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Pregnancy Bliss | Reproductive Health Hub

Contact Answers In the News Hot Topics

Trying to conceive after a miscarriage

Question: How long should one wait to conceive again after a miscarriage(missed)to have a successful pregnancy? A. (India)

Answer: Most miscarriages are due to random genetic or chromosomal disorders. They, therefore, do not influence what happens in a subsequent pregnancy. Whether one tries within a month of a miscarriage or after an interval of several months, it does not make any difference in the chances of a successful outcome. You can never guarantee yourself a successful outcome when embarking upon a pregnancy. However, the balance of probability for most women favours a successful outcome after a miscarriage. The  length of the interval in between is irrelevant.

Partial Monosomy 15: Prader Willi Syndrome (PWS)

Question: What’s monosomy of chromosome 15? Does a missed abortion occur due to this? Does this happen again in next pregnancy? A. (India)

Answer: There is a condition known as Prader Willi syndrome (PWS) which is caused by partial deletion of Chromosome 15. In other words, part of chromosome 15 is missing. That is why it is also descriptively called ‘Partial Monosomy 15’. Prader Willi Syndrome is very rare. An infant born with this condition will be characteristically quite floppy, with poor muscle tone (hypotonia). Other problems are observed soon after. These may include difficuty establishing respiration, poor feeding (and therefore failure to thrive), excessive sleeping etc, The child will also have intellectual development delay and delayed milestones in general. In later childhood, obesity is a prominent feature.

Partial Monosomy 15 is not a known cause of miscarriage but mothers who have had these children have been observed to have a higher than average rate of late miscarriage. As mentioned earlier, Partial Monosomy 15 is rare and chances of recurrence are rarer still.

On the other hand, Monosomy X, which is called Turner’s syndrome, is the commonest known chromosomal abnormality cause of miscarriage. 99% of pregnancies affected by this chromosomal aberration end in miscarriage. As the name suggests, with Monosomy X, one X chromosome is missing. It is therefore described as 45X0 (instead of the normal 46XX for a girl).

Persistent bleeding in early viable pregnancy

Question: I am 8 weeks pregnant and have been bleeding for a week already.  Had 2 scans and everything seems to be fine but the bleeding won't stop. C. (UK)

Answer: A lot of the time, bleeding in early pregnancy cannot be fully explained. It may not be possible to know why you are bleeding and when this is going to stop. Two scans, presumably several days apart, showing a viable pregnancy is a very reassuring situation. However, as long as vaginal bleeding is still continuing, that has got to be regarded as threatened miscarriage. That means, the close surveillance that your doctors have kept in place will need to continue until there has been a resolution. Just remember, as a guide figure, roughly 90% of all cases of threatened miscarriage resolve successfully.

Ventouse delivery and subsequent speech delay

Question: My 3 year old grandson has a speech delay although his understanding of language is good. Could the ventouse delivery have had an effect on the brain as he had a huge bruise/swelling on his head after the delivery and was kept in the Special Care Baby Unit for a week after his birth? B.L.(UK)

Answer: It is very difficult for anybody not in possession of the full clinical details of what transpired on the day to answer that question. Anything I say here will be nothing short of wild speculation.

As a general statement I can say it is exceedingly unusual for a ventouse to cause any sort of brain injury. That is, unless it is employed on a baby that is significantly premature.

A swelling on the scalp, also called a chignon, is a common aftermath of ventouse delivery. It is nothing more than oedema of the scalp skin and usually resolves in about 36 - 72 hours. Some degree of bruising could last for a while longer.

Delayed menstrual period after a miscarriage

Question: I had a miscarriage and D&C six weeks ago and have still not received my period. Can you please tell me how long does it take for your period to come back after a D&C is done. Kind Regards. K. (UK)

Answer: It usually takes between 4 and 6 weeks for periods to resume after an early trimester miscarriage. This of-course depends on whether the woman's periods were regular in the first place. In situations where the person's cycles are normally irregular or longer than average, this interval could be longer than that. If your miscarriage was six weeks ago (and you have regular cycles), I would expect you to have a period any time now. A D&C does not influence timing of resumption of menstruation.

Another scenario which cannot be discounted is, if you have resumed having unprotected sex, it is not inconceivable that you might be pregnant. Conception so soon after a miscarriage is not unknown bearing in mind that you can ovulate within 2 - 3 weeks of a miscarriage.

Spiramycin use in pregnancy

Question: Is it safe to use Spiramycin antibiotic for an ear infection during pregnancy? S.P. (Egypt)

Answer: There is no evidence of adverse effect from Spiramycin use in pregnancy. However, this is not the same as saying that it is definitely safe. In any case, my main concern with your issue is the fact that you are proposing to use this antibiotic for "an ear infection". Spiramycin is an antibiotic that is used almost exclusively for toxoplasmosis in pregnancy. There are so many other effective alternatives for an ear infection that I am left puzzled as to why Spiramycin has been recommended or prescribed in your case. This is a matter that you can take up with your doctor.

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chignon after ventouse delivery

A swelling at the top of the head after a ventouse delivery can look scary but it is, in most cases, nothing but oedema of the scalp skin. It resolves in  2 or 3 days. There are no residual effects from it.