ORAL CARE AND PREGNANCY- Blog by Dr. Omar Farookh

Pregnancy oral care tips by Dr. Omar - Motherhood Hospital India.

Pregnancy can lead to dental problems including gum disease and an increased risk of tooth decay.
During pregnancy increased hormonal changes can affect the body’s response to the plaque on your
Teeth. However, the demands of pregnancy can lead to particular dental problems in some women,
With proper hygiene at home and professional help from your dentist, your teeth should remain
healthy throughout pregnancy.
Dental disease can affect a developing baby
Research has found a link between gum disease in pregnant women and premature birth with low
Birth weight. Babies who are born prematurely may be at risk of a range of health conditions including
Cerebral palsy and problems with eyesight and hearing.
Estimates suggest that up to 18 out of every 100 premature births may be triggered by periodontal
disease, which is a chronic infection of the gums. Appropriate dental treatment for the expectant
mother may reduce the risk of premature birth.
Causes of dental health problems:
Gum problems The hormones associated with pregnancy can make women susceptible to gum
problems like gingivitis (gum inflammation), more likely to occur from the first trimester with
symptoms including swelling of the gums and bleeding particularly during brushing and when
flossing between teeth.
Undiagnosed or untreated periodontal disease, pregnancy may worsen this infection and can
lead to tooth loss.
Pregnancy epulis, a localized enlargement of the gum, which can bleed easily.
During pregnancy, the gum problems that occur are not due to increased plaque, but a worse
response to plaque as a result of increased hormone levels.
Tooth Decay- Some women experience unusual food cravings while they are pregnant and a
regular desire for sugary snacks may increase the risk of tooth decay.
Morning sickness- Pregnancy hormones can cause gastric reflux (regurgitating food or drink) or
the vomiting associated with morning sickness that can coat the teeth with strong stomach
acids. Repeated reflux and vomiting can damage tooth enamel and increase the risk of decay.
Dental treatment and Pregnancy: Safety Factor
The safest time to undergo dental treatment is the 2 and trimester of pregnancy. Preventive
scaling or professional cleaning of the gums and teeth, cavity fillings and annual dental check-
ups during pregnancy are not only safe but are recommended. Elective treatments such as teeth
whitening and other cosmetic procedures should be postponed until after birth. However,
sometimes emergency dental procedures like tooth extraction or a root canal treatment can be
performed under precaution and following strict protocols.
Medications: Anesthesia is an integral part of dental procedures if needed the amount of
anesthesia to be administered should be as little as possible, but enough to make the patient
comfortable, at times additional anesthesia may be required. According American Dental
Association controlled administration of local anesthesia does not cause any significant harm to

the developing baby or the mother. Certain group of antibiotics and analgesics can safely be
prescribed throughout the 9 month pregnancy period.
X-rays: Routine x-rays typically taken during annual check-ups can usually be postponed until
birth. X-rays are necessary to perform many dental procedures especially emergencies. According
to American College of Radiology, no single x-ray has a radiation dose significant enough to cause
adverse effects in a developing embryo or fetus with appropriate shielding.
Treatment Planning during Pregnancy:
1. All pre-existing dental issues need to be sorted out before planning for a child, it is
recommended.
2. If already pregnant with pre-existing dental issues, it is advised to inform the dentist about
the pregnancy, the stage of pregnancy and the due date for the delivery. This information is
very important for the dentist to plan and execute the best possible oral care.
Home oral Care:
1. Brush your teeth with fluoridated toothpaste twice daily.
2. Floss your teeth regularly and rinse your mouth with an alcohol-free mouthwash.
3. Replace the toothbrush every month and use a soft bristle toothbrush.

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

 

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

World Hepatitis Day

28th July is recognized as World Hepatitis Day; and today we would help you understand the common causes and Effect of Hepatitis in Pregnancy.

Hepatitis is an infection and inflammation of the liver caused by a virus. Jaundice during pregnancy is mainly caused by Hepatitis.

Normally, being pregnant will not hasten the disease process or make it worse, unless a woman has hepatitis E.

Most of the times pregnant women are completely unaware that they have been infected with a hepatitis virus. Usually this is because any symptoms of the illness may only be felt or at times there are no symptoms at all. Good antenatal care and blood screening are important during pregnancy, to avoid and cure it at an early stage.

The common types of Hepatitis are:

Hepatitis A :

Hepatitis A is transmitted by the oral-fecal route, such as from contaminated water or diapers. The main treatment is rest and a nutritious diet, and usually the woman will recover within a month or two. If a newborn is exposed, the infection is usually mild and they will have a lifelong immunity to the disease. If a pregnant woman gets exposed, she will be given immune gamma globulin (IG) to help protect her from getting the disease. It is always recommended to the pregnant ladies who plans a travel to get immunized.

Hepatitis B:

Hepatitis B is one of the most highly transmitted forms of hepatitis from mother to child around the world. Usually, the disease is passed on during delivery with exposure to the blood and fluids during the birthing process.

When the infant is born, the newborn will receive hepatitis B immune globulin at birth, and should be vaccinated with a hepatitis B vaccine at one week, one month, and six months after birth.

Hepatitis C:

Hepatitis C occurs if a person is exposed through transfusions, contaminated needles, or injected drug use. Mostly women become pregnant during the years between 20 and 40, which is also the age group in which the incidence of hepatitis C, hence screening for hepatitis C before and during pregnancy is done. The risk of a pregnant woman passing the hepatitis C virus to her unborn child is generally low and has been related to the levels of quantitative RNA levels in the motherŸ??s blood.

Hepatitis E:

Hepatitis E is a rare and sporadic viral infection of the liver. Its risk of transmission is highest in regions where there are low standards of sanitation. It is transmitted via the fecal-oral route through contaminated water. When this illness affects pregnant women, they may experience a more severe form of illness, which may possibly lead to acute liver failure.

1. What are the signs of hepatitis during pregnancy?

Common signs of Hepatitis are:

  • Nausea and vomiting
  • Loss of appetite
  • Fever
  • Abdominal pain
  • Yellowing of the skin and the whites of the eyes.

The problem is, depending on the type of virus, symptoms might not show up for months after infection, or you may have no symptoms at all.

2. How can we analyses that a person is infected with hepatitis during pregnancy?

Blood Test can indicate the presence of hepatitis. There are blood tests which can also show the liver condition.

3. How will hepatitis affect the unborn baby?

The baby would be fine throughout the pregnancy. Some risk factors involve only during the time of birth. ThatŸ??s why all pregnant women are tested for hepatitis B. If the test shows the mother has been infected, doctor will take steps to minimize the baby’s chances of infection.

 

Dr. Sireesha Reddy

Obstetrics & Gynaecology

PCOS and Pregnancy

Polycystic ovary syndrome is a complex, commonest endocrine metabolic condition in the reproductive years of a woman. There is no single attributing factor. It is multifactorial.

Its impact on pregnancy is not elucidated entirely. Women with recurrent pregnancy loss, subfertility, obesity causing concerns are associated with PCOS.Spontaneous miscarriage is seen in almost 40% of patients in early pregnancy. Recurrent pregnancy loss and subfertility could be related due to increased secretion of LH hormone causing concerns with egg maturity and uterine lining receptivity. Pregnancy induced insulin resistance due to other pregnancy hormones puts patients at risk to develop Gestational diabetes, pregnancy induced hypertension.

In women who have been on insulin sensitizers like Metformin before pregnancy to decrease insulin resistance and in obese women , continuing them on Metformin after conception have been associated with less pregnancy losses, hence recommended to continue till 12 weeks of pregnancy. There is no additional risk of abnormalities by continuing Metformin.

Lifestyle modifications including diet and exercise will help women with PCOS contemplating pregnancy reduces the above mentioned risk

Dr. Madhushree Vijayakumar

Consultant OBGYN

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