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Pregnancy Bliss | Reproductive Health Hub

Bleeding and leaking water in mid-pregnancy

Question: My partner is pregnant and started bleeding when the preg is 4weeks old. Though the bleeding is on and off until about 13 weeks old when she started bleeding virtually everyday. She was diagnosed to have marginal placenta previa. At about 15 weeks, she started leaking water the obstetrician said the amniotic sac is ruptured. At this time the scan revealed that the placenta has gone up i.e normal position. After a while the bleeding resumes. Will my baby develop normally? And what are the risk associated with this condition? She had two CS deliveries before, what would you advise we should do at this point. S. (USA)

Answer: This is a cause for considerable concern. In fact the bleeding does not worry me too much considering it has been happening on and off since very early in pregnancy. The bleeding is quite possibly unrelated to placental position despite those early scan findings. This sounds like one of those cases of ‘unexplained’ bleeding in pregnancy which can carry on practically right through the pregnancy. Trhese types of bleeding usually have no impact on fetal well-being but they do understandably cause considerable distress.

My main concern in the history is the apparent membrane rupture at such an early stage of pregnancy. Has this been confirmed or was the obstetrician simply giving you possible causes of the water leakage? Such early rupture, if confirmed, tends to have a really bleak prognosis. Almost all these pregnancies end in miscarriage or extreme premature delivery. Even where the pregnancy continues against the odds, the babies tend to do quite poorly because of surviving in a fluid-free environment in the womb. Amniotic fluid is critical for lung development and if this is missing there is poor development of lung tissue and outside the womb these lungs are virtually non-functional.

I suspect, however, that membrane rupture has not been confirmed in this case otherwise the obstetrician will almost certainly have advised you about all this. If your partner has had subsequent scans and they show amniotic fluid then membrane rupture has almost certainly not taken place. I hope it all works out well for you.

Trying to conceive

Question: I want to ask how much time it takes to be pregnant i was taking pills but at time of intercourse which was also just once in a week. i have been married in 2008 and had one abortion too just after marriage. i have periods for 5 day and 28 cycle...can u just tell tell when i can get pregnant. S. (Australia)

Answer: You have been pregnant once and your periods are quite regular. This means you should conceive relatively easily. My only concern is that you are having sex too infreMenstrual cyclequently. Once a week is really not enough. Regular sexual intercourse when trying for a baby means sex three or four times a week. If this is difficult for whatever reason, then at least try to have sex as much as possible in the mid-cycle. I am including an illustration of the cycle to remind you of the most fertile period (mid-cycle) when you should attempt to have sex daily or at least every other day. You should succeed soon. Best wishes.

Taking Albendazole in early pregnancy

Question: Albendazole was taken without knowing pregnancy.Will it harm the foetus? A. (India)

Answer: Whilst Albendazole can be safely taken in the second trimester and later in pregnancy, the advice is not to use in the first trimester (first 13 weeks) as there is a risk of causing harm to the baby in this the most sensitive stage of pregnancy. The mentioned small risk of birth defects comes from animal studies hence the advice to avoid in early pregnancy.

Let me stress the fact that experience in humans suggest the risk is probably quite small but it is certainly not advised to take it at this stage and doctors should always inquire about the possibility of pregnancy before prescribing it to any woman in a child-bearing age.

Cannabis in pregnancy

Question: On Cannabis use during pregnancy, you say it can independently causes IUGR and malformations etc, but you haven't provided a single reference to the research findings which originally informed you. Where are the facts? Many thanks. J.B. (UK)

Answer: You are completely right to question these assertions as this remains a subject of lively scientific debate. Older studies tended to consistently show association between cannabis use in pregnancy and problems such as increased risk of prematurity, fetal growth restriction and major malformations. You can see that in the studies published or quoted here, here and here. However, more recent studies have not been so conclusive. Almost all researchers have been anonymous in their analysis that many, if not most, cannabis users also smoke cigarettes, use alcohol and sometimes use other illicit drugs such as cocaine, all of which are known to be associated with these pregnancy complications. With these and other socio-economic confounding factors (as shown in this study), it becomes very difficult to effectively establish independent cannabis effects. As such, the debate remains whether, on its own, cannabis can have these effects and to what extent. The reality is, in modern societies, it is very difficult to find a big enough sample size of exclusive cannabis users to try to replicate (or disprove) results found in studies conducted and published 20-25 years ago. This scientific conundrum is probably best illustrated in this paper. In fairness (to us), in the section on this subject, we have stated that cannabis may cause these effects, implicitly acknowledging it is not a settled question.