Question: What age of pregnancy is said to be safe not to expose measles infection? Is 15 weeks safe? L.A. (Philippines)
Answer: Measles infection in pregnancy does not have a direct adverse effect on the baby in the womb. However, the baby is in potential peril because a measles infection for the mother can lead to a serious disease which may provoke a miscarriage or preterm labour and delivery. In most parts of the world the majority of women in a child-bearing age (15 - 45) are already immune to measles, either through vaccination or a previous infection. As such, an exposure to measles would not affect them or their unborn baby.
Question: What are the medication for migraine headache? M.N.H. (Djibouti)
Answer: I am going to assume you are asking about medication used for migraine during pregnancy. Migraine is not uncommon during pregnancy simply because women are more affected than men by a factor of 3:1 and the age group most affected is 25 - 45 years. However, it is also true that, during pregnancy, rates of migraine attacks drop by about 50%. The commonly used medication for migraine are Ergot derivatives which, because they are non-selective 5HT1 agonists, cannot be used during pregnancy. The safest medication to start with would be the humble Paracetamol (Acetaminophen). This may not be very effective but is, realistically, the best there is that is completely safe. Sumatriptan, better known by brand names Imigran and Imitrex, is a selective 5HT1 agonist and is a very effective medication for controlling migraine. Its use in pregnancy remains rather controversial. There has been no hard evidence of specific adverse effect to babies exposed to Sumatriptan during pregnancy but still its safety cannot be absolutely guaranteed. Many experts are of the opinion that if a mother has debilitating migraine attacks, Sumatriptan can and should be used but to avoid using it in the first trimester.
Question: Hi, my partner has found a breast lump which after a biopsy the doctor say it is pre-cancerous. They have offered to operate immediately. The problem is, she is 22 weeks pregnant and we have been warned there is a small chance surgery may provoke labour. The obstetrician says in fact if that were to happen the baby is unlikely to survive. We have discussed the possibility of postponing the operation for a few weeks to give the baby a chance but the surgeon is not at all happy about this. The doctors have been very good but the decision on our part is proving really difficult. What is your opinion? Thanks. P.R. (UK)
Answer: It would be monumentally presumptuous of me to pretend to know better than the specialist treating your partner. As a general statement, about 1 in 10 of these lumps labelled pre-cancerous by a needle biopsy, on total removal and analysis will be found to be malignant. In pregnancy, speed is particularly important because of the increased vascularity. This increases the risk of early spread and that would be the reason why your partner’s surgeon is anxious to get on with the surgery, just in case. If it is any consolation, the risk of labour ensuing as a result of this type of surgery is less than 1%. My humble view from the distance is that your partner should listen to her surgeon’s advice. A lot may hinge on this.
Answer: I am going to assume that you are pregnant hence your concern about safety of these products. ‘Fiery Jack’ preparations contain four different active ingredients. These include the pepper extract called Capsicum oleoresin. This is also known as ‘Capsaicin topical’. It is not absolutely clear whether this is safe to use in pregnancy and, like in all such situations, the standard advice is to avoid. It is also doubtful whether this could really help in pregnancy-related back pain.