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Pregnancy Bliss | Reproductive Health Hub

Contact Answers In the News Hot Topics

Pregnancy with sickle cell trait

Question: What is the significance of sickle cell trait and how is the fetus affected? J.M. (USA)

Answer: Sickle cell trait tends to pose little if any problems during pregnancy. Pregnancies of those with the trait are managed as low-risk and there is no increase in the risk of miscarriage, preterm labor or stillbirth, issues that are unfortunately a feature among those with sickle cell disease (SCD). As for the significance of the sickle cell trait, any woman with this needs to check the status of her partner as far as the defective gene is concerned. A partner with the trait means there is at least a 1 in 4 chance any offspring could have the full-fledged sickle cell disease.  There is more comprehensive details on this subject here:

History of big babies and shoulder dystocia

Question: I have 6 children already; my smallest was 9 pounds 1oz, my biggest was 10 pounds 6oz. I’m scared this one is gonna be big too.Is there anything I can do to not have such a big baby this time? Could dieting help? My biggest baby had shoulder dystocia and I’m so scared of that happening again :( E.L. (UK)

Answer: Whatever you do, don’t try to diet during pregnancy if the dieting involves some sort of starving yourself. It will not help and could do a lot of harm to both you and your unborn baby. Just try to have a healthy diet and of-course don’t over-indulge. As for your history of consistently big babies, it is clear that this is genetic. You are therefore not in a position to influence the size of your baby. You are right in saying that this baby too is almost certainly going to be big if born at term. It is unusual for such a trend to suddenly change. Shoulder dystocia is a quite unpredictable complication. As you can testify, you have had six children, all being well above average size, but only one of those deliveries have been complicated by shoulder dystocia. The fact that you have such a history means the size of the baby and progress of labour will be monitored much more carefully so as to take the necessary measures if there is a strong suggestion of such a complication happening again. You should be alright.

Trying to conceive  while on Lamotrigine

Question: Hi, I’m 25 and have been epileptic for over 10 years. I’m on lamotrigine and would like to start trying for a baby early next year. Do I need to change medicine as I cannot come off altogether. Thanx. J.J (UK)

Answer: No, you do not need to change medication. It is true that there is no such thing as a completely safe anti-epileptic medicine in pregnancy. However, while drugs like Valproic acid are certainly high risk and should not be used in pregnancy if at all possible, Lamotrigine is on the other end of the scale of risk. It is one of the more effective anticonvulsants with a relatively much lower risk of causing fetal malformationslamotrigine in pregnancy. Stick with this and certainly let your doctor know of your plans. Best wishes in your quest.

Missed period, then a vaginal bleed 11 days later. Pregnant?

Question: If i had sex on A FRIDAY; MISSED MY PERIOD the following Monday but 11 days later i had what seems like a period, can i be pregnant? T. (Barbados)

Answer: Unlikely but not impossible. From the brief details in your question, it seems you had sex just a couple of days before the expected date of your next period. That period never arrived. 11 days later you saw a vaginal bleed similar to a period. There are several possible scenarios here: If your periods are usually regular and you did not have unprotected sex earlier in that cycle, it is probably unlikely that you could be pregnant. It may just mean you had a cycle where you did not ovulate and the period arrived late as a consequence. On the other hand, if your periods aren’t that regular, then your expectation of a period on the mentioned Monday may have been misguided. This may have been one of your longer cycles which will still mean you are not pregnant. Yet another scenario is that, if you had had sex on other occasions earlier in that cycle, you could have conceived earlier, hence the ‘missed’ period. The bleed that you had later could have been what is sometimes called an implantation bleed. However, I have to say, an implantation bleed tends to be quite light, certainly not like a normal period. In the end,  you may have to perform a pregnancy test to remove any doubt.

Using Suboxone in pregnancy

Question:  I have been using suboxone for about 8 months now and yesterday I discovered im pregnant. It is probably two months. Can I continue with suboxone, is it safe for the baby? S.V. (USA)

Answer: Suboxone, also known as Subutex, is a recognised and widely used heroin substitute. However, its use during pregnancy remains controversial. Whilst, there are no known adverse effects on the baby in the womb, there is simply not enough information on its safety to give it a clean bill. In any case, in situations where there is a significant danger of the woman falling back into heroin dependency during pregnancy, it has been used. This would particularly be the case for somebody like yourself who is already on the substitution program. I would suggest that you see your doctor promptly to discuss how this is going to be handled during your pregnancy. Best wishes.

Transplanting an ectopic pregnancy

Question:  Is it possible to transplant an ectopic pregnancy from a tube into the womb? P (Ghana)

Answer: No, this is not possible. In fact, this is something that has been attempted in the last couple of decades but success does not appear to be on the horizon.