Pregnancy continuing beyond the expected day of delivery

Question: Today is my EDD and no symptoms of labour yet. I delivered my first and second babies at 38wks. What can be the cause of this prolonged pregnancy? Secondly,2 wks ago i saw a blood stain when i wiped after urinating. i actually thought it was my show. Pls what do u think is happening? Thank u. A. (Nigeria)

Answer: You really don’t need to worry. I understand that after 40 weeks of pregnancy, it is only naturally that you get impatient when labour does not seemto be imminent when you have arrived at your calculated expected date of delivery (EDD). However, it is important to be aware that a substantial number of pregnancies continue well beyond the EDD. You may be aware that a pregnancy is technically still at term until 42 completed weeks. That is 2 weeks after the EDD. The calculated EDD is only a guide around which labour will be expected to happen. If you are well and the bay is active, I would advise that you wait. If you are concerned for whatever reason about the baby’s well-being, then you need to contact your doctor for an assessment to be made. Again, I need to stress that going beyond an expected date of delivery is neither uncommon nor an abnormal development.

Prolonged labour

Question: Thanks for your kindness and really your answer helped me. I would like you to help me answer this question: Prolonged labour, causes,prevention and management. B.J. (Gambia)

Answer: Prolonged labour is a subject we have discussed in the section on ‘Abnormal labour’. You can reach the section on the subject by clicking here: I hope you find the answers you need.

IVF after endometrial ablation

Question: After suffering from horrendous periods for years I underwent an ablation of the womb which worked well. However the doctor insisted that I be sterilised at the time as a condition for getting the ablation. Ive got two children but now I really want to have another baby. Do you think I could have a successful IVF? Z.A. (UK)

Answer: The short answer is no. This is why: When your gynaecologist insisted on you having a reliable form of contraception, in this case, a sterilisation, it was ultimately for you own good. Ablation of the lining of the womb is a very effective treatment for chronic heavy periods. However, it can only be offered to people who have definitely completed their families.This is simply because it is dangerous for a woman to carry a pregnancy after she has undergone the procedure. There has, in fact, been fatalities when women have conceived after undergoing endometrial ablation. You are therefore unlikely to find a specialist who will perform an IVF procedure with your background history. That will be reckless. My advice is therefore that, if you are resolute that you want another child, then you should be looking at either surrogacy (discussed here) or adoption. Best wishes.

Abdominal pain in early pregnancy

Question: My son’s girlfriend is two months pregnant. For a week she been in pain. She’s had scan , hospital said the baby is fine, they said it could be that her bowels could of moved or it could be phantom period pains. I myself have never heard of this. I don’t know what’s going on, they will not tell me anything. S.T. (UK)

Answer: Abdominal pain in the early part of pregnancy is not as uncommon as you might think. When a woman presents with this problem, the first thing to do is to rule out any problem with the pregnancy itself. An ultrasound scan as was done in this case is the correct thing to do. It is not always possible to tell exactly what is causing the pain but the most likely source is the bowels. I think the “bowels could have moved” was a misunderstanding. However, in most cases of non-specific abdominal pain in pregnancy, bowels are to blame. The pains do almost always settle and if they are very distressing, safe pain-killers are available to give relief. Codeine and Paracetamol or a combination of the two can be used. There is no such thing as ‘phantom periods’. I hope she gets better quickly.

Echogenic lungs and other abnormalities on a detailed scan

Question: On my 21 week target scanning some abnormalities is found like stomach of baby is not clearly seen, one kidney is not clearly seen and lung is echotropic. Doctor advise us to discontinue with pregnancy. We want to know what will be the better decision for my baby. P.J. (India)

Answer: This is a very difficult situation you find yourself in. The detailed ultrasound scan has revealed a number of so-called soft-tissue markers. The findings are usually a warning that there might be a serious problem with the baby. The presence of multiple such markers does increase the possibility significantly. In some cases, this could be a sign that the baby has a chromosomal disorder such as Down’s syndrome.

Not all babies found with those markers do badly but a substantial proportion unfortunately do not make it. The one feature of echogenic lungs is particularly important. Causes of this include a blocked main airway called ‘tracheal atresia’. These babies do badly. Another cause is congenital diaphragmatic hernia. Affected babies also do badly. The inability to see the stomach and one of the kidneys mean the likelihood of this baby being affected by a serious chromosomal disorder is high. In places where facilities are available, the next logical step before you decide on whether to continue with the pregnancy or not is to have a diagnostic test to establish this fact. This would normally involve getting a small placental tissue by performing chorionic villus sampling (CVS) or getting a sample of amniotic fluid. The chromosomal make up of the baby is then analysed to give you a clearer picture of the prognosis for your baby. This would facilitate your decision. If you do not have such facilities available in your area, the most you should do is have a thorough discussion of the findings with your specialist to help you reach a decision. It is never easy. It is obviously not possible for me to tell you the right or wrong decision. That, in the end, has got to be your decision.

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