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Pregnancy Bliss | Reproductive Health Hub

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With a blighted ovum, the scan shows an empty sac like this

Dilated renal pelvis (baby)

Question:  I am 21  weeks pregnant and i had my scan last week. I have been told that my baby’s right kidney has a water. They booked me another scan for 34 weeks. Is there anything i need to worry about? M. (UK)

Answer: I suspect what has been shown on the scan is what is described as a 'dilated renal pelvis'. This is a fairly common finding and it is rarely serious. The actual degree of dilatation is also important. A scan in the third trimester, as has been arranged in your case, is mainly for reassurance to see if this has resolved. If this is found to be persistent or increased, then a paediatric review for the baby will be arranged after the birth. This is not always necessary and, in the main, you don't need to worry.

Vaginal bleeding in very early pregnancy

Question: Hi, i recently found out i was  pregnant i have started to bleed (like a really light bleed like brown discharge) along with dull period-like pains in my lower stomach. I am too early for the pregnancy to be seen on scan but my hormone in my bloods are still rising daily. What do you think this could be? H. (UK)

Answer: Such symptoms as you describe mean that we are looking at a threatened miscarriage but also the possibility of an ectopic pregnancy. It is important that the ongoing monitoring of your blood pregnancy hormone (beta-hCG) is maintained until clarity is obtained. This will normally be checked every other day, shorter intervals are not very useful. Getting clarity could take anything up to 2 weeks but in most cases shorter than that.

Vaginal birth after caesarean section (VBAC)

Question: I am pregnant with my 2nd child now i had an emergency c section with my first child i have been told i have a 70-30% chance of having a normal birth but im not sure it is right for me, i would like another c section but can i have one if i have been told that i can have one normally? K.H. (UK)

Answer: It is certainly the case that when there is no complication with a subsequent pregnancy, it is strongly advised that a mother should aim for a vaginal delivery. This advice is based on the proven fact that a vaginal birth is safer for both mother and baby. Each person is, of-course, assessed for their individual suitability for this strategy and for some, a repeat caesarean section may be the recommended option. Ultimately, the decision is the mother’s (in the UK). Having said that, I would advise that you seriously consider a vaginal birth unless there is a problem in your current pregnancy.

An empty gestational sac

Question:  My sister is 8 weeks pregnant but has been told by a scan woman that she is only 6 weeks and that there is no baby in the sac. Is this normal as she has not experienced any bleeding or pains.The sac has grown in a space of a week could you help please? C.B. (UK)

Answer: If the scan shows an empty sac which is smaller than it should be by her dates, this will be strongly suggestive of a blighted ovum (anembryonic pregnancy) explained here:

It is not unusual for a blighted ovum to be discovered during a routine booking scan where there has been no symptoms. I hope your sister has another scan planned, maybe within two weeks of the original one, to ensure the findings and diagnosis are correct.

Dandy Walker Syndrome risk

Question: I was wondering if you can help......I tragically decided it was best to terminate my pregnancy at 23 and half weeks due to 'Dandy-walker' syndrome and coartation of the aorta.  My partner and I have been to specialists/genetics,etc since I am epileptic to find the cause of our daughter's major problems.  My epilepsy specialist thinks a lot of the problems were due to medication I take-Topiramate, 150mg twice daily.  I have slowly came off this since I wanted to lower the risks of this ever happening again.  However, my partner and I are scared to try for another pregnancy without knowing risks of this happening again.....can you give us any answers? G.M. (UK)

Answer: I am sorry to hear of your recent baby loss. Dandy Walker syndrome is clearly one of the most serious congenital abnormalities that can affect a baby in the womb. The presence of coarctation of the aorta is not surprising since cardiac conditions are some of the commonest abnormalities associated with this syndrome.

I cannot say for sure whether Topiramate is to blame for this particular development but your specialist may well be right in this assumption. No anticonvulsant is completely safe to take in pregnancy but Topiramate (also known as Topamax) is one of the more teratogenic of this group of drugs. Your move to wean yourself off this medication is clearly the right thing to do.

Even if events dictate that you need to go back to an anticonvulsant medication, I would strongly suggest that you are tried on one of the relatively safer anticonvulsants in pregnancy. It certainly should not be Topiramate.

Your being epileptic means you have a slightly higher risk of fetal malformation compared to the general average of 3%. This is, even without being on medication. However, the chances of having an unaffected baby is well over 95%. One cannot quantify the actual risk of Dandy Walker syndrome recurrence in the absence of an identified risk factor for you as a couple. I can, however, confidently state that such a risk is very small indeed. That is all that one can honestly say without engaging in speculation and guess-work.

‘Botox’ injections for vaginismus

Question: Hi, I was just wondering if you knew where in the UK I could get someone to give me botox injection for vaginismus? N. (UK)

Answer: It will be a mistake for you to go directly shopping for a particular remedy for a medical problem. You may have the wrong diagnosis and it may not be the right treatment for you. This type of condition is very frustrating and distressing but it is my honest opinion that you should  follow the normal channel to get a solution. Your first stop should, therefore, be your GP. They may not be able to offer you a referral to an NHS specialist but they they are best placed to advise you on whether it is right for you and where you can get it from.