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Pregnancy Bliss | Reproductive Health Hub

Contact Answers In the News Hot Topics



Pregnancy with chromosomal balanced translocation

Question:  I am currently 6 weeks pregnant and I have an appointment with a clinical geneticist ref my balanced translocation (5;8)(p15;q13). Are you able to give a general idea of issues that may arise from this if passed on as unbalanced? (I'm not expecting a diagnosis at all!!) Many thanks in advance. S.H. (UK)


Answer: I am sure you are well versed in the facts of your chromosomal make-up. With the information you have given me, you have chromosomal material from the short arm of chromosome 5 swapping position with material from the long arm of chromosome 8. Since this is a so-called Non-Robertsonian reciprocal translocation which is balanced, it is completely harmless to you.

However, as you pointed out, there is a possibility that you could produce eggs where the material is unbalanced therefore creating a baby with unbalanced translocation. As a general sweeping statement, that kind of inheritance carries a risk of miscarriage or a variety of abnormalities. There is also an increased risk of some forms of cancer for the offspring.

However, that statement is a broad-brush for a phenomenon which is fiendishly complex. You will certainly be better served by that visit to the geneticist who should be able to give you an expert, detailed and individualised advice.





Pre-eclampsia in the postnatal period

Question: i have been told i possibly have postnatal PIH. my bp went back to normal after the birth of my 4th child but has since started to rise. How long will this last for? G.S. (UK)


Answer: Postnatal pre-eclampsia is uncommon (but not unknown). Pre-eclampsia in a 4th pregnancy and occurring postnatally is certainly unusual. There is a real possibility that you had latent hypertension that you didn't know about before you conceived, especially if you are already in your 30s (or, dare I say it; further on).

If what you have is true pre-eclampsia it should last no more than a few days at most. However, if you have latent hypertension (as I suspect), the blood pressure may persist at a raised level, especially if you are not on medication or you come off. The main thing is therefore to continue keeping an eye with regular checks for the next few weeks and months.






Recurrence  and predictability of placental abruption

Question:  My first daughter (now 16) was born prematurely via C.S. due to placental abruption.

My 2nd pregnancy was fine (boy).

My 3rd pregnancy (girl) was stillborn due to placental abruption. The two girls placentas came away at the same time (7½ months), both weighing just over 3lbs. I am also insulin dependent.  Why was i not told of the suspected complications by the ******* hospital (Edinburgh)? This was ten years ago and I’m still looking for answers.


Answer: I am sorry to hear of your tragic loss ten years ago. This kind of event is always heart-wrenching, not least because, Mary; there are really no answers. I am sure over the last 10 years you have searched for these, clearly without success.

The fact of the matter is placental abruption is notorious for being unpredictable. Your own story is testament to this. You had the complication with your first pregnancy. Your second one was fine (presumably born at Term) and then you had this tragic recurrence with your third one. Yes, it is true that a previous history of placental abruption means your risk in any subsequent pregnancy is increased somewhat. However, two facts are also true:

Sadly, I don't think there was anything that anybody could have done to prevent this. That is the nature of placental abruption. My reply is obviously couched in general terms. Regarding your individual circumstances, hopefully you had the opportunity to discuss the whole issue with your obstetrician.




Hyperthyroidism and fertility

Question:  can hyperthyroidism affect fertility even if it is already treated? J. (Ireland)


Answer: Hyperthyroidism, if well controlled with medication (or surgery), does not and should not influence fertility at all. If the individual is continuing with medication, she can conceive in the safe knowledge that the standard forms of medication are safe to use in pregnancy. it is, however, important to ensure drug levels are monitored during pregnancy. There is more detail on the subject here.





Previous caesarean, head not engaged at Term: Mode of delivery?

Question:  I'm 40 weeks pregnant, still my baby is up and cervix is closed. How can i deliver my baby normal,and my previous baby born from c section. Why i can’t induce and give birth normally for this baby? Pleeeease help. F. (United Arab Emirates)


Answer: It is important that you listen carefully to the advice of your obstetrician. If you had a previous caesarean section and at 40 weeks the head is not yet engaged, induction of labour may not be ideal. Of-course your doctor will assess the whole situation and offer a considered opinion. If, for instance, on assessing your cervix, it is found to be unfavourable and the head is not in the pelvis, I don’t think induction of labour will be wise. For one thing, it is unlikely to succeed and secondly, it increases the risk of requiring an emergency caesarean section. My view, with the little information I have about you is that, if the baby is fine, just await events. If spontaneous labour does not ensue by the time you are 42 weeks, and you are still unfavourable for induction, then a caesarean section will have to be performed. Your desire for a vaginal delivery is commendable but ultimately your safety and that of your baby has got to be paramount.




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