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Pregnancy Bliss | Reproductive Health Hub

Contact Answers In the News Hot Topics

Exposure to measles in late pregnancy

Question: My friend is 7 months pregnant and her daughter has measles. What precautions mother has to take? F.J. (United Arab Emirates)

Answer: Most adults would either have been vaccinated against or would have had measles themselves earlier during childhood. I would think your friend falls in that category. If that is the case, she does not need to take any precaution since she is immune and her daughter’s measles should have no effect on her at all. However, in the very unlikely event that she is not immune there is something that she can do post-exposure which may be beneficial. A form of injection which is meant to give passive immunity can be administered as long as no more than seven days have elapsed since exposure. This does not give total immunity but will moderate the disease were she to develop it. Were she to start getting symptoms suggestive of the infection, she will need to be seen by a doctor promptly since measles tends to be more serious when it affects adults and the possibility of going into preterm labour will be rather high. Hopefully this is not the case.

Using Fentanyl and Tramadol at time of conception

Question: Wondering if you can help.  7 months ago I had major back surgery and have been on Fentanyl and Tramadol since.  I have cut them right down to half a 25mg patch of Fentanyl and 2 Tramadol every other night.  My husband and myself have been talking about having a child and I just wanted to know do I need to be completely off these drugs and if so for how long is recommended before it is safe to fall pregnant? Thanks. T.C. (UK)

Answer: Fentanyl is a very strong synthetic opiate; in fact much stronger than morphine. It is one of those drugs where the advice is that it should only be used in pregnancy when benefit definitely outweighs potential risks. It is known for a fact that being on regular Fentanyl use reduces your chances of spontaneous conception, so that is one of the factors that you need to consider. Whilst no congenital anomalies have been directly attributed to Fentanyl in humans (probably because it is rarely used), animal studies show that it has the potential to be toxic to an embryo or fetus in the early stages. This is the main reason for the extreme caution.

Even though Tramadol is not as strong as Fentanyl, the advice is actually similar. Tramadol is a synthetic cousin of codeine, a drug that is frequently resorted to for pain control during pregnancy. If you feel it will be very difficult to be off these completely, you should probably try to come off temporarily when you are actually trying to conceive and keep off during the critical first 6 to 8 weeks of pregnancy. If necessary, you can then re-introduce Tramadol. Use throughout the course of pregnancy will almost certainly result in withdrawal problems for the baby after the birth so that is another area to look at carefully. I hope you will have an opportunity to discuss this in detail with a specialist before you embark upon your quest. Best wishes.

Terminating a pregnancy

Question: If i choose not to continue with my pregnancy will i be delivered like a regular delivery or will it be a d&c? C. (USA)

Answer: No, pregnancy termination is never done like a normal delivery. Whether you would have to have a ‘D&C’ will depend on the gestation. If it is in the first trimester (less than 13 weeks) then this is an option. If it is later, you are likely to have medication to provoke a miscarriage and this might be followed by surgical evacuation (‘D&C’). Late pregnancy termination is illegal in most countries except for medical reasons.

Trying to conceive

Question: I’m trying to conceive since a year and not able to do so. We have good relationship and do intercourse every alternate days. I went to a gynaecologist and we went through investigations in which i had a border line fasting glucose and he prescribed me Metformin 500mg TID with starting Clomid which i have taken the first cycle. My husband semen analysis says Linear Progression of sperms around 15% out of 1 million which is little low. I want to ask usually how much time it takes for pregnancy to occur since we have started all the treatments. M. (Pakistan)

Answer: There are some issues here which may require further action. With a borderline fasting glucose you probably have some degree of polycystic ovaries (PCOS). In such a situation, I would totally agree with your gynaecologist that a combination of Metformin and Clomid will optimise your chances of regular ovulation and possible spontaneous conception. However, the issue of your husband’s semen analysis results does concern me. A count of 1 million is quite low and would tend to reduce the chances of spontaneous conception quite substantially. I would expect that this is to be repeated and if there is no change in the count then it may very well be time to look at whether assisted conception in the form of ICSI is the way forward. I would want to think that other tests on your part specifically to check fallopian tube patency have all been completed and they are normal. The time it takes for successful conception to occur varies enormously and it is not possible to give one standard figure. However, as a rough guide, when there are no problems, over 75% of couples having regular sex like you will be successful within 12 months.

Hepatitis B infection in pregnancy

Question: I am pregnant and upon testing I was hepatitis B positive(+++). What is the way out? B. (Ghana)

Answer: I am not sure what you mean by ‘way out’. If the test has shown that you have the hepatitis B antigen, it means you have this infection as a chronic condition. There is really no treatment for it. What is important is to get clarification from your doctors whether this appears to be a new infection or whether it is something you acquired some time ago. For a new infection, there is always a possibility that your body is going to get rid of it. In fact this is what happens to the majority of people who get the infection. For about 10% of people affected, the infection stays for life. In the long term it could lead to liver problems so this will need to be monitored regularly. The most important thing is to take measures to protect your unborn baby. Both passive and active immunisation will be required to achieve this and it is very effective. We have described details of what needs to be done for the baby on the day he/she is born in this section.

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