Most babies are born at term, which means between 37 and 42 weeks. Occasionally a mother will go into labour prematurely and much research has been done to try to predict who is risk of delivering early and ultimately to stop this happening. One way of identifying those at risk is to look at the cervix – the neck of the womb. The shorter the cervix, the higher the chance of premature labour. It is not usual to look at the cervix routinely, but if a mother has had a previous preterm delivery, or has had treatment on her cervix in the past, it is worth having a cervical assessment scan. Your own hospital will usually arrange this for you if you are at high risk, but it can also be arranged through Beard Mill Clinic. It is best done at about 23 – 24 weeks, but can be done at other gestations if there is a specific indication, so do ask if you are unsure.
Position / Presentation Scan
We prefer the baby to come out head first, but occasionally the baby has other ideas and tries to enter the world bottom first – in a breech position. The doctors and midwives looking after you can usually tell which way up the baby is by just feeling your abdomen, but sometimes it isn’t always that easy to tell, or you may just want to double check. You can do this by requesting a presentation scan at Beard Mill Clinic.
This isn’t normally done until after 36 weeks – before this the baby still has time to turn around on its own – but if it is breech at this point, you will need to be referred to the Breech Clinic at your local hospital and Victoria can arrange this for you.
Please note that this scan is only available to those who have had earlier scans at Beard Mill Clinic during their current pregnancy. If you are new to the Clinic or this is a new pregnancy, please book as a late wellbeing scan instead to make ensure there is sufficient time for a thorough consultation.
Endometrial Thickness Scan
There is a growing number of women who seek fertility treatment abroad. Often patients will be prescribed a treatment to thicken the lining of the womb (the endometrium) prior to them going to the fertility clinic for embryo transfer.
It may be necessary to do a scan to check the thickness of the lining to make sure that the treatment has worked before you go and Beard Mill Clinic is able to offer this service.
Your fertility clinic will usually advise you when you need to have this scan, so please discuss this with them directly, but Victoria is able to do the scan and pass on the results to the clinic to finalise the timing of your treatment.
A normal “home” pregnancy test works by identifying the hormone human chorionic gonadotrophin (hCG) present in a urine sample. This hormone is produced very early on in the pregnancy and can be picked up in urine from about one week after conception. Some of the new “digital” pregnancy tests work by quantifying how much hormone is present and using this to estimate how far pregnant you are. But a much more accurate way of doing this is to measure the hormone levels in your blood.
This is particularly helpful for patients who have had IVF treatment and want to find out at the earliest opportunity whether the treatment has worked, and for those who have had an inconclusive early scan and it isn’t entirely clear if they have a very early pregnancy (too early to see on scan yet), a failing pregnancy or an ectopic pregnancy.
Typically the hCG levels double every 48 hours in early pregnancy, so sometimes a single test doesn’t give enough information and it has to be repeated two-days later to give a better indication.
This blood test can be done at Beard Mill Clinic and Victoria will contact you with the results the following working day and she will arrange any necessary follow-up for you.
Strep B Screening
Group B Streptococcus (GBS) is a common bacterium, carried by 20-40% of adults, most commonly in the gut, but also in the vagina in women. It rarely causes symptoms or side-effects in adults, but in newborn babies it can occasionally cause a very serious infection, such as sepsis, pneumonia or meningitis.
It is very rare for GBS to be passed to the baby while the membranes surrounding the baby are still intact, so it is not usually a problem during the pregnancy, but the biggest risk is during labour, as the baby comes through the birth canal. If you are known to be a GBS carrier (GBS positive), it is recommended that intravenous antibiotics are given to you in labour to prevent the infection being passed on to your baby. There is little point in treating beforehand as it is easy to become recolonized with the infection after treatment.
Some patients choose to have GBS screening to know if they are a GBS carrier. Swabs to test for GBS are taken at around 36 weeks – late enough for the results to reflect your GBS status as you go into labour, but not so late that there is a chance you will labour before the results are available. If the swabs are negative, it is unlikely you will become colonized before you go into labour and don’t need to be unduly concerned. If you are positive, we would recommend that you have antibiotics while you are in labour or the baby is monitored for any signs of GBS infection after birth.
It is possible to send off for a pack and take these swabs yourself, but Victoria can assist with this, taking the swabs for you, sending them off to the laboratory and contacting you two working days later to explain the results.
Cytomegalovirus (CMV) is a common viral infection that is usually harmless and rarely causes a significant illness in children and adults, but it can be passed on to your baby if you contract it during your pregnancy. It may not affect the baby at all, but if it does it can cause neurological complications and developmental delay. It is passed from person to person through bodily fluids, such as saliva or urine, so advice to avoid coming into contact with it while you are pregnant includes:
- Throughout your pregnancy practice good personal hygiene, including hand washing with soap and water.
- Refrain from sharing food, eating utensils and drinking utensils with anyone.
But if you have already had the infection before becoming pregnant, you will already have antibodies to protect you from getting the virus again and be “immune”, so it is very unlikely that the virus will pass to your baby. Knowing this early on in your pregnancy means that you don’t have to be quite so anxious and Victoria can arrange this simple blood test for you.
Toxoplasmosis is a germ commonly found in raw meat, and in sheep, lamb and cat faeces. It can sometimes cause serious harm to an unborn baby.
Universal screening is offered in some European countries where the incidence of toxoplasmosis infection is high, but in the UK it is less common and universal screening is not recommended. But if you know that you may be at high risk because of your lifestyle, it can make you very anxious.
However if you have already had the infection before becoming pregnant, you will already have antibodies to protect you from getting it again and be “immune”. Sometimes it really helps to know this so you don’t need to be quite so cautious. If you haven’t then it is important to be very careful and take the precautions listed.
A simple blood test will usually clarify if you have had the infection before and Victoria can arrange this for you and explain the results.
To avoid it:
- Wash your hands after handling raw meat
- Do not eat raw or undercooked (rare) meat
- Wash salads and vegetables as any dirt may have been contaminated by cat faeces
- Get someone else to clean out any cat litter trays while you are pregnant
- Always wear gloves when gardening
- Avoid sheep, especially during the lambing season
Parvovirus causes a common illness known as “slap cheek syndrome” or fifth disease. Children typically present with bright red cheeks, rash and a temperature, but adults may be asymptomatic. If you get slapped cheek syndrome during your pregnancy, particularly during the first 20 weeks, the baby may not be affected at all, but there is an increased risk of miscarriage and a small chance that the baby will develop anaemia. This is treatable, but needs to be recognised early.
However if you have had parvovirus infection before you get pregnant – and it is estimated that up to 60% of adults have – then you are immune to the condition and cannot get it again during your pregnancy. Knowing this means that you don’t have to be too concerned if you are around children a lot or in close contact with relatives that you know have the illness.
A simple blood test will tell you whether or not you are immune and Victoria can arrange this for you and explain the results.