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Dr Marlena du Toit

Obstetrics
Information about RUBELLA during pregnancy. PDF Print E-mail

Rubella, or German measles, is most dangerous to your baby if you catch it during the first 16 weeks of pregnancy. Rubella can cause miscarriage, stillbirth, or birth defects in unborn babies, such as:

  • deafness,
  • brain damage,
  • heart defects, and
  • cataracts.

This is called congenital rubella syndrome and it is transmitted to the baby through the placenta. Rubella is now a rare condition because people were either vaccinated at school, or as part of the childhood MMR vaccine.

Rubella is transmitted by coughs and sneezes, and is very contagious. Being immune to rubella ensures that your baby is very unlikely to be affected if you come into contact with the infection. You will have a blood test to check your rubella immunity as part of your antenatal tests. This will usually be at your first check-up.

Rubella immunity test

If you are planning to get pregnant, you should have the rubella immunity test first. Even if you were vaccinated at school, immunity does not last as long as previously thought, and the effects of the vaccine may have worn off.
If you are not immune, you cannot have the jab while pregnant because the vaccination contains a live virus, which could cause rubella infection in the baby. For the same reason, you should not become pregnant for at least a month after having your rubella jab.
Symptoms of rubella are mild and include fever, headache, joint pains and sore throat. A distinctive red-pink rash usually appears shortly after the glands swell.

Risks during pregnancy

The risks from getting rubella during the different stages of pregnancy are outlined below.

  • First trimester (weeks 0 to 13): If you contract rubella during the first trimester, there is a very high risk (up to 90%) that your baby will be affected. The earlier in your pregnancy that you catch rubella, the greater the risk to the baby.
    After week 10, the risk to the baby is reduced, however, they may develop problems with their sight or hearing, which may not become apparent until they are older.
  • Second trimester (weeks 14 to 26): In weeks 14 and 15, there is still a risk to the baby. They may develop problems with their sight or hearing that may not become apparent until they are older.
  • Third trimester (week 27 to birth): After week 16, the risk to the baby is low.

If you are pregnant and you know that you are not immune to rubella, you must keep away from anyone who has rubella, particularly during your first 16 weeks of pregnancy.
If you come into contact with someone with rubella, you should inform your gynaecologist immediately. They will be able to diagnose rubella and may offer you a test to see if your baby has been affected.
If your baby has been affected by rubella, you will be encouraged to have some counseling and talk to your gynaecologist, a nurse or midwife. There are a number of options available to parents who are expecting a baby affected by congenital rubella syndrome.
N.B. If you are having chemotherapy, or if your immune system is low for another reason, or if you are allergic to the medicines neomycin, or polymyxin, you should not have the rubella vaccination.

 
Rubella or German Measles PDF Print E-mail

Rubella, or German measles, is most dangerous to your baby if you catch it during the first 16 weeks of pregnancy. Rubella can cause miscarriage, stillbirth, or birth defects in unborn babies, such as:

deafness,

brain damage,

heart defects, and

cataracts.

This is called congenital rubella syndrome and it is transmitted to the baby through the placenta. Rubella is now a rare condition because people were either vaccinated at school, or as part of the childhood MMR vaccine.

Rubella is transmitted by coughs and sneezes, and is very contagious. Being immune to rubella ensures that your baby is very unlikely to be affected if you come into contact with the infection. You will have a blood test to check your rubella immunity as part of your antenatal tests. This will usually be at your first check-up.

Rubella immunity test

If you are planning to get pregnant, you should have the rubella immunity test first. Even if you were vaccinated at school, immunity does not last as long as previously thought, and the effects of the vaccine may have worn off.

If you are not immune, you cannot have the jab while pregnant because the vaccination contains a live virus which could cause rubella infection in the baby. For the same reason, you should not become pregnant for at least a month after having your rubella jab.

Symptoms of rubella are mild and include fever, headache, joint pains and sore throat. A distinctive red-pink rash usually appears shortly after the glands swell.

Risks during pregnancy

The risks from getting rubella during the different stages of pregnancy are outlined below.

First trimester (weeks 0 to 13): If you contract rubella during the first trimester, there is a very high risk (up to 90%) that your baby will be affected. The earlier in your pregnancy that you catch rubella, the greater the risk to the baby. 
After week 10, the risk to the baby is reduced, however, they may develop problems with their sight or hearing, which may not become apparent until they are older.

Second trimester (weeks 14 to 26): In weeks 14 and 15, there is still a risk to the baby. They may develop problems with their sight or hearing that may not become apparent until they are older.

Third trimester (week 27 to birth): After week 16, the risk to the baby is low.

If you are pregnant and you know that you are not immune to rubella, you must keep away from anyone who has rubella, particularly during your first 16 weeks of pregnancy.

If you come into contact with someone with rubella, you should see your doctor immediately. They will be able to diagnose rubella and may offer you a test to see if your baby has been affected.

If your baby has been affected by rubella, you will be encouraged to have some counseling and talk to your consultant, GP, nurse or midwife. There are a number of options available to parents who are expecting a baby affected by congenital rubella syndrome.

 

N.B. If you are having chemotherapy, or if your immune system is low for another reason, or if you are allergic to the medicines neomycin, or polymyxin, you should not have the rubella vaccination. See your doctor for advice.

 
Post natal classes for moms and babes PDF Print E-mail

Postnatal classes for new mom and baby

What does the classes entail?

The classes are focused on mothers and a babies from six weeks after birth – normal vaginal birth or birth by casearean section. It rehabilites mom after the birth – with special attention being stomach muscle strenghtening and improving mobility. With all the exercises, your baby will be involved as well. A programme to stimulate the baby will be followed, tailor-made according to the age of the baby.After each class you will be supplied with a programme to follow at home. Group sessions or individual sessions available.

Where: LOUIS LEIPOLDT Medi-Clinic, FAIRWAY 5

When: once a week for 6 weeks – from 12:00- 13:00

Contact/Enquiries: Marulize Swart Fisioterapeute

021 9484052

0825510645

 

 
Down Syndrome PDF Print E-mail

Risk and Recurrence Risk of Down Syndrome

Paul J. Benke, M.D., Ph.D. Director, Clinical Genetics, Virginia Carver, Ph.D. Prenatal Diagnosis Program Roger Donahue, Ph.D Director, Cytogenetics Laboratory Genetics Division, Department of Pediatrics University of Miami School of Medicine Miami, Fla. USA October 1995

Children with Down Syndrome (DS) account for one of every 800 births. The risk of chromosome disorders like DS, trisomy 13 and trisomy 18 increases with maternal age. The incidence of DS at birth is lower at age 20 (1/1600) than at age 35 (1/370), but many more younger women have children than older women. So most (75-80%) DS children are born to younger women. If a couple has a child with DS, there is usually an increased risk for a second affected child.

Read more...
 
Epidural Information PDF Print E-mail

Epidural anaesthesia

Childbirth is a natural process; it causes pain for most women. Breathing exercises and relaxation techniques may help, but many women will still need medical assistance to control or reduce pain.

If labour pains become severe, your obstetrician may prescribe an opioid injection or other medication. In some cases, these medicines will be inadequate or may adversely affect the baby of your health and in such a case, your obstetrician may recommend epidural anaesthesia for pain control.

Read more...
 
Vaginal birth after caesarean section (VBAC) PDF Print E-mail

 

Caesarean section is a common surgical procedure. For decades it had been generally assumed that once a woman had a caesarean section, all her future babies would have to be delivered by caesarean section.

However, this concept has changed due to improvements in obstetric care and surgical techniques. Many women who had a caesarean section can safely give birth through the vagina during subsequent labour. This is known as VBAC. With careful selection of patients and good obstetric care, from five to eight women who attempt VBAC are successful.

Read more...
 
PDF Print E-mail

Information on Caesarean section

Definitions and terminology

A Caesarean section is a surgical procedure to deliver a baby through an incision in the mother’s abdomen. A caesarean section is need when delivery of the baby through the birth canal (vagina) is not possible or when vaginal delivery pose a danger to the mother or the baby.

A caesarean section can be planned in advance as an elective procedure or it may be performed as an emergency if a serious complication that may harm the mother or the baby develops during labour. It may also be performed during labour if it becomes likely that a vaginal delivery will not occur without a high risk or harmful factor present. In such a case it is part of safe obstetric practise and not classified as an emergency caesarean section.

Read more...
 
Warning Signs PDF Print E-mail

  • Light bleeding with or without cramps during the first three months are common. Contact me should these increase.
  • Heavy vomiting and the inability to keep any food/liquid in.
  • Continued dizziness or fainting.
  • Continued headache for more than two days with no relief despite the use of paracetamol.
  • Light flashes which interfere with your vision/double vision.
  • Pain in/swelling of one leg only.
  • After 26 weeks – if your baby doesn’t move for 12 hours or move less than usual.
  • Water running from your vagina.

 
Medication PDF Print E-mail

Treatment of colds

  • Vitamin C: One gram twice daily.
  • Paracetamol: One gram four times daily for two days. Contact your doctor if there is no improvement.
  • Steam yourself with tea tree oil or drip eucalyptus oil/Karvol on your pillow.
  • Saline nasal spray or sinus rinse – mix half a cup of lukewarm water with half a teaspoon salt and half a teaspoon baking soda.

Nausea treatment

  • Eat six small meals daily instead of bigger portions. Avoid strong foods such as curry.
  • Avoid the intake of food and drinks/liquid one after the other.
  • A cup of tea and biscuit in bed in the mornings can do wonders to avoid nausea (and it’s good mood food!)
  • Asic: Two tablets in the evening and one in the morning.
  • Emex syrup: 5 ml three times daily or as needed.

Headache treatment

  • Use paracetamol: One gram every six hours. Consult your doctor after two days.
If you don’t have a family doctor, it’s a good idea to choose one soon. Should you have any medical problems, you can contact your doctor who can contact me in turn if he/she needs advice.

 

 

 
Eating PDF Print E-mail

  • Avoid unpasteurised milk and milk products – including soft cheese such as feta, brie, camembert and blue cheese unless specified that they were prepared with pasteurised milk.
  • Avoid cold meats including viennas and pâtés.
  • Avoid pre-prepared cold foods.
  • Avoid cold smoked seafood such as salmon.
  • Avoid big, long-lived fish such as shark and swordfish with high mercury levels.
  • Avoid raw and under-cooked meat.

 
Lifestyle PDF Print E-mail

  • REST, REST, REST!
  • Drink enough water, avoid caffeine – drink rooibos tea and warm chocolate drinks such as Milo or Horlicks.
  • Reduce your caffeine intake, avoid smoke and alcohol as well as other drugs.
  • Discuss medication intake beforehand with your doctor.
  • Continue with regular safe exercise, but don’t overdo it and take enough liquid while you train.
  • Keep your body temperate below 38°C. Treat fever with Panado, avoid saunas and warm Jacuzzis. Spa body treatments are allowed.
  • Avoid x-rays. If necessary, inform the staff