Question: can a 20 weeks scan pick up if the baby has a hole in the heart? Can it
also pick up any dysmorphic features or conditions such as reigers syndrome? T (UK)
Answer: Yes indeed. One of the vital organs examined in detail at the 20 weeks anatomy
scan is the heart. Most congenital anomalies, including ‘a hole in the heart’ medically
termed ‘septal defects’ will be identified. Very small defects can be missed but
those tend to be clinically insignificant anyway. Most major dysmorphic features
of the limbs, body or face will be picked up.
Reiger’s syndrome is a different matter. It is virtually impossible to pick this
up using a pregnancy scan because the part mainly affected is the eye. Teeth are
also affected but these are, of-course, not there in the womb.
Botulinum for Vaginismus
Question: Hi, I wonder if you can help. I’m very stressed. I’ve been married almost
3 years and haven’t been able to have full sexual intercourse. I know I’m suffering
from vaginismus. I’ve tried tampons,dilators and several lubricants, nothing seems
to help me. I’m very much interested in the BOTOX. Please can you advise me on this,
and where to go from here, to get this botox treatment, as I’m desperate now. I want
to start a family as well. Please advise me. (UK)
Answer: In the UK, this should be straight-forward. You need to go to your GP, who,
presumably will already have records of your problem. You need to come out straight
with the suggestion that you want to explore this treatment modality for the vaginismus
problem so you can be referred to a specialist at your local hospital.
Most gynaecologists are aware of this treatment now and, with any luck, there will
be a gynaecologist at your local hospital with a special interest in this area. You
can then be seen and with your history of failed treatment with other modalities,
I do not foresee any problem with you being tried on this, hopefully with a successful
Sickle Cell Trait and Pregnancy
Question: I would like to ask you how is sickle cell trait affects my pregnancy.
(29 weeks+1 day from my last period) . My husband has normal blood type.
I come to ask you as I feel numbness and light pain on my fingers lately, that worsens
during night. I wonder if it is related with lack of oxygen in my blood and what
can I do to relieve these symptoms. I have a fine blood pressure, no diabetes and
normal iron levels. M.V (Greece)
Answer: It is extremely unlikely that the symptoms you describe are due to the sickle
cell trait. The presentation is suggestive of a condition called ‘Carpal Tunnel Syndrome’.
This is fairly common in pregnancy and can affect anybody. It is not related to the
sickle cell trait. Carpal Tunnel Syndrome is caused by retention of fluid in your
hands and the increasing tightness affects the nerves thereby leading to numbness,
‘pins-and-needles’ sensation and even pain which can be fairly severe sometimes.
The problem resolves quite quickly after delivery.
Secondary toxoplasmosis and pregnancy
Question: My daughter found out she had toxoplasmosis some 10 yrs ago. It has infected
her eye and she has scar tissue ( bear print ) at the back of her eye now ...and
during regular eye checks it appears it is sometimes active. My concern is she has
just found out she is 7 weeks pregnant. How can this affect the baby and what are
the chances of the baby contracting it? L (UK)
Answer: ‘Secondary’ toxoplasmosis which really means a flare-up of an old infection
typically with ocular manifestations (as is the case with your daughter) poses no
risk to the unborn baby. No special action is therefore required.
Pregnancy after a blighted ovum
Question: I had to go for abortion due to blighted ovum so I’m afraid does this
have a treatment and can I conceive successfully in future? This was my first abortion
and have no child as of now. R.M (India)
Answer: Regardless of the nature of the pregnancy loss, it is almost always harrowing.
Unfortunately, miscarriage in the form of a blighted ovum is not uncommon. A blighted
ovum means conception took place but the baby did not form. It is always difficult
to know why this happens but it is quite rare for it to re-occur.
Other than evacuating the womb to empty it of its non-viable contents, no further
treatment is required. What is more, there is absolutely no impact at all on your
ability to conceive and have a successful outcome of a pregnancy in future. Nor do
you need to wait before trying. Ovulation usually resumes within 2 - 4 weeks of
the uterine evacuation and, after that, your body is ready to carry another pregnancy.
I sincerely hope you will have a better outcome next time around.
Identifying the baby’s gender on ultrasound
Question: I just wanted to know if the gender, suggested by the doctor, done by ultrasound
is always correct? In addition do inform how doctors differentiate between a boy
and girl during ultrasound. A.K (Belgium)
Answer: it is actually fairly easy to identify with a large degree of certainty
the sex of the baby in the womb by the time the pregnancy reaches around the half-way
mark (20 weeks). The major organs and appendages outside and inside the body of the
baby can be visualised in great detail. The gender is therefore established by looking
at the sex organs. It is important to be aware that, by its very nature (patient,
machine and operator-dependent), this examination is not foolproof and sometimes
you can get it wrong. However, with an ultrasound performed at 20 weeks or beyond,
such an error is uncommon indeed.