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Pregnancy Bliss | Reproductive Health Hub

CTG before caesarean section

Question:  Is a CTG necessary 2 days prior to giving birth through a C- section? S.T. (Kuwait)

Answer: A CTG should be done only when there is legitimate concern for the baby’s well-being. A planned caesarean section is not an indication for a routine CTG.

Loss of one twin in first trimester

Question:  i am in my 8th weeks of pregnancy. I had a TVS scan, and it shows that am pregnant with twins, both grow with fetal pole, but at 6 weeks only one heartbeat was found. A few days ago i had spotting, i went for another scan, the one with heartbeat, doctor said that it is growing well, but the other is not. Please advice me what i can do. Do you still think that the other one can till have heartbeat or not, wether it will affect the one with heartbeat. Thanks. A. (UK)

Answer: This must be a time of considerable anxiety for you and that is completely understandable. The fact of the matter is, loss of one twin in the early stages of pregnancy is not at all uncommon. There are a lot of pregnancies which start off as twins where one either dies or is actually miscarried well before the end of the first trimester. Loss of one twin at such an early stage does not normally imperil the surviving twin. Chances of your surviving twin to continue and thrive normally to term are excellent. You do not need to do anything. My best wishes.

Maternal death soon after childbirth

Question:  My friend has died immediately after giving birth to a very healthy baby. When the cause was checked the doctor said she was anaemic. It was a very sad story because everyone is wondering for all the 6 hours she was in labour nobody noticed this. If you looked at her hands and eyes they were purely white. In this case do you sue the doctors and hospital or what is the way forward because I believe this was a very preventable death. The baby is okay but we buried the mother. Very sad story i would not want it to happen to any woman out there. J.M (Kenya)

Answer: A very tragic story. Unfortunately, this scenario is repeated on a daily basis several times in many parts of the developing world. Most of such deaths are definitely preventable. You have said that your friend was found to be anaemic. I take it this was not detected during pregnancy before she went into labour or is it that she lost a lot of blood during delivery? In any case, it appears that you and your friend’s family need to get proper answers as to what transpired. My advice is that you should seek a formal meeting with the hospital administration to seek a proper detailed explanation as to the care she received and how she ended up losing her life. If you feel the explanation is unsatisfactory or does not seem to add up then you could consider legal action. The hospital is responsible for the care and if you are going to go the route of suing, then it is the hospital that you will sue. My sincerely condolences to you and your friend’s family.

Labor after a vaginal examination

Question: Would it be possible that a somewhat rough internal exam bring on labor. I am 3 days past due and felt sore and had trouble walking after my exam. a few hours later i started  having bloody show. C. (Canada)

Answer: No, a vaginal examination, however conducted cannot provoke labour. Even with a membrane sweep will only bring about labour in a quarter of all women who have it and that is in 48 hours of having this. Vaginal examinations can be fairly uncomfortable at such a late stage of pregnancy.

Treating Group B strep ‘infection’

Question: How long does it take for the medication to take affect to clear group b haemolytic strep. I’ve been prescribed phenoxymethylpenicillin. N.S. (UK)

Answer: Phenoxymethylpenicillin and in fact any other type of penicillin is very effective against Group B haemolytic strep. Effect is immediate. I am not sure why you are having this treated as this is not usually done. The bacteria is a ‘normal’ resident of the vaginal canal. Antibiotics given during labour are meant to protect the baby. The mother who carries the bacteria cannot be harmed by it. Re-colonisation of the genital tract after ‘treatment’ is quite common. There are more details on the subject here:

Cocaine use early in pregnancy

Question: I took cocaine and i didn’t know i was pregnant. I stopped when i found out but I’m worried i have harmed my baby. K. (UK)

Answer: Cocaine use in pregnancy is almost invariably bad news for the baby. The good news for you is it appears once you found out you were pregnant, you stopped using the drug. At least that is the impression I get from your details. This means you have averted the enormous risks that your baby would have otherwise faced. These include a much higher risk of growth restriction, stillbirth, preterm birth, placental abruption and even after the birth, a much higher risk of cot death.

It is true that cocaine abuse especially in early pregnancy has been associated with increased risk of congenital anomalies especially those of the skull, heart and urinary tract. Hopefully your (apparently) casual and limited use has not affected your baby and your 20 weeks anatomy scan should be able to give you peace of mind on this. The most important message here is that you should not be tempted to use the drug again particularly so while still pregnant.

Difficulty conceiving

Question: Hi there; I’m 23 yrs and engaged. My fiance and i have been trying to have a baby for a year but until now nothing is happening. I just miss my periods for a month only and everything will be back to normal, and even when i get tested the result comes negative. My question is am i not fertile because my fiance have a baby from a previous relationship and i have never used any contraception or any pills. Is there anything wrong with my womb ? Please help me; your advice will be appreciated. Thank you. F. (South Africa)

Answer: OK. The first thing you need to know is that difficulty with conception can be due to a wide variety of causes. It is simply not possible to speculate on what might be the matter in your case just on the basis of the information you have provided. If you have been actively trying to conceive for 12 months without success, the best advice I can give you is to arrange to see a specialist gynaecologist for a thorough review of all the factors to see if a problem can be identified.

Difficulty with conception could be due to erratic or even absent ovulation, presence of diseases like endometriosis, blocked fallopian tubes or a ‘male factor’ (on the part of your partner). Remember, even if a man has had a child from a previous relationship, something might have happened since to affect the quality or quantity of his sperm. It is also entirely possible that there is actually nothing wrong with either of you and this is just a delay in conception.

You have hinted in your question that sometimes you miss your periods without actually being pregnant. Erratic periods can be one of the features of polycystic ovarian syndrome (PCOS) which can sometimes be associated with subfertility. We have discussed this condition is more detail here and you may wish to read this to see if it may apply to you. In the end, a review by a specialist may be inevitable. Best wishes.