Early pregnancy health worries – your questions answered

What do you need to know about bleeding, pregnancy diabetes or slapped cheek disease? Our midwife provides the essential info

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Some women develop diabetes through their pregnancies

Q. I have a needle phobia – what can I do about pregnancy blood tests?

A. I’m afraid there are no alternatives, but ultimately it’s your choice. Do speak to your midwife about each test, because, like with any fear, if you understand them and why they matter for you and your baby, you may feel braver.

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The blood tests range from a full blood count that checks for anaemia and a test that screens for sickle cell disease and thalassaemia major – serious inherited blood disorders – to screening for HIV, hepatitis B, syphilis and rubella. If they know about your fear of needles, your midwife can help make the experience less traumatic by getting you to lie down for the blood tests, or she could even organise for you to use a cream on your arm that will numb the area before she takes the blood.

Q. My grandparents both have diabetes, so my midwife has said I’ll need testing. Why is this?

A. Lots of women are checked for diabetes in pregnancy, known as gestational diabetes, and between two and five per cent will have it. This includes women with a family history of diabetes. While most women with a family history still don’t develop it, it’s best to make sure.

Most areas check women using a glucose tolerance test. Blood is taken first thing in the morning (you’ll be asked not to eat beforehand), followed by a sweet syrupy glucose drink, then at least one more blood test. The majority of women who develop gestational diabetes successfully control it with diet and care, and in most cases it goes away after the birth.

Q. There’s an outbreak of slapped cheek syndrome at my daughter’s nursery. I’m seven months pregnant – should I be worried?

A. Slapped cheek syndrome (Parvovirus B19) is a virus that causes a rash and, in some cases, flu-like symptoms and commonly affects children.

If you were to catch the virus while seven months pregnant, it wouldn’t cause a problem.

Mums-to-be earlier in pregnancy need to take note though, as between 9-20 weeks a woman who gets Parvovirus B19 has a tiny chance of her baby developing a serious condition called fetal hydrops (where fluid gathers in the baby’s tissue), and there’s a low risk of miscarriage. However, this is rare and in most cases women who’ve caught the virus early in pregnancy have healthy babies. If you think you have symptoms, ask your midwife for a blood test to confirm.

Q. I’m 15 weeks pregnant and when I was just six weeks pregnant I had a small amount of bleeding. A scan showed things were fine, but I’m worried I may still miscarry

A. A small amount of bleeding in early pregnancy is common, and affects about 25 per cent of women. It can cause anxiety as it’s often referred to as a ‘threatened miscarriage’.

It’s normal to feel pelvic congestion and then get a small amount of breakthrough bleeding or spotting (known as an implantation bleed) 6-10 days after conception. This is the fertilised egg implanting in the lining of the womb.

In the first few weeks, some women have a light bleed around the time their period was due. It’s not possible to say someone definitely won’t miscarry, as that can’t be predicted, but light spotting is normal.

The fact that you’ve seen your baby on the scan is also a very positive sign.

Reduce the risk of miscarriage by eating healthily and cutting out alcohol and smoking. Around 80 per cent of miscarriages occur in the first 12 weeks, but the highest risk is in the first eight weeks.

Once a baby’s heartbeat has been seen on a scan then the risk of miscarriage is significantly less.

Q. I’ve just had my first blood test at 10 weeks of pregnancy and been told that I have low platelets. What does this mean?

A. Low platelets in pregnancy is called gestational thrombocytopenia. Platelets play an essential part in blood clotting, so your body can stop bleeding.

Between 150-400 platelets per ml of blood is classed as normal, but if yours drop to 50 or lower you’re more likely to bleed heavily, either during or after giving birth, or while having a caesarean.

With close monitoring and regular testing your platelet levels can be controlled, but if you do drop below 50 platelets per ml then you’ll be given medication to raise your levels.

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In extreme cases you might be given a platelet transfusion but this is a very rare occurrence, so don’t worry. Once your baby is born, your platelets will return to normal.

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