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Pregnancy Bliss | Reproductive Health Hub

Contact Answers In the News Hot Topics

Sex linked miscarriages?

Question:  I had a normal pregnancy which delivered a boy then 2 miscarriages at ten wks with scans confirming heartbeats prior to miscarriage. I went on to have 2 more normal pregnancies delivering boys.Is it possible to only miscarry a certain sex baby or was it just bad luck? L.B. (Ireland)

Answer: This is almost certainly chance more than anything. The fact that all your pregnancies that carried to Term resulted in boys does not mean the miscarriages were somehow because you were carrying girls. This is the reason behind my view: There are genetic conditions that are linked to the sex chromosomes. The chromosome affected is the ‘X’. Now, you may be aware that women have two X chromosomes and men have one X chromosome and one ‘Y’ chromosome. Conditions in which there is a gene mutation on the X chromosome will therefore tend to affect boys more than girls. This is because the only copy of the X chromosome that a boy has will be affected. For girls, there is an insurance of a second X chromosome which, if normal, they will either not be affected at all or the manifestation of the disease will be mild. The most widely known X-linked genetic disorders are Duchenne’s muscular dystrophy and Fragile X syndrome. What’s more, these conditions are not associated with an increased risk of miscarriage.

All in all, if you were a carrier of an X-linked genetic mutation, you could potentially pass this on to your babies. However, boys are the ones who will be affected and girls are likely to be just healthy. This is, in fact, a simplification of a much more complex subject of genetics but the underlying principle is addressed.

Total iron infusion

Question: I am anemic and 35 weeks pregnant. The hospital wants me to have iron transfusion because I can’t take tablets. Is this safe? T.A. (UK)

Answer: Iron administered via the intravenous route, also known as total iron infusion (TII) is a safe, reliable and effective way of correcting iron deficiency anaemia. This is the case even in pregnancy. Normally, a test will be done to ensure there is no allergic reaction (this is rare) and then the infusion administered. The advantage of this is that, the dose is calculated  on the basis of your weight and the level of anaemia. This ensures that you get all the iron you need to correct the deficiency. With you being so close to Term, I will urge you to take up this offer from the hospital. CosmoFer is the most widely used brand for this. It can also be administered in the form of intra-muscular injections over a number of days. This, however, involves more pain and takes much longer.

Is it 40 weeks or 9 months?

Question: Thanks for answering my question on head engagement of baby. Here is another question i have. How long is pregnancy expected to last? 36 weeks means 9 months while 40 weeks means 10 months. Which one is most appropriate? A.O.M. (Nigeria)

Answer: In fact 40 weeks means 9 months rather than 10 months you are suggesting. Your calculation is based on a month lasting exactly 4 weeks. However, remember only February lasts 4 weeks. Every other month in a year is 30 or 31 days which is roughly 4½ weeks. Nine months therefore works out as 40 weeks and that is the normal average duration of a ‘Term’ pregnancy. Using either is perfectly appropriate.

Progesterone use in pregnancy

Question: I’m 10 wk and 5 days pregnant  and taking progesterone supplement 200 mg twice a day . My doctor asked me to stop at 10 weeks but i heard placenta fully matures at 12 weeks only. Can i take progesterone supplement till 12 weeks or will it harm  the fetus? If i stop now is there chance of miscarriage? S. (USA)

Answer: Progesterone is perfectly safe to take at any stage of pregnancy. It will not harm the baby in any way. Whether your taking it will be beneficial is the question. Remember the placenta produces vast amounts of this hormone right through the course of the pregnancy. In cases of assisted n (IVF), progesterone supplements are used and are of proven value in supporting the pregnancy until the placenta fully takes over at around 12 weeks. In other pregnancy situations, the use of progesterone hormone in early pregnancy is of unproven value. As I do not know the indication for using it in your case, I cannot comment on this. However, with regard to your primary question; yes, if you will feel more reassured by taking it for longer, it is perfectly safe to do so.

Twins and mode of delivery

Question: My daughter is expecting twins. They are due in six weeks. A scan at the hospital yesterday showed that the second twin is breech. The doctor has advised her to have a normal delivery. Do you think there is any danger for the babies or should she be having a caesarean? Thank you. D.B. (UK)

Answer: A breech presenting second twin is in itself not an indication for recommending a caesarean section. Everything else being normal and the first (leading) twin presenting head first means it is appropriate to recommend a vaginal delivery. However, in most units (in the UK), the decision is left to the expectant mother. I would therefore concur with the advice she has been given.

Group B strep in pregnancy

Question: I’m five months pregnant and I have been found to have group B strep infection. The doctor insisted that they are not going to treat it until im in labour. I’m really worried because I had a miscarriage two years ago. Why can’t I be treated now? B. (UK)

Answer: Trust your obstetrician. This is the correct course of action. For one thing, this is not a ‘true’ infection. Group B streptococcal (GBS) bacteria reside in the vagina. 25-30% of women carry this bacteria in their lower genital tract at one time or another. If you were given antibiotics now the bacteria will be eliminated but there is no guarantee that you won’t have it back just a few weeks down the line. It is therefore a pointless exercise. Plus, the presence of GBS in your lower genital tract is not doing you or the baby any harm. The only issue of concern for Group B strep is during vaginal birth. This is when there is risk to the baby and this is the correct time to give you antibiotics. More details can be found here:

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