Pregnancy is a very special time in a woman's life when there is an added focus to take care of yourself and your unborn child. The adage'you are what you eat' takes on a whole new meaning during this period as it becomes the soon to be mother's responsibility to pack in extra nutrition to nourish her growing bump. Doctors often add in a dose of vitamins to ensure that the both mother and child are well nourished. But beyond that, the food choices you make will maintain a healthy weight gain for you and your baby and eventually even help when you want to shed the extra weight after your child is born.

Here are some tips to have a perfect diet during your pregnancy

Load up on the good stuff: even if you've always been eating healthy, it is time to crank things up a notch and include more proteins, vitamins, minerals especially folic acid and iron and some extra calories for energy and increase it as you progress in your pregnancy. But eating to get more nutrients doesn't have to mean eating more in general. If you are already at a healthy weight, then you don't need extra calories in the first trimester. In the second trimester, you need about 340 extra calories a day and about 450 extra calories a day in the third trimester. The numbers will change if you are underweight or overweight.

Say no to some: during pregnancy, give a skip to food items like raw seafood and undercooked meat and poultry. This could lead to potentially dangerous infections. Other foods to steer clear from include unpasteurized milk and soft cheese. All of these are possible sources of bacteria that can be harmful to an unborn child. It is always good to give your fruits and veggies a good extra wash, as always. Try to avoid the known culprits like popular local fruits that may be laden with artificial ripeners. Also avoid food with excess oil or preservatives. 

You will also have to say a complete no to alcohol or smoking during this period. While most sites suggest that you also ditch your caffeine fix, you can best keep it less than 200 mg or 12 ounces in a day. Stick to decaffeinated tea and sodas when possible. Some other foods that have to be avoided during pregnancy are packaged food, cold drinks, preserved food items as they contain preservatives, which are harmful. Also, chinese food should be avoided as it contains monosodium glutamate, which is again harmful due to teratogenic chemical.

Diet a big no: another big no during pregnancy is dieting or controlling the intake of food to lose weight. Pregnancy is the time you actually, for once, get to legally gain weight and be happy about. Don't mess up your natural system with forced diets.

Keep the food coming: pregnancy is the time for food craving at all odd hours and the time to give into them without an ounce of guilt! if you are dealing with nausea and food aversion, try to stick to small meals throughout the day. Replace the chips with carrot sticks and the pizza slice with soup. If that sweet tooth starts acting up, give it a frozen fruit dessert or shake.

Diet in Pregnancy

Reasons for spotting during pregnancy and what you can do about it

Seeing spots of blood during pregnancy is usually a cause for concern. However, it is not uncommon. The light bleeding, which is known as spotting may occur for a number of reasons.

Bleeding during the first trimester

Spotting is most likely to happen during early pregnancy and the reasons could be many, such as:

- implantation bleeding occurs during the first month of pregnancy when the fertilised egg gets attached to the wall of the uterus.

- cervical polyps ( a tumour that form on the surface of the cervix) or yeast infection may also cause episodes of spotting.

- miscarriage may be another possible reason for spotting

- ectopic pregnancy is another cause. It is the condition in which the embryo plants itself in either of the fallopian tubes instead of the uterus.

- molar pregnancy is a rare condition associated with spotting during pregnancy. When this is the case, instead of your baby, an abnormal tissue grows inside the uterus. Sometimes it can be cancerous too.

Bleeding during the second or third trimesters

Spotting may also occur during late pregnancy and the possible reasons are listed below.

- problems related to placenta like placenta previa placental abruption can also result in spotting. These are serious conditions when the placenta either covers the cervix or it gets detached from the uterine wall respectively.

- uterine rupture is the rare and unfortunate event when a scar from a previous surgery (like the removal of fibroid or previous caesarean scar bursts open and the baby slips into the pregnant woman's abdomen.

- premature labour occurs when your body is too eager to deliver the baby, usually one month before the due date of delivery.

- vasa Previa is another rare condition when a baby who is still developing has his blood vessels entangled in the umbilical cord or placenta-crossing the cervix. It is extremely dangerous because the blood vessels may burst open thus causing the baby to bleed and lose oxygen.

Here's what you can do about spotting

It is strongly recommended that you should immediately see your doctor as soon as you detect any spotting during your pregnancy. Only a well-qualified medical expert can suggest the appropriate steps to be taken, depending on your individual reasons and symptoms related to spotting.

If you would like to consult with me privately, please click on 'consult'.
Related Tip: 6 Changes You Can Expect During the 2nd Trimester of Pregnancy

Reasons for Spotting During Pregnancy

Hypertension or high blood pressure is common in pregnant women, even in those who have no previous history of high blood pressure. This leads to complications in about 6 to 10% of all pregnancies around the world. High blood pressure may develop before or after conception and as such needs special medical attention.

Hypertension prevents sufficient flow of blood to the placenta and this inhibits the normal growth of the fetus. This could result in low birth weight of the child. However, if diagnosed in time and treated properly, hypertension does not affect the child's health too much. There are various types of hypertension during pregnancies, such as:

Gestational hypertension: This type of hypertension is developed about 20 weeks after conception. There is no abnormality in urine or any signs of other organ damage (as is common with hypertension during pregnancy) but the condition can worsen and complicate very quickly. Pregnant women below the age of 20 and above the age of 40 are often diagnosed with high levels of blood pressure. Women who have heart or kidney conditions before pregnancy and women carrying more than one child are also likely to develop gestational hypertension.
Chronic hypertension: Chronic hypertension is high blood pressure which develops around 20 weeks before conception and does not normalize within 12 weeks after childbirth. The patient may also have been suffering from high blood pressure for a long time but the complications appear only during pregnancy because high blood pressure rarely exhibits symptoms without an associated condition.
Chronic hypertension superimposed with Preeclampsia: Women who have hypertension before pregnancy may develop even higher blood pressure levels during pregnancy. This leads to several health disorders like frequent headaches, fatigue and depression.
Preeclampsia: Preeclampsia is often a serious complication of gestational pregnancy and affects about 5% to 7% of all pregnancies globally. Gestational pregnancy does not always develop into preeclampsia but it needs to be diagnosed and treated in time to avoid the complication. Women who have conceived for the first time or have a history of hypertension in the family are at a greater risk of preeclampsia. The symptoms of the condition are throbbing headaches, blurred vision, nausea and vomiting, pain in the upper abdominal region and shortness of breath.

Types Of Hypertensions Experienced During Pregnancy

Miscarriage is termed as the loss of the fetus in or before 20th week of pregnancy. Medically, miscarriage is known as spontaneous abortion, though the word spontaneous is more of a keyword as it is not an abortion.

Symptoms of Miscarriage 
Miscarriage happens due to weakness, back pain, fever, abdominal pain along with severe cramps and bleeding, which starts from slow to heavy.

Cause of Miscarriage 
Common cause of miscarriage is when the fetus is known to have fatal genetic problems and these are not related with the mother. The other causes are infection, medical problems like thyroid and diabetes, immune system rejection, hormonal imbalance, abnormalities of the uterus, and physical problems of the mother. If a woman is over 35 years of age, has thyroid and diabetes and had an miscarriage earlier then that woman is at a high risk of getting a miscarriage.

Sometimes a miscarriage might take place due to the cervical insufficiency. This is due to the weak cervix, also known as the incompetent cervix, which is unable to hold the pregnancy. A miscarriage in this condition usually occurs in the second trimester. Though there are a very few symptoms in this, but there might be a feeling of sudden pressure that the water is going to break and tissues from the placenta and fetus are released without any pain. This can however, be treated by a stitch in the cervix at 12 weeks. This stitch helps to hold the cervix until the full term is completed. If it is first pregnancy and cervical insufficiency is diagnosed, then also a stitch can be applied, thus resulting in full term and avoiding miscarriage.

Diagnosis of Miscarriage: 
-   The doctor does a pelvic test, an ultrasound and blood tests to confirm a miscarriage
-   Blood tests are done to analyze the pregnancy hormone hCG. This is monitored regularly if miscarriage is suspected
-   Genetic tests, blood tests and medication are important in women who have a history of prior miscarriages
-   Pelvic ultrasound and hysterosalpingography are tests, which are done when there are repeated miscarriages
-   Test like hysteroscopy is also done. In this the doctor observes the inside of the uterus with a device, which is thin telescope like device. This is inserted in the vagina and cervix.
-   If the cervix is dilated, then the woman might be diagnosed with an incompetent cervix and this can be corrected by cerclage, a procedure done to close the cervix.
-   If the blood type of the pregnant woman is Rh negative, she is prescribed a blood product called Rh immune globulin (Rhogam). This prevents from forming, antibodies which could turn to be harmful for the baby.

Bleeding in Early Pregnancy: Diagnosing Miscarriage

What You Must Know About ZIKA VIRUS

Introduction to the ZIKA VIRUS:

After the deadly Yellow Fever and Ebola pandemics, Zika Virus is yet another disease borne out of the African soil and spreading across the world right now. Named after the Zika forest in Uganda, where it originated, this virus spreads through a mosquito bite - that of ‘aedes aegypti’ mosquito. It can also be passed on from mother to child, blood transfusion and sex. 

What’s so deadly about ‘Aedes Aegypti’ Mosquito?

Zika Virus spreads via ‘aedes aegypti’ mosquito, same mosquito that also spreads Dengue and Chikungunya.These mosquitoes typically lay eggs in and near still water found in buckets, bowls, animal dishes, flower pots and vases.  They are aggressive daytime biters, prefer to bite people, and live indoors and outdoors near people.
These mosquitoes become infected when they feed on a person already infected with the virus. Infected mosquitoes can then spread the virus to other people through bites.

Symptoms of Zika Virus Attack
A person bit by an infected mosquito takes about 2-7 days to show symptoms like:
- Mild fever 
- Skin Rash
- Conjunctivitis
- Muscle and joint pain 
- Weakness and Fatigue

However, it lasts no more than a week and is usually milder than its cousins Dengue or Chikungunya. Although it is not a fatal disease, the real reason behind the panic is for the women who are pregnant. Zika is found to be a major cause of microcephaly – a birth defect due to which children are born with visibly smaller heads, severely limiting their mental and physical abilities. 

Should India Worry?

While it originated in the African continent, Zika has already taken South American countries like Brazil, and most others. Although the virus hasn’t reached Indian shores yet, we are very prone to mosquito borne diseases. The Dengue menace since last few years says it all. Since it is from the same family, we need to be all the more cautious. 

Preventions and Precautions:

Since no vaccine exists to prevent Zika virus attack, it’s best to act with caution to prevent the spread.

1. Mosquitoes that spread Zika virus bite mostly during the daytime. Stay in places with air conditioning or that use window and door screens to keep mosquitoes outside.
2. Use Mosquito Repellents during the day when exposed to areas prone to mosquitoes and cover yourself very well.
3. Never allow water to stagnate in or around your habitation. Avoid letting the water stand for long eg: puddles, or water in buckets or potted plants, sewage etc.



What is ZIKA VIRUS? Is it Deadlier than Dengue? Is India Ready To Face the ZIKA 

Cervical Cancer is most treatable when it is diagnosed and treated early. Problems found can usually be treated, depending on their severity and on the woman's age, past medical history, and other test results. Most women who get routine cervical cancer screening and follow up as told by their provider can find problems before cancer even develops. Prevention is always better than treatment.
Other HPV cancers are also more treatable when diagnosed and treated early. Although there is no routine screening test for these cancers, you should visit your doctor regularly for checkups.
Your doctor might recommend the HPV test if:
Your Pap test was abnormal, showing atypical squamous cells of undetermined significance (ASCUS)
You're age 30 or older
The HPV test is available only for women; no HPV test yet exists to detect the virus in men. However, men can be infected with HPV and pass the virus along to their sex partners.
What is a HPV Test?
The HPV test is a screening test for cervical cancer, but the test doesn't tell you whether you have cancer. Instead, the test detects the presence of HPV, the virus that causes cervical cancer, in your system. Certain types of HPV - including types 16 and 18 - increase your cervical cancer risk.
Knowing whether you have a type of HPV that puts you at high risk of cervical cancer means that you and your doctor can better decide on the next steps in your health care. Those steps might include follow-up monitoring, further testing, or treatment of abnormal or precancerous cells.
Pap- HPV Test:
HPV spreads through sexual contact and is very common in young women, so, frequently, the test results will be positive. However, HPV infections often clear on their own within a year or two. Cervical changes that lead to cancer take several years - often 10 years or more - to develop. For these reasons, you might follow a course of watchful waiting instead of undergoing treatment for cervical changes resulting from an HPV infection.
A combination Pap-HPV test is performed in your doctor's office and takes only a few minutes. You'll lie on your back on an exam table with your knees bent, your doctor will gently insert an instrument called a speculum into your vagina. The speculum holds the walls of the vagina apart and a flat scraping device called a spatula or a soft brush is used to take samples of your cervical cells. This doesn't hurt, and you may not even feel the sample being taken.
Results of your HPV test are given as positive or negative 
Positive HPV test:A positive test result means that you have a type of high-risk HPV that's linked to cervical cancer. It doesn't mean that you have cervical cancer now, but it's a warning sign that cervical cancer could develop in the future. Your doctor will probably recommend a follow-up test in a year to see if the infection has cleared or to check for signs of cervical cancer.
Negative HPV test: A negative test result means that you don't have any of the types of HPV that cause cervical cancer.
Depending on your test results, your doctor may recommend one of the following as a next step:
Normal monitoring:If you're over age 30, your HPV test is negative and your Pap test normal, you'll follow the generally recommended schedule for repeating both tests in five years.
Colposcopy: In this follow-up procedure, your doctor uses a special magnifying lens (colposcope) to more closely examine your cervix.
Biopsy:In this procedure, sometimes done in conjunction with colposcopy, your doctor takes a sample of cervical cells (biopsy) to be examined more closely under a microscope.
Removal of abnormal cervical cells:To prevent abnormal cells from developing into cancerous cells, your doctor may suggest a procedure to remove the areas of tissue that contain the abnormal cells.
Seeing a specialist: If your Pap test or HPV test results are abnormal, your healthcare provider will probably refer you to a gynecologist for a colposcopic exam. If test results show that you might have cancer, you may be referred to a doctor who specializes in treating cancers of the female genital tract (gynecologic oncologist) for treatment.

Cervical Treatment Diagnosis, Tests and Treatment

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