High-Risk Pregnancy

Motherhood can be considered to be one of the most beautiful experiences in a woman’s life. It is important to ensure motherŸ??s health is taken care of that will eventually result in growth and development of the fetus. Regular antenatal care will assure a healthy and safe delivery for the mother. If adequate steps are not taken in ensuring the health of the mother and the fetus high risk concerns may set in.

What is considered a High-Risk Pregnancy?

Pregnancy can be considered as high risk if there are potential complications that could affect either you, your baby, or both. These cases require special intervention by experts and specialists to ensure that the best possible outcome occurs for both the mother and the baby. Unforeseen illnesses or preexisting diseases can complicate the pregnancy, which, in turn, puts you and your baby at risk.

High-Risk Pregnancy Factors

These are some of the factors that can classify a pregnancy as a high-risk pregnancy-
  • Teenage pregnancy and Pregnancy above the age of 35.
  • Women with previous history of repeated pregnancy losses, previous preterm delivery, previous history of preeclampsia (increase blood pressure with edema). History of gestational diabetes in the previous pregnancy or any other medical disorder including psychiatry illness.
  • History of placenta praevia, antepartum bleeding, preterm premature rupture of membranes also come under high risk category.
  • Women with preexisting conditions like Hypertension, Diabetes mellitus, Cardiac disease, Anemia, Blood Dyscrasia, Haemoglobinopathy, Platelet disorders and Liver problems.
  • Women with a history of thromboembolism (obstruction of a blood vessel by a blood clot that has become dislodged from another site in the circulation), strokes, myocardial infarction.
  • Some women who have autoimmune diseases, thyroid, other endocrine disorders, renal disorders
  • Lifestyle choices like smoking cigarettes, drinking alcohol, substance abuse and obesity.
  • Women with neurological problems like epilepsy, brain tumours, multiple sclerosis, cerebral venous thrombosis and psychiatric illness.

What You Can Do to Ensure a Safe Delivery

If you are expecting a baby or want to have one in the future, there are some guidelines to be followed for a safe, healthy pregnancy and delivery-
  • Schedule a preconception appointment Ÿ?? if you are trying to conceive, make sure that you consult your healthcare provider. If you have a medical condition or have recently been diagnosed with one, your treatment might need to be adjusted to prepare for the pregnancy.
  • Seek prenatal care regularly Ÿ?? prenatal visits can help your healthcare provider in monitoring your health and your baby’s health.
  • Have a healthy diet – youŸ??ll need more folic acid, calcium, iron and other essential nutrients during pregnancy. A daily dosage of prenatal vitamins can help as well.
  • Gaining the right amount of weight can support the health of your baby and make it easier to shed the extra pounds after your delivery.
  • Opt for a tertiary centre as all the specialty doctors at that centre will be available and that will be beneficial to both the mother and the baby.
  • Avoid risky substances such as cigarettes and drugs. Make sure that you consult your healthcare provider before you start or stop taking any medications or supplements.

Specific Symptoms to Look Out For

If you have the following signs or symptoms during your pregnancy period, be sure to consult your doctor-
  • Vaginal bleeding
  • Decreased fetal activity
  • Pain or cramps in the lower abdomen
  • Watery vaginal discharge in a gush or a trickle
  • Regular or frequent contractions Ÿ?? a tightening sensation in the abdomen area
  • Pain or burning during urination
  • Changes in vision, including blurred vision
  • Persistent headaches
To conclude high risk pregnancy should be monitored and managed in a center with facilities available for adequate maternal and fetal care. Consultant liaison with Physicians, Neonatologists, Anesthesiologist and senior Obstetricians, optimum care can be provided for the better outcome.

All you need to know about Labor Epidurals- By Dr. Shashidhar K.B

One of the biggest confusion during pregnancy is having a normal delivery or a caesarean section. Even though every woman wants to undergo the pleasant experience of natural birth, most of them can’t stick to it because of the intense, excruciating pain.

More than half of the pregnant women can deliver vaginally, but sadly due to the labor pain, only few can go through it. But darling, if you are one of those women who want to experience the natural way of childbirth, don’t you worry. There is an Epidural for you.

What is an Epidural Anesthesia?

As the name says, Epidural Anesthesia is an anesthetic injection administrated by an anesthetist into the space around the spinal nerves (lower back). The primary objective of this procedure is to stop the sensation of pain in your body.

What is Labor Epidurals?

When Epidural Anesthesia is given to control the labor pain, it is known as Labor Epidurals. It is famously used during a natural birth or virginal birth (optionally used for caesarean section) where it effectively blocks the pain from labor contractions and facilitates the energy drained mother to move and push the baby out with ease. Epidural medications fall into the category of local anesthetics and are combined with narcotics when delivered.

How does Labor Epidurals work?

When a woman undergoes through labor, the contraction of the uterus causes the pain. Nerves carry this pain associated with labor to the spinal cord where it intensifies. The Labor Epidurals (local) blocks the nerves carrying pain sensation to the spinal cord and works as a painkiller.

How Is Epidural Administered?

  1. Before an Epidural (and during the delivery) Intravenous fluids are given to maintain blood pressure. Since an Epidural injection dilates the blood vessels, it causes the blood pressure to drop suddenly.
  2. An anesthesiologist will ask the patient to sit at the edge of the bed and arch the back in a bent position. It will increase the surface area for the administration of the injection because it opens up the spine.
  3. An antiseptic lotion/liquid is applied to the area to make it sterile.
  4. The anesthesiologist first looks for area/spaces between the spines, where he/she injects a local anesthetic to numb the skin in the area to where later the Epidural needle is inserted.
  5. A hollow Epidural needle is inserted into the numb area along. With this a thin tube is threaded through the needle. The needle is then removed, and the catheter (tube) is left behind. So that the catheter doesn’t slip, it is taped to the back.
  6. Through the tube, injections are given periodically or continuously.

Are there any risks related to Labor Epidurals?

Well, everything has a negative and a positive side. So here are few of the risks related to Labor Epidurals:

  1. Epidural injection dilates the blood vessels. This causes the blood pressure to drop suddenly.
  2. Itching and rashes may occur.
  3. Since the drug will numb the region between the waist and upper legs, this numbness is felt even after the delivery (3-4 hours). Therefore you would need assistance to walk.

At Motherhood our doctors recommend you this treatment option only after a careful examination, study, and collaboration with the experts from other fields to ensure you receive the best multidisciplinary care. Therefore, there is more than just one reason to entrust us with your health.

By Dr. Shashidhar K.B., Consultant Anaesthesiologist, Motherhood Hospital, Hebbal

Book your appointment today with our experts or send us an inquiry.

Changes in human body during pregnancy

Human body undergoes enormous changes during pregnancy. It affects the body from head to toes. It is amazing how the body accommodates the baby so smoothly.

1) There is a new growth spurt in hair, glow on the face and bleeding gums because of increased estrogen in the blood.

2) Increased pigmentation on face ,neck , nipples and abdomen due to increase in melanin . This pigmentation is also known as melasma or chloasma or PREGNANCY MASK.

3) Water retention leading to puffiness of face , swelling of fingers and toes . Swelling around sciatic nerve causes pain in lower back and thigh . Contact lens users feel difficulty in their usage.

4) There is marked increase in the size of breasts as they need to get ready for nursing the baby.

5) Dryness of skin and breakage of collagen leading to stretch marks.

6) Constipation because of progesterone ,the hormone of pregnancy ,it is known to make the bowel sluggish.

7) Joints and ligaments loosen around pelvis and other places because of pregnancy hormones specially RELAXIN, this helps for accommodating baby and delivery. Loosening also results in back pain, change in gait WADDLING.

8) Increase in body temperature, heart rate and breathlessness due to increase in metabolic rate and increased cardiac output.

9) Increase in stagnation of venous blood flow leads to hemorrhoids or piles, varicose veins.

10) Acne worsens as the hormonal shift makes skin very oily.

By,

Dr. Suhasini Inamdar

Hernia in Pregnancy By Dr. Sangeeta Gomes

Dr. Sangeeta Maternal guidance on hernia in pregnancy - Motherhood Hospital India

Hernia is a hole or gap in the abdominal muscle wall that causes either intestine or fatty tissue to protrude through.

Areas of Hernia: Abdomen, Groin, Incisional sites.

Hernia types:

  • Umbilical or belly button: Umbilical Hernia is the most common of Hernias in pregnancy. It is the site where umbilical cord is attached when child is born. There is a small opening in this area and an increased pressure can stretch it open. It appears in pregnancy and disappears after delivery.
  • Inguinal hernia/Femoral hernia: These are seen in the groin area.
  • Incisional hernia: It develops in the operation site, and is usually seen in vertical scar on abdomen.

Hernia normally occurs after 18-20 weeks of pregnancy and around 2% of women get Hernia during or after their pregnancy. Approximately 0.02% of women require surgery.

2 per 1000 women with transverse incision and 10 to 30% women with vertical incision can get hernia.

Hernia in pregnancy does not require immediate attention, unless it becomes painful. If painful and left untreated can lead to serious and life-threatening complications like obstruction and intestinal gangrene.

Babies may not get affected by mothers Hernia.10-30% of infants have umbilical hernia after birth which usually closes by 1 year and 2% remain which may require surgery.

Predisposing factors:

  • Women having muscle weakness from birth.
  • Aggregating factors like chronic cough, constipation, asthma and obesity
  • Big baby, twins, polyhydramnios can also stretch muscle making them thin and weak, and tear them due to pressure of growing baby in uterus.
  • Heavy weight lifting.
  • Fluid in the abdomen.
  • Tumor in the abdomen raising intra-abdominal pressure.

Signs and symptoms of Hernia:

Many women have no symptoms. Some can see or feel a bulge while lying down, standing or coughing, in the inguinal or belly button area. Some have dull aching pain while laughing talking, coughing and sneezing. Some may find difficult to walk if they become bigger. If symptoms like pain, fever, nausea are there, they should meet the doctor immediately.

Diagnostic tests:

  • By physical examination on inspection and palpation feeling the gap in the hernia site and reducing the contents back into the abdomen.
  • By cough impulse one can feel the touch of the intestine gurgling in the hernia site.
  • Ultrasound examination of abdomen and pelvis can show the site, size, shape and contents of the gap. Higher test like CT scan also be done.

Treatment of hernia:

Once detected treat with good physical support at the site of a hernia to prevent the further discomfort. Hernia support band, compression therapy groin bands etc to be used under DoctorŸ??s supervision. While sleeping take off the hernia support band. Keep pillow between or under knees for support.

ItŸ??s not recommended to have surgery during pregnancy unless its posing risk to the mother and baby. If due to some complication, surgery has to be done, plan it in second trimester of pregnancy. This carries a risk of preterm delivery.

For Pregnancy with Hernia, Caesarian section is not mandatory, they can deliver normally. Caesarian section is done only if obstetrics reasons are there. After delivery allow the body to recover fully which can be from 3 to 6 months. Then surgery can be done, if Hernia persists.

Tips for Prevention:

  • Go for pre-conception counseling which includes general and physical examination to rule out Hernia.
  • Minimize excess physical activity like lifting heavy weight.
  • Yoga and muscle strengthening exercises under guidance
  • Maintain healthy body weight
  • Maintain balance diet, avoid constipation.
  • Avoid lifting or carrying children in arm.
  • Avoid smoking, and avoid pushing hard during bowel movement or passing urine.

Types of surgery:

  • Open method
  • Laparoscopic method

In both the methods hernia gap is repaired using a mesh.

By,
Dr.Sangeeta Gomes

Multiple Pregnancy

Multiple pregnancy is when there are more than one embryo getting attached to uterine lining and developing into multiple foetuses. This can be twins, triplets, quadruplets or higher order pregnancies. The incidence of twins is gone up from 18.9/1000 live births in 1980 to 32.1/1000 live births.

How multiple pregnancy happens?

One baby growing in the womb (uterus) on its own is called a singleton pregnancy. By far the most common type of multiple pregnancy is a twin pregnancy when there are two babies. Having three babies in the same pregnancy is known as triplets and having four is known as quadruplets. It is very rare to have more than four. Multiple pregnancy happens because two to three eggs get fertilized with two to three sperms or when one fertilised egg make two to three instead of one embryo.

Let us understand about TWINS as this is the commonest of all multiple pregnancies. Also, it is important to understand that the placenta is crucial to the pregnancy – it is the place where your body ‘meets’ your baby directly to pass across the nutrients your baby needs to grow. When an egg is fertilized it starts dividing till it convert itself into a zygote. If split occurs in early stage of cell division identical twins are formed. This cell division continues until it converts into a ball of cells and starts implanting itself in the lining of womb and becomes an embryo. The cells will form distinct areas like central group forms the baby and outer lining form the amniotic sac.

Types of twins:

  • Dichorionic diamniotic (DCDA): Two placenta and two amniotic sacs.
  • Mono chorionic diamniotic (MCDA): One placenta and two sacs.
  • Mono chorionic mono amniotic (MCMA): One placenta and one sac

Causes of multiple pregnancy:

  • Maternal age: women more than 35 are more prone to conceive multiple.
  • Fertility medication: These drugs stimulate ovaries to produce multiple eggs
  • Family history: History of multiple gestation in the family makes one prone for the same.
  • Had a history of twin in the past.

Risks to foetuses

  • premature birth
  • low birth weight
  • Twin to twin transfusion
  • Discordant growth
  • Miscarriages

RISKS TO MOTHER

  • Gestational diabetes
  • Preeclampsia or hypertension
  • Severe hyperemesis

Management

  • Foetal reduction: this is termination of one or more foetuses after the NT USG . Proper understanding of the procedure from parental side is very important. Risk of abortion needs special attention.
  • More frequent visits to obstetrician
  • Cervical encircalage / stitch: It’s role in preventing miscarriage is doubtful
  • Vaginal progesterone: this is known to help keep cervical integrity
  • Dietician advice to help prevent GDM
  • Ecosprin can be advised for prevention of preeclampsia
  • More frequent scans to understand the growth pattern.
  • Intervention by foetal Medicine expert if required
  • Vigilant postnatal care as the chances of post-natal depression is high
  • Avoid alcohol, smoking as advised with any singleton pregnancy.
  • Steroid injection: these injections are given to mother to help the maturity of foetal lungs, by doing this we can avoid/ decrease the stay of babies in NICU

Mode and time of delivery

Chances of Normal Vaginal Delivery is high under following conditions:

  • The babies are growing properly
  • Position of babies in the womb normal and conducive for normal delivery

LSCS would be a method of choice for:

  • MCMA twins
  • Pprom: water break/ leaking prematurely before term
  • Unfavourable position
  • CPD wherein the birth passage is narrow
  • Second twin after vaginal birth of first baby, if vaginal delivery not possible due to abnormal lie and position of baby, decreasing heart rate, placental abruption

As per guidelines the ideal time of delivery is around 38 weeks, any time before is 32 weeks has high risks for babies

Special attention

Genetic screening: Please talk to your obstetrician and opt for amniocentesis if indicated, double/quadruple marker, CVS and NIPT screening methods are not conclusive

Bed rest: not indicated

Eat for three: not required, should get consultation with dietician

Breastfeeding: no issues and both the babies can be fed properly

ENJOY YOUR PREGNANCY AND FEEL FREE TO ASK FOR HELP FROM FAMILY AND FRIENDS DURING PREGNANCY AND POST YOUR DELIVERY AS MULTIPLE PREGNANCY IS A VERY DEMANDING CONDITION PHYSICALLY AND MENTALLY.

By,
Dr. Suhasini Inamdar

 

ECTOPIC PREGNANCY

By Dr. Suhasini Inamdhar

An ectopic pregnancy is an early pregnancy that occurs outside of the normal location (uterine lining) for a developing pregnancy. The vast majority of ectopic pregnancies are so-called tubal pregnancies and occur in the Fallopian tube. An ectopic pregnancy occurs in about one in 1%-2% of all pregnancies.

These other places can be:

1) Fallopian tubes
2) Ovaries
3) Cervix
4) Cornua of uterus
5) Abdominal Cavity

The major health risk of ectopic pregnancy is rupture leading to internal bleeding. Before the 19th century, the mortality rate (death rate) from ectopic pregnancies exceeded 50%. Statistics suggest that with current advances in early detection, the mortality rate has improved to less than five in 10,000. The survival rate from ectopic pregnancies is improving even though the incidence of ectopic pregnancies is also increasing. The major reason for a poor outcome is failure to seek early medical attention. Ectopic pregnancy remains the leading cause of pregnancy-related death in the first trimester of pregnancy.

Causes of Ectopic pregnancy:
1)LAZY EMBRYO

The embryo does not travel till the cavity of uterus, but gets attached in the ovary, tube or cornua of uterus .
2) PELVIC INFLAMMATORY DISEASE (PID) : infection because of :

1) chlamydia,
2) bacteria
3) acute appendicitis
4) recurrent D & C/ MTP
5) pelvic surgery

inflammation of the pelvis sets in and the fallopian tubes get damaged, form adhesions, get partially /completely blocked and impede the movement of embryo. This makes embryo to get settled in the tube.

3) ENDOMETRIOSIS
Here the anatomy of Fallopian Tubes and Pelvis gets distorted and tubes do not function to the full potential.

4) TUBAL LIGATION OR REVERSAL OF THE SAME
Family planning procedure where the tubes are tied sometimes fails and this can lead to partial blockage of tubes.
5) IUCD
It is sometimes the cause of genital tract infection and can lead to damaged tubes.

6) PREVIOUS ECTOPIC PREGNANCY

7) EMERGENCY CONTRACEPTIVE PILL
Here the egg is already fertilised and it’s movement is hampered because of change in the hormonal miluea
8) PROGESTERONE ONLY PILL (MINI PILL)
Here the mucus membrane of tubes gets altered and the motility of tube also is affected
9)CIGARETTE SMOKING
It is known to increase the level of protein PROKR1 in the fallopian tube and this protein is known to help in implantation of embryo.
Please remember: ectopic pregnancy is not your fault and it just happens, one needs to be vigilant and aware.

By,
Suhasini Inamdar

My Gynaec – The Essential App For Expecting And New Moms

Motherhood Hospitals is a comprehensive woman and child care hospital committed to providing a gamut of services to women, newborns and paediatrics. Our multidisciplinary team provides comprehensive and personalised care, including obstetrics, gynaecology, neonatology, paediatrics, fetal medicine, radiology and speciality outpatient clinics. Situated in chief areas of Bangalore such as Indiranagar, Sarjapur Road and Hebbal, Motherhood hospitals ensure the safest and most hygienic services for mums and hence, must be on the top of every mum’s list of healthcare centres. Their hospitals comprise teams of highly qualified gynaecologists and paediatricians, making them Tiny steps top choice in terms of a recommendation for you.

Here, weŸ??re reviewing one of the newest features Motherhood has added to reach out to mums in need – My Gynaec: Motherhood. It is an app designed keeping in mind the convenience of every mum who indulges in the childbirth frenzy. It is inclusive of everything a mom-to-be can possibly run for – from appointments with doctors to reminders for medicines.

The app is simple to understand and access, with explicit features related to pregnancy and womenŸ??s health. All it requires you to do in order to access it is sign up using your personal details, which then leads you to a dashboard of categories you can choose to explore. These categories revolve around the matters of pregnancy and women health and care, further leading you into the world of motherhood.

They allow you to keep a tab on not only your doctorŸ??s appointment, but also let you calculate the following:

  1. Due date (using LMP- last menstrual period)
  2. Ovulation cycle
  3. Menstrual cycle
  4. BabyŸ??s growth status
  5. Menopause
  6. Condition of your breasts during and after pregnancy

With features such as a well-built alarm and calendar system, you can now keep a check on all of the above things. You can also collect all your special pregnancy memories through features such as the pregnancy milestone, which allows you to capture every single milestone you cover during pregnancy with dates, personal descriptions and pictures.

What actually makes this app so efficient is the connectivity it provides you with the world around you. In the case of emergencies, it allows you to be in touch with both your hubby and gynaecologist. With features such as Emergency calls, you can now make sure your husband is the first person to know in case youŸ??ve faced any emergency, including your labour. Here, your husband will be receiving notifications about your appointments, due date and the stages of your babyŸ??s growth.

Overall, the app is built to make your life easier during pregnancy. In case you feel the need to contribute to the app or suggest changes in it, you can always choose the feedback option from the home screen dashboard. In our opinion, it is a must on your phone.

My Gynaec is available both on iOS and Android. It is only a click away from installation. We suggest you get this app on your phone right now!

Take care!

Article Source Credits : TinyStep

Dengue and Malaria Beware of the Fever During Pregnancy

Monsoon is the season where everyone starts enjoying their life. This season gets the child out in you. Many wants to play in the rain water, get drenched in the rain and the list goes on. Yes, enjoying is one part of monsoon. But getting ready to fall sick is another aspect which everyone needs to be careful during this season.

Dengue, Malaria, Chikungunya, Swine flu are common in the monsoon season. In the last 2 -3 years, there is a sudden spurt in the dengue cases everywhere. Most of the time hospitals will be completely filled with dengue patients and they turn away the patients because of the unavailability of the beds. But fever like dengue, malaria and swine flu could be dangerous during pregnancy if the care is not taken properly.

Dengue infection in pregnancy carries the risk of haemorrhage for both the mother and the new-born. Also there is a serious risk of premature birth and fetal death. In the case of infection developing close to the delivery time, there is a risk of vertical transmission.

Similarly malaria and swine flu during pregnancy can lead to miscarriage, congenital infections etc. Malaria can also cause anaemia in pregnant women and may result in convulsion, kidney failure. So it is important to monitor for dengue, malariaand swine flu during pregnancy.

Measures to be taken to avoid dengue, malaria and swine flu

  • Don’t travel to areas where dengue, malaria are prevalent
  • Keep your surroundings clean. Close the window in the morning and evening to avoid mosquitos entering the house
  • Wear protective cloths like long pants, long sleeve dresses
  • Use bed nets, preferably treated with an insecticide to prevent mosquito bite.

Simple treatments which a pregnant women can follow during dengue, malaria and

  • Drink plenty of fluids like water, fresh juice, coconut water. This will help to prevent dehydration.
  • Avoid taking medicines like aspirin for fever. This may lead to bleeding and other complication
  • Antipyretics helps to manage fever and body pain.
  • Meet the physician as early as possible.

Food For A Healthy Mind & Pregnancy

Every day, pregnant and nursing women have to make important dietary decisions by consuming healthy meals that include essential nutrients such as folic acid, calcium and pre-natal vitamins. Omega-3 fatty acids, which are long-chain polyunsaturated essential fatty acids, are also crucial for the mother’s health and also for the overall development of a healthy baby.

Research indicates that one of the most essential Omega-3 fatty acids is DHA (docosahexaenoic acid), which is critical for the development and functioning of the brain, the eyes and the central nervous system. Since Omega-3 fatty acids are not generated by the human body, pregnant and lactating women must obtain it either through diet or supplements. Babies rely on their mothers to get the much-needed DHA.

The Benefits

The European Food Safety Authority Scientific Panel recommends that pregnant and nursing women should consume 350 to 450 mg of DHA every day. Research suggests that DHA helps pregnant women by reducing the risk of pre-term birth and postpartum depression. According to a recent study in The American Journal of Clinical Nutrition, taking DHA helps optimal pregnancy outcomes. By ingesting supplements during the last half of pregnancy, women have longer gestation cycles, bigger babies, and fewer preterm births.

DHA also benefits the baby. Research shows that it results in an increase in brain weight and a child’s IQ, better hand-eye coordination. Babies get DHA from breastmilk, where it is found naturally. Infant formulas are now being supplemented with DHA.

Research indicates that preterm infants born without the benefit of DHA in last trimester of the pregnancy did not perform well on cognitive mental tests. Low levels of DHA in children have been linked to an increased risk of Attention Deficit Hyperactivity Disorder (ADHD), vision problems and depression.

In India, there is a low level of importance given to DHA during pregnancy and lactation. DHA intake in India among pregnant women is 10 times lesser than the intake among mothers in developed countries.

There are different dietary sources of DHA such as:

  • Algae: Certain microalgae are natural sources of DHA. A natural vegetarian source of DHA can now be produced from microalgae, and is currently available in dietary supplements, fortified foods, and a number of infant formulas.
  • Fatty fishes such as anchovies, salmon, herring, mackerel, tuna and halibut
  • Organ meat such as liver
  • Fish oil
  • Poultry and egg yolks
  • Breast milk

Of the above, significant amounts of DHA are found in animal organs and fatty fish, which is a challenge for Indias huge vegetarian population. Non-vegetarians have the highest DHA levels. Not only that, pregnant women are usually advised to limit consumption of fish due to concerns over toxins such as mercury.

A common misconception that many have come across is the use of flaxseed and walnuts in the belief that these foods are a rich source of DHA. That is not true. Flaxseeds and flaxseed oil contain a particular omega-3 fat called ALA (alpha-linolenic acid), a precursor of DHA. While the body can convert small amounts of ALA into DHA, it is not sufficient. According to World Health Organisation, marine oil supplements are often recommended to pregnant women to fulfil their Omega-3 requirements as they contain fatty acids DHA and EPA, which are the precursors of prostaglandins. Marine oils are usually promoted as a treatment for hypertension among pregnant women and non-pregnant adults.

Preeclamsia & Prematurity

Preeclampsia and Prematurity Insights on Managing Challenges in Pregnancy- Motherhood Hospital India

Pre – Eclampsia is a serious health problem affecting 5-8% of pregnancy worldwide

(8-10)% of pregnant women in India gets affected by it.

40% indicated or medically induced prematurity is caused by pre – Eclampsia and eclampsia in order to save life of mother and baby as delivery is the final option for this disease of placental origin.

Main indications of premature delivery are

Fetal:

  • Fetal disease
  • Intrauterine growth restriction
  • Oligo hydramnios
  • Placental abruption
  • Abnormal blood to fetus or abnormal doppler study

Maternal indications :

  • Recurrent eclampsia
  • HELLP syndrome
  • D/C
  • Liver hematoma
  • Renal failure
  • Hypertensive encephalopathy
  • Pulmonary edema

Can pre-elcampsia, eclampsia and prematurity can be prevented?

Primary prevention:

To prevent disease from happening

  • Avoid smoking and alcohol (It reduces disease by 30 – 40 %)
  • Maintain healthy weight
  • Avoid late marriage and late pregnancy
  • Diet rich in antioxidant such as Vit C, Vit E,Magnesium,. Zinc and calcium if positive family history of hypertension pre-eclampsia and eclampsia
  • Medication
  • Role of low dose of ecospirin is still no confirmed

SECONDARY PREVENTION

  • Medicines as such as Nifedipine, Labetalol, Hydralazsine
  • Sodium nitro prusside sodium

Tertiary Prevention to avoid recurrence by Magnesium sulphate

The main culprit of Pre-Eclampsia and eclampsia is placenta, which provides nourishment for baby.

There is no 100% effective screening method to prevent it. So, final outcome depends on experienced and dedicated obstetrician for early diagnosis organized antenatal care and family decision of delivery

Authored By : Dr Deepmala