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Pregnancy Bliss | Reproductive Health Hub

Exposure to methane gas in early pregnancy

Question:  Hi, I am 9 weeks pregnant and have been working in a landfill for the past 10 weeks or so. I can smell gas in certain areas, and try to avoid them. I am wondering if the methane gas in the landfill is harmful for my unborn baby? Thank you. M (USA)

Answer: There is no evidence to suggest that ‘normal’ environmental exposure to methane gas can adversely affect the unborn baby. The general advice is that if the gas does not adversely affect the mother, it is unlikely to affect the baby in the womb. Heavy prolonged exposure that leads to symptoms such as headache should of-course be avoided because that would indicate that there are reduced oxygen levels in your circulation. However, even in such circumstances, the fetus is likely to extract all the oxygen it needs.

Choroid plexus cysts significance in pregnancy

Question: Hello, My doctor has suggested me the target scan for pregnancy. In that doctor found Fetal brain & skull: Normal size of fetal head & normal sonodensity of fetal skull bones, normally seen fetal cerebral ventricles. Bilateral Choroid plexus cysts. The one on Lt side is 10.6m in size & is complex in nature. The cyst on Rt side is smaller & measure 5.2mm in size. Cerebelli, vermis & cysterna magna are normal. Atria of lateral cerebral ventricle measures 5.2mms. Normal cranio-vertebral junction observed.
So please suggest me is this any serious matter if DGA is 20 weeks. Please reply me as soon as possible. Thanks & Regards. K.B. (India)

Answer: Choroid plexus cysts are regarded as one form of ‘soft markers’  looked for when performing a detailed pregnancy scan for possible fetal abnormality. Like all fetal ‘soft markers’, their presence is only a guide for possible underlying chromosomal or genetic disorder and, in themselves, are not a diagnosis. In other words, presence of such a soft marker is by no means synonymous with a diagnosis of fetal abnormality. In fact, choroid plexus cysts are relatively common and, in the majority of cases, are innocuous and harmless. When they occur in isolation, that is, in the absence of other soft markers, there is rarely any reason to worry. When the fetus has more than one type of soft markers, that changes the picture and is reason enough to actively seek to establish a possible underlying condition. The impression I get from your information given is that no other soft markers were identified. If that is indeed the case, I think you it is reasonable for you to be reassured. The subject of soft markers is discussed in more details here and I would encourage you to read that section for a complete understanding. My best wishes.

Neonatal alloimmune thrombocytopenia?

Question: Hi my brother and his lady had a baby 1 month ago he had very low blood platelets and was a different blood type which caused problems with antibodies rejection he has since then had 5-6 blood platelet transfusions but still is not forming his own antibodies to help wipe out what he has left from the mother now My question is that no one seems to answer isn't the antibodies in mothers breast milk the same as in her blood therefore if she is breastfeeding wont baby be still getting her antibodies and maybe that is why his blood platelets keep dropping every few days can you help. Give us some information on thrombocytopenia babies rejecting mothers blood platelets able to breastfeed safely from the mother please. R.P. (New Zealand)

Answer: I am not sure I understand the exact nature of this baby’s condition. From your details, it appears the baby was found to have a very low platelet count soon after birth. What is unclear to me is whether this was confirmed to be a case of congenital inherited thrombocytopenia where the baby is not producing sufficient amounts of  platelets himself or whether, indeed, this is acquired thrombocytopenia whereby antibodies from another person, in this case the mother, are attacking and destroying his antibodies.

Your details appear to suggest the latter is the case. The antibodies would have been passed to him via the placenta whilst in the womb. If this is so, that will mean this is a case of Neonatal Alloimmune Thrombocytopenia (NAIT). The issue of breast feeding in such cases does not have clear-cut answers. In theory, breast milk can contain IgG antibodies. Anti-platelet antibodies belong in this class of antibodies. However, there has been numerous case reports published in the medical literature over the years showing that, in fact, breast feeding in such cases is perfectly safe and does not exacerbate the problem. If a mother whose baby has been affected by this condition wants to breast-feed, she would not be dissuaded from doing so. I suspect your sister-in-law was given a similar advice.

Having repeat platelet transfusion is the correct treatment until his platelets stabilise above a certain count where bleeding risk is deemed minimal.

IVF on the NHS

Question: Can you tell me if my daughter would qualify for ivf on the nhs .she had 1 ivf about 4 years ago without success she is 41. A client of mine had ivf twice in a well known London clinic a few years ago because it didn't work down here in Bournemouth and it was a success so I wondered if my daughter could do this. B. (UK)

Answer: It will depend on a number of factors. Primary Care Trusts (PCTs) in every locality have their set criteria about eligibility for assisted conception. Unfortunately, the criteria vary from one PCT to another. This is based on the fact that the finite pot of money that each PCT has has got to be divided and allocated in accordance to that area’s population healthcare needs. That’s why there is this apparent Postcode lottery. Now, your daughter needs to check with her GP what her PCT’s criteria are. This information is freely available and she may, in fact, be able to access it online if she knows where to look. If for instance her local PCT has a cut-off age below 41 (many have 40, some 38), then she will fall on that hurdle. Others will only give each person one IVF cycle. Again, that could be where she misses out. I am therefore unable to give you specific advice about her eligibility but her GP should be able to do so. Best wishes.

A Choroid Plexus Cyst in the fetal brain