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How to take care of my precious pregnancy?

Q: I am three and a half months pregnant. I had a miscarriage three years back after which I was not able to conceive, as I had a polycystic ovary. Laparoscopy, hysteroscopy and ovarian drilling were done. Following this I also had spillage in the tube which was identified by HSG. For 3 months I was given placentrex injection in the tube and Metrodin HP intra-muscular injection. However, after taking all this I conceived. Now my doctor has advised me to take Profasi 5000 injection every week along with Microgest 100 mg (twice daily), folvite, Evion (Vit E) and Becadexamine. I am staying in Bihar and my Gynaecologist is in Kolkata (500 km away). My doctor wants to examine me. Will it be safe for me to travel by train? What precautions should I take while travelling? What type of movement will not harm my baby up down or side wise, so that I can take side berth or inside berth in the train? My nipples are getting tender and there is pain as well. I also have swelling and bleeding gums. Is it normal? I can't take milk so I take a cup of Complan in the morning and one cup of Horlicks in the evening. Please suggest me a diet, I do not like fruits except the banana. I had a USG which is OK. When can I have my next USG? Is my baby fine and has no abnormalities?

A:I am surprised that your treatment does not follow any accepted principles of medicine. Your problems were understandable till your conception. After conceiving, your pregnancy is no different from any other pregnancy. Your pregnancy is perfectly normal. The drugs you are taking are potentially harmful. You seem to be suffering from a dangerous pregnancy syndrome. Going through a lot of treatment and having had an abortion you are convinced that you are carrying a dangerous condition called pregnancy! For heavens sake have faith in nature. Babies are not born or aborted according to how many medicines or precautions you take, but according to whether the baby conceived is normal or not. Most abortions occur in early pregnancy because the baby is formed less than perfect. You had a little higher chance of aborting in PCOS in early pregnancy but you have passed that period successfully. Since your ultrasound shows a normal pregnancy please allow nature to do its job and you do yours. Your job is to knit booties and prepare to receive the new born into the family and not imagine all that can possibly go wrong in your pregnancy henceforth. Once the fetal heart is seen in a pregnancy your chances of losing this pregnancy is less than 3%. Moreover even in patients shown to have PCOS and hence a higher chance of abortion they have not been able to prevent these by giving hormones. Of all the medicines you are taking the only one probably helps in reducing abnormalities in babies is folvite and that too has no role after 14 weeks unless you have definite Folic acid deficiency. Besides you are taking injection HCG and Progesterone pessaries both these are potentially harmful as they are both potent hormones. Progesterones have been shown to be harmful to a developing fetus by inducing abnormalities and may also interfere in its growth. For heavens sake please stop taking steroids! are you sure they have been prescribed? Now the obvious question is that if all these drugs are so harmful and of no proven value why have they been prescribed? The doctors prescribing you these drugs are not your enemies and do not mean harm. But they themselves suffer from a dangerous pregnancy syndrome and they want to leave no stone unturned and since nothing can be done to ensure that you have a normal pregnancy they are doing all kinds of unproven treatments to you. Just with the desire to do something, since something must be done! Giving you a list of vitamins and hormones in order to do something is not an acceptable argument in todays world of evidence based medicine. Please go to the royal college of obstetricians and gynaecologists site (www.rcog.org.uk) and read about recurrent abortions. Also read about care to be given to a healthy pregnant woman. Even in proven cases of recurrent abortions hormones progesterones and steroids have not been able to prevent abortions. Another common myth is that bed rest prevents abortions. This is far from true. While exertion may not be very good, but moderate activity will help the pregnancy. You cannot harm the baby even if you want to. Mode of travel, diet, activity, work, sex, etc. will not change the course of your pregnancy. Just listen to your body and do as much activity as your body allows. More activity than what your body can withstand may cause pains but will not cause fetal growth retardation or an abortion. Bed rest is not only useless it is harmful to pregnancy. To answer your other anxieties: Milk is a good source of calcium and if you can take about ½ kg of milk in any form like curd and paneer it is good enough. If you cannot take dairy products at all you can take some simple calcium tablets. Other dietary sources of calcium are fruits and vegetables. Nipples will feel raw at this stage and there is no need to do anything for it. Bleeding gums are also very common at this stage. You need to see a dentist and if there are no dental problems use a mouth wash and avoid vigorous brushing and use softest possible brushes. You need a triple test at 16 weeks and a detailed scan (ultrasound) at 22 weeks and if these are normal you shall have a normal baby. If you are travelling by train please use the seat/ berth. The concept that a train journey will cause an abortion is ridiculous and scientifically impossible. What you may get is nausea or backache and if you eat infected food you may get an infection in the gut. Please avoid infected food and water on the way but the rest is not a problem.

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