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Pregnancy Bliss | Reproductive Health Hub

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Bleeding and anti-D injections in pregnancy

Question: I am 3 weeks away from my due date.  A bit of back round.....I am also Rhesus Negative and have received about 4 injections during my pregnancy as a result of bleeding.  The bleeding has been mostly brought on by sexual intercourse. About 5 days ago, I had a bit of blood from sexual intercourse and decided not to see the doctor as I had experienced this before and had received the anti-d drug at about 32 weeks.  This morning, I noticed a spot of fresh blood mixed with some mucous and the mucous was slightly discoloured.  Should I be concerned?  Is this serious?  Will I need another anti-D injection? C (Hong Kong)

Answer: I don't think you need to worry. The bleeding you have had post-coital is your blood rather than the baby's. That means the risk of sensitization is negligible to nil. I know your doctors, by giving you injections repeatedly, have been adopting the 'better safe than sorry' strategy, which is OK. However, it is clear they were not required. This should not be a cause for concern as the anti-D injections cannot do you (or the baby0 any harm. If the bleed is definitely provoked by intercourse, anti-D is unnecessary. You can rest easy. The only exception in this case would be if you have been identified to have a low-lying placenta (placenta praevia). In any case, with such a diagnosis, you would have been advised to avoid penetrative sex altogether.

Ciprofloxacin antibiotic use in pregnancy

Question:  My last menstrual period was three months ago.  Three weeks later, doctors prescribed me to use ciprofloxacin antibiotic to treat my urinary tract infection for a week. I do not even know that I was pregnant at that time. Doctor checked my urine and blood samples at the start but did not say that I was pregnant. My period which was supposed to occur a week later, did not occur. Later, I was told that I am pregnant. Will there be any harmful effect on my baby due to this Cipro antibiotic? Please kindly provide me your suggestions. L. (Canada)

Answer: To begin with, I do not think a pregnancy test was done when you wciprofloxacin not recommended in pregnancyere first seen by your doctors. There would have been no indication as you were only in your third week of the cycle. In any case, the test would, in all probability been negative as it was far too early.

On the specific question of this antibiotic, Ciprofloxacin is not recommended for use in pregnancy (even though from time to time it has been used). This advice for caution is based on animal studies which showed that it can cause joint problem for the offspring. However, you do not need to be unduly alarmed by this. Where it has been used in humans, usually inadvertently like in your case, no such problems have been reported.

Urine test showing mixed growth

Question: I received a letter from the hospital, saying i should go to antenatal clinic for a urine test for mixed growth, would you know what mixed growth is? Please let me know asap. V.G (UAE)

Answer: When a vaginal swab or a urine sample is tested in the laboratory for infection, the responsible bacteria is usually identified using a culture where it will grow predominantly. There may be other types of bacteria bacteria grown in the culture but the responsible one will be markedly predominant. A result showing a mixed growth  simply mean there was no predominant bacteria isolated. It is therefore unlikely to be significant. However, if you have symptoms, they may want to repeat the test just to be sure nothing significant is being missed.

Recurrence of a chromosomal disorder

Question:  Does monotony of chromosome in first pregnancy effects the next one? How much are the chances of having chromosomal disorders in next pregnancy if one have in first? A. (India)

Answer: I am not sure I understand what you mean by the term ‘monotony of chromosome’ (or did you mean monosomy?). If you clarify, I would be happy to update the answer accordingly. Turning to the second part of your question about the chances of a chromosomal disorder recurrence in a subsequent pregnancy, that is a complex subject. In a very simplified form, you need to know that most cases of chromosomal disorders, Down’s syndrome being the commonest example, are random occurrences. By this I mean, the parents are not particularly prone to have affected offsprings. It follows therefore that, on balance, a recurrence is very unlikely. However, any mother who has had a child with a chromosomal disorder has a higher than average chance of having another child with such a disorder. In addition, where the child is born to a mother who has a known risk factor, such as advanced age, that risk will not change and therefore she will remain at higher than average risk of having such a child again. Take an example of Down’s syndrome: The average risk for any mother aged 30 is 1 in 900. However, for a mother of 30 who has had a Down’s syndrome baby in the past, the risk is significantly higher at 1 in 200.

The exception to all these estimations is for people who are themselves healthy but who carry what is known as balanced Robertsonian chromosomal dislocation. An individual with this condition has a very high 1 in 4  (25%) chance of having a Down’s syndrome child. That is, if Chromosome 21 is involved in the translocation.  Robertsonian translocation is quite uncommon but accounts for 5% of all Down’s syndrome cases.

Size of gestational sac

Question: I had an ultrasound scan that gave me a gestational sac measurement of 8mm. The nurse said this would be 4 weeks pregnant. I did 3 HPT's (home pregnancy tests) two and a half weeks ago. So from my calculations, I must be at least 5½ weeks pregnant. Is this possible from the measurement? S.M. (UK)

Answer: I am not sure where the Nurse got her figures from. A 4 week gestational sac is only 3 mm in diameter. At 5 weeks it reaches 6 - 7 mm and it will be around 14 mm a week later. From the information provided, I would say you are nearer the mark than the nurse was. There is no mention of a fetal cardiac pulsation in your question. After 5 weeks, with a vaginal scan (or an abdominal scan in a slim individual), this will be expected to be seen.

Glucose in urine during pregnancy

Question: I had a trace of glucose in my urine yesterday, despite a normal random glucose blood test last week and a normal urine dipstick the week before. My obstetrician asked for another random glucose and Hb1Ac, which has been done. I am scared stiff that I am now diabetic and my birth plan of a home birth is now not possible, is this likely to be the case? I am 28 +2 days pregnant. H.B (UK)

Answer: I am rather puzzled by this apparent over-reaction on the part of your doctors to a 'trace of glucose' in your urine. Presence of sugar in urine during pregnancy is very common and, in most cases, completely insignificant. It would be of concern if there were other features, such as an apparently bigger than average fetus or increased amniotic fluid suggestive of gestational diabetes. In such a case, a fasting (not random!!) blood glucose test would be appropriate. The decision to check HbA1c is even more puzzling for somebody with no history of diabetes. I have limited information here but if I were to bet I would say your investigation results would be almost certainly normal.

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