Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.

Brief Answer:
Some more information. Fetal heart check up.

Detailed Answer:
Hi there, Dr. Purushottam Neurgaonkar here.

First of all do not panic.

Sorry to know about your daughter's previous pregnancy losses.

It is good to know that she is having fetal heart monitor with her at home.
I will suggest that she should keep daily tracking of fetal heart at least once in a day.
This will answer help to reduce her anxiety level.

I would like to know if she has history of constipation or piles before ?
Has she got any treatment for the such issues in the past?
Also, I would like to know about her current diet pattern and daily water intake.
Also please let me know if she is taking any iron supplements.
This information will be useful to help you out in a better day manner.

Generally there is tendency of constipation during pregnancy.
But you are right in having concern when she is reporting about bleeding.
I will also suggest that she should keep watch, if she notices the bleeding again.
Also it will be of help if she could find outo if the blood is coming out from vagina or from anus.
Generally speaking, straining and pushing hard while passing motion should be avoided as far as possible.

Please convey her not to worry.
Please feel free to communicate with me again.

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Brief Answer:
Salads, water intake. IRON before food. Lactulose if needed.

Detailed Answer:
Hi there, thanks for appreciating the answer and reverting back to me.

I appreciate your feedback about her dietary habits.

I will suggest that she should increase amount of salads in daily diet.
She can eat plenty of cucumber, tomatoes, lettuce, iceberg lettuce at the beginning of her meals.
All, fruits with pulp and lot of water like oranges and sweet lime, banana can be taken during breakfast and in between meals.
Most important thing is that she should consume 10 to 12 glasses of water in a day.

I usually suggest to avoid refined sugars and deep fried foods and bakery products in the diet.

All these measures will help to overcome the problem of constipation.

Secondly, I usually suggest that iron preparation should be taken at least half an hour before meals. This ensures maximum absorption of iron from the gut- intestine.
Many times unabsorbed iron creates disturbances like nuasea and vomiting and constipation.
If needed iron preparation with stool softener that are available can be considered.

Lastly, if her constipation still remains inspite of all these measures then stool softener like Liquid Lactulose can be taken 15 ml at night with a glass of water. She might need prescription support from her treating doctor for the same.

Hope I have answered your query. Let me know if I can assist you further.

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