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Pregnancy Bliss | Reproductive Health Hub

Too soon for a positive pregnancy test?

Question:   Can you get a positive pregnancy test 4 or 5 days after intercourse? S. (USA)

Answer: No you cannot. Five days after intercourse even implantation has not taken place. There is therefore no hCG, the pregnancy hormone that is detected in a pregnancy test. If you have an extremely sensitive test able to detect very low levels of the hormone in the urine, the earliest you can have a positive urine pregnancy test is about 10 days after intercourse, which will be 3 or 4 days after implantation has taken place.

Ruptured membranes in early pregnancy

Question:  My pregnancy is now 16 weeks and yesterday my waters went. A scan at the hospital shows there is no water around the baby. The doctor told me it is unlikely the baby will survive and I should consider an abortion. I am devastated by this. Is there really no hope for my baby? T.G. (UK)

Answer: This is heart-rending. Fact is; it is exceedingly unlikely that the pregnancy will continue even if you do not take active steps to terminate it. The most likely scenario is that miscarriage will take place in the coming days anyway. Even in the very unlikely event of the pregnancy continuing, the absence of any amniotic fluid means there will not be any lung development. That means; the prognosis for the baby will be hopelessly bleak. There is also the ever present spectre of ascending infection as a result of ruptured membranes. This can be a serious complication for you and therefore, should conservative management be adopted, a close vigilance will be required to keep a lookout for this and take aggressive action should there be any early signs for it.

Your situation is difficult but there is no rush to make a decision. If your waters have been definitely confirmed to have gone at this early stage of pregnancy, it is difficult for me to see how we can expect a good outcome.

Maternal height and risk of caesarean section

Question:  I’m only 4 foot 11 inches tall and in my first pregnancy. Will I have to have a caesarean section? C.Z. (UK)

Answer: You may be surprised by this but evidence about increased risk of caesarean delivery due to short maternal stature is sort of conflicting. There are studies that have shown that short stature does significantly increase risk of caesarean section. However, the majority of studies in fact show that height looked at independently is not a risk factor for caesarean section. However, depending on your age, you may be interested to know that these same studies, on further analysis of the data, show that when the short mothers are relatively young (under 19) or relatively older (over 39), the risk is, indeed increased. Most studies have used your very height as the cut-off reference point; that is 4’11” or 150 cm.

Limbs and digits at a 20 weeks’ scan

Question: Hello, please can you answer this question for me: In the 20  week scan can they see if all the fingers and toes are there? Thank you. T.A (UK)

Answer: Absolutely, without any problem at all. Analysing the limbs and all the digits is pretty straight-forward at 20 weeks of gestation. It is very unusual to miss any problems affecting the four limbs and their appendages (toes and fingers) at that stage of a pregnancy. You can see how easy it is to assess these on example images on this page posted in response to an earlier question we received.

Conception whilst on Oxytol

Question: I think I am pregnant. I am taking oxytol 300 once a day presently. Off and on i was on anti epileptic drug before marriage for 8 years. then i was seizure free. doctors stopped the medicine for about 4 years. After the delivery of my first child who was born as with cleft palate and cleft lip i got seizures again. For 8 years I am taking the medicine oxytol 300 kindly advise whether it is advisable to continue pregnancy? R. (India)

Answer: I am afraid  I am not familiar with the drug Oxytol that you are using. This drug is not in use in Western Europe. I am therefore not in a position to give you specific advice about this. However, I can say this: All anti-epileptic medications can cause problems of fetal abnormalities. The degree of risk differs from one type to another.

There is no anti-epileptic that is completely safe. The main concern is usually neuro-tube defects such as spina bifida and facial defects like the one suffered by your first child. However, you need to always take things in perspective. The vast majority of children born to mothers on anti-epileptic medication will not be affected in any way. You need to bear that in mind. If facilities allow, the best thing in my view is to get yourself an ultrasound scan, may be around 18 weeks or so for a detailed look at the fetal anatomy. This will then allow you to make an informed advice. My best wishes.

Addendum: It was brought to our attention that the drug branded  ‘Oxytol’ in India is in fact Oxcarbazepine. We there after updated our answer, sent directly to the questioner like this: Oxcarbazepine is a derivative of Carbamazepine, a widely used anticonvulsant.

Carbamazepine is regarded to be one of the safest anti-convulsants that can be used by mothers with epilepsy who are trying to conceive. It is not completely risk-free but the chances of the baby ending up with anomalies as a result of the medication is relatively low. I am therefore of the view that you should carry on with the pregnancy. I hope it all works out well for you and your baby

Diagnosing cervical cancer in pregnancy

Question: In the information it keeps saying if cervical cancer is found; but how is it found?? Would it be when a scan is performed?? how would they detect it without a smear test?? Thanks. E.K. (UK)

Answer: I am not sure which information you are referring to. However, if it is with reference to cervical cancer diagnosed during pregnancy, no; a scan cannot make this diagnosis. A diagnosis will be suspected if a woman presents with suspicious symptoms such as a persistent or recurrent brownish or blood-stained discharge or bleeding after intercourse. This will then prompt an examination which might reveal suspicious features. The next logical step after that will be to perform a smear, a biopsy or a colposcopy examination and biopsy. It is following any of those measures that a diagnosis can be conclusively made. A scan is not used for this purpose.

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