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Pregnancy Bliss | Reproductive Health Hub

Car seatbelt in pregnancy

Question: My husband and I were in the car this morning and he was parking.  He ran into the curb pretty hard and it jarred me.  I believe I was wearing my seatbelt in the correct position, below my belly.  I feel okay but don't know if something could be wrong with the baby?  What should I do? S.B. (USA)

Answer: When worn properly a car seatbelt is almost invariably protective to the pseatbelt in pregnancyregnant mother and baby, especially in the face of a significant impact. Even if incorrectly worn, the amount of force exerted in a sudden stop in a parking manoeuvre is unlikely to have an injurious effect on the baby in the womb. The cushioning effect of the amniotic fluid is pretty effective. Since you are feeling well and have had no symptoms such as persistent abdominal pain or bleeding, it is quite reasonable for you to be reassured. The main point remains the correct position of the belt. In such a case, there is really no need to worry.

Trying to conceive aged mid-40s

Question:  I am 44 yrs of age. I have had 3 pregnancies. No miscarriages. My last child was born in 1989, after which my tubes were tied. I am healthy, in excellent shape and would like to get pregnant. I have read my chances are slim due to my age. I am wondering if my health, active lifestyle, and previous "fertileness" increase my chances? I would of course have my eggs tested for abnormalities. ET's with livestock are so simple, even with older animals.  Why are we so much different I wonder? My mate incidentally is much younger and has had one healthy child. G. (USA)

Answer: It is all a matter of the biology of evolution. As a human female, you have been engineered over a course of millions of years to do certain things at a particular time of your life. The ‘reproductive age’ in human beings is currently routinely quoted as 15 - 45 years. I’m sure in the 16th or 17th century, when women (and men) routinely died in their 30s and 40s, such a quote would have appeared ridiculous. It is not beyond the realm of imagination that in the 25th century, the female reproductive age will be different, maybe 15 - 55. It may seem implausible now but that is the slow wheel of evolution for you.

The reality is that the modern woman has quite erratic ovulation by the time she has gone past her 37th birthday. What is more, a progressively larger proportion of her eggs are anomalous, increasing the risk of genetic and chromosomal abnormalities. It is not that a woman in her mid-40s can't have a child. It simply means her chances of spontaneous conception are progressively reduced and the chances of ending up with a child with significant abnormality is higher the older she gets. For the well known chromosomal disorder, namely, Down’s syndrome, your risk 21 years ago when you had your last baby was approximately 1 in 1400. At 44 years of age, that risk has already risen to 1 in 40. That is the reality of the situation. Since your tubes were tied, your avenue for getting a baby with your own genetic material will have to be through IVF, using your own eggs. That, of course, gives you a chance to have the embryos created tested for common chromosomal anomalies before being implanted. That is possible albeit at a monetary price.

No fetal movements at 19 weeks

Question:  Hey! I am 19 weeks pregnant but not feeling the baby..till few days back, my abdomen used to be heavy and was difficult for me,while changing the sides My gynaecologist advised to go for ultrasound after another another 2 weeks. White sticky discharge was also there. I’m taking meds for that too. Is everything ok? Had 2 miscarriages 2 yrs back. P.S. (India)

Answer: Iam not in a position to say for sure if everything is OK. However, there is nothfetal heartbeat machineing that you have described here that will cause undue concern. It is by no means unusual not to feel movements until you are over 20 weeks gestation. This is particularly the case with a first pregnancy. I am not sure why your doctor wants you to wait for two weeks to have a scan if you just want to be reassured of the fetal wellbeing. It would take only a few minutes to do a viability scan. Alternatively, you could have a doctor or midwife listen in using a Doppler instrument (pictured) which, at 19 weeks, should pick up the fetal heartbeats fairly easily. All in all I do not think you have described anything here that should worry you. Regarding the discharge, if it is your doctor’s opinion that it requires treatment then he/she is duty bound to tell you what exactly is being treated. The medication used should also be safe for use in pregnancy.

Since you did not give these details, I am unable to comment further on this.

Sterilisation reversal

Question:  Where do i go to see about having my sterilisation reversed privately and how much it will cost. I am 41 in June and need to know asap thank you. J.B. (UK)

Answer: You are right. Reversal of sterilisation is no longer available on the NHS throughout the UK. Anybody wishing to have this done has got to arrange it privately.

Many gynaecologists doing private practice would be able to offer this type of operation, the majority doing it as an open procedure. A few may offer to do this by keyhole (laparoscopic) surgery. This tends to cost considerably more. It is not possible for me to give you an exact figure of what it would cost.

It varies widely depending on where you are in the country and other circumstances specific to you. You are looking at anything from £3000 to £5000. For a surgeon who might be able to do this for you, the best person to contact is your GP who will point you in the right direction. Best wishes.

Inconclusive booking pregnancy scan

Question:  I’ve been told today that when i went for my first scan I’m now 11 weeks and 3 days. They also said the baby’s head is not formed properly and that i need to go back either tomorrow or Thursday to see a specialist just to confirm that is right but the lady said that she couldn’t get a perfect picture due to the way the baby was lying. Wondering if you could tell me what they do and what the specialist will do. Many thanks. K.A. (UK)

Answer: Normally, if the person performing a baby scan is unsure of what she is seeing, feels unable to conclusively tell if all is OK or is genuinely suspecting an abnormality, it is standard practise to seek a second opinion. This could from another ultrasonographer or a doctor (specialist) as has been done in your case. It appears a second opinion has been sought here for some reason. I would not want to second guess the reason for that. This is for the best and I hope it all turns out well for you and your baby. Best wishes.

Treating gingival disease in pregnancy

Question:  Which antibiotics can I use for pregnant women with gingival disease? Dr A. (Djibouti)

Answer: Like management of any infection in pregnancy, the  first consideration is safety. If there are resource constraints making it difficult to perform studies to identify effective antibiotics for the specific infection, the next best strategy is to use the safe broad-spectrum antibiotics. Since anaerobes cause over 75% of oral infections, Metronidazole is a good choice. Alternatively, you could use Co-amoxiclav (Augmentin) which is actually broader. If both these are unavailable, simple Amoxicillin may suffice for many patients. Another good option is Clindamycin.

Correct position of seatbelt in pregnancy is very important