Question: Can at any time, during a very bad labour, can there be injury to the
baby? If so, can you let me have a list. Thank you. P.M (UK)
Answer: I am afraid I did not quite understand your question. When you say ‘a very
bad labour’, what exactly do you mean? A prolonged labour; a very painful labour;
or something else. I will need clarity to be able to do justice to your question
otherwise I may end up misleading you (and everybody else). Please feel free to re-send
the question with more detail.
Protein S deficiency and Pregnancy
Question: I have Protein S deficiency and have had 3 pulmonary embolisms and I
am currently on Warfarin. Can I try to fall pregnant? Someone told me I won’t be
able as my blood will clot and it will result in a miscarriage. E.V (South Africa)
Answer: Protein S deficiency is one of the conditions which constitute what is known
as Thrombophilia syndrome. People like yourself with this condition have a significantly
increased tendency to form clots within their blood vessels (thrombosis). This is
why you have had those pulmonary embolisms (PE).
With three episodes of PE, I am sure you have already been advised that you are going
to be on anticoagulant medication throughout your life.
Yes, indeed, you can try to become pregnant. However, and this is a big caveat, special
measures will need to be in place for you to embark on this. This is both for your
safety and to maximize chances of a good outcome of the pregnancy. It is therefore
crucial that you involve experts from the pre-conception stage and right through
the pregnancy and beyond.
It is true that anybody with your condition has an increased chance of miscarriage
if not anti-coagulated. As you are already on Warfarin, this reduces the possibility
of this complication quite significantly. However, Warfarin itself could be a problem
as it can cause harm to the baby in the womb. You will therefore need to be switched
to Heparin which is harmless to the baby. This could be in the form of one of the
so-called low molecular weight heparins (LMWH). Unfortunately, unlike Warfarin,
these can only be administered in the form of injections, given once or twice a day.
This should continue throughout the duration of the pregnancy and for a few weeks
after. You can then be switched back to Warfarin.
Raspberry leaf tea in pregnancy
Question: Hiya, please can you tell me when it’s ok to start drinking raspberry
leaf tea. Also I’ve been told that my placenta is blocking the baby’s exit,is there
anything I can do about this,and is it still ok to have sex as normal? Thanks. M.T
Answer: Raspberry leaf tea is claimed to have a number of benefits in pregnancy.
Most of these claims are unsubstantiated. It is known to be a rich source of iron.
Because its absolute safety cannot be guaranteed, it is advised that you don't use
this in the first trimester. This means, if you are beyond 13 weeks gestation, you
can safely use it.
Regarding your apparent low placental location, you did not mention what stage of
pregnancy you are. If you are beyond the half-way mark (20 weeks), it is probably
best to avoid penetrative sexual intercourse and if you are beyond 32 weeks, then
sex is a definite no-no.
Membrane sweep and labour onset
Question: A doctor performed a sweep and said I was 2cm dilated and four hours
later i had my show. I was just wondering how long before established labour also
having regular 20 min pains. H.A. (UK)
Answer You are asking the proverbial 64 million dollar question! Fact is, nobody
can give a precise answer to this. A membrane sweep is a very safe and useful way
of giving labour onset a nudge. Unfortunately, it doesn’t always work.
However, all the signs (as described by you) suggest that you are in the latent phase
of labour (which can last from several minutes to several hours). All things being
equal, I think it is safe to say you will be establishing in labour within the next
few hours. I wouldn't bet my house on it though!
Iron tablets during breast-feeding
Question: Is it safe to take 600 mg of ferrous sulphate a day while breastfeeding?
Answer: Oral iron at any dose is perfectly safe with breast-feeding. Remember, you
will only absorb what the body requires and the rest is passed in fecal waste regardless
of how much you are taking. There is therefore no risk of over-dosing yourself, let
alone the baby. In fact, it is rather curious that you have been prescribed 600 mg
of Ferrous Sulphate because there is ample evidence that 400 mg ( 200 mg twice a
day) is an optimal dose and as good as the higher 600 mg dose.
Vitamin B12 deficiency in pregnancy
Question: I have been diagnosed with B12 deficiency whilst pregnant. it is not pernicious
anemia as this has come back negative. I am 28, this is my second child and have
no other symptoms. Can pregnancy alone cause B12 deficiency as it also causes me
to have low platelets and low iron? I feel fine!!! E.K. (UK)
Answer: If pernicious anaemia has been conclusively ruled out then your B12 deficiency
is likely to be dietary. Are you vegetarian? Vitamin B12 deficiency is not uncommon
among strict vegans. Another rare cause is a condition called Tropical sprue. Despite
its name, it is found in non-tropical countries too.
Yes; marked Vitamin B12 deficiency can affect your platelet count but it has no relationship
to your iron levels (or did you mean Hb level?). Iron is also a dietary component
and if this is indeed low, your diet may be to blame, unless you have a history of
excessive menstrual loss prior to your pregnancy.