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Pregnancy Bliss | Reproductive Health Hub

Cervical cancer (HPV) vaccine and miscarriage

Question: My  daughter who is 15 had the cervical cancer vaccine two months ago. She was not aware then that she was pregnant. She has now found out that she is 10 weeks pregnant. Is there a risk of miscarriage or problems for the baby? Should she have her follow up doses of the vaccine and if not what happens in the future? Thank you. K.M. (UK)

Answer: It so happens that findings of a brand new study have just been published in the British Medical Journal (March 2, 2010) on the subject of the HPV vaccine and risk of miscarriage. The results from the study show that there is no evidence that administration of this vaccine does not increase risk of miscarriage. It is not possible to state with absolute certainty whether there could be other effects on the baby in the womb. However, it is reasonable, by the nature of the vaccine to assume that adverse effects are unlikely. Like all forms of active vaccinations, administration during pregnancy is not recommended. This is purely precautionary. Your daughter’s other doses of the vaccine will therefore be cancelled now she is known to be pregnant. It is likely that the schedule will start from scratch once she has delivered. The HPV vaccine to protect against cervical cancer is showing tremendous promise since its introduction a couple of years ago. It is important that she gets vaccinated. The subject is covered in more detail here:

Risk of conception in the absence of penetration

Question:  I already finished my first sex, now I’m worried about pregnancy! Well, let me explain, my boyfriend doesn't enter his penis but he try to enter penis to me without condom, it touch my vagina couple of times, then he use condom & have finished our sex, now I’m really afraid coz at da beginning his penis touch my vagina, does it make me pregnant? Plz somebody give me answer with details. A. (UK)

Answer: Whilst it is not impossible, it is really quite unlikely that a pregnancy could result from a sexual encounter that you have described. It is true that sperm is produced even before orgasm and ejaculation. That, in theory, means it is possible for a woman to become pregnant as a result of her genitalia coming into contact with a penis of a man who is highly aroused (and therefore passing sperm). In reality this rarely happens. On balance of probabilities, it is therefore unlikely that you could have conceived as a result of this sexual encounter. You will be well advised in the future to ensure no unprotected genitalia contact as an effective protection against unplanned pregnancy as well as sexually transmitted infections. This is just sensible and it avoids unnecessary anxiety like in this case.

Girl under 10 year old: Risk of pregnancy

Question:  My daughter is not going to be 10 until August (in 5 months). I have just found out that she is sexually active and I am scared to death she is going to end up pregnant. Talking to her is difficult. My question is, what are the chances of a 9 or 10 year old girl getting pregnant and, secondly, what can I do as a parent to prevent this from happening? P.N. (UK)

Answer: It is quite possible for a girl of nine or even younger to get pregnant. Reports of children of this age giving birth have appeared in the news media from time to time and even though uncommon, conception for girls under 10 are by no means rare. Pregnancy is a physiological process. If a girl starts having periods, by implication it means she is producing eggs (ovulating). If this girl becomes sexually active, she could become pregnant just like any other woman in the child-bearing age.

If you are sure your daughter is sexually active and communicating with her is a challenge, you could get help from your GP or, alternatively, try to get her to be seen at a Brook clinic which cater for young people regarding their contraception and sexual health needs. Here, she will have an opportunity to discuss, in a completely non-judgemental way, her options for effective contraception. Just as important, she will be counselled on practical ways of preventing sexually transmitted infection. You should also keep probing to find a way to get through to her because, let’s face it; nothing is as effective as loving parental guidance. Good luck.

Fetal kidney dilatation

Question:  What is the significance of renal pelvis dilatation in pregnancy and what effect will this have on the baby? Z.P. (UK)

Answer: An ultrasound scan of the baby in the womb sometimes shows that one (or rarely both) kidney is somewhat distended with fluid. This will be described as ‘renal pelvis dilatation’.

This tends to be mild and usually non-progressive. In the majority of cases, the cause is never established and in fact the dilatation resolves spontaneously either before the birth or within weeks of delivery.

Occasionally an underlying kidney problem is discovered that may require treatment. This is uncommon. In any case, a significant renal pelvis dilation is always followed up by specialist children’s doctors (paediatricians) to ensure there are no persisting problems and that kidney function is normal. For the majority, this is the case.

About 1 in 100 babies found to have renal pelvis dilatation in the womb are found to have a serious kidney condition where one or rarely both kidneys are significantly enlarged with multiple cysts. This condition is better known as Multicystic Dysplastic Kidneys (MCDK).

MCDK is a serious congenital condition which affects boys more than girls. When both kidneys are affected, the condition is not compatible with life. This is rare. Overall, MCDK affects 1 in 2400 live births.

Speculum vaginal examination

Question:  I’ve  received an invitation from my GP to go for my smear. This will be my first one. The leaflet mentioned ‘speculum insertion to take the smear’. What is ‘speculum’ and where does it go. How big is this? Can somebody please give me details because I really want to have my smear but this speculum is really freaking me out!! Thanks. A. (UK)

Answer: It is standard practise to use an instrument called a ‘speculum’ when taking a cervical smear. This could be a disposable plastic or the re-usable metallic one. Either is similarly sspeculum examinationhaped and will do the job satisfactorily. The standard speculum has got two curved blades which, when closed, form a hollow tube, narrow at the tip and widening gently towards the ‘stem’. This tubular instrument is inserted gently whilst closed. Once fully inserted, it is gently opened to reveal the neck of the womb (cervix). In effect, it facilitates access to the cervix to enable the taking of the smear. Yes, it might be uncomfortable but it certainly shouldn’t be painful. All going smoothly, from insertion to removal should not take more than a minute. Yours is an understandable fear of the unknown. Please rest assured that the nurses and doctors doing this are well trained in using this and in fact, it is one of the easier procedures that they routinely perform.

An open speculum inside the vaginal canal. Insertion is done with the speculum closed. Withdrawal likewise.