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Pregnancy Bliss | Reproductive Health Hub

Cause of pernicious anaemia

Question:  What is the cause with pernicious anaemia,how did I get it, coz i have to have injections for life. K. (UK)

Answer: Most cases of anaemia are due to iron deficiency. Pernicious anaemia is different. Pernicious anaemia is a type of anaemia where the cause is deficiency of Vitamin B12.  Vitamin B12 deficiency can be due to dietary deficiency whereby not enough of it is obtained through food. Strict vegetarians are particularly prone to this. However, with pernicious anaemia, the cause is not dietary deficiency but poor absorption from the gut.

Normally, the stomach lining produces a chemical called intrinsic factor. This chemical facilitates the absorption of Vitamin B12 found in food. Some people (and it appears you are one of these) produce antibodies which destroy the cells that produce this intrinsic factor. As a result very little of this chemical is produced and consequently Vitamin B12 cannot be absorbed in sufficient quantities. The end result is pernicious anaemia. Since it is not possible to reverse this effect, such a person will need to have her Vitamin B12  via injections for life. Pernicious anaemia is quite uncommon in young people but it does happen.

Safety of Vitamin B12 injection in pregnancy

Question:  Is Vitamin b-12 injection safe in pregnancy? A.T. (Nigeria)

Answer: Vitamin B12 is administered in pregnancy if and when required and is considered to be safe. Vitamin B12 deficiency happens to be rare in pregnancy. However, the little information available about it indicate that such a deficiency may be deleterious to the baby in the womb. We have discussed this in an answer to an earlier question that you can reach by clicking here:

Chances of a conception after one act of sex

Question:  I am a male, and am wondering.. What are the actual chances of a single encounter turning out to be a pregnancy? I also would like to know if ejaculation does not happen inside the female, but there was still some slight residual, what are the chances of an unplanned pregnancy? C.L. (USA)

Answer: it is never realistic to quantify the actual probability of an act of sexual intercourse resulting in pregnancy. There are far too many variables that need to be considered before you can give an objective estimation of the chances of conception. Let me frame the answer by giving an example. If intercourse takes place within a day or so of the woman ovulating, she has healthy tubes and the man is producing healthy sperm, chances are rather high that this act of coitus will result in conception. If intercourse takes place close to her date of menstruation, chances of conception are so low as to be close to zero. This will also depend on whether this woman has regular cycles and therefore there is little or no chance of ovulation taking place much later than usual. As you can see, there are many factors to consider.

On your second query, there is certainly a fair quantity of spermatozoa that are passed into the vagina during sex well before the actual orgasm and ejaculation. This is the main reason why withdrawal is such a hopelessly ineffective form of contraception. Spermatozoa passed before ejaculation are just as effective in fertilizing the egg if it happens to have been released at that time.

Exposure to cat litter in early pregnancy

Question:  I’ve had a few teeth out under local anaesthetic not knowing i was pregnant, also handling cat litter for a recently purchased cat on the understanding previous owners already wormed him. Has my baby been put at health risk if so what should i do? C.S. (UK)

Answer: The use of a local anaesthetic in early pregnancy and, indeed, at any stage of pregnancy is safe for the baby in the womb. There is no need to worry about this. Handling cat litter during pregnancy is usually discouraged because of the theoretical risk of exposing yourself to the infection called Toxoplasmosis. This is a subject we have covered in more detail here: If you are concerned that this may be an issue, you could contact your GP and a blood test can be arranged which, hopefully, will put your mind at rest. Toxoplasmosis is uncommon in the UK.

Swollen, bruised face in pregnancy

Question:  My daughter is 21 yrs old and 16 weeks pregnant. Her face has suddenly started to swell up and she has bruises coming out on it. She has been to the hospital and they said it is nothing to do with the pregnancy. Could you suggest anything? Thank you. G. (UK)

Answer: I would tend to agree with the view expressed at the hospital. This is unlikely to be directly related to the pregnancy. It is more likely to be incidental that it has happened while she is pregnant. Do I know what it is? The answer is no. I have far too little information to go on and anything I can think of will be more of a guess than based on solid evidence. It could be anything from a self-limiting viral infection to an allergic reaction. Your daughter’s GP is, in my view, the best person to look at this and hopefully it will be sorted speedily.

Induction of labour at 38 weeks

Question:  I’m currently 36 wks pregnant with my 3rd baby, i would like to no if i ask to be started 2 wks early can they do it the baby is a good weight but i suffer from bad depression and i have a son with adhd but i cant run about after him and am at my wits end. N.D. (UK)

Answer: I do genuinely feel for you. The final weeks of pregnancy can sometimes be very difficult. However, I think it is unlikely that your obstetrician will be willing to acquiesce to a request for induction of labour before 39 completed weeks. That is, at the earliest, a week before your calculated due date. This is always for a good reason. In fact, when done, inductions before the due date are almost always done for fetal rather than maternal reasons. When you are in physical distress, as you seem to be, that can come across as being uncaring. That is not so. The doctor has a duty to look at the bigger long term picture hence the reluctance to induce labours so many days from the due date. Having said all that, it is possible that, on assessing the situation, your obstetrician may take the view that inducing you at 38 weeks is a reasonable and the best thing to do. Do bring this to the attention of your midwife. My best wishes.

Fetal movements felt on one side only

Question:  I'm 31 weeks pregnant & was wondering if I should be alarmed that I only feel my baby on the right side of my belly? Thanks. S. (USA)

Answer: I don’t think there is any cause for alarm. It is not unusual for fetal movements to be more pronounced on one side of the abdomen. This is usually where the limbs are. Some women will not perceive movements on one side because that side is occupied by a mass, usually a uterine fibroid, which effectively masks all fetal activity. If you have any other reasons to think there is more to this, a quick ultrasound scan should give clarity to the situation. As things stand, my view is that this is just a result of fetal position.