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Pregnancy Bliss | Reproductive Health Hub

Pre-labour rupture of membranes

Question:  After suffering a dural tap, can you tell me how long after can u still get bad headaches? G.H  (UK)

Answer: A dural tap is a complication of epidural analgesia as commonly uesd during labour. It is not a common complication. Headache associated with a dural tap can be quite severe and debilitating. In the majority of cases, this resolves completely within about a week. Occasionally, however, the headache can persist to some degree for up to a month, rarely longer. Also, bear in mind that not everybody who has an accidental dural tap will end up with headache, medically called ‘post dural puncture headache (PDPH)’. In fact the majority of people do not get this. An epidural blood patch is the treatment of choice and done properly, over 95% of affected patients will get total or substantial relief from the headache.

Latent phase of labour

Question:  How long does the latent stage of labour last as my daughter as been in it for 4 days now and she is really tired and wondering how much longer she will be. F. (UK)

Answer: As we have mentioned in the main section on this topic, the latent phase of labour duration is so variable that there is no length of time beyond which it can be said to have been prolonged. Since the latent phase is, strictly speaking, pre-labour, it can be difficult to pin down. Some women have quite marked discomfort and even pain in the period leading up to labour and in some extreme cases this can last a couple of weeks, sometimes longer. This does occasionally lead to an offer of labour induction. Your daughter’s four days of this ordeal is not a record beater but it is clearly quite long.

Blood-stained white discharge in pregnancy

Question:  I am pregnant and had a white discharge with blood mixed in it. Is it serious? V.

Answer: A vaginal discharge is quite common in pregnancy. The commonest is vaginal thrush which is a result of over-growth of the fungus called Candida. This is not a true infection as Candida is commonly found in the vagina. Sometimes the cervix gets inflamed and the discharge can then have streaks of blood in it. This may very well what is going on with you. However, if you are concerned and this is out of the ordinary for you, it may be worthwhile to have an examination by the midwife or doctor to make sure nothing important is being missed.

Intramural fibroids and chances of pregnancy

Question:  I just found out that i have fibroids and it is intramural. the uterus is now 13 by 7cms. Am trying to conceive now just this month, do u think it is gonna be a problem?  I have no symptoms whatsoever.  I have painful menses but i have always had it since menarche. Am 27 now. Last menstrual period was 08/16 and i had up sex on the 28th and 30, could i be preggars? Had an HSG on the 25th and tubes were clear..... what are the chances? My cycle ranges from 26 or 28.....  A. (USA)

Answer: Intramural fibroids are those fibroids within the muscle body of the womb. Even though at 13 x 7cm, your womb is enlarged (moderately), this is unlikely to be a problem. Fibroids can interfere with fertility but for that to be the case, location is critical. Submucosal fibroid are the ones that have been associated with some form of sub-fertility. This is because they distort the critical womb cavity where implantation takes place. The type of fibroids you have can be associated with heavy periods but not normally fertility problems.

You have not said how long you have been trying to conceive. However, seeing as you have had a tubal patency diagnostic test in the form of an HSG, I am assuming you have been trying for sometime, right? Well, it is clearly good news that your tubes are patent so that is one potential obstacle ticked off. Your cycles are quite regular which will tend to signify that you are ovulating regularly which is another positive. You had sex at the right time last month and hopefully things work out quickly for you but if a period arrives this month, don’t let that send you into despair. It can take several months of trying before things happen. If you have been trying for 12 months or more, it would be advisable to get your partner to have a semen analysis. This is the simplest of fertility tests and many aren’t aware that, problems on the male partner’s side does account for up to a third of sub-fertility problems among affected couples. I need to stress, however, that from the information you have given, I cannot say I have an impression of any problem. Good luck.

Fibroid degeneration during pregnancy

Question:  Why do fibroids bleed in pregnancy? N. (Pakistan)
Answer: Fibroids do not bleed during pregnancy but I suspect you are probably referring to what is known as red degeneration which fibroids can undergo during pregnancy. Red fibroid degeneration refers to a process where the core of a large fibroid breaks down. This tends to be manifested in the form of pain which can sometimes be quite severe. Red degeneration is not exclusive to pregnancy but is commonest during this time. It is thought to be due to the hormonal influence fibroids are subjected to during this time. Nothing much can be done about this other than to try to control the pain.

Fibroids that have undergone red degeneration are usually surgically removed but this cannot be done during pregnancy. The mainstay of managing red degeneration during pregnancy is therefore pain control only.

Analgesics and miscarriage

Question:  Can analgesics cause a miscarriage? C.S. (Poland)

Answer: It would be wrong to regard analgesics (pain-killers) as one group of drugs with the same effect on pregnancy. Most pain-killers, when used as a one off, are safe in pregnancy. Non-steroidal anti-inflammatory drugs or NSAIDs cannot be used in pregnancy. They are associated with other adverse pregnancy complications. Paracetamol (Acetaminophen) is the commonly used pain-killer in pregnancy  because it is known to be safe at any stage of pregnancy. Opiate analgesics such as Morphine do not cause miscarriage but cannot be used on a regular basis because of the risk of addiction. So, to answer your original question, analgesics or pain-killers are not normally associated with miscarriage but some are contra-indicated for use in pregnancy because of other potential adverse effects.

Post-pill conception

Question:  Me and my husband have decided to start a family i have been off the pill for a month. In the last 2 weeks i have experienced pregnancy symptoms. Could i be pregnant? P. (UK)

Answer: If the body behaves normally after coming off the pill, ovulation should resume within 2 weeks. That means, in theory, it is possible to conceive within a month of coming off the pill. This is not always the case of course and, for some women, it takes a few months before normal ovulatory cycles resume. Some women in fact will not have periods for several months after coming off the pill.

It is therefore possible for you to be pregnant. However, I doubt very much that the ‘symptoms’ you are feeling are to do with a pregnancy because it would be too early for you to get symptoms. If you are pregnant, the furthest you can be is 2 weeks and you have had these ‘symptoms’ for two weeks so, as you can see, it does not add up.