Living and Loving – August 2019

FUTURE FERTILTIY

Q|

I gave birth to a stillborn

baby as a result of spina

bifida. I was then sterilised,

but the doctors couldn’t

find my right tube so only

one tube was cut. To my

surprise, I fell pregnant again.

Unfortunately, I miscarried

two months later. I would like

to have another baby. What

are my chances of becoming

pregnant again and having a

healthy baby after all this?

A

There are two problems that

must be addressed: the history

of spina bifida, as well as your

future fertility. Spina bifida is when

the bony part of the vertebrae

don’t develop completely, resulting

in a vertebral column defect.

It’s still unknown what causes

the majority of cases, but certain

medication for epilepsy may increase

the risk. Supplementation with folic

acid has been proven to reduce

the risk of spina bifida by as much

as 70%. Where spina bifida has

previously occured, there is an

increased risk of recurrence. 4mg

of folic acid per day can reduce

the likelihood substantially. The fact

that you did become pregnant

implies that at least one of your

fallopian tubes must be open.

I would suggest giving yourself

a chance (four to six months) to

become pregnant naturally, but if

you don’t, see a doctor to evaluate

the status of your tubes and

perform further tests if indicated.

Your risk of an ectopic pregnancy

may be slightly increased and a scan

should be done as soon as possible

should you become pregnant, to

confirm the pregnancy is in the womb.

Dr Marienus Trouw, obstetrician,

gynaecologist and fertility specialist

NO PREGNANCY

SIGNS

Q|

I’m seven weeks

pregnant, but I don’t

have any nausea and

still have light bleeding.

My gynae did a blood

test and assured me I’m

still pregnant. Is it normal

not to have any signs

of pregnancy yet?

A

It sounds like you could be

less than seven weeks

pregnant. I say this because

at seven weeks, your gynae

would have been able to do

an ultrasound to see the sac in

which the foetus is growing.

Slight bleeding can happen

in early pregnancy as the foetus

implants in the uterus, but this

doesn’t usually last long. If

persistent bleeding occurs, consult

your gynae again to exclude any

early pregnancy complications

like a miscarriage or an ectopic

pregnancy (a pregnancy that

implants outside of the uterus,

commonly in a fallopian tube). See

your gynae in two weeks for an

ultrasound and a repeat blood test

for the pregnancy hormone hCG,

which will indicate what you can

expect to see on an ultrasound.

Dr Lindiwe Cebekulu,

obstetrician and gynaecologist

Our experts answer some

of your top concerns.

6 | AUGUST 2019 | L&L