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Pregnancy Bliss | Reproductive Health Hub

Have my waters broken?

Question:  i am 32 weeks pregnant my baby has polycystic kidneys and i am suffering from a suspected PE and spd. I have also been told that my baby is quite big. This morning i had what i presume to be my waters break although i am not sure. As i sat up on the edge of the bed i felt my baby pushing down hard and some water gushed out, not a torrent but it was milky coloured. I have had another couple of gushes and my underwear is constantly damp the baby has gone quiet and i am having a lot of pain in my back which all in all is making me very uncomfortable. Do you think my waters may have broken? There is no distinct smell at all and i do not want to run up the hospital all the time. S.H. (UK)

Answer: The possibility of waters breaking at such a relatively early stage of pregnancy is potentially significant. At 32 weeks, this would be categorised as ‘Preterm Pre-labour Rupture of Membranes’ (PPROM). There are number of things that can be done to try to prolong the pregnancy and also prevent possible infection. These need to be instituted as early as possible in a case of confirmed PPROM. I would therefore not risk speculating as to what might have happened in your case. You really need to have an examination to see if your waters have broken or not. There is no other way this can be verified. Don’t feel reticent just because you may have been to the hospital a number of times in this pregnancy. It is better to be safe than sorry. In the end, you and your care-givers at the hospital have one goal: The safe delivery of your baby. If that takes multiple visits during the pregnancy, so be it.

Taking nutritional supplements in first trimester

Question:  Is it safe to start the iron,folic acid, calcium, vit B complex supplements in the recommended doses during the first trimester of pregnancy? R.R. (Egypt)

Answer:  The vitamins and minerals you have listed here are all quite safe to take at any stage of pregnancy including the first trimester. You have quite rightly emphasized on sticking to the recommended doses. In such a case, there ought to be no concern. Vitamin B12 and calcium supplements are particularly important for strict vegetarians.

Abortion at 7-8 weeks gestation

Comment:  I want to ask about abortion which happens at 7-8 weeks on the first pregnancy for women age 29yrs. Thanks. T.S. (UK)

Reply: I am not sure whether I understand your question. If you are asking about what might have caused a spontaneous miscarriage at 7-8 weeks gestation then the honest answer is, it is difficult to be sure. Miscarriage is common. Over a quarter of all women will experience one or more miscarriages in their reproductive years. The vast majority of these will be in the first trimester (before 13 weeks) and will remain unexplained. The lady you are inquiring about appears to fall in that category. Since this was her first pregnancy, the most practical advice to give her is to try again once she is ready.

Reduced amniotic fluid in early pregnancy

Question:  What are the probable causes of reduced amniotic fluid? If detected at an early stage i.e. 12 - 15 weeks, are there remedies or treatment to get this corrected? J.B. (UK)

Answer:  A true reduced amniotic fluid volume (oligohydramnios) at such an early stage of pregnancy would be a legitimate cause for concern. This problem is quite uncommon in the early part of the second trimester and therefore, the first thing is to be certain that, there is, indeed, true oligohydramnios and it isn’t merely a false scare. When it is confirmed, there will be concern about the possibility of chromosomal and/or genetic malformations and invasive diagnostic tests should be offered. Of-course the possibility of amniotic membrane rupture should also be explored and actively ruled out. However, this is exceedingly unusual at this stage of pregnancy. One cannot talk of treatment to ‘correct’ reduced amniotic fluid at such a stage of pregnancy. Rather, the issue is to establish the underlying cause and thereby advise on the prognosis for the baby. In true oligohydramnios in early second trimester, the prognosis for the baby, regardless of the cause, is not very good.

Infant milestones

Question:  hello, my daughter is 56 days old,she is not smiling but she is always smiling on the sleeping time,sound producing the time she is not move that side other situations she is move to any side,so I am very worried about those problems. What are the developments seen at this age? Please help me. P. (India)

Answer:  I have to confess that this is not exactly the right place to inquire about a baby’s well being. We are comfortable answering all questions to do with pregnancy and childbirth. Children’s health is a different specialty that we do not cover.

I have managed to obtain some information on what you asked and I can briefly tell you that, the main milestones expected for the infant  in the first few months are as follows:

I hope that helps for a start. You can certainly find more information from more specialised sources and there are plenty of these online.

Metformin (Glucophage) in pregnancy

Comment:  Thank you for this wonderful site. I would like to know if using metformin (glucophage) is safe for the baby. I use it to treat my PCOS and its worked well, but I am concerned that I might have reached the sensitive 3 weeks described in your site, and I do not want to take anything that will affect the fetus in any negative way. Thank you for your response. Stay blessed. A. (Nigeria)

Reply: Metformin is used mainly to manage Type 2 diabetes, a condition for which it remains the main drug. In selected patients with polycystic ovaries (PCOS), it can be useful in bringing about regular cycles, hopefully facilitating regular ovulation in the process and thereby increase chances of spontaneous conception. Metformin has been used for this purpose for several years now and there has been no evidence of any adverse effects on the fetus. In general, Metformin is regarded to be safe throughout pregnancy and whilst it was not used in pregnancy for diabetes in the past, it has been increasingly employed for this purpose, typically in combination with insulin. This is because the issue of its safety in pregnancy is largely settled now. My best wishes in your pregnancy