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Pregnancy Bliss | Reproductive Health Hub

Contact Answers In the News Hot Topics

Ciprofloxacin in early pregnancy

Question:  I am 15 weeks pregnant. I have had recurrent water infections, antibiotics don’t seem to do much. Now the hospital has given me Cipro which I haven’t used before. Is it safe? N.A. (Egypt)

Answer: No, you should not use this antibiotic if you are pregnant. It is a very potent antibiotic that is used for a variety of infections including urinary tract infections. However, it is known to be teratogenic, meaning it can cause fetal malformations if taken during pregnancy. It is therefore one of those antibiotics which should not be used during this time. In fairness, your prescribing doctor quite possibly didn’t know you were pregnant. It is always important to bring this to the attention of the attending physician. You should get in touch promptly with them to have a safe alternative prescribed.

Placenta praevia and mode of delivery

Question:  I have been diagnosed with major placenta praevia at my 21 week scan. I have been offered another scan at 36 weeks. What are the chances of me having a c-section? M. (UK)

Answer: You have been misled slightly. There is no such thing as a placenta praevia at 21 weeks gestation in the strict sense of the term. At that stage of pregnancy you can only talk in terms of a low lying placenta. I get the impression that the placenta was found to be covering the internal cervical opening. If that state persisted into the third trimester, then that can be legitimately labelled as major placenta praevia.

The offer of a scan at 36 weeks is meant to verify this. If you are indeed found to have major placenta praevia at that scan then mode of delivery is a guaranteed caesarean section. What are the chances that this will be the case? Well; it is estimated that in 10% of cases like yours, the placenta will still be low in that final phase of pregnancy. That means, for 90% of those found to have a low lying placenta at the 20-21 weeks scan, the placenta will be normally located as they get into the ‘home stretch’. With everything else being normal, that means they can expect to have a normal delivery.

Heroin and Methadone use in pregnancy

Question:  a friend of mine is pregnant and she was using(smoking) 5 - 10 pounds worth of heroin for about 3 weeks before she became pregnant, sinse then she has been using methadone approx 5 - 6 mls per day but has used heroin a few times when unable to get methadone. she really wants to quit but knows she cant go cold turkey whilst pregnant. Have you got any advice. I have advised her to go to the drug centre place and get on a regular script for methadone but she is frightened they will put her on a high dose and she wont be able to come off of it. as she is using a relativly low amount what are the risks to the babys development and is it possible for her to come of the methadone completely whilst pregnant as she wants to be clean when the child is born.  D. (UK)

Answer: Your friend is right in one aspect: She should not attempt to go cold turkey. For one thing, it is unlikely to work and secondly; the baby will be badly distressed by that especially if it is latter on in pregnancy when the baby is also already dependent. However, I do not agree with her on one aspect> It is my firm view that she should get expert help at her local hospital without delay. The fact that she is sometimes forced to use heroin is doing far more harm to her baby than if she went onto a properly managed program. It is simply not true that if she were to be started on such a program she will be put on “too high a dose”. The basic tenet of the program is to find the lowest effective dose for the individual and to assess whether she is suitable for a tapering strategy whereby the dose could be gradually reduced over weeks and months as the pregnancy advances. Not everybody can manage this but the support is there to ensure each individual’s case is managed according to need. Frankly, I do wonder whether her reluctance to embrace that is a subliminal denial of the extent of her problem. With the few details you have given here I do not honestly think she would be suitable for an attempt to come off methadone altogether. I just don’t think she will manage it.

I hope she will have the courage and motivation to pursue the appropriate help via the Methadone substitution program. That gives her baby the best chance. Issues of Heroin and Methadone in pregnancy are discussed in more details here: My best wishes.

RhoGAM (anti-D) injection timing

Question:  Am 7 months pregnant, pls, when is the best time to take rhogam injection? Second question; what do i take 2 stop vaginal itching? C.I. (Nigeria)

Answer: RhoGAM injection is the Rhesus D Immunoglobulin injection given exclusively to Rhesus D Negative blood group women during pregnancy. RhoGAM is a brand name and this injection is more popularly known by the generic descriptive term of Anti-D injection. This is because it consists the protective anti-D antibodies. There are several other brands of the same thing. I take it therefore that you are Rhesus D Negative. The practise in those countries where only one injection is administered is to give it at 28 weeks. At “7 months”, you are there or just over. You should therefore get your injection now. In some countries the practise is to administer two injections, one at 28 weeks and a repeat at around 34-36 weeks. There is no evidence that this confers any advantage over those who get only one injection. We have covered the subject of Rhesus groups and Rhesus disease in detail and you can find that information by clicking here:

Clotrimazole 500 mg vaginal pessary

Regarding your second question (vaginal itching); you most probably have thrush, something quite common during pregnancy. You can use a Clotrimazole vaginal pessary. One dose of a 500mg suppository inserted vaginally will usually clear it.  This is very effective but recurrence especially in pregnancy is not uncommon.

More questions and answers on the next page

placenta praevia

Placenta overlying the cervical opening (Major placenta praevia)