Dr. Balakrishnan R
Obstetrics and Gynecology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I am 21 weeks pregnant, and I have all my tests done. All of it seems well. The only concern is the baby is having an echogenic intracardiac focus in left ventricle which was found in anomaly scan following which my doctor prescribed a quad screen test and I did that as well. My doctor is very supportive and understanding, but with both my double marker and quad marker test my chances for Down's syndrome was 1:1071 and 1:1384 respectively, and she keeps saying, she would have been happy if it was 1:10000 and with finding of echogenic intracardiac focus, I am a bit anxious and worried about how to actually take it. I am looking for a strong opinion on your experience. Also, please note, there were two complications I faced. During my eighth week, I had a minor brownish spotting, which was subsided by extra dose of Progesterone and Duphaston and following which I had major itching issues, which when examined found out to be increase in AST and ALT level. All possible tests for hepatitis and ultrasound for liver were clear, and with Udiliv 300 it came back to normal. But my AST and ALT levels were high since the 11th week of pregnancy which according to any doctor is not heard of but it is in control with Udiliv. Other than that, I feel absolutely no physical discomfort or complications. Please tell me if there seems anything alarming.
Hello,
Welcome to icliniq.com.
How are you doing?
Let me assure you that you and your baby are absolutely normal and will have no problems. Let me explain one by one.
A single soft tissue marker like the echogenic cardiac focus is not at all to be worried about. We do not need to do any marker or even a fetal echocardiography. Forget the risk ratio. Even if noted anything above 1 in 250 is not to be worried about at all. Even echocardiography will be normal and post-delivery follow up will be normal.
Brownish discharge in first three months of pregnancy is normal. When the embryo implants, the minimal blood which comes due to the burrowing embryo will clot and come out within first three months of pregnancy. Even without the progesterone, the clot will resolve. So do not consider it as a problem.
Pregnancy is a cholestatic state and liver enzymes will raise. But that is quite early as you mentioned. Just have symptomatic management.
In short, I feel both you and your baby are absolutely fine. Nothing needs to be done.
Hope I have clarified your query, do write back if any more queries. All the best.
For more information consult an infertility specialist online.
Patient's Query
Hello doctor,
Thank you for the reply.
It surely relieves me by getting a second opinion on my reports. I really studied your approach which focusses more on positives and I believe that is what is much needed at such times. My AST and ALT levels still keep jumping in between but my doctor has told that as far as bilirubin is under control, she is not too worried and she will prescribe medicine only if required.
Hello,
Welcome back to icliniq.com.
Rightly said, take everything positively. Understand a fact that pregnancy is not a disease, it is only a physiological condition. When you are normal, how can the pregnancy be abnormal?
I can bet that bilirubin will never go above normal limits till 36 to 37 weeks. All these are liver enzymes, usually only bilirubin is to be looked for and a small rise is not to be worried at all.
All the best, do write back if any more queries.
For further queries consult an infertility specialist online.
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Obstetrics and Gynecology
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