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Pregnancy Bliss | Reproductive Health Hub

Contact Answers In the News Hot Topics

Skull fracture on a newborn

Question: My friend had her first baby 6 wks ago.The delivery was long and after 22hrs labour it was decided that forceps and ventouse be used. A few days ago the baby was taken into hospital as she had somehow fell from the sofa to the floor when having nappy change and  it was revealed that a fracture too the baby’s skull was present. Although the distance from the sofa to the floor was extremely low,the hospital commented that it was unlikely that the fracture was due to the fall,but that the use of forceps and ventouse suction at birth was most probably the cause. My friend now is being seen by social services,and since the hospital it has now been suggested that no fracture was present on the scan?? Is this possible? Can my friend find some way of clearing her name as a bad mother as it was her friend who was changing the baby when the accident occurred. B.G. (UK)

Answer: I do feel for your friend but cannot understand why this matter appears to have escalated so. The story is not clear to me and all I can do is stick to the obstetric side of the story where my expertise lies. Yes, in rare situations, forceps delivery can cause depressed skull fracture. There will usually be telltale clinical signs from the outset. Ventouse never causes fracture. I take it from your story that the baby had a scan after delivery. Is that so? If that was the case and the scan showed no evidence of fracture then we have to accept that was the case. On the other hand, an accidental fall from a sofa onto a floor, especially if it is a hard floor can certainly cause a fracture, even if it is a low sofa. The bones of a newborn are very fragile. The type of fracture found may also shed more light on the possible cause. The examination findings after that fall are also important. I am afraid I cannot comment on the issue of the social services as I am neither an expert nor am I in possession of the full picture to qualify to make an informed opinion.

Using warfarin during pregnancy

Question: I have been on warfarin for two years. Now that im trying for a baby a family friend who is a doctor has advised me to stop warfarin and ask for injection. Is this wise? Thanks. J.I. (UK)

Answer: Your friend is right. There is a significant risk to the baby from Warfarin use particularly so in the early part of pregnancy. You have not said why you were put on Warfarin. In any case, you should bring your plans to the attention of your doctor who will most probably refer you to a haematologist to plan carefully the switch from Warfarin to low molecular weight heparin injections such as Clexane (Enoxaparin) or Fragmin (Dalteparin). You are likely to need one or two injections daily, depending on the indication and your body weight, throughout the course of pregnancy. Best wishes.

Calculating Body Mass Index (BMI)

Question: I have been told that I should get my BMI below 30 before trying for IVF. How can I tell my BMI? My current weight is 233 lb. Z. (USA)

Answer: Body Mass Index is calculated from your size (height) and body weight. The ideal body mass index (BMI) ranges from 25 to 29.9 hence the advice you have been given. We have a free calculator on this site and you can reach it by clicking here. It will enable you to calculate your BMI instantly as long as you know your height and weight.

Withdrawal method for contraception

Question: I had a baby four months ago and since resuming sex we are using the withdrawal method only. I am terrified I could get pregnant but I cannot use the pill because of my weight. Please help. D.R. (India)

Answer: The withdrawal method is probably the least reliable mode of contraception. In fact, it is probably incorrect to refer to it as a form of contraception. If you have been advised against using the Pill, I would have thought you have had an opportunity to explore other forms of reliable contraception such as the intrauterine device, the implant or even injections. We have discussed the various forms of long acting reversible contraceptives here:

Valoid (cyclizine) and breast-feeding

Question: Is Valoid safe to use while Breast Feeding and what is Valoid used for? M. (South Africa)

Answer: Valoid is one of the oldest antihistamines used to treat nausea and vomiting. Its generic name is Cyclizine. It is one of the more common antiemetics used to control morning sickness during pregnancy. It is safe for use during this time. There is not enough data regarding its excretion in breast milk and therefore its safety for the baby cannot be absolutely guaranteed.

Implantation bleed

Question: Can implantation cause bleeding?  The bleeding is of a light peach colour and hardly any at all so far. J.B. (UK)

Answer: Yes, there is indeed such a thing as an implantation bleed and, yes, it tends to be light, short-lasting and painless. Implantation takes place within the second week after fertilization of the egg. We have discussed this here:

Breech presentation at 33 weeks

Question: i am 33 week pregnant an have frank  breech presentation. What are the chances of my baby to change position to cephalic? M. (Pakistan)

Answer: It is not possible to put it into specific figures but clearly, at 33 weeks, time is starting to run out.  Conventional data shows that up to 15% of all babies are still breech up to 32 weeks gestation and, without any intervention, only about 4% are still breech at term. It is clearly the case therefore that this baby of yours could still spontaneously turn to lead with the head at term. If this does not happen by 37 completed weeks, there is always the fall-back option of an external cephalic version as long as there is no contraindication to this.

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