Cervical Mucus and Early Pregnancy: What to Expect

Question
25 yrs old. First pregnancy. LMP 25 Sep o5.

I have a history of VERY irregular periods. I began menstrating at 10 yrs of age, only 3 times a yr. I was on birth control pill to regulate my cycle at age 16, and decided to stop using the pill at age 19 due to its potential negative side effects. Through acupuncture tx's I have brought my cycle from 192 days to more like 32-47 days.

A home pregnancy test on 2 Nov showed very positive result. Since my ovulation date varies, on 7 Nov 05 I had my first ultrasound to determine size and dates for my pregnancy. At that time there was "a tiny (4mm) focal hypoechoic area in uterine canal fundal region. The endometrium measures 16.4mm. As of yet, if indeed this is a viable gestation, there is no evident of cardiac activity, yolk sac, or fetal pole."

And for the last two weeks I have been having thick brown cervical mucus spotting. My last paps were all normal and healthy. No history of any unusual infections. I have other signs of pregnancy-firm, full tender breasts, nausea, loss of appetite, food and smell aversions, tiredness, slightly crampy at the very beginning. Any thoughts? Should I worry about miscarriage? (Even so, I know there is nothing I've done to cause it, or anything I can do.) Thank you for your time.

Answer
It is common in early pregnancy, to have brownish discharge. This can be "old" blood that is being extruded from the uterus by the growing fetus. It is difficult to determine exactly how far pregnant you are at this time. If you have a 32 day cycle, ovulation occurs on cycle day #18, However, if you have a 47 day cycle, ovulation occurs on 33. If the sonogram did not show a gestational sac, it may merely be too early in the pregnancy. If you are less than 6 weeks pregnant, a sonogram will usually only show an empty gestational sac, but no fetus or fetal heartbeat. Once you are more than 6 weeks gestation, you will see a fetus and a fetal heartbeat. I would suggest that you take two blood tests for pregnancy (Beta HCG) 48 hours apart. If there is a doubling of the results in 48 hours, it is a viable pregnancy. If there is a halving of the results in 48 hours, it indicates a miscarriage. Miscarriages occur in 15-20% of every pregnancy. There is nothing you can do to cause a miscarriage and there is nothing you can do to prevent a miscarriage. If the HCG results indicate the presence of a viable pregnancy, repeat the sonogram in a few weeks, as long as you are not having heavy bleeding and cramps. If you had a 47 day cycle in September, and your last period was September 25, you would have ovulated on cycle day #33, which was October 27. If you did become pregnant around that date, a pregnancy test wouls show a positive result by the beginning of  September. By the way, why did you stop the birth control pills? The pills do not have any potentially  negative side effects. The new low-dose pills may cause some headaches, breakthrough bleeding, or nause for the first three months of use, but then no longer has any side effects. As long as you do not smoke, there are no complications from use of the pill. You can continue taking the pill until you reach menopause. You really should have your cycle regulated after you have the baby. Good Luck.