I am Dr Surekha Jain, I am practicing since last 38 years in Shalimar Bagh Delhi. And I am curtsy consultant to Shalimar Bagh Fortis hospital. Today I am going to talk about a very important hormone which is known as pregnancy hormone or beta HCG. Why it is called pregnancy hormone because this hormone beta HCG is the first hormone to increase and which can diagnose pregnancy very early. Why we should diagnose pregnancy very early, now days in a era of assistant reproductive techniques like IVF, ETSY, IUI etc. We want to know whether our patient is pregnant or not very early so that we can support her and we can give her certain medications which will help her to continue her pregnancy. This is a pregnancy hormone which starts as soon as when embryo is form that is 14 to 15 days after your ovulation or egg pick up. We can detect up to 100mIU’s of Beta HCG on the 14th day after ovulation, if pregnancy is occur. So to know the welfare of the pregnancy or to know first of all whether you are pregnant or not, we do your beta HCG. Anything about 10mIU/ML is taken as positive, it is just positive but to know whether the patient is doing fine or not, we can repeat this hormone every 48 to 72 hours that is every third day and it should almost double up every third day which shows that now the pregnancy is going fine and now we are assured. And we keep on following the patient. When the beta HCG levels they reach around 1000 to 1500 International unit the gynaecologist or your doctor should be able to see by Trans vaginal sonography at least sack. If she cannot see the sack at 1000 to 1500 International unit then there must be something wrong either blighted over or anything else. Now how can you test a beta HCG there are two methods to test beta HCG one is urine and other is blood, urine beta HCG is very simple to test anybody can test it at home. You can buy a simple strip from any chemist and then you can put fresh clean urine in the small socket formed on the slide 3 drops of fresh urine and wait for about 3 to 5 minutes. What you can see on the slide is either a one single line of about red or violet colour which shows that you are not pregnant but you have done your test alright. But if you see 2 parallel lines of equal strength you are happy because indicates that you are pregnant and your pregnancy is fine. But in case you don't see any of the lines, it shows that you have not done that test correctly or you are suffering from some severe urinary tract infection or your urine is very diluted. You have taken it after lot of consumption of water or some liquids. So Urine Pregnancy Test is very easy the drawback with Urine Pregnancy Test is it just tells you that you are pregnant, it doesn't tell you what will happen or what time of the pregnancy it is. Now the second method to test beta HCG is blood, it's very important definitive and very good test to know about the conception and its progress and the time of weeks. So if you get your blood beta HCG done in your blood as I told you anything about 10mIU/ML is positive test and then you follow it every third day to find out that it becomes double or not and then when it is about 1000mIU/ML then it should be seen in the trans vaginal sonography. What is the use of this hormone, why this hormone is there it is with some purpose the purpose of this particular hormone is that when you conceive and after just fertilizations 8 to 10 days after fertilization the embryo goes and implants in the uterus and there it is formed by the plasanta, this sends a message to the ovary that corpus luteum has to keep on working because corpus luteum give the hormone progesterone which is very-very necessary for the pregnancy. Now once the corpus luteum is giving progesterone and gradually the plasanta develops. When the plasnta develops it takes so what the corpus luteum, see the nature's method tell the Corpus luteum to maintain the corpus luteum in pregnancy the beta HCG is keep on increasing till 8 to 10 weeks it is the highest it around 10 weeks its level is about 100, 1000 international unit but as soon as the plasnka takes over the work of making progesterone corpus luteum is no more required. And hence the beta HCG also keeps on reducing and it makes effective Plateau at around 20 weaks its only 20000 then it goes to Plateau and it remains at the same level till full top. Beta HCG other than telling you about the welfare of the pregnancy has certain other many important jobs to do. First of all if your beta HCG is not corresponding with the weeks of pregnancy shown in your lab report, it shows that either your pregnancy is not progressing well or you might be having ectopic pregnancy that is your pregnancy might be other than the in the uterus. It can be it outside the uterus which is very dangerous for the health of the patient. Second it shows if it is very high it shows either you are having multiple pregnancy or some pregnancy related cancers which are known as trophoblastic disease of the pregnancy. Which are also again very dangerous and followed by beta HCG test and thirdly this test is also done to know about the welfare of the foetus in the first trimester of your pregnancy that is known as double marker. So it's a very-very important hormone and is related to all the pregnancy welfares, miscarriages, blighted ovum, ectopic, twins, cancer-related pregnancy that's all, ok.read more
Causes, symptoms and diagnosis of Thyroid
Hello friends. I am Dr. Surekha Jain practicing as a gynecologist and obstetrician since last 40 years. I own my own hospital at Shalimar Bagh with the name of Jain Child and Maternity Hopsital Pvt. Ltd. I am also attached with the Fortis Hospital, Shalimar Bagh as a Senior Gynecologist and Obstetrician. Today, I am planning to tell you about Thyroid Diseases during Pregnancy. The reason for choosing this topic is that it is very common nowadays to find thyroid disease during pregnancy and the smallest variation in the thyroid organ can really affect your pregnancy. The thyroid disease is present in two forms: Hyperthyroidism and Hypothyroidism. Hyperthyroidism means over active thyroid and Hypothyroidism means which is under active thyroid.
Thyroid is an organ which is located in the front of your organ like a butterfly and it releases hormones which control metabolism of your body it controls even single cell of your body. Thyroid affects the whole body. During pregnancy, why we are worried about the thyroid disease that if you already know that you have hyperthyroidism or hypothyroidism at the very first consultation of your pregnancy, you should tell your obstetrician that you are either Hyperthyroid or hypothyroid and what drugs you are already taking. So that the doctor can help you adjust those medications. In case you do not know the status of your thyroid at very first visit the doctor will you investigations to be done and thyroid status is one of them.
Why is it so important to do early? Because the thyroid functions are more important in the first trimester of pregnancy to control the development of the baby. You very well know that during the very first three months of your pregnancy, the child being made, all the organs, all the systems are developed and after that the child only grows inside so the first three months are very crucial. And thyroid controls the activities in the mother and the baby. So, you should know the status of thyroid. Now, let us know what are the most important irregularities you can have in thyroid? Hyperthyroidism, even though it is rare, in early pregnancy signs and symptoms they quite mimic hyperthyroidism like excessive vomiting, nausea, irritability, giddiness and irregular heartbeat, even nervousness. So, these are very common in pregnancy as well as in hyperthyroidism.
So, if they are in a moderate amount, you can think of having these symptoms because of pregnancy. But, in case there is excessive, your doctor will definitely test you for hyperthyroid by doing certain blood tests and manage you accordingly on anti-thyroid drugs. The second most important is hypothyroidism. Hypothyroidism being more common than hyperthyroidism, therefore, it is very important to manage hypothyroidism in early pregnancy. In first, seven to nine weeks, the fetus doesn’t have any thyroid function in itself. So whatever it is getting it is from the mother. If the mother is deficient, the child will also become deficient and later on it can have multiple problems of nervous system, skeletal system, and developmental problems. Now, how do you diagnose the thyroid disease? It is very simple. Only by blood test you can diagnose thyroid. Three blood tests are there, TSH (Thyroid Stimulating Hormone), T3 and T4. These are the hormones which are released by thyroid and thyroid stimulating hormone is the controlling hormone which keeps adjusting itself according to the hormone. Only by test you can come to know whether you are youth thyroid that is normal thyroid or you are hypothyroid or hyperthyroid.
If thyroid is not controlled properly during pregnancy then there can be multiple things which can happen to the mother and the baby. Now, if it not controlled in the first trimester, then developmental problems can be there. Baby can have certain congenital birth defects but later on it can lead to prematurity, and high blood pressure. Now, how can you come to know you are suffering from symptoms only? Hyperthyroidism can lead to severe nausea, vomiting, and slight tremors in your body, trouble sleeping, weight loss, or low weight for pregnant women. How can you know about hypothyroidism? Symptoms of hypothyroidism are such as extreme tiredness, weight gain, confusion, constipation, concentration and memory problems.
So, once your doctor knows whether you are hypo or hyper, they will treat you accordingly. If you want to know more, you can contact me through Lybrate, Dr. Surekha Jain. I am a certified thyroid disease treatment giver to the patients so you can contact me by chat, telephone, by putting your questions directly to me through Lybrate. They know my telephone number, my address. You can contact me, come to me, you can chat with me and even have video chat with me. Thank you.read more
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I am 36 years female. My uterus is anteverted, size is 99*43*40 mm and a hypoechoic SOL (measuring 31*23 mm) seen at anterior wall of uterus s/o fibroid with normal endometrial thickness 6.7 mm. Right ovary is normal. A cystic lesion (35*29*25 mm, vol. 13. 5 cc) with hyperechoic ball like structure (23*19 mm) seen in left ovary s/o dermoid cyst. please help. Thanks and regards.
Mujhe calccified fibroid hai 4.2 cm ka. Kay mujhe pep semer test karwana chahiye .sge 36+,weight 71, height 164 cm.
I am 26 years old and taken medicine to avoid pregnancy but feeling weakness and bleeding now post 4 weeks.
Sir, I have tested my pregnancy four times with prega news kit. Still got negative. I had my period on 10 Th June and had sex, after that I took Unwanted 72. After 6 days i.e on 16th June I had bleeding for 4 days and having white discharge continuously. Next month like in July I missed my period. However I took mifegest. Please advice how to take four small pills which comes with mifegest Kit. Also is it necessary to take Vaginally?
During taken course of primolut n if bleeding start in between this course (28 days) than course is continually regular or stop it ?Please give it suggestions.
Pregnancy is considered to be one of the most challenging and important phases in the life of a woman. Pregnancy Complications are health problems that occur during pregnancy. They can involve the mother’s health, the baby’s health, or both. Some women have health problems before they become pregnant that could lead to complications. Other problems arise during the pregnancy. Keep in mind that whether a complication is common or rare, there are ways to manage problems that come up during pregnancy.
Some complications that might occur during pregnancy are discussed below:
- Severe Nausea and Vomiting: It is common for nausea and vomiting to occur during a pregnancy. In order to avoid this condition, one should consume several small meals throughout the day and completely avoid spicy and fatty foods.
- A persistent abdominal pain, severe headache, swelling and visual disturbances during the third trimester: This can be a fatal condition and often is a sign of high blood preeclampsia (pregnancy complication involving high blood pressure as well as damage to another organ system). It can be diagnosed early using good prenatal care which essentially comprises of frequent check-ups with the doctor and all the necessary treatment during pregnancy.
- Flu Symptoms: It is recommended that flu vaccine should be administered to pregnant women as they usually tend to develop the disease during their pregnancy.
- Gestational Diabetes: Gestational diabetes can increase the chance of a larger baby at birth and create delivery complications, increase your risk for high blood pressure and cause the baby to have blood sugar problems after birth. If you are diagnosed, it’s important to consult your gynecologist to control your blood sugar level, which can often be done through diet and exercise.
- Baby’s activity level significantly declines: Sometimes, the activity of a previously active baby might decline. This can be felt by reducing the number of the kicks by the baby. The doctor has specific equipment that aids in identifying and resolving the problem.
- Bleeding: Heavy bleeding accompanied by abdominal pain and menstrual-type cramps during the first trimester might indicate an ectopic pregnancy (embryo is implanted outside one’s uterus) or a miscarriage while occurrence in the third semester indicates placental abruption (characterized by the placenta separating from the womb’s walls). Any form of bleeding warrants the immediate attention of the doctor. Steps to avoid bleeding include bed rest, avoiding heavy work, and keeping yourself hydrated.
A Healthy Pregnancy
The best way to ensure a healthy pregnancy is to focus on the things you can control and don’t obsess about what could happen. Take good care of yourself and your developing baby and talk with your healthcare provider when you have concerns.
Pregnancy is a special period that every woman waits with bated breath. While the happiness and excitement are there, the health of the mother and baby are extremely important as well. Incidences of complications during pregnancy and childbirth are not new. Many pregnant women suffer from preeclampsia (high blood pressure often associated with the presence of proteins in the urine), and gestational diabetes, which, left attended can be risky for both the mother and the baby. Lack of awareness and proper guidance are often found to be the main contributors, affecting the maternal and fetal health during pregnancy. The NICE (National Institute for Health and Care Excellence) suggests that complications or not, all women should be under medical guidance and assessment during pregnancy.
Antenatal Care and Assessment has been a revelation ensuring that a woman enjoys a safe and healthy pregnancy sans any complications. There are regular health check-ups, diagnostic and screening tests and prenatal counseling for the pregnant women and their families. The initiatives have been truly noteworthy, bringing about a significant reduction in the incidences of miscarriages and other pregnancy-related complications.
What does Antenatal Care and Assessment include?
Each trimester brings about changes that need care and attention. The Antenatal Care involves assessing and guiding a pregnant woman and their loved ones as the pregnancy progresses through each trimester.
- The program aims at identifying the conditions that may pose a threat to the maternal and fetal health during pregnancy and work towards eliminating it.
- Medical conditions such as anemia, HIV infection, Sexually Transmitted infections, stress, and fatigue can spell doom, affecting the pregnancy beyond imagination. Thus, time and again, a pregnant woman is screened for the mentioned complications.
- The diet can play a crucial role during pregnancy. A pregnant woman should eat a nutritionally enriched diet as the fetus receives the nutrients directly from the mother. Antenatal care lays great emphasis on the diet of the pregnant woman.
- De-worming and immunization programs are carried out to immunize the mother and the baby against harmful infections, including, tetanus and malaria.
- Antenatal care is a complete package that includes prenatal as well as postnatal care and assessment so that the mother and the baby enjoy good health.
- Pregnancy brings about a new phase in the life of couples. While most couples accept the changes graciously, many find it difficult to cope with the situation. Thus, the program aims at counseling such couples both mentally as well as emotionally so that things get a less stressful and challenging. The program also educates the other family members and loved ones about prenatal and postpartum care and management.
Many women have benefitted immensely from the antenatal care and assessment programs, safeguarding the mother and the baby from various health problems. In fact, efforts are being made to aware and educate the rural India about the immense health benefits associated with the antenatal care.
I am 31 year old and I guess in February I has unprotected encounter. Seem to have contacted STD- Chlamydia or Gonorrhea. Symptoms- Burning sensation in genital along with partial pain in genital pipe. Fluid also is yellow in colour when ejaculated. Symptoms are seen intermittently. 1. Please suggest what medication to be taken (Azithromycin or Amoxicillin). 2. What quantity- 1g per dose or 500 mg. 3. For How many days? 4. Should I need to get tested for Chlamydia Trachomatis IgM? Or any other test? Infection seem to be 3 months old. Request pointwise reply on this. Thanking you, Best Regards.
During pregnancy, it is not uncommon for women to contract thyroid diseases like gestational hyperthyroidism and gestational hypothyroidism. The main problem, however, is that the symptoms of gestational hypothyroidism are very much similar to those which can be observed during a normal pregnancy. The difficulty in differentiating between the two is the sole reason why many pregnant women are caught unawares, eventually resulting in further complications after the first trimester.
If gestational thyroid diseases are left untreated, you and your baby may experience a ton of problems such as preeclampsia, low birth weight, miscarriage and pre-mature birth amongst others. Needless to say, if you already have a history of pre-existing hypothyroidism, then you will most certainly need more medical attention than is required.
Symptoms of gestational hypothyroidism, like high fatigue and excessive weight gain, are hardly distinguishable from those associated with a normal pregnancy. Other symptoms can also include:
- Severe constipation
- Muscle cramps
- Trouble sleeping
- Hair loss
- Dry skin
- Difficulty concentration
- Memory problems
- Intolerance to cold temperatures
There may be a variety of causes that are responsible for the development of gestational hypothyroidism but the most common cause is usually an autoimmune disease known as Hashimoto's thyroiditis, which stimulates the body's immune system to attack thyroid gland cells, leading to a deficiency in the number of active thyroid cells and enzymes, and ultimately resulting in a shortage of the thyroid hormone.
Treatment for gestational hypothyroidism is normally uncomplicated, and follows just two simple steps:-
- Proper diagnosis, via the use of a synthetic hormone called levothyroxine, which is very much similar to the hormone T4 produced by the thyroid.
- Continuous monitoring of thyroid function tests held every four to six weeks during pregnancy.
In case you have a concern or query you can always consult an expert & get answers to your questions!
The most devastating period for any pregnant women is a miscarriage. This normally happens because of genetic abnormality noticed in the fetus caused due to tripling of a chromosome. This is also called ‘spontaneous abortion’ because the body rejects the random genetic abnormality. Apart from this, there are many other reasons for miscarriage namely blood clotting, deshaped uterus, uterine fibroids, unhealthy cervix and so on. Now, this could lead you to the next question - What can we do to prevent miscarriage?
Time to meet the gynaecologist:
When there is tripling of chromosomes or genetic mismatch, the body actually rejects the fetus, thereby preventing birth of an unhealthy baby. But, if the miscarriage repeats several times, then you have to meet your gynaecologist for further tests and appropriate medical intervention.
Symptoms of miscarriage:
In the normal course, when miscarriage occurs, the women would experience back pain or vaginal bleeding or blood in the vaginal mucus or cramping or abdominal pain. Ironically, sometimes the miscarriage may happen without any of these symptoms. It would get noticed only during routine scanning. However, in the normal course, the chance of a miscarriage is highest before the 12th week. But if miscarriage happens after the 12th week and before the 24th week, then it is called spontaneous abortion. Thereafter, it is known as a ‘still born’ baby.
However, there are some steps that can help women prevent a miscarriage. These steps are briefly explained here.
- Nicotine retards growth of fetus and it is for this reason the couple should shun smoking, months before they plan pregnancy. This change in lifestyle has remarkable effects in preventing miscarriage. Similarly, caffeine can also be the cause of miscarriage. Therefore, women should regulate their intake of coffee as per the advice given by the gynaecologist.
- Women suffering from chronic ailments like lupus, problems with thyroid, epilepsy and such other ailments are prone to a miscarriage. Similarly, it is also advisable that women should get tested for STD/HIV because these ailments can cause a miscarriage. Women suffering from such ailments should be under constant medical care.
- In addition to these, the women should take food rich in vitamins, proteins, Omega-3 and fibres. Further, they should also do physical exercises as per the instructions given by the gynaecologist. One should drink enough water so as to keep oneself sufficiently hydrated. Women must practice meditation, which helps in reducing stress.
The causes of a miscarriage are many; women should discuss about the issues relating to a miscarriage with their gynecologist. This helps them take appropriate preventive steps against this unwanted situation.
In case you have a concern or query you can always consult an expert & get answers to your questions!