Brief Answer:
Some more information required for appropriate guidance.

Detailed Answer:
Dear XXXX,

You seem to be quite stressed. Please shoulder off the stress less the risk of wrong decisions.

I shall definitely provide you the solutions for your problems; however, I would need some more information.

1. What was the date of her previous menses (LMP)? Has she missed her period? What is the frequency of menstrual cycle?

2. On which days of her cycle you had unprotected sexual intercourse?

I would not give importance to the incidental nipple tenderness when it has gone now. Breathlessness is definitely worth taking cognisance of. Has breathlessness started after these incidences of sexual intercourse or she is having it for long time?

I am more concerned about her pain the in the lower abdomen which is associated with vomiting. Normal pregnancy is never associated with pain in abdomen. However, before I opine on it, I would like to have her date wise menstrual history. Such symptoms can occur in ectopic pregnancy.

Ectopic pregnancy is a condition in which the pregnancy gets implanted somewhere outside (mostly tube) the uterine cavity. Such pregnancy does not grow and may rupture causing the bleeding emergency requiring surgical intervention with many units of blood transfusion. However, if detected before rupture, it can be successfully managed by medicines.

Withdrawal technique is very unsafe technique of avoiding pregnancy. You are never sure that you have not ejaculated partly. Moreover, before ejaculation, always some secretions are released by penis UNKNOWINGLY. These pre-ejaculatory secretions (precum) do contain sufficient amount of sperms which are capable of causing pregnancy.

The pregnancy can be detected earliest 10 days after the last unprotected sexual intercourse by performing Beta hCG test on the blood. This is highly sensitive test. I would advise you opt for it rather than waiting for her menses to be missed (if she has already not missed them). Please upload the results of this test for my review which will help me to advise you appropriately.

Has she taken post coital emergency contraceptive pill within 72 hours of the unprotected intercourse? If not, now it is not possible to prevent the pregnancy if it is there, however it can be easily terminated by medicines.

I wish to sincerely guide you in this situation medically and scientifically. Please respond to this message ASAP with the information I have asked for.

For any more information, I am always available for you, Shrivastava.

Dr. Nishikant Shrotri

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