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Pregnancy Bliss | Reproductive Health Hub

Induction and augmentation of labour

Question: The definition,method,contraindication of induction & augmentation. A. (Ethiopia)

Answer: It is probably a safe bet on my part to assume from the question that you are a medical student or something similar. Well, you are in luck. There is a whole chapter on labour induction and augmentation covering several pages on this site. The subject is dealt with comprehensively. Just click here to get there.

Early pregnancy vaginal bleeding

Question:   I’ve done a preg test on Monday (yesterday), it was positive but later on that day i started a light bleed but today i lost a dark red clot with no pain. I haven't had any pain at all.  Can u help me? I’m confused. A. (UK)

Answer: There could be a number of things going on. I take it this is very early pregnancy. If that is so, this could be simply a threatened miscarriage which, on balance, would spontaneously resolve. The painless bleed could also be an early sign of a failing pregnancy, a pregnancy that is no longer viable. I think giving you all the possible explanations of this is not going to give you practical assistance. Early pregnancy bleeding, even without pain, is regarded as an emergency. I would therefore advise that you contact your doctor or your local hospital’s early pregnancy unit for a proper assessment.

Is this measles in pregnancy?

Question:  I'm 18 weeks pregnant & my doctor tells me that I have measles when I came to her after seeing spots on my tummy & arms w/c appeared after eating fish for lunch. I went to get a 2nd opinion & the other doctor tells me that they're just allergies. Now I'm wondering if they are really measles since I don't have any of the symptoms like fever or cold. I'm not sure whether I had measles when I was a child or was even vaccinated. S.

Answer: I will stick my neck out and say it is exceedingly unlikely that what you have is measles. Measles never presents that quietly. Remember measles is not a skin condition as such even though its most visible feature is the rush. Measles is a systemic illness with quite significant general symptoms like the ones you have hinted at in your question. Before the rash appears there is the so-called prodromal phase with fever, headache, joint pains, runny nose etc. These general symptoms are, in fact, more pronounced in adults like yourself than they are in children. I think your doctor got this one wrong.

Risk of recurrence of pre-eclampsia and HELLP syndrome

Question:   My daughter, nearly 21, recently developed pre-eclampsia and help-syndrome. A traumatic end to a much wanted pregnancy. How do i find out the chances of something like this happening again? S.P. (UK)

Answer: It is, unfortunately, not possible to quantify any individual woman’s chances of having recurrence of pre-eclampsia and/or HELLP syndrome, both being potentially very serious pregnancy complications. It is however the case that for a woman who has been affected by pre-eclampsia and HELLP syndrome, her risk of having pre-eclampsia (without HELLP) is significantly higher than average and it approaches 1 in 2.  The positive view of that is your daughter has a roughly just over 50% chance that she will have a trouble free next pregnancy. The risk of recurrence of HELLP syndrome (with or without pre-eclampsia) is lower at 1 in 4 (25%).

Falling pregnant after sterilisation

Question:   I was sterilised straight after a c section seven years ago but every now and then i still fall pregnant and always lose it in the first couple of weeks. Is there anything i can do? L.D. (UK)

Answer: I am not sure I understand the kind of help you want. Do you want to avoid falling pregnant considering you were sterilised in the past or do you want advice to ensure you don’t miscarry? First things first: Are you absolutely certain that you have actually conceived and miscarried? Is there any chance that what you consider to be pregnancies and early miscarriages could simply be late periods?  If you have objective proof that you have indeed conceived and miscarried, it will mean failed sterilisation.

If you are still of the view that you do not want any more children, you need to be seen by your GP for a referral back to a gynaecologist. If, however, you are now of the view that you wouldn’t mind having another child, you probably don’t need to do anything. If you have carried pregnancies successfully to term in the past, that will happen again. If you have had more than two proven miscarriages, it may be worthwhile to bring that to the attention of the  the  GP even though it is unlikely anything will need to be done.

Conception after losing both fallopian tubes

Question:  I have had two ectopic pregnancies & as a result have lost both fallopian tubes, Is it at all possible for me to get pregnant naturally as I have always been very regular with my period & I am now 2 weeks late. L.G. (Australia)

Answer: If you are certain that both fallopian tubes were surgically removed, spontaneous conception of a pregnancy in the womb is not possible. I am saying ‘if you are sure’ because it is possible for an ectopic pregnancy to be managed by a surgical technique that conserves the tube with the specific aim of preserving the woman’s ability to conceive naturally. If you are unsure about the surgical procedure employed especially with your second ectopic, I would urge you to seek that information promptly from the hospital where you were treated. Another possible dimension to this scenario is a repeat ectopic pregnancy. Even with tube conserving surgery, after two ectopic pregnancies, the risk of another ectopic pregnancy is quite high. Moreover, even after both tubes have been removed it is possible to conceive and that tends to be an abdominal ectopic pregnancy. It is rare but it happens.

Your first act should be to do a pregnancy test. If this is negative, you are dealing with a delayed period. If it is positive, you are pregnant and location of this pregnancy will need to be done using an ultrasound scan as a matter of utmost priority.

Fansidar safety in pregnancy

Question:  Is Fansidar safe in pregnancy ? I.S.

Answer: Fansidar is a drug used to treat malaria. It is a combination of Sulfadoxine and Pyrimethamine. There are no specific studies on effects in human pregnancy. However, Fansidar has been shown to cause malformations in animal studies especially when used over a prolonged period. It should therefore not be used for prevention of malaria during pregnancy. Its use for treating a bout of malaria is also advised against unless no effective (and safe) alternative is available. This is particularly the case towards the end of pregnancy. We have discussed anti-malarial medication in pregnancy here: