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Pregnancy Bliss | Reproductive Health Hub

Measles exposure in pregnancy

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.

Treating migraine in pregnancy

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.

Pre-cancer breast lump during pregnancy  

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.

Fiery Jack cream for backache (in pregnancy)

Question: Hi there; I suffer with terrible backache is it safe to use muscle or heat rub such as fiery jack etc? J.R. (UK)

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.

Heavy vaginal bleeding at 14 weeks gestation

Question: I had a heavy bleeding but ultrasound scan revealed that the heartbeat was fine and that the baby was fine too (at 14 weeks). Bed rest was then recommended after which further scan will be done, please what is the likelihood of miscarriage not occurring? A.T. (Nigeria)

Answer: Yes, that is threatened miscarriage. The recommended bed rest may reassure you and if you prefer this, by all means have it. However, bed rest will not make any difference to what happens to the pregnancy. This is old school management with no place in modern obstetric practise.

With regard to the likelihood of miscarriage not happening, that is roughly 90%. My best wishes.

Am I pregnant?

Question: I feel nausea and gassy and abdominal cramps. My ovulation was on 11th of April (six days ago). I had conception all days after that. Am i pregnant? E. (United Arab Emirates)

Answer: I have got to clarify a few things: You say you ovulated on the 11th. I don’t know how you know this. If it is by a test kit, you need to know that these tests can be strongly suggestive of ovulation but they are not foolproof.

You also say, you had “conception all days after that”. I guess you mean you had sexual intercourse. The bottom line is, the symptoms you describe cannot have anything to do with a pregnancy. Even if you conceived, the symptoms cannot have started as it is far too early for that. Neither a blood test nor a scan can answer this at this stage. The best thing to do is to wait and see what happens when your period is due. If it does not happen, that will be the time to do a pregnancy test.

Post-coital vaginal bleeding

Question: I've had vaginal bleeding, but only when my husband and i have sex and i cramp afterward. I've had a urine test and a blood test done and they both were negative, but i feel nauseous in the mornings. Could i still be pregnant and it's just too early to show up on the test? We use protection but he's had a few break on us and he pulled out when he felt it break. Could i get pregnant from the precum? T.G. (USA)

Answer: You have not said when your proper period was or whether, indeed, you have actually missed a period. I think if the tests, especially so the blood test, have been negative, it is most unlikely that you could be pregnant. As a separate response to the other part of your question, yes, the secretions produced before actual ejaculation do contain spermatozoa. It is therefore possible to get pregnant as a result of these found their way into the vagina even without actual ejaculation. I also would like to point out that the occurrence of bleeding after sex, however light it might be, needs to be looked at. This type of bleeding is more often than not cervical in origin. At the very least you should have your cervix examined. This is, even if you are up to date with your smears.