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Pregnancy Bliss | Reproductive Health Hub

Doxycycline in early pregnancy

Question:  i just missed my period and had a feelings that i might be pregnant. it good for me to take Doxycyclin prescribed by my GP. I already took 3 tablets and i am worried. M. (UK)

Answer: First of all, you need to do that all important pregnancy test to see whether you are, indeed pregnant. Doxycycline is a tetracycline. Like all tetracyclines, this should not be used in early or any other stage of pregnancy. If pregnancy is confirmed, you will need to stop using this forthwith and  contact your doctor who prescribed this so a safe alternative can be prescribed instead.  If this is confirmed, my best wishes in your pregnancy.

Conception whilst partner is on Champix

Question:  Hi, my husband and I want to start trying for a baby.  I stopped taking Champix approximately 2 weeks ago, my husband is still taking the Champix.  Do we need to wait for him to cease taking them before we start trying? K.H. (Australia)

Answer: The issue of the use of Champix (or Chantix as is otherwise known) in pregnancy is  something we have discussed here a few times. You are quite right in that anybody planning to get pregnChantix in pregnancyant and actively trying to do so should not be on Champix. Your stopping is therefore the right move. The contraindication extends to the time of pregnancy itself as well as breast-feeding. When it comes to the partner using Champix at this time, the advice is not so clear-cut. For it to have an adverse effect on the baby, Champix will have to have a negative effect on the quality of the sperm produced. No such evidence exists. However, this is not a subject that has has been specifically studied and Champix has been in use for smoking cessation for under 5 years so we may not have the final word on this.

Champix is a partial agonist of the nicotinic acetylcholine receptor subtype  α4β2 in the brain. That is its main area of action. It works by binding to this receptor without creating a full nicotine effect on the release of the brain chemical dopamine. The generic name for Champix is Varenicline.

Flucloxacillin and breast-feeding

Question:  Is it safe to take Flucloxacillin while breast feeding? The baby is two weeks old and only takes breast  milk. V. (UK)

Answer: Flucloxacillin is safe to use when breast-feeding. It is one of the broad group of drugs collectively known as Penicillins. You can use it and breast feed at the same time.

Pain above the pubic area in late pregnancy

Question:  I am 35+2 weeks pregnant and for the last 5 days i have had very sharp pains underneath my stomach(in the crease area above the pubic region), which is extremely painful, not just uncomfortable. Is  this a sign of engagement? C.S. (UK)

Answer: No; those symptoms are very unlikely to be due to engagement of the baby’s head. Engagement can sometimes produce significant discomfort but is certainly not a cause of pain. Even significant discomfort is not that common. The description of the degree of pain, the location and the timing is more suggestive of symphysis pubis dysfunction. However, I have too little information here to be certain of that. It is certainly worth contacting your midwife or even your local hospital about this.

Fear and adrenaline during labour

Question:  What is the effect of fear during prolonged labor? B.C. (Philippines)

Answer: Fear can potentially influence the labour process. The chemical adrenaline that is normally released when fear strikes (for any reason) has the effect of slowing down the contractions and in very high concentrations, it can theoretically at least, stop it altogether. In real life, adrenaline concentrations required to have such an influence probably never occur. So, to come back to your question; if a woman is terrified, that may have the influence of prolonging the duration of labour. It is however, quite difficult to establish whether ‘fear’ had influenced duration of labour in any individual case.

Excessive amniotic fluid at 20 weeks

Question:  I had an ultrasound done at 16 weeks and the doctor found a cyst that went away in the 18th week. Then on the 20th week of ultrasound he found an excess amount of amniotic fluid. I need advice on what to do. Should I have an ultrasound done or are these findings common? T. (USA)

Answer: You have not said where this cyst was. If it was an ovarian cyst, that is not uncommon at that stage of pregnancy and its resolution should be reassuring. ‘Excessive’ amniotic fluid is a different matter. It is rather unusual to find excessive fluid at such an early stage of pregnancy.

We have discussed potential causes of excessive fluid (polyhydramnios) here: Bear in mind that for a substantial proportion of cases, no reason for the increase is ever established and babies are perfectly healthy. However, for this to be manifest at 20 weeks is not common. With the little information you have given, all I can advise is that you arrange a repeat scan about 3 weeks after that last one. If the fluid is persisting at a higher than expected level, you will need to see a specialist to discuss appropriate tests.

Recurrent thrush

Question:  I am a 46 year old woman who has had 5 bouts of thrush in 5 months.  Last month I attended a local hospital who also diagnosed Haemolytic Strep B Infection.  Any information on the internet about this infection seems to be for pregnant women, but I'm not pregnant and was wondering what the implications of this infection are for me? I have now been referred to a Gynaecologist as I now have pain in the area where my ovaries are.  Can you please advise.  Am both demented with itch now for 5 months and desperate for some help. J.C. (UK)

Answer: Yes, recurrent thrush can be very distressing. The reason the finding of Haemolytic Group B Strep has not provoked any action is because it is not actually an ‘infection’. This bacteria is a normal resident of the vaginal canal. It does not require treatment nor does it cause any problem for the person carrying it. It only acquires importance when the person in question becomes pregnant. We have discussed that in the relevant section. Coming back to your current problem, what needs to be done is to confirm that the cause of your symptoms (?Itchy vaginal discharge) is, indeed, thrush. Vaginal swabs should do that. You will then need to have basic tests to rule out any underlying problem. Development of Type 2 diabetes can sometimes be the culprit. If all that is sorted and there are no related issues, recurrent or persistent thrush is treated using oral medication (Itraconazole 400 mg) which is taken for one day every month for a minimum of six months. It is very effective. Alternatives, both vaginal and oral are available. The wider subject of vaginal thrush is discussed here: My best wishes.