Doctors in Motherhood- Banashankari
Patient Review Highlights
Expecting a baby is the best feeling for any woman but this may or may not be the case in teenage pregnancy. Getting pregnant at the early age can cause serious damage to her not only to her health but also her future. Any pregnancy that occurs in women under the age of 20 is termed as teenage pregnancy. It is classified as high-risk pregnancy which can cause grave danger to the mother as well as her unborn child.
Technically, a girl can become pregnant after sexual intercourse anytime after beginning ovulation. In common- speak, a girl can become pregnant after she begins menstruating.
Risks of Teenage Pregnancy
Usually what happens is that a teenager gets pregnant against her wish… She doesn’t plan to but gets pregnant maybe due to unprotected sex. This increases the risk to both her and her baby.
It usually leads to a lag in her accessing and getting prenatal care. This can lead to problems later on like-
- High blood pressure
- Premature births
- Low birth weight
Controlling high blood pressure during pregnancy and getting regular prenatal care is the single most important thing that a pregnant teen can do for her own and her baby’s health.
Teenage mothers are at high risk for suffering from high BP which means they are at high risk for developing pre-eclampsia. This is a sudden increase in blood pressure after the 20th week of pregnancy and can be life-threatening for both the mother and the unborn baby. There are no proven ways to prevent it and most women who have signs of pre-eclampsia are monitored to lessen the harm and to avoid complications. The only way to cure pre-eclampsia is to deliver the baby. Usually, doctors manage high blood pressure in pregnancy by closely monitoring the baby, lifestyle changes by the mother and use of medicines. Compliance among teenagers for making lifestyle changes is usually low according to experts.
Premature babies are also common in teenagers and these babies can have health problems at the drop of the hat because their organs did not have enough time to develop in the womb. Problems that they are prone to are-
- Breathing problems
- Cerebral palsy
- Developmental problems
- Problem with vision
- Hearing problems
- Feeding problems
Low birth weight babies are another risk of teenage pregnancies. These babies who weigh less than 5 pounds are at higher risk for health problems like delayed motor and social development or learning disabilities. They also become sick more often in the first days of life or develop infections.
Risks of low birth weight, premature labour, anemia, and pre-clampsia are linked to the low age of the mother and all of these are observed in teen births even after controlling for other risk factors such as prenatal care.
What can be done?
A pregnant teen, therefore, should do the following-
- Get regular prenatal check-ups
- Take vitamins and iron to prevent birth defects
- Staying away from smoking, alcohol, and drugs to prevent birth defects
- Use a condom during sex to prevent sexually transmitted diseases that could hurt the foetus
The only way to prevent teenage pregnancies is educational interventions and promotion of birth control. And both of these should be used to prevent these high-risk pregnancies.
The placenta is a rich vascular tissue seen in the inner wall of the uterus. It provides nutrition to the growing baby through the umbilical cord. It also helps in removal of wastes from the developing baby. The placenta is usually present on the upper part of the uterus and grows during pregnancy in size and vascularity.
However, if this placenta is towards the lower portion near the cervix, it is known as previa, meaning prolapse. This could happen during the third trimester of pregnancy. There are chances that it will block the cervix, which is the opening of the uterus into the birth canal. This may hinder normal delivery and can be one of the reasons necessitating cesarean section. As the baby tries to push through the placenta, the highly vascular placenta can tear and cause significant bleeding. It can be a big risk to both the mother and the baby.
Placenta previa is quite common and can happen for every 1 in 200 pregnancies. Though what causes it is not very clear, some of the predisposing factors include the following:
- Advanced maternal age (35 or more)
- Smoking mothers
- Have had children
- History of C-section
- Carrying twins or triplets
- History of uterine surgeries
There could be complete previa or total previa.
- If the placenta is in the lower portion of the uterus, but not close to the cervix, with about 2 cm distance between the cervix and the placenta tip, it is termed as low-lying placenta.
- If the placenta sits on the border of the cervix, but does not cover the opening, it is partial or marginal previa.
- When it is in the lower portion and completely covers the cervix, it is complete previa.
Placental position is monitored throughout pregnancy, and by the second trimester, the doctor can suspect potential previa. Though the placenta may be in the lower half of the uterus during the first trimester, it usually moves up towards the end of the second trimester. If it does not, then the doctor might request for periodic testing to ensure it is in place.
- Fresh bleeding during the third trimester is indicative of previa. Managing previa depends on how far you are into the pregnancy and how severe the bleeding is.
- If it is minimal, then only observation will suffice. Bed rest with no intercourse, no pelvic exams, and limited travelling is recommended.
- If the previa is confirmed and there is no bleeding, a C-section will be scheduled at 37 weeks.
- If delivery cannot wait, then the baby will be immediately delivered at the end of 34 weeks, post which the baby and mother will be kept under observation.
Travelling during pregnancy - Is it safe?
Pregnancy places some restrictions on the expectant mother, and one of them is limiting travel so much so that most women do only the required and essential commutes and skip any other travel, including vacations and business travel, completely until delivery. However, with the lifestyle changing for the woman so radically, this is being revisited. The doctor’s current advice is that unless there are potential complications expected or significant concerns, it is completely safe to travel.
The first trimester especially is a little tricky for travel, with the morning sickness. The second trimester is considered more ideal for travel, as the morning sickness and the feeling of being pregnant is sunk in, so the mother is comfortable. The third trimester is fine too, but the chances of fatigue are higher, and so travel is better avoided.
Read on to know some significant things to remember whether you are on a plane, train, or road during your pregnancy.
- Always buckle yourself up as soon as you enter the car. Use both the seat belt and the lap belt.
- Keep the air bags turned on.
- Try to avoid travel time of four hours at a stretch.
- When stopping for breaks, try to walk around a bit and stretch so that you do not feel the strain of sitting for long hours.
- Most airlines allow women to travel during the first eight months of pregnancy.
- Some airlines do allow for travel during the ninth month, if the doctor approves it, or if there is an attendant with the expectant woman.
- It is okay to walk through airport screening during pregnancy. There are some women who are apprehensive about this aspect.
- Similarly the cabin pressure in the commercial planes reduces, but does not bear any significant impact for a pregnant woman.
- Select an aisle seat, as it allows for easy seating and getting up.
- Walking to the restroom and back should be carefully managed. The aisle is quite narrow and care must be taken to avoid hurting yourself.
- Use the seats for providing support when walking through the aisle.
- Especially, in turbulent stretches, try remaining seated, bearing in mind the safety aspects for yourself and the baby.
- Traveling by bus is safe, but trips to the restroom would be difficult.
- Trains are generally considered safer, as there is a lot of room for movement. Restrooms are available anytime, which is another major advantage.
- Sea travel is also considered safe, but sea sickness could add to the nausea.
- For long-term sailing, check with the cruise provider or the boat facility about availability of a healthcare provider on the ship.
Technology and science have advanced to a great level and there are now several cures for so many diseases and illnesses. However, when it comes to curing menstrual or premenstrual cramps, there are certain old-fashioned cures that have proven to be the most effective.
These are as follows:
- Apply a castor oil pack: To make a castor oil pack, soak three layers of cotton wool or a cloth in castor oil till the material is totally wet, but not trickling. Put it over your lower belly and cover it with plastic and place a container with boiling hot water or a warm cushion on top. Relax with your pack for 30 to 45 minutes.
- Chasteberry: A herb that can treat PMS is Chasteberry (otherwise known as Chaste-Tree Berry or Vitex). The herb works by directing the pituitary gland, which adjusts the levels of the hormones produced by the ovaries: estrogen and progesterone.
- Have an orgasm: An orgasm can mitigate strain in the pelvic muscles and help in relaxing the muscles.
- Stick cold cabbage in your bra: Cabbage has calming properties. It functions as a mitigation agent and helps the delicate breasts. Chilled cabbage leaves can also treat and bring down stomach pain when placed on the stomach.
- Relax and detoxify: When you have cramps, try to relax. De-stressing and detoxifying are the most ignored systems for relieving excruciating pain. However, they are the easiest and most efficient of all solutions. Going for a walk or listening to music can also help.
- Brew and drink some herbal tea: Home-brewed teas and edibles have been a go-to solution for hundreds of years. Herbal tea, as its name proposes, has for quite some time been a solid treatment for issues as its oils help in resolving muscle fits or cramps. Red raspberry leaf is a sweet tasting and an exceedingly effective spasm cure when taken as a tea. You can make your own tea from the dried leaves; there are many other tea options possible.
- Make a homegrown tincture to limit the bleeding: Women with troublesome periods, particularly those who have issues like fibroids, blisters, endometriosis, and different conditions that can influence bleeding, may want to regulate their stream. You can take a mitigating herb and mix it in a very little amount of alcohol to keep the blood flow warm and avoid clots.
In case the bleeding goes on for more than seven days, or in case you bleed more than you are supposed to in one day, the bleeding could be an indication that something is not exactly right. Take care of your body and see a specialist if your period is reliably strange.
When it comes to pregnancy, caring for your body begins even before conception. Preconception health care focuses on what you need to do before getting pregnant and increases your chances of having a healthy baby. For some women, it can take a merely a few months to prepare their body for pregnancy while for others, it can take longer.
Here are a few steps to help you get ready for a healthy pregnancy.
- Visit the doctor: Your first visit to a doctor should be scheduled long before you conceive a child. Your doctor will typically want to know what medication you are on and if any vaccinations are scheduled. He or she will also discuss your medical history and any medical conditions that may affect the baby’s development. You may be asked to undergo a routine blood and urine test to check your hormone levels and rule out any infections. A visit to the dentist is also a good idea.
- Start nutritional supplements: Expectant mothers are almost always advised to start folic acid supplements early in the pregnancy. This helps the development of the baby in its first few weeks of life and helps prevent birth deformities such as spina bifida. Other supplements that may be recommended include zinc and calcium. However, it is always a good idea to take these supplements only after consulting a doctor.
- Make positive lifestyle changes: If you drink alcohol or smoke, now would be a good time to stop. Alcohol and nicotine can affect your baby’s health and hence it is important to cleanse your body of these toxins before conception. Alcohol and caffeine have both been linked to the risk of miscarriages and lower the chances of conceiving a baby. Consider moving if you live around a toxic atmosphere and shifting jobs if your work stresses you out too much.
- Exercise: Regular exercise helps keep you fit and boosts your stamina and immunity. Regular exercise also helps avoid pregnancy complications such as preeclampsia and diabetes. Additionally, it helps keep weight gain under control and can help shorten labour time. However, do not start anything extremely strenuous but limit yourself to simple exercises like walking and swimming.
- Maintain a healthy weight: Being overweight can increase your risk of pregnancy complications and hence if you are planning on conceiving a child, now is the time to reach a healthy BMI. To do this, you must follow a healthy diet and exercise regularly. Being underweight can also trigger problems and hence you should talk to your doctor about finding a way to reach the optimum weight.
There are a number of ways in modern day medical science for helping couples conceive, in case they are not able to do so in a natural way. Apart from IUI, IVF and other forms of artificial insemination, one such way is ovulation induction. In this procedure, the ovaries are stimulated to release an egg which can maximize the chances of natural conception, or even through IUI. This is an effective process that works well, provided there are no other infections and diseases at play. It basically works by stoking the relevant hormones with the help of tablets and injections.
Let us find out more about the process.
Varied Tests: Before embarking on the process, the doctor will conduct a number of tests to ensure that you are capable of conceiving by natural means or even with artificial insemination. These tests help in making sure that there are no other ailments in the picture, which may hamper the process of ovulation induction or affect the ovaries in general.
Ovulation Cycle: Thereafter, the doctor will take blood samples in order to study the exact ovulation cycle that the body follows. These blood samples will be studied to measure the level of hormones at different stages so as to find out the most opportune time when the situation may be congenial for the ovulation induction to begin. A transvaginal ultrasound will also be carried out so that the doctor may study the development of follicles within the ovaries. These follicles usually line the ovaries. This ultrasound will also study the thickness and appearance of the womb’s lining.
The Ovulation Induction Cycle: The ovulation induction cycle will begin with tests that will happen starting from day one to day four. Once the tests have ascertained that the body is ready to go through the process with maximum chances of conception, the process will begin on fourth day. On this day, the patient will be given medication like Clomiphene Citrate. This medicine is also usually given to patients who are undergoing IUI or artificial insemination as it is said to increase the likelihood of conception. The Follicle Stimulating Hormone injection will also be given to the patient on the same day.
After the Medication: Once the medication and injections have been administered, the patient will have to go through a test to study the hormone levels in the body. This usually takes place around day 10 or 11. Thereafter, two weeks later, the patient will go through an ultrasound to find out if the ovulation is about to begin.
Time: While this is an effective method, one must remember that the ovulation results may take time for women who do not have normal menstrual cycles.
Most women stay confused with the time of their ovulation. Couples who are sexually healthy and are in their 20s and 30s and are not using any birth control measures have 20% chances of getting pregnant. It is interesting to know that you have a high chance of getting pregnant at the time of ovulation. It is a small window period that comes each month. It is the time when your ovary produces ovum or egg and the egg is open for fertilisation. Even if you are having sex two or three days before ovulation, there is a high possibility of fertilisation. After ovulation is over, the window period gets shut for the next cycle. It is the safe period. Though doctors say that it cannot be considered 100% safe to have unprotected sex during this period, the chances of getting pregnant are considerably lower.
When does ovulation actually start?
It should be remembered that ovulation takes place at the middle of your menstrual cycle. It usually occurs halfway through the cycle. Commonly, the average time period of a cycle is 28 days. But, in some cases, women may have cycles as long as 23 to 35 days.
How will you know that you are ovulating?
- Check your calendar: It is a healthy habit to keep a menstrual calendar. You must maintain the dates for a few months. This will give you an idea as to when you actually ovulate.It is difficult to know the actual time of ovulation if you are having irregular periods.
- Carefully listen to your body: It is a common thing that your body spontaneously sends a memo to you before ovulation starts. You get cramps or feel pain in the lower abdomen before ovulation starts. This pain is called mittelschmerz. It is a reminder of the coming periods.
- Chart your body temperature: Well, you will need to keep a record of your basal body temperature. You can measure it after three to five hours of sleep. Your basal body temperature changes throughout the monthly ovulation cycle. Progesterone hormone is responsible for the increase in body temperature. In the first half of the month, the progesterone levels are low and hence the temperature remains low as compared to the second half of ovulation.
- You can go for saliva test: Your saliva contains the estrogen hormone. Its level changes throughout the cycle. You can also use an ovulation detector kit to know the dates.
It is a well-known fact that the placenta is one of the most important organs related to pregnancy. However, it can also be said that when there is not enough placenta, the stage is set for a lot of complications.
This sort of condition goes by a variety of names. Among them are placental insufficiency, which is most commonly used, placental dysfunction as well as uteroplacental vascular insufficiency, which sounds like a mouthful to pronounce!
The condition refers to the case where the blood supply itself is not large enough. The placenta is the key connection, which exists between the mother and the developing child. By making use of this connection, the mother can transfer nutrients and oxygen to the child for it to develop in a sufficient manner.
Taking this into account, it can be imagined what a ruinous impact the shortage of these nutrients and even basic oxygen can have on the baby. In fact, there is a 1 in 300 chance of there being placental insufficiency for a woman who is expecting a baby.
What causes placental insufficiency?
Complications such as placental insufficiency are caused in a general sense, by some lifestyle bad habits such as smoking and the consumption of drugs. However, it also depends on the health of the mother when she conceives. Some women are already suffering from diseases, such as diabetes and chronic high blood pressure as well as disorders which relate to the clotting of blood when they get pregnant.
A case of placental insufficiency cannot be cured fully but the good news is that a lot can be done by the way of medication and practices to try to reduce the ill effects it has on the development of a baby. It can be said crucial for this purpose that the condition of placental insufficiency is detected well in advance of the expected date of delivery. When the case is such that there is a serious chance that the baby may be delivered prematurely, it is very important that a doctor is consulted.
The course of medicine, which is likely to be suggested is the administration of steroids by a qualified medical professional to the mother who is expecting a baby. The reason why this is done is so that the steroids can transfer from the mother to the developing child by making use of the placenta and can work to strengthen the lungs of the baby.
Pregnancy is a normal life function that many women go through. Yet, this is a function or a part of life where one has to take special care of one’s health and condition as there are many biological changes that happen in one’s body. Swollen legs and ankles are a common part of one’s pregnancy. This condition is most commonly known as edema and it usually occurs when fluid collects in the tissue. This in turn happens when the blood chemistry changes and the fluid gets routed to the tissue. This is a common occurrence due to the hormonal changes that one goes through during pregnancy. The condition usually troubles pregnant ladies during their third trimester.
Read on to find out the various ways in which one can deal with it.
- When to call a doctor: Call a doctor or a midwife for a thorough check up if you happen to see any puffiness or swelling in your face and eyes. This could point at a more serious problem like the onset of preeclampsia. Also, if you happen to notice that one leg is more swollen than the other, then you may want to see a doctor about it, as it could mean that there is a blood clot in the leg.
- Put your feet up: This is especially important if you are at a desk all day. The best way to deal with such swelling is to put your feet up every once in a while, so that the swelling may reduce. You can use a foot stool or even a pile of books for this purpose.
- Breaks: If you are constantly sitting or lying down, it would be a good idea to give it a break and walk around a little so that there is better blood circulation. This also keeps the blood from pooling into the lower regions of the legs, which can prevent an increase in the swelling.
- Comfortable footwear: One should stick to flat and comfortable footwear with an even elevation as well as foam soles so that the comfort level while walking and standing is optimum. Choose your shoes so that they can accommodate your swelling instead of pinching your feet. Also, you can choose to wear snug socks and stockings, which will form a band around your feet. This will ensure that the swelling does not increase to a painful level. At the same time, you must avoid socks that have bands, which are too tight as this may lead to blood pooling and subsequent swelling in the legs and ankles.
- Water: Drinking plenty of water ensures that there is less fluid retention. This is one of the best ways of fighting edema whether or not you are pregnant.
The uterus or womb is a strong structure that is held up by the pelvic muscles and tendons. In case that these muscles or tendons extend or get distinctly powerless, they are no longer ready to support the uterus, bringing about prolapse. Uterine prolapse happens when the uterus hangs or slips from its ordinary position, into the vagina or birth channel.
Uterine prolapse might be fragmented or complex. A deficient prolapse happens when the uterus is just halfway drooping into the vagina. An entire prolapse depicts a circumstance in which the uterus falls so far down that some tissue rests outside of the vagina.
The danger of having a prolapsed uterus increases as a woman ages and her estrogen levels diminish. Estrogen is the hormone that keeps the pelvic muscles solid. Harm to pelvic muscles and tissues during pregnancy and labor may likewise lead to prolapse. Women with more than one vaginal birth and in their postmenopausal period are under the most significant risk. Any action that puts weight on the pelvic muscles can expand your danger of a uterine prolapse. Different variables that can increase your risk for the condition include:
Women who have a minor uterine prolapse might not have any side effects. Direct to serious prolapse may bring about side effects, for example:
- Having an inclination that you are sitting on a ball
- Vaginal bleeding
- Expanded discharge
- Issues with sex
- Feeling the uterus or cervix leaving the vagina
- A pulling or substantial feeling in the pelvis
- Bladder infections
In case that you experience these symptoms, it is important to see your specialist. Without appropriate diagnosis, the condition can weaken your vagina, bladder, and sexual capacity. Treatment is not generally fundamental for this condition. In case that prolapse is serious, talk with your specialist about which treatment choice is suitable for you. Nonsurgical medicines include:
- Shedding pounds to take the strain off of pelvic structures
- Maintaining a strategic distance from truly difficult work
- Doing Kegel works out, which are pelvic floor exercises that strengthen the vaginal muscles
- Taking estrogen substitution treatment
- Wearing a pessary, which is a device embedded into the vagina that fits under the cervix and pushes up and settles the uterus and cervix
Surgical medications include uterine suspension or hysterectomy. During uterine suspension, your specialist puts the uterus once again into its normal position by reattaching pelvic tendons or utilizing surgical materials. During a hysterectomy, your specialist expels the uterus from the body through the stomach area or the vagina. Surgery is usually successful; however, it is not suggested for women who anticipate having a baby later on.