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Pregnant, have red dots and spots on face. Want to have second baby after 1 year. Any complication?

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Practicing since : 1999
Answered : 1677 Questions
Hi Dr. Raichle,
It's me again. I will be 7 months soon and I have a condition where the little capillaries on my face break if I do any sort of exercise that needs pushing. Sometimes my face is just covered in red dots and bigger spots for a few days. We also have strokes in my family (my grandfather). So I have never had to do so much pushing as is required for labor and my obgyn agreed to do a C-section if I wanted to. I was very happy he is giving me that choice. But everyone around me is trying to convince me the opposite. Also, we want to start trying for a second baby maybe 10-11 months after the birth of this one so potentially if it works out, the second baby could be born around 19-20 months after the first one with another c-section. I want to be able to do the IVF before the end of my 1 year mat leave so I can take the time to lie down at home. So does that present higher risk of complications such as placenta previa, uterine rupture etc (having a pregnancy so soon after a C-section i.e. less than 2 years)? I am reading studies online but they seem to go both ways. Thanks for all your help.
Posted Tue, 19 Mar 2013 in Pregnancy
Answered by Dr. Timothy Raichle 1 hour later
Hello and thank you for the direct question. You bring up two issues.

First with regard to the red dots and spots on your face. It sounds like this might represent "burst" blood vessels and might also reflect some abnormality in the way cells called platelets function. I would request a CBC to check the platelet number. If this is normal, and there is not some underlying risk for extra bleeding, then it is not really an indication to do a Cesarean section. I would explore this a little further before you make a decision.

Second, the issue of inter-pregnancy interval. The main issue is if you have a Cesarean section and then want to labor with your next pregnancy. The interval between deliveries must be at least 18 months. Given what you are saying, it would be reasonable to either have a repeat Cesarean section OR consider a TOLAC with the second pregnancy (if you had a Cesarean with the current pregnancy).

So, ask some more questions about the skin 'hemorrhages' and request a CBC to start. The intervals between your pregnancies, regardless how you deliver, are appropriate and do not pose additional risks.

I hope that this helps! Please ask if you have additional question.
Above answer was peer-reviewed by
Follow-up: Pregnant, have red dots and spots on face. Want to have second baby after 1 year. Any complication? 12 minutes later
Thank you very much dr. Raichle, my endocrinologist did a CBC recently and my platelet count seems to be normal. My RBC count and hematocrit are slightly below the range, but a very small difference. But if my platelet count is normal, I am wondering why my face is so bad after pushing, it could look quite scary, where I have hundreds of dots all over, one right next to another, almost blending into bigger spots. It almost feels like if I need to push harder, something bigger would burst.

Also, in this day and age, isn't C-section fairly safe for the mother and baby? I have read about the risks but there is risks in vaginal delivery too, the only thing is, C-section is over much faster...

I have one more question, but I can close this discussion and ask it separately, since it's unrelated, please let me know what would you prefer.
Answered by Dr. Timothy Raichle 1 hour later
While I do a little more research on the original question, please ask you additional question here. It will take me until later tonight to get back to you. Thank you for your patience!
Above answer was peer-reviewed by
Follow-up: Pregnant, have red dots and spots on face. Want to have second baby after 1 year. Any complication? 6 minutes later
Thank you Dr. Raichle,

Sure, so my last question is on baby movements. I know that once I start the 28th week next week I have to count the baby's movements. I read in different places that in about 2 hrs he has to have 6-10 movements. I am really not sure how many movements since different guidelines say different things. My baby though does not kick for hours some times - 6-7 hrs and then he kicks and sometimes he kicks a lot and sometimes only 2-3 movements. I know this is not exactly according to the guidelines but I was not sure I need to run to the hospital/ultrasound for it either. My obgyn has a doppler device and he just listened to my baby's heartbeat on Tuesday and said my baby was ok. So would you say it's normal for the baby not to always kick 6 times every 2 hrs i.e. when should I really be concerned? Thanks!
Answered by Dr. Timothy Raichle 23 hours later
Sorry about the delay. Based on what I can say based on what you are describing, you might have a condition called Rosacea. In includes:
1. Redness
2. Blushing easily
3. Raised, red bumps
4. Tiny, swollen blood vessels on the skin (called “telangiectasias”)
Someone with rosacea has redness and tiny, swollen blood vessels (called "telangiectasias") on the cheeks, nose, and chin.

This might actually fit! I would recommend a visit with a Dermatologist. It is not significant in terms of the pregnancy, but to know that this is what it is would be helpful for your peace of mind.

With regard to the issue of Cesearean Section (C/S), in general, vaginal birth is safer and associated with fewer complications for the mother and the baby. Yes, there are some women who schedule C/S electively, and this is a decision between you and your doctor. If you are planning on only having two children, then I believe you can make a decent argument for either mode of delivery. This is a controversial statement, though. The main risks come with additional repeat C/S, usually at 3 or greater.

Finally, with regard to fetal movements, I tell patients:
1. By 28-32 weeks, you should be able to feel the baby move within any 2 hour window where you are paying attention
2. Anything counts - kicks, rolls, etc.
3. A common recommendation is 10 movements in 2 hours
4. There are patterns of increased activity (after meals and in the evening are more)
5. If you cannot XXXXXXX these criteria, then an ultrasound for growth and check of amniotic fluid would be appropriate

I hope that this helps. Please ask if you have additional questions and I will get back to you tonight!!!
Above answer was peer-reviewed by
Follow-up: Pregnant, have red dots and spots on face. Want to have second baby after 1 year. Any complication? 3 minutes later
Thank you very much Dr. Raichle, this is really helpful!
Answered by Dr. Timothy Raichle 4 hours later
You are very welcome. If you ever have a question, please ask me directly and I will try to get back to you quickly!!
Above answer was peer-reviewed by
Follow-up: Pregnant, have red dots and spots on face. Want to have second baby after 1 year. Any complication? 2 hours later
Thank you so much Dr. Raichle, I will.

Actually I just wanted to clarify one little thing about the baby movements. Once I start following them next week, should I pay careful attention every two hours? My baby books says to check in the morning and evening and the rest of the time to only worry if I notice a huge gap. I can try and follow them every two hours but then at night I sleep XXXXXXX and usually don't feel them and during the day sometimes you get distracted.

Also, if I was to go to an ultrasound, and they find the baby is not growing enough or there is not enough amniotic fluid, can the doctors do something about that actually?
Answered by Dr. Timothy Raichle 3 minutes later
I think that it is a good idea to pay attention at a time of day when:
1. The baby is usually active
2. You have the time

I agree that this seems like a great idea to do twice daily, and the rest of the day you can just go on your instincts.

If for some reason your baby was diagnosed with growth restriction or decreasing amniotic fluid, there is nothing they can do except follow you closer until a gestational age where it is safe to get you delivered.

I hope that this helps!
Above answer was peer-reviewed by
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