Infections To Look Out For During Pregnancy

Expectant mothers are more susceptible to various viral, bacterial and other types of infections compared to regular people. Being aware and taking precautions is significant in ensuring the health of mother and baby

Pregnant women are at increased risk of acquiring infections because of the lower immunity levels.According to Dr Teena Thomas, Consultant Obstetrician and Gynaecologist at Motherhood Hospitals, it is common for pregnant women to catch infections as their immunity is generally low. Ÿ??Urinary tract Infections and conditions such as bacterial vaginosis are quite common but with the right advice and medical treatment, these types of problems during pregnancy can to resolved,Ÿ? says Dr Thomas.

At Motherhood Hospitals, doctors strive to ensure that all expectant mothers get the best quality care and assistance. All the necessary diagnostic tests are carried out for early detection of any infection and timely treatment is given for the same.

There are different types of infections that might affect women in pregnancy. These can be categorised into Ÿ??

VIRAL INFECTIONS

  1. Chicken Pox Ÿ?? This infection is rarely seen in pregnant women, as most people get chicken pox in childhood and because of this become naturally immune to the virus. But in women who have never been affected, there are chances of getting it during pregnancy. If affected by the chicken pox (varicella) virus, pregnant women are at risk of contracting pneumonia. It can be dangerous for the newborn if the virus affects the expectant mother at the end of the 1st trimester or very close to the delivery. In the first trimester, there is a one per cent chance of the baby developing a serious condition called Varicella syndrome, a rare condition in infants that results in low birth weight and certain developmental/brain abnormalities and hence may require terminations. If the mother is diagnosed with chicken pox very near to the delivery time, then there is a risk of the baby also getting infected.

Ÿ??If the non-immune expectant mother is infected nearing delivery. She can be administered the varicella zoster immunoglobin as soon as possible to minimise the effect of the infection. The infected newborn should also be administered the same immunoglobin and effective treatment for the ailment needs to be given by a team of specialists.We have had mothers with chicken pox coming in to the hospital and with timely care and treatment both baby and mother came out of danger,Ÿ? said Dr Thomas.

  1. Cytomegalovirus (CMV) Ÿ?? It is a common virus, belonging to the Herpes virus family and many people get infected by it at some point in their lives. But it rarely causes any symptoms. While CMV infection is quite rare, it can be a cause of concern in pregnancy, as 1-4 in 100 babies can get infected by the virus through their mothers. It may cause flu-like symptoms in the pregnant woman. Most infected babies donŸ??t have any problems but some may have congenital abnormalities including hearing loss, visual impairment and so on. The virus can be detected with a blood test and treated accordingly.
  1. Hepatitis B (HBV) Ÿ?? This virus is highly infectious and can be blood borne or sexually transmitted. It can cause liver problems later in life. Pregnant women who are infected by the virus can pass it on to the foetus. So babies at risk should be immunised at birth with HBV vaccine as this is 90-95 per cent effective in preventing the disease.

Ÿ??We screen expectant mothers for HBV as part of the antenatal care and if found positive, appropriate treatment is given,Ÿ? adds Dr Thomas.

  1. Hepatitis C Ÿ?? This virus is also passed on through the blood or sexually transmitted. If the mother passes on the infection to the newborn, medical assessment needs to be done and care is provided.
  2. Herpes Ÿ?? This viral infection can be of different kinds, most commonly oral herpes and genital herpes. Primary genital herpes is diagnosed by actively present blisters and ulcers in the vaginal area particularly dangerous for the baby and it can be passed on during a vaginal delivery. Normally, doctors advise a Caesarean section delivery to prevent transmission.
  3. HIV Ÿ?? A test for the virus is offered as part of antenatal care to all mothers. An HIV positive pregnant woman can pass on the infection to her baby. Ÿ??But constant monitoring and active treatment from 28 weeks of pregnancy, apart from an elective C-section can bring down the risk of transmission. Late booking patientŸ??s treatments can also be commenced at 36 weeks in labour.After birth also the baby is monitored for some time to rule out transmission,Ÿ? says Dr Thomas.
  4. Parvovirus Ÿ?? This is rare type of virus but if there is primary infection during pregnancy, the expectant mother might have mild rash and fever. Some complications of Parvovirus include miscarriage or the fetal anaemia. There is a test to diagnose the infection and can be treated with medications and requires fetal monitoring.
  5. Rubella Ÿ?? It is a contagious infection caused by the Rubella virus which causes fever, rashes, sore throat and swollen glands. In India, rubella infection is very rare as it is part of the standard immunisation plan. But Primary Rubella affects the mother in the first half of pregnancy it can lead to serious complications in the baby including blindness and mental retardation. In the later part of the pregnancy, it can result in pre-term labour.

Ÿ??We had a young mother who was diagnosed with Rubella at 28 weeks of pregnancy through a test. She was monitored carefully by the hospital and all necessary care was taken. She went into preterm labour and birth and the baby weighed only 1.1 kg. But with good care in the NICU, the baby went home healthy,Ÿ? recalls Dr Thomas.

PARASITIC

Toxoplasmosis Ÿ?? This is the most common parasitic infection seen during pregnancy and is caused by the parasite Toxoplasma gondii, found in cat faces. If the pregnant mother comes in contact with the parasite, by handling cat litter or eating raw contaminated food, there is a risk of passing it on to the foetus. The infection is dangerous in pregnancy as it can cause stillbirth, miscarriage and congenital abnormalities in the baby. Such infections can be easily prevented by taking necessary precautions but if the pregnant woman is found to be infected, antibiotic medications are administered till delivery.

BACTERIAL

Urinary tract infection (UTI) Ÿ?? The most common infection in pregnancy, it is an infection of the urinary tract caused by bacteria which causes burning sensation, fever and chills.Most women are checked for UTIs during antenatal screening and treated accordingly, Asymptomatic bacteria (without symptoms) also needs to be treated. It can cause complications such as low birth weight and preterm labour .

Bacterial Vaginosis (BV) Ÿ?? This is an infection caused by overgrowth of hormonal commensal bacteria of the vagina and is typically characterised by fishy odour in the vaginal discharge. BV in pregnancy can lead to complications such as preterm labour, miscarriage and premature rupture of the membrane and hence requires prompt treatment with Antibiotics.

Group B Streptococci Ÿ?? This is a bacterial infection that is mostly asymptomatic but in some pregnancies, it can cause serious complications in the baby. It results in preterm labour and premature rupture of membrane.

All the three bacterial infections can be treated successfully with antibiotics.

Sexually Transmitted Diseases (STDs) Ÿ?? There are a few common sexually transmitted diseases such as Gonorrhoea and Chlamydia that when present in a pregnant woman can cause problems. Complications include preterm labour, miscarriage & new-born infections. STDs should be diagnosed and detected early and treated with medications.

HOW TO PREVENT INFECTIONS

Sometimes a little bit of care and sound advice from the gynaecologist can go a long way in preventing harmful infections during pregnancy.

According to the Centers for Disease Control and Prevention, simple measures can prevent infection. These include Ÿ??

  1. Washing your hands often especially after touching raw food and meat, using the bathroom, playing with children, touching dirt and soil
  2. Avoid eating uncooked food and raw and processed meat.
  3. Drink lots of water to prevent UTIs. (around 2.5 l/ day)
  4. Stay away from animal droppings and cat litter.
  5. Get checked for infections such as HIV, STDs and Hepatitis B
  6. Make sure to get vaccinations
  7. Healthy diet and lifestyle remains till date the key to prevent it.

Content Credits: Dr Teena Thomas (Obstetrics & Gynaecology)

CERVICAL CANCER

Introduction

Cervical cancer is one of the commonest causes of cancer-related deaths amongst women in developing countries. Every year in India, 122,844 women are diagnosed with Cervical cancer and about half of them die due to this fatal disease. Worldwide, Cervical cancer accounts for 500,000 new cases every year and India contributes nearly 25%.

Who are prone to Cervical cancer?

The median age of diagnosis for women is 48 years, and the majority of cases are diagnosed between 35 and 55 years when women are in the prime of their lives.

What causes Cervical cancer?

Long-term use of hormonal contraceptives, high parity, early initiation of sexual activity, multiple sex partners, tobacco smoking and co-infection with HIV, immunosuppression, low socio-economic status, poor hygiene and diet low in antioxidants increase the likelihood of developing Cervical cancer

There is a firm establishment of a causal relationship between persistent infection with high-risk Human PapillomaVirus (HPV) genotypes and Cervical cancer.

HPV infection occurs in a high percentage of sexually active women. Most of these infections clear spontaneously within months to a few years, a small proportion of persistent infection will progress to cancer.

Symptoms

The first symptom is abnormal vaginal bleeding, usually postcoital. Vaginal discomfort, malodorous discharge, and dysuria are common symptoms.

The tumor grows by extending upward to the endometrial cavity, downward to the vagina, and laterally to the pelvic wall, who can then present with constipation, hematuria, vaginal fistula.

How can it be prevented?

Primary prevention involves intervention for sexual and health care-seeking behavior or through mass immunization against high-risk HPV.

The objective of Cervical screening/secondary prevention is to prevent invasive Cervical cancer from developing by detecting and treating women with precancerous lesions, and the effectiveness is determined by reduction in incidence and mortality.

What is screening and how is it done in Cervical cancer patients?

There are 2 types of tests used for Cervical cancer screening.

The PAP test can find early cell changes and treat them before they become cancer. The Pap test can also find cervical cancer early when it’s easier to treat.

The HPV (Human Papilloma Virus) test finds certain infections that can lead to cell changes and cancer. HPV infections are very common.

American Cancer Society recommends all women should begin Cervical cancer screening at the age of 21 years. Women between 21 and 29 years should have a PAP test every 3 years. Women between the age of 30 and 65 should have both a PAP test and an HPV test every 5 years or a Pap test alone every 3 years.

Women over age 65 who have had regular and normal results should not be screened. Women who have been diagnosed with Cervical pre-cancer should continue to be screened.

Women post hysterectomy who have their cervix removed need not to be screened.

Women who have had the HPV vaccine should still follow the screening recommendations for their age group.

Cervical cancer vaccination

Two vaccines licensed globally are available in India; a quadrivalent vaccine (Gardasil ) and a bivalent vaccine (Cervarix )

The recommended age for initiation of vaccination is 9 12 years. A total of three doses at 0, 2 and 6 months are recommended with Gardasil or 0, 1 and 6 months with Cervarix .

Treatment

The treatment of Cervical cancer varies with the stage of the disease. For early invasive cancer, surgery is the treatment of choice. In more advanced cases, radiation combined with chemotherapy is the current standard of care.

Contraception : The Voluntary Prevention Of Pregnancy

Considerations when Choosing a Contraceptive Method

  • Safety
  • Protection from sexually transmissible diseases
  • Effectiveness
  • Acceptability
  • Convenience
  • Education needed
  • Side Effects
  • Benefits
  • Interference with spontaneity
  • Availability
  • Expense
  • Preference

Methods of Contraception

  • Temporary
  • Behavioral
  • Hormonal
  • Barrier – Spermicides
  • Long-Term / Permanent

Types of Contraception

  1. Barrier contraceptives
  2. Hormonal contraceptives
  3. Sterilization

Note: No single method of birth control is the Ÿ??bestŸ? one. Each has its own advantages and disadvantages. Abstinence is the only 100% effective way to prevent pregnancy and STDŸ??s

Barrier Contraceptives

Methods that physically or chemically block sperm from reaching an egg AND provide a BARRIER between direct skin to skin contact

Act as a physical block between you and your sexual partner

Great for STD protection!

Barrier Methods

  • Male condom
  • Female condom
  • Diaphragm
  • Cervical cap
  • Spermicides

MALE CONDOM

Perfect effectiveness rate = 97%

Typical effectiveness rate = 88%

Latex and polyurethane condoms are available

Combining condoms with spermicides raises effectiveness levels to 99%

  • Male condoms are 82 to 98 percent effective at preventing pregnancy
  • Condoms can only be used once
  • Do not use oil-based lubricants such as massage oils, baby oil, lotions, or petroleum jelly.They will weaken the condom, causing it to tear or break.
  • Water-based are the best Ÿ?? can prevent breaking of condom.
  • Good choices: Latex condoms and polyurethane
  • Bad choices: Never choose Ÿ??naturalŸ? or Ÿ??lambskinŸ?

FEMALE CONDOM

What is it? – A soft, loose pouch that is inserted in the vagina.Flexible rings at each end hold it in place.Can be put in up to hours before sex.

Not mandatory

How do you use it?– Insert the small ring in vagina, large ring stays outside partially covering labia.

Notes: Can be used if you are allergic to latex (made of nitrile).Men usually feel no reduction in sensation.

Access: Available at many pharmacies, clinics, and online

Effectiveness: 79-95%

  • Made as an alternative to male condoms
  • Polyurethane
  • Physically inserted in the vagina
  • Perfect rate = 95%
  • Typical rate = 79%
  • Woman can use female condom if partner refuses

Diaphragm & Cervical Cap

What is it? -A soft, silicone dome that covers the cervix w/ a flexible rim that holds spermicide

How do you use it? -Put a tbsp of spermicide in and slide it into the vagina.Protection lasts 2 hours, and needs to be left in for 6 hours after sex

Notes: Neither partners should feel the diaphragm.Get re-fitted if you gain/lose 15 pounds

Access: Doctor/clinic visit needed for prescription and fitting

Effectiveness: 82-94%

Spermicides

  • Cream
  • Gel
  • Foam
  • Film
  • Suppository
  • Sponge

What is it? Chemicals that go in the vagina before sex.Immobilize or kills sperm.Most work for 1 hour, sponge for 24 hours

How do you use it? Put in vagina following packaging directions.Most need to be put in 10 minutes before intercourse.

Notes: Key ingredient is Nonoxynol 9.Neither partner should notice spermicide.

Access: Easy to buy in a pharmacy

Effectiveness: 72-91%

Behavioral Methods

  • Predicting fertility: Basal Body

Temperature & Calendar method

  • Withdrawal/Pullout
  • Abstinence**- The only 100% effective way to prevent pregnancy, STIs, HIV/AIDS
Withdrawal/Pullout

What is it ? The man takes his penis out of the vagina before he ejaculates

How ? The male needs to ejaculate away from female; sperm on legs and labia can still travel into vagina

Notes: Depends on a maleŸ??s self knowledge and self control

Access: Free, available to anyone

Effectiveness: 78-96%

How effective is it?

  • Of every 100 women whose partners use withdrawal, 4 will become pregnant each year if they always do it correctly.
  • Of every 100 women whose partners use withdrawal, 27 will become pregnant each year if they don’t always do it correctly.
  • Pregnancy is also possible if semen or pre-ejaculate is spilled on the vulva.

Hormonal Methods

  • Methods that prevent the release of an egg (ovulation)
  • Prevents a fertilized egg from implanting in the uterus (prevents pregnancy).
  • NO hormonal methods reduce chances of STDŸ??s!

Types of Hormonal Methods

  • The Pill
  • The Patch
  • Vaginal Ring
  • The Shot
  • IUD
  • Emergency Contraception
  • These methods add chemicals similar to hormones to stop the release of an egg and weaken the sperm.
  • The hormones change your cervical mucus and uterine lining, slow sperm, and reduce ability of fertilized egg to implant into uterine wall.

Oral Contraceptives

Also called Ÿ??the pill,Ÿ?some contain estrogen, progestin, or mix of other hormones depending on pill

The pill is 91 to 99 percent effective at preventing pregnancy & is always prescribed by the doctor.

A pill is taken at the same time each day (once a day for three weeks, no pill fourth week -will get menstrual period)

What is it?A pill taken orally every day at about the same time

Notes: There are many different brands.Your doctor can help you find the right one for you. Your period can occur monthly, every 3 months, or not at all

Access: Prescription needed

Effectiveness: 91-99.7%

How does the pill work?
  • Stops ovulation
  • Thins uterine lining
  • Thickens cervical mucus
Positive Benefits of Birth Control Pills
  • Prevents pregnancy
  • Eases menstrual cramps
  • Shortens period
  • Regulates period
  • Decreases incidence of ovarian cysts
  • Prevents ovarian and uterine cancer
  • Decreases acne
Side-effects
  • Breast tenderness
  • Nausea
  • Increase in headaches
  • Moodiness
  • Weight change
  • Spotting

Ÿ??The PatchŸ? Ÿ?? Ortho Evra

What is it? A bandage-like patch that sticks to your skin

How do you use it? Changed weekly, no patch on 4th week.Hormones are absorbed through the skin

Notes:Less effective if you weigh over 198 pounds.May cause skin irritation.

Access: Prescription needed

Effectiveness: 91-99.7%

Vaginal Ring/Nuvaring

What is it? A clear, soft, flexible 2 inch circle worn in the vagina

How to use it? The body absorbs hormones from the ring through vaginal wall.The ring is inserted and left in the vagina for 3 weeks.

Notes: One size fits all, neither partner usually feels the ring

Access: Prescription needed

Effectiveness: 91-99.7%

  • The birth control ring releases the hormones progestin and estrogen
  • It is 91 to 99 percent effective at preventing pregnancy
  • Ring goes inside vagina up around your cervix
  • You wear the ring for three weeks, take it out for the week you have your period, and then put in a new ring
  • This method does not protect you from HIV or other STDs.

The ShotŸ? Ÿ?? Depo Provera

What is it? A long acting hormone injection

How do you use it? Female is given a shot one time every 3 months

Notes: Not reversible- once the injection occurs, the hormones are in the woman for at least 3 months.It may take a long time to get pregnant after the shot. More chance of weight gain than any other method

Access: Clinic / doctor visit needed every 3 months

Effectiveness: 94-99.8%

  • Birth control shot given once every three months to prevent pregnancy
  • 99.7% effective preventing pregnancy
  • No daily pills to remember

Birth Control Shot

  • Every 3 months (or 12 weeks), women get shots of the hormone progestin in the buttocks or arm from their doctor.
  • It is 94 to 99 percent effective at preventing pregnancy.
  • It does not protect you from HIV or other STDs
Side Effects
  • Irregular menstrual bleeding and spotting for 3-6 months!
  • NO PERIOD after 3-6 months
  • Weight change
  • Breast tenderness
  • Mood change
*NOT EVERY WOMAN HAS SIDE-EFFECTS!

Emergency Contraception

  • Also known as the Ÿ??morning after pillŸ?
  • The pills are 75 to 89 percent effective at preventing pregnancy
  • Can be take up to 3 days(72 hrs) AFTER unprotected sex (depending on brand)
  • Effectiveness decreases after 24 hours
  • Emergency contraception should only be used after no birth control was used during sex, or if the birth control method failed, such as if a condom broke

When should I use it?

  • The condom broke or slipped off, and he ejaculated in your vagina.
  • You forgot to take your birth control pills, insert your ring, or apply your patch.
  • Your diaphragm or cap slipped out of place, and he ejaculated inside your vagina.
  • You miscalculated your “safe” days.
  • He didn’t pull out in time.
  • You weren’t using any birth control.
  • You were forced to have unprotected vaginal sex, or were raped.

How does it work?

The hormones in the morning after pill work by keeping a woman’s ovaries from releasing eggs Ÿ?? ovulation. Pregnancy cannot happen if there is no egg to join with sperm. The hormones in the morning after pill also prevent pregnancy by thickening a woman’s cervical mucus. The mucus blocks sperm and keeps it from joining with an egg.

Long-Term / Permanent

Female- Tubal ligation

Male- Vasectomy

    • These procedures are permanent, and are usually done by people 35+ years
    • Both procedures are done in a doctorŸ??s office
IUD: Copper (10 years)

Tubal Ligation (Female)

The fallopian Tube is ligated and sperm and ovum can no longer meet.A small incision is made in the abdomen to access the fallopian tubes. Fallopian tubes are blocked, burned, or clipped shut to prevent the egg from traveling through the tubes

Recovery usually takes 4-6 days

  • Tubal ligation or Ÿ??tying tubes.Ÿ?
  • A woman can have her fallopian tubes tied (or closed) to stop eggs from being fertilized
  • Over time, the ends of your fallopian tubes could fuse back together, and it may be possible to get pregnant

VASECTOMY (Male)

This operation is done to keep a manŸ??s sperm from going to his penis, so his ejaculate never has any sperm in it that can fertilize an egg. Operation is more simple than tying a womanŸ??s tubes. A small incision is made to access the vas deferens, the tube the sperm travels from the testicle to the penis, and is sealed, tied, or cut. After a vasectomy, a male will still ejaculate, but there wonŸ??t be any sperm present

  • It has no effect on potency
  • Male hormones are still produced, so male secondary sex characteristics are not affected
  • Sperm production continues

Vasectomy

  • Patient Teaching:
    • Apply ice to scrotum
    • Moderate activity for two days
      • Sterility is not immediate –some sperm will remain in the sperm ducts so, the male must have ejaculations to rid the ducts of these sperm
    • After he has 2 negative sperm counts, he then can resume sexual activity without use of another contraceptive.

Intrauterine Device

  • It is placed inside the uterus by a doctor.
  • 99% effective at preventing pregnancy
  • Copper IUD: Can stay for up to 10 years – Interferes with sperm, fertilization, and prevents implantation
  • Hormonal IUD: Can stay for up to 5 years – It releases a small amount of hormone each day to keep you from getting pregnant.

Intra Uterine Device (IUD)

What is it? A small plastic Ÿ??TŸ? with a string inserted into the uterus

How do you use it? Releases synthetic progestin hormone that changes cervical mucus, fallopian tubes and the uterine lining.Stops or slows sperm and egg

Notes: Lasts 5 years.Insertion can cause a few minutes of pain, but removal is fast and easy

Access: Clinic / doctor visit needed for insertion & removal

Effectiveness: 99.8%

Content Credits: Dr. Sunitha P Shekokar

Breast Milk – The Elixir of Life

Ÿ??BREAST FEEDING IS A MOTHERŸ??S GIFT TO HERSELF, HER BABY AND THE EARTHŸ?-Pamela K Wiggins

Of every 1000 children born in India, 39 infants do not live to see their first birthday. Almost fifty percent of infant deaths in India are due to respiratory infections and diarrhoea. Breast feeding alone can reduce the infant deaths significantly. Exclusive breast feeding for 6 months protects the infant against pneumonia, diarrhoea, malnutrition, allergies and chronic illnesses. It is also said that breastfed babies score higher in IQ tests. Breast feeding contributes to the health and wellbeing of mothers also. In India only 64.9% infants are exclusively breastfed for first 6 months.

To enable mothers to establish and sustain exclusive breastfeeding for 6 months, WHO and UNICEF recommend:

  • Initiation of breastfeeding within the first hour of life
  • Exclusive breastfeeding Ÿ?? that is the infant only receives breast milk without any additional food or drink, not even water
  • Breastfeeding on demand Ÿ?? that is as often as the child wants, day and night
  • No use of bottles, teats or pacifiers

The first milk-colostrum is rich in antibodies which helps in building babyŸ??s immune system. Breast milk provides all the nutrients required for first six months. For the first week after birth, it is recommended that mothers breastfeed their newborns 8-12 times in 24hrs.

Breast milk can increase if the mother eats well, drinks well and rests well. The more your baby breastfeeds Ÿ?? the more milk you will produce! All mothers should remember that-Ÿ??Caring is more important than worryingŸ??.

Adequacy of breast feeding in this critical period should be monitored. Danger signs like not feeding well, decreased activity, developing fever, less than 4 urinations per day after day 3, continuous cry should be watched for in the first week of life. Excessive weight loss (>10%) and weight faltering requires immediate treatment. A proper positioning and latching will prevent from sore, painful and cracked nipples. Mother should continue breastfeeding even if suffering from minor infections like cold, or fever.

Juggling work and breastfeeding is not easy. Have confidence in yourself. You can do this! Make a commitment before you return to work. Expressed breast milk can be kept at room temperature for up to 6hrs, in insulated cooler for one day and in refrigerator for 5-8 days.

Breast feeding should be given exclusively for first six months of age and then till two years along with complementary food.

Mother should communicate, look into the eyes, touch and caress the baby while feeding. Mothers need to practice responsive feeding. Breastfeeding is the best gift a mother can give her baby which lasts a lifetime. Breastfeeding is not a choice itŸ??s a responsibility.

Content Credits: Dr. Priya Shivalli

Preterm labor – be on the alert By Dr. Beena Jeysingh

Preterm labor is when your body gets ready for birth too early in your pregnancy. It is premature if it starts earlier than 3 weeks of due date.

Risk factors are overweight or underweight at time of conception, hypertension, diabetes, smoking, alcohol, pregnancy induced hypertension, gestational diabetes, uterine abnormalities, previous history of preterm delivery, any severe maternal infection. Report to obstetrician if severe backache, cramping in lower abdomen, fluid leaking from vagina, vaginal bleeding.

Preterm birth is the most important single determinant of adverse infant outcome hence prevention and early detection is important.

By
Dr.Beena Jeysingh

Morning Sickness -don’t fear! By Dr. Beena Jeysingh

It is an uncomfortable feeling of just nausea or nausea with vomiting experienced in the early
weeks of pregnancy due to hormones. About 50 percent of pregnant women experience it.
Usually starts around 6weeks of pregnancy and disappears by end of 3months though rarely can
stay until end of pregnancy. Report to obstetrician if excess vomitting, less or dark color urine,
blood in vomitus. Management is by intake of frequent small feeds and in severe cases
medications to reduce vomiting.

By

Dr.Beena Jeysingh

Preconception Counselling By Dr.Beena Jeysingh

Caring for your health before you become pregnant will help you learn about any risk factors and treat any medical problems before you conceive.This helps you make healthy choices for you and your baby.
During the preconception visit you will be questioned regarding your medical and surgical history,family and genetic history,previous obstetric history and lifestyle habits.A basic physical examination,weight and BP check is done.
Blood test to check rubella virus immunity done.
Based on the assesment, lifestyle modification,to avoid any medications that can be harmful to baby and appropriate counselling if any required given to ensure a healthy pregnancy and baby. Folic acid is advised to be taken from atleast 2 months prior to pregnancy .If not immune to rubella, vaccination advised.

By
Dr.Beena Jeysingh

Travel during pregnancy by Dr.Beena Jeysingh

You can still enjoy a holiday or travel for professional reasons during pregnancy. But, yes there will be some restrictions and precautions that you need to take & maintain.

The best time to travel is the middle of your pregnancy between 14 and 28 weeks. Most of the emergencies happen in the 1st and 3rd trimester & it would be difficult to move around once youŸ??re pregnant for 28 weeks and over.

When you’re travelling by air, domestic airlines normally do not allow women who are pregnant above 36 weeks while international flights itŸ??s after 28weeks. But itŸ??s always best you confirm with your airlines . You may also require a“fit to fly” medical certificate from your treating obstetrician prior to flying. Make sure to book an aisle seat if possible, so that itŸ??s easy to get up and stretch your legs.

Important Things To Keep In Mind While Travelling

  • Hydrate yourself adequately.
  • Avoid carbonated drinks during and before your flight.
  • If you are prone to nausea or vomiting get prescription for anti-vomiting drugs from your obstetrician.
  • Keep moving your legs and rotating the ankles frequently.
  • During a road trip (car or train), limit travel to 6 hours per day with breaks during travel to stretch your legs.
  • For a cruise ship be sure to carry your medications to handle sea-sickness.
  • Wear comfortable clothes.
  • Take advice on health insurance and any vaccinations if required.
  • Carry a dictionary of the local language spoken if it is a language not known to you.

Happy & Safe Travels

By Dr.Beena Jeysingh

10 THINGS YOU SHOULD KNOW ABOUT NEWBORN BABIES By Dr. Pradeep Kumar

  1. New-born babies should pass meconium (First stool) within 24 hours and urine within 48 hours.
  2. Breastfeeding should be started as soon as possible, usually within 30 minutes of normal delivery and within 4 hours in case of caesarean section.
  3. First 2 -3 days milk secretion will be less in most mothers but it will be sufficient for the baby as it is rich in energy. The milk secretion will increase only if baby keeps sucking at breast which leads to prolactin reflex and increase in milk secretion. So please make baby sucks every 2 hours.
  4. Red rashes over the face and body is common which needs no treatment.
  5. On second or third day new-born babies develop jaundice which is physiological and only few babies will require phototherapy if jaundice level is high. Frequent feeding will help to bring down jaundice.
  6. Nowadays in most of the hospitals BCG, Hepatitis B and Vitamin K are given at birth or before discharge.
  7. New-born and preterm babies should be nicely wrapped and kept warm.
  8. Honey, oil or other things should not be given to the baby as they are of no benefit and sometimes can result in serious problems.
  9. White discharge or bloody discharge from vagina in female babies are normal which does not require any treatment.
  10. All new-born babies lose weight in first 7 days as they lose excess water from the body. They regain birth weight at 10-12 days of life and from then onwards they should gain 30gms every day for first 3 months.
By Dr. Pradeep Kumar

Misrepresented Facts Clarified

This post is with the sole purpose to clarify the misrepresentation of facts by Times of India.We hope that each one of you takes note of the facts and and the dedication with which expecting mothers are dealt with regularly at Motherhood Hospitals.

  1. Doctor not present in the hospital.

Fact: The consultant is a doctor of immense commitment and dedication and she had called to check on the patient at 5 amon her own and then came to the hospital at 5.08 am to ensure the safety of her patient and the baby.

  1. Competent anaesthetist not available

Fact:There was an anaesthetist in house and at all Motherhood hospitals we have a full time qualified Obstetricians on call 24/7 and a dedicated team of anaesthetists also 24/7. In this case the anaesthetist on call was the patients own friend who was present at her bedside and is a qualified person.

  1. Media says doctor administered a wrong injection.

Fact: The patient was admitted for induction of labour to facilitate a natural birth and the injection was given at 6 pmthe previous day. An allergic reaction or adverse reaction will not take 10 hours to happen.

  1. Baby was pulled out with forceps

Fact: The mother had a emergency caesarean section so the baby could not have had a forceps delivery. Baby was delivered at 5.40 am. Baby had suffered some oxygen deprivation due to the mothers illness and was saved.

  1. Patient taken to OT and nothing was done

Fact: The anaesthetist on call was her friend and 5 am patient was shifted to OT and 5.40 am the baby was delivered. The mother was resuscitated for 3 full hours by the team of doctors but she suffered from amniotic fluid embolism which is fatal event and not something the doctor could have stopped. For more details on Amniotic Fluid Embolism, please read this http://www.mayoclinic.org/diseases-conditions/amniotic-fluid-embolism/basics/definition/con-20035462

  1. The baby had passed stool

Fact: It is called a meconium stained liqor and happens in 15-20% of all term deliveries. It is nothing to be worried about just the neonatologist pay more attention to babies born with stained liqor. You can read more about this here as well. https://www.ucsfbenioffchildrens.org/pdf/manuals/5_MeconiumAF.pdf