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Having A Baby. Again Pregnant. Health Condition Not Suitable For Another Birth. Advise?

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Posted on Thu, 30 May 2013
Question: Hello Madam,

I am 20 years old and having a baby about 18 months old.
I suspect I may be pregnant now.. I tested with the instant home pregnancy test and the result gave as +ve. LMP on 2nd Apr 2013.
I am still feeding my child.
my health condition not suitable for giving birth to another child at this situation.

Please give your suggestion
regards,
XXXXXXX



doctor
Answered by Dr. Nirmala P (10 hours later)
Hi XXXXXXX
Thanks for asking in Healthcare Magic.

Generally pregnancy may not occur in lactating women due to high level of Prolactin, a hormone that helps in lactation. This hormone inhibits ovulation (release of egg from ovum). But this is variable and many women conceive while breast feeding their child.

Yes I understand your problem XXXXXXX One should be mentally and physically strong and determined to face pregnancy and childbirth. The changes that occur during the early months of pregnancy like nausea and fatigue along with the chores of looking after an young active child can be very exhausting and probably that's why you feel so. You should rule out anemia as this can also add up to your tiredness.

If you are still opting for abortion, it is very much possible since you are in the early stages of pregnancy (first trimester). But it must be done only under the supervision of a gynaecologist to prevent complications like incomplete abortion. You will have to give a a signed consent form before the procedure. Oral tablets like Mifepristone and Misoprostol are available for medical termination of pregnancy. Your treating Dr will know about these drugs

Since repeated abortions are not advisable, I would suggest you to choose a contraceptive method in future to prevent conception, if you don't want to conceive. Repeated abortions will affect your health and will interfere with your regular menstrual cycles and normal physiology of uterus and ovary.

I hope this helps. Please address to me if you have any further concerns. I will be very happy to assist you.
Good Day XXXXXXX
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Nirmala P (24 hours later)
Hello Madam,

Thanks for your reply and valuable suggestion.

I went to consult gynecologist, she advised me to take a scan and ectopic pregnancy to be ruled out. suggest serum b hcg correlation and follow up scan after three weeks.

Scan survey: no intrauterine g sac seen at present. thickend endometrium 14 mm only seen.

I have taken the blood test today and awaiting for the results.

Regards,
XXXXXX.
doctor
Answered by Dr. Nirmala P (18 minutes later)
Hi XXXXXXX
Welcome back to Healthcare Magic forum.

Thanks for following up the suggestions. Endometrium is the inner lining of uterus. Endometrial thickening 14 mm means that your uterus is in proliferative stage. No gestational sac present means that you are not pregnant now and that will now relieve your anxiety.

However please come back with your blood test and follow up scan reports. Blood test will give a clear picture about your present status of pregnancy. Follow up scan will confirm the blood test results.

Good Luck and Be Happy.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Nirmala P (24 hours later)
Hello Madam,

Thanks again for giving your valuable reply.

please find the below blood test result and let me know your comments, it is look alike i am pregnant.

Hemoglobin : 12.3       female : 12. 15.5 gms %
PCV Heamatocrit 35.3 % women 36-44 %
Blood sugar fasting 88 mg/dl 70-100 mg/dl
Blood sugar post parandial 134 mg/dl 80-150 mg/dl

Hba1c
Method:
Glychohemoglobin ion exchange resin
Glycosylated hemoglobin 5.17 % normal : <6.0 %



Free thyroid function test

Free T4 1.07 mg/dl 0.7-2.0 ng/dl
TSH 4.03 mIu/ml adults 0.35-5.50

Beta hcg 133.8mIu/ml

Reference
Non pregnant 0- 10
16-23 days lmp 10-40
24-30 days lmp 50-100
31-38 days lmp 100-1000
1st trimester 0000-0000
2nd trimester 6000 0000
3rd trimester 400-0000

Looking forward to your reply

Regards,
XXXXXX
doctor
Answered by Dr. Nirmala P (2 hours later)
Dear XXXXXXX

HCG is produced by placenta, that nourishes the implanted fertilized ovum. A value of more than 25 mlU/ml is positive for pregnancy and it appears that you are pregnant.

Your blood report is perfect. You are not anemic and you are in perfect health and in great shape. Only, you have to decide if you want to continue the pregnancy. In my opinion, you can continue and then can go in for a permanent contraceptive method after your baby is born so that this problem does not recur.

But you are the best judge of your life and you know your circumstances better than me. So if you decide to terminate your pregnancy, please don't waste time and earlier the better. You XXXXXXX your gynecologist and discuss this issue with her as soon as possible. Termination of pregnancy done under the supervision of a DR. is safe.

As I mentioned earlier, Tab. Misoprostol and Tab. Mifepristone will start the bleeding by dislodging the implanted ovum. Different protocols with variable doses are available for this combination and some may need vaginal insertion of Misoprostol. Your Dr will decide the protocol suitable for you.

Good Luck XXXXXXX
Regards.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Nirmala P

General & Family Physician

Practicing since :1986

Answered : 458 Questions

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Having A Baby. Again Pregnant. Health Condition Not Suitable For Another Birth. Advise?

Hi XXXXXXX
Thanks for asking in Healthcare Magic.

Generally pregnancy may not occur in lactating women due to high level of Prolactin, a hormone that helps in lactation. This hormone inhibits ovulation (release of egg from ovum). But this is variable and many women conceive while breast feeding their child.

Yes I understand your problem XXXXXXX One should be mentally and physically strong and determined to face pregnancy and childbirth. The changes that occur during the early months of pregnancy like nausea and fatigue along with the chores of looking after an young active child can be very exhausting and probably that's why you feel so. You should rule out anemia as this can also add up to your tiredness.

If you are still opting for abortion, it is very much possible since you are in the early stages of pregnancy (first trimester). But it must be done only under the supervision of a gynaecologist to prevent complications like incomplete abortion. You will have to give a a signed consent form before the procedure. Oral tablets like Mifepristone and Misoprostol are available for medical termination of pregnancy. Your treating Dr will know about these drugs

Since repeated abortions are not advisable, I would suggest you to choose a contraceptive method in future to prevent conception, if you don't want to conceive. Repeated abortions will affect your health and will interfere with your regular menstrual cycles and normal physiology of uterus and ovary.

I hope this helps. Please address to me if you have any further concerns. I will be very happy to assist you.
Good Day XXXXXXX
Regards.