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Pregnancy Bliss | Reproductive Health Hub

Partner’s diabetes and recurrent miscarriage

Question: My hubby has just been diagnosed as having very high blood sugar.Do you think it can be traced as a possible cause for the recurrent miscarriages iv had in the past (though,i had a child previously). O. (Nigeria)

Answer: I take it from your details above that your husband has been diagnosed to be diabetic. Diabetes on the part of the male partner is not and cannot cause recurrent miscarriage. Poorly controlled diabetes over a prolonged period of time can cause erectile dysfunction and even impotence. It does not cause miscarriage.

Preterm delivery of twins

Question:  I suffered preterm rupture of membranes when my twins were 28weeks old. What caused it? My twins passed away at 4 days and 9 days old respectively after successful delivery and while under intensive care in an incubator. What could have happened? A.N. (Uganda)

Answer: This is a really tragic story. It is difficult for me to know what might have led to the pre-term membrane rupture and subsequent delivery. Difficult not least because I have too little information here to go on. In any case, prematurity is one of the commonest complications of twin pregnancy. If these were identical twins sharing a placenta (monochorionic twins), that does carry a risk of twin to twin transfusion syndrome (TTTS) which can be deadly and increases the risk of pre-term rupture of membranes and labour.

Regarding the subsequent tragic loss of your twins, that would also depend on the facilities you had available in the special care baby unit they were looked after. While nursing in an incubator is an essential part of their care, it is far from the only one and is probably not even the most important. These babies born at 28 weeks are certain to have inadequate lung function and respiratory distress is the biggest problem. Whether there were adequate facilities to address this is an important question. In addition, these babies are at high risk of developing intra-cerebral haemorrhage and measures to prevent this are essential. Other potential complications which can be life-threatening involve the bowel. This is a situation where your babies’ doctor is best placed to explain what might have happened.

I do hope you will be able to get that information to allow you to come to terms with the loss and move on from this very sad chapter in your life.

Air travel at 30 weeks pregnant

Question:  Sir please advice me now I am 30 weeks pregnant.(now in Bahrain). I need to go to Mangalure October 8 to 10 dates ( not fixed ). Can I go ?  Pls give me valuable advice. D.R. (Bahrain)

Answer: I take it you are planning to travel to the city of Mangalore in Karnataka, South-Western India. From Bahrain, that will be an almost 3,000 kilometre flight. Even at the best of times, that is a fairly long flight. Your proposed flight dates mean you will be around 32-33 weeks. You may find that most international airlines do not allow flights at such a late stage of pregnancy. This restriction is really in your interest and that of your baby in the womb. Pregnancy is unpredictable and were you to suddenly go into labour mid-flight, hours from anywhere, it could be a potentially serious problem. Unless the journey is absolutely necessary, my view is that you should cancel it.

Bleeding in early pregnancy

Question:  I have about 4 weeks pregnancy. I had a blood test to analyse the age of the baby since there was nothing detected during ultrasound . I had some bleeding for two days. It was far less than half of the menstrual bleeding. Doctor has suggested I have a scanning only after 5 weeks completion. Will there be any complication with this bleeding? A. (Oman)

Answer: I am struggling to understand what is going on here. You are saying you are “4 weeks pregnant”. That, in effect, means you have not yet missed a period. You also say you “had a blood test to analyse the age of the baby” but you have not said what the results of that test were.

It is important first of all to be sure that you are actually pregnant and if so, how far this pregnancy is. If you are pregnant, then it is clearly the case case that no ultrasound scan should be attempted before at least 5 weeks have elapsed since your last period. Scanning before then will be a waste of time as nothing can be seen and it will only create anxiety on your part. Could the bleeding have caused any harm to the pregnancy? It is not possible to say until that first scan is done. If your suggested dates are correct, that will be in a week’s time so the best thing is to be patient and wait for that. My best wishes.

Sickle Cell Disease and mode of delivery

Question:  Is it normal for a sickle cell patient to have small breast that to even remove your bra in front of friends u feel ashamed of yourself. can such a person breast feed? Is it good for an SCD patient to go for a normal delivery or Caesarean Section? F (Nigeria)

Answer: If a woman with Sickle Cell Disease happens to have small breasts, the two are not necessarily connected. Sickle Cell Disease, especially if not well managed, can cause chronic growth restriction and that can cause stunted growth which might include delayed development of secondary sexual characteristics (onset of periods, breast development etc). However, the eventual size of breasts is not usually influenced by the condition.

Regarding mode of delivery, unless there are other issues to preclude this, a woman with sickle cell disease should be encouraged to aim for a vaginal delivery. It is important to ensure adequate hydration and effective pain control during labour.

Severely preterm babies tend to need much more than the warmth of the incubator.