Welcome to the kick your Expert led podcast, helping you explore and learn everything about gettingant, pregnancy, birth, and becoming a parent.

On the podcast and our online pregnancy program Grow My Baby, we share my experience of helping more than four thousand babies to be born.

And our experience of running a women's health clinic and parenting for boys.

We're here to help everyone to feel empowered in pregnancy and birth with real life practical information.

Welcome everyone.

I'm Bridgid Maloney.

And I'm obstetrician doctor Patrick Maloney.

And we've co opted eron.

Our senior registrar, doctor Aaron Stewart.

Is still here in the studio.

I'm just going to help us with Q and a yes.

So we said just hang out, hang out.

You might be able to impart your wisdom as well, and so it's a two for one deal.

People.

We are.

Good so erin.

How this works is people ring in with their questions.

I don't ring, we don't have a phone.

They were not a.

Nobody in any way.

They go onto a website called speak Pipe and they leave their questions.

Great, and then we also get some via our email sometimes our program people doing the grow my Baby program also leave a question, so I've got a couple of those today as well.

Also, we've got a we had a really great one from one of our program people on secondary infertility.

So we're lining up a guest to come on and talk to us about secondary infertility.

So if you're listening, that's why your question isn't on this one, but it will be very very soon because it's an in depth one that we want to cover.

All right, well, I'm going to start with this one.

Hi, doctor Pat and Bridgid.

First up, thank you very much for your podcast.

Absolutely love it and constantly learning new things, so really appreciate it.

My name is Emma and I'm currently pregnant.

I had a miscarriage earlier this year in June, which was a miss miscarriage, and I'm currently pregnant again currently eight weeks and I just got back some results from my GP recently, including blood results you're in and a swab, And as part of that swab, they found some europlasma species and in particular one that's called PAVM.

My GP mentioned to me that he had done some quick research, but it's something new that they've only started testing in the last five years and basically that there is some sort of link between europlasma PAVM to miscarriages or infertility.

Obviously, because I've already had one missed miscarriage this year, I'm obviously quite concerned that that could happen again.

So very curious to get your thoughts and insight into you know, the res and what I should consider, uh and what would be a good next step?

Thank you so much?

Good Is that a good one to introduce you?

I just don't even know what what is Europlasma pavim urea.

Plasma is one of the micro organisms that can be you know, cultured from the vagina in a in a if we swap the vagina and grow it in the lab, and there's a there's a large number of different things that can that can live in healthy vagina that we are we are constantly learning little bits of extra information about despite knowing for you know, hundreds of years that vagina was an environment rich in in microbiology.

The questions we we we're gonna ask is there's a lot of bacteria in the vagina, and what's supposed to be there and what's not, what's what's a what's the disease needing treatment and what's a and what's a bacteria that actually belongs there?

And then can these things cause disease and should we be treating it?

Is it possible to eradicate things from the vagina And so that's the that's the area of research.

Now, Aaron, you worked in an MFM unit.

Can you tell people just remind people what an MFM is.

We've actually had an MFM on who was one of your supervisors, So just firstly what is that?

And you had something to also impart about this particular issue.

Yeah, So MFM is the maternal feed or medicine unit and I worked underneath a range of specialists in that unit and it was great to learn high risk obstetrics ultimately, and whether that's mother or baby reasons.

UREA plasma was one that we commonly saw and there is a small increased risk of miscarriage, preterm birth, preterm pre labor, rupture of membranes with your rear plasma, and it was ultimately an area of stetrics is still being researched and probably like the gp SEAD, it's a more new area of research.

But ultimately, if your rea plasma was found it would be treated, and it'd be treated with a safe antibiotic called a zithromycin, And that was for a range of reasons, but ultimately the thought was that there is greater benefit to treating the condition than leaving it.

But there's a lot more space needed to research this area.

So tell me if somebody had is this a normal or a routine swab that somebody would have after a miscarriage.

It's not really a routine thing to do.

It might become one if it turns I just.

Thinking anyone listening to that will go Okay, well I want to be swabbed after a miscarriage.

Now, Yeah, if it turned out that somebody's that the bacteria in the vachina had played at previously unknown, really important role in first trimester miscarriage, then maybe routines swapping afterwards would become part of it.

But it's not current practice.

We know that most first trimester miscarriages come down to the enormous complexity of making a whole new person out of half the DNA from the mother and the DNA from the father, and when those two sets of DNA from the sperm and the egg come together in one big giant, enormous ZIP to create the DNA of the new person.

That process is fabulously complicated and sadly often goes wrong, and so there are a number of reasons why someone might have a first trimester miscarriage.

But the best probably understood is that we wind up with a big, long strand of DNA that can sustain a pregnancy little six or seven weeks, but doesn't have the genetic wherewithal to go beyond there, And we might have a very small number that are due to infection.

But it makes a lot more sense, for example, that if someone had a really short cervix in the second trimester and was under investigation for that, that that really short cervix might not be quite providing the microbiological barrier to the baby that a big, long, closed cervix would have, and so we'd be much more interested in what was going on in the vagina.

So then we would swab, We would find these things, and we would say, fine, if it's there, we'll treat it.

Yeah, are you surprised that a GP did the swab or would you think that this person now needs to go to an MFM or what would be the course of her pregnancy.

Now, I think that now that it's known to be there, I think there's absolutely no no dramas in treating it.

Yeah, and I'm not aware of data showing how effectively it could be eradicated from someone who currently wasn't pregnant, and whether that would last until they were pregnant again, I don't.

I guess that perhaps nobody knows that.

But you could treat it being eight weeks pregnant, it's safe to take that in pregnancy.

Well, I think the listener had a miscarriage.

I know she is now currently eight weeks pregnant.

Okay, yes, I believe it is.

Sorry, that's what I heard.

Yeah, all right, Emma, I hope that helps you in it's often sort of just maybe the GP.

I've had it before in my own life, where the GP sort of throws a line away and that's what you hang on to.

You go, okay, GP said that that must be really bad.

Then you go home and you research it.

And you think, yeah, look that this is This raises a good point about do we treat things just because they're there, or do we need proof that that thing is actually causing our problem?

And then and when we look at something like first time it's to miscarriage people.

In my experience, people find it very frustrating that we can often not indicate the cause, and we can often not offer a future course of action other than finding the strength within to try again.

And that people go, wow, that's a bit lame.

I thought you'd do better than that.

So I can understand why someone would want to latch onto this as a potential cause, But to be honest, I think it's most unlikely to be relevant.

Good, All right, I'm going to read our next question.

It's anonymous.

Hi, I'd love to know more about blood pressure suddenly dropping in pregnancy, a phase of vaguel I've experienced this a few years ago pre pregnancy, and more recently it happened twice in one day at eleven weeks pregnant.

My GP didn't really have any answers other than it can just happen.

Thank you love the podcast.

Good one.

This is another one.

This is another one where it's a really common phenomenon that we don't have a really clever explanation for.

Is that right, Eric, Yeah, These really big circulatory changes happen in pregnancy.

It's amazing what happens to the cardiovascular system of the pregnant woman.

I find it's really interesting so that even from the start, little changes happen in heart rate and respiratory rate as a result of hormonal changes, and then later on, the amount of blood circulating around a pregnant woman a circulatary system is much larger, the stroke volume, how much the heart pumps out per pump is much larger, and all these sort of things really make some pretty radical changes to the way the cardiovascular system works.

And it's not that weird to me that occasionally that leads to some funny things like palpitations and fainting especially.

I mean, if she's had that a few years ago pre pregnancy, is that somebody that just is a fainter, well.

It'd be good to further investigate them to see if there's a non pregnant reason as to why they're painting as well.

And I think that's part of the complexity of our specialty, is that just because we're women and we're pregnant doesn't mean that you can't have a whole range of other conditions that also need to be separately treated.

That you came into the pregnancy with that as an issue.

Yeah, if we're talking about that's a very good point.

If you're talking about someone who's you know, we take a careful history from this person, who say we're talking about a momentarily the moment of dizziness when you stood up too fast, or are we talking about falling down and losing consciousness because you could have some severe thing like a complete heart block on an electrical problem with the heart that could happen to a pregnant person just because they're a person.

Good.

Well, I hope for you that you have no more vasa vagels in your pregnancy and you get through the whole forty weeks.

People who are prone, women who are prone to benign vasovagal events have to be careful of them because if we've ruled out nasty things and it's nine, So I do talk to people who clearly get lightheaded on standing that that could lead to a faint, which could injure them.

So if you get out of bed, if you're toasty warm in bed, everybody's blood pressure is pretty low, and because it doesn't take much pressure to get a blood around your body, if you line down and your toasty warm, and then suddenly you get out spear at morning, you stand up, it's freezing gold everywhere, and then suddenly, so there's a you should sit for a moment before you stand.

And I also recommend pregnant women, if you're in the bathroom, especially if it's cold in the bathroom, that you set the shower to warm and then heat it up, because I saw someone once who just got into a hot shower, changed the temperature change very quickly, fainted and.

Got burnt, right, yeah, yeah, and I was at the risk of hitting your head when you're finished.

That's all right, Well that went somewhere I didn't expect it to, so yeah, exactly.

Just be careful if if you're prone to fainting, Just to go at a slower pace, a slower pace, not like an Aaron Stewart pace, which is really fast.

She goes really fast everywhere.

All right, Hi, doctor pat and Bridget, thank you so much for your podcast.

I've just discovered it and been listening to far too many episodes for the last couple of weeks.

I have a question about viruses in pregnancy.

So I am twenty one weeks pregnant, just had a good twenty one week oldra sound this morning, which is great, But I am always worried about catching something from my other children.

What sorts of viruses do we have to worry about?

I know about CMB and parvo virus, but what about sort of others beavers and rashes of unknown causes that's always come down with It would be great to hear a bit about that.

Now before we start.

We have got this in our Grow My Baby program.

We've got a whole bundle on infectious diseases.

So yeah, if you if you're caen to get that sort of information, then I invite you to come along and join us on our Grow My Baby program.

But let's let's do a quick quick overview.

What else should she be worried about?

What else can those little pesky kids from daycare bring home.

All sorts of stuff?

Yeah, so we've concentrated in obstetrics on the things that are dangerous in pregnancy, so and I think historically that we were just concentrated on those because the vast majority of the other things that the bugs that kids come home with a running nose and so forth from daycare or primary school, they are a bummer for the household to have to deal with, but they are not dangerous for pregnancy.

Yeah, So the things that we can do is to make sure that before you're pregnant that your rebela vaccination that you had as a child is still working.

Get that check at a booster before you're pregnant.

If not, we don't have vaccines for CMV and PAVO, which is why we concentrate on those two.

And you know, we've covered those in other podcast episodes.

And we should be aware of chicken pox as well.

A small number of people have neither had the illness as a child nor been vaccinated, and they're they're at risk of getting a primary chickenpox exposure in pregnancy, which is which is relevant if they're right at the start of the pregnancy, you're right at the end and a pretty big paint in the bomb to get in the middle, but not terribly dangerous.

And so those those are the ones that we that we concentrate on.

Have I left anything out there?

No?

That was great.

We also you'll hear a lot of food advice in pregnancy as well, making sure that you know, make sure you don't eat deli meats or you know, you hear this common concept of not changing the kiddy litter.

So there's other other conditions that we worry about, like listeria or toxic plasmosis, and it's just really important to adhere to those food safety standards to reduce the risk of those infections in pregnancy as well.

What about what about changing your toddlers nappy or was there something that I remember someone said that.

That's changing other toddlers nappies.

Yeah, so that comes up with childcare workers and CMV.

Yeah, so that a child with CMV can shead that for a long time.

And if you are pregnant or planning a pregnancy, then then higher rate of care about those things is needed.

What about RSB flu We've got vaccines for those at least.

Yes, yeah, we do.

No, no, we do.

It's just that that's a little bit different because the way that so if an adult gets RSV, that is not a serious illness for that for that adult.

The reason we're vaccinating pregnant women for RSV is not just not for them, it's for the baby.

So some immunity goes through the baby through the placenta in the court and the baby comes out partially immune and the risk of seasonal flu is also a little bit different.

That is bad for babies because mum may become in a very rare circumstances critically unwell.

So if mum's got bilateral pneumonia from seasonal flu and can't get enough oxygen herself, then the baby's not getting enough either.

And the worst way that could affect the baby is we might have to say, right, this baby's coming out, even if it's not ready, because we can't get enough oxygen into mum to oxygenate the baby.

And that was the whole basis of the of the outcomes in COVID, the pregnancy outcomes in COVID.

It wasn't that COVID was inherently dangerous for a baby to get, give or take.

It was that it was the poor fetus was suffering the effects of mum's severe pneumonia.

Other things like slap cheek is that problematic?

Slap cheek is parv.

Good?

What about herpes?

I think that'd be worth while talking about herpes as well.

So toddlers with a could.

Saw, people with a cold saw are shedding virus and we should be as careful as we can be.

Again to get a cold saw on your mouth in pregnancy is more unfortunate than disastrous, because the advice would be not to kiss the newborn, and they're pretty kissable newborns, you know, So that's always a seeing if you can bumble when that happens, and then and then there's a It's not as common as one would think, but if you have in the age of suppressive therapy, but if you've got an active genital lesion, then it's a problem for a vaginal birth.

But thankfully we don't see too much of that because if someone's prone to recurrent chanital outbreaks, you can take suppressive treatment in pregnancy which is extremely safe for mother and baby, and then you just don't get the outbreaks and you're almost guaranteed not to have one at term.

So I mean, you probably you look at your toddler as a bit of a Petri dish, don't you.

So what are some of the things that people can do.

You can't prevent it all, but what can you do to keep yourself safe?

Mostly I think it's just good hygiene, like just you know, hand washing is you know, have a proper thing of proper soap, but next to next to all the sinks in your house and just and hand washing is probably the main thing.

It's such a fact of life for kids to touch each other and and and share, you know, things pencils and and and to and to give each other infections.

It's just part of being a kid, thankfully, apart from those named ones.

It's very inconvenient to get a bad cold in pregnancy, but not otherwise dangerous.

And we want everyone to love on their toddler like they would normally, but making sure you adhere to safety, you know, like you said, washing hands, but don't limit the amount of love that you give your child because of the concern that you may Yeah, that's right.

Yeah, just maybe don't share their fork if you're if you're feeding them, which I used to do all the time, like, oh that looks delicious.

A little bit of that, all right.

I'm going to move on to this question.

High Bridget High, doctor Pat, I'm wondering if there is any more information on trying to conceive after a primary c in the infection.

I went for my preconception blood, so stead of tried for my third kid, I've got a nearly one year old and my toddler is just over two, so a bit of a sitting duck with them both in daycare a few days a week.

I saw the new South Wales health guidelines recommend possibly waiting up to twelve months, but I couldn't find any information on what they're recommended in the UK or the US.

I really don't want to wait if I don't have to.

We're going to start trying at the end of this month.

They've taken another blood test to make sure it's not a false positive.

But I'm keen to understand what the next results, you know, could say, whether you know it's an old infection or a new one.

And at what point would it be fine to start trying sooner rather than later?

And at what point should I wait?

Thanks?

Bye, Aaron.

I'm gonna ask you, yeah, because you're you're the closest to probably knowing their guidelines.

Well, I don't know that we do that because we did the same.

So what do you think, er?

When can you start crying?

Yeah?

So it is a really complex question because CMB in blood tests, you can look at previous exposure, so you've got IgG and then you can look at more acute exposure, which is called IgM, and both will show up in a blood test.

The complexity with CMB is that IgM, which can show a new or acute infection, can last for years, so even with the additive information that you've got a positive IgM, it's hard to say exactly when that started.

In the last few years, there is good testing now that we do keep early pregnancy blood tests for even up to twelve months, so you can get retrospective additional information from blood tests that are held by the lab and they look at what's called yuvidity and vidity can tell really the change and the IgG and the IgM over time and whether it is more likely that it's a new or past infection.

But ultimately the guidelines do suggest waiting that six to twelve months from the time that you have a primary infection, and that really we'd have to see the blood test to see what that means, but if it is a true primary infection, it's suggested to be six to twelve months.

Alternative things are that you can continue to get blood tests to see when that IgM disappears, but ultimately that could be quite a long road and it could be longer than six to twelve months.

It's a hard position to be in knowing that information, and sometimes when we do know the information, we then have to act on it, and a lot of the time we don't test for CMB as well.

Is the other thing to take into account that there are many people that have a very healthy pregnancy and they haven't been tested for CMB and we don't know their status.

But I would say, ultimately, as a summary, the guideline would be six to twelve months.

Probably not exactly what you wanted to hear, But aren't we glad we brought erin along?

That was a excellent.

Move, excellent answer.

So the idea is that that from a primary infection, viral load can hang around for quite a while and could infect a pregnancy long after the person the woman had recovered from the primary infection, as long as six or twelve months after.

Yeah, And it is a difficult situation because once you know, you can't unknow it and you can't give up anything other than sensible advice.

I'm hearing from the listener that she wants to get on with us.

Yeah, but how some of these things hang around for a while even after your Well, if we had good evidence that it was a primary infection, then those guidelines are there for a reason.

Good luck with your decision around that.

I'm going to read one now, and I picked this because we often get questions about dating, as in dating the pregnancy, not dating somebody.

It's the wrong podcast, wrong podcast for that.

Okay, so high team, I've been listening to your podcast and getting great info for my first pregnancy.

Thank you.

Most questions I have are answered with your well informed episodes, but I have one I'd like to clarify.

I am supposedly eight weeks pregnant, but confused about the gestational age and due date.

The date of conception, as estimated by the dating scan was nine days after my LMP, so we were told a discrepancy of less than fourteen days tends to be counted from L and P.

I typically have a very consistent thirty day cycle.

My GP also said scan showed the baby is a little small for its age, but I don't know what its age is, and has referred us for a subsequent dating scan at the end of the week.

I'm confused about what this means and why the forty week count happens from different times.

I'm small.

Maybe my baby is just a little small.

Any clarification would be great, All right, Pat, I view.

Look, it's a good question.

It's a common source of confusion in people who bothered to map the numbers out and going on, I meant, that doesn't seem quite right.

My understanding is that the is that is that the idea of a forty week pregnancy and that you know, how pregnant you were, dated back to the days before ultrasound, when the only piece of information we had was the first day of the women's last menstrual period.

And of course the first on the first day of the women's last menstrual period's not pregnant at all.

And so for that, no matter, no matter what your definition of pregnancy having started yet, it certainly hasn't started then.

And so for the first two weeks of the pregnancy that are counted in that forty you're actually not pregnant at all.

And that's because that's the only place they knew that they could reliably start from.

So they meant that.

They meant that a that a pregnancy would in forty weeks of a min area no periods, but the but that sperm and egg didn't even come together until the first two weeks that period was up.

Uh.

There are sometimes discrepancies in when people know that they menstruated, know that they ovulated, or know when they had intercourse, and it doesn't seem to match up.

And to be honest, it's it's it is.

It's kind of good to have an accurate estimated due date because if you're well over that estimated due date, we start to recommend that perhaps we should interfere.

So it's nice to be accurate to know that you really are over you and that the dates aren't wrong.

So what I do is if there's if there's an if there's an apparent discrepancy, an expertly done first mess to pregnancy scan within the first eight weeks is extremely accurate.

You've got to be good at it.

You have to make sure you're measuring the right bit of the baby and they're actually measuring the full length.

But it's very accurate and it's likely to be a better bet than any of the other things which are an.

Estimate, because she says, the GP says that a baby's measuring small and that she's small.

Maybe the baby's just small, But at that gestation, aren't they all about the same.

Whether you're very tall or very short, It doesn't matter.

Differences from your personal genetics and your cultural background don't come into later on.

All human embryos are about the same size at that time of pregnancy development, so that's why you can say that if it's that long, then you're that pregnant.

So her GP's right by saying, let's go and do another dating scan at the end of the week and then she'll know exactly, you know, what gestation she's at.

Yeah, I think having regular cycles is really important, and it's great that you've got that data there that you can look back on.

But yeah, if you've got such a discrepancy, very important to get more scans.

Yeah, the scans will show a consistent growth as well.

So if you had one at six weeks and then another one at eight weeks, and the growth between the two scans is about two weeks worth of growth and we know two weeks have gone by, then that all fits in.

And if those are out, then one of the scans might have been wrong.

But if they're both, if they both show two weeks of growth occurring within two weeks, then that strongly indicates that they're both accurate.

Great, all right, I think we've got time for one more because both Aaron and Pat have to get back consulting.

In fact, I think you're running late, so let's go for one more.

My name is Caitlin.

I am not currently pregnant, but have been pregnant twice this year so far.

My first pregnancy was a missed miscarriage at ten weeks.

My second pregnancy and did just last week at seven weeks, when it was discovered by an ultrasound that I had a eptopic pregnancy.

My fillopian tube was removed by a keyhole surgery, and I was very unconfident with the decision that the doctors had made because I thought I had an incomplete miscourage due to bleeding and passing tissue.

One key thing that really has stumbled myself and everyone is that I experienced no pain.

The pictures of the filipian tube from the surgery show that it was very inflamed and I had internal bleeding.

My question is why didn't I experience any pain or other symptoms of the ectopic pregnancy even at seven weeks.

What do I do next time to make sure I can get to it sooner so I don't lose my other filopian tube?

And is there any connection between my topic pregnancy and my missed miscarriage.

Obviously, my body isn't showing me things, showing me or telling me when something is wrong.

Thank you, Paul Love.

I can hear the emotion in her force.

You know, it's a tough time.

Two miscarriages in a row, one topic.

Yeah, that's tough.

That's tough to hear, and I'm sorry that you're going through all of that.

The maybe well answer the last bit first, I don't think that there's a connection.

These really are two different things.

And what you've had here is a shock and run of bad luck, and we're sorry to hear about that.

But when we have a bunch of things happen in a row, it's easy to think that that those things are connected, and in fact there's some sort of broader, broader problem here.

But to the very best of our knowledge, a common thing like a first trimester miscarriage happening in one month and a common thing like an ectopic pregnancy happening in another month, whilst it's heartbreaking for you, is not connected events.

We would look at the two things separately and give advice going forward based on those.

Do you think she was saying that she was unconfident that it was an ectopic pregnancy.

I think the key art here as well is that they the Filippins.

You would have been sent off for testing and that will come back with the histology diagnosis that there was pregnancy tissue.

But it's such a hard decision to make in the moment, when you're being told about a complex complexity to your pregnancy and then that you need to go through surgery.

That's a huge thing to have to deal with and to ask questions or to be unsure, I think is quite normal to answer.

One of the questions that she asked was that bleeding can be a really common part of an ectopic pregnancy, and albeit the pain is also common, sometimes it doesn't happen.

It's interesting to hear that there was bleeding inside the purvis as well, and there was no pain, So I think that may not necessarily be the common presentation of an ectopic pregnancy, but bleeding can be as well.

It would be interesting to hear about the follow up appointment that they would make.

I've definitely seen many ek topics in my career that weren't painful and there was nothing thought to be wrong to the point where they went where the woman went for a dating scand eate and a half weeks and they could see the ec topic and blood in the pelvis, and when I did the operation that there was free blood in the pelvis and the woman still report no pain.

So that is to the point where the most recent one that was this year, it almost went undiagnosed for an extra couple of days because the woman felt so well.

And it was just that the story as it was given to me by the referring GP didn't quite add up that I wanted her to be to be checked for an ectopic, and sure enough there there was.

And it was interesting when she went for her ultrasound.

Even the ultra scenographer was unconvinced that it was a bleeding ectopic because she wasn't even tender.

But you know, it was one of those situations where if it looks like this, that's probably what you're looking at, you know.

So as Aaron said, there should be no real doubt about whether it was an ectpic or it wasn't.

I understand that the listeners concerned because an ectopics supposed to be painful.

Maybe they've got the diagnos wrong.

No, some are not painful, and thethology test on the tube should settle that discussion once and for all.

We've done some discussion on the podcast about ec topics before, and one thing I think is of some consolation to people is that they imagine, sometimes people imagine that that only having one tube is going to reduce their future fertility highly significantly.

Perhaps I think maybe it's fifty percent.

You know, I've only got one tube, I'm only half as fertile, And of course it doesn't work that way, and if the other tube is normal, a future outcomes are good.

So I think she's one step ahead because and she might have been one step ahead because she's already listened to our ectopic episode.

So if you're in your first trimester and you haven't listened to that episode yet, I really recommend that you go back and listen to that.

But she's saying she's worried about what to do so she doesn't lose the second tube.

Yes, so that's a little bit of a complex question in that having an ultrasound early on when she's pregnant again, we'll hopefully identify a pregnancy within the uterine cavity and not in the other tube, and that'll be really reassuring.

Relax about it, it's not another topic.

Let's carry on.

So what week would that be at?

Oh, you can reliably see some evidence of a of a pregnancy within the uterus around five and a half to six weeks, and then shortly, you know, shortly thereafter you know an actual feetal pole with a heartbeat.

But in very keen people, we can look even before we can see the heartbeat and at least see a sack, a convincing sack within the uterus and say, radio, that looks like it's growing in the right place.

Let's have another look in seven to ten days.

And there's a the complexity comes in that if you do get another topic in the other tube, it may or may not be possible to fix that in a way that saves that tube.

So people are as, if they get to it early, can it save the tube?

And there's some complexity to that, but at least at least it won't rupture if we know it's there.

All right, Well, that's all the questions that I bought this week, which is good.

As I said, you're already running lately.

Thanks everyone for giving us your attention for this episode.

We appreciate all your questions and all your feedback.

If you want to leave one of your questions for us to cover on the speak Pipe, you just go to speakpipe dot com slash grow my Baby.

But better still, we'll just put a link in the show notes so you can just directly link on too it, or you can go to our website, which is grow mybaby dot com dot au.

All right, everyone, thank you so much for joining us.

Keep safe, keep well, keep growing your baby, and we'll see you again next week.

Thanks for listening everybody.

Bye for now.

Hey, even though doctor Pat is well a doctor and we get lots of other doctors and other experts on our podcast, I just need to remind you that this podcast is for informational purposes only.

We share lots of medical insights and experience, but everything we talk about is general in nature and may not apply to your specific situation.

Please always consult with your own healthcare provider for your individual medical advice when you grow your baby.