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Pregnancy Bliss | Reproductive Health Hub

Flu vaccine in pregnancy

Question:  Hi, i am 24 weeks pregnant with my first baby. My pregnancy was so far fine apart from me having few issues with shingles, chest infection and throat infection. Now i have recovered and in good health. I had my anomaly scan at 20th week, which was fine.

My question is i feel my baby is moving very lightly (quickening only, no kicks so far)and very occasionally only. Most of the time once a day, same as earlier weeks. Some busy days I don’t even feeling whether my baby moved at all.  One of my friends who is same weeks pregnant as me said she even can see the kicks from outside her bump.  So I am bit concerned now. Is it normal or should i contact my GP?


Also, since I had few infections in the past my GP suggested me to have flu vaccine once I feel better. Does Flu vaccine in the UK include protection against swine flu as well and at 24 weeks, is it safe to have it, can there be any side effects for the pregnancy? Also, as a result of Flu Vaccine does the baby get some kind of a protection against flu once he is born? K. (UK)



Answer: There are two distinct questions here. Regarding the fetal movements, it is the case that rates and intensity of movements vary enormously from one woman to another and, indeed, from one pregnancy to another even for the same person. Having said that, this is a feature that is so subjective that, if a mother is concerned, the best advice is to have fetal wellbeing checked to make sure all is well with the baby. I would therefore advise that you contact your midwife to discuss this matter. She may see you herself and, if she thinks it necessary, she will arrange for you to be seen by your consultant.


Regarding the flu vaccine, that is a very important advice you have had from your GP there. It is absolutely important for every pregnant woman to have the flu vaccine. It is more so for any woman whose immunity might be low as appears to be the case with you as you recover from the various infections you have suffered in the recent past. The fact that pregnant women who acquire swine flu are much more severely affected by the disease than the average patient is not in dispute. Statistics from  the UK in the current epidemic (2010/11) show that a pregnant woman acquiring swine flu has a seven-fold increase in the risk of dying from the infection than the average patient. Yes, the current flu vaccine protects against both seasonal flu and swine flu. It is safe at any stage of the pregnancy and the protective antibodies the mother develops do cross the placenta to the fetus. This means the baby is born with a fair degree of protection.



Vaginal bleeding at 8 weeks pregnant

Question:  My wife is pregnant of about 8 weeks, i am so afraid today because in the morning she found herself bleeding, it is the first time since she get pregnancy . She has been suffering from stomach pain for the 8 weeks, what should we do? Z. (Tanzania)


Answer:  This can only be categorised as threatened miscarriage until proven otherwise. At 8 weeks the only practical step that can be taken to give you absolute clarity of what is going on and, more importantly, the viability, is to have an ultrasound scan. You need to arrange to get this done as a matter of priority.



Vaginal spotting in early pregnancy

Question:  I am a pregnant mother with early baby.  Each day I see a spot of light bleeding with normal odour for a week now. What can be the cause and what should I do? L.O. (Nigeria)


Answer: I cannot pretend to know the exact cause of this ‘early’ pregnancy vaginal spotting that you are describing. There are several potential causes, most of them associated with the pregnancy and a few of them being purely coincidental. Early pregnancy problems that can manifest in vaginal bleeding, usually light and mostly painless include missed miscarriage, anembryonic pregnancy (also known as blighted ovum), molar pregnancy, ectopic pregnancy and threatened miscarriage. All these are discussed in more detail in the relevant section. Conditions causing vaginal spotting but not directly related to the pregnancy include inflammation of the cervix (cervicitis), cervical ectropion (also called cervical ‘erosion’) and, rarely, cervical cancer. To verify what is going on, you should arrange to see a doctor for an examination and, quite possibly, an ultrasound scan.



Anti-D injection after a miscarriage

Question:  I had the anti D injection with my first baby as I'm rhesus negative. I had a miscarriage recently but was not offered the anti D again. Should I have been given it or is the one I had the first time sufficient? Many thanks. S.B. (UK)


Answer: The need for the anti-D injection depends on the stage of pregnancy at which the miscarriage occurred. It is accepted that if it is an early miscarriage (12 weeks or less), there is no need for the anti-D injection. That may have been the reason why it wasn’t offered. In any case, this should have been explained without you having to inquire.

Any anti-D injection you have is effective for a number of weeks only so the one you had in the previous pregnancy would confer no protection in any subsequent pregnancy.



Thalassaemia major and pregnancy

Question:  If the mother is homozygous for thalassaemia & father is trait what is the chance of affection of baby& whether mother can take iron supplement? SFC (Bangladesh)


Answer:  If the mother has thalassaemia major and the father has a trait, there is a 50% chance that the baby will have thalassaemia major and a 50% chance that s/he will be a carrier. An individual with thalassaemia major will almost always have an iron overload  (due to repeated transfusions) and should never use iron supplements; oral or otherwise.



Ultrasound measurements in pregnancy

Question:  In the U.S when getting an ultrasound does the tech ALWAYS take measurements of fetus to make sure mother's dates are accurate?? If someone was 15 weeks further along then thought would the tech notice this or could it go unnoticed? J. (USA)


Answer:  An ultrasound scan in pregnancy will usually be for a reason so measurements may not be taken. A first scan in pregnancy will always involve taking measurements of the fetus because one of the indications is to confirm gestation. Subsequent scans could be for other reasons such as placental location, amniotic fluid volume, blood flow in the cord etc. It is impossible to miss a discrepancy of 15 weeks in a gestation on a scan. Even a 5 weeks discrepancy cannot be missed. To give you a flavor, abdominal circumference at 20 weeks averages 151mm. 15 weeks later, at 35 weeks, the average abdominal circumference is 315mm. The ultrasonographer will need to be blind to miss that.