Question: I would like to know if botox for vaginismus is available within the NHS or if not where i can seek treatment (in lanashire area, any advice would be great. S.S. (UK)
Answer: Unfortunately, this is one of those forms of treatment, the availability of which varies widely from place to place; what the media loves to call ‘the Postcode lottery’. I therefore have no way of giving you advice regarding availability in your specific area. The best I can do is advise you to arrange to see your doctor to discuss the matter. He/she will certainly be in a position to know if there is a gynaecologist in your area who specialises in this area, who it is and whether, indeed, they offer this type of treatment. Even if your doctor does not have this information, the essential step for you to take is to get referred to any gynaecologist in your area. When you are seen by the specialist, you will have the opportunity to discuss your problem, the forms of treatment you have already tried and, ofcourse, the issue of the Botox option. My best wishes.
Question: I have send my question earlier and you answer it very well but as i am through the scan and find out more so i want you to have a detailed look on my situation and answer me according to these all information that i am giving you now.
My fundal measurement at 22+4 was 22,25+4 was 23(my midwife write HIP all well in comments),28+4 was 26,31+4 was 28 and 32+4 was 29 and 32+5 was 29.
I had my scan and MDAU(they attach a machine with my tummy and monitored fetal heart beat for 20-25 min's and it was alright as they told me).
The readings from scan are
fetal heart beat and movement seen,presentation cephalic,placenta=anterior,site=clear of os, EDF= present,Liq=low,EFW=1532.0 g,FL=53.0 mm,HC=295.0mm,AC=255.0 g and comments are "The AFI=13 cm which is below the 3rd centile"
They told me that my baby is measuring small and fluid is bit low but blood count across placenta is good and have booked me in for another scan at mdau after 10 days and another scan after 15 days.
I request you to please clarify to me what all this means and what can be the possible outcome and risks of this situation and what are the steps that i can take to improve this situation. I will be very much thankful to you. tc. Regards. J.M. (UK)
Answer: It is true that the baby’s growth appears to have been lagging slightly behind but, up until the last couple of weeks, the rate of growth has been satisfactory. The last two measurements were the same (29 cm) and that is to be expected because they were done only one day apart so no change was to be expected. Seeing as your doctors were somewhat concerned about the measurements they did the next logical step, which was to check the growth using a scan. That also gave them an opportunity to perform other tests including measuring the amount of amniotic fluid as well as the blood flow in the cord. These are useful guides as to the baby’s well-being. Let’s look at the results:
The Estimated Fetal Weight (EFW) was 1532 grams. That is below the average for 32-33 weeks gestation, the range of which is 1700-1900 grams. The estimated weight of 1532 grams is the expected average weight at 31 weeks. Since the weight is calculated from the baby measurements, it is a safe conclusion to make that the measurements fell somewhat below the average for the gestation.
Liquor (amniotic fluid) has been reported as being “low” with the amniotic fluid index (AFI) measured at 13. However, I am rather puzzled by the description of an AFI of 13 as being below the 3rd centile. If the measurements have been reproduced accurately then an AFI of 13 at 32-33 weeks is certainly NOT below the 3rd centile. For that to be the case, the AFI has got to be below 8. I think you need to bring this to the attention of your midwife or doctor. In other words, an AFI of 13 at almost 33 weeks is normal.
All in all, there is enough evidence here to suggest some modest degree of intra-uterine growth restriction. You do not need to do anything specific as long as you maintain a healthy diet and you are a non-smoker. Your doctors will continue monitoring your baby and giving you appropriate advice. If any kind of intervention is required, I am sure they will advise you accordingly. There certainly appears to be no compelling reason for that at present.
Question: My daughters waters erupted at 3am on friday morning she was told to go
to hospital on Saturday at 8am. she is still there they have done nothing with her
and have not checked her or baby since 4.30pm today (Saturday). Surely that is not
the correct care. S. (UK)
Answer: I’m not sure what was done after your daughter was admitted with ruptured membranes. I’m also assuming she is already at term (over 37 weeks). If that is the case, once the mum has been examined to confirm membrane rupture and the baby has been monitored to ensure all is well, nothing more needs to be done for at least 24 hours. This is to allow for nature to take its course. That’s because the majority of women who present with ruptured membranes at term will go into labour spontaneously within 24-48 hours. A hands-off approach is therefore preferred. This would not be adopted if there is cause for concern. I hope all has concluded well with your daughter.
Answer: Paracetamol at a normal dose is safe to take at any stage of the pregnancy. It can also be taken safely alongside any antibiotic. What is unclear to me is why you are taking antibiotics if you have been diagnosed with flu. Antibiotics are not used to treat flu as they will be completely ineffective. May be there is more to your respiratory problems than just flu but I’m sure your doctor has explained all that.