Frequently Asked Questions

Infertility

When do I have to say that there is a problem and seek ?

Typically they say to wait one year of unprotected sex to say it's worth viewing. Thus 85% of couples have been pregnant at some point this year. Some exceptions: maternal age, a couple that is found only little because of travel ...

What is the fertile phase of the menstrual cycle ?

For a 28-day cycle, ovulation takes place around the 13th to 14th day. The fertile phase would be in the week surrounding this date.

What is the proper rhythm of sex ?

Every other day for a week starting the 10th day of the cycle, if the cycle is 28 days.

Will take her temperature every morning is helpful to predict ovulation ?

No, because once there is rise in temperature, the egg is fertilized more. The temperature curve is still to estimate the quality of the ovulatory cycle and the corpus luteum, which has resulted.

How many days of abstinence before the semen analysis ?

It must be done on the 4th day of abstinence. He gives himself through masturbation at the laboratory, indicating the time of specimen collection.

Pregnancy

How about smoking during pregnancy

Smoking doesn’t correlate with fetal malformations but is thought o increase the risk of complications such as growth retardation, fetal demise, placental abruption... Women who say that they are unable to quit smoking during their pregnancy should be encouraged to diminish to a maximum their consumption. To be noted that narguile consumption is considered smoking. If the partner smokes , he should do it in balconies or outside.

Alcohol consumption during pregnancy

Chronic use of alcohol results in fetal alcohol syndrome, which consists mainly of morphological abnormal appearance and mental retardation. The exact amount of alcohol to result in fetal harm is unknown, so pregnant women are advised to restrain from alcohol. Chronic consumption also result in maternal malnutrition, accidental falls psychological problems in the postpartum period.

Sushi and pregnancy

Primary concern with high levels of heavy metal ( cadmium, mercury..) in fish like salmon and tuna have been considered unproven thereafter. In fact in many eastern countries sushi is the base of all pregnant women’s diet, and no pathologies have been noted. Sushi is also considered a valuable source of protein, especially in vegetarian patients.

Toxoplasmosis and pregnancy

Immunitary status is defined by a laboratory test at the start of pregnancy and even before pregnancy if possible. If not immune the patient should avoid sources of possible contamination such as raw or uncooked meat, not well washed vegetables ( salads in restaurants...) and thoroughly wash their hands before eating, especially if cats are in the house they are visiting.

Rubella and pregnancy

Rubella is a viral infection that leads to fetal malformations if contracted in pregnancy. Immunitary status is preferably determined before pregnancy , because a vaccine exists. Following vaccination, pregnancy is avoided for three months.

Sport activity

Sport is permitted in all stages of pregnancy, given the absence of pain or bleeding. Sports to be avoided are the one where the patients is breathless ( heavy aerobics...) . Body injury is increased in the third trimester because of instability. Some questions are difficult to answer: horse riding, marathon ...!

Sexual intercourse

Much taboo surrounds this aspect of daily life during pregnancy. It is allowed to have sexual intercourse , provided that there is no bleeding, abdominal pain or suspicion of fluid leakage or obstetrical problems like placenta previa ou premature labor. Sexual positions can be varied but care is to avoid situations were direct trauma could be exerted upon the abdomen, especially during the last trimester.

Gynecology

What is the characteristic of a 'normal' menstrual cycle?

A cycle is not always srtictly regular . We usually consider a 28 day cycle to be normal, + or - 7 days. We see then a wide spectrum of normality. 

The amount of menses is also variable . Variations should be reported to physician.

Obstetrics

How much time do i have to come if i notice fluid leakage

We usually say to come without hurrying ( that is not to risk car accidents!) ; Of course unnecessary waste of time is also ill-advised. In particular situations your treating doctors will tell you in advance of the degree of emergency to come.

Childbirth

How many persons will be in the room when i will be delivering? Is my husband allowed?

I will be there of course! There will also be the midwife, one or two medicl aids, the resident who will assist me, and eventually persons from the team of anesthesia ( for epidural increase) or paediatrics ( in case problems are anticipated).  One person of your family is allowed , and is to sit  next to you at the level of the bed head. Your husband is therefore welcome and we will be happy that he participate in these moments, but of course that is if really likes to because some fathers get to be real anxious or dizzy during delivery, even if they don’t actually see the baby coming out. If you think that your husband couldn’t stand the situation, then it is best that he awaits in the corridor, and then enters when the baby is on the heating table .  During caesarean section hospital administration usually doesn’t permit the father-to-be in the operating room

What to take to the hospital

 

Usually everything is arranged so th you won’t need any bodies or pyjama for the babies , except the one when leaving the hospital. Milk bottles are also available during your stay.

Maternal pads are provided and hence no need for bringing. Personal items are to be brought bythe patient.

When to come to the hospital

 

Any particular event that is unusual should alert you , and you need there to keep in tooch with your doctor or to come to hospital if he is unreachable . Such events include: bleeding, suspicion of fluid leakage , baby moving less than usual, contractions ( could be felt as abdominal pain, backache pain or  abdominal hardening). Consulting for these symptoms doesn’t implicate necessarily that we will keep you after that to deliver, but it is important to assess the situation of the baby and to see how close is delivery.

How much time do i have to come if i notice fluid leakage

 

We usually say to come without hurrying ( that is not to risk car accidents!) ; Of course unnecessary waste of time is also ill-advised. In particular situations your treating doctors will tell you in advance of the degree of emergency to come.

Where do i go when arriving to hospital

 

Delivery room is where to go. Don’t waste time in administrative workup ; your husband can take care of that after you arrive in delivery room.

 -In Hotel-Dieu it is situated at level3  ( ask at  emergency room if needed).

-In Bellevue MC it is at level B2, turning right then left from elevators.

-In St Therese Hosp it is on 5 th floor

A midwive will receive you there, take a brief history, blood pressure and if needed perform a fetal monitoring and pelvic exam before contacting me.

Do i need to do an epidural?

 

This a personal decision. Of course i usually advise my patients to do it to relieve labor and deliver pain;  Some patients choose no to have it , for many reasons: personal beliefs that it will do harm, fear, few pain, economical reasons...

How an epidural is performed?

 

The person that do it is the anaesthesiologist. He or she can decide no to do it if there is a risk ( even small) that it will cause harm , like bleeding anomalies, neurological abnormalities, local infection...).

The insertion of a  very small catheter is done under local anesthesia, at the midline of the lower back. Your cooperation is strongly needed, and sometimes, epidural can need few tries to be inserted in the correct place. After it is in place progressive decrease in pain is noted. The catheter is retrieved once delivery is finished and eventually stitches performed.

What is episiotomy ? is it always required?

 

At the moment of delivery of the fetal head , considerable stretching is pplied to the maternal soft tissues. The operator will assess the situation and could use a limited incision in the perineal area to avoid undesirable large tears , that cold be difficult to repair after tat. We do not perform systemically an episiotomy , and the decision is left to the obstetrician who will decide it only in the last  moments. He will suture it appropriately after delivery of the baby and of placenta after that. Of course the rate of episiotomy is higher in patients delivering for the first time.

What happens after the baby comes out

 

It is custom to put the baby unto the mother’s abdomen, and then to clamp the umbilical cor and section it. This moment is incredibly powerful for most of the parents. You shouldn’t be afraid of blood covering the baby ( it is yours!).You will have few seconds to look at it or even caress him. The midwife will  then immediately take care of the baby a few meters away from you on a heating table, so that the baby won’t lose heat rapidly. She will do aspiration of amniotic fluid in his mouth and respiratory area, and stimulate the baby . Sometimes energetic friction of the baby and respiratory help are required, and this shouldn’t worry you . If needed pediatric team is contacted bedore or during delivery when we anticipate problems in the newborn. 

How does the placenta comes out?

 

The rest of the umbilical cord is connected to the placenta that is still inside the uterus. After a few minutes of rest, the uterus will start contracting again and expulsion of placenta is facilitated by gentle massage of the uterus. Rarely we have to ‘ go and get it’ , especially in case of emergencies and to avoid unnecessary blood loss. Uterine massage will continue after that to assess the uterus and to avoid relaxation of uterine muscle that can lead to bleeding. Medical treatment is also given in the perfusion or intramuscularly for  the same purpose. These medication can give a sensation of ‘heat’, nausea, vomiting, that are transient and don’t need to worry you .

When do i leave the delivery room

 

Basically when all is finished and a 30 minutes surveillance ( mean time) is reassuring. Epidural catheter is retrieved. Baby is next to you during that period of time , and you are encouraged to hold him, with the aid of the midwive if you are feeling good.  Walking is forbidden a that time and you will get to your room by wheel chair or moving bed.

News

A new website is born!   |

2011-02-16 22:00 16
2011
It is a great pleasure to announce the birth of this new website! It is destined mainly......more