Planning a Pregnancy

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Planning a Pregnancy ? Consider These Tips

With increasing stress and changes in lifestyle, younger generation is facing initial problems in conceiving. While meeting a senior gynaecologist is advised, following tips can be useful:

  • Visit a gynaecologist 2 to 3 months before planning a pregnancy for Baseline tests. Any disease running in the family, of either partner, needs to be discussed. A mid-cycle ultrasound can give a clue as to whether ovulation is occurring normally
  • Start folic acid supplement. Treat/ control medical disorders like, anaemia, high blood pressure, thyroid disease, asthma, diabetes, leucorrhoea, chronic cough and UTI (by drinking enough water).
  • Lose weight if you are over-weight by exercising, and maintain a normal BMI. Eat a balanced diet.
  • Maintain a menstrual diary, note dates of menstrual cycles for the last six months at least.
  • Stop smoking, both active and passive, and alcohol consumption as they are likely causes of birth defects.
  • Do not take over-the-counter medicine in the time period when trying to conceive.
  • Avoid radiation exposure, (X-rays) while trying to conceive and during first three months of pregnancy
  • If you are actively trying to conceive for one year and are above 30 years, consult an experienced gynaecologist.
  • In cases of one or recurrent miscarriages, investigations are required.
  • Try meditation/ yoga to re-main stress free and read about parenthood.
  • A few tests for husband are also advised.

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Although spontaneous abortion occurs in approximately 15% of clinically diagnosed pregnancies of re-productive age women, RPL occurs in 1% – 2% of this population. RPL includes those couples with three or more spontaneous, consecutive pregnancy losses, excluding ectopic & molar pregnancies. It is found reasonable to start an aggressive evaluation after two or more spontaneous miscarriages to determine the cause especially when the woman is older than 35 years, or when the couple has had difficulty conceiving.

The chief causes of Recurrent Pregnancy Loss have been believed to be embryonic chromosomal abnormalities, maternal anatomic abnormalities such as uterine septum, luteal phase defects and antiphospholipid syndrome.

Other factors could be infection and a hypercoagulable state. Evaluating a woman with RPL includes a complete history including documentation of previous pregnancies or tests that were performed on previous miscarriages.

If the Karyotype evaluation of the previous abortions shows Aneuploidy, the diagnosis is clinched. If not, a complete evaluation for RPL shows possible causes in 60% of cases. This includes blood tests for hormones, thyroid status, blood sugars, tests for ovarian reserve, ruling out malformations of the uterus such as septate or bicornuate uterus, intrauterine adhesions, fibroids, polyps, ovarian cysts, which are picked up by tests like hysteroscopy & laparoscopy and treated at the same sitting. In-competent cervix which causes inability of uterus to retain pregnancy can be treated by a cervical stitch. More than two thirds of couples after treatment have successful pregnancies. Lifestyle modification goes a long way. Smoking, alcohol in-take, obesity, caffeine and expo-sure to ionising radiations are to be avoided.


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You may wonder what symptoms during pregnancy warrant immediate medical attention and what symptoms can wait until your next prenatal visit.
Always ask about your concerns. But keep in mind some symptoms do need swift attention.
1. Bleeding
Bleeding needs attention throughout your pregnancy. If you are bleeding heavily and have severe abdominal pain and menstrual-like cramps or feel like you are going to faint during first trimester, it could be a sign of an ectopic pregnancy. Ectopic pregnancy, which occurs when the fertilized egg implants somewhere other than the uterus, can be life-threatening.

Heavy bleeding with cramping could also be a sign of miscarriage in first or early second trimester. By contrast, bleeding with abdominal pain in the third trimester may indicate placental abruption, which occurs when the placenta separates from the uterine lining.

“Bleeding is always serious,” Any bleeding during pregnancy needs immediate attention. Call us immediately or go to the Labour Room.

2. Severe Nausea and Vomiting
It’s very common to have some nausea when you’re pregnant. If it gets to be severe, that may be more serious.
“If you can’t eat or drink anything, you run the risk of becoming dehydrated,” Being malnourished and dehydrated can harm your baby.

3. Baby’s Activity Level Significantly Declines
What does it mean if your previously active baby seems to have less energy? It may be normal. But how can you tell?
Some troubleshooting can help determine if there is a problem. We suggests that you first drink or eat something. Then lie on your side to see if this gets the baby moving.
Counting kicks can also helps. “There is no optimal or critical number of movements but generally you should establish a baseline and have a subjective perception of whether your baby is moving more or less. Anything less should prompt a phone call to us.”
We have monitoring equipment that can be used to determine if the baby is moving and growing appropriately.

4. Contractions Early in the Third Trimester
Contractions could be a sign of preterm labor. “But a lot of first-time moms may confuse true labor and false labor,”. False labor contractions are called Braxton-Hicks contractions. They’re unpredictable, non-rhythmic, and do not increase in intensity. “They will subside in an hour or with hydration and rest,”. “But regular contractions are about 10 minutes apart or less and increase in intensity.”
If you’re in your third trimester and think you’re having contractions, call us right away. If it is too early for the baby to be born, we may be able to stop labor.

5. Your Water Breaks
If you feel a sudden flood of water rush down your legs, your water could have broken, but during pregnancy the enlarged uterus can cause pressure on your bladder too. So it could be urine leakage. Sometimes water breaking is a dramatic gush of fluid, but other times it is more subtle.
“If you are not sure if it is urine versus a true rupture of the membrane, go to the bathroom and empty your bladder,” she says. “If the fluid continues, then you have broken your water.” Call us immediately.

6. A Persistent Severe Headache, Abdominal Pain, Visual Disturbances, and Swelling During Your Third Trimester
These symptoms could be a sign of preeclampsia. That’s a serious condition that develops during pregnancy and is potentially fatal. The disorder is marked by high blood pressure and excess protein in your urine that typically occurs after the 20th week of pregnancy.



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