Pregnancy Concerns and Questions

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I want an iron infusion

I want an iron infusion

It is becoming more popular for pregnant women to request an iron infusion because of tiredness in pregnancy. The iron infusion will only benefit if there is an iron deficiency, which can be checked by a blood test. Most tiredness in pregnancy is not due to iron...

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Urinary incontinence and pregnancy

Urinary incontinence and pregnancy

Urinary incontinence is a common and distressing pregnancy and postpartum problem. It is usually urinary stress incontinence. Stress incontinence happens when the bladder sphincter muscle does not function well enough to hold in urine in the bladder. Recently I was...

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Eight pregnancies, two babies

Eight pregnancies, two babies

I first met Laura in 2013. She saw me for management of her third pregnancy. Her first two pregnancies had been unsuccessful. She had had two early first trimester miscarriages. She was not aware of a reason why she miscarried. Her third pregnancy was also not...

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Caesarean section by choice

Caesarean section by choice

When asked: “Can I have a Caesarean section?” I always answer: “YES”. There is an increasing number of women who choose to have an elective Caesarean section as the mode of delivery, rather than a vaginal delivery. The request is usually made at the first antenatal...

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Severe diabetes and pregnancy

Severe diabetes and pregnancy

Desiree saw me initially for management of her first pregnancy in 2015. She had been an insulin dependent diabetic since she was five years old and was requiring 30 units of insulin per day when I saw her for her first antenatal visit. She also had a history of...

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A sudden turn of events

A sudden turn of events

A patient booked with me for management of her 4th pregnancy management. The pregnancy progressed well until 38 weeks and 3 days gestation. That evening she became aware of painful vein swelling in her left thigh. Her GP arranged a doppler ultrasound scan the next...

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Do I look ok?

Do I look ok?

Physical appearance is an important matter to many women and being pregnant can cause major concern because of the associated changes in body shape. There are some pregnant women who enjoy the physical appearance changes that come with being pregnant, while others...

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Differences between Braxton Hicks and Labour Contractions

Differences between Braxton Hicks and Labour Contractions

Braxton Hicks contractions are named after the English doctor John Braxton Hicks who first described them in 1872. He reported many women felt contractions without being near confinement. He said this process was usually painless, but caused women confusion as to...

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When do I need my diabetes check in pregnancy?

When do I need my diabetes check in pregnancy?

I am often asked early in the pregnancy about when to have gestational diabetes mellitus (GDM) screening, with the patient under the impression that is should be done as soon as possible. This is not the case. GDM screening is usually done at 26 to 28 weeks pregnancy....

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“I have itchy hands and itchy feet”

“I have itchy hands and itchy feet”

Bronwyn presented at 10 weeks pregnancy for management of her second ongoing pregnancy. Her first ongoing pregnancy had been complicated by preeclampsia (requiring medication to control her blood pressure) and intrauterine foetal growth retardation. She had a...

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Breast cancer in pregnancy

Breast cancer in pregnancy

It was Monday afternoon last week. Rebecca attended with her husband Russell for her antenatal visit at 38 weeks 6 days gestation. She had had a right breast biopsy the previous Thursday and was anxious to find out the result. The result had just come through. I had...

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“I have been having hypo’s more often.”

“I have been having hypo’s more often.”

Sherree saw me for management of her first pregnancy. She had been a diabetic for five years before her pregnancy. Before her first visit with me, she had an appointment with her endocrinologist. Prior to being pregnant, he had managed her diabetes with oral...

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Never quit

Never quit

This is an amazing and wonderful story of a fabulous couple who after 15 years of trying to have to baby and despite a very challenging high-risk pregnancy because of severe preeclampsia have been blessed with was a beautiful baby boy. Irene and her husband married in...

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Please don’t ‘Dr Google’

Please don’t ‘Dr Google’

An anxious patient contacted me on Thursday evening. She had a pregnancy-related discomfort and decided to search on Google for the reason. She became concerned about what she read. She came to the conclusion from what she read that she had a particularly serious...

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Never quit

Never quit

A patient recently saw me for her postnatal visit. A postnatal visit is always a wonderful visit of celebration - the end of a successful pregnancy and the birth of a new baby. This was a very special postnatal visit because of this patient’s obstetric history. In...

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Exercise and sport in pregnancy

Exercise and sport in pregnancy

Chantell saw me for her postnatal visit this week. Chantell is a first-time mum who is also a group fitness instructor. Prior to her pregnancy, she took lots of group fitness classes at the gym, with her favourite being combat classes. When she saw me for her first...

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Travel insurance and pregnancy

Travel insurance and pregnancy

Patients frequently ask for my permission to travel overseas during pregnancy. I usually make the comment, “Make sure you have appropriate travel insurance cover for pregnancy”. I had never thought more about travel insurance in pregnancy until recently when I read a...

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The Non-Invasive Prenatal Test (NIPT) post updated

The Non-Invasive Prenatal Test (NIPT) post updated

I have updated information on the Non-Invasive Prenatal Test (NIPT) in the Questions & Answers section of my website. Since I published on this topic there have been lots of positive developments, especially recently: There are more test-provider options and more...

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Pre-eclampsia

Pre-eclampsia

I was in the special care nursery to visit the babies of two patients I recently delivered. Both patients needed delivery at 35-weeks pregnancy because of pre-eclampsia. Pre-eclampsia is one of the commonest complications of pregnancy. While in most patients it is...

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Early pregnancy diabetes detection

Early pregnancy diabetes detection

I recently introduced to my obstetric practice the new RANZCOG criteria for screening for diabetes in pregnancy. There is information about this in the Questions & Answers section of my website under the topic 'Diabetes screening in pregnancy'. Recently a...

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Nuchal Translucency scan got it wrong

Nuchal Translucency scan got it wrong

A 29 year old patient in her second pregnancy had a Nuchal Translucency ultrasound scan (NTS) to check whether her baby has Down syndrome (Trisomy 21). The serum test maternal serum screening (PAPP-A and beta HCG levels) was also done to increase the accuracy of the...

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From despair to excitement

From despair to excitement

Last week was a very busy week. Wonderful patients had successful pregnancy outcomes of beautiful babies. I saw lots of antenatal patients for mid-pregnancy routine checks. I saw patients for their first pregnancy visit who were both excited and nervous. I saw...

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Your baby will prefer your music and your food!

Your baby will prefer your music and your food!

In the excellent video clip titled ‘Importance of the early years’ by Professor Glover of Imperial College London UK which I mentioned in my previous blog ‘Foundations of childhood behaviour’ Professor Glover also states “We now know that towards the end of pregnancy...

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Foundations of childhood behaviour

Foundations of childhood behaviour

Last weekend my wife and I spent time with old friends from our time living in Oxford UK, Dave and Di Nutt. Dave is now a psychiatrist and neuropsychopharmacologist working at Imperial College London UK and is a world authority on brain function specialising in the...

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Nuchal Translucency scan – consider carefully first

Nuchal Translucency scan – consider carefully first

Three patients recently had nuchal translucency scans with serum checking to reassure that baby was at low risk of Down syndrome (Trisomy 21). All had high risk results. One baby has a 1 in 8 risk of Down syndrome, the second 1 in 38 and the third 1 in 138 risk of...

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The fish that got away

The fish that got away

The husband of a pregnant patient who attended with his wife today for an antenatal visit commented after a question from his wife: “You must have to spend a lot of time reassuring your patients because of old wives tales told to them.” The answer is: “Yes”. It is...

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Miscarriage – Karyotype checking

Miscarriage – Karyotype checking

I saw a couple today for follow up after her third miscarriage. I met her for the first time for her first antenatal visit of this most recent pregnancy. She was nine weeks pregnant by dates at the time of her first antenatal visit. She was well and excited. All was...

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Will the grieving stop?

Will the grieving stop?

A patient sent me a Facebook message the other day. Her son had tragically died in utero at 37 weeks gestation 7 years ago. After delivery, the cause for his death was very apparent. The umbilical cord was tightly tied around his neck twice. There was so much...

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Can I stop getting stretch marks?

Can I stop getting stretch marks?

Stretch marks are due to tearing of the deeper (dermis) layer of the skin. Usually stretch marks appear as angry red lines While common in pregnancy, not every pregnant woman gets them. As well they can occur at other times when not pregnant such as with rapid growth...

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Can I stop the swelling of my hands and feet?

Can I stop the swelling of my hands and feet?

Swelling of hands and feet is common in pregnancy. Swelling is due to pregnancy hormones resulting in fluid retention in the body. It usually occurs in the feet/ankles and hands/wrists. It can also be noticed in the vulval area, in the face and in the general body....

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How do I figure out the date of conception?

How do I figure out the date of conception?

That is not an easy question to answer. The reason why we use the first date of the last menstrual period (LMP) in calculating the expected date of confinement (EDC) is because most women know their LMP date. But most women don’t know the actual date of ovulation. The...

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Grieving after a miscarriage

Grieving after a miscarriage

In a health topics Q & A website where I was invited to be a health expert I was asked the question: “How do you recover from a miscarriage? My family thinks I should "be over" my miscarriage by now, but I'm still grieving. Is this normal?” This is a very relevant...

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Sciatica pain in pregnancy

Sciatica pain in pregnancy

Sciatica pain is due to compression sciatic nerve In pregnancy this can be caused by the pressure of the gravid uterus and in advanced pregnancy of the baby on the sciatic nerve. I once had a gynaecology patient who had severe sciatica and a large fibroid uterus...

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Can pregnant women eat pineapples and papayas?

Can pregnant women eat pineapples and papayas?

While many say eating pineapples and papaya should be avoided in pregnancy because they can trigger miscarriage and the onset of premature labour, this opinion are based on theoretical consideration and some laboratory animal studies. I am not aware of any clinical...

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Is there such a thing as a fear of being pregnant?

Is there such a thing as a fear of being pregnant?

I find that most women, to some extent, have a fear of being pregnant. This is often because pregnancy is something new, they have no experience and they are not in control over it to a large extent. So fear can be regarded as a normal reaction. But as well a woman’s...

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Coping with grief

Coping with grief

It was 4.00pm Monday afternoon. I was in consultation with a gynaecology patient in my office when my mobile phone rang. It was a call from the Birth Unit midwife. A patient who was 32 weeks pregnant was attending a routine antenatal class at the hospital and...

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