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Pregnancy Bliss | Reproductive Health Hub

Pre-term rupture of membrane and delivery

Question:  I am 35 years old and have two kids .On my third pregnancy The membrane ruptured at 27 weeks of pregnancy. The doctor put me under supervision in the hospital for 3 days giving me erythromycin antibiotic.Then there was  an outbreak of infection, the doctor make pregnancy termination. The baby died after 20 days  in the incubator. I delivered him with caesarean section. Knowing that i have no history of preterm labor or rupture.

I am very sad about the baby I want to get pregnant again as soon as possible, but first  i want to know what r the possible causes of preterm rupture, how long is the time recommended to get pregnant again, knowing that i am now 35 years old. What are the precaution i have to take to avoid any  complications.

With lot of thanks. G. (Egypt)

Answer: Yours is a very sad story. Unfortunately this sort of thing does happen. In the majority of cases, no explanation can be found. Your doctor was completely right in putting you immediately on Erythromycin. This was meant to prevent infection and allow the baby to stay in the womb for as long as it was practicable. Unfortunately the strategy did not work. Once you had an infection in the womb your doctors had no choice but to deliver you and tragically the baby did not make it. It is possible that there was an infection in the genital tract already before the membrane rupture. This could be something like bacterial vaginosis which has, on occasions, been associated with preterm membrane rupture and/or preterm delivery. I cannot be sure that was the case but it is a possibility. With your history of two uneventful pregnancies previously, it is very unlikely that you will experience this sort of complication again in the future. It is likely to have been a one-off tragic event. As to when you should be trying for another pregnancy, once you feel psychologically ready to embark upon this, you can go ahead. This is, as long as your caesarean was the standard ‘lower segment’ incision type. If, on the other hand, it was a classical incision, you will need to give the scar time to strengthen properly and that should be not less than 12 months. My best wishes.

Rhesus negative group, anti-D and bleeding during pregnancy

Question:  Hi, I'm 5 wks pregnant and started bleeding at the weekend the hospital cant scan me for another week. I have 2 boys and my 1st pregnancy was perfect with an easy labour and birth. My second pregnancy was awful, i bled from 6-20 wks then had emergency c-section at 32 wks as my waters broke. My blood type is rhesus negative and was told i should have been given a jab of anti d after each birth i never got it after my 2nd birth. That has been confirmed by my GP. If i never got it, could that have been the problem with my 2nd pregnancy and any future ones i have? If that is the problem is there a way to fix it so i can have a healthy pregnancy? Thanks. C. M. (UK)


Answer: I do hope this current bleed turns out to be a false alarm. Turning to your concern about your blood group and the anti-D injection, there are a few issues that are unclear to me. If you are indeed Rhesus negative, you are supposed to have an anti-D injection when you have a bleed during pregnancy (after the first trimester) and after the birth. You also get an injection routinely at 28 weeks gestation. All these measures are meant to prevent development of antibodies. If you were to develop antibodies,  these cannot affect that particular pregnancy but they can potentially affect a future pregnancy. There are a whole number of permutations. All I can state categorically is that the prolonged bleeding you had in your second pregnancy had absolutely nothing to do with your blood group. That is not a problem associated with Rhesus Negative status. It is also certain that your preterm rupture of membranes had nothing to do with this. I cannot really answer why you apparently did not have the anti-D injection after that birth. You will need to verify this information with the hospital where you delivered. Situations where anti-D injection would not be required include, if you have already developed antibodies (it will be ineffective) or if the baby is also Rhesus Negative(it will be unnecessary).

What is required now to put your mind at rest is to have a blood test to check whether you have anti-D antibodies. This test is part of the routine booking blood tests. If you don’t have these you can relax. The subject of Rhesus Negative blood group in pregnancy is discussed in greater detail here:

Bleeding with pelvic pain in early pregnancy

Question:  have been bleeding with a lot of pain in the pelvis for more than a week, i went to see a doctor yesterday and confirmed that I am pregnant. now am worried that i might have lost the baby due to heavy bleeding. T (UK)

Answer: Needless to say, heavy bleeding in early pregnancy is not a good sign. You said you were confirmed by the doctor to be pregnant but have not said how this was done.

Did you have an ultrasound scan? If so, has the “heavy bleeding and pelvic pain” occurred after that scan? If so, you need to have another scan to verify what is going on. If the pregnancy was confirmed using a urine pregnancy test only, you need that first scan urgently. My best wishes.

Sickle cell disease (SCD) in very cold climate

Question:  As a student and a sickle cell patient, is it advisable to choose a place like Norway to learn and work especially during winter? This question because i learnt sickle cell does not like low temperatures. A.Q. (UK)

Answer: I am not actually sure how this question is pregnancy related... Anyhow, it is true that extremely cold temperatures can trigger a sickling crisis. It is therefore important for a sickle cell sufferer in that kind of environment to ensure she stays warm.  If you had a choice of places, you should give preference to warmer areas. However, the very cold winters (and they do get really cold there!) do not mean you cannot live there; it only means you will need to take the necessary precautions.

Fetal monitoring information

Question:  Plz could u send me some information on fetal heartbeat monitoring either a dvd or video or brochure will do. My address is *****  I.M. (UK)

Answer: I am afraid we are unable to help in the way you would prefer. The information we provide to our visitors is via this site only. You may be able to find the information you are looking for by clicking here. If you find it useful, you could, of-course, print it out for reference when away from a computer terminal.

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