[0.45] Brigid and Dr Pat introduce this week’s episode.

[1.13] Pia asks about the considerations taken into pregnancy for someone with cardiac concerns and how someone’s obstetric care provider would work with a cardiologist during pregnancy and birth.

[2.16] Dr Pat explains what coarctation of the aorta is.

[2.35] Dr Pat talks about how pregnancies in women with congenital heart diseases are managed with both the obstetrics care provider and the cardiologist.

[4.36] Dr Pat talks about how obstetricians work with other specialists.

[5.00] Dr Pat talks about how pregnancies in women with congenital heart diseases are managed and some adjustments that might be made.

[7.51] Ruby asks what a slightly positive anticardiolipin result means for her fertility after 2 consecutive miscarriages and how worried she should be about a borderline anticardiolipin result. She also asks if there is anything she can do for her fertility after her miscarriages. Ruby also asks whether a Subchorionic Haematoma found in her first miscarriage, could be a cause of the miscarriage.

[11.15] Dr Pat talks about pregnancy loss and the recent changes to the recurrent miscarriage guidelines. You can listen to ep 153. New Miscarriage Guidelines here.

[13.16] Dr Pat talks about what should happen after a miscarriage.

[15.08] Dr Pat talks about the levels at which a miscarriage should be managed

[15.48] Dr Pat discusses whether a Subchorionic Haematoma could be a cause of a miscarriage.

[16.42] Dr Pat talks about a slightly positive anticardiolipin result means.

[17.25] Dr Pat explains what the best plan forward should look like.

[17.38] Laura asks whether it is true that having a C-Section causes a woman to either develop Endometriosis or become infertile.

[18.17] Dr Pat and Brigid talk about how false information like this can cause guilt for women.

[18.30] Dr Pat talks about how a Caesarean Section is an operation with risks like all other operations and how a Caesarean is done because it is the right decision for the woman at that time with the information at hand in the circumstance being faced.

[19.40] Dr Pat talks about how there isn’t a connect between having a caesarean section and the development of Endometriosis, but there is a potential connection with Adenomyosis.

[20.00] Dr Pat explains the difference between Endometriosis and Adenomyosis and how Adenomyosis is generally developed later in a woman’s life and is therefore less likely to impact a woman’s fertility.

[21.20] Brigid and Dr Pat talk about how Adenomyosis can occur even if a woman doesn’t have a C-Section and how just because a woman has a C-Section it doesn’t mean that she will develop Adenomyosis.

[22.25] Brigid talks about some of the things that have been said to her about her C-Section’s, such as the baby’s development being delayed. Dr Pat and Brigid talk about how these types of comments and conversations are not helpful and can lead to feelings such as guilt.

[23.27] Dr Pat talks about the connection between Caesareans and future fertility.

[24.15] Dr Pat talks about a condition called Caesarean Scar Defect. He also talks about an operation that can be done and how this condition can be diagnosed on an ultrasound.

[26.43] Nina asks about the likelihood of developing granulation tissue on an episiotomy scar in her second birth after it developed after her first birth, and she had to have 2 procedures done to remove it. Because of this the public hospital has offered her a C-Section for her second birth. Nina was wanting to know if choosing a C-Section for this reason is a valid concern. She also wants to know whether she should remove a cervical polyp before trying to conceive and whether they can have any impact on conception.

[28.16] Dr Pat talks about how it is important to remove cervical polyps and some of the ways this can be done.

[29.45] Dr Pat talks about the conversation that should be had with a woman about what to do in a subsequent pregnancy and birth if there has been a perineal injury in a previous birth.

[30.38] Dr Pat talks about the difference in the conversations depending on the degree of the tear/injury that had previously occurred.

[32.15] Dr Pat explains what granulation tissue is and how it is treated.

[33.02] Dr Pat talks about making the decision and the importance of listening to the patient.

[33.54] Dr Pat talks about how the risk of tearing degrees with each birth.

[34.10] Dr Pat talks about how common granulation tissue is on an episiotomy scar.

[34.40] Dr Pat talks about what Nina’s care team should do.