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Pregnancy Bliss | Reproductive Health Hub

Anaemia in pregnancy, labour and postnatally

Question: What are the effects of anemia to the mother during pregnancy, labour, and postnatal period and effects of anemia to the fetus? S.A.B. (Nepal)

Answer: Anaemia will have the same effect in a pregnant woman as it would have in anybody else, only more so. As such, feeling tired and lethargic is a common feature. When the anaemia is due to iron deficiency (the commonest type), the woman is more susceptible to infections since iron deficiency also causes depressed immunity. An anaemic woman is also more at risk of such complications as heavy bleeding after delivery (postpartum haemorrhage) something that is especially dangerous for her. Anaemia does not tend to affect the baby in the womb but, inevitably, the baby is born with low reserves of iron (if this was the cause). The infant will therefore be at risk of developing anaemia himself/herself. This is also the case with folic acid deficiency anaemia. The newly delivered mother may also struggle to look after her baby because of lack of energy. You may find the dedicated section ‘Anaemia in Pregnancy’ a useful read.

‘Botox’ for vaginismus

Question:  Is botox for vaginismus available as a treatment option in the UK, and if so is it available via NHS? If not available via NHS what are the costs privately? Can you give me information of places where it is offered? D. (UK)

Answer: Botox or, to give it its proper generic name ‘botulinum toxin’, is available in the UK for the treatment of vaginismus. However, you may find that it is one of those forms of treatment that are only available on a ‘named-patient basis’. That simply means it does not have approval for general availability and if your consultant feels that you should be having that treatment they have to make a case for it to the Primary Care Trust (PCT) for their prior approval. In the case of vaginismus, this can only be approved if the consultant is able to show that other ‘standard’ forms of treatment have been tried without success or they are unsuitable for the particular individual. If a patient feels that that route is too convoluted for them, the alternative is to try the private route. There are many gynaecologists who are able to offer this in the country. I do not know where you live so I cannot make a geographically convenient recommendation. If by some chance you live in or close to the Midlands, one private provider of this service located in the city of Birmingham can be accessed here: My best wishes.

Diagnosing anencephaly

Question:  My wife was carrying anencephalic baby and doctor in Dubai could not detect it even in 17th week. My wife and myself are going through acute depression as we got 6 month baby terminated. I would appreciate if you could provide the info proving that anencephalpic could be detected in 12th week of preganancy.Thanks in advance.J (United Arab Emirates)

Answer: This is, quite understandably, a very emotional situation for any parents to deal with. Speaking in general terms (rather than specific to your case, the details of which I do not possess), it is unusual not to be able to identify anencephaly at a 12-13 weeks ultrasound scan. A missing cranial vault, which is the specific abnormality in this condition, means the shape of the fetus looks significantly different on a scan. There are many situations that can make scan views poor especially in the first trimester. A markedly overweight woman, an under-filled urinary bladder or a poor quality ultrasound scanning machine are some of the factors that can lead to sub-optimal results and missed diagnosis. This could be the case for trans-abdominal scans. As I said, I do not know the circumstances of your case. I am therefore unable to offer an explanation as to why the diagnosis was apparently delayed. I hope you will be able to get satisfactory answers to allow you to grieve properly for your baby.

Am I miscarrying?

Question:  Hi - as per my dates, i am 10 weeks pregnant. I had my last ultrasound at about 7 weeks, where the doc said all was fine (heartbeat at 146 beats per min). I am also on progesterone supplements taking them twice a day.

I am worried about having a miscarriage - as i do not really have any preg symptoms. sore breasts until last week but that too is fine now. no cramping, no bleeding - but could it be that progesterone supplements delay the bleeding. i am worried about almost everything these days. Pls help. N.S. (India)

Answer: I believe your worrying may be unwarranted. It is not unusual at all for pregnancy symptoms to disappear towards the end of the first trimester. This is likely to be what is going on.

Taking progesterone supplements would not prevent bleeding in an evolving miscarriage. I am not even sure why you are taking these supplements but that is another matter. There isn’t anything that you have described here that would make me suspect a threatened miscarriage. If you feel very concerned, the only way you will be able to get a cast-iron reassurance is to have another scan but I cannot say that I see a compelling need for one. My best wishes.

Jelly-like vaginal discharge at term

Question:  I'm 40 weeks and on thursday I started coming out this jelly like thing with a bit of blood and I was feeling pains. I was brought back. Now the pains are gone but this jelly thing still comes out after four days. Is this normal? B.C. (UK)

Answer: What you are describing is a classic ‘show’. That is the mucous cervical plug that comes away as the cervix starts thinning in readiness for labour and delivery. It is something seen to varying degrees by most women in the lead up to actual labour. The fact that it has continued for a few days should not be a cause for concern. As long as everything is normal, just wait and labour should ensue and soon.