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Pregnancy Bliss | Reproductive Health Hub

Anencephaly recurrence and prevention

Question: If first baby is anancephaly, does the second baby have the same risk? If yes, how can you prevent it?? B. (India)

Answer: Anencephaly recurrence is quite uncommon. The chances of this happening is roughly 4%. It means the chances of having an unaffected baby is 96%. The exception to this is when anencephaly is associated with a genetic or chromosomal disorder. In such a case, the recurrence is significantly higher at around 25%

Anencephaly is part of a group of conditions called neural tube defects (NTD). Like all other neural tube defects, risk of occurrence (or recurrence) of anencephaly can be reduced significantly by taking Folic Acid in the pre-conception stage and the first trimester of pregnancy. A dose as low as 400 mcg (0.4mg) of folic acid daily is sufficient for this purpose.

Threatened miscarriage; two previous miscarriages

Question:  I am 10 weeks pregnant but have been bleeding on and off. We went to the hospital and they detected a heart beat that was done at 6 weeks and again at 9 wks. They didn’t tell us why this is happening but its 90% chance i will go on to have a healthy baby. Last night my partner and i had sex and again this morning. i had a shower about 2pm, got dressed was sitting waiting to go out. I got up and went into the kitchen and a gush of blood came out, it was watery. I suffer from constipation and i think this is the pain I’m having. I know this is because i have always suffered from it. I had a miscarriage in july 09 and again in dec 09 now i hope this is not happening again. Please can you reassure me. H. (UK)

Answer: What you are going through is a threatened miscarriage. The doctors at the hospital could not tell you why you are bleeding because they don’t know. This is almost always the case. It is rarely possible to explain why miscarriage is threatening. Even when miscarriage occurs, particularly if this is in the early trimester, it is usually quite difficult to explain why it has happened. The only practical advice you can be given is that you should definitely refrain from penetrative sex as long as the vaginal bleeding is continuing. Your chances of weathering this storm and going on to have a healthy baby are as quoted at 9 out of 10 (90%). My best wishes.

Reliability of ‘Integrated Test’  

Question:  Hello there, I am 41 and am 19 weeks and 1 day pregnant. I got the results for the integrated test back last week and the odds of having an affected pregnancy came as 1:1600 - based on the NT, my age and the first and second trimester blood tests. My doctor says that the results are as good as can be, my risk is the same as that of an 18 year old pregnant woman. Of course it is reassuring as I didn't want to have any invasive tests done. Would you please tell me what you think of it? Many thanks. L.

Answer: I would concur with the views of your obstetrician that the results are quite good and should be almost completely reassuring for you. Just bear in mind that, on age alone your risk of having a baby with Down’s syndrome are around 1 in 80 to 1 in 85. By including all those other markers, this risk has plummeted by a factor of 20! By any measure, that should be reassuring and as good as you can get short of having an invasive diagnostic test. Enjoy your pregnancy and my best wishes.

Water birth for a first child

Question:  Since water birth is new in my country ( IRAN )and there is lots of concern in this regard , I would like to know if I could give birth to my first child in water. Is there any contraindication for giving birth to first child in the water?  R. (Iran)

Answer: A first pregnancy is not in any way a contraindication to a water birth. If everything is normal with your pregnancy and no potential risk factors have been identified, you can water birthcertainly have a go at a water birth. The important thing is to ensure you have all the appropriate professional support. Water birth is ideal for low risk pregnancies and that is why it is an option for those wanting to have the birth at home as well (picture, right). A first baby does not make the pregnancy high risk.

Emotional disconnect to the pregnancy

Question:  My daughter in law is quite concerned that she feels 'distant' and unreal about her pregnancy. It seems to bring her no interest or excitement. She would like to know if this is a recognised state of affairs. She is 27 weeks pregnant. J.B. (UK)

Answer: This is not that rare but is always a cause for concern. There is a whole lot of circumstances that can lead to this emotional disconnect to an ongoing pregnancy.

The practical thing for your daughter-in-law to do is to bring this to the attention of her community midwife immediately. She will then be referred to the appropriate specialist at her local hospital who will try to disentangle all the stuff that may have led to this state of affairs. It is vital to be aware that there is almost always an underlying reason and, surprisingly, this may not be immediately obvious to the prospective mother herself. She needs that professional help.

Vaginal discharge in pregnancy

Question: I am 20 weeks pregnant and experiencing some watery vaginal discharge for 3 days now and last night I had some thick paste like discharge. I went in to the hospital for a check, they told me the cervix is closed, baby is fine, the amniotic fluid is normal. Why am I then having this discharge, is it normal to have such a discharge when everything else seem fine? I. (Italy)

Answer: Your hospital doctors have done all the right checks and you should be reassured. Sometimes the ‘normal’ vaginal discharge is increased dramatically during pregnancy and this can cause understandable concern. Once a watery discharge is confirmed not to be amniotic fluid (not hard to do), you can and should relax. The “thick paste-like discharge”, if white, could be thrush, a very common development during pregnancy for which a single dose of Clotrimazole (Canesten) pessary is effective and safe.