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Pregnancy Bliss | Reproductive Health Hub

Vitamin B12 deficiency and miscarriage

Question: Hi, could it be possible that b12 deficiency  cause you to lose a baby? My daughter was told her baby had died at 7 weeks pregnant. As the baby did not miscarry, she had to have op to remove it. Now the same thing has happened again  at 7 weeks again and she has to have another op to remove as it still has not come away. The folic acid she was taking was not working for her. Would the hospital have known this as she has always had problem with her blood and would this happen to her again if she gets pregnant a 3rd time? Thanks. J. (UK)

Answer: Your daughter has had two consecutive miscarriages early in the first trimester. You mention that she has Vitamin B12 deficiency and wondered whether this could be the underlying cause. It is indeed the case that significant Vitamin B12 deficiency has been associated with miscarriage albeit as a very rare cause. The fact that your daughter has successfully conceived twice in (apparently) quick succession would seem to suggest that B12 deficiency is very unlikely to be the cause of her miscarriages. Significant B12 deficiency tends to make it difficult to conceive in the first place. You have not said whether she was having B12 injections to address that apparent deficiency.

In your details you also appear to confuse two issues. You have mentioned that ‘the Folic Acid she was  taking was not working’. It is almost certainly the case that the folic acid she was advised to take was as a general measure to ensure a healthy baby and prevent conditions such as spina bifida. It was not to prevent miscarriage. Folic acid is advised for most mothers planning to conceive.

I cannot answer the question of whether miscarriage will happen again. She does need to have the cause of the miscarriages investigated and hopefully the doctors are planning to do this. As I said before, it is unlikely B12 deficiency is responsible. My best wishes to her.

Antimalarials in the first trimester of pregnancy

Question:  Can u pls tell me antimalarias that can be used in the first trimester of pregnancy ? D.M. (Nigeria)

Answer: There is limited data on the safety of antimalarials in pregnancy. Advice given is mainly based on observational studies and experience in various parts of the world. It cannot therefore be regarded as foolproof.

Botox injections for vaginismus

Question:  I suffer from Vaginismus. I trailed the internet looking for a surgery that offers Botox injections for this and haven't found one. Could you let me know.  I live 72 miles from London, England. Thanks. C.P. (UK)

Answer: I couldn’t tell you a specific clinic that will offer this in your area because I do not know. This is a recognised clinical condition and therefore private hospitals, by regulation, cannot advertise this service. You may, in fact, be able to get this treatment on the NHS at the local hospital. You need to contact your GP and explain the problem. If you have not been seen before for this problem you should really go with an open mind to allow the doctors to do a proper assessment, reach a diagnosis and offer you treatment options. If you go specifically demanding Botulinum (Botox) injections, you may very well end up meeting resistance. However, if you have been seen before for this problem and remedies tried proved ineffective, it is completely legitimate for you to suggest this treatment for yourself. If this is not available at your local hospital, your doctor may be able to request this to be funded on a ‘named-patient basis’ from your local Primary Care Trust (PCT). The final avenue, if all that fails, would be to try to get this at any of the nearby private hospitals. Your GP should be in a position to suggest a consultant who offers that. My best wishes.

Trying to conceive after a miscarriage

Question: Hello, I was 15 weeks pregnant when i lost our little boy. When i was taken to the hospital they took tests from me and baby to see why this had happened and they found nothing wrong with me or baby. Two weeks before i lost him i also had a heavy bleed. Now we would like to try again for our 6th baby but we r not sure if the same thing will happen again. Please help. J.C. (UK)

Answer: Losing a baby is always a very difficult experience to go through. It is made more difficult by the fact that, in most cases, the underlying cause for the pregnancy loss is never established. Your anxiety about the future is therefore understandable.

From what you have said, I think this is likely to be a one off. Your details suggest that you have had four successful pregnancies and deliveries. That will tend to reinforce the impression that this pregnancy loss was a sporadic event, unlikely to recur. Of course nobody can give you an absolute guarantee that this can’t happen. However, on balance of probabilities, it is reasonable to say it is unlikely. Best wishes for the future.

Chicken Pox  contracted in first trimester of pregnancy

Question:  Dear sir, my wife contracted chicken pox in the ninth week of pregnancy. Is there any chance of baby getting affected? Thank you. N.D. (UK)

Answer: There is a possibility that the baby might be affected. With your wife having contracted the infection in the first trimester, the risk is about 1 in 10. Of course the positive side to this information is that the unborn baby has a 90% chance of escaping completely unscathed. It is impossible to know which exposed babies are likely to end up being affected. The effects of congenital chicken pox infections are discussed in more detail here:

Pregnancy following two miscarriages

Question:  My girlfriend is 4 weeks pregnant she has had 2 miscarriages . When we asked the doctor he said you we can't really do anything until women have had 3 miscarriages. Any advice please would be very helpful. K. (UK)

Answer: It is always difficult to give objective advice without access to all the relevant information about the person in question. It would be helpful for instance to know her age, what stage of pregnancy she was when miscarriages occurred, whether there are any medical problems, whether  she is of normal weight, smoker or not etc. These are all important if you are to be objective in your assessment of risk. However, assuming there is no obvious explanation for the pregnancy loss, the one advise which might be useful is for your girlfriend to start taking low dose aspirin. This should be at a dose of 75mg daily and needs to be taken well into late pregnancy (36 weeks). It can’t do any harm and in fact might potentially do a lot of good. My best wishes to you both.