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Pregnancy Bliss | Reproductive Health Hub

Trying for twins

Question: hi ,i would like to have twins can u contact me let me know what can u do for me i have already two kids. VT (UK)

Answer: Thank you for your enquiry. I am not sure I understand your question. Do you want to be helped to have a twin pregnancy? If that is the case, you will find a specific service of that kind is not available. It is possible to increase your chances of having a twin pregnancy by using ovulation induction medication such as Clomiphene. However, using this medication for this specific reason would be against the license for the drug. Moreover, you would not be guaranteed success and you could also end up with more than two babies. IVF allows for a pregnancy with more than one baby and, in your case, you would have to get this done privately as you already have two children. Regulations (in the UK) are that only two embryos can be put back in the womb which, if both implant, you will end up with a twin pregnancy. There is, of course, no guarantee that both or even one will successfully implant. IVF is an intensive and emotionally process and is best pursued near where you live.

Early pregnancy scan

Question:  When we done obstetric scan in 5 weeks days the report is 15.0 x5.0mm sized irregular hypoechoic subchorionic collection seen adjacent to the gestational sac/good surrounding trophoblastic is noted/o embryonal pole/or cardiac activity seen/yolk sac is identified/gestational sac measures approx 6.5mm corresponding to approximately 5 weeks maturity/bilateral ovaries and adnexae show no focal lesion/the internal os is closed and cervix is of adequate length(3.9cm)impression;early intrauterine pregnancy of 5 weeks maturity. Pls tell me this report is bad sign? now what will do/my age 41yrs and i have a boy 11yrs. Pls advise. Thanks. A. (United Arab Emirates)

Answer: All the results detailed in this scan report are
normal apart from the ‘hypoechoeic sub-chorionic collection’. That is suggestive of a small bleed behind where the placenta is forming. It is impossible for anybody to accurately assess the potential significance of that. What we know from this is that you have a viable early pregnancy and that there may have been a bleed. Beyond that, anything said will be pure speculation. In the vast majority of cases, such episodes of occult pregnancy bleeding are self-limited and do not affect the progress of the pregnancy. However, only time will tell. Can I also stress that you do not need to do anything or take any medication for this. Just carry on as normal and chances are overwhelmingly that everything will be alright. My best wishes.

Cervical stitch to prevent pregnancy loss

Question:  I have ready your articles relating to “preterm pre-labour rupture of membranes" (PPROM). I am 37 years of age and at 20 weeks and lost my baby due to PPROM. My Doctor has suggested that I receive a cervical stitch with my next pregnancy. Would this help to reduce the risk of it happening again? Your assistance would really be appreciated. Thank you. M. (South Africa)

Answer: If the pregnancy loss you suffered at 20 weeks gestation was preceded by unprovoked membrane rupture, there is a good possibility you have cervical weakness (cervical incompetence). This is the only condition where a cervical stitch (cervical cerclage) can be applied. If your doctor feels that you may benefit from having a cervical stitch, this may very well be the basis of that advice.  If you are considering having this done, make sure it is performed by a specialist with appropriate expertise and experience. Even though it is not a particularly difficult procedure technically, there is evidence that a lot of doctors do not insert the stitch properly rendering the measure useless. In fact, if the expertise is available to you, you should be enquiring whether you can have the cervical stitch applied via the abdominal route. There is incontrovertible evidence that this is the superior technique with the best results in preventing pregnancy loss associated with cervical weakness. Best wishes.

Birth canal too narrow?

Question: I am a first time mother and i am 3 months pregnant but the problem is i am wondering if my passage is too small to deliver the baby and i am 19 yrs of age an i am wondering what can i do to prevent tearing because i am in fear of getting stitches. E.Y. (Jamaica)

Answer: You really shouldn’t worry. Nature is a wonderful thing. When you become pregnant, the entire birth canal, from the womb, the cervix down to the vaginal canal, undergoes tremendous changes to facilitate the successful carrying of a pregnancy and safe delivery of the baby. That is, without harming the baby or the mother. Consider this: Your womb normally is the size of a little girl’s fist, weighing barely 50 grams. By the time you are term, the uterus would have increased in size and weight about 20 times. Similarly, the lower genital tract undergoes physiological changes increasing its elasticity that will allow it to stretch enough to allow the passage of the baby during delivery. The starting point doesn’t really matter. The issue of whether you will need to have your external passage increased by applying a cut (episiotomy) cannot really be determined up-front.

Many factors play a role in determining on whether an episiotomy is required, either to facilitate expedited delivery, to prevent a tear or both. That is best left to the midwife or doctor who is assisting in the delivery to decide. If an episiotomy is deemed necessary, that is a far better strategy to take than aiming to avoid this at all cost at risk of sustaining an uncontrolled tear. An appropriately applied and repaired episiotomy should really not be a cause for concern. The healing is very good, in most cases leaving hardly any mark. Best wishes in your pregnancy.

Botox for painful intercourse (vaginismus)

Question: I have read on the website about the use of botox injections to treat vaginismus and would like to know where I could go to get this treatment. F. (UK)

Answer: Sourcing this treatment depends on where you live. The best thing to do will be to see your GP and have the problem looked at properly. This will, ofcourse, involve a referral to a gynaecologist at your local hospital. If the diagnosis is confirmed to be 'true vaginismus', management options will be explored with you. You may find that this treatment is available at your local NHS hospital and that will be ideal. If that isn't the case, your GP or the gynaecologist may be able to recommend a nearby centre where you can get this. However, the crucial first step is to confirm the diagnosis.