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Pregnancy Bliss | Reproductive Health Hub

Contact Answers In the News Hot Topics

Identical twins

Question: I am pregnant with twins they are in separate sacs but share the same placenta i am just wandering if they are identical or non-identical? K. (UK)

Answer: Non-identical twins never share a placenta. If you are sure there is one placenta then that is firm evidence that your twins are identical. Remember identical twins can share a sac or have separate sacs. They can also share a placenta or have two separate placentas. It all depends on the timing of the division of the fertilized egg. It is all explained here.

Vaginal birth after caesarean section (VBAC)

Question: Sorry to bother you, but can you explain the risks of me giving birth naturally after I had a c-section? (there will be 20 months in between)The reason for the c-section was the baby was back to back and got stuck. Thank you for help and advice. S.B.  (UK)

Answer: Most mothers who have had a caesarean section can successfully deliver vaginally subsequently. The indication for a caesarean section in your case is what is described as non-recurrent. If there was no identifiable additional risk factor in the current pregnancy then I would expect that you would be encouraged to consider a vaginal delivery. There is a theoretical risk of scar dehiscence which, in practise, is very uncommon indeed. In any case, such a labour is actively managed so that any potential complication is detected early. Experience shows that the only thing to worry about is slow labour progress (which can affect any labour) which, in this case, will lead to intervention in the form of a repeat caesarean section. The interval between deliveries is not a significant factor.

Subutex and sperm count

Question: Does taking subutex effect a mans sperm count, can u still get pregnant? L.M. (UK)

Answer: Subutex, also known by its generic name of Buprenorphine, will not affect sperm count. A man taking that should ensure he or his partner is using reliable contraception to avoid unplanned pregnancy.

Topical antibiotics in pregnancy

Question:  Are topical antibiotic preparations safe to use during pregnancy? B.M.(UK)

Answer: Advice regarding particular antibiotic use in pregnancy is the same regardless of whether they are taken orally, intravenous or applied to skin. Those antibiotics that are contraindicated in pregnancy, such as Tetracyclines, remain so even in topical form.

Pregnancy hormone (beta-hCG) not rising as expected

Question: I emailed you a few days ago and really appreciated your advice. Can I ask something else?

I am approx 5 weeks pregnant. Last week, on Wednesday, I started bleeding. Friday I started with bad pain across my stomach, my lower back and top of legs which lasted 2 hours.

I went to A&E and blood tests were taken and swab as too early for scan. Then 48 hrs later I had another blood test done to see if hormone levels had doubled.

I have had no more pain since and no more bleeding apart from tiny bit of old looking blood when i wipe.

I got results today and my hormone levels have increased from 300 to 450 but i was told they should have increased to 600 really so they are concerned about ectopic or miscarrying.

I go to the hospital tomorrow afternoon for an appointment with a doctor to find out more. I am just worried. Is it at all possible that my pregnancy could continue fine and for the egg to be developing in my womb? I just feel in limbo at the moment. D.O. (UK)

Answer: I have to say that modest increase in the hCG hormone levels is a cause for legitimate concern. The two main possibilities are an evolving miscarriage (more likely) and an ectopic pregnancy. There is still a possibility of ongoing pregnancy but that is really small. With the absence of pain and ongoing vaginal bleeding, I would be inclined to advise a repeat blood test for hCG levels. If these are continuing to rise slowly, levelling off or falling, it will confirm that the pregnancy is not viable. It will, then, be important to establish whether this is a miscarriage or potentially an ectopic pregnancy. I hope it all turns out alright for you.

Taking glucosamine and anti-inflammatory drugs in pregnancy

Question:  I have bursitis in my knees and am finding that being pregnant is exacerbating the problem. I have a long haul flight coming up and have 2 queries: Firstly can I still take glucosamine sulphate for joint lubrication and health and secondly I normally take anti-inflammatories to assist with the pain on long flights but am concerned with effects on the baby of taking such medication. Please help! A.J. (South Africa)

Answer: The standard advice regarding Glucosamine in pregnancy is that it should nGlucosamine in Pregnancyot be used. This is based on the fact that there is insufficient data regarding its safety in pregnancy. Whenever there is that kind of uncertainty, the standard medical advice is to avoid unless absolutely necessary. I cannot think of a situation where that would be the case with glucosamine.

With regard to non-steroidal anti-inflammatory drugs (NSAIDs), these are almost universally contra-indicated in pregnancy. I would certainly avoid these. Instead, you could use safe pain-killers such as Paracetamol or codeine to help relieve the symptoms. They may not be as effective but they are safe.

Diclofenac in Pregnancy

More questions and answers on the next page

It may be applied through the skin but this tetracycline type of antibiotic would still be contra-indicated in pregnancy.

Glucosamine sulphate is a popular nutritional supplement even though its effectiveness is a matter of hot debate. Its safety in pregnancy cannot be guaranteed. NSAIDs such as Diclofenac (right, bottom) are effective pain-killers but they cannot be used in pregnancy