Q: I am a 29 years old woman married since 5 years. I conceived twins 4 years back but had a miscarriage at 9 weeks of pregnancy and dilatation and curettage (D & C) was done. That time I was diagnosed with hypothyroidism and I am on replacement therapy - Thyronorm 25 mcg since then. The next year I conceived again, however, I had a spontaneous abortion. Seven months back I successfully delivered a baby boy. It was an elective c-section as my blood pressure went high (160/110 mmHg) at 37th week. I also have an intramural fibroid measuring 8 cm on the anterior wall of the uterus. Now, I am pregnant again since 5 weeks as per my LMP. The scan showed no gestational sac, however, urine pregnancy test was positive. The doctor suggested a re-scan after 2 weeks and also advised Utrogestan 200 mg vaginally everyday and folic acid. I do not have any symptoms of pregnancy other than missed period. Is utrogestan safe while breast-feeding my 7-month-old son? Will gestational sac appear in 2 weeks of scan? Is it safe to continue with this pregnancy?

A:In your case because of previous bad obstetrics history- you must carry the pregnancy this time. Chance of repeat high BP is there again and you will need careful follow up through out for that as well as risk of early labour. The Susten in the low dose is safe as now child is already 7 months and can be slowly weaned of breast milk / reduced. Safety precautions for the pregnancy include avoiding weights, stress, sex, and very heavy work. Regular meals, light exercise and adequate sleep are essential enough - 1 litre /day milk intake with plenty of fresh fruits and vegetables and proteins – 15 gm/ day is necessary.