WEBVTT - 199. Q&A: How Much Sleep Do You Need During Pregnancy? & Are Molar Pregnancies Genetic? 0:00:03.880 --> 0:00:06.960 Welcome to the kick your Expert led podcast, helping you 0:00:07.040 --> 0:00:11.040 explore and learn everything about getting pregnant, pregnancy, birth, and 0:00:11.080 --> 0:00:11.879 becoming a parent. 0:00:12.200 --> 0:00:15.960 On the podcast and our online pregnancy program grow My Baby, 0:00:16.120 --> 0:00:19.120 we share my experience of helping more than four thousand 0:00:19.160 --> 0:00:20.280 babies to be born. 0:00:20.280 --> 0:00:22.960 And our experience of running a women's health clinic and 0:00:23.040 --> 0:00:24.120 parenting for boys. 0:00:24.360 --> 0:00:27.320 We're here to help everyone to feel empowered in pregnancy 0:00:27.480 --> 0:00:30.320 and birth with real life, practical information. 0:00:32.479 --> 0:00:34.440 Welcome everyone. I'm Bridget Malaney. 0:00:34.240 --> 0:00:36.320 And I'm obstatrician doctor Patrick. 0:00:36.000 --> 0:00:38.680 Maine, and today we've got a Q and A because 0:00:38.720 --> 0:00:41.360 we have so many and you know, they're fun. 0:00:41.520 --> 0:00:41.959 I like them. 0:00:41.960 --> 0:00:44.960 I hope everybody else likes them as much as people do. Yeah, yeah, good, 0:00:45.560 --> 0:00:47.640 I've actually we're going to, you know, do our typical 0:00:47.640 --> 0:00:50.040 thing and start straight at it. Pat, We're going to 0:00:50.040 --> 0:00:53.800 start now, okay, and I'm going to start by reading one. 0:00:54.080 --> 0:00:56.160 Okay, yes, but don't normally read them. I thought it 0:00:56.160 --> 0:00:59.960 was a good one. Good. Thanks for your fab podcast. 0:01:00.040 --> 0:01:02.120 Stumm a thirty six year old female who works in 0:01:02.160 --> 0:01:04.920 Allied Health so have good health literacy, but I have 0:01:04.959 --> 0:01:07.040 a couple of specific questions. I thought you could do 0:01:07.120 --> 0:01:10.720 a generic version of them on the pod. Well, trying 0:01:10.760 --> 0:01:14.360 to conceive, should you stick to Class A drugs and pregnancy, 0:01:14.400 --> 0:01:17.560 say foods given you might be pregnant seems like it 0:01:17.560 --> 0:01:20.000 could be a long time ago without though, depending on 0:01:20.040 --> 0:01:22.960 how long it takes to get pregnant, especially things like 0:01:23.120 --> 0:01:27.399 migrain wafers or running eggs. So basically, if you're trying 0:01:27.440 --> 0:01:31.160 to get pregnant, should you actually already have you already? 0:01:31.160 --> 0:01:31.319 Are? 0:01:31.600 --> 0:01:31.839 Yeah? 0:01:31.920 --> 0:01:38.320 Yeah? The simple answer is not real. The risks from 0:01:38.840 --> 0:01:42.360 these things are from when the pregnancy starts. In most cases, 0:01:43.360 --> 0:01:46.640 there are a couple of things that need special attention. 0:01:46.720 --> 0:01:51.160 There are some drugs that are so bad for a 0:01:51.200 --> 0:01:55.360 pregnancy that you've got to be really, really really careful 0:01:56.200 --> 0:02:00.320 that you don't get pregnant on that drug with very 0:02:00.360 --> 0:02:04.160 reliable contraceptive plan. And then there are some drugs where 0:02:04.280 --> 0:02:07.280 once you stop using that drug, there's a known gap 0:02:07.320 --> 0:02:10.920 before you should get pregnant after using it. So I 0:02:10.919 --> 0:02:13.400 guess those things you've got to be they're a special case. 0:02:14.080 --> 0:02:16.560 The majority of the other drugs, the risk and applies 0:02:16.720 --> 0:02:19.560 in pregnancy, and there is time to stop them when 0:02:19.600 --> 0:02:22.960 you get a positive presency test and convert to something 0:02:22.960 --> 0:02:28.200 else before it becomes relevant. The foods. We should be 0:02:28.240 --> 0:02:32.360 a non smoker anyway, we should be a we should 0:02:32.440 --> 0:02:36.160 be trying to maintain a healthy body weight, neat well anyway. 0:02:36.680 --> 0:02:40.120 But the specific risks again start when you're actually pregnant. 0:02:40.520 --> 0:02:43.520 What about alcohol, it's a good question. 0:02:45.600 --> 0:02:49.880 Safe alcohol is broadly thought to have us there is 0:02:49.919 --> 0:02:54.440 a safe level of intake, and compared to say smoking, 0:02:54.480 --> 0:02:58.840 there's probably no safe level of smoking. So with alcohol, 0:02:59.000 --> 0:03:02.000 we would say that people should have a safe level 0:03:02.240 --> 0:03:05.200 suitable for somebody who is likely to want to conceive soon. 0:03:05.600 --> 0:03:10.480 So that's actually surprisingly little, but it's not nune. 0:03:11.160 --> 0:03:13.360 Yeah, so a glass every now and then, but not 0:03:13.639 --> 0:03:14.960 big wild nights. 0:03:15.440 --> 0:03:18.880 Yeah, it depends. Are you trying or are you just 0:03:18.919 --> 0:03:20.359 thinking I might have a babe in a few months 0:03:20.360 --> 0:03:23.200 but I'm actually still on the pill. Yeah, it's different. 0:03:23.440 --> 0:03:24.080 It is different. 0:03:24.400 --> 0:03:27.640 And for people that are wondering about their medication and 0:03:27.680 --> 0:03:30.040 whether that medication is safe, what's the best thing for 0:03:30.080 --> 0:03:30.560 them to do? 0:03:31.040 --> 0:03:34.880 This is the main indication for a pre operative for 0:03:34.880 --> 0:03:37.920 for a pre pregnancy GP visit. Ye, So don't wait 0:03:37.960 --> 0:03:40.160 to be actually pregnant, go along, talk to your family 0:03:40.160 --> 0:03:42.520 doctor and say right I've got this plan. I want 0:03:42.560 --> 0:03:47.440 to be pregnant by Christmas. What should I be looking at? 0:03:47.680 --> 0:03:50.040 And one of them will be a plan for medications, 0:03:51.560 --> 0:03:56.520 A plan for maximizing the pre maximizing the state of 0:03:56.520 --> 0:03:59.400 any pre pregnancy conditions you've already got, so if you're 0:03:59.440 --> 0:04:01.320 known to have HYPEI isn't making sure you're on the 0:04:01.360 --> 0:04:05.480 right amount of your drugs? And then and then a 0:04:05.480 --> 0:04:10.720 plan for a genetic prepregnancy genetics screen Yeah. 0:04:10.240 --> 0:04:13.280 Yeah, which is free if you're an Australian citizen with 0:04:13.320 --> 0:04:15.960 a Medicare card. It's now free to do that. Pre 0:04:16.040 --> 0:04:17.760 genetic carrier screen. 0:04:17.560 --> 0:04:20.520 Went from four hundred Dodar bucks to zero. 0:04:20.640 --> 0:04:21.719 Yeah good. 0:04:22.480 --> 0:04:25.400 A follow up here is I live in regional in 0:04:25.440 --> 0:04:28.520 a regional area Golden Valley River in a area, and 0:04:28.560 --> 0:04:31.320 I always assumed I would have a private pregnancy and 0:04:31.400 --> 0:04:34.240 birth but it appears that might not be possible. Being 0:04:34.240 --> 0:04:36.960 a type A vibe woman expecting control and choice as 0:04:36.960 --> 0:04:39.599 well as an older mum meaning more risks. I was 0:04:39.640 --> 0:04:42.160 shocked that I was likely to have to drive three 0:04:42.160 --> 0:04:43.800 hours to Melbourne to see a private O and G 0:04:44.640 --> 0:04:46.240 is this safe or worth it? 0:04:46.520 --> 0:04:47.800 Or should I just suck it up? 0:04:48.000 --> 0:04:51.080 Her words and go public at my nearest regional hub. 0:04:51.200 --> 0:04:53.839 My biggest fear is being treated by students by. 0:04:53.720 --> 0:04:58.960 Student Okay, all right, a little bit of background for listeners, 0:04:59.000 --> 0:05:05.279 particularly over these. Australia has has a a bit of 0:05:05.320 --> 0:05:10.240 an oddly distributed population where the vast majority of the 0:05:10.279 --> 0:05:15.600 population live in big cities on the on the coast, 0:05:16.320 --> 0:05:21.159 and very few people as a percentage, live the further 0:05:21.200 --> 0:05:26.720 inland you go. So you could be living in parts 0:05:26.960 --> 0:05:31.359 of any state in Australia where despite being well resourced, 0:05:31.400 --> 0:05:33.040 you could be you could be rich to gether the 0:05:33.040 --> 0:05:36.080 world's best private insurance. There may not be a private 0:05:36.160 --> 0:05:39.640 health facility there for you to use, and this is 0:05:39.720 --> 0:05:45.000 this is not uncommon. So people from areas of Victoria 0:05:45.120 --> 0:05:50.159 not well serviced by private either might have a pregnancy 0:05:50.279 --> 0:05:53.080 in their local public unit, or they might or they 0:05:53.160 --> 0:05:58.200 might travel for one to one private care. And your 0:05:59.000 --> 0:06:03.040 your local public unit is likely to be it's likely 0:06:03.120 --> 0:06:06.000 to have good, good data and good outcomes. The care 0:06:06.040 --> 0:06:09.760 by global standards is very safe. The problems people have 0:06:10.279 --> 0:06:12.440 is typically related to lack of continuity of care. You 0:06:12.520 --> 0:06:15.240 might see someone different every time you go there. If 0:06:15.240 --> 0:06:19.000 there's a student involved in your care, they'll be supervised. 0:06:19.200 --> 0:06:22.880 Yeah, and you know, maybe just quickly, can you say 0:06:22.920 --> 0:06:26.840 that the levels, Like, so she doesn't mean a medical student, 0:06:26.880 --> 0:06:29.760 she means a registrar, which is the next level up. 0:06:29.800 --> 0:06:33.560 Yeah, yeah, sure, So a student, an undergraduate student, somebody 0:06:33.560 --> 0:06:36.200 who's training to be to be a doctor. At the 0:06:36.240 --> 0:06:40.000 most basic level, that person would always be supervised. And 0:06:40.040 --> 0:06:43.000 then if what we mean is a specialist in training, 0:06:43.480 --> 0:06:46.920 then those people again are supervised in the junior levels 0:06:46.920 --> 0:06:49.880 of their training and less and less unsupervised the more 0:06:49.960 --> 0:06:53.360 senior they get. But that's appropriate because by then they 0:06:53.400 --> 0:06:54.919 have substantial expertise. 0:06:55.839 --> 0:06:58.680 And if she's worried, like a a registrar that's in 0:06:58.720 --> 0:07:01.960 their fifth or sixth year, they've been training for thirteen 0:07:02.000 --> 0:07:02.760 years already. 0:07:03.120 --> 0:07:05.359 I think they're like the best obstitutions, to be honest, 0:07:05.839 --> 0:07:09.880 because you're if you're the senior registrate at the at 0:07:09.920 --> 0:07:11.960 a at a by hospital like the role Women's where 0:07:12.000 --> 0:07:19.640 I trained, you are doing. You are supervising, monitoring, and 0:07:19.760 --> 0:07:24.440 assisting with more babies in a week than someone in 0:07:24.680 --> 0:07:27.960 private practice might do in a month or several months. 0:07:28.720 --> 0:07:32.240 So that may actually be they may actually be the 0:07:32.360 --> 0:07:33.720 very best obstitutions. 0:07:34.920 --> 0:07:35.760 So I don't know. 0:07:35.880 --> 0:07:39.320 Maybe if she tries her local public hospital and the 0:07:39.360 --> 0:07:42.800 initial start isn't great, then she can make any different 0:07:42.840 --> 0:07:44.800 decision and say, yes it is worth me going to 0:07:44.840 --> 0:07:46.280 Melbourne or Bellarat. 0:07:47.120 --> 0:07:49.280 And you can also be booked for with two services. So, 0:07:50.600 --> 0:07:54.320 for example, as the pregnancy progresses, let's say for argument's sake, 0:07:54.880 --> 0:07:59.320 it became clear that for some important reason the baby 0:07:59.440 --> 0:08:02.080 medical and the baby either should be born by cesarean 0:08:02.160 --> 0:08:04.720 section or should be born by induced labor at thirty 0:08:04.760 --> 0:08:09.040 seven weeks or something on account of whatever condition xyst. 0:08:09.520 --> 0:08:13.480 Then that would give you the ability to get down 0:08:13.560 --> 0:08:18.320 to your private obstetriction in the capital city because you 0:08:18.320 --> 0:08:19.600 wouldn't have to come down in labor. 0:08:19.960 --> 0:08:23.160 And we don't talk about shared care enough, just very quickly. 0:08:23.200 --> 0:08:27.240 Shared care is if you have a GP who might 0:08:27.320 --> 0:08:31.640 have a qualification called DRANSCOG, which is a diploma in 0:08:31.760 --> 0:08:35.040 obstetrics and gynecology. You might have someone in your town 0:08:35.280 --> 0:08:37.920 that does shared care, so instead of going to the 0:08:37.920 --> 0:08:40.280 public unit, you could be seen at your doctor's office. 0:08:40.280 --> 0:08:44.160 And then yeah, we utilize those people for even in 0:08:44.200 --> 0:08:46.200 my private practice, so I'll have people who are two 0:08:46.240 --> 0:08:48.719 or three hours away and rather than bring them down 0:08:48.760 --> 0:08:51.120 every week to check their blood pressure. That they have 0:08:51.880 --> 0:08:55.040 most of the checks locally, and some key ones with 0:08:55.120 --> 0:08:58.200 me and in the public of course, will do that 0:08:58.400 --> 0:09:01.880 all the time. If somebody's got certain complexity which means 0:09:01.880 --> 0:09:04.600 they need to be delivered in our big hospital, doesn't 0:09:04.600 --> 0:09:07.160 mean they need to have every visit in our big hospital, So. 0:09:07.160 --> 0:09:09.280 That that might be an option for you too. 0:09:09.320 --> 0:09:11.280 You know, you have most of your care in your 0:09:11.320 --> 0:09:13.600 local area, but you have your big appointments like your 0:09:13.600 --> 0:09:16.600 twelve week or twenty week like and then probably your 0:09:17.000 --> 0:09:20.000 thirties and forties I mean hopefully not forties, but yeah, 0:09:20.040 --> 0:09:21.920 and then your birth at at that hospital. 0:09:22.000 --> 0:09:23.000 That's right, all. 0:09:22.960 --> 0:09:25.600 Right, I'm going to move on to our s big 0:09:25.640 --> 0:09:26.640 pipe now, pat. 0:09:27.360 --> 0:09:30.800 Hi, doctor Patton Bridget. My name's Free. I'm from perf Wa. 0:09:31.080 --> 0:09:34.439 I'm not currently pregnant, however, we are looking to start 0:09:34.480 --> 0:09:39.480 trying next month. I've just finished listening to all one 0:09:39.559 --> 0:09:43.080 hundred and ninety one episodes of your podcast in just 0:09:43.160 --> 0:09:46.440 over three months. I started on the fifth of January. 0:09:47.280 --> 0:09:50.079 It's taken me ninety five days, and I just wanted 0:09:50.120 --> 0:09:53.920 to thank you that it's been a wonderful source of 0:09:53.960 --> 0:09:58.440 reassurance for me as an educational resource. I have OCD, 0:09:58.960 --> 0:10:02.719 so the the idea of having to rearrange and make 0:10:02.800 --> 0:10:06.080 you plans every two seconds and all the uncertainties that 0:10:06.120 --> 0:10:09.560 come with pregnancy has certainly going to be something that 0:10:09.600 --> 0:10:13.680 I will need to practice on overcoming. However, my question 0:10:13.760 --> 0:10:17.320 today is more in regards to sleeping disorders and pregnant women. 0:10:17.480 --> 0:10:23.640 I also have diagnosed insomnia and was recently on kutaypin 0:10:23.720 --> 0:10:26.480 at a lower dose to help with that, which I've 0:10:26.520 --> 0:10:30.240 been recommended to come off due to it being a 0:10:30.240 --> 0:10:34.719 Class C drug, And I'm currently on some older antihistamines 0:10:34.800 --> 0:10:39.160 now which are working. But I'm a little bit cautious 0:10:39.160 --> 0:10:42.200 of the fact that my sleep whilst I am pregnant 0:10:42.640 --> 0:10:47.640 might become more turbulent, and having existing insomnia probably isn't 0:10:47.640 --> 0:10:50.199 going to be great. I was wondering if there's any 0:10:50.559 --> 0:10:54.440 existing research or study around how many hours of sleep 0:10:54.840 --> 0:10:59.720 pregnant woman needs to actually maintain a healthy baby. I 0:10:59.760 --> 0:11:01.880 know that eight hours or so and a half hours 0:11:01.960 --> 0:11:06.040 is obviously the gold standard, but I'd like to know 0:11:06.240 --> 0:11:09.880 how many hours we can we can feel reassured that 0:11:09.920 --> 0:11:12.360 whilst we might be feeling really tired, we're not actually 0:11:12.400 --> 0:11:17.200 doing harm to the baby. So yeah, any info you 0:11:17.200 --> 0:11:20.880 have on that would be great. I'll probably speak to 0:11:20.920 --> 0:11:21.480 you guys later. 0:11:21.640 --> 0:11:22.080 Bye. 0:11:22.480 --> 0:11:25.719 Sleeping pregnancy is hard as it is, and yet you 0:11:25.720 --> 0:11:29.800 put on something on top with insomnia like this, poor lady. 0:11:29.840 --> 0:11:31.160 That's that's tough, isn't it? 0:11:31.240 --> 0:11:34.000 Sure is? I think that's a great question, because really 0:11:34.760 --> 0:11:36.360 I think, I mean, I think you've found a few 0:11:36.360 --> 0:11:40.600 things on this, but I don't know tons about this. 0:11:42.840 --> 0:11:45.720 I would typic if if someone was using a medication 0:11:45.760 --> 0:11:49.000 to help them sleep and wasn't pregnant yet. My usual 0:11:49.000 --> 0:11:51.680 advice will be keep using a thing and we'll change 0:11:51.720 --> 0:11:55.120 you over when you actually are pregnant. In pregnancy we 0:11:55.240 --> 0:11:58.880 use you know, the insomnia can be really quite quite something. 0:11:59.280 --> 0:12:01.319 It's thought to be an effect of the progesterone from 0:12:01.320 --> 0:12:03.680 the placenta on the sleep wake center in our brain 0:12:03.720 --> 0:12:06.160 stem that makes us go to sleep and then sets 0:12:06.160 --> 0:12:08.800 the time and wakes up again, and that that can 0:12:08.840 --> 0:12:11.199 be really quite disturbing. And then, of course in the 0:12:11.240 --> 0:12:13.960 second half the pregnancy, he add to that fidel movements 0:12:14.440 --> 0:12:17.160 pressure on your bladder and musculos gally little pain in 0:12:17.160 --> 0:12:20.400 your hips, so that it's uncomfortable in one position for 0:12:20.520 --> 0:12:23.760 very long and then it's meracle to get any sleep. 0:12:25.600 --> 0:12:30.280 We use those category A antihistamines quite a bit because 0:12:30.320 --> 0:12:36.280 they are powerfully sedative and really quite useful, but also 0:12:37.000 --> 0:12:41.400 category A so so they can be really really worth 0:12:41.600 --> 0:12:47.880 worth using. But in terms of how much sleep we're 0:12:47.880 --> 0:12:49.800 supposed to get to have a safe pregnancy, what did 0:12:49.840 --> 0:12:50.200 you find? 0:12:50.520 --> 0:12:50.600 So? 0:12:51.240 --> 0:12:52.480 I found a couple of studies. 0:12:52.559 --> 0:12:57.200 One that said that there's a median sleep so the average, well, 0:12:57.240 --> 0:13:01.320 the median sleep during pregnancy for the normal population is 0:13:01.440 --> 0:13:03.880 seven point two to seven point five hours a night. 0:13:04.840 --> 0:13:06.360 That sounds fatter than I thought. 0:13:06.440 --> 0:13:10.719 Yeah, normal, Like that's that's as much as I get. Yeah. 0:13:10.760 --> 0:13:15.079 And then another study that said that too much more 0:13:15.120 --> 0:13:17.520 than nine to ten hours a night or too little 0:13:18.200 --> 0:13:21.520 less than six to seven hours a night has an 0:13:21.559 --> 0:13:26.160 association with a higher risk of gestational diabetes diabetes. 0:13:27.559 --> 0:13:28.319 That's interesting. 0:13:28.640 --> 0:13:31.400 So mostly people said it's about quality of sleep, But 0:13:31.400 --> 0:13:35.280 there's there's a lot of observational studies, but there's no 0:13:35.440 --> 0:13:37.959 real study that we could probably hang our hat on there. 0:13:38.200 --> 0:13:40.280 That's interesting. And did they look at mental health in 0:13:40.320 --> 0:13:43.360 that study? No? Because I think the people who are 0:13:43.400 --> 0:13:47.200 sleeping way too much or way too little might have 0:13:47.240 --> 0:13:50.839 a pre existing mental health problem, or or it might 0:13:50.920 --> 0:13:53.400 create its own mental health problem. 0:13:53.480 --> 0:13:58.360 Yeah, so you know, I don't know how this call 0:13:58.480 --> 0:14:00.400 is going with her sleep. She didn't mention how many 0:14:00.400 --> 0:14:03.520 hours she's currently getting. There was another study that said 0:14:03.600 --> 0:14:06.760 that people who having more than an hour nap during 0:14:06.800 --> 0:14:10.160 the day have higher risk of things like hypertension and 0:14:10.480 --> 0:14:13.360 gestational diabetes too. But whether you know that's something that 0:14:13.360 --> 0:14:14.920 we can hang out hat on, I don't know. 0:14:15.920 --> 0:14:19.120 I'm not aware of any big number highly influential studies 0:14:19.160 --> 0:14:22.080 on this. We could keep looking. It's very interesting question. 0:14:22.800 --> 0:14:25.760 One thing that the caller should take into consideration is that, yes, 0:14:25.800 --> 0:14:29.240 she's got some OCD now, and she's been medicating so forth. 0:14:29.480 --> 0:14:32.600 But some people just go way better than they think 0:14:32.600 --> 0:14:38.440 they're going to. Yeah, it's easy if you're thinking about 0:14:38.440 --> 0:14:41.800 pregnancy in advance, and I guess if you've got OCD 0:14:42.240 --> 0:14:45.280 to worry in advance about things that may not actually happen. 0:14:45.600 --> 0:14:47.960 Yeah, good luck, Brey. I hope. 0:14:48.000 --> 0:14:50.360 I hope it all runs smoothly for you and you 0:14:50.360 --> 0:14:53.120 get pregnant in the next month or so. As you 0:14:53.520 --> 0:14:55.560 it's clearly want to like you're doing so much pre 0:14:55.640 --> 0:14:56.840 work that's so great. 0:14:57.040 --> 0:14:59.560 Good luck keep listening. All right, let's move on to 0:14:59.600 --> 0:15:00.840 this one. 0:15:01.520 --> 0:15:03.840 Hi, doctor Patton Bridgett, thank you for your podcast. I 0:15:03.880 --> 0:15:06.200 absolutely love it. My name is Laura. I wanted to 0:15:06.280 --> 0:15:09.360 share my person experience of having a partial molar pregnancy. 0:15:10.080 --> 0:15:11.800 It happened a few years ago when I was twenty eight. 0:15:11.920 --> 0:15:14.520 We started trying for a baby, got pregnant on the 0:15:14.560 --> 0:15:18.040 first try. We felt so fortunate, so lucky, and then 0:15:18.080 --> 0:15:20.840 at the eleven a week mark, I had a scan 0:15:20.960 --> 0:15:23.680 and it confirmed that I had miscarried, so I had 0:15:23.720 --> 0:15:27.760 a DNC. Following the DNC, I bled heavily for about 0:15:27.800 --> 0:15:31.480 six weeks. I had blood test done and my doctor 0:15:31.520 --> 0:15:34.360 sent me to get a pelvic ultra sound and that 0:15:34.560 --> 0:15:38.040 old sound confirmed that I had retained products of conception. 0:15:38.800 --> 0:15:41.840 So I had a second DNC, and at that point 0:15:42.640 --> 0:15:45.480 I received the news that I had had originally a 0:15:45.560 --> 0:15:51.840 partial molar pregnancy. So I remember at the time they said, oh, 0:15:51.960 --> 0:15:54.160 you do have a higher chance of having a second 0:15:54.360 --> 0:15:56.040 partial moler because you've had one. 0:15:56.680 --> 0:15:58.120 I can't remember what the odds were. 0:15:59.120 --> 0:16:04.240 I've subsequently had two little girls, easily complication free, and 0:16:04.880 --> 0:16:07.480 I've kind of wondered whether there's a genetic component to 0:16:07.560 --> 0:16:09.040 being prone to having. 0:16:10.240 --> 0:16:14.720 Partial Mola pregnancies or molars. It was such a confusing time. 0:16:14.800 --> 0:16:15.640 I remember. 0:16:17.040 --> 0:16:18.720 Talking to friends about it and they just had no 0:16:18.800 --> 0:16:21.560 idea and I hadn't heard about the time, and I know. 0:16:21.520 --> 0:16:23.240 It's really rare. I just wanted if you have any 0:16:23.280 --> 0:16:27.520 personal experience managing partial molars and what your knowledge is 0:16:27.520 --> 0:16:29.400 of them. Thank you, Biks. 0:16:29.440 --> 0:16:32.480 All Right, Patti, Mola pregnancies is quite a big topic, 0:16:32.520 --> 0:16:34.760 and I think we've covered that elsewhere, so we're going 0:16:34.800 --> 0:16:36.960 to put that into the show notes. But do you 0:16:36.960 --> 0:16:39.560 think this caller is asking because she wants more children 0:16:39.720 --> 0:16:43.200 or she worried about having a genetic component for her children. 0:16:43.520 --> 0:16:45.960 Yeah, it's not that's not clear, is it. But then 0:16:46.400 --> 0:16:48.640 either way, if she's talking about whether you can be 0:16:48.640 --> 0:16:53.880 predisposed to these things, and I think if really mala 0:16:53.960 --> 0:16:57.120 pregnancy is sort of bad luck on the on the 0:16:57.480 --> 0:17:01.560 day when the Superman air come together, and there are 0:17:01.720 --> 0:17:04.600 protocols for managing those, we do the curret, we find 0:17:06.000 --> 0:17:10.120 the molar pregnancy material, and then depending on the genetics 0:17:10.160 --> 0:17:13.840 of that particular pregnancy, we say you can drive another 0:17:13.880 --> 0:17:16.600 pregnancy after so many weeks or it might be a 0:17:16.640 --> 0:17:21.600 longer period necessary between pregnancies before you can try again. 0:17:22.760 --> 0:17:25.080 As long as we follow those rules, the risk for 0:17:25.119 --> 0:17:30.639 the next pregnancy is low. Then there is a rare 0:17:31.560 --> 0:17:35.119 genetic problem that people can have where they are actually 0:17:35.119 --> 0:17:38.680 genetically predisposed to molar pregnancies. And this is something I 0:17:38.760 --> 0:17:42.400 only learned when we research this question. I didn't really 0:17:42.440 --> 0:17:46.399 know about this. So you can actually carry a gene 0:17:46.400 --> 0:17:52.440 that predisposes you, so that there is actually a way 0:17:52.440 --> 0:17:56.560 that people can be genetically predisposed towards molar pregnancies. And 0:17:56.600 --> 0:18:00.440 it's something called familial recurrent attitude for Mole, which is 0:18:00.480 --> 0:18:07.560 actually a genetic predisposition, And some authoritative bodies suggest that 0:18:07.640 --> 0:18:09.959 if you've had two mole pregnancies, you probably should be 0:18:10.280 --> 0:18:12.560 treated tested for that gene. 0:18:13.119 --> 0:18:17.880 Yeah, but yeah, so whether this woman's asking for her 0:18:17.920 --> 0:18:20.160 own girls or not, like, you know, you're not recommending 0:18:20.160 --> 0:18:22.280 that her girls get tested or not. 0:18:22.359 --> 0:18:25.159 If she's only had one, that's much more likely to 0:18:25.200 --> 0:18:28.120 just be bad luck. Yeah, it's like the old discussion 0:18:28.119 --> 0:18:30.920 about you know, early pregnancy loss if you have if 0:18:30.960 --> 0:18:35.160 you have one, it is there's unlikely to be severe 0:18:36.600 --> 0:18:39.080 underlying pathology. But the more you've had in a row, 0:18:39.240 --> 0:18:41.920 the more likely there is to be severe underlying pathology. 0:18:42.400 --> 0:18:44.640 Good. Thank you so much for calling in and telling 0:18:44.720 --> 0:18:47.200 us about your MOLA pregnancies and that you had two 0:18:47.320 --> 0:18:47.840 healthy girls. 0:18:47.840 --> 0:18:49.280 I hope you're going super well. 0:18:49.400 --> 0:18:49.960 That's prilliant. 0:18:50.560 --> 0:18:52.119 All right, let's go to this caller. 0:18:52.840 --> 0:18:56.679 Hi, doctor part and Bridgette. I recently started listening to 0:18:56.680 --> 0:19:01.800 your podcast. I started on the episode pregnancy one O one, 0:19:02.800 --> 0:19:06.200 which is perfect timing for me. Me and my partner 0:19:06.320 --> 0:19:12.320 we asked thinking of starting to start trying to get pregnant. 0:19:12.760 --> 0:19:17.320 I'm thirty three and my partner is thirty five. 0:19:18.320 --> 0:19:18.800 And. 0:19:20.440 --> 0:19:28.040 I'm diagnosed with hyperthyroids up. I've been keeping it. I've 0:19:28.040 --> 0:19:33.119 been managing with my GP and my levels are correct. 0:19:34.320 --> 0:19:40.919 She tested me for PCOS and there's no signs of it. 0:19:41.520 --> 0:19:45.040 But I have irregular periods. I've always had irregular periods. 0:19:45.400 --> 0:19:51.800 It ranges from thirty thirty to fifty sometimes sixty two, 0:19:51.960 --> 0:19:59.960 sometimes even more. And I'm thinking, how do I'm how 0:20:01.480 --> 0:20:05.760 how do I know ovulating or how do is pregnant? 0:20:05.840 --> 0:20:06.560 Getting pregnant? 0:20:07.560 --> 0:20:08.040 With that. 0:20:09.600 --> 0:20:10.119 On work? 0:20:11.600 --> 0:20:15.520 I love your to know your answers. Thank you. 0:20:16.320 --> 0:20:18.480 Before I start, Can I just do a little sidebar 0:20:18.680 --> 0:20:20.639 and say we need to do another episode on p 0:20:20.720 --> 0:20:24.119 C O S because it's now called p M O S. Yes, yeah, 0:20:24.160 --> 0:20:24.960 so there's been an update. 0:20:25.040 --> 0:20:27.720 Can do that, but anyway, good question. 0:20:27.920 --> 0:20:30.720 This is wow, very irregular period also. 0:20:30.520 --> 0:20:34.800 Do to our heart because we don't like people to 0:20:35.960 --> 0:20:38.199 when people come in and say that they've been trying 0:20:38.359 --> 0:20:40.800 for a year and they're still not pregnant, and they've 0:20:40.800 --> 0:20:42.359 come along because they've been trying for a year, but 0:20:42.359 --> 0:20:45.080 they they've had a significant problem with one of the 0:20:45.160 --> 0:20:48.320 ingredients that was obvious at the start. Then that year 0:20:48.640 --> 0:20:51.000 could could have been a kind of waste of time. 0:20:51.400 --> 0:20:54.919 And that's always been a bit disappointing and frustrating because 0:20:54.960 --> 0:20:57.639 we would rather have helped that person a year ago. Yeah. 0:20:57.760 --> 0:21:03.920 So this this cycle is highly highly abnormal and there's 0:21:03.960 --> 0:21:07.080 every chance you're not ovulating at all. So we would 0:21:07.119 --> 0:21:08.960 not want that person, this person to come along and 0:21:08.960 --> 0:21:10.960 see us. So after a year of trying, we would 0:21:11.000 --> 0:21:17.720 want to sort this out. Now. Okay, so through a 0:21:17.760 --> 0:21:21.880 dedicated women's health GP or a specialist obstrition and gynecologist, 0:21:22.160 --> 0:21:24.760 we want to work out what's try and work out 0:21:24.760 --> 0:21:31.200 what's wrongs. Some things that are relatively straightforward to rule out. 0:21:31.240 --> 0:21:33.159 There are some things that blood tests will need to 0:21:33.240 --> 0:21:35.280 rule out, and then there's a group of women who 0:21:35.359 --> 0:21:40.280 just done ovulating for no apparent reason. Some of these 0:21:40.320 --> 0:21:44.359 things are correctible and others not. It is possible to 0:21:44.440 --> 0:21:47.760 have a really prolonged cycle like this and still be ovulating, 0:21:48.320 --> 0:21:51.280 but it can be very difficult to track down exactly 0:21:51.359 --> 0:21:54.600 when that ovulation is happening. And the problem with that 0:21:54.720 --> 0:21:56.600 is that unless you're an early wad to having sex 0:21:56.640 --> 0:22:02.119 every day, it's hard to time intercourse around the ovulatory 0:22:02.119 --> 0:22:04.840 time if you don't know when that is. So with 0:22:04.920 --> 0:22:08.480 a cycle it's really long like this, we would want 0:22:08.520 --> 0:22:11.680 to try and work out is there any evidence of ovulation, 0:22:11.760 --> 0:22:13.879 and we can do that with some cereal blood tests. 0:22:14.080 --> 0:22:16.920 More likely there's not, and the bleeding just comes when 0:22:16.960 --> 0:22:20.280 it's ready, and that needs to be corrected before you 0:22:20.280 --> 0:22:23.680 get pregnant at all. So this is someone we would 0:22:23.760 --> 0:22:27.560 like to meet with, investigate and treat. 0:22:27.920 --> 0:22:31.280