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Pregnancy Bliss | Reproductive Health Hub

Rhesus incompatibility in pregnancy

Question:  I am carrying pregnancy 8th month now. I am suffering with rh incompatibility and polyhydramnios. Is it effect to my baby and to me? S. (India)

Answer:  Rhesus incompatibility is a potentially serious pregnancy complication. It means you are blood group Rhesus negative and your baby in the womb is Rhesus positive. It also means, you have been carrying anti-D antibodies in your blood since before conception. These antibodies are attacking your baby’s blood cells and destroying them. This is the reason why you have polyhydramnios (excessive amniotic fluid). I have no way of knowing how severe your particular case is. However, as a rule of thumb, when stable, delivery should be planned for around 37-38 weeks. That is two to three weeks before your expected date of delivery. You are very close to that point and I would hope your doctor has planned this for you already. Rhesus incompatibility will not affect you directly but the baby can be quite adversely affected depending on how severe the condition is. At birth the baby will be assessed and may well require exchange transfusion. This is a measure taken to eliminate as much as possible the offending antibodies and to correct the anaemia caused by destruction of the baby’s blood cells. At this stage of your pregnancy, the most important measure is to plan your delivery. Best wishes.

Inheriting the ‘trait’

Question: Is it true that if I have a baby with someone that has the trait my child will have it too? W.M. (USA)

Answer: I am assuming that by ‘the trait’ you mean the sickle cell trait. If that is so then there are a number of permutations to consider. If you are sure you do not have the trait and only your partner has it then the chances of your child together inheriting the trait is 50%. There is therefore a 50% chance also that the child will not have the trait. A person with sickle cell trait has one normal (Hb) gene and one defective gene. He can contribute one or the other. Chances of contributing either are exactly the same hence the 50:50 chance. I hope that clarifies the situation for you. You can look at the details of this pattern in the relevant section here:

Yellow fever vaccine prior to IVF

Question: Can i get Yellow fever vaccine prior to my I.V.F. 5th cycle. I intend to travel. I had chorioamniotis at 20 wks last October and lost a twin pregnancy. i was leaking amniotic fluid prior to the contractions and i did not realise it it time! H.K. (Uganda)

Answer: I am afraid you will need to choose one or the other. The yellow fever vaccine is a ‘live’ (weakened) type of vaccine and like similar such vaccines, it should not be given to those already pregnant or those planning to conceive within 12 weeks of administration. In view of that, if it is imperative that you travel to presumably an endemic area, you will need to postpone the IVF cycle for the suggested duration (if you have the vaccine). Alternatively, if this is an option, cancel the planned trip and concentrate on the IVF. My very best wishes on your quest.

Habituale abortiane

Question:  What is the cause of  habituale abortiane? E.(Ethiopia)

Answer: The term ‘habituale abortiane’ that you have used here is not in the English language medical parlance. I am therefore going to make an assumption from the words used that you are referring to ‘recurrent miscarriage’ (recurrent spontaneous abortion).  If I am right then this is a broad subject. Recurrent miscarriage affects up to 1% of all women trying to conceive. Where the cause has been identified in recurrent pregnancy loss, typically in the first trimester or early second trimester, the antiphospholipid syndrome is to blame. In this syndrome,  also known as ‘sticky blood syndrome’, the woman is found to carry antibodies which are known to cause tiny clots which are thought to compromise circulation in the still tiny fetus where the blood vessels can be clogged even by these micro-clots. The antibodies such as ‘anticardiolipin antibodies’, ‘lupus anticoagulant’ and a few others will not normally affect the woman herself but tend to be lethal to the fetus especially in the early phase of the pregnancy. We have discussed this syndrome in more detail here:

The management  strategy for this condition hinges on preventing this tendency to thrombosis. Such women will be put on low dose aspirin (75mg daily) from early pregnancy and, where resources allow, are also put on daily low molecular weight heparin injections such as Tinzaparin or Enoxaparin. This treatment is effective as over 75% of mothers so treated will achieve a full-term pregnancy. Another possible cause of recurrent miscarriage which would typically occur late in the second trimester is cervical weakness, also called cervical incompetence. This is discussed here:

Head engagement and timing of labour onset

Question:  After the head being fixed when is the earliest that the labor will begin as my baby's head has got fixed in 34th week? N.S. (India)

Answer: Contrary to what you may have heard, head engagement has nothing to do with timing of labour onset. In other words, the head can remain engaged for several weeks before labour starts. In other cases, the head does not engage until the labour is actually underway. There is, therefore, no relationship between head engagement and labour onset.

Exposure to chickenpox in early pregnancy

Question:  My daughter is 10½ weeks pregnant. She thinks her daughter may have chicken pox.Is this a cause for alarm at such an early stage? She has had chicken pox as a child. Thank you. M.. (UK)

Answer: The answer is a very categorical No. There is nothing for her to worry about. The vital piece of information here is that your pregnant daughter has had chicken pox herself in the past. That means she is immune and exposure to somebody with the condition now or in the future will not affect her. The antibodies circulating in her body will also protect her baby in the womb and for a few months after he/she is born. She should not worry.