We receive a lot of questions in regards to missed periods and negative pregnancy tests. questions like Am I pregnant? Could I be pregnant?

Of course pregnancy is the first thing that we think of when our period is delayed or missed especially if sexual activity has taken place. But there are other reasons for you to have a late or missed period. Pregnancy is not the only reason for people to have a late period.

Here are the 12 most common reasons that you’ve missed your period:

1. Stress
Stress can affect many functions of our bodies including our periods. Scientists know that stress boosts levels of stress hormones – glucocorticoids such as cortisol. Elevated cortisol can inhibit the body’s main sex hormone, gonadotropin releasing hormone (GnRH), and subsequently suppresses ovulation.

Sometimes we can get so stressed out that our body decreases the amount of this Gonadotropin-releasing hormone. This hormone receives instruction from the pituitary gland and is necessary to set in motion activity from other hormones to instruct the ovaries to produce and release and an egg during ovulation and then subsequent menstruation occurs.

Working with your doctor or midwife can help you figure out what you need to do to relax and get back on schedule. This can sometimes take a few months or more to work itself out.

2. Illness
A sudden, short illness or even a longer illness can cause your periods to be delayed. If you get a bad case of the flu or a stomach bug you might skip your period for the month.

Irritable Bowel can also cause you to skip a period here and there. This is usually temporary but talk to your doctor about when to expect your period to return.

3. Change in Schedules
Changing schedules can really throw off the natural rhythms of your body. This is particularly true if you work shift work. Did you also know that many women travelers find their usual menstrual cycle changes or even stops while they’re on the road.

4. Change in Medications
Although it is not always conclusive many medications can affect menstruation. Medications such as antidepressants, blood pressure pills, and even antibiotics can affect your periods. Be sure to talk to your doctor or midwife about any side effects. Missed or irregular cycles can be very common with some methods of birth control. If you change medications, be sure to ask what effects this may have on your period.

5. Being Overweight
Carrying around too much weight can shift or disrupt your cycles or even stop them. Basic cholesterol compounds in fat cells can change into a type of weak estrogen called estrone. Overweight or obese women carrying extra fat cells have little estrone-making factories, which have an estrogen effect on glands.

This added estrogen can cause bleeding or menstrual disorders. A woman may go months without ovulating, for example, but the uterine lining is still accumulating — to the point that it becomes unstable. A woman can then have a period that is like a flood and with prolonged or very heavy bleeding. Most women will see a return to normal cycles and fertility with the loss of some weight, even if they are still considered overweight.

6. Being Underweight
If you do not have enough body fat you will not have regular periods, sometimes can even cause your periods to stop all together. This is called amenorrhea. Underweight women and women with eating disorders, like anorexia nervosa, that result in extreme weight loss may also be unintentionally impacting their menstrual cycles.

Women without much fat on their bodies may have fewer periods or go longer without ovulating. These women may be so underweight that their bodies simply stop making estrogen. Additionally, the lack of fat doesn’t allow cells to convert cholesterol into extra estrogen. Typically a weight gain will help you have your periods return.

7. Miscalculation
The menstrual cycle varies from woman to woman. While we say that the average menstrual cycle is 28 days long, that is not true for everyone. Some women have cycles as short as 21 days or as long as 35 days. Sometimes our period is believed to be late when actually we have simply miscalculated. If you have irregular menstrual cycles, but know when you ovulate, look for your period to start about two weeks after you ovulate.

8. Peri-Menopause
Peri-menopause is the period of time where you are transitioning from your reproductive years to your non-reproductive age. Your periods may be lighter, heavier, more frequent or less frequent – but mostly just not normal. If you do not wish to get pregnant, be sure to continue to use birth control because you are still fertile.

9. Menopause
Menopause is when you have reached the point in your life where you will no longer ovulate or menstruate. Menopause is one of nature’s natural events or it can happen surgically through hysterectomy / oophrectomy which means that your uterus and ovaries have been removed or through a chemical cause such as various forms of chemotherapy.

10. Thyroid
The thyroid is a gland that sits in our neck that helps regulate out bodies functions, such as your period. Women who go to their doctor with a complaint of missed period, discover that the doctor will first and foremost do an examination to see if there are any potential thyroid problems.

It is understandable that the thyroid could have an effect on the menstrual cycle, as it is a hormone producer, and the problem with missed period most often is, it is all based around the imbalance of the hormones needed for the reproductive system.

Tuberculosis and Diabetes can also cause you to skip a period here and there.

11. Excessive Exercise
Excessive exercise can cause period irregularities. You may miss your period completely or you may just have symptoms such as spotting or intermittent bleeding, or even painful menstruation. Not every woman that becomes involved in strenuous sports or excessive exercise, will run into these types of problems but it can be a cause of missed or abnormal bleeding.

This can happen because during long regimes of excessive exercise the body needs more energy. While it is producing this new needed energy it ignores some of the other body functions like the menstrual cycle. This is not a dangerous situation but if continued it may be advisable to reduce the amount of exercise.

If this has become a problem for you speak to your doctor as to whether you should continue with your current exercise program, and also to be sure that this is the root cause of the problem and not something else.

It can take several months of missed periods before the menstrual cycle will return to normal, even after stopping excessive exercise completely.

12. Pregnancy
Finally yes, your missed period might be because you’re pregnant! A simple pregnancy test can usually help you determine if you have missed your period because you are pregnant. Home pregnancy test kits that are on the market today are 97% accurate.

If you are pregnant, you should call to make a prenatal appointment.
If you have taken a pregnancy test and it is negative. Most tests advise you to wait another week and retest. If the second test is negative or if you have a good idea of why your period is missing, then you can and should call the doctor or midwife sooner for a physical exam.

A doctor may also perform a blood work  test and can sometimes prescribe medications to help bring on your period.

What is a miscarriage?
A miscarriage is the spontaneous loss of a pregnancy before the fetus is able to survive outside the monther’s womb. I know this can be a very sad and distressing experience as I’ve been through this myself. You may feel as though your hopes for the future have been taken from you. These feelings can be very real even if the pregnancy is only a few weeks along.

There’s no set of rules about what you will or will not feel after a pregnancy loss. You may simply feel numb for awhile. Allow yourself the time to work through these feelings.

Grieving a pregnancy loss takes time. Some couples may think that they must try to conceive again right away in order to replace the pain.

Unfortunately it is unlikely that a subsequent pregnancy will carry the same joy, because a new pregnancy after a loss can be fraught with anxiety and fear that something may go wrong.

I want to stress that although a pregnancy loss can be extremely difficult it doesn’t mean you won’t be able to have another baby. In most cases your chances of having a successful future pregnancy is still very good even if you have suffered several pregnancy losses.

I suffered three miscarriages and one ectopic pregnancy but have also given birth to 6 healthy children…all adults now!

Miscarriage is not uncommon. It is estimated that up to 20% of pregnancies end in miscarriage.

The information I am about to share with you is designed to help you cope with the loss of your pregnancy. I will try to provide answers to some of the questions we have been receiving.

So, you may wonder what happens next?
Well, this depends on what type of miscarriage you have had. It is quite possible that the doctor / sonographer has diagnosed that your miscarriage is complete which means that most of the pregnancy has passed and that there is no need for further treatment. You may still experience blood loss which can go on for up to two weeks.

If your miscarriage has been diagnosed as being a missed or incomplete that means that there is some pregnancy tissue retained within the womb. Depending on your own individual circumstances there are some incomplete miscarriages which are best treated surgically with dilation and curettage also known as ‘D&C’. A D&C is a procedure that opens up the cervix and remove the contents of the uterus.

Other miscarriages may be treated either with no treatment or occasionally using tablets to expel the remaining pregnancy tissue. You will be advised as to which approach is best for your situation by your health care provider. Often it is appropriate to discuss the different approaches.

The three ways of dealing with a pregnancy that is not progressing are as follows:

1. Wait and see approach (leaving things to nature).
In the past an operation was nearly always performed in cases of miscarriage, however, with the use of ultrasound we can reasonably confidently predict those miscarriages that do not require any treatment. If you have had no bleeding it may take up to 3 weeks for you to start miscarrying. The bleeding may be heavier than a normal period and you may experience strong period like pains in your lower abdomen as the womb contracts in an attempt to expel the pregnancy tissue. If the bleeding is very heavy, the pain very severe, or you feel unwell you should attend the hospital for review. In a small number of cases an operation may still be necessary should there be some tissue left within the womb or if the bleeding becomes too heavy.

The 2nd is the medical approach:
Medicines may be used to start a miscarriage if you prefer not to wait. Misoprostol is a medicine that you can take by mouth (or occasionally by placing the tablets in the vagina). You may need to take a few doses before bleeding commences (as described above). The advantages of this approach is that you avoid a hospital admission, an anaesthetic and a surgical procedure. In about 10% of cases an operation may still be necessary should there be some tissue left within the womb or if the bleeding becomes too heavy. This medication can only be prescribed by your doctor or hospital.

The third apprach is Surgery (D & C).
D and C, dilation and curettage. The cervix (neck of the womb) is dilated by using either plastic or metal instruments and then the pregnancy tissue is removed from the womb. It is correctly called an ERPC (evacuation of retained products of pregnancy).

This is done under general anesthesia through the vagina and you will not have any cuts/stitches. As with all operations there are small risks such as infection or injury to the womb and cervix. The advantage of this approach is that it clears out the womb quicker than the above approaches.

Generally your chances of having successful pregnancy in the future are just as good irrespective of which approach you choose.

Following any of the above approaches, you may have a period like bleeding for up to 14 days which is quite normal and should gradually diminish with time.

What is a Threatened Miscarriage:
A threatened miscarriage is a pregnancy where the vaginal bleeding has taken place but an ultrasound has shown a healthy fetus and fetal heartbeat. The bleeding can be very varied and can occur at any time after a missing period. It can range from being a smear of pink, brown or red loss on the toilet paper to heavy vaginal bleeding similar or even heavier than a period.

The diagnosis of a threatened miscarriage is made when you attend for an ultrasound scan. As long as you are at least 6 weeks pregnant the ultrasound should be able to visualise your tiny embryo and show a healthy heartbeat. It may be necessary to demonstrate by performing an internal vaginal scan.

Sometimes the scan may demonstrate a small haematoma (blood clot) around the pregnancy sac but very often nothing abnormal is seen and it is difficult to explain why the bleeding has occurred. The bleeding may have come from the implantation site which is when the placenta of your baby burrows itself into the lining of the womb. This process may cause some bleeding. If we can see a baby’s heartbeat on ultrasound it is very likely your pregnancy will continue with success rates exceeding 95%.

It is very uncommon to miscarry after 12 weeks gestation and affects only 1 to 2 perenct of pregnancies.

Follow-Up:
If there is a collection of blood around the pregnancy sac and the bleeding continues, it may be appropriate to repeat an ultrasound scan in 1-2 weeks. In any case the heartbeat will be checked at your first booking visit.

If the bleeding settles down there is probably no need for a further scan unless you have further anxieties. Traditionally bed rest has been advised for mothers with threatened miscarriage but all the evidence would suggest that this does not prevent miscarriage. It may help some patients psychologically to rest in bed but it is not necessary.

Unfortunately there is no specific treatment to stop the bleeding and if you do adopt bed rest there is a possibility that on standing up bleeding may become heavier due to pooling of blood in the vagina that results from lying down.

With regard to work, our advice will depend on the nature of work, your history and the nature of bleeding, but it is probably prudent to stop work if you are having significant bleeding.

If you have further heavy bright red bleeding, particularly if this is associated with crampy abdominal pains, it is appropriate to get in touch with the early pregnancy assessment unit for advice.

There is no evidence that having intercourse at any stage in pregnancy causes miscarriage or pregnancy loss though again it seems sensible to avoid intercourse until the bleeding has completely stopped.

What Does an Inconclusive Scan Result Mean?
Sometimes, following a visit to an early pregnancy unit,  it may not have been possible to confirm whether your pregnancy is going to continue or not. It can be difficult to take in all the facts when you are anxious.

There are three main reasons for uncertainty during an ultrasound to determine whether or not you are having a miscarriage;

1) It is possible that a fetus and fetal heartbeat is not seen because you are too early in the pregnancy. A repeat scan in 7 to 10 days should clarify whether the pregnancy is healthy or not.

2) It is also possible that the pregnancy is not growing as it should and the bleeding may be a sign of an impending miscarriage. Similarly, a repeat scan will clarify the situation.

3) There is also the outside possibility that the pregnancy is outside the womb. This is unlikely but it cannot be excluded at this stage as it is too early to diagnose.

If an ectopic is suspected it may be suggested that you follow up with your doctor or hospital to perform a blood test called Beta HCG (Human Chorionic gonadatrophin). It is a hormone produced by the placental tissue and its levels roughly double every two days in a normally growing early pregnancy. They may also repeat the scan in a few days. It is quite possible that you will have further bleeding if you have bled already and as long as it is not too heavy you may stay at home and wait for the follow-up scan in 7-10 days which should clarify the situation for you. However, if you develop sharp pain or are aware of increasing crampy abdominal pains, it is reasonable to take paracetamol tablets. If the pain becomes too severe or the bleeding becomes too heavy, or indeed if you are anxious about your situation, please do not hesitate to get in touch with your doctor.

Frequently Asked Questions about Miscarriage:
Why did I miscarry?
Miscarriage is a process, not a single event. Approximately 1 in 5 pregnancies end in a miscarriage. It is often very difficult to give a definitive answer as to why you had a miscarriage. Many studies have shown that approximately 2 out of every 3 miscarriages are explained by a chromosome problem. This means that when the egg was fertilized by the sperm the process of fusing together was somewhat faulty and in many cases gave rise to one extra chromosome. A normal embryo has 23 from the mother and 23 from the father. Where there is a problem at conception this may give rise to a total of 45 or 47 chromosomes. Very often these chromosome problems are not compatible with life and nature will determine that these pregnancies do not progress and they will then end in miscarriage.

Occasionally you may have a miscarriage because of an infection associated with a high temperature / fever, though this is unusual.

Occasionally there may be a problem with the cervix and or uterus (womb). An irregularly shaped womb or the presence of fibroids encroaching into the cavity of the womb are associated with a higher chance of miscarriage.

Unfortunately, in many cases we are unable to give a definitive cause.

Will this happen again?
If you have had one miscarriage it is extremely likely you will be able to go on and have a normal pregnancy. It is important to say that the risk of miscarriage increases as maternal age increases and also if a woman has had other miscarriages.

Even after several miscarriages though there is a good chance of a successful pregnancy.

Is there anything I can do to prevent a miscarriage?
In truth the answer to this question is almost certainly no. If we assume that 2 out of every 3 miscarriages occur because of a chromosome problem then no amount of rest or medication will make any difference to a pregnancy that might already be faulty. There is very little evidence that bed rest reduces the chance of miscarriage.

How long should I wait before trying again?
There is no perfect time to aim for another pregnancy. This may depend on many different circumstances such as your age, co-existing health problems etc. It is certainly wise to wait until you have at least one normal period, which usually occurs about 3-6 weeks after a miscarriage. Some people would advise waiting until you have had a few periods to allow your cycle to go back to being regular, if indeed they were regular before.

Do I need a follow-up appointment in the hospital?
In general, most hospitals do not have specific clinics for early miscarriage follow-up. It is probably more appropriate for you to see your family doctor who will probably know better and who can help you through this difficult time.

It may help to talk things over with your partner, friends and other members of the family. It is quite normal to be tearful and feel low from time to time but, if you feel that you are getting depressed and unable to cope it is important to alert your family doctor, or indeed the bereavement counseling service at your local hospital.

Recurrent miscarriage which is usually defined as more than 3 consecutive pregnancy losses is uncommon and affects only 1 percent of couples. Most couples in this situation will likely want to undergo investigations sooner rather than later in order to establish whether or not they have an underlying cause for their repeated miscarriages.

A referral to a hospital or clinic that has an interest in miscarriages is very valuable since they these centers  offer the most recent investigations and treatment trials. Also, those in this situation will benefit from knowing they have done everything possible to prevent miscarriage from recurring.

Final Thoughts:
* All women have a right to grieve whether they lose their babies through early or late miscarriage. Losing a baby at any stage can be a devastating experience. The stages of loss can be a lengthy process as one moves through the stages of acute greif, mourning and healing.

* Not every woman grieves following a miscarriage and some recover quite quickly emotionally and physically.

* For others, losing their baby can leave them feeling shocked, angry, empty and depressed

* It is generally assumed that men will take care of their partners. Sadly, it is often forgotten that they have suffered a loss too. Their hopes and dreams for the future have also been shattered.

* Your grief may manifest itself in a physical way and the depth of your feelings can be very frightening. If you are worried, maybe talking to your doctor would help.

* Try not to rush the “back to normal” routine. Take things slowly and allow yourself the time to grieve for your baby.

* Physically, you may recover quickly from your miscarriage while emotionally, it may take weeks or even months to come to terms with your loss.

* You may have no mementos if you lost your baby in early pregnancy and this can be heartbreaking. It may be important to make your baby tangible in some way for you.

* It is never too late to acknowledge your baby.

Eventually you will become resigned and accepting of what happened and although this never completely takes away the emotional pain you will be able to deal with it in a more controlled way.

I understand that this can be a very difficult time so if you have any questions please join us in the forums at pregnancychat.com

Thanks for watching, I’m Monica Healy.

My Ectopic Pregnancy Story:

Today want to talk about ectopic pregnancy but before I do I want to share a story about my own personal experience with an ectopic, which could have been fatal!

Years ago, I suffered a miscarriage and had to have a D and C (also known as dilation and curettage), which is a surgical procedure often performed after a first trimester miscarriage. Dilation means to open up the cervix; curettage means to remove the contents, the products of conception.

A month later I had some abnormal bleeding but thought that my periods were just trying to regulate after my miscarriage.

One evening I bent over to pick something up and suddenly felt very ill, dizzy, with diarrhea and sharp pain. I started to feel better for few hours but then suddenly again started to feel very ill, so I crawled into bed just thinking I was sick. By the time I realized I was in trouble I was too weak to call for help.

Thankfully a family member came by my home and found me there, in my bed, too weak to get up.

I was suffering from a ruptured ectopic pregnancy and I didn’t even know I was pregnant. I was bleeding internally. If it had not been for her I would have died.

I was rushed to the hospital and they performed the necessary surgery that saved my life.

I wanted to share this with you so you know how important and life threatening an ectopic pregnancy is.

So it’s important to understand first…

What is an Ectopic Pregnancy?

An ectopic, or tubal pregnancy is one in which the fertilized egg attaches itself in a place other than within the lining of the uterus. More than 95 % of ectopic pregnancies occur in a fallopian tube but they can also occur in the abdomen, ovary or cervix.

How does an Ectopic Pregnancy Occur?

An ectopic pregnancy occurs approximately in 2% of all pregnancies. Sperm is the smallest cell in the body and an egg from the Mother is the largest cell in the body so although a sperm may finds its way to the egg the newly fertilized egg may not be able to find its way back through the tube to the uterus successfully, especially as it is growing.

Ectopic pregnancies can also happen with invitro fetilization. Yes that’s right, an implanted egg can go back into the fallopian tube, this is called retrograde embryo migration.

Because the fallopian tube is too narrow to hold a growing baby, ectopic pregnancies cannot proceed normally. Eventually the walls of the fallopian tube stretch causing the tube to rupture putting the woman in danger of life threatening blood loss.

Ectopic pregnancy can also be difficult to diagnose because symptoms often mirror those of a normal early pregnancy. These can include a missed period, breast tenderness, nausea, vomiting, fatigue and frequent urination.

In addition you may start bleeding and think that this is a normal period not even being aware that you are pregnant as in my story.

How are Ectopic Pregnancies Diagnosed?

The warning signs of an ectopic pregnancy are most often a mix of pain, vaginal bleeding and an adnexal mass or pelvic swelling (The adnexa is the area where your ovaries live), but these symptoms are present in only 45% of ectopic pregnancies.

There might also be pain in the pelvis, generalized abdominal pain, or even shoulder pain. Shoulder pain can be caused when blood from a ruptured ectopic pregnancy irritates the lining of your abdomen, this pain can manifest in the shoulder. Pain can be mild cramps or more sever sharp or stabbing pain.

Other warning signs of ectopic pregnancy include gastrointestinal symptoms such as diarrhea. You may also experience dizziness and lightheadedness because your blood pressure may drop.

If you experience any of these symptoms contact your health care provider right away.

Your doctor will test to see if you are indeed pregnant. If you are pregnant, your doctor will likely want to rule out ectopic pregnancy first although there may be other reasons for your symptoms.

Unless your condition is obvious or you’re clearly in an emergency situation, lab tests and ultrasound are almost always used to confirm diagnosis.

How are Ectopic Pregnancies Treated?

Narrow fallopian tubes aren’t designed to hold a growing embryo. As a result the fertilized egg cannot develop normally.

The pregnancy must be removed to prevent the rupture of the tube and other complications.
If you receive a diagnosis of an ectopic pregnancy surgery is the most common treatment method. It’s often possible to remove an ectopic pregnancy laparoscopically (known as key hole surgery).

In this procedure, a small incision is made in the lower abdomen near the navel. The surgeon inserts a long surgical instrument called a laparoscope. This allows the surgeon to see and remove the ectopic pregnancy and to repair or remove the fallopian tube.

In certain circumstances medication called methotrexate can be used to treat an early ectopic pregnancy. Methotrexate stops the growth of rapidly dividing cells, such as embryonic, fetal, or early placenta cells.Methotrexate treatment can be given orally or as a single shot or as several injections. Hormone levels and size of the ectopic gestation will be the deciding factor in determining the best treatment. This is something you will want to speak to your doctor about.

Factors known to Increase the Risk of Tubal or Ectopic Pregnancy:

• An infection or inflammation of the tube that has caused it to become partly or entirely blocked

• Previous surgery in the pelvic area or the fallopian tubes or a D/C from a previous miscarriage

• A condition called endometriosis in which tissue that normally lines the uterus is found outside the uterus, causing a blockage.

• An abnormality in the shape of a fallopian tube

• The highest risk factor for ectopic pregnancy is pelvic inflammatory disease (PID), an infection of the uterus, fallopian tubes or ovaries. The risk can be as high as 27 %.

• The risk of ectopic pregnancy is also higher in women who have had any of the following:

• Previous ectopic pregnancy because the risk factors are still present

• Surgery on a fallopian tube

• Infertility problems as 4.5% of embryos transferred can travel into the tube

• Medication to stimulate ovulation.

• Intrauterine contraception device

What Are The Chances of a Future Successful Pregnancy?

If you have had an ectopic pregnancy the pregnancy your chances of having a successful pregnancy outcome are a bit lower but are still very good. Even if one fallopian tube has been removed, you still have more than a 40 % chance of a successful pregnancy but your chances of having another ectopic pregnancy increases around 12.6 % so your health care provider should monitor you closely the next time you conceive.

To summarize if a woman is capable of conceiving she is capable of having an ectopic pregnancy, so you’ll want to watch out for any warning signs and if you are worried to contact your health care provider.

I hope that gives you a better understanding of ectopic pregnancy. If you have any question please join the conversation in the forums.

Most pregnant women experience some abdominal aches, pains and cramping in early pregnancy. Not surprisingly these early pregnancy developments are accompanied by significant changes in the way your body functions. Many changes are happening during this time and your amazing body is registering some of these changes in the form of cramping. I know cramps can be a source of worry so it helps to know and understand what is happening and why. That said, here are 6 common causes for cramps in early pregnancy:

1. Hormones — your body is producing a flood of hormones some of which cause cramps as the body prepares to expand and change. Virtually every organ system in your body needs to adapt to cope with the increasing demands that your pregnancy will make on it.
2. Implantation— When the newly fertilized egg implants into the lining of the womb a woman can experience implantation cramps sometimes accompanied by a very small amount of bleeding.
3. Your uterus — The uterus begins to experience changes as soon as the implanted egg burrows into the lining. As the uterus stretches and expands, some women experience aches and cramps. These pains can also be referred to the groin and hip area. These cramps reflect changes in the pelvis in particular your growing uterus. It can be perfectly normal to experience menstrual-type cramps in early pregnancy because this growth occurs where the ligaments and muscles attach and support your womb to the internal abdominal wall, one ligament especially, called the round ligament and results in cramps.
4. Gas and constipation— Elevated levels of the hormone relaxin causes the body’s muscles to relax, including those that make up the digestive system, which slows down during pregnancy. This can result in excess gas and constipation, which produces a wide range of pains and pressures, bloating and cramping.
5. Ectopic pregnancy— Cramping and pain may occur on either side of the pelvis and be accompanied by nausea, spotting and dizziness. An ectopic pregnancy is a medical emergency and you need to see a doctor right away.
6. The corpus luteum cyst— This is the cyst of pregnancy and it is from this structure that your egg was released and subsequently fertilized. This cyst plays an important role in the early weeks of pregnancy as the corpus lutem cyst produces hormones that support the pregnancy. This corpus luteum cyst can vary in size and the larger ones can cause some tenderness and cramping. The presence of this cyst is usually assessed during your early pregnancy ultrasound and will resolves on its own.

Women in early pregnancy will experience quite a few strange and even uncomfortable sensations, twinges and cramping. Each pregnancy can be quite different; so consider these bumps along the road of an amazing journey!

Please note that if cramping is severe or prolonged this may not be normal and you must call your doctor immediately.

So those are some common causes for cramps in early pregnancy. If you have any questions or comments please join in the conversation in the forums at pregnancychat.com.

Signs of Pregnancy:

About one week would have passed since fertilization by the time your developing embryo called a blastocyst, soon to be your baby, would have traveled through the fallopian tube and implanted itself inside the lining of your womb.

It’s at this time that you may experience spotting, a very small amount of mentrual flow or yellowish vaginal discharge. Some women often mistake this as the beginning of the next normal menstrual period.

1. Spotting: a small amount of menstrual flow or yellowish vaginal discharge is in fact one of the first signs of pregnancy and this bleeding is caused by the implantation of the blastocyst into the lining of your womb, also referred to as implantation bleeding.
2. Tender Breasts: Other symptoms of pregnancy are tender breasts or a tingling feeling within them.
3. Urinate Frequently: You may need to bathroom a little more than usual.
4. Fatigue: You may be feeling more tired than usual.
5. Change in Taste: Experiencing changes in taste, for example you may suddenly be turned off your morning cup of coffee.
6. Nauseous: You may feel sick or nauseous, especially in the mornings.
7. Change in Mood: You may feel down or just plain moody.
8. Missed Period: Last but not least a missed period may be a sign that you are pregnant.

The first day after a missed period is a good time to take your first pregnancy test. These tests measure the amount of human chorionic gonadotropin known as HCG in your urine and is produced by the placenta even thought it is quite small at this early stage it is already producing hormones.

The blood tests that are offered during pregnancy are performed for many reasons. Some to see whether you are low in iron, have diabetes and other reasons but the serum screening blood test, done around 15 to 18 weeks is specifically performed to screen for Mom’s that may be at risk of carrying a baby with a problem.

Prenatal serum screening blood tests can measure between two, three or four substances within the Mother’s blood to predict whether your baby is at risk for Down’s syndrome or a neural tube defect such as spina bifida. These tests are commonly carried out between 15 to 18 weeks.

It is very important to remember what a screening test is before have one performed which will also help alleviate some of the anxiety that can accompany test results. These tests, called screening tests are just that…a screening, and not a definite diagnosis. These tests try to identify those babies that may be at a higher risk for an abnormality but this does NOT diagnose a problem. The test only gives us an indication or risk level and determine a need for further investigation or not.  It is important to discuss the risks and benefits of testing at length with your doctor before pursuing any screening. You may not want to pursue any further investigations and this is important to establish. Whatever decision you feel most comfortable with is the right one, but it is always good to speak with your doctor.

There Are Three Different Serum Screen Blood Tests:

Some facilities may only offer one of the following tests.

1. The double test measures the level of two substances in the Mother’s blood, alpha-fetoprotein and free beta-HCG.

2. The triple test measures the level of three substances in the Mother’s blood, alpha-fetoprotein, free beta-HCG, and oestriol.

3. The quadruple test measures the level of four substances in the Mother’s blood, alpha-fetoprotein, free beta-HCG, oestriol and inhibin A. In my opinion, the quad screen in place of the double or triple test increases the likelihood of identifying pregnancies at risk for Down Syndrome and also lowers the false positive rate.

• Alpha-fetoprotein is a protein that is produced by the fetus
• Free beta-HCG (beta-human chorionic gonadotropin) is a hormone produced within the placenta
• Oestriol is an estrogen produced by both the fetus and the placenta
• Inhibin A is a protein produced by the placenta and the ovaries

Not every women or couple choose to have the serum blood screening done. But, the quad serum screen may be recommended for women who:

• Have used certain harmful medications or drugs during early pregnancy
• Are 35 years or older
• Have a family history of birth defects
• Have had a viral sickness during pregnancy such as toxoplasmosis, rubella, cytomegalovirus
• Are diabetic and are on insulin

These substances (Alpha-fetoprotein, Free beta-HCG, Oestriol, Inhibin A) that are carried in the Mother’s blood give an indication of a possible risk that Mother is carrying a fetus with an abnormality but one must remember that if one of these tests is positive it does not mean that your baby has an abnormality just that there is a higher risk of one.

What does the quad screen test check ?

The quad blood screen measures high or low levels of alpha-fetoprotein , abnormal levels of hCG and oestriol, and high levels of Inhibin-A. These results are combined with the mother’s age and ethnicity in order to assess probabilities of any potential genetic disorders. These results are to be interpreted by your doctor.

High levels of alpha-fetoprotein may suggest that the developing baby has a neural tube defect such as spina bifida or anencephaly (an-en-sef-uh-lee), which is a baby that is developing without the top of the head.

Low levels of alpha-fetoprotein  and abnormal levels of hCG and estriol may indicate that the developing baby has Trisomy 21(Down syndrome), Trisomy 18 (Edwards Syndrome) or another type of chromosome abnormality.

I want to emphasize that the most common reason for elevated alpha-fetoprotein levels is due to inaccurate dating of the pregnancy. This means that while you may have thought you were 15 weeks pregnant you may actually be 17 weeks pregnant, which explains the adjusted level of alpha-fetoprotein levels in your blood.

How Are The Tests Performed?

These tests are carried out by taking a sample of Mother’s blood, which only takes a few minutes. The blood is then sent to a special laboratory to be analyzed. It may take several days to receive the results.

The blood results are not the only element of this screening process that determine your risk factor. Ethnic background, age of the Mother,  gestational age of the baby and the levels of these substances togeather are entered into a computer algorithm to calculate your individual risk.

Except for the discomfort of drawing blood, there are no known risks or side effects associated with the quad screen test.

What do results mean?

It is important to remember that the quad screen is a screening test and not a diagnostic test. This test only notes that a mother is at risk of carrying a baby with a genetic disorder. Many women who experience an abnormal test result go on to deliver healthy babies.

Abnormal test results warrant additional testing in order to make a diagnosis. A more conservative approach involves performing a second quad screen followed by a high definition ultrasound. If the testing still maintains abnormal results, a more invasive procedure such as amniocentesis may be performed.

Any invasive procedure should be discussed thoroughly with your partner, your doctor and you may require additional counselling and discussions with a counsellor or social worker.

What are the reasons for further testing?

Reasons to pursue further testing vary from person to person and couple to couple. Further testing can confirm a diagnosis and then offer information and opportunities to:

Some individuals or couples may decide not to do any further testing for personal, religious or moral reasons and still other parents opt for no further invasive testing because of the potential risk of losing the pregnancy. It is important to discuss the risks and benefits of testing thoroughly with doctor as these decisions are important and your doctor can help you evaluate what tests are right for you and the benefits versus the risks.

About Your Placenta:

The placenta is truly an amazing organ. The word placenta is Latin for cake as this structure is round and flat and is attached to the inside of the womb. This organ is a single structure, one side facing the baby, the fetal portion of the placenta and the other side facing the mother, attached to the womb forming the maternal portion of the placenta.

Diffusion:

By a process known as diffusion, nutrients and oxygen are moved from the mother to the baby through the placenta. Waste products and carbon dioxide (deoxygenated blood) are taken from baby and returned back to the mother to be eliminated. Although the mother and the baby’s blood come very close together during this exchange, the blood never actually mixes.

Cell Division & Endometrium Development:

About a day after conception, the fertilized egg divides for the first time. This cell division continues on its way down the fallopian tube. After four or five days this newly fertilized egg, now known as a blastocyst has multiplied and divided into two sets of different cells. The outer set of cells develops into the baby’s part of the placenta and the inner set develops into the embryo, which will become your baby.

At the same time the mother’s endometrium or lining of the womb is undergoing it’s own changes and will become the mothers side of the placenta.

The endometrium increases in thickness and creates a flow path to increase maternal blood flow to where the placenta is attached to the lining of the womb. Spaces within this newly formed placenta are called intervillous spaces and provide channels where the transfer of oxygen and nutrients occur between mother and baby.

The Umbilical Cord

On the baby’s side of the placenta is where the umbilical cord enters this cake like structure called the placenta the other end of the cord enters into the baby’s mid abdomen, the place where we all find our belly button. This umbilical cord contains 3 vessels. One vein and two arteries. Oxygenated blood from the mother passes through the placenta and is carried to the fetus via the single vein, you can see this demonstrated in blue on the colour doppler ultrasound.

The baby’s deoxygenated blood passes via two umbilical arteries back to the placenta which is shown in red. You may notice during your ultrasound scan that the sonongrapher will make sure that the umbilical cord has 3 vessels. At the junction of umbilical cord and placenta, the umbilical arteries branch radially to form chorionic arteries. Chorionic arteries, in turn, branch again and these vessels eventually branch to form an extensive arteriocapillary venous system, bringing the fetal blood extremely close to the maternal blood; close enough for an exchange of nutrients by diffusion but no intermingling of fetal and maternal blood occurs. The exchange of nutrients happens through a series of pressure changes caused by arterial blood pressure and uterine contractions.

The placenta continues to grow throughout pregnancy. A well defined placenta can be seen on an ultrasound by 10 to 12 weeks. A normal placenta can grow to about 15 to 20cm in diameter.

The Placenta Organ:

Because the placenta is primarily a fetal organ, its size is often a reflection of the health and size of the baby. Throughout the pregnancy the placenta will grow continuously and it’s thickness is usually equal to the number of weeks of gestation, about 1mm for each week of the pregnancy. So for example if your baby is 15 weeks in gestation the placenta will be about 15mm in thickness.

Placenta Summary:

So in summary the placenta protects the baby, brings into close relationship two blood circulations that of the Mother and that of the baby to support fetal nutrition. Also near the time of delivery produces hormones that help mature baby’s organs in preparation for life outside the womb.

We receive a lot of questions in regards to swollen tummies. During pregnancy, hormones play havoc with your gastrointestinal tract. Under the influence of these hormones, mainly progesterone, smooth muscle within your body relaxes and unfortunately that includes the lining of our intestines, which causes your digestive system to slow down. Unlike the muscles of your arms and legs this type of muscle motion is involuntary so it’s not under your control.

The good news is that this slowing down of digestion allows increased nutrient absorption into your bloodstream therefore allowing increased nutrition to reach your baby. Although these hormones are important for baby’s health the bad news is that this slowing down of digestion can cause bloating and flatulence for you.

To minimize the amount of gas and bloating you experience you may want to keep your bowels moving. Constipation can be a common cause of these symptoms. To avoid this, drink plenty of fluids, eat a variety of foods high in fibre and partake in physical activity on a regular basis.

In addition we suggest you eat slowly so that you are not swallowing air. Eat small frequent meals so that you don’t overload your digestive system. It’s a good idea also to avoid gas-producing foods such as cabbage, cauliflower, garlic, broccoli, onions, fried foods, beans and carbonated beverages to name a few.

Everyone is different and so you may have to experiment a little to find out what foods you can tolerate well.

Give your stomach time to empty before lying down as this can cause heartburn and reflux.