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Pregnancy Bliss | Reproductive Health Hub

Estimated fetal weight at 34 weeks

Question: I had my scan on my 34 weeks and 3 days pregnancy and my doctor said that baby's weight is 2.6kg. and my doc keep saying baby is of a normal size not too big not too small. I read online fetal weight chart and that shows my baby is slightly bigger in weight. my water level is also normal. Is higher in weight a concerning issue? D. (Singapore)


Answer: Your doctor is completely right. The estimated weight of 2.6kg (2600g) is completely normal for a fetus of 34 weeks gestation. That is NOT raised fetal weight. The range of expected weight at 34 weeks is 1.97kg to 2.78kg. Any weight in between those two points on the scale will be regarded as normal. With the amniotic fluid being reported as normal also, I see no cause for concern here. Enjoy your pregnancy and best wishes for the fast approaching motherhood.



Bleeding during sex

Question:  I always appreciate this site because of your prompt response to enquiries and questions. I want to know what is the cause of vaginal bleeding during sex and how it can be treated. Sometimes i experience vaginal bleeding when i am making love with my husband (not always) but immediately after the sex it will stop, i was told it is caused by vaginal dryness. Please what drugs can i take because it is causing embarrassment in my marriage. Thank you for your usual response. J.E. (Nigeria)

Answer: Well, let me, first of all thank you for your compliments. We appreciate a positive feedback. It is extremely unlikely that vaginal dryness is the cause of the bleeding you have been experiencing during sex. Dryness to the extent of causing bleeding during sex is quite uncommon for women before menopause. Even after the menopause, it is not that common and will only occur several years after the change. The commonest cause of bleeding during or after intercourse in women of child-bearing age (15-45 years) is cervical pathology. A benign change to the cervix commonly known as ‘cervical erosion’ (medical term is cervical ectropion) is rather common and this is the most likely cause of bleeding provoked by intercourse. This  condition tends to resolve spontaneously but can persist for a long time. Another possible cause is simple cervical inflammation (cervicitis). There is also a more serious potential cause of bleeding with intercourse in the form of cancer f the cervix. This is quite uncommon but something that always needs to be ruled out, not least for peace of mind. I would urge you to see a gynaecologist for at least a speculum examination which will enable him/her to visualise the cervix and find out what is going on.





Sertraline in pregnancy

Question:  Hi , my wife has taken setraline anti depression drug for years and has now fallen pregnant. We have decided to stop her sertraline under recommendation but the depressive aggressiveness is starting to show. I have googled a herbal alternative and been told b12 vitamin or fish oil tablets may help. Would they be safe to take firstly and Any other advise would be greatly appreciated? K. (UK)


Answer: You will almost certainly be aware that Sertraline belongs to the group of anti-depressants called ‘selective serotonin re-uptake inhibitors (SSRIs)’. SSRIs are regarded to be the safest anti-depressants to take in pregnancy. That is in relative terms. Among the SSRIs, Sertraline is also believed to be one of the safer options. True, some congenital abnormalities have been associated with use of Sertraline in early pregnancy. These include cardiac septal defects (hole in the heart) and, much rarer, abdominal wall defects.


It is important to stress that all these mentioned potential adverse effects are quite rarely seen. Another potential problem that has been associated with use of SSRIs during the later phase of pregnancy is increased blood pressure in the lung circulation of the newborn, a condition known as ‘pulmonary hypertension’. Again, this too is rarely seen. What all this means is that the continued use of anti-depressants such as Sertraline during pregnancy is a balancing act. However, in most cases where medication has been essential for maintaining the woman’s well-being, the advice is almost always to continue with the medication. In some cases, the dose may be reduced in the first trimester because this is the only phase of pregnancy where the said congenital defects can occur. Beyond 12 weeks, that risk would have passed.


With regard to ‘herbal’ alternatives, it is not possible for me to advise you on their merit because I do not and would not have any evidence to back up such an advice, one way or the other. As for Vitamin B12 or fish oil tablets (neither of which is herbal), there is really no shred of evidence that either would be useful in combating symptoms of depression. What’s more, like all Vitamins, supplements are only ever useful if there is evidence of deficiency in the particular individual. If your wife has no deficiency of Vitamin B12, giving her more would be a waste of time and resources. Fish oil tablets are rich in omega-3 fatty acids. It is true that there has been many scientific studies to see if Omega 3 Fatty Acids could be useful in clinical depression. Unfortunately, results in this regard, have been disappointing. Omega-3 fatty acids are very good in preventing fat build-up in the blood vessels, thereby protecting against heart disease. Looking at the overall picture you have described, I feel your wife needs to see her GP to look at the possibility of going back on Sertraline after 12 weeks gestation. My best wishes.







A cervical ectropion (erosion) is by far the commonest cause of bleeding during sex or post-coital bleeding.