Dear Doctor ‘P’ 20

Send your questions to: preanant@intearal-advisorv.com
pregnant@integral-advisory.com
answers are provided jointly
by our team of doctors

Our Team Of Experts

Dr. Blasio Omuga
Lecturer, School of Nursing Sciences, University of Nairobi
Consultant Obstetrician/Gynaecologist
Based at Doctor’s Plaza, Clinic No.18,Kenyatta National Hospital

Dr. David Kiragu
Consultant Obstetrician/Gynaecologist
Based at KAM Health Services
IPS Building, 1st Floor, Kimathi Street, Nairobi

Dr. Njoki Fernandes
Resident Obstetrician/Gynaecologist
Based at Kenyatta National Hospital

Cervical mucus and conception
What is the relationships between the cervical mucus and conception?

Following ejaculation, semen is’ stored’ within the cervix where it is nourished by secretions released by cervical glands. Small quantities of sperm are then released and enter the uterus and hence of the fallopian tubes where fertilization occurs.

Cervical mucus during the ovulation period is thin, easy following and abundant. This facilitates entry and forwards movement of the sperms. A few factors can hinder production of good quality mucus. These includes immunological factors where maternal antibodies impede the movement of sperm. Chronic cervical infection: Effects of some infertility drugs and other uncertain contributory factors could be harmful to mucus quality. The most effective way of managing infertility arising from this phenomenon is artificial insemination where sperms are deposieted directly inside the uterus using a catheter (tube)while the woman is ovulating. Oestrogen tablets may help improve poor quality mucus.

Travelling
I am 32 weeks pregnant and have to go on a business trip. Is travelling safe for me?
You have not mentioned where you are going and how you are travelling. Nevertheless, here are some considerations:

o The best time to travel is the second trimester, when the pregnancy is firmly established.
o If you are driving, choose a seat with a plenty of leg-room and move your legs off during the journey.
Take advantages of any stop to stretch your legs. Break the journey whenever you feel tired. Avoid speeding and be especially slow on bumpy sections of the road.
o Carry your medical information and scans if you have any. They will be handy in an emergency.
o Last but very important; make sure you get a go ahead to travel from your doctor first.

Am I still fertile?
I gave birth to my son in the year 1999 February when i was 25. I was on family planning (FP)drugs till mid 2005, using the injection. My periods thereafter have been normal just as they were during the time i was using FP drugs.
Until now, i have not been able to conceive again. I expect my system to be clear by now. Are my chances of getting pregnant really there? I am now 35.
You indicate you stop using family planning mid- 2005 since then you have not conceived. This duration is long enough to raise the possibility of ‘secondly infertility’ which is the inability to conceive by someone who previously successfully carried pregnancy. Your complete history should be taken, relevant physical examination performed, and relevant tests done.

Elusive pregnancy
I went for a pregnancy test in October 2008 and it was positive. After one week, I started spotting which went on for two weeks then disappeared. On 2nd November 2008, I went for a scan and the results showed i was pregnant. I later went for a pregnancy test, which turned out positive. What could be the problem? Please advise.

The first time you could have been pregnant and subsequently have a micro-abortion which you assumed to be spotting.
If pregnancy tests persist without evidence of pregnancy, you may have a condition known as trophoblastic disease  (having rare tumours that involve abnormal growth of cells in the uterus). You are advised to see a gynaecologist for evaluation and further management.

END: PG20/8

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