Q: I am a 28 years old woman who had a caesarean delivery without any complications 3 years back and a miscarriage last year, now I am 8 weeks pregnant. I witnessed mild spotting during the 6th week of pregnancy. The doctor recommended a progesterone test, which was reported at 30.9 ng/ml. Thereafter, the doctor prescribed micronised progesterone 200 mg, to be taken orally twice daily for 2 months and Eltroxin 50 mg daily for thyroid. She is also giving me injections of HCG 5000 I.U. every week. The ultrasound confirmed that the growth of the fetus was normal.

1. Why does spotting happen and is it a matter of concern?
2. Do I need to take progesterone with the reported levels of 30.9 ng/ml in the body?
3. Does it have any side effects or will an overdose lead to hormonal imbalance?
4. Why am I being given HCG injections and what are its uses & side effects?
5. Will I be able to have a normal pregnancy?

A:

1. Spotting may occur because of:
   • Weak attachment of the implantation of the foetus or,
   • Any extra physical exertion, e.g. lifting heavy objects or,
   • Following intercourse in early pregnancy.
2. The injections prescribed to you, and the dosage, are alright. They have no side-effects. Take these till 12 weeks and get a repeat ultrasound.
3. You can have normal pregnancy. The delivery can be normal, a 50% probability. However, it depends on the reason for the previous caesarean.