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Pregnancy Bliss | Reproductive Health Hub

Bleeding at 9 weeks pregnant

Comment: Hi,at 9 wks i had a small bleeding, my doctor did an ultrasound and told me it's a 'mild detachment of the lower pole of placenta'.Two wks later i went for checkup now at 11wks he said i have 'a simple viable IVP of 11wks and a mild periovular hematoma'. Please, i like to know if these conditions are serious and if it can have any effect on my baby. Thanks C.K (Cameroon)

Answer: There is really only one event here and the findings at the two scans reflect the same thing. It is clear you had a bleed which, according to the original scan at 9 weeks, was a result of a partial detachment of the placental edge. Your repeat scan two weeks later simply shows that some of the blood is still retained in the form of a clot (hematoma). This is normal and should resolve in due course. I believe the actual wording of your doctor’s report was ‘a simple viable IUP of 11 weeks...’ with the IUP standing for ‘intra-uterine pregnancy’; in other words, in a normal location. All in all, this is a straight-forward case of a threatened miscarriage, the vast majority of which would resolve and carry on normally. There are no long term adverse effects on the baby at all. You do not need to do anything or take any medication. My best wishes.

Severe back pain in late pregnancy

Question:  i am 36 weeks pregnant and i am having severe back pain. i am taking enough rest as well, but still it’s not helpful. I took Panadol as well but even its not relieving the pain. What may be the reason for that? M.S. (Maldives)

Answer: I am afraid I am going to disappoint you. Back pain in late pregnancy is quite common and in some cases can be debilitatingly severe.  In most cases, there is nothing wrong and it is just a feature of late pregnancy; a manifestation of the strain put on the lower back by the heavily pregnant uterus. Panadol (Paracetamol) is a good and safe pain-killer but it may not be sufficient. You can add Codeine at 30mg up to four times a day on top of the Paracetamol and that combination may prove more effective.

Both parents have sickle cell trait

Question:  If both couples have sickle cell trait ,what effect does the fetus have? Y.M. (USA)

Answer: If both prospective parents are carriers of the sickle cell gene they are then known to have sickle cell trait. People with sickle cell trait lead normal healthy lives for the most part. However, when it comes to offsprings, there is a possibility of some of the children having the full blown sickle cell disease. This will occur if a child inherits the defective gene from each of the parent thereby ending up with two defective genes. The chances of this happening for any of the children is 1 in 4 or 25%. There is a detailed answer to a similar question, complete with an illustration, that you may find useful and more illuminating. You can reach this by clicking here:

Can I choose my baby’s sex?

Question:  Can you help me make sex choice of baby and what is the cost average? Y. (Indonesia)

Answer: There are many claimed techniques for ensuring you get a baby of one gender or another. I can tell you categorically that all those so-called techniques are unproven and many are outright fraudulent. Keep your money where it ought to be; in your pocket. The only reliable way of ensuring a baby is of a particular sex is through the assisted conception method where pre-implantation gender determination is done. In this, in vitro fertilization (IVF) is done and the embryos created (outside the womb) are examined to determine the gender of each. Only those embryos of the desired sex are then implanted in the womb.  Pre-implantation gender determination for social reasons is illegal in many countries (including the UK). This subject is discussed in more detail in a dedicated section here:

Unengaged head at Term

Question:  I'm 40 weeks plus and still the baby's head is floating and not fully engaged, and according to my OB it's very rare for me to deliver normally, but slight brownish discharge has started to come out yesterday. due date is up to 25th of this month, so my OB advised me to wait until 2 days. so will there be any chances for me to deliver normally or ill i have to undergo a CS? and if i wait will there be any chances of having a risk to the baby now or during delivery like cord prolapse? i am so worried about this.. hope you will help me through it. Thanx... M.S.

Answer: It is important to be aware that engagement does not always take place before labour onset. There are a lot of women who have engagement taking place at the onset of labour or as labour gets underway. That is by no means uncommon.

It will be highly controversial to offer a caesarean section simply on the basis of unengaged head. If there are other concerns such as a low-lying placenta, that could be a legitimate reason to consider an elective caesarean delivery. My view on your described situation would be to await spontaneous labour. The expectant management would be completely reasonable up until 42 completed weeks as long as there is no concern about the baby’s wellbeing. At that point, if labour has not ensued, your obstetrician could assess you for feasibility of labour induction. If the head is very high, this might involve what is called ‘stabilising induction’ whereby your waters are broken in a controlled manner to facilitate descent of the head into the pelvis. This is fairly common practise. In experienced hands, the risk of cord prolapse from  that is very small indeed and even if that was to happen, you will be in the right place for a caesarean section. I would certainly say a caesarean section is not inevitable in this case. My best wishes.