
Amy

Ovulation predictor

What would show up in an ovulation kit if I am pregnant? Would it still show two lines, one darker then the other, or the same color?

Thank you,
Milwifenlv

Dear Milwifenlv,

An ovulation predictor kit detects an increase in the level of luteinizing hormone (LH). If you are pregnant, you are not ovulating, so an ovulation predictor test would be negative. Of course, if you were pregnant, a pregnancy test would be positive.

Sincerely,
Amy

No symptoms at 6 weeks

Dear Dr Amy,

I am 39 years old and have a 7 year old son. The first day of my last period was September 6, 2005. I have taken 4 home pregnancy tests and all were positive. This puts me at 6 plus weeks pregnant. My problem is that missed periods and tender breasts are my only symptoms. When does the uterus start to grow where I will feel it? About two weeks ago I experienced some light pink watery discharge after sexual intercourse. Could this be a problem?

Thank you so much.
Kathy

Dear Kathy,

Every pregnancy is different, and the lack of symptoms this time does not necessarily mean anything. At this point, the baby is about 1/4 inch long so it is not surprising that you cannot notice your uterus growing. Some women do not begin to show until after the first trimester. The discharge you had two weeks ago does not sound significant since it went away by itself.

Sincerely,
Amy

Wednesday, October 19, 2005

By what age should you get your first period

What is the oldest age a girl should wait before going to doctor, before she gets her first period?

DM

Dear DM,

Most girls will get their first period between ages 9-16. The first period usually occurs about two years after the beginning of puberty (growing underarm and pubic hair), so you can estimate when to expect the first period.

If a girl hasn't gotten her first period by age 16, she should check with her doctor.

Sincerely,
Amy

When did I get pregnant?

Dear Dr Amy,

I am currently 16 weeks pregnant, & conceived in mid-July(my due date is april 4th). However, at the end of June, I had a positive home pregnancy test.

I believed I was pregnant when 3 days before my period, I had some light pink spotting. The next day I took a test which was positive, I had no spotting that day. The next day, I spotted again lightly. The next morning I started to bleed lighter than a period but bright red blood for 2 days. I then had another positive test on July 21st. So I assumed I would be 18 weeks, & I had not miscarried.

A few weeks ago I had my first sonogram, I was 14 weeks. So this was a new pregnancy.

The ultra-sound nurse told me that the incident before was probably a false positive & a normal period. However, I strongly feel that I had an early miscarriage. On the other hand, It had taken me 5 months to conceive, so if it was a miscarriage, I can't see how I got pregnant so few days after. I'm really confused. I feel like I want to mourn for a lost baby, but at the same time, I don't know if I ever did.

I was just wondering, which is most likely, because even though I am estatic about the baby I am carrying now, I don't feel like I can be totally at peace until I have an idea of exactly went on. I don't feel like I can forget that I may have carried a life before, even if for only a few days.

Thanks for your help,
Rosie

Dear Rosie,

It sounds like you had a chemical pregnancy in June and then got pregnant with this pregnancy in July. A chemical pregnancy is just another name for an extremely early miscarriage, one that can occur even before you miss your period. If that were the case, you would have had a period at the end of June and conceived again 2 weeks later. That would put you at 16 weeks now.

Chemical pregnancies are extremely common. In fact, that is probably what happens in many months that you don't get pregnant even though you are trying. You may have had additional chemical pregnancies in other months of the 5 months that you were trying to conceive.

Sincerely,
Amy

Symptoms of miscarriage

Dear Dr.,

What are the symptoms of miscarriage?

Thanks,
Ashika

Dear Ashika,

The main symptoms of miscarriage are bleeding and cramping occuring at the same time.

Sincerely,
Amy

Getting pregnant before first period

Can you get pregnant if you have never had a period before?

X

Dear X,

Yes, you certainly can. That's because you get pregnant when you ovulate (release an egg), and you ovulate for the first time two weeks before your first period. If you want to keep from getting pregnant, you must always use birth control.

Sincerely,
Amy

Tuesday, October 18, 2005

Accuracy of very early pregnancy tests

Dear Dr. Amy,

How accurate are pregnancy test that you buy off the Internet? I bought some because they were so much cheaper. This brand claims that it can detect hcg 6 days past ovulation. Is this possible? I am 6 days past ovulation and took one this morning and it was negative. I have been charting my BBT and did ovulation predictor kits so I know about when I ovulated. So should I wait and test again when my period is due?

Thanks so much!
Beth
I also love you new pregnancy quiz!

Dear Beth,

Theoretically, HCG can be detected in the bloodstream as early as 6 days after ovulation, if the fertilized egg implants at that time. However, most fertilized eggs will implant sometime between 6-8 days after ovulation.

I don't recommend testing before the day you expect your period for two reasons, even if you have a test that claims to test very low levels of HCG. First, the false negative rate is extremely high, so if you get a negative result, you still need to test again. Second, even if you get a positive result, the rate of miscarriage before your period (chemical pregnancy) is quite high and you will just be disappointed. There's no harm in testing before you expect your period, but you just have to keep these factors in mind.

I'm glad that you like the pregnancy quiz.

Sincerely,
Amy

Anti-E antibodies

Hi,

I'm 16 weeks pregnant and just been to the midwife who told me my blood test results were good, but they found traces of anti-e in it. As I'm rhesus negative I just wondered what that meant and if it gets any worse in my next blood test what that might mean for me and the baby.

Tracey

Dear Tracey,

Rh disease can occur if the mother is Rh negative and the baby is Rh positive. The mother can make antibodies against the baby's blood cells. These antibodies can cross the placenta and destroy the baby's blood cells making the baby very sick. There are many different Rh antibodies, but when we speak of Rh negative, we are referring the the D antibodies (most of the antibodies are named by letter).

A much less common form of Rh disease can be caused by E antibodies. That is a possibility in your case. Typically, though, the level of antibodies remains stable throughout the pregnancy, and there is no problem. Occasionally, the antibody level begins to rise indicating that it is possible that the baby is affected. In that case, the baby would be monitored with regular ultrasounds to be sure that he or she is still doing well. In the rare case that the baby develops anti-E Rh disease, it can be treated with a transfusion while it is still inside the uterus.

Sincerely,
Amy

Black bleeding after LEEP

Hi,
I recently had a LEEP procedure to remove high grade squamous and glandular cells from my cervix. After the procedure I was bleeding black like they told me I would. I have had two normal periods since then, but my third period is back to bleeding black and I can't find any information on what to do about it. Is it a complication of my LEEP or something else? I would greatly appreciate any information or advice you can offer about this.

Thank you!
Autumn

Dear Autumn,

The black material you saw after the LEEP is usually the result of the medication that is put on the cervix to stop the bleeding. It's hard to imagine that the medication is still there so long after the procedure, so I'm not sure what is going on. You should talk it over with your doctor.

Sincerely,
Amy

Weight gain during pregnancy

Hi,

I am 28.5 weeks pregnant and about 68kg. I was 55kg before I became pregnant. What proportion of my body weight now is attributable to the pregnancy?

Thanks,
Vicki

Dear Vicki,

The recommended weight gain for pregnancy is about 30 pounds. That would be the result of gaining 1/2 pound per week for the first 20 weeks, and about a pound a week for the last 20 weeks. Therefore, at 28 weeks, you should have gained 13 pounds. The baby accounts for only 2 pounds; the rest is increased weight of the uterus itself, amniotic fluid, increased blood volume, and more.

So far, you've gained 13 kg which is approximately 28.6 pounds. Personally, I think the recommendations are unrealistic. Most women gain considerably more than the recommended weight and then they lose it after the baby is born. In my experience, the amount of weight that you have gained is typical.

Sincerely,
Amy

Monday, October 17, 2005

Miscarriage of one twin

Is it possible to be pregnant with twins, but then have a miscarriage of only one baby, and still be pregnant with the other?

Thanks,
Victoria

Dear Victoria,

Yes, that does happen occasionally. If it happens in the first trimester, there are usually no effects on the surviving baby. If it happens later in pregnancy, it can cause problems.

Sincerely,
Amy

Morning sickness

Dear Dr. Amy,

I am 13 weeks pregnant. I have had severe morning sickness which my Dr. has given me Premesis to calm it down which i find sometimes only contributes to my all day sickness. I also have this this mucous in the back of my throat which causes me to vomit even more. The crackers, toast, ginger ale has not helped any. Any insight on this? It has caused me to lose some weight and i would like to avoid any more weight loss. My next appointment isn't for a few weeks i just wanted some feedback.

Thank you,
ALR

Dear ALR,

Morning sickness is extremely unpleasant, but there is not much that you can do for it. It tends to go away after the first trimester though, so hopefully it will begin to ease up soon.

Sincerely,
Amy

IUD and pregnancy tests

Hello there,

I am 26 years old and a mother of two boys. I had the IUD inserted 17 months ago without any problems. My periods are normally regular, I am two weeks late this time, I have done a pregnancy test and this shows negative. Is it possible to have a false reading whilst IUD in place.

Thanks,
Heather

Dear Heather,

An IUD has not effect on a pregnancy test. Certain IUDs contain hormones and these can cause you to miss a period. Talk it over with your doctor.

Sincerely,
Amy

Acebutelol

Dr. Amy,

I just had a miscarriage 2 weeks ago, and I have borderline high blood pressure. I would like to concieve again but I have been put on acebutelol to control my blood pressure. Will this have any effect on the fetus?

Sherry

Dear Sherry,

Uncontrolled high blood pressure can cause problems in pregnancy so it is important to keep your blood pressure under control. Acebutelol is considered safe in pregnancy. Talk with your gynecologist, though, to be sure that this is the best medicine for you during a pregnancy.

Sincerely,
Amy

Fluoxetine (Prozac)

Can I take Fluoxetine (20mg) during pregnancy? I have been taking this for the past year and have recently stopped taking it (for the last 2 months) I notice a HUGE difference in my everyday life. Fluoxetine has been very helpful for me. the reason i stopped taking it was because my husband and I would like to get preganant and i didn't know if this would be harmful in my system?Please let me know!

Kayli

Dear Kayli,

This is a controversial issue in obstetrics right now. On the one hand, there is a suggestion that some anti-depressants can cause birth defects. On the other hand, significant depression is a health risk, too. You need to talk with the doctor who prescribed the fluoxetine and with an obstetrician to find out all the risks and benefits in your particular situation so you can make an informed decision.

Sincerely,
Amy

Sunday, October 16, 2005

Still bleeding 9 weeks after the baby is born.

Dr. Amy,

I had my baby almost 9 weeks ago. I know that afterwards my period will last anywhere between 6 to 8 weeks, but it going on nine weeks and i still haven't stopped. Is this normal?

MA

Dear MA,

No, this is not normal. The bleeding should stop by 6 weeks (it usually stops between 3-4 weeks) and women who are not nursing usually get their first period 6-8 weeks after the baby is born. You should talk this over with your doctor. It could be a sign that a small piece of placenta was left behind.

Sincerely,
Amy

Group B strep and fertility

My daughter-in-law has just found out that she was treated for strep b a year ago. Could you please let us know if carrying this virus would stop her concieving. Many thanks for your time.

Pam

Dear Pam,

Group B strep is a bacteria and when it is in the vagina at the time of birth can cause illness in a newborn baby. That's why women who carry group B strep in the vagina are treated with antibiotics. It has no effect on fertility.

Sincerely,
Amy

Can I find out if I had a miscarriage by taking a pregnancy test?

Hi,

I just recently found out that i was pregnant, but i lately i have had several symptoms of a miscarriage. If i took another pregnancy test, can I find out if I actually had a miscarriage?

Andrea

Dear Andrea,

No, a home pregnancy test cannot tell you whether you have had a miscarriage. That's because a home pregnancy test detects the presence or absence of HCG (the pregnancy hormone). The hormone can stay in your body for weeks after a miscarriage, so a home pregnancy test will still be positive long after the miscarriage is over.

A blood pregnancy test can tell you the actual amount of HCG. If you have two tests several days apart, and the level of HCG is falling, it is sign that the pregnancy is not normal and you probably have had a miscarriage.

Sincerely,
Amy

Do you ovulate when you take the inactive pills?

Dear Amy,

I take a birth control pill everyday. The pills I take are called Seasonale. They are great because I only have to have 4 periods a year. WoooHooo!!!! My husband and I had intercouse while I was taking my white pills. I was ovulating during this time. Is there a chance of getting pegnant during this time or am I protected with the pill still in my system?

Thank you,
Nina

Dear Nina,

You never ovulate while you are taking the Pill, even when you take the inactive pills. You are always protected as long as you faithfully take the pills.

Sincerely,
Amy

Angleman Syndrome

My fiance has a daughter from his previous relationship. She has angelman syndrome. What are the chances of the happening to us when we decide to have a baby? Should we do testing before hand? Thank you.

Amy

Dear Amy,

Angleman Sydrome is caused by a genetic problem that is inherited from a parent, often the father. Therefore, it could happen when you decide to have a baby together. You should see a genetic counselor, and your fiance should have genetic testing. That way you will know if he carries the defect and what the chances are of passing it on again.

Sincerely,
Amy

Pregnancy and heparin

I am currently 10 weeks pregnant with my 6th and only so far successful pregnancy. My mother is a Phlebotomist, and she had suspected with my previous pregnancies that I had a clotting problem which may have contributed to my miscarriages. I am also Rh neg. When I discovered I was pregnant again, I demanded my doctor put me on heparin. At first he was hesitant, but after talking to my mother about my blood work, he put me on 5,000 units twice a day via injection. I have seen a reproductive specialist up to this point. My CBC's and PTT's have continuously come back in normal range up to this point. My Specialist recommended I stop my injections when I am 12 weeks pregnant. I am having a hard time finding any information on my circumstance, and was wondering if you have ever had a patient in my scenario, or know if my blood starts clotting after 12 weeks, how detrimental that would be to my baby. Also do you have any resources on my condition. Thank you.

Tracy

Dear Tracy,

I'm not sure I understand what your condition is. Based on what you wrote, you are on heparin because you insisted on it. However, heparin is the appropriate treatment for specific conditions such as clotting factor problems or unusual antibodies (eg. factor V Leiden, or anti-phospholipid antibodies) . These tests are different from basic clotting studies like PT and PTT. You need to have a diagnosis in order to figure out whether you need heparin and how how long you should be on it.

Sincerely,
Amy

Saturday, October 15, 2005

Spinal vs. epidural

Dear Dr. Amy,

I am 37/ 1/2 weeks almost 38 weeks tuesday. The baby will be c-sectioned, october.24,2005. This is my 2nd c-section and my doctor said I'm having a spinal not a epidural. Is the spinal better? What they will do and what should I expect because the epidural really hurt me.

Sincerely,

Lacy

Dear Lacy,

An epidural is recommended for labor because the anesthesiologist can add to it to continue it for as many hours as necessary. A spinal lasts for about 1 1/2-2 hours, more than enough time for a C-section. A spinal is easier and faster to put in, too. The needle is inserted in the same place on your back, but the anesthetic is simply injected and the needle is removed. There is no catheter (small tube) that is left in your back.

Sincerely,

Amy

Follow up question on premature rupture of membranes

Dear Dr Amy,

Thank you for the response, I went to see my doctor and also my consultant regarding me being 35 weeks now. it has been nearly 2 weeks since my waters broke and I asked if they were going to induce me. They told me to make another appointment for a weeks time and if i haven't gone into labour on my own that they will induce me when i get to 37 weeks. Will this be ok? They have not given me another course of antibiotics either. Can i do anything else?

Julia

Dear Julia,

I would ask about the risk of infection. Studies of prolonged premature rupture of membranes indicates that the risk of infection increases as the duration of ruptured membranes increases. Therefore, once the baby's lungs are mature, delivery is recommended.

I don't know if the recommendations are the same in your country, but I would definitely ask. The most important questions are:

What is the risk of infection in ruptured membranes? We know that if you get an infection it can have serious consequences for the baby.
What is the risk to the baby of being delivered now (as long as the lungs are mature)?
Which risk is greater?

They should be able to answer these questions for you. Unless the risk of being delivered early is significantly greater than the risk of infection, the vast majority of doctors would recommend induction.

Sincerely,
Amy

Twins

Hi,

Do twins often come on their due dates or are they known to come early?

Thank you,
Lauren

Dear Lauren,

Twins are usually born early.

Sincerely,
Amy

Umbilical cord cyst

I had an ultrasound done at 19 weeks and received a call from the doctor's office a couple of days later saying not to worry, but that I need to see a specialist about a cyst on the umbilical cord. Even though they said not to worry they offered no explanation of what this really means. I am concerned as to what this could mean for my baby boy! I am 30 years old and this is my first pregnancy.

Very concerned,
Carrie

Dear Carrie,

Most umbilical cysts do not indicate a problem. However, about 20% of the time umbilical cysts are associated with birth defects or chromosome problems. If the ultrasound shows no problems besides the cyst, it is likely everything is fine. However, if there are any questions about other structures, the doctor may recommend amniocentesis to check the baby's chromosomes.

Sincerely,
Amy

Trisomy 18

I found out at a routine check-up with the midwife that the baby did not have a heartbeat. I was 18wks+4 days. An ultra sound confirmed the baby had died. I delivered him on 12 sept 05. The results of the chromosomes from our baby have shown a male karyotype with an extra chromosome no.18. I have 4 boys from my first marriage. This was to be my new partner's first baby, and our first together. We are due back to see our consultant obstetrician on 7 nov 05 and as it's only 15 oct. Our main question is can we have a normal pregnancy or is there a risk that 'edwards syndrome' will happen to us again.

With thanks,
Diane

Dear Diane,

I am so sorry to hear about the loss of your son.

Trisomy 18 is similar to Down's Syndrome (trisomy 21), but more severe. Babies born with trisomy 18 rarely survive even a few days after birth.

Like Down's Syndrome, the risk of trisomy 18 increases as the age of the mother increases. If you have already had one child with a trisomy, the risk of another is about 1%. The risk may be even higher depending on your age. Of course, this means that the chances of having a normal baby is still quite high.

Sincerely,
Amy

Positive pregnancy test after miscarriage

Hi Dr. Amy,

I had a miscarriage after being five weeks pregnant. Thirty two days have now gone by since the first date of the miscarriage. I have this morning done a pregnancy test and it is positive. Is this okay? Am I supposed to have a proper period between? Silly question but you read all sorts of things!!

Thanks,
LF

Dear LF,

You don't need to have a period before getting pregnant again. However, it is possible that you had a positive pregnancy test because you still have pregnancy hormone left over from the previous pregnancy. This can be sorted out by measuring your blood levels of HCG to see if they are rising (new pregnancy) or falling (miscarriage).

Sincerely,
Amy

Friday, October 14, 2005

Thalassemia minor

Dear Dr. Amy.

I am 31 yrs old, and have the condition thalassaemia minor. My husband is negative. Do I need to take any other precautions when I'm pregnant?

Regards,
Annette

Dear Annette,

If your husband is documented by blood test to be thalassemia negative, you do not need to worry about the baby getting thalassemia major. Even so, you should talk this over with your doctor.

Sincerely,
Amy

Bad cold during pregnancy

Dear Dr. Amy,

I just found out that I am three weeks pregnant and that I have a terrible chest cold. I am coughing so much it feels as if my lungs are gonna collapse. I was told that there is nothing I can take except tylenol. Is that true? Is that all a pregnant woman can take for a cold? There has got to be something out there I can take. Pregnant women are more apt. to getting sick, right? Thank you and hopefully you know of something I can take.

Thanks,
Jessi

Dear Jessi,

You can take cough medicine during pregnancy. However, it sounds like you may have bronchitis and need antibiotics. You should call your doctor and go in to be checked.

Sincerely,
Amy

Husband's decreased sex drive after birth of the baby

Dear Dr. Amy,

My husband and I had a baby about five months ago. We had taken every precaution to have it go the way we planned it. Unfortunately it did not. I have always had a female doctor as this is what I was comfortable with.

My problems is I went into labor 10 weeks early and was sent to another hospital. I had made multiple requests for a female doctor and one was eventualy brought in for us. Before she arrived a male doctor came into the room and asked to check me. I was scared and my husband was not happy. When the dostor asked if he could check me I never answered him and he did it anyway. I felt I had no choice in this matter and it has caused many undersirable consiqences in our marriage.

My husband has a hard time getting this out of his mind and I am getting really worried about him. Our sex life has gone down hill dramatically as every time we get ready and get undressed all he sees is the doctor inserting his fingers into my vagina. This has taken control of his life and damaged our marriage.

I guess I can understand where this would affect him. I am shocked this doctor could do this without my approval. My husband and I had talked about male doctors before the delivery and I knew how he felt and I never stopped it from happening. Now what do I do?

Thanks,
Jeanne

Dear Jeanne,

You are right to be concerned because this is a very unusual response. It sounds like this incident has stirred up some serious emotional issues for your husband and he needs to find out what is going on. I suspect that he could get a lot of relief by discussing it with a mental health professional. If he will not go, you could go on your own. You may be able to learn some helpful techniques for dealing with this.

I have heard about men having decreased sex drive after witnessing childbirth because they are subconsciously afraid to cause their wives such pain again, or are subconciously afraid of another unplanned pregnancy. I have not of anyone upset about a male doctor doing a vaginal exam since, until fairly recently most doctors were men.

Good luck with this problem.

Sincerely,
Amy

Nair in pregnancy

Hi,

I am 24 weeks pregnant and it is getting hard for me to shave my legs I was wondering if I could use Nair hair remover.

J

Dear J,

I don't know if it has been studied, but I would avoid it.

Sincerely,
Amy

Seasonale and mood changes

My normal healthy happy 17 yo daughter has become very emotional the past 6-8 weeks, cries at the drop of a hat with no warning, and crawls in bed with me. I've asked her what has been bothering her and she states she doesn't know. I've asked her if she needs to talk to someone other than myself she states she doesn't know. The only change during this time was that she was started on Seasonale. Is this common? Should she switch birth control pills or should I give it a few more weeks? It hurts to see my happy beautiful girl likes this.

Thanks,
Mom in PA

Dear Mom in PA,

Birth control pills can lead to mood changes and in some cases can cause depression. You should talk to her doctor as soon as possible since he or she knows your daughter's medical history. Based on what you told me it sounds like she should stop taking the Seasonale. When she stops, it will precipitate a period.

Sincerely,
Amy

Metronidazole (Flagyl) in early pregnancy

I was taking Metronidazole at a dose of 400mg tid and later found out that I was pregnant. I am 6+ weeks now and have calculated that I would have been around 2 and a half weeks pregnant at the time I was taking the Metranidazole. Can you tell me if this was a high dose of Metranidazole and also if it may have any negative effects on my unborn baby?

Thanks,
Jen

Dear Jen,

You were taking the standard dose of metronidazole. Metronidazole is considered safe for use in pregnancy if medically necessary, although it is usually avoided in pregnant women because it has not been well studied. The risks in your case are theoretical because you were taking it in the very earliest stage of pregnancy, perhaps before the embryo implanted. Be sure to talk over your concerns with your doctor. He or she should be able to reassure you.

Sincerely,
Amy

Thursday, October 13, 2005

HCG levels not doubling

I guess I am looking for reassurance. I am roughly 7 wks pregnant and my hcgs have looked like this:
9-23-05 78,
9-25-05 95,
9-27-05 128
10-11-05 5001.

I believe my lmp was 8-23-05. I have been symptomatic, ie., intermittent breast tenderness with more blue veins on upper chest, frequent urination, a bit more fatigue, and constant queasiness, as well as heavy gas(belching) and some abdominal heaviness. I have had NO signs of impending miscarriage(I have had 3 in the last 3 1/2 yrs.) My early number obviously did not double and now the average doubling time (1st hcg to last) is now averaged at 72 hrs. Am I fighting a losing battle or have there been successes with this kind of beginning.

44 & Praying Hard
Cheryl

Dear Cheryl,

I am very sorry to say that I cannot offer reassurance or encouragement. You already know that the HCG levels indicate that the pregnancy is not normal. I have never seen a situation like this work out. By now, an ultrasound should show a baby and perhaps the heartbeat. If the baby has not yet been seen, you can be sure that this is a miscarriage.

I'm sorry.

Sincerely,
Amy

Quitting smoking while pregnant

I have been a pack a day smoker for the past two years and was a light smoker for a few years before I stated smoking more. I recently found out I was pregnant. I am 18 years old and about 5 weeks along. Some people have told me to quit cold turkey so my baby will be healthy and I not have a miscarriage, while others say if I quit cold turkey my body and my baby will go into shock and I will have a miscarriage. What is the best option? I m so scared of having a miscarriage, and I want to do the best thing for my baby.

S

Dear S,

Quitting smoking cold turkey will not cause a miscarriage. In fact, quitting smoking will reduce your risk of miscarriage. Keep in mind, though, that the risk of miscarriage in any pregnancy is 20%, so quitting does not guarantee that you couldn't have a miscarriage.

Sincerely,
Amy

Abnormal bleeding on Lexapro

Dr. Amy,

I am a 44 year old woman. I recently started taking Lexapro to treat PMS/Perimenopause symptoms. The med. is working great! The trouble is that I had no period at all for 2 mo. after starting the Lexapro. Then 3 weeks ago I started my period & I'm still on it! For the most part it is very light bleeding but last week I had a day that I was bleeding so heavily I went through 8 tampons in 3 hours. Is any of this normal? Help! I'm spending a fortune on tampons!

Thanks!
J

Dear J,

It is not a common side effect, but Lexapro is known to cause menstrual disturbances. Of course, perimenopause is also characterized by menstrual disturbances, so it is dfficult to know what factor is responsible. You should talk this over with your gynecologist. He or she will probably recommend a short course of Provera to bring an end to your period. Then you see whether this problem persists, of if it will go away by itself.

Sincerely,
Amy

Reflexology treatment in pregnancy

Hi,

Can you have a reflexology treatment when you are pregnant?

KF

Dear KF,

Yes, you can. That's because reflexology appears to have no effects of any kind, either beneficial or harmful. The basic principle of reflexology is that the hands and feet are related to the internal organs. There is no scientific evidence that the hands and feet are connected in any way to the internal organs.

Sincerely,
Amy

Daughter's periods have stopped

Dear Dr. Amy

My daughter has not have her period this year. First she was having irregular periods and now it just stopped. I have an appointment to see an obgyn next week but I am very worried and concerned because she is just fourteen and as a mother who had never experience this before I am very scared. I hope it is nothing serious.

Thanks,
A worried mother

Dear Worried Mother,

Many young teenage girls are very irregular, but it makes sense to get this checked out. It is possible that she has polycystic ovary syndrome (PCOS), a hormone problem that can cause irregular periods. If that's the case, the doctor will most likely prescribe birth control pills to regulate her period, even if she doesn't need protection from pregnancy. That's because going months at a time without a period puts her at risk for developing abnormal cells in the uterus many years in the future.

The doctor may also order a pregnancy test, since that is always a possibility. It may not really be a possibility in this case, but the doctor doesn't know that, and young girls often lie to the doctor about sexual activity.

Sincerely,
Amy

Premature rupture of membranes

My waters broke 11 days ago when i was 33 weeks + 3 days. I went to hospital and they kept me in. They gave me 2 steroid injections to help baby's lungs mature and told me I may go into labour but I didn't. I am now 35 weeks today and still no sign of baby arriving. They have let me home with antibiotics and I have to monitor my temperature , and if I start to feel unwell I should go back. How long they will let me go before they decide to induce me? I know baby makes more fluid but i am leaking all the time.

Julia

Dear Julia,

Once you rupture your membranes, you are at high risk of developing an infection that could be harmful to the baby. The baby should be delivered as soon as possible after your doctor makes sure that the baby's lungs are mature (ready to breathe). A sample of amniotic fluid can be sent to the lab to check the baby's lungs. If they are not mature you would need to wait a little longer. If they are mature, you can be admitted for an induction.

Talk with your doctor tomorrow and ask him (or her) when he will check the baby's lungs. Most babies will be mature by 35 weeks, especially if you had steroids.

Sincerely,
Amy

Sleeping position in pregnancy

I'm 23 weeks pregnant. Is it ok to sleep on both sides- left and right or do I absolutely have to sleep on my left side only. Also is it ok to sleep on my back?

CM

Dear CM,

Toward the end of pregnancy, when the baby is heavier, it can press on a major vein of yours when you are laying on your back. This could theoretically reduce the flow of blood to the baby. It's an important point during any surgery you might have while pregnant (including a C-section), because you wouldn't change your position.

When it comes to sleeping, though, it is a different matter. First of all, you would not sleep flat on your back in the later stages of pregnancy because it would be difficult for you to breathe. Second, when you sleep, you move around all the time, so you would not be stuck in one position.

You can sleep in whatever position you are comfortable unless your doctor advise otherwise.

Sincerely,
Amy

Wednesday, October 12, 2005

Hypothyroidism

Hi Dr. Amy,

I have been under an endocrinologist's care for the past three years. I take Levoxyl every day, and will have to for the rest of my life. At first, after taking the medication for a few months, I felt like a new person. I couldn't believe the difference it made! But little by little, the symptoms returned after about a year and a half. They are worse than ever now, but I haven't been able to convince the doctor to increase the dosage, which is 75mcgs. He just chalks my symptoms up to approaching menopause, because I am now 47. He has said the same thing for the last two years, but my gynecologist says I am NOT yet in menopause, and that many doctors blame that for things they don't want to treat or explore. I tried going to another endocrinologist, and the second doctor was even more oblivious. I have thyroid nodules, and that issue, coupled with obvious symptoms prompted my doctor to begin treating me in the first place. My blood work did not seem to indicate a problem, and I have discovered that that is very common. Here is my question: I have my annual appointment with him next week. Being a doctor yourself, do you know of anything I could say or do that may help get his attention? I don't think I can take another year of feeling so horrible, and I am getting worse all the time. Thank you so much for your time.

Sincerely,
Nancy

Dear Nancy,

You are not alone with this problem. You still have symptoms despite normal thyroid tests. This can also happen in untreated patients who have all the symptoms of hypothyroidism but normal blood tests. Whether or not to treat these people, or increase the dose of medication is a controversial area of medicine. A prominent endocrinologist has written an influential article which insists that such people should not be treated.

Personally, I think it is the job of physicians to treat the patient, not the lab tests. Talk with your doctor about a trial of an increased dose of your medication. Ask him what the potential risks are and tell him that you would be willing accept any risk (if there are any, and if you are willing to accept them). If he won't budge, you'll have to look for a different endocrinologist. Perhaps your gynecologist will help you find someone who is more sympathetic.

Sincerely,
Amy

Lower abdominal pain and bleeding

Dear Dr. Amy,

I am experiencing lower abdominal pain and intermittent bleeding. I did not have a positive pregnancy test but am trying to get pregnant. My periods do not normally feel this way and the pain seems worse when I am up and moving around. I still experience a dull ache in my abdomen constantly and the pain is more acute when I get up and down stairs and walk around. Also my bleeding started 4 days ago and has stopped and then started again. I am wondering if this is a miscarriage instead of a regular period. I am also being treated for PCOS.

Thanks,
BH

Dear BH,

I'm not sure what is going on, but you should definitely see a doctor. My main concern is that you might have an ectopic (tubal) pregnancy. That's when the fertilized egg gets stuck in the fallopian tube and begins growing there instead of in the uterus. The classic signs of an ectopic pregnancy are lower abdominal (usually on one side), vaginal bleeding and a positive pregnancy test. It is possible that the pregnancy test you used is not sensitive enough to detect an ectopic pregnancy which usually has a lower than normal level of HCG (pregnancy hormone).

Sincerely,
Amy

Repeated miscarriages

My wife and I has been trying to have a baby for the past few years. Unfortunately, we been unable to achieve that precious gold as yet. My wife has had 4 miscarriage now and all of them have been 8 weeks or less. We have done few tests and doctors cannot find anything wrong. There must be something wrong for some one to have 4 miscarriage, so I am asking you if you could recomend us to a specialist for some advise.

Many thanks,
Gayon

Dear Gayon,

You are right. Having 4 miscarriages means that there is a problem. You and your wife need to see an infertility specialist. An infertility specialist is also an expert in repeated miscarriages. He or she can order the correct tests, diagnose the problem, and recommend the appropriate treatment.

On the Links page of this website (www.askdramy.com/links.html) , you can find out how to locate an infertility specialist in your area.

Good luck!

Sincerely,
Amy

Dental work in pregnancy

I have to get a cavity filled today and I haven’t been to my first prenatal visit with my doctor. I am about 7 weeks pregnant. Can I get a shot of novacaine or is it harmful to my baby?

Natalie

Dear Natalie,

You can have dental work including novacaine during pregnancy. Be sure to tell your dentist about the pregnancy so that they won't use any medications that could cause a problem.

Sincerely,
Amy

Cystic structure near baby's head

What does it mean if after my last ultra sound ( at 8 weeks) they said they saw "possible cystic area at cephalic end of embryo" ? They have scheduled a second ultra sound to try to get a better look. I am now 11 weeks. What could it mean if there is a cystic area at the baby's head?

CJ

Dear CJ,

At 8 weeks the baby is very small, so it is difficult to get a good look at the different parts of the baby. They are concerned because they saw a cyst (fluid filled sac) near the baby's head. It could have gone away by itself by now, or it could be a sign of a problem like a brain cyst. The next ultrasound should give you much more information.

Sincerely,

Amy

Late period on the Pill

I have had severe anemia in the past and just started taking birth control pill to regulate my blood loss. My period is late, which I didn't expect to happen since I took the pills as directed. Is this normal and how long before my period becomes regular?

AR

Dear AR,

As long as you get your period during the week that you are taking the inactive pills, your period is not late. If don't get your period by the time you finish the pack, you should talk it over with your doctor because of the possibility of pregnancy.

Sincerely,
Amy

Due date

Please advise if falling pregnant while taking the contraception pill makes a difference to your due date. Hospital has states at due date 30th October 2005.

last date of period 4th January 2005

Can you please confirm if this is correct !

Thanks for your help in this matter

Regards
Donna

Dear Donna,

Whether or not you are taking the Pill when you get pregnant makes no difference in calculating your due date. However, if an ultrasound differs dramatically from the due date calculated from your last period, your due date will be changed.

Sincerely,
Amy

How many weeks am I?

Last night I took a pregnancy test and it was positive, so I did the same the thing this morning and it was positive. My last period was August 20. How many weeks I am and when to start the next week.

Cherie

Dear Cherie,

Check out our new Pregnancy Calculator at Pregnancy Calculator at www.askdramy.com/pcalctry.html. If you put in the date of your last period and the average length of your cycle, it will estimate your due date and how many weeks pregnant you are. It will also calculate when you likely conceived.

Sincerely,
Amy

Beta thalassemia

Dr Amy,

My sister was diagnosed with beta thalassemia a year ago. I never really knew what it was but now that I have been looking it up I am very scared for her. I am very worried because she does not have any health insurance and doesnt go to the doctor. She's a very hardworking mother of six kids and never thinks about her self. She does have problems with anemia, which i hear comes with this disorder. I dont know what to do...I help her out when I can. I know that it could be life threatening especially if she's not being monitored by a doctor. Do you know if there's any programs that she can find that can help her? She lives in North Carolina. She has been told that she does not qualify for medicaid, and with the scarce jobs, the one she has now does not offer any benefits.

What warning signs should she look out for in having this disorder? I am very worried because i read that some people can die by the time they're 30 if not treated and she's 26.

Also, since it is a genetic disorder, do you think it would be wise for me to get screened as well?
Thank you for your time

Nia

Dear Nia,

Beta thalasemia is caused by an abnormal gene, and it occurs in two forms. If you have one copy of the gene, you will have thalassemia minor (also known as thalassemia trait). If you have two copies of the gene, you will have thalassemia major.

Thalassemia major is a very serious illness that is usually diagnosed in the first few months of life. Thalassemia minor causes few, if any symptoms, and is typically diagnosed in adulthood. It sounds like your sister has thalasemia minor. She does not need to have any specialized care.

You can get tested to see if you also have thalassemia minor. If you were to have a child with a man who also had thalassemia minor, that child could have thalassemia major. It would be important to monitor for that during any pregnancy.

Sincerely,
Amy

Tuesday, October 11, 2005

Braxton-Hicks contractions

At what stage in pregnancy do you get braxton hicks? Does it depend on whether it's your 1st or 4th baby?

T

Dear T,

Braxton-Hicks contractions (painless tightening of the uterus) usually start in the third trimester. It does not matter what number baby it is.

Sincerely,
Amy

Metallic taste

Dear Dr Amy,

I am 11 weeks pregnant and in the last few days have been getting a very stong taste of metal in my mouth. Can you please tell my what may be causing this ? Is it related to the pregnancy? Is it normal?

Thank you kindly,
Julie

Dear Julie,

It is related to the pregnancy. Some pregnant women experience a metallic taste in early pregnancy. No one understands why this happens. Fortunately, it usually goes away at the end of the first trimester.

Sincerely,
Amy

Metformin in early pregnancy

I found out I was pregnant on Sept 25th. Today I went in for my first ultrasound thinking i was 7w4d but I was only 6w1d by what the ultrasound measured. The heart beat was 124.

I was put on metformin 500mg once a day to even out my insulin levels b/c of being dx with PCOS and now the doctor wants me to stop it. I read nothing but bad stuff on when you
stop taking that med in the first trimester. I requested to stay on it till I hit my 12 week mark. Is there really any harm on staying on that since I'm only taking that once a day?

Also with the heart beat what is the normal range? Do boys have a faster heartrate or is it girls?

Thanks,
Stephanie

Dear Stephanie,

In one study metformin was shown to dramatically lower the risk of miscarriage in women with PCOS. However, this was a small study and it is difficult to know if the results would be the same when studied in a larger group. There is currently no evidence that metformin causes birth defects, but until recently it was never used in pregnancy so we don't have much experience to go on yet.

Metformin has not been approved or recommended for use in early pregnancy, so it puts most doctors in a difficult situation. The preliminary evidence suggests that it can prevent miscarriage, but it is important to understand that this is an "off-label" (unapproved) use of the drug. As long as you understand the potential risks, your doctor may be willing to let you continue the medication.

As far as the heart rate is concerned: the normal heart rate ranges from 120-160. There is no difference between boys and girls; that's just an old wives tale.

Sincerely,
Amy

Breast discharge

I had my tubes tied a little over 4 yrs ago. Just this last week I noticed cloudy white liquid coming from my left breast. The only time this has happened was when I was pregnant with my other two kids. Any advice?

M

Dear M,

You need to make an appointment with your doctor for an exam and probably a mammogram as well. Breast discharge can be a sign of problem. It might be a hormonal problem, or rarely, breast cancer. Breast discharge should always be investigated.

Sincerely,
Amy

Pumping instead of breastfeeding

Dear Dr. Amy,

I am 5 1/2 months pregnant and have been looking into the benefits and hassles with breast feeding. I would like to avoid the complications that come with the baby not latching on properly by feeding by bottle. I am planning on using, by pumping, my breast milk like I would formula. I am aware that the mature milk isn't produced for a few days after the baby is born and colostrum is produced until then, but I would like your suggestion as to what to do during those few days. Should I pump the colostrum? Is there enough to pump? Will it be ok to feed the baby from the bottle instead of my breast? Does not wanting the baby feed from my breast (out of fear of pain) make me a bad mother already?

Thank you,
Gina

Dear Gina,

That plan very rarely works out. Pumping is much more difficult than breastfeeding. The pump is a poor approximation of the baby and it is difficult to build up an adequate milk supply. Pumping also takes longer and, if not done properly, can increase the risk of breast infections.

Nursing is not necessarily going to be painful. Some women and some babies take to it right away and never have a problem. There's no way to know, though, unless you try. There's no question that breastfeeding can be inconvenient, but the benefits to the baby are so great, and the actual amount of time you spend breastfeeding is so small, that the benefits far outweight the burdens.

Try breastfeeding for 3 weeks. Almost everyone who sticks with it for that long wants to continue. If you don't like it, you can always try the pump.

Sincerely,
Amy

Cyst in pregnancy

Hi,

What are the risks of having a cyst when you are pregnant. Can it harm the baby?

Thank you,
Lori

Dear Lori,

It depends on the type of cyst. The most common ovarian cyst in early pregnancy is a corpus luteum cyst. This cyst forms on the ovary at the site where the egg was released. The majority of corpus luteum cysts will go away by themselves. Occasionally a cyst will cause pain. Rarely a cyst will rupture and cause bleeding and severe pain. The cyst itself cannot harm the baby.

Sincerely,
Amy

Is this another ectopic pregnancy?

I had an ectopic pregnancy earlier this year following a reversal of sterilisation. I'm pregnant again, about 5 weeks, and keep getting the odd sharp twinge. Could this be another ectopic pregnancy??

Vicki

Dear Vicki,

It certainly could. You are at extremely high risk for another ectopic pregnancy because of your history of tubal reversal, and the fact that you have had a previous ectopic pregnancy. You should call your doctor as soon as possible. He or she will want to check your HCG levels and an ultrasound to be sure that this is not another ectopic pregnancy.

Sincerely,
Amy

Breakthrough bleeding on Seasonale

I started taking Seasonale birth control pills about 2-1/2 months ago. As I get closer to the end of the 91 day cycle I am experiencing quite a bit of breakthrough bleeding. I never had that on other BC pills. Should I continue with the Seasonale? Or can I go back to the other kind and just skip the inert pills?

BM

Dear BM,

Seasonale is birth control pills with the inert pills removed; it's not a special type of Pill. While it works very well for some women, it does have a high incidence of breakthrough bleeding, especially with the first few packs. The breakthrough bleeding may go away by itself over the next few months, but if you find that it becomes too annoying, you can switch back to the Pill you were using before.

Sincerely,
Amy

Monday, October 10, 2005

HCG levels not doubling

A few months ago I had IVF and was pregnant but missed carried at 7 weeks. My 2nd beta test my numbers did not double but were very close but I still miscarried. Had IVF 2 weeks ago and found out was pregnant again. My first numbers were very good but they did not double for my 2nd beta HCG. Is this a sign that I will miscarry again?

Tammy

Dear Tammy,

I am sorry to say that this is not a good sign. You didn't tell me what the numbers were, but if they are not doubling appropriately, it is not likely that this is a normal pregnancy.

Sincerely,
Amy

Getting insurance for prenatal care

Dear Dr. Amy,

I am 21 years old and 8 months pregnant. My fiance and I have tried everything to get insurance, but we haven't been able to get it. No doctor will see us without it. Will I be able to tell if there is something wrong with my baby before it is born? Thank you.

Alora

Dear Alora,

Many states have special programs for pregnant women who don't have insurance. The state provides insurance until the baby is born, and then the state provides insurance for the baby. You should check with your state government to see what is offered. There are also free clinics and hospital based clinics that provide medical care for uninsured women who are pregnant. You should make every effort to get some prenatal care, both for your sake and that of the baby.

There is no reason to think that there is anything wrong with your baby, but there is no way to know for sure until the baby is born.

Sincerely,
Amy

Can you have a miscarriage without bleeding and cramping?

I went to the Dr last week to have my ultrasound and the Dr could not find the baby's heart beat or even find the baby on the ultrasound. I don't understand why if I have lost the baby why haven't I had the bleeding and cramping. I had a miscarriage 12 years ago so I definitely know what that feels like. Please advise me what has happen?

Confused,
Toni

Dear Toni,

In most miscarriages, the baby has stopped growing, or never grew, long before the bleeding and cramping start. This may have been what happened in this case. The pregnancy has miscarried, but the pregnancy tissue has not yet been expelled.

Occasionally, the woman's body will not expel the pregnancy tissue. In that case, a D&C is needed to remove the pregnancy tissue.

Sincerely,
Amy

Miscarriage

Dr. Amy,

My daughter-in-law is pregnant and scheduled a doctor appointment with her OB/GYN. When they arrived, she was given an ultrasound, with the internal Doppler. According to her calculations, she was six weeks, but according to the doctor's calculations, they said she was eight weeks. The yolk sac was intact according to the doctor, however, no heartbeat was detected. The doctor stated to her and my son that they were to come back in two days and decide what they wanted to do, because she was sure there would be no change.

They were devastated to say the least, since she didn't explain any of her reasons as to what she was basis her information on. Since there was a discrepancy between the doctor's calculations and their calculations, is it possible that the reason they did not hear the heartbeat was because it was too small?

My daughter-in-law had a miscarriage a little over a year ago, but she was only three weeks along, and didn't even know she was pregnant. Since this doctor visit, she has had a little cramping and light spotting, but I think some of it is due to the stress by the doctor's suggestions that she have a D&C. They are scheduled to go back to the doctor this week, which according to their calculations, she will be 8 weeks. Just to reassure them, what should they be able to see and hear at 8 weeks? If they do not hear a heartbeat by internal Doppler at 8 weeks, does that mean there is a problem?

I am wanting them to seek a second opinion if this doctor is still insisting on a D&C. What do you think?

Concerned Grandma

Dear Concerned Grandma,

Before a D&C can be done, it must be proven that this is a miscarriage. Your daughter-in-law should insist on blood tests to check HCG (pregnancy hormone) levels. In a normal pregnancy, the HCG levels will double approximately every 48 hours. If the HCG levels are not rising appropriately, the pregnancy is not normal.

The discrepancy between your daughter-in-law's calculations and the doctor's calculations may be due to the fact that your daughter-in-law is counting from conception, while the doctor is counting from the first day of the last period (the standard measurement of pregnancy). You should be able to see the heartbeat between 7-8 weeks of pregnancy (5-6 weeks after conception).

Stress does not cause spotting or cramping, so it is possible that these are additional signs of miscarriage.

Sincerely,

Amy

I have been breastfeeding my twins for the past 20 months. I had my first period when they were about 4 months old, then none until about 4 months ago. I found that at the last 2 periods have been very long, about 3 - 4 weeks in length. They are not heavier than normal, and I do not have any other symptoms, apart from feeling frustrated at the extended length of bleeding time. I understand that they can be a little erratic to begin with. Is this possibly the cause? I also have a history of PCOS and infrequent periods. Any input from you about this would be greatly appreciated.

Regards,
Sue

Dear Sue,

I suspect that you are not ovulating due to the effects of PCOS and breastfeeding. The lining of your uterus continues to grow and has started sloughing off on its own, without the hormonal signal of ovulation. Since they are not regulated by ovulation, your periods can be longer or heavier than normal. This should go away by itself when you stop breastfeeding. If you have any other menstrual abnormalities, you may want to talk it over with your doctor who knows more about your medical history and family history.

Sincerely,
Amy

Communicable diseases and pregnancy

I am a nursing student who is a about a month or so pregnant. I was wondering what kind of patients I should avoid, or not work with. Thank you.

Sarah

Dear Sarah,

If you are up to date with your immunizations, you should be able to work with anyone. Of course, you should always use appropriate precautions, just as you would if you were not pregnant.

If you have never had chickenpox, and have not been immunized, you should avoid people with chickenpox.

Sincerely,
Amy

Husband has decreased sex drive

Dear Dr. Amy,

Ever since my husband and I have started trying to have a baby, his sex drive has taken a major dive. I have asked him if this is because he maybe feels he isn't ready, and he has assured me that is not the problem. He is having a hard time getting aroused and he is only 24. Obviously, this is going to be a problem for us in our baby making endeavors. I already have endometriosis and PCOS. He is just as frustrated as I am about the issue and it is causing problems in our marriage. (We have been married 4 years). Is this normal? Any suggestions? He isn't comfortable asking a Dr. about the problem.

Thank you,
Rachel

Dear Rachel,

Decreased sex drive can be caused by physical problems or psychological issues. Certain medications can cause decrease sex drive and medical problems can also cause decreased sex drive. It makes sense to start with a full physical exam to be sure that he is physically fine. He does not need to mention the reason to his doctor if he is not comfortable with that.

It is very possible that this is a psychological issue. Sex has changed from something that is purely exciting and pleasurable into a task. He may also be worried about the increased financial pressure and the change in your relationship that will come with being parents.

If it is psychological, it is not his fault and he cannot control it. It may stem from his upbringing or some other factor that he cannot control. A few sessions with a mental health professional may help him get to the bottom of this. If he refuses to go, you might consider consulting a mental health professional by yourself. He or she may be able to offer strategies that you can use to help your husband figure out what is wrong.

Sincerely,
Amy

Sunday, October 09, 2005

Chance of miscarriage after seeing the fetal heart beat

Dear Dr. Amy,

Two years ago I had a chemical miscarriage. In Apr. 05 I had a missed abortion at 7 wks. A D&C was done.

I am now pregnant again, and I am about 10wks. I hardly have any pregnancy symptoms. I had an ultrasound done on Oct. 5/05 which showed everything was ok and there was a heartbeat. After seeing a heartbeat on the ultrasound what are the chances of a pregnancy ending in miscarriage?

Marie

Dear Marie,

The chance of miscarriage in any pregnancy is 20%. This drops down to 10% after seeing the fetal heart beat on ultrasound, regardless of whether or not you have pregnancy symptoms.

Sincerely,
Amy

Is this miscarriage a result of a short luteal phase?

I just had a miscarriage around or under 6 weeks. Im breastfeeding and I know my luteal phase is on the short side (9-12 days) from charting so could of the miscarriage been cause by my short luteal phase? Is there anything I can do to prevent this from happening again?

Thank you,

Tiff

Dear Tiff,

If you are having regular periods at least 27 days apart, you do not have a short luteal phase. Special testing (usually an endometrial biopsy) is needed to make the diagnosis of short luteal phase.

Did you need progesterone supplements in your most recent pregnancy? If not, that would also make it unlikely that you have a luteal phase deficiency.

The most common cause of miscarriage is a one time, non-repeating genetic abnormality in the embryo.

Sincerely,

Amy

Blood work

My doctor recently sent me for blood work after my annual exam. I am unsure of the reasoning for this blood work and am trying to decipher the things he is having checked. Some of the things he is testing for is progesterone, CBC with Diff, TSH, Prolactin, Free and total testosterone, DHEAS, LH, FSH among others. I am just wondering, could he suspect I am pregnant, thus the blood test? Overall though, I was wondering what the hormones are associated with pregnancy.

Thanks for your help!

A

Dear A,

None of these hormone tests are for pregnancy. Only a measurement of HCG (human chorionic gonadotropin) will tell you if you are pregnant.

The CBC is just a blood count that is often done routine to be sure that you are not anemic. The other tests are hormones that are associated with menstrual problems and fertility problems. If you complained about irregular periods or difficulty getting pregnant, these tests are a first step in evaluating the problem.

Sincerely,
Amy

What is a normal fetal heart rate?

Is 156 a normal heart rate for a baby who is 33 weeks along. My baby's heart rate is normally around 145- 148. At my last visit it was 156. Is this normal?

MM

Dear MM,

A normal fetal heart rate is anywhere from 120-160. The heart rate will often be somewhat higher if the baby is moving at the time the heart rate is measured. That is a good sign.

Sincerely,
Amy

Trouble conceiving

Dear Dr. Amy,

I am a 29 year-old woman who is trying to get pregnant with my partner. We already have a child each from previous relationships and for the past two years we've been trying to get pregnant but it hasn't been a success. With my previous partner I contracted Chlamydia back in 1997 and had it treated immediately as soon as I found out. My ex-partner has recently become a father again with his new partner. I am concerned that because of the infection it has left me unable to conceive. I also have very regular periods. I feel that if another year goes by then we would have no choice but to go for Assisted Conception. Please help.

LR

Dear LR,

If you have been trying to get pregnant for more than a year without success, there is likely to be a problem of some kind. You should make an appointment with a gynecologist or an infertility specialist for a complete evaluation. The evaluation should identify the problem, and you can consider the appropriate treatment options.

Sincerely,
Amy

Toxoplasmosis

Is toxoplasmosis common? Do you see many babies born with severe congenital toxoplasmosis?

MB

Dear MB,

Toxoplasmosis is extremely uncommon. I have never seen a baby with congenital toxoplasmosis, although I have heard about such children.

Sincerely,
Amy

Sex after C-section

Hi, Dr.,

I was wondering how long should i wait beforehaving sex after a c-section on 9/30.

Also I have been getting swollen feet after the c-section. What can I do about it? I have been getting headaches ever since the c-section and was wondering if it has anything to do with the epidural I had. They stuck me 5 times before they got it in right. I am concerned that my future pregnancies will be delivered by c-section since the first was a c-section. How must I wait before getting pregnant again? Thank You!

YR

Dear YR,

At a minimum, you should wait until you stop bleeding. As long as you are bleeding, your cervix is open and you risk infection if you have intercourse. After that, you should follow your doctor's advice.

If the swelling and headaches have not gone away on their own, you need to talk to your doctor to be sure that you do not have a blood pressure problem. That is unlikely, but it is not impossible.

You do not have to have a C-section for future deliveries as long as you can find a doctor who is willing to let you try for a vaginal birth. Some doctors have stopped doing such deliveries for insurance reasons.

You can try to get pregnant again as soon as you would like. It makes sense to wait at least a few months though, to let your body build up reserves of iron and calcium to support another pregnancy.

Sincerely,
Amy

If I have HPV, does it mean my husband cheated?

I'm 40 and for the first time after 20 years of normal paps. Mine comes back abnormal. Dr. said that it was most likely caused by the HPV virus. Only have had 2 partners and the 1st was only once and my husband of 15 years. The doctor said that it looked as though I had it for 3 mo. 3 mo. ago I had a miscarriage and serious uti. She said because of the HPV one of us must have cheated in the last 3 mo. I was appalled!! We been together 15 years and we have 3 boys, and I would never and my husband never ever cheated.

Could the recent miscarriage and uti cause a few cells to be abnormal? The 1st partner I was with the one time was 17 years ago. Can the virus lay dormant that long?

Mr. dr. kept me waiting 3 hrs even when I had an appt. and then bec. she was running late, wouldn't asnwer any of my questions or even take another exam. She said I need the coloscopy and biopsy and that's final.

Thank you for your concern.

LD

Dear LD,

An abnormal Pap smear is NOT a sign of infidelity! It was very irresponsible (not to mention wrong) for the doctor to suggest this.

First of all, a Pap smear is a screening test. It identifies women who MIGHT have abnormal cervical cells. Therefore, we don't yet know if you have abnormal cells. Second, a Pap smear is not a test for HPV. There is a specific test for HPV so you can ask for that test to see if you really do have HPV.

Colposcopy and biopsies is the only way to actually diagnose abnormal cells. Any woman who has had an abnormal Pap smear should have a colposcopy and biopsies. Many women will find that they don't have a problem.

If it turns out that you do indeed have HPV, it could have been dormant in your body for years, perhaps even decades. You could have got it from your first boyfriend, or you could have gotten it from your husband, unless he was a virgin before he met you. Men usually have no symptoms of HPV, so he would never know that he has it.

Sincerely,
Amy

Can you delay a period?

My daughter is getting married November 5th of this year. She got her period yesterday which will make next months cycle arrive around November 3rd. Is there something she can take to either delay her period or force it start so that she can be period free for her wedding and week long honeymoon?

Thanks,
Concerned Mom

Dear Concerned Mom,

The only way to delay a period is if you are on birth control pills and skip the last week of the pack, proceeding immediately to the next pack. If you are not on the Pill, there is nothing that you can do.

Sincerely,
Amy

Postpartum exam

Hi!

I recently had a stillbirth at 27 weeks due to the umbilical cord wrapped around his neck. I had an appointment with my doctor 2 weeks later just to talk. My doctor gave us the go ahead to start trying again, but i did not have a post partum exam to make sure everything has returned to normal. Am i suppose to have one? What would you recommend. I'm just scared because i don't want to start trying again and find out everything didn't heal and lose another one.

Thank you so much,
Serena

Dear Serena,

I am so sorry to hear about the loss of your son.

What happened was a rare occurence that could not have been prevented and is extremely unlikely to happen again.

A postpartum exam is usually done at 6 weeks after the birth. Doing it earlier does not give you enough time to heal. There is virtually nothing that the doctor would find that would have any impact on future pregnancies, so you do not need to be concerned about that.

Sincerely,
Amy

Strep in vagina

I have hemolytic vaginal streptococci and am on my third course of penicillin in order to cure it. Can this have an impact on fertility?

Thanks,
Rose

Dear Rose,

Strep bacteria in the vagina is usually not treated unless it is diagnosed during pregnancy. That's because it is harmless to the mother, but can cause serious illness in a newborn if the baby catches it during delivery. Antibiotics are used to treat the bacteria during pregnancy and again at the time of delivery.

Sincerely,
Amy

Coffee in pregnancy

Dear Dr Amy,

Can drinking coffee during pregnancy cause any problems? My sister is concerned she may be drinking too much. She is currently 30 weeks and has an 11th month old baby. She saw her gynacologist this week and was told that the heart beat is very fast is now worried that it is due to her coffee drinking. Would appreciate any advice.

Many thanks,
Sandra

Dear Sandra,

It all depends on what the heartrate is and whether there is any abnormal heart rhythm. Coffee usually does not cause any problems, but if there is an abnormal heart rhythm, this should be investigated with an ultrasound and, if there is any sign of a problem, she may need to eliminate caffeine from her diet. She should talk it over with her doctor to get her doctor's recommendation.

Sincerely,
Amy

Pregnant after molar pregnancy

Hi,

I have previously hade a molar pregnancy (in feb 05). I was told not to get pregnant for one year but also not to use any contraception. I think I may have fallen pregnant again and am scared the whole thing will happen again. What will happen? Will i have to have blood tests all the time or have ultrasounds alot?

Thanks heaps,
abi

Dear Abi,

It's hard to imagine that anyone told you not to use contraception since every woman who has had a molar pregnancy is told to use contraception (usually the Pill) for a year after the pregnancy. This is because you must have regular blood tests throughout the year to be sure that the molar tissue did not turn into cancer and return.

You need to see your doctor right away to have your HCG level checked, and to have an ultrasound. That's because this type of cancer would also cause a positive pregnancy test so you need to make sure that this is really a new pregnancy and not cancer.

Sincerely,

Amy

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