Preparation for IVF treatment?

IVF: An overview

When it comes to fertility treatments, IVF tops the list of almost everyone. In vitro fertilization (IVF Process) signifies fertilization that occurs in a glass. IVF treatment involves the fertilization of an egg by sperm in a plastic dish. IVF entails a technique of assisted reproduction. In the IVF procedure, the egg and sperm are fertilized outside the body towards the formation of an embryo. The embryo gets transferred subsequently to a uterus for implantation and pregnancy. IVF was brought into existence to assist women having blocked fallopian tubes. IVF procedure still actively helps women with disadvantaged fallopian tubes. IVF assists even when a couple grapples with unexplained infertility. 

Below are the other conditions wherein IVF may offer some promise to the couples willing to become parents:

  1. Cervical issues
  2. Polycystic Ovary Syndrome 
  3. Fibroids
  4. Endometriosis
  5. Ovulatory problems
  6. Male factor infertility

Is IVF procedure stressful?

IVF isn’t an event or technique that completes in a day. IVF treatment involves a series of events to be completed. Some couples may feel bored with mood swings and anxiety often joining the joy and excitement. The women and their experience going through IVF may hugely depend on various factors around them. They may be their overall emotional predisposition, thoughts or ideas about IVF, their support pillars, and relationship with the partners. The way they respond to fertility medicines and their length is yet another factor.

How would you prepare your body for IVF?

You should consider giving time for relaxation and recovery after each phase of treatment. You mustn’t lead a life you did before starting IVF. The couples should develop a proper level of sensitivity to the treatment. They should accept the transformations brought to their energy levels. The couples should try to abstain from the activities harmful to the conception. They may consider prioritizing the activities mentioned by theirIVF experts or support members at the clinic. 

Prepare your body for the IVF in some easy steps:

Being diagnosed with infertility itself may distress you. You should give yourself at least 3-6 months and start preparing your body for IVF. You may have lesser time than 3-6 months. It’s best to start preparing yourself physically and emotionally for an experience lasting for months.

Achieve the desired weight and prepare yourself metabolically:

Evidence suggests that body mass index (BMI) has a role to play before pregnancy. Weight gain and nutritional history are two important determinants in an effective pregnancy. A poor nutritional history before IVF may hinder IVF. Being obese may interfere with the overall IVF outcome. Therefore, it’s important to maintain an ideal weight to increase the chances of IVF’s success. Various clinics may issue various guidelines about IVF. And the experts at motherhood guide you as to how you can achieve your target. 

Eat whatever boosts your reproductive health:

Enjoy fresh fruits and add some vegetables to your platter as directed by your IVF expert/staff members. Stop consuming burnt meat, red meat, sugar, refined grains or processed foods. Add spices and herbs to your routine diet. Avoid foods containing mercury including various fish species. You may even design your diet under obstetric or expert supervision. Include chickpeas, lentils and various other leguminous products. Start relying on low-fat milk and low-fat dairy food. Take Avocado, nuts and seeds in abundance. You may start taking prenatal vitamins. You must take an obstetrician’s advice before starting any prenatal vitamin. Your obstetrician will surely alert you about a category of chemicals. The category is called Endocrine-disrupting chemicals (EDC). 

Don’t drink and avoid smoke in every way possible:

One good decision to kick the butt brings hundreds of sighs of relief. Smoking is a dependence that creates many hindrances. Stop smoking preferably at least 6 months before you start planning for IVF. Studies show that Nicotine can interfere with ovaries and age them. They may render eggs resistant to fertilization. One can’t even imagine how severely it may damage foetal development and health. Alcohol is also known to hinder the success levels of IVF by more than 50%. Caffeine is another ingredient you should abstain from as you progress to your IVF treatment. 

Stay committed to Yoga and other exercises:

The way you breathe has many things to convey about you. When you take healthy breaths, many issues may start resolving on their own. And nothing replaces Yoga when it comes to assuring those healthy breaths naturally. Yoga will be the first good move to help you relax and rejuvenate effectively. Light yoga and relaxation techniques will guide your healthy way through those IVF protocols. You may consider registering for online exercise classes. They are mostly conducted by experts. They will inspire you to adopt a healthy lifestyle and stay on track from the day you conceive with IVF till the day you deliver your baby.  

Start preparing for healthy sleep as you do for a successful IVF:

Sleep is vital to ensure many aspects of your health. The quality of sleep influences sperm production, sex hormones, and ovulation. Make sure both you and your partner are getting ample sleep as your IVF expert directs. 

You may consider adopting the following habits for healthy and undisturbed sleep:

  1. Unwind by reading some comic or light-hearted stuff before getting off to bed.
  2. Make sure you have made a timetable and are sticking to it every night.
  3. Stop using alcohol or any stimulant ingredients that may interfere with your sleep.
  4. Enjoy some good exercise routines every day.
  5. Exercise routines come up with many perks. Aligning you with a peaceful sleep pattern every night is one of those invaluable perks.
  6. It may create psychological burdens if you have a TV, laptop, or other electronic items in the bedroom.
  7. Try to keep your bedroom free of any professional material like journals, books, files, or other documents.
  8. Address and treat stress. Emotional stress may hamper many good things you enjoy every day.

These steps will allow you to stay active and refreshed as you progress to various phases of your IVF cycle. Your obstetrician will always be there to guide you on essentials or lifestyle choices based on your medical history. 

Team Motherhood is always here to help you in your blissful journey to parenthood. Book an Appointment!

Book an Appointment!

Signs Of Gynaecological Cancer Which Women Shouldn’t Ignore

By Dr Madhuri Burande Laha, Consultant Obstetrician & Gynaecologist, Motherhood Hospital, Kharadi

 

You will be shocked to know that any type of cancer that begins in the reproductive organs of women can be termed as gynaecological cancers.? Cervical, ovarian, and uterine cancer is the ones that will require immediate attention. And as a group, they will be called as gynaecologic cancer. Fallopian tube cancer another type but it occurs rarely. It is the need of the hour to understand the symptoms of gynaecological cancers and improve the quality of life.

A woman’s body tends to undergo changes at every stage of life. While the transition is completely normal but there will be some changes that can be bothersome and maybe the symptoms. Yes, you have heard it right! Those can be symptoms of gynaecological cancers that are women’s cancer. There are 4 types of gynaecological cancers such as cervical cancer that begins from the cells lining of the cervix, ovarian cancer that starts in the ovaries, uterine cancer that originates from the uterus, and fallopian tube cancer occurring in women with a history of ovarian or breast cancer. The number of women suffering from gynaecological cancers is rising in India. Thus, early diagnosis of symptoms can aid proper treatment and reduce mortality. Here, we tell you about the symptoms that you must watch out.

These are the symptoms of gynaecological cancers that shouldn’t be neglected

Abdominal and pelvic pain:

Ovarian cancer can invite back and abdominal pain whilepelvic pain can be seen in the patients having uterine cancer.Likewise, bloating is a symptom of cervical cancer. In case, there is a pain in the same location for over a month then immediately consult the doctor.

Bleeding or discharge:

Do you bleed after sex? Or in between your periods? Then, beware! It can be worrisome and you will have to seek medical attention as bleeding and discharge can be the symptoms of ovarian, uterine, and cervical cancer.

Tiredness: 

Do you feel fatigued all the time? Then, it is time to get yourself evaluated as it can also be the symptom of gynaecological cancer.

Unintentional weight loss: 

Is there sudden weight loss even when you haven’t changed your diet or exercise pattern then you must be watchful of it. Though shedding those excess kilos is a dream of every woman but unexplained weight loss can be dangerous for the health.

Diarrhoea or constipation: 

Is there a change in your bowel and bladder habits? Do you notice symptoms such as constipation or diarrhea or even frequent urination? Then, take note of them and consult the doctor.

Change in eating habits: 

If you tend to full quick or find it difficult to eat food then it can be a sign of ovarian cancer.

 Also, those changes in one’s vulva color or skin (that is a rash, sores, warts, or ulcers) are also the symptoms that need to be managed.

When should you see a fertility specialist?

Expert guidance on fertility concerns - Motherhood Hospitals India

If you are facing any difficulty in conceiving or are unable to carry your pregnancy to term, your General Physician will prescribe a formal visit to the fertility specialist or a Reproductive Endocrinologist (RE). A fertility specialist acts a guide in your birthing journey.

In such cases it is okay to feel anxious, but know that you arenŸ??t alone in the quest. Approximately, 8% to 10% of couples worldwide are suffering from fertility problems. The ability of conception right when they are physically and mentally ready is something almost every couple takes for granted. Most couples are even shocked to realize that the conception isnŸ??t occurring as planned. 

What is infertility?

Infertility is a condition involving the inability to conceive after a year or longer of unprotected physical intimacies. Infertility is caused by various factors which may include issues with ovulation and other causes differing from person to person. Infertility may be an issue with unknown complexities. But, dozens of treatments can uplift the chances of conception and make a coupleŸ??s journey to parenthood smoother than they think. 

Your General Physician might recommend an early fertility evaluation under various circumstances. Or you or your partner should consult a relevant specialist in certain scenarios if:

  1. The male partner has a varicocele.
  2. The semen analysis reports of the male partner are abnormal.
  3. The genital pathology of the male partner is clinically worrisome.
  4. The male partner carries undescended testes.
  5. The male partner carries a medical history of surgeries like urogenital surgery.
  6. The female and/or male partner carries a history of Sexually Transmitted Diseases (STDs) or pelvic inflammatory disease.
  7. The female partner carries a medical history of examinations like abnormal pelvic examination.
  8. The female partner has a medical history of surgeries such as abdominal or pelvic surgery.
  9. The female partner carries medical conditions like Amenorrhoea or oligomenorrhoea.
  10. The female partner is more than 35 years of age and is unable to conceive even after 12 months of unprotected sexual intercourse.
  11. The female partner has Polycystic Ovary Syndrome (PCOS), Primary Ovarian Insufficiency (POI), Uterine Fibroids, Endometriosis and age above 40.

Are there any genetic predispositions causing infertility? 

Yes. Genetic abnormalities are making it hard for a lady to become pregnant. A woman with certain genetic predispositions may face issues carrying the pregnancy to term. Rearrangement of genetic material or translocation is the two examples of genetic predispositions. There are more complicated occurrences in the wake of which a couple with genetic issues may wish to avoid inheriting certain illnesses to their future generation. 

Preimplantation Genetic Diagnosis (PGD) combined with IVF present a range of benefits if a couple wishes to screen their heritable genetic abnormalities. PGD enables a couple to discover genetic details about their embryos before the couple proceeds for the implantation of the embryos. However, this type of treatment is helpful in certain clinical situations. An obstetrician or gynaecologist recommends this treatment based on various factors like medical history and current situation of the couple. 

Clinical evaluation of infertility in men:

Smoking, alcohol consumption, obesity and old age are some of the common factors contributing to male factor infertility. However, these factors manifest as additional risk factors. Some of the main causes of infertility in men are antinuclear or autoimmune antibodies to sperm, chromosomal abnormalities, systemic diseases, history of infections, injury and anatomic variances. 

Evaluation of male factor infertility begins with a medical history and the physical examination based on previous surgeries. The evaluation in the laboratory starts with a semen analysis. The analyst or laboratorian may ask the patient to abstain from ejaculation for 48-72 hours before the patient appears for the semen analysis. The sperm generation time spans mostly across 2 months. Therefore, the patient might have to wait for at least three months before going for the semen analysis again. 

Clinical evaluation of infertility in women:

The clinical evaluation of infertility in women primarily covers the history of surgeries on reproductive organs. The analysis could look out for the factors such as tobacco consumption, alcohol consumption, occupational exposure, substance abuse, medication use, previous pregnancies and results, a previous usage of contraceptive medicines, time and frequency of sexual intercourse and menstrual history.

Below are the principles of care and advice for a healthy conception:

  1. All the experienced Reproductive Endocrinologists (RE) or fertility experts deploy a specialist team to treat a couple grappling infertility.
  2. The mainstay of the infertility treatment involves the couple, the sensitivity of the expert team towards the coupleŸ??s clinical and emotional needs and patient information literature.
  3. Couples are advised to stop smoking or being around passive smokers.
  4. Couples are advised to stop or limit alcohol intake.
  5. Couples are requested to stay away from recreational drug use.

Are there any special instructions for men?

Men are advised by the andrologist/expert to avoid using tight clothes or underwear as they can cause testicular hyperthermia. 

What is the key advice for the women willing to conceive and carry the pregnancy to term?

  1. Obstetricians might start with the analysis of Rubella. It may be followed by immunization as and if needed and the expert may chalk out further advice on pregnancy.
  2. The expert may seek to enhance the physical and emotional welfare before conception. It may range from proper BMI management to diabetic control.
  3. The advice may further include the prescriptions of 400 mcg Folic Acid before conception and up to 12 weeks of gestation.
  4. Most experts in Reproductive Healthcare may focus on extra precautions if the woman is on anticonvulsants or antidiabetic medications.
  5. The women on anticonvulsants or antidiabetic medications or those having a child with neural tube defect are prescribed 5 mg folic acid per day.
  6. The women with a body mass index greater than 29 kg/m2 are advised to lose weight.

The backbone of managing any illness including infertility is prevention. It tends to be difficult if not impossible to manage infertility caused by the congenital factors. The good news is unexplained infertility has treatments like intrauterine injections and IVF.

Advice to women planning to delay pregnancy for some reason 

A womenŸ??s fertility is at peak upto 30 to 35 years and thereafter it starts going downhill . In some women it may go down even at younger age . If for reason it is not possible to conceive earlier please see a Gynaec and get your ovarian reserve checked by AMH blood test and or sonography. If your ovarian reserveŸ??s is not so good the it is important to conceive In time or freeze your eggs to be used at later stage This is known as social egg freezing. 

What do Braxton Hicks contractions feel like?

Braxton Hicks contractions to understanding pregnancy sensations - Motherhood Hospital India.

Braxton Hicks contractions are spasmodic contractions and relaxations of the uterine muscle. They are also known as false labour . They are perceived to begin on the 6th week of gestation but are not felt at least until the second or third trimester of pregnancy. Braxton Hicks contractions are the contractions of the uterus that help the expectant mother’s body prepare for actual labour. They are irregular and often painless. 

As the date of delivery approaches faster, the Braxton Hicks contractions help soften your cervix. Although they are the body’s way to prepare for actual labour, they neither indicate the outset of the labour nor its signals. Braxton Hicks contractions form a normal part of the pregnancy. Despite being uncomfortable, women describe them as mild menstrual cramps or a tightened sensation in an abdominal area that comes and goes. 

Some quick facts about Braxton Hicks contractions:

  1. Braxton Hicks contractions occur predominantly during the second or third trimester of pregnancy.
  2. They are less painful than the actual labour.
  3. Braxton Hicks contractions are unpredictable unlike actual labour and do not occur at definite intervals and do not get intensified over time.
  4. Consider changing positions to mitigate the discomforts caused by Braxton Hicks contractions.
  5. Braxton Hicks contractions might not occur regularly or get closer together.
  6. Braxton Hicks contractions neither cause cervical dilatation nor culminate in childbirth.

The causes of Braxton Hicks contractions are as below:

  1. Dehydration
  2. Regularly touched maternal abdomen
  3. Bladder distention
  4. Sexual intercourse
  5. Increase in maternal or foetal activity

Below are the home remedies to help resolve Braxton Hicks contractions:

  1. Take a warm bath for 30 minutes
  2. Eat something
  3. Drink a glass of water or a cup of tea
  4. Change positions as needed 
  5. Take a stroll 
  6. Take rest for a while if you have been physically active

When are the Braxton Hicks contractions a cause of worry?

You should consider calling your doctor  if the frequency of contractions is increasing. If the pain bothers you excessively or if the symptoms are resembling preterm labour. 

Below are the situations to look for if you think Braxton Hicks contractions are a cause of concern for you:

  1. If the contractions exceed an hour
  2. If pain is not releived after the above remedies
  3. Increase in the vaginal bleeding, vaginal discharge or spotting

Braxton Hicks contractions occur in all pregnancies. Although each woman’s experience is different, most women become aware of Braxton Hicks contractions in the third trimester. The onset of Braxton Hicks contractions near the end of the third trimester of pregnancy gets often mistaken as the actual labour. The management of Braxton Hicks contractions is easy and uncomplicated. 

The role of physiotherapy in women’s health

As we know, physiotherapists are the professionals committed to improving and upholding functional independence and physical performance. And when it comes to womenŸ??s health, pieces of evidence suggest that physiotherapy can mitigate pain and help relieve various symptoms. Most women lack knowledge about the help and assistance available to restore health and reinstate the healthy state of body and mind.

Physiotherapy associated with womenŸ??s health covers a range of services including obstetrics, osteoporosis, urinary incontinence, neuromusculoskeletal issues, prenatal and postnatal care and rehabilitation. Physiotherapy acknowledges the physical differences of the female population and stays updated to assist women in their quest for a stress-free, pain-free and enjoyable life. 

How does physiotherapy assist prenatal health?

Pregnancy is undoubtedly the dreamiest phase in womenŸ??sŸ?? life. However, this phase involves its share of tensions and stress. A range of health conditions occurs in pregnancy. Physiotherapy and physiotherapists help relieve many medical conditions and offer a symptomatic cure to them. The common health concerns in pregnancy are lower back pain, the severity of injuries, weakness of the pelvic floor muscles and Carpal Tunnel Syndrome to name a few. 

Role of physiotherapy in obstetric care:

Physiotherapy plays a crucial role in obstetric care that includes both antepartum and postpartum services. Manual techniques combined with posture-related education works wonders for pregnant women. Physiotherapists specialized in lower and upper back care and healthy modification of daily activities promise optimal posture alignment thereby reducing the orthopaedic tension in expectant mothers. 

Physiotherapists promote the participation of pregnant women in healthy activities and various exercises that strengthen their abilities. Postpartum physiotherapy recognizes structural and postural futilities prevalent in pregnancy, delivery or postpartum phases. Physiotherapists regularize on correct muscle activation and effective utilization of all the necessary support structures. 

How does prepartum and postpartum physiotherapy work? 

The assistance of expectant mothers depends mainly upon the current conditions. Like every other consultation, the physiotherapistŸ??s role begins with detailing the medical history. Prepartum and postpartum health are difficult to discuss. The assessment mainly includes taking into account the onset of oneŸ??s symptoms. It offers a clinical insight into how expectant motherŸ??s daily life gets shaped by various factors. 

The physical assessment begins most likely with the analysis of the pregnant ladyŸ??s abdominal muscles, pelvis and lumbar spine. This examination is crucial to identifying the texture, vigour and vitality of oneŸ??s pelvic floor muscles. Physiotherapists use finger palpation to examine the connective tissue and pelvic floor muscles. The treatment depends upon the primary symptoms and the conclusion drawn after the detailed assessment. 

Applications of physiotherapy in early and late pregnancy:

  1. More than half of the expectant mother suffer from low back pain and the right way to naturally prevent the low back pain is to get a good nightŸ??s sleep.
  2. Physiotherapy offers a range of physical therapies to help women tackle pain and make pregnancy more comfortable.
  3. Physiotherapy promotes stabilization exercises focusing on the muscles around the spine and help reduce back pain.
  4. Research suggests that physical therapy is effective in minimizing the urinary incontinence.
  5. Most physiotherapists encourage targeted therapies to reduce the recurrences of urinary incontinence in late pregnancy.
  6. Physiotherapists help to restore flexibility enhancements so that pregnancy and labour become easier.
  7. A physiotherapistŸ??s role promotes the active participation of women into healthy exercises directed at the pelvic floor health and perineal massage.
  8. They give you clear advice on the ways to recover after childbirth.
  9. They generate proper guidelines by examining the womanŸ??s posture, abdominal muscle gap, pelvic floor muscle function and respiration.
  10. They help create a detailed plan to reinstate the pelvic floor muscles and abdominal muscles after the childbirth.
  11. Most importantly, they ensure a safe and healthy postpartum exercise.

Conclusion:

Posture includes a dynamic state affecting all activities throughout a personŸ??s lifespan. Various physical, emotional and occupational factors impact functions, posture, behaviour and eventually the quality of life. Earlier the women acquire the right postural habits, higher are their chances to dissuade or effectively manage the stresses on their body. Physiotherapists promote physical and mental welfare enforcing the overall balance. Physiotherapy makes it easy for expectant mothers to enjoy each moment throughout their pregnancy.

Stretch marks in pregnancy

Approximately 50% to 80% of women are likely to develop stretch marks in pregnancy. Miscellaneous creams are known to offer some benefit in striae gravidarum. But no reliable evidence is available to conclude that any creams or topical ointments can help prevent stretch marks. Although not an illness, stretch marks can give nervousness to many expectant mothers. Some studies indicate that women who have developed stretch marks in pregnancy can avoid getting further marks in pregnancy. 

What are stretch marks?  

Stretch mark is a scar developed when the skin stretches or shrivels abruptly. The abruptness of these changes leads to the rupture of the collagen and elastin. When the skin starts to heal, stretch marks can appear. Stretch marks may not be present on every expectant motherŸ??s body.Fluctuations in hormonal levels play a role. Stretch marks may run in families. If someone close to an expectant mother had stretch marks, such an expectant mother is more prone to develop stretch marks. 

What are the body parts most prone to develop stretch marks?

  1. Thighs
  2. Hips
  3. Bottom
  4. Chest
  5. Stomach

What are some of the most common situations to develop stretch marks?

  1. Pregnancy
  2. Growth series occurring in puberty
  3. Sudden weight gain or sudden weight loss
  4. Weight management program while undergoing rapid muscle growth

What are the risk factors identified in the development of stretch mark?

General risk factors:

  1. Body mass index
  2. High pre-pregnancy weight
  3. Family history of stretch marks
  4. High weight during the delivery
  5. High gestational weight gain
  6. Young age

Maternal risk factors in pregnancy:

  1. Low intake of water
  2. Low level of serum relaxin
  3. Increase in the abdominal and hip circumference
  4. Low level of serum vitamin C
  5. Increased body mass index at delivery

Are there any techniques to prevent the stretch marks?

Genetics, as per experts, are the causes for stretch marks. But it may not always mean that a person will get stretch marks if either of the parents has it. Maintaining a healthy body mass index could be the first effective step towards preventing stretch marks. Ample consumption of water can help prevent the possible damage caused by the stretches of the skin. 

ItŸ??s best to include the foods rich in zinc in the diet. Foods rich in Vitamin A, Vitamin C, Vitamin D such as milk, citrus and sweet potatoes can benefit in stretch marks.

Diets and exercise: 

  1. Aerobics:

Aerobic is a kind of exercise mostly known to augment the blood circulation. It assures that the nutrients needed to the skin are aptly supplied to the surface. It may lessen the severity of the stretch marks. Morning walks can help those with stretch marks to an enormous extent. Half an hour every day or at least four days of a week should be spent in aerobics. 

  • Push-ups:

Push-ups help reduce the stretch marks around the breasts. One can start push-ups and increase their inclusion as needed. 

  • Abdominal exercises:

Abdominal stretch marks can be a reason for public embarrassment. While the stretch marks on abdomen are hard to treat, sit-ups and crunches can work wonders provided they are performed regularly. 

  • Squats:

Squats are a known ally to the muscle tone in hips, thighs and butts. Even when it comes to squats, those who are new to them can start with fewer squats and go on increasing them every day. 

What are the methods to remove the stretch marks?

The efficacy and results of the removal methods may vary from person to person. The results may be satisfactory in the first few days. 

  1. Microdermabrasion 
  2. Surgical intervention
  3. Radiofrequency treatment
  4. Light therapy and laser intervention
  5. Topical medications and creams or ointments

Almond Oil:

Oils have been known for centuries to generate moisture and increase the blood flow to various areas. There is no enough evidence to demonstrate whether the combination of massage and oil prevents stretch marks or not. Bitter almond oil is used by some people to treat the expectant mothers as it doesnŸ??t pose a risk to mother or the foetus. 

Hyaluronic Acid:

There are creams available in the modern marketplace today such as Verum and Alphastria. Alphastria is a proprietary medicine with Hyaluronic Acid, Vitamin A, Vitamin E, Allantoin and Calcium Pantothenate as the main constituents. Verum is another proprietary cream that contains Vitamin E, essential fatty acids, panthenol, hyaluronic acid, elastin and menthol.

Hyaluronic acid is the constituent common in both the proprietary medicines. Hyaluronic Acid is reported to facilitate tensile resistance to mechanical pressures and palliate the atrophy by inducing fibroblast activity and collagen synthesis thereby increasing the skin volume. 

Tretinoin:

Tretinoin is a category C drug in pregnancy and therefore caution is required while administering it in patients. Patients are advised not to use it until the lactation period. Erythematous Stretch marks become less severe after Tretinoin is administered in the treatment of stretch marks. 

Centella:

Centella in combination with other ingredients is reported to help prevent stretch marks. Centella is a medicinal herb whose usage in various creams can help prevent the stretch marks or minimize their severity. Centella is a popular name for Centella Asiatica, a plant commonly found in South Asia. ItŸ??s used to treat Leprosy, Venous stasis, ulcers and eczemas. Trofolastin is a proprietary medicine containing centella extracts. 

Lasers and other light devices:

Lasers and treatments involving lasers and other light devices are becoming popular nowadays. 585-nm flashlamp-pumped pulsed-dye laser is one of the most preferred lasers to treat stretch marks. Pulsed-dye laser, Excimer Laser, 1450-nm Diode Laser and Copper-Bromide Laser are some of the other laser variants used to treat stretch marks. 

ItŸ??s mandatory to consult the obstetrics and gynaecology department or a seasoned dermatologist before administering any treatment. A gynaecologist may ask for the medical history before administering the standalone treatment or combinations. A good diet and regular exercise are the best ways to prevent stretch marks. 

I am pregnant. Am I at the risk of testing positive for COVID-19?

COVID-19 and its transmission:

COVID-19 was first identified in Wuhan, China by the end of the year 2019. A healthcare professional may diagnose COVID-19 based on signs, symptoms and purported exposure, or using a positive test for SARS-CoV-2 even when there are no palpable symptoms. 

Infectivity and transfer

The majority of cases involving COVID-19 transmission denote the evidence of human-to-human transfer. The virus is readily isolable from respiratory droplets faeces, fomites or bodily secretions. Close or accidental contact with an infected person or an infected surface may transmit the virus. When it comes to the possibility of vertical transmission, evidence suggests that it may be uncommon for a pregnant lady to transmit the virus prenatally. In the event of a transmission of the virus from mother to her child, it suggests various possibilities. It may be least affected by the factors such as delayed cord clamping, skin-to-skin kangaroo care, breastfeeding or colocation (rooming-in). 

Possible risk of catching COVID-19 in pregnancy

At present, there’s no concrete evidence to conclude whether pregnant women are more prone to COVID-19 infection than the nonpregnant counterparts. However, it may be noted that pregnancy involves various physiological changes. The changes even include alterations in the immune system. The alterations in the immune system may make a few women more prone to infections with a marked reduction in the body’s defences against virulent microbes. However, there may be a group of women more prone to severe complications from COVID-19 infection. Certain complications may even require hospitalization. Therefore, precautions and preventive measures against exposure to the virus are important. 

Is it safe to continue with prenatal care in the COVID-19 pandemic?

Of course, it’s safe and important. Obstetricians worldwide are striving to make the most out of healthcare availabilities. They are busy making all the possible changes and help patients and healthcare staffs prevent COVID-19 exposure. Most obstetric setups and firms dedicated to obstetric care are converting traditional antenatal care to tele-healthcare. However, it doesn’t mean the traditional visits will no longer be available. Most setups treat common symptoms using telephonic consultations or video consultations.

Various pregnancy-specific tests may continue based on your consent and your obstetrician’s decisions. Your obstetrician may guide you about how to count the kick and ascertain that the baby is healthy and hale and hearty. You might consider buying something like a blood pressure cuff and a scale. It will make it easy for you to produce your blood pressure and other parameters during telehealth sessions. 

Steps to safeguard yourself from COVID-19 in pregnancy:

  1. Most guidelines to ensure personal safety during the COVID-19 pandemic for pregnant women are the same as those for nonpregnant counterparts.
  2. Stay home, stay safe.
  3. Wear a mask while moving out.
  4. Observe healthy social distances and restrict your social interactions with others.
  5. Use a sanitiser preferably recommended by your obstetrician.
  6. Use a handwash recommended by your obstetrician and wash hands regularly, and specifically after an interaction with an outsider.
  7. Avoid visiting places with rush and crowd.

What is the risk of preterm birth with COVID-19?

Owing to the lack of knowledge on the virus and its interventions in obstetric health, people have less awareness about COVID-19 impact on pregnant women. Studies worldwide haven’t concluded anything on the possible rise in the risk of spontaneous abortion in pregnant women with COVID-19. Women with a certain medical history and health status may be more prone to COVID-19 complications.

If a pregnant woman develops severe symptoms with COVID-19 infection, she may need ICU attention and early delivery. Nonetheless, the data available about the correlation between the virus and preterm delivery is less. Therefore, it may be unwise to conclude that COVID-19 can be the direct cause of preterm delivery. 

Is it true that pregnant women may transmit the virus to their baby during pregnancy and childbirth?

Respiratory or saliva droplets of an infected person are the main modes that may infect a healthy person with COVID-19. Few cases of COVID-19 are reported in neonates. The good news is that most pregnant women infected with COVID-19 gave birth to healthy neonates. Studies are yet to find any traces of coronavirus in cord blood, breastmilk or amniotic fluid. The evidence available on the overall infectivity is unclear. 

Alterations in prenatal care to minimize the risk of COVID-19

The healthcare setups should consider crafting alterations for low-versus-high-risk pregnancies. Women with pregnancy-specific disorders or pre-existing conditions like Hypertension, Diabetes mat require special attention. Healthcare departments should restrict the number of visitors and enhance the quality of care based on various parameters. 

What are the symptoms of COVID-19 infection in pregnancy?

Most pregnant women infected with COVID-19 remain asymptomatic. Most women with symptoms may develop flulike signs alongside mild to moderate cold. The other uncommon symptoms may include diarrhoea, loss of taste and smell, myalgia and dyspnoea. Pregnant women infected with COVID-19 may be more prone to myalgia and fever than the nonpregnant counterparts. 

Severe complications of COVID-19 infection in pregnant women

About two-thirds of pregnant women infected with COVID-19 are asymptomatic. But women with COVID-19 are more likely than the nonpregnant counterparts to get admitted to the Intensive Care Unit (ICU). Most reliable surveys show that women with COVID-19 aren’t at a raised risk of death from COVID-19. But compared to pregnant women without COVID-19, some of the pregnant counterparts with symptomatic COVID-19 may encounter worse clinical outcomes. 

What are the risk factors associated with COVID-19 infection in pregnancy?

  1. A BMI of 25kg/m2 or more
  2. pregnancy-specific morbidities
  3. Pre-existent conditions such as diabetes and hypertension 
  4. Advanced maternal age
  5. Residence in high-risk areas of the areas of high prevalence

What are the effects of COVID-19 on foetal health?

COVID-19 positive women who are symptomatic may have to face certain challenges ahead. Nonetheless, the studies or data available on the risk of COVID-19 on the foetus are scarce. Symptomatic maternal COVID-19 may be linked to an increase in the risk of iatrogenic preterm birth. Besides preterm birth, COVID-19 infection may not leave any harmful effects on the foetal health or neonatal outcomes.

The evidence denoting any possibility of congenital anomalies isn’t yet available. There is no concrete evidence to date showing any possibilities of neonatal mortalities or stillbirth in response to maternal COVID-19 infection. There is no evidence even suggesting that spontaneous abortion is possible in the wake of maternal COVID-19 infection. 

Is it safe to get the COVID-19 vaccination during pregnancy?

COVID-19 in pregnancy: An overview

The government ruled that the third phase of vaccination for adults between 18 and 44 years would start soon. May 1, 2021, saw its effective outset. One of the most crucial questions at this juncture is, whether pregnant women can take it or not. Initial studies were unclear about the risk of COVID-19 in pregnancy. The studies went ahead to establish, however, that pregnant women may be at a more raised risk of severe COVID-19 than non-pregnant ones. Pregnant women may develop severe symptoms including COVID-19-specific illness warranting immediate hospitalization and ICU transfer. Details about COVID-19, the effect of the disease on pregnancy and details about COVID-19 vaccines under progress are evolving in swift phases. 

COVID-19 vaccination, pregnancy and lactation:

Pregnant and lactating women heaved a sigh of relief after the Federation of Obstetrics and
Gynaecology Societies in India (FOGSCI) unveiled their stance on how pregnant and lactating women
should plan for COVID-19 vaccination. The details by FOGSCI shed light on COVID-19 development
and vaccine safety in maternity health. The guidelines suggest that every pregnant and lactating
woman has the right to vaccinate herself. Nonetheless, it should be her wish and not something out
of subtle psychological pressure. The robust clinical benefits of vaccination for pregnant and
lactating women outweigh the presupposed risks of vaccination.

Women who are lactating also present themselves as suitable candidates since the vaccine doesn’t seem to endanger the neonate who is breastfeeding. Women should receive proper consultation and counselling. They should receive optimal emotional support from their caregivers and next of kin. Both acceptors and exempts should receive equal and fair treatment. The guidelines recommend that obstetricians and gynaecologists should promote vaccination drive in pregnant and lactating women with clinical preparations to tackle any adverse or contraindicative responses (if any).

For women who are planning to get pregnant:

Guidelines rule that women planning for pregnancy may consider administering the vaccine at any
time before confirming the pregnancy as per their convenience. No scientific literature lays any
foundations to postpone the pregnancy or treatment for taking the vaccine. The scientific literature
hasn’t yet found concrete evidence demonstrating the possibility of infertility or miscarriage due to
vaccine administration.

Menstruation:

May 1, 2021, saw the centre ruling that everyone above 18 years of age can take the vaccination.
Soon after the judgement of the centre, several women asked whether it was suitable to take
COVID-19 vaccination in pregnancy or not. Various social media platforms were thronged with
questions and comments on the subject. Women should avoid taking COVID-19 vaccines 5 days
before and after their period. The reason behind the guideline is the immune system’s futility. The
immunity in women tends to be less in periods. Their periods last for 5 days. The same 5 days
witness the endometrium shedding. The menstrual cycle is the period which witnesses the
endometrial growth to a bulky and glandular tissue layer full of blood vessels. The immunity and
everything sensitive in the female body remains healthy afterwards. And the period except 5 days
before and after periods may be safe for women to inoculate themselves.

How would the healthcare facilities address COVID-19 and its possible effects on pregnancy?

Healthcare setups should assess the contraindications of the COVID-19 vaccine in pregnancy or breastfeeding. Pregnant women may be offered vaccinationat any point in pregnancy if there are no contraindications. Individual woman’s consent and the overall knowledge that the hazards of COVID-19 infection and morbidities from COVID-19 exceed the hypotheses and presupposed risks of vaccination in pregnancy and while breastfeeding. Therefore, pregnant women shouldn’t be dissuaded from vaccination under the pretext of pregnancy or breastfeeding

COVID-19 and its effects on pregnancy:

The majority of pregnant women infected with COVID-19 may develop mild-to-moderate symptoms
with many remaining asymptomatic. International data, however, suggests that approximately 7-
11% of pregnant women need hospitalization for COVID-19-specific morbidities with about 1-4% of
them needing ICU. In comparison with non-pregnant counterparts, pregnant women with COVID-19
may be in increased need of hospitalization, intensive care and invasive ventilation.

The perils of COVID-19 in pregnant women associate itself with various risk factors. They may
include Asthma, Obesity, Existent Hypertension, Existent Diabetes and Heart Diseases. Studies even
denote that in the event of an increase in the risk of preterm birth associated with COVID-19
infection in pregnancy, it may cause increased morbidities in the premature infant.

COVID-19 vaccination in pregnancy and while breastfeeding:

Various vaccines obstetric experts administer during pregnancy suggest that we may witness an
identical efficacy for the COVID-19 vaccines in pregnant women in comparison with non-pregnant counterparts. Vaccines may generate a good immunogenic response with a good degree of efficacy
in pregnant women. While primordial clinical details on the safety and efficacy of COVID-19 vaccines
in pregnant populations are still under scrutiny, resolute surveillance finds no signs of unfavourable
prenatal or neonatal outcomes related to the administration of COVID-19 vaccines. Nonvaccinated
pregnant women may be at raised risk of COVID-19 infection and a higher risk of morbidities in the
event of infection in comparison with non-pregnant women.

Infection of COVID-19 may complicate maternal, foetal and neonatal health. Pregnancy doesn’t raise the risk of COVID-19 infection. But pregnant women who are active in sensitive areas like healthcare or social care during pandemics may be vulnerable to COVID-19 infection. Advanced maternal age, conditions that underlie and pregnant women below the poverty line may face severe COVID-19 risk. Studies denote that the COVID-19 vaccine may be the right choice provided that a proper risk assessment is done. If analysis confirms that the benefits outweigh the risks for pregnant women and foetal health, it may be recommended. 

Healthcare experts and women should consider the factors below as they set out to vaccinate themselves:

  • Time of vaccination in pregnancy
  • Perils and potential risk of any existent maternal condition (if any) which may include the possible effects of the disease on the foetal health and new-born
  • Availability of data about the administration of a vaccine in pregnancy
  • level of infectivity of the virus in the vicinity/local community.

Covid Vaccines and Menses: Is it Safe?

COVID-19 vaccine does not meddle with the menstrual cycle, say, Motherhood doctors

As more people come forward to get vaccinated against the Coronavirus, it is important to get some myths around the vaccine and womenŸ??s health out of the way.

When 40-year-old Snehal was going through the stream of messages circulating in her friendsŸ?? groups on social media platforms, she was surprised to notice a concerning status about periods and vaccination. This forwarded message, which has gone viral, said that women should not take the COVID-19 vaccine five days prior and five days after they get their periods as it would affect their immunity and result in irregular periods.  

She had just taken her jab a few days earlier while she was menstruating, so she was perplexed by this information. Ÿ??I was on the third day of my periods when I took the first shot of the COVID-19 vaccine and I do not seem to have any issues. Of course, I felt a little tired and had a mild fever, but I was already told that these are common reactions to the vaccine that would subside soonŸ?.

As the Indian Government has opened vaccinations above the age of 18 years from May 1 onwards, there are a lot of myths flying around on the effect of the vaccines on menstruating, pregnant, and lactating women. Social media is full of such posts warning such groups of women to refrain from taking the jab. As the vaccinations are available to all adults now, this has resulted in confusion. Many women who have seen the message, are concerned whether the vaccine have an adverse affect on their menstrual cycle. But doctors at Motherhood Hospital have reiterated that the claims being circulated have no basis in the truth and that it is completely safe for women to get inoculated before, during, and after the menstruation cycle.

With the COVID vaccine bringing hope for all adults in India to get protection against the deadly virus, it is important to bust any myths around vaccines in relation to womenŸ??s reproductive health. According to Dr. Manju Gupta, Consultant Obstetrician and Gynaecologist at Motherhood Hospital, Noida, it is a myth that womenŸ??s immunity is weakened during the menstrual cycle and that taking the jab at such a time will result in heavy or irregular periods.   

Ÿ??COVID vaccinations are for increasing your bodyŸ??s immunity to fight against the virus. So, how can it have an adverse impact on the body? There is no scientific data available to prove that taking the COVID vaccine before, during, or after menstruation will meddle with our periods. Women should stay away from such claims. Generally, our periods last for five days, and during this time, we shed our endometrium (the lining or inner membrane of the uterus). During the menstrual cycle, the endometrium grows into a thick, blood vessel-rich, glandular tissue layer, and this tissue is shed, which results in bleeding. So, the bodyŸ??s immunity is intact and does not get weakened,Ÿ? explains Dr. Gupta.

She added that many of the women doctors have taken their vaccine during periods and did not have any problems. Ÿ??Vaccination is essential even if you get COVID after taking the jab, it protects you from getting your condition worsened. Women should not believe such myths. If you are unsure, contact your physician or gynaecologist to get an expert opinion. But, get yourself vaccinated and follow COVID appropriate behavior,Ÿ? said Dr. Gupta.

Following social media posts about menstruation and the COVID-19 vaccine, various medical and womenŸ??s health organizations have come forward to dispel such invalid posts. The American College of Obstetrics and Gynaecology (ACOG) and the Centers for Disease Control and Prevention (CDC) have both released statements assuring that the COVID-19 vaccine does not adversely affect a womanŸ??s menstrual cycle and that it is safe to take the vaccine during periods.

In fact, both agencies have reiterated that early data regarding the vaccine reveals that it is safe for pregnant and lactating mothers to administer the vaccine and that it may not cause any harm to mother and baby. Here, the Indian Government responding to the fake news has appealed to the people to ignore such messages and take the initiative to get themselves and all family members above 18 years of age, vaccinated.     

Are you getting enough vitamins during pregnancy?

Pregnancy care involves a balance of nutrition and optimum personal hygiene. Enjoying a healthy and vivid diet in pregnancy allows you to make the most out of the three trimesters. Pregnancy includes physiological changes resulting in increased plasma volume. The other physiological changes in pregnancy are a rise in red blood cells and a decrease in the concentration of proteins and micronutrients that bind nutrients. Nutrition in pregnancy starts always with taking the necessary steps. The steps may include taking prenatal vitamins and designing a balanced diet. Pregnancy tips on safety and nutrition may mainly include a full-fledged dietary regimen. It may follow clinical guidelines depending upon various factors. 

Many women prefer attending pregnancy exercise class or aerobics. In a few geographical regions, undernutrition or deficiency may affect the physiological changes of pregnancy. During pregnancy, a baby receives necessary nutrition from the mother. A pregnant woman needs more nutrition from the day she conceives. Make sure that the prenatal vitamins you include have folic acid, calcium and iron in them. Ask your obstetrician/gynaecologist to round off a diet supplying ample vitamin D, DHA and iodine each day. 

Prenatal vitamins:

As the name suggests, prenatal vitamins are the multivitamins for pregnant women or those willing to conceive. Contrary to regular vitamins, prenatal vitamins contain major ingredients you need for a healthy pregnancy. It’s great to follow the multivitamin prescribed by an obstetrician or midwife. 

Your body thrives on the nutrients, minerals and other nutritional availabilities in the food. If you are a vegetarian or prone to food allergies, your healthcare provider may prescribe a suitable supplement. Some supplements will help you get the most out of the nutritional availabilities. 

How does your nutritional journey start with prenatal vitamins?

Prenatal vitamins allow you to get the right nutrition throughout the pregnancy.

The ideal prenatal vitamins are:

400 mcg of folic acid

400 IU of vitamin D

2mg of riboflavin

3mg of thiamine

6mcg of vitamin B12

10mg of vitamin E

15mg of zinc

17mg of iron

150 mcg of iodine

200-300 mg of calcium

70 mg of vitamin C

20mg of niacin

  • Folate:

Folate is a B vitamin aiding the process of DNA synthesis, foetal growth and development and red blood cell production. Folic acid is the synthetic form of folate available in various supplements. The body receives an active form of folate with folic acid. The active form of folate the body gets is called L-methyl folate. Expert obstetricians recommend at least 400 mcg of folate or folic acid to cut the risk of neural tube defects and congenital malformations. Folate is essential to prevent the abnormalities such as heart defects and cleft palate. 

  • Iron:

The iron requirement of pregnant women rises drastically due to the rise in maternal blood volume by 45%. Iron is irreplaceable in pregnancy for various reasons. Iron promotes oxygen transport and the healthy development of your baby and placenta. Various health issues are linked to the lack or scarcity of iron in pregnancy. Maternal depression, infant anaemia and preterm delivery are the 3 main health issues due to lack of iron in pregnancy. 17mg of iron per day is enough to meet the nutritional requirement. Your obstetricians may recommend higher doses of iron if you are suffering or have suffered from anaemia. Don’t exceed the dosage recommended by your obstetrician. An excessive dose of iron may cause nausea, constipation and abnormally high haemoglobin. 

  • Vitamin D

Vitamin D deficiency in pregnancy may increase the risk of caesarean section, preeclampsia, gestational diabetes and preterm birth. Vitamin D is a fat-soluble vitamin aiding various functions such as immune responses, bone health and cell division. The recommended intake of vitamin D in pregnancy is 400 IU per day. Many experts recommend extensive doses of vitamin D in pregnancy. However, you mustn’t exceed the dose recommended without consulting your obstetrician. 

  • Calcium

Calcium is a mineral aiding the development of a baby’s bones, heart, muscles, teeth and nerves. The requirement for calcium rises in pregnancy. You may require 200-300 mg of calcium every day when you are pregnant. You may optimise the calcium intake by following the dietary recommendations. You may consider taking more calcium by introducing certain foods to your platter. They may be Broccoli and kale, orange, milk, yoghurt and cheese. 

  • Iodine:

Iodine is a mineral aiding the synthesis of thyroid hormones. Thyroid hormones allow the body to reserve and utilize energy from food. Pregnant women require iodine in pregnancy to aid the growth of their baby’s nervous system. The brain, nerves and spinal cord form the nervous system. The nervous system helps the baby to move, feel and think. Pregnant women may seek their obstetrician’s guidance to determine how much iodine they need in pregnancy. Not every prenatal vitamin contains iodine. The total amount of iodine needed in pregnancy may differ from person to person. Make sure that you are regularly consuming the foods that contain iodine. 

  • Thiamine:

Thiamine usage is recommended based on the obstetrician’s guidance. The recommended daily allowance (RDA) for thiamine in pregnancy is 1.4mg/day regardless of the pregnant woman’s age. Some obstetricians may recommend 3mg of thiamine in pregnancy. Women carrying more than one foetus may require a higher dose of thiamine. 

  • Zinc:

Women trying to conceive should try to increase the intake of zinc. Both the partners should introduce zinc to their regular diet. It’s unlikely for you to suffer from a deficiency of zinc provided your diet is healthy and balanced. The recommended intake of zinc is 8mg per day for adult women. Your obstetrician may recommend an intake of up to 12mg or 15mg of zinc per day in pregnancy and lactation.

  • Vitamin E:

Vitamin E helps in the production and nourishment of red blood cells, eyes and healthy skin. It promotes a healthy immune response. It’s best to include a healthy amount of vitamin E in your platter based on your obstetrician’s guidance. The recommended daily intake of vitamin E in pregnancy is 3mg. A healthy and balanced diet should suffice. If your medical history denotes higher doses of vitamin E, your obstetrician may recommend a dose of up to 10mg.  

  • Riboflavin:

Riboflavin is vitamin B2. Riboflavin is essential in the maintenance of various tissues of the body. Riboflavin is used to treat or prevent deficiency of vitamin B2. Ask your obstetrician if it’s safe for you to administer riboflavin in your regular diet. Your obstetrician may study the medical history. If you have a history of cirrhosis or other liver disease or any gallbladder issues, riboflavin should be carefully used. Don’t use riboflavin without your obstetrician’s advice. 

  • Niacin:

Niacin or Nicotinic acid (Vitamin B3) is a water-soluble chemical. Nicotinamide is another form of Vitamin B3 available for human consumption. Niacin plays a crucial role in the growth and development of the foetus. Niacin may help prevent birth defects and miscarriage. It may be essential in the baby’s brain development. It energizes us. It provides optimum nutrition for the skin and other organs. It helps reduce nausea and improve digestive power. Niacin is also linked to a reduction in migraines. The recommended intake of niacin is 20mg. 

  • Vitamin B12:

Vitamin B12 is vital in the production of red blood cells. It may help nourish the nerve tissue. The deficiency of vitamin B12 may lead to anaemia, nerve damage and brain damage. 6mcg of vitamin B12 may be essential in pregnancy. If you need higher doses of vitamin B12, your obstetrician may recommend them based on your medical history and current health status.

  • Vitamin C:

Proper intake of vitamin C helps reduce the risk of placental abruption. Vitamin C alone helps reduce the risk of preterm labour and prelabour rupture of membranes (PROM). However, some studies suggest that vitamin C in combination with vitamin E raises the risk of PROM. Pregnant women should be careful while including vitamin C in the platter. We recommend that you seek your obstetrician’s guidance on the amount of vitamin C to include in your platter.