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Pregnancy Bliss | Reproductive Health Hub

Anencephalic baby

Question:  Is anencephalic baby of normal size, i mean in height and weight? S.K. (Pakistan)

Answer: In the womb, an anencephalic baby will tend to grow at the normal rate because that is mainly dependent on placental function. If the pregnancy gets to term, the baby will be of normal size and weight. These babies do not survive outside the womb.

Labour ‘problems’  and subsequent cerebral palsy

Question: My second daughter’s labour was slow. She was in ROL position. I felt like I was ready to have her a long time before I was. The contractions were not far apart; 2 minutes at most but nothing was happening. They kept asking whether I needed to push and I said No. They said give a little push if you want to but when I eventually needed to they stopped me for about 30 minutes then eventually said go on push. She came out in 2 pushes. I have 3 children and this was my second and it didn’t seem right. Can you explain why this may have happened? When she came out she was really squashed all down one side and her arm on one side looked like a person who has had stroke. Now at 3½ she has been diagnosed with hypotonic/ataxic cerebral palsy. An MRI showed scarring on the left of her brain so I suppose what I’m asking is, does this sound like a normal labour? Why would it have happened like this? Why was she squashed? Why did they stop me pushing and could it have caused the brain scarring? I would appreciate any help. N.C (UK)

Answer: Whilst I do genuinely feel for you with this outcome to your pregnancy, I cannot pretend to have answers to the specific questions you have posed here. Your quite detailed description of the final phase of your labour gives me an impression that it was not overly prolonged. You may have been stopped from pushing earlier because the baby’s head may not have descended enough and the assessment was that further descent was necessary to achieve effective pushing and delivery. Alternatively, the issue might have been the position and it may have been deemed ideal to allow the head to rotate into a more favourable position for delivery. You say your contractions were roughly every 2 minutes. That is a good frequency but there is also the issue of the strength of the contractions which would also be an important factor. It may have been a combination of all these. Being stopped from active pushing for half an hour or even longer in the second stage of labour is by no means uncommon. It is important for the midwife to ensure pushing is only done when there is a realistic possibility of delivery in a reasonable time duration. If the efforts are started too early this may not happen and the mother might get exhausted to an extent where she cannot deliver without instrumental assistance and, in some cases, even a caesarean section. I can therefore understand why you might have been given the advice you were even though I couldn’t possibly be more specific.

The issue of the cerebral palsy that your daughter has been diagnosed with is obviously the most important question. Cerebral palsy is almost always a result of parts of the brain being starved of oxygen either before or during labour. All the events during mid/late pregnancy and in your labour and indeed, the early period after the birth, need to be looked at carefully and in detail to try to establish why your daughter ended up with this. I simply don’t have anywhere near enough information here to give you that answer. Anything I say will be pure speculation and will not be helpful. I hope you will have an opportunity to sit down with your specialists, both your obstetrician and your baby’s paediatrician, to get those details and hopefully the answers. My best wishes for you and your daughter for the future.

Previous preterm delivery of twins, now pregnant again

Question:  1. After delivering my twins prematurely at 28 weeks, i bled for two months. I had to undergo D&C. What was the cause of the prolonged bleeding?
2. Currently am 4 months pregnant. However, i usually get lower abdominal pain especially when i sit or walk for long. Is this situation putting my baby in danger or is it normal. What is the cause anyway?
3. My breasts are expanding abnormally yet am only 4 mths pregnant. For how long is this likely to go on. A.N. (Uganda)

Answer: Preterm delivery in twin pregnancy is relatively common, even though at 28 weeks, that was significantly earlier than the stage where this normally occurs. However, it is reasonable to assume that the prematurity was purely or largely because this was a twin pregnancy. The persistent postpartum bleeding was most likely due to retained products of conceptions, that is; bits of placenta and/or membranes. The D&C was the appropriate corrective procedure.

The pains you have mentioned are probably nothing more than a nuisance and unlikely to impact the well being of your baby in the womb in any way. This is a fairly common occurrence in pregnancy. I can of course understand your heightened anxiety following your experience in the previous pregnancy.

Breast enlargement should also not bother you unduly. This is a normal pregnancy development and varies from person to person and pregnancy to pregnancy. Being almost halfway through this pregnancy, there is unlikely to be much more enlargement to come. My best wishes.

Fertility chances at 41

Question: Hi,  I am 41 years old and just got married two months back. After an ultrasound scan the doctor found out that I have small ovaries. I am of small build but healthy and having a normal menses cycle so far have had no problems in my menses cycle. Please let me know my chances of getting pregnant. Thanks. M

Answer: I don’t actually know what your doctor meant by “small ovaries”. You have not said what the pattern of your periods is. It is, of course possible to get pregnant at 41 and chances of a successful conception and pregnancy are, in general terms, not bad. However, this varies from person to person and specific advice can only be given when a doctor has all the relevant information about that individual. With you, I do not have that. The general advice I can give is that for any woman, ovulation start getting irregular from the late 30’s onwards, thereby reducing chances of spontaneous conception to some degree. Another important factor that increases with age is the risk of having a baby with a chromosomal disorder such as Down’s syndrome. Some chromosomal disorders are lethal and therefore increase chances of pregnancy loss. I hope your doctor has arranged all the relevant tests including a hormone profile to give you a clearer picture of your chances. My best wishes.

Symptoms of temporary stroke after delivery

Question:  I give birth at 17yrs old. 7-9 hrs after, the left side of my body went numb and my speech went. My face lowered on left side too. It lasted for 5-8 mins. Also throughout my pregnancy  i often blacked out and trembled before an after this occurred. L.B. (UK)

Answer: You are describing an episode of a temporary stroke or what would be called a ‘transient ischaemic attack’ in medical terminology after the delivery. I would expect that you were thoroughly investigated including having an MRI scan of the brain to establish why this happened. This kind of medical problem is particularly uncommon in somebody so young. The episodes of black outs you experienced during the course of your pregnancy are probably unrelated to that later episode. The most likely explanation for recurrent blackouts which start only during pregnancy is episodic low blood pressure.