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Pregnancy Bliss | Reproductive Health Hub

Safety of cervical cerclage

Question:  What is the risk of having an abnormal ceclage in when you are pregnant? M. (USA)  

Answer: If I understand you correctly, you want to know what risks are posed by having a stitch placed in the cervix during pregnancy. That is what is known by cervical cerclage. I am a little confused by your use of the term ‘abnormal’. In any case, cervical cerclage is advised where there is a proven or strongly suspected cervical weakness which would have led to a mid-trimester miscarriage or extreme prematurity in the past. There will normally be a history of some kind of cervical surgery in the past. In such a case, cervical cerclage is crucial and is probably the only hope of having a desired outcome to a pregnancy.

There is a small risk of provoking a miscarriage as a result of applying the stitch. However, there is consensus that this quite small risk is far outweighed by the potential benefit.

Repeat caesarean section or vaginal delivery?

Question:  Hello, I’m just wondering i had an emergency c-section with  my first child due to baby distressed and i had a awful time. This was 4 yrs ago and trying for a second baby was just wondering whether i can elect a 2nd c-section. Thank you. C.C. (UK)

Answer: Of-course you can have a second caesarean section if that’s what you firmly believe you want. Almost all units in the country operate a policy whereby a mother with a previous caesarean section has the final say on the mode of delivery in any subsequent pregnancy. If that is a caesarean section, normally that will be respected. You are unlikely to be coerced into an attempt at a vaginal delivery of you do not want. Having said all that, I have to say that in the absence of any potential problems in the ongoing pregnancy, the advice from your obstetrician will almost certainly be to consider a vaginal birth; what is termed ‘VBAC’ or vaginal birth after a caesarean. This is because, it is a proven fact that, in any ideal situation, where there are no identifiable potential problems, a vaginal birth is better for both mum and baby. You will therefore have the freedom to decline that advice but please do give it proper consideration.

Safety of the antibiotic Velosef in pregnancy

Question:  Hello, my wife is pregnant last 3 month before, she has pimple in under arm, doctor advice her to take a antibiotic (Velosef i.e cephradina)and also for swelling tryefin/chymotrytsin. I want to know its safe for pregnancy. Her pregnancy 3 month and 1 week older. J.A. (Canada)

Answer: As you correctly pointed out, the antibiotic velosef’s generic name is Cephradine. This belongs to a group of antibiotics called Cephalosporins. These are safe to use at any stage of pregnancy. I could not quite work out what the other medication you mentioned was so I am not able to advise you on that. If you can get its proper name and send it to me, I will be happy to help.

Missed periods; positive pregnancy test after sterilisation

Question:  I got sterilised 6 years ago but i have missed 2 periods, felt symptoms as on my other children so did a test and it came up positive. Am i pregnant or could it be a phantom? Been broody recently now is this my body playing tricks on me? K.J. (UK)

Answer: With two missed periods and a positive pregnancy test, you are most likely pregnant. A pregnancy test in a phantom pregnancy is always negative. This development is actually rather urgent: Following sterilisation, when you conceive you have a significantly higher risk of the pregnancy being ectopic. Even if you do not currently have symptoms to suggest this, you need to bring this to the attention of your GP without delay. The GP will organise an urgent review at your local hospital’s Early Pregnancy Assessment Unit where an ultrasound scan will be done straight away. This will serve the purpose of confirming the pregnancy, determining gestation and most importantly in your case, confirm pregnancy location. Best wishes.

Recurrent joint pains during pregnancy and postnatally

Question:  Ok, where to start?! While I was 5 months pregnant with my second son (now 2.5 months), I experienced some terrible joint pain. It started in the 5th month and lasted for about a month and a half. I had the pain in various places (not at the same time) - shoulder, thigh and knee and wrists (this could have been carpal tunnel). The pain usually lasted for 3 days, peaking on the second day. Paracetamol had no effect at all and my OB prescribed mild cortisone but they too did nothing. Anyway, the pains went away eventually (didn't experience ANY such pain in my first pregnancy).

My second son is now 2.5 months old and last week (after having a niggling back pain for a few days)the dreaded, acute pain (it felt as though it was in the muscle this time - not joint) returned in my neck and shoulder - I was unable to even lift the baby to feed him. At the same time, I had slight pain in the muscle above my knee and in my ankle - this was bearable and NOTHING like the pain in my shoulder. This pain started on the first day in my neck and by day 2 had moved to the muscle above my breast bone and I also had tingling in my hand and fingers.

My GP suggested it was caused by continuous lifting of the baby and my positioning when breast feeding. She prescribed Paracetamol and Voltaren cream - neither of which helped. The pain disappeared after 2 days.

But, yesterday (3 days after the shoulder pain had ceased) another pain in my hip AND arm started making it very difficult to move around the house again. I feel tired and not my energetic self. I  put on 20 kilos during the pregnancy and I’m 39. What an earth could it be? I would be very grateful for any advice/opinions/thoughts.. E.S. (Greece)

Answer: Thank you for your question. I am going to cut to the chase: I have no idea what the cause of these pains could be.

The description of your symptoms does strongly suggest that the problem is unlikely to be pregnancy related despite its initial timing. The presentation simply does not fit any pregnancy related condition I can think of. The recurrence of the symptoms over two months postnatally would tend to reinforce my view. What do I think of your GP’s suggestion that it is the lifting of the baby? If the pains are similar to the ones you had during pregnancy; well, this does not add up does it?

I don’t want to speculate as to what this might be. I am truly baffled and being an obstetrician this appears to be out of my area of expertise. Its intermittent nature does not suggest a progressive condition but, I am afraid, the only honest advice I can give is that you need to bite the bullet and overcome those logistical hurdles to avail yourself proper tests and specialist review. It sounds like you need quite a few tests and as we always say, the sooner the better.