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Pregnancy Bliss | Reproductive Health Hub

Severe prematurity and survival

Question:  Why can't a baby born at 21 weeks survive? Any baby survive so far born at 21 weeks? J. (Singapore)

Answer: 21 weeks is, strictly speaking, not a delivery but a ‘late miscarriage’. The reason why ‘delivery’ at 21 weeks gestation, survival of the baby is virtually impossible is because many vital organs, particularly so the lungs, are extremely underdeveloped that they are completely non-functional. Remember, unlike the heart, kidneys or liver; lungs don’t start to function until after the birth. Their maturity is therefore delayed and babies born before at least 26 weeks struggle and those born before 23 weeks cannot be expected to survive. There has been no recorded survival of a baby born at 21 weeks anywhere in the world, nor would this be expected.

Trying to conceive after a miscarriage

Question:   Hello. Two weeks ago my husband & I tried to get pregnant. It would have been our first time ´trying´. We´re both 35 years old. About 7 days later I got had a blood spot. A good sign, thought it was ‘impregnating [implantation] spot´. During the following week I noticed changes for myself, like an increase in my appetite & decrease in my energy levels. My husband & I then had intercourse a few days ago, and the next morning I had bleeding (very red blood) and a blood clot. Now, 2 days later, I got my period & the timing & flow of it seems normal. I´m assuming that this initial blood was an early ´miscarriage´. My question is: how soon is it safe to try again? Is this month too early or should I wait at least another month before trying again? Thank you. M. (Brazil)

Answer: Unlike you, I am not at all sure you were ever pregnant in this cycle. Your period arrived bang on time and the symptoms you describe are so non-specific that I think it will be a stretch to describe them as pregnancy symptoms. In any case, were we to assume that you were indeed pregnant, there is absolutely no problem with trying to conceive straight-away. Following a miscarriage, even a late one, the body is physiologically ready to carry another pregnancy within 2 - 4 weeks and that is why, for many, the next period arrives on time, usually preceded by an ovulation 2 weeks earlier.

‘Casual’ use of heroin in pregnancy

Question:  Helloo, I’m pregnant now one and half months, I m not addictive from heroine, but I use it sometimes, not regularly. How can it affect my baby? B. (UK)

Answer: I will be frank with you. You are making a big mistake. There is no such thing as a casual use of these drugs. Presumably you are injecting the heroin. I don’t need to tell you about the risks associated with this method of administration. You can dismiss this by saying you are taking all the appropriate precautions but that is a fallacy. Also, you should be aware that, by virtue of being illegal, purity cannot be guaranteed. When not pregnant, it is your life. Pregnant means you have to be responsible for another human being so my plea is that stay away from the heroin. You have said yourself that you are not addicted so you are using it as a matter of choice and not because of dependence.

Alpha thalassaemia and pregnancy

Question: Does alpha thalassaemia carrier mean the baby will be born with sickle cell disease? B. (UK)

Answer: Alpha thalassaemia is nothing to do with sickle cell disease. These are two distinct conditions with completely different issues to contend with during pregnancy, both for the mother and the baby in the womb. Since your concern is about alpha thalassaemia, I will direct you to the appropriate section with the information you need. Just click here:

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:

Intact hymen

Question: Am 28 years old.  I found a pic for an intact hymen in one of your answers to a girl asking about restoring virginity,, and i have the same shape of hymen and i thought i lost mine because a friend of mine told me that the hymen is not like what i have and it must cover all the vagina hole and she show me some photos. So what am asking which one is true as i said mine is like the one in your website not like the other one. I am so worried and i really need your help to get out from this nightmare. M

Answer: I am afraid your friend has misled you. A normal intact hymen never covers the entire vaginal opening. Think about it: If it did so, how will a girl starting to have menstruation pass the blood?

The hymenal skin is also not usually uniformly even as may be presented in some drawn illustrations. In real life it tends to be slightly irregular. There is a condition that affects a small number of girls where the hymen is completely covering the vaginal opening. That is what is known as imperforate hymen. With this, the affected girl’s periods will not happen. Instead the blood is retained in the womb and vagina and in due course she may start getting cyclical lower abdominal pain which will lead to seeking medical help. The diagnosis is made and the imperforate hymen is surgically opened to release accumulated menstrual blood. Below, I have another picture of an intact hymen as well as a picture of an imperforate hymen (inset).

Imperforate hymen Intact (virginal) hymen

Intact (virginal) hymen

Imperforate hymen