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Pregnancy Bliss | Reproductive Health Hub

Contact Answers In the News Hot Topics

Exposure to pesticides during pregnancy

Question: I’m currently trying to find out information regarding the side effects of insecticides and pesticides during pregnancy. I am 20 weeks pregnant. My home has woodworm to exposed beams upstairs. I told the pest control company that I am pregnant.The pest control company told me that I only have to be away from my home for 6 hours whilst they treat the timbers and that it is safe for me to return home after this period. Friends and relatives have shown concern regarding this matter. I also have 3 other children and my partner living at the same property. I don`t know what insecticides/pesticides the company will be using. Can you help? J.E. (UK)

Answer: It is rather difficult to give you definitive advice without knowing the exact type of pesticides to be used. However, the general advice given to pregnant women is that they should avoid exposure to insecticides and pesticides. Granted, you are well past the most sensitive phase of the pregnancy which is the first 6 - 8 weeks when organ formation is taking place. Exposure to pesticides and insecticides is a recognised risk factor for such malformations as cleft lip and palate, neural tube defects and even cardiac defects. For this to happen, exposure has to be within the critical organogenesis phase mentioned. Pesticides have also been associated with increased risk of miscarriage.

As far as your particular situation is concerned, you will need to know the exact type of pesticide to be used to be able to get specific advice. In any case, ensure you stay away for the advised duration and if facilities allow, why don’t you double that time just to be absolutely certain? Best wishes.

Scan to check fetal growth; fetal kidney dilatation

Question: My gynae doctor suggest me to have growth scan at 29th week of gestation at that time my baby weight was 1700 gm is it normal how often i should repeat ultrasounds now onwards. Is there any indication of IUGR Another thing i want to ask is at that ultrasound at 29th week showed baby right kidney dilation of 0.5 cm is it dangerous? What can i do to resolve it and for this problem how often i should repeat ultrasound? M. (Pakistan)

Answer: I am not sure why your doctor wanted you to have a fetal growth scan. It is good practice to explain to a patient/mother why you are requesting a particular test and your doctor should be giving you these details. In any case, if the calculated fetal weight at 29 weeks was 1700 grams, there is certainly no hint of growth restriction. In fact, that baby appears to be well above average size. The mean weight at 29 weeks is 1150 grams. That weight (1700 gm) is attained at around 32 weeks. Remember, ultrasound weight estimation has a margin of error of around 15% but in any case, there is no IUGR here.

Regarding the issue of kidney dilatation which I gather is on one side only, it does not appear to be a cause for concern. At 0.5 cm, the dilatation is very mild. You can have a repeat scan in about 4 weeks which should give you peace of mind. Around 1% of all fetuses scanned are found to have renal pelvis (kidney)dilatation. The vast majority, especially if mild, are of no clinical significance. You do not need numerous scans for any of the issues you have mentioned. Try to relax and enjoy your pregnancy. More importantly, always press your doctor to explain things. Don’t allow yourself to leave the clinic in a state of confusion and unnecessary anxiety.

Membrane rupture at 17 weeks

Question: My membranes ruptured when I was seventeen weeks and it was my first pregnancy. The doctors could not give me an exact reason why it happened, but I would like to know if my fiancee and I were to try again in the future would I be at risk of my membranes rupturing pre term again? And should I have certain tests performed to see if something is wrong with me before we try to conceive again? K. (USA)

Answer: The reason your doctor did not give you an explanation is because they almost certainly didn’t know why it happened. It is rare to establish with certainty why such early membrane rupture occurs. Recurrence is also quite uncommon. Some women with cervical weakness (incompetence) are prone to recurrent late miscarriages which are typically preceded by a sudden membrane rupture and gush of fluid. However, this is virtually unknown to occur in a first pregnancy unless the woman has had  prior significant surgical treatment to the cervix. There are no specific tests required for the future. However, you may wish to have vaginal swabs to rule out conditions like bacterial vaginosis (discussed here) which have been blamed for preterm labor and delivery in some cases. That may help allay anxiety.

Anencephaly and planning future pregnancies

Question: my sister  is 36 years old - she had abortion in anencephaly baby --would you advise her to allow pregnancy if she wants? If so, what investigation should be done before the next pregnancy? A.R. (Egypt)

Answer: Anencephaly is a devastating condition with the baby having no possibility of survival. It is one of the most serious forms of neural tube defects (NTDs). Advising for the future is not so straight-forward. This is because mode of transmission of the condition is multi-factorial. The condition is  sometimes an expression of a single gene defect but commonly multiple genes are involved as well as environmental factors. In some cases anencephaly is part of a chromosomal defect. In yet other cases, it is purely a result of amniotic membrane disruption. You can therefore appreciate that counselling has got to be highly individualised, ideally after tests have been done to see if an underlying cause can be established. In most cases, this is not apparent.

Even with that complex picture there are certain simple steps that any previously affected woman can take to minimise the risk of recurrence. Chief among these is to ensure there is no possibility of folic acid deficiency. Taking Folic acid at 5mg daily during the preconception phase right through the first 8 -10 weeks of gestation will eliminate any possibility of deficiency. If the woman is an epileptic and on valproic acid, this should be changed to a safer anticonvulsant. If she is a diabetic and on insulin, it is important to ensure the diabetes control is good before embarking on trying for a pregnancy. For most women such measures are sufficient. I wish your sister well for the future.

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