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Pregnant, was on birth control. Not having any symptoms of pregnancy except missed period. Normal?

Mar 2016
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Practicing since : 2011
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I'm almost 18 weeks pregnant with my first child. For he past ten years, I was on birth control. The past few years my period had grown very short and light to where during my "placebo" week, the period would not come right away but rather two or three days into the placebo pills and last 2-3 days XXXXXXX This happened off the pill too. In other words, my period WOULD come every 21 days (28 day cycle roughly) but would only last 2-3 days at most and be very light. I kept asking my obgyn about this as I wanted to try, and he kept saying as long as my period is coming every 28 days don't worry and relax and you'll get pregnant. Well, we did get pregnant the month we tried (had sex every other day) buti e had no symptoms really except my missed period and a slightly bigger stomach. No morning sickness, not overly tired, breasts never hurt nor do they look bigger. All my appts have been great and I have my 20 week anatomy scan scheduled 2 weeks from now. I just have is overriding fear what if my placenta doesn't have enough hormones to sustain the pregnancy since I didn't get many symptoms and I don't feel a lot and stuff? I need help and reassurance?!
Posted Fri, 5 Apr 2013 in Women's Health
Answered by Dr. S Patra 2 hours later

Thanks for writing to us. I am trying to solve your problem.

First of all, long term use of birth control pill (more than 10 years) may cause low menstrual flow or early menstrual cycle than usual in some women. like to congratulate for that.

From above information, I can assume that you had confirmed your pregnancy in early weeks by blood test for beta HCG and obstetrical ultrasound scan (USG).

Now, at 18 weeks of pregnancy, it is unusual for you not to feel any pregnancy symptoms or changes in the body. Though, it is seen in very few percentage of pregnant women.

The reasons behind this are as follows:

1) Long term use of birth control pill, accustomed with your body changes by hormonal influence.
2) Intrauterine growth retardation (IUGR) of the developing baby.
3) Gestational trophoblastic disease (GTD) or molar pregnancy.
4) Intrauterine Fetal Death (IUFD) or missed abortion.
5) Unknown etiology in some cases for the first time pregnancy.

If it is true pregnancy with viable fetus, you can feel your baby movement or kick in this time period. Though, all women do not feel this in her first pregnancy as early as 16-18 weeks. Most can feel lately and after 20 weeks.

Placenta produce many hormone like estrogen, progesterone, human chorionic gonadotrophin (HCG), placental lactogens and relaxin. In general, above mentioned hormones always support a normal pregnancy till the term and in such cases, you have nothing to worry.

Otherwise pregnancy may be lose in case of molar pregnancy or GTD and missed abortion or IUFD.

Only obstetrical ultrasound scan (USG for FPP) can confirm the viability of the growing fetus and rule out other possible etiology in this context.

Please contact with your obstetrician regarding this for other investigation & next line of management.

Following things are advisable for healthy pregnancy:

1) Take Healthy protein XXXXXXX diet (Milk/ Meat/ Fish/ Pulses/ Beans/ Nuts/ Dals etc.) with extra 350 Kcal/day than usual and eat more XXXXXXX vegetables & fresh fruits.
2) Drink lots of fluid/water to stay hydrated & for better feto-placental circulation.
3) Take an adequate bed rest and preferably 8-10 hrs daily in divided schedule.
4) Maintain personal hygiene including breast & genital care with proper washing.
5) Try to avoid stress/tension/emotional upset by regular XXXXXXX breathing.
6) Take Iron/calcium supplements and Two doses of TT in the 2nd trimester and complete all necessary investigations.

Hope I have answered your query. If you have any further questions, I will be happy to help.

Wish you for good health and successful motherhood. Hope for positive things.

Good luck.

Dr Soumen.
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