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Pregnancy Bliss | Reproductive Health Hub

Rhesus sensitization and amniotic fluid volume

Question:  Can reduced amniotic fluid in pregnancy be caused by rhesus sensitivity? I'm Rhesus Negative and 30 weeks pregnant. Which tests can i take to check my Rh antibodies? B. (Nigeria)

Answer: If you have been found to have possible reduced amniotic fluid on an ultrasound scan or even on examination, this is unlikely to be due to rhesus sensitization. If you have access to appropriate facilities, your doctor can check whether, indeed, you have anti-D antibodies. Checking for presence or absence of anti-D Rhesus antibodies is a straight-forward test that is available in most hospitals including those in low resource countries.

If presence of antibodies is confirmed, it may be important to quantify them and that will be an integral part of the management of the rest of the pregnancy and might influence the timing of the delivery. Can I also state that, if this is your first pregnancy and you have never received a blood transfusion, then it is virtually impossible for you to have Rhesus anti-D antibodies. If you have had children before then a theoretical possibility of carrying these antibodies exist. They won’t, however, be the cause of reduced amniotic fluid.

Chest infection, antibiotics and breast-feeding

Question: I have a chest infection, i still breastfeed my baby. Is this harming my baby? What kind of antibiotics should i take? Is this safe for my baby? Thank you. L. (UK)

Answer: Neither a chest infection nor its treatment preclude breast-feeding. You can and, whenever possible, should continue to breast feed. Of-course, the type of antibiotic is important as some may be unsafe and others can change the taste of milk putting the baby off feeding. This subject of antibiotics and breastfeeding, including the types that can be safely taken, has been covered in more detail here:

Exposure to a gas-leak in early pregnancy

Question:  I spent two hours having lunch at a restaurant that had a gas leak. The smell was quite strong, people were telling the waitresses to check it but everybody stayed and the main door was kept open at all times. I left the restaurant with a headache that went away an hour later or so. I'm wondering if inhaling gas for two hours could have caused any harm to my unborn baby, I'm 4 weeks pregnant. Thank you. M. (Mexico)

Answer: It is probably safe for me to assume that you are referring to ‘natural gas’; the type commonly used for cooking and heating. This gas is mostly Methane (up to 90%). There is no known adverse effect from prolonged exposure and inhalation of this gas during pregnancy.

Cystic Fibrosis sufferer trying for a pregnancy

Question:   my sister in law-to-be has cystic fibrosis. She is 19 and her partner is 38. They are trying for a baby and she has been told that she would need scans about every two weeks and would have to be 'knocked out' completely and have a c section delivery. This she's, for want of better words, quite happy with. The problem is that she has been told for every active sperm her body will reject another. Due to ages and CF this limits things. Also she's told she has to gain a stone in weight before the doctor would condone a pregnancy. This part is proving difficult she doesn't seem to be able to gain any weight. Can someone give any advice or ideas to help my sister get the baby she is already so devoted to? A.K.(UK)

Answer: Your sister in law’s doctor appears to have covered the bases really. If one has to summarise the advice to a cystic fibrosis sufferer planning a pregnancy it will take the form of ‘ensuring she is in the best possible physical shape’ at the outset. There are definite red lines. If her lung function is already significantly compromised, pregnancy should not be considered. If complications such as pulmonary hypertension have already set in, pregnancy could be fatal to the mother. There is one apparent advice she has been given that I do not understand. You say she has been told that “for every active sperm her body will reject another”. I am not sure what is meant by this. All in all, it is vital that her ambition to become a mother does not blind her to the real challenges that are unique to CF sufferers. Ensuring she is in an optimal nutritional state is one of the important pre-requisites. You can see more detailed advice for CF prospective mothers here: My best wishes to her.

Using Ciprofloxacin in very early pregnancy

Question:  My wife had taken ciprofloxacin for 6 days while she was pregnant 3wks. Now she is on the 5wks ultrasonography shows pulsatile sac 14 mm. Please I need advice to terminate or not regarding teratogenic effect. H. (Egypt)

Answer: I can understand your concerns but there is no need for panic. Ciprofloxacin belongs to a group of antibiotics called fluoroquinolones.

The advice is to avoid (or where absolutely necessary, use with caution) in pregnancy. The advice is based in observed joints developmental problems in animals exposed to this antibiotic in the womb. Several studies have shown that most babies exposed to this antibiotic, usually inadvertently, before the mother is aware she is pregnant have been OK. I would certainly not consider pregnancy termination simply on this basis. My best wishes.

Estimated fetal weight at 27 weeks gestation

Question:  I was informed by my obstetrician that my baby weighs only 1.2kg at 27 weeks gestation. Is this low birth weight? What can i do to improve the baby's weight? What foods should i concentrate on? Thank you. B. (Nigeria)

Answer:  The average fetal weight (50th centile) at 27 weeks gestation is 875 grams. 1.2kg is an average weight of a fetus at around 29 weeks. The scan is therefore showing your baby to be above average (but still within the normal range). You can relax.

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