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Pregnancy Bliss | Reproductive Health Hub

Fetal anatomy scan

Question:  How many times should I do the anatomy scan ? E.K. (South Africa)

Answer: I am assuming you are pregnant and you are referring to the fetal anatomy scan. If that is the case then, for most women, one scan is usually sufficient. This needs to be correctly timed. If it is done too early (before 18 weeks), it may not be possible to adequately check the anatomy of all the vital organs. 20 weeks is optimal. For very obese women, a repeat scan may be required to get a sufficiently clear view of all the vital organs. As stated before, for the majority, one scan, at around 20 weeks gestation is sufficient.

IVF for the over 40s

Question:  Can you please give me a contact number as a friend of mine is over 40 and is desperate to have a baby and would like ivf for over 40 years olds. M (UK)

Answer: As explained in our section on this subject, assisted conception in the form of IVF can and is usually fairly intensive. It involves administration of several hormone injections, serial ultrasound scan to track the development of egg follicles, harvesting of the eggs, preparation of the embryos, replacing the embryo into the womb, monitoring whether the procedure has been successful etc. What I am trying to say is that, this; for practical reasons, cannot be done remotely. Your friend will be better served by searching for an expert locally. A search online should yield instant results. My best wishes to her.

Conceiving after a cervical cancer vaccine

Question:  How soon can I get pregnant after I get the third dose of cervical cancer vaccine?  Is it okay to get pregnant right after I get the last dose of cervical cancer vaccine? Ideally, how long should I wait to get pregnant after the third dose? months, weeks, days?  does it matter?  If ever I get pregnant right after the last dose, will it harm my baby? A. (Philippines)

Answer: Whilst the administration of the cervical cancer vaccine, be it Cervarix or Gardasil, is not recommended if you are already pregnant, there is no restriction time-wise, to getting pregnant after you have had the vaccine. Remember, neither vaccine utilises a live virus. There is no risk of any disease to you or the baby were you to become pregnant after you have had the vaccine. You can safely try to get pregnant right after you finish the vaccine course.

Painkillers and antibiotics in pregnancy

Question:  My wife is only 20. At 3 months pregnant, she took some painkillers such as paracetamol and septrin. A month later, she's having headaches and regular running her baby safe? I am concerned coz I’m   living separately from her, several miles away and cannot therefore take her to hospital. Thank you for your advice. M.K. (Kenya)

Answer: There is no problem with using Paracetamol during pregnancy as long as it is used in the correct dose. It can be taken safely, even repeatedly, during pregnancy. Septrin, which is, of course not a painkiller but an antibiotic is one of those drugs where the advice is to avoid during pregnancy. This is because it contains Trimethoprim, a drug that is a folic acid antagonist. Whilst this does not make it an absolute contra-indication, the advice is normally to use an alternative that is known to be definitely safe. Any of the Penicillins or Cephalosporins can be used safely in pregnancy. There are many of these.  I do not think a single, possibly 5-7 day course of Septrin would have harmed the baby. However, a repeat would certainly not be recommended.

If your wife has been feeling under the weather for sometime now, it will be best to get her to see a doctor so she can be investigated properly to see if there is an underlying problem. That is particularly important seeing as she is not even half-way through this pregnancy. Best wishes.

Reduced amniotic fluid

Question:  If amniotic fluid is less AFI 8-9, does it cause any harm to baby? Now its 27 wks. What could be done to have it normal? B.S. (India)

Answer: At an amniotic fluid index (AFI) of 8-9 at 27 weeks, the fluid volume is at the lower border of normal. It is not always possible to identify the cause of reduced amniotic fluid volume. You have not said if the baby’s own growth is normal or reduced too. If growth appears normal, then that is reassuring even though it means you will need to continue having serial growth scans every 2-3 weeks to ensure the growth trend remains normal. You cannot do anything to influence the amniotic fluid volume.

I have had questions from people who have had expensive intravenous infusions administered with a promise that this will increase the amniotic fluid. That is an out and out deception and blatantly unethical. The important thing is to continue with close monitoring of fetal wellbeing. It is quite possible there is nothing wrong. However, if the baby does not appear to be faring well in the womb, an early delivery could be advised.

Erratic periods after a caesarean section

Question: I had a c section and my baby is 7 months old. My periods are irregular after delivery, sometime i have a light black discharge. Can u tell me why it is like this? A. (India)

Answer: Periods can be irregular after a delivery, be it vaginal or caesarean. That is not unusual. In fact, if you are breast feeding, this is expected. The pattern of your periods has nothing to do with the fact that you had a caesarean section. If you are not breast-feeding and you are not on any contraception, your periods should have gone back to your norm by now. If that is the case, then you need to bring this to the attention of the doctor. If you are using a progestogen only type of contraception (mini-pill; implanon etc), that may be the cause of the pattern you described.

Brown vaginal discharge in early pregnancy

Question: My daughter had a miscarriage at 2 months. Now she is pregnant again, she is 13 weeks. She has a brown discharge. Is this normal? Thanks. S.R. (UK)

Answer: Any vaginal discharge that is suggestive of bleeding cannot be described as normal. This is not the same as saying there is anything serious going on. This needs to be reported promptly to your daughter’s GP so an urgent ultrasound scan can be arranged for her, either at the Surgery (if available) or at the local hospital’s Early Pregnancy Assessment Unit.

‘Rhythmic beating’ in a pregnant abdomen

Question: I have a rhythmic beating in my belly, I am six months pregnant and want to know what the rhythmic beating is. I have been told by friends and family it may be the baby hiccupping but I would like to know more or if this is true please. Thank you. My midwife is on annual leave. C.M. (UK)

Answer: I have to confess that I am not sure what that could be. I would not like to hazard a guess since your description of what you are experiencing is not very clear to me. If you are concerned that it may be something significant and in the absence of your community midwife, just ring your local hospital’s antenatal clinic. There is always a midwife at hand to answer queries. If they are unsure, they will invite you over for a closer look.