Question: Hi Doc,

I am 35 year old woman, turning 36 this November 28th. I got married in the year 2011. Please note I HAVE O NEGATIVE BLOOD GROUP and my husband is O POSITIVE. Since, I got enrolled in my Ph.D. (Chemistry) just after marriage, me and my husband decided to have our first kid only after completion of my degree. Both of us had comfortable physical relationship but without intercourse. This October, I got my degree and now I am pregnant. The first day of my last menstrual cycle was on 20th October, 2015. I took home pregnancy test on 16th of November and again on 18th November. Both times, it was positive. Thereafter I consulted a doctor (General Physician) who prescribed me Sysfol -Activ tablets for 30 days (She mentioned the strength/power verbally as 5 mg; one tablet at night) : The chemist gave me sysfol activ with composition:
L-Methyl Folate calcium equivalent to L-Methyl Folate : 1mg, Mecobalamin JP: 1500 mcg; Pyridoxal-5-Phosphate: 1.5 mg.
Also some prenatal Biochemistry and Haematology tests were conducted. The reports are attached below for your reference. Kindly provide me explanation of the reports and also whether or not the capsule I am taking is of adequate power and is okay?

Thereafter, I also referred a qualified Gynaecologist and Obstetrician. She scared me to almost death that I should have quit my studies and had children first and also I should not even think of a normal pregnancy; only C-section can be done. Chances of XXX (down's syndrome) are also quite high. Please note that I am a healthy 35 + woman with weight 58.5 Kg. I never ever had any hard drink nor I smoke. I am also not addicted to caffeine and have no family history of illness except that my father-in-law had diabetes. I walk for 35-40 min everyday. This doctor without any examination asked me to stop taking Sysfol Activ and asked me to take the below prescribed medicines for 15 days:
1) NOMOSIC- PLUS ( no strength mentioned)
2) Cypron Syrup
3) Natural Micronized Progesterone Sustained Release Tablets (300 mg) by Michelle-SR.
Even on request, she did not tell me the use of these medicines nor the dosage. She said you must have trust on your doctor and chemist would tell you the dosage. Please tell me whether or not it is advisable to take the above drugs? Also whether or not should I stop taking Sysfol Active and if No, is the above composition okay? Please note that I have no symptoms of nausea, vomiting, headache or morning sickness as of now. Only I feel bloated most of the time. Also tell me are there chances of normal delivery? What are the problems that I can face because of my blood group (O negative) and age? When should I get the ultrasound done? For how long should I avoid journey? What kind of diet should I follow?

Thanks and regards- Dr. XXXXXXX XXXXXXX

Thanks Doc for your advice and assurance for a normal delivery.

Kindly help me with the following queries:
1) Is sysfol Active of above composition (1 mg) sufficient or do I need to take a higher dosage(5 mg)?

2) I am currently staying at XXXXXXX (Madhya Pradesh) and the TVS scan you recommended is not available here? Will an Ultrasound help instead? The doctor I consulted advised me to get an Ultrasound on Dec 6th 2015. Please advice when shall I get the Ultrasound done and also is it a substitute to TVS?

3) I have no early pregnancy symptoms except for bloating of stomach and slight pain in lower breast area. Is that a matter of concern such as no development of embryo?

4) Will it be possible to seek consultation and advice and in later stage delivery under your guidance and supervision? Or can you suggest some good gynecologist at XXXXXXX (M.P.)?

Thanks and regards- Dr. XXXXXXX XXXXXXX

Thanks again Doc!

Please help me with following queries:

1) I went to get transabdominal ultrasound scan yesterday, doctor advised it is too early and also told that if I insist and if she is unable to detect heartbeat then she can do the the next scan only after 3 months. As these tests can be harmful for the developing fetus. That will make me anxious too. Is she correct or do I need to wait? How much should be a gap between two ultrasounds and how many ultrasound are required throughout my pregnancy?

2) I had a little spotting today morning (few drops of light red color blood at around 11:50 am). Is it normal or do I need to rush to my gynae again? She isn't taking call. This is the first time I am experiencing spotting. The food item that I included yesterday was peanut chhiki. I had 4-5 pieces only after I read on the internet that it is a rich source of folic acid and I can take 4-5 pieces. Should I completely avoid it? Also I had ripe tomato in salad?

3) Is masturbation or intercourse safe during the first trimester?

4) It will be nice if you could suggest some female gynae located in Delhi?

Thank you once again for your time and advice- Dr. XXXXXXX XXXXXXX

Hi Doc,


Well, my beta-serum blood test and Thyroid reports are attached for your reference. The docs says they are normal but I doubt the thyroid one (specially after reading the reference data for pregnant woman). Please go through them and suggests clearly what does the reports indicate and whether or not I am suffering or in high risk zone of hypo/hyperthyroidism? Also plausible medicines if in case the tests are positive.

Well, I consulted another gynae at my place (Guna). I zeroed in on her on the basis of mouth to mouth kind of publicity. The nearest major city i.e, XXXXXXX is 280 Km from my place and the road conditions are really bad so presently I had to settle for a gynae here itself. She went through the previous diagnosis and was concerned about spotting. As written to you above, I had spotting (1-2 drops of blood) on two days (alternate). She quickly prescribed me Cap Lupigest SR (15 days) and Tab Duphaton (15 days). I have attached the prescription that she has scribbled on a piece of paper. She told I have to take them religiously to sustain pregnancy because spotting is a major concern (unlike what you told me above). When I asked her that I have conceived normally without any issue (within first month of planning a baby) then why am I asked to take progesterone, she said you have to take it if you don't want miscarriage. Well, I am confused why all three gynae that I consulted have prescribed in progesterone in one or the other forms. What shall I do? I feel i should not take it but I doubt what if something goes wrong? Me and my husband are in dilemma. WHAT SHOULD I DO? I am from XXXXXXX but as of now I can't travel until completion of 3 months.

I also have a little breathlessness and have to take deep breaths to feel okay especially after eating or when I talk at a stretch or walk or lie down. I do walk 3-4 km slowly everyday and since I am living in lush green campus, pollution isn't an issue. What could be the cause and solution for the same?

Can I do some prenatal yoga at this stage? I am in 6 weeks of my pregnancy.

Also can I do without wearing a bra most of the size because my breasts have become fuller or Should I purchase some new bras/maternity bras? I feel most comfortable without wearing one but will that lead to sagging?

Best regards- Dr. XXXXXXX XXXXXXX

Hi Doc,

Thanks for answering.

Please address the following issues:

1) The thing that is bothering me in my thyroid report is the note given below stating "correlate the values with your clinical conditions". According to it the reference value for first trimester TSH level is provided as 0.1-2.5 and my value has been detected as 4.24. Please explain this?

2) I got an appointment for TVS scan in a fertility clinic nearby, what all information I would be able to procure from the scan and any precautions to be taken while getting that test done?

3) i recently noticed gum swelling and slight bleeding, Is this also a symptom associated with early pregnancy or I need to consult a dentist?

4) When shall I get a HIV test conducted?

Thanks and regards- Dr. XXXXXXX XXXXXXX