Dr. T K Kohli

Intrauterine growth restriction is a condition where the foetus is smaller than it should be according to its age because it is not growing at a normal rate inside the uterus. This puts the baby at risk for several dangerous conditions during pregnancy, delivery and post-birth. Some of these are low weight at birth, caesarian delivery, decreased oxygen levels, low blood sugar, low resistance power, breathing problems and low body temperature. IUGR can lead to stillbirth in extreme conditions and to long-term growth problems too. This is the main reason why prenatal birth monitoring is very important.

Causes
IUGR can occur in expecting mothers who have a problem with the placenta. We already know that placenta is the cord of life that joins the mother with the foetus. It provides oxygen and food to the developing baby inside the womb. Apart from this, IUGR can occur if the mother has:

1. Diabetes
2. Hypertension
3. Heart disease
4. Rubella or syphilis infections
5. Kidney or lung disease
6. Malnutrition or anaemia
7. Twins and triplets also increase the risk for IUGR

The main symptom of IUGR is a small baby for its age in the womb. It may look small and sickly and the placenta is dry and shrivelled.

Management
Dealing with IUGR depends on many factors. Usually, doctors go for a slew of tests to see how the infant is doing. A detailed sonogram is usually performed to look for foetal anomalies. Tests like a urine sample, ultrasound, platelet count and liver function test are also administered to the mother. The mother is put on bed rest to improve blood flow to the foetus and antenatal steroids are prescribed to promote foetal lung maturity. General management also includes treatment of maternal disease like high BP and cessation of substance abuse or alcohol.

For management of IUGR, daily blood pressure measurements, foetal movement profiles, serial ultrasound examinations are important to determine the severity and progression of IUGR. If the situation becomes critical, labour is induced and the baby is delivered by caesarian section.

IUGR can’t be cured and can only be managed so it’s best to prevent it in the first place by keeping all of your prenatal appointments. You must be aware of your baby's movements. If your baby is not moving much or stops suddenly, you should rush to your doctor. You must also not take any medicine without consulting your doctor during pregnancy. Eat healthy and rest fully to have a risk free birth and last, but not the least, stay away from drugs, alcohol and smoke, even second hand, for the health of your baby. If you wish to discuss about any specific problem, you can consult a Gynaecologist.

Did you know that your tooth brush could be home of over a million bacteria including the flu virus, E coli, staph and yeast fungus? But, can your tooth brush really make you fall ill? Luckily, our immune system ensures that toothbrushes do not make us ill. However, in rare cases, the bacteria on a toothbrush can get past our defenses.

The problem lies in how a toothbrush is stored. The bathroom is humid and moist making it the best place for bacteria to multiply. Storing a toothbrush near the toilet further adds to the problem. Here are a few tips to make your toothbrush healthier.

1. Wash your hands before and after brushing. Also rinse your toothbrush well before putting toothpaste on it. Using hot water is better than cold water.
2. Change your toothbrush every three months or whenever the bristles are worn out; whichever comes first. In addition, also change your toothbrush after recovering from any illness. If you use an electric toothbrush, change the head every 3-4 months. Children’s brushes need to be changed more often than adult’s toothbrushes.
3. Do not share a toothbrush and avoid storing toothbrushes together. If the bristles touch each other, germs could move from one toothbrush to the other.
4. Toothbrush caps may not be as good an idea as they seem as it traps moisture inside and does not allow the brush to dry properly. Instead, keep your brush submerged in hydrogen peroxide or any alcohol based mouthwash.
5. Do not store your toothbrush horizontally. Your toothbrush should always be stored vertically with the brush side on top.
6. When travelling, if you use a toothbrush cap, allow the brush to dry completely before putting the cap on.
7. Store your toothbrush away from the toilet and away from the sink such that it cannot get contaminated form water that splashes when you wash your hands or face.
8. If possible, store your toothbrush in your medicine cabinet.
9. Always put the cover down before flushing the toilet. This will reduce the number of air borne bacteria that can attach themselves to your toothbrush,
10. Along with your toothbrush also clean out your toothbrush holder regularly.
11. Do not try sterilizing your toothbrush in a microwave. Toothbrushes are not designed to withstand extreme temperatures and hence this could damage your toothbrush.
12. Use a mouthwash after brushing to rinse out any bacteria that may be left behind form your teeth or your toothbrush.

Do not let that round bump come in the way of lovemaking. Pregnancy often brings about substantial physical distance between couples. The mother goes through unimaginable bodily exhaustion while the father could be busy balancing things inside and outside the household; they hardly find time to reach out to one another through physical expression of love. However, an expecting couple should find ways to make love quite often as it is the best way to relieve stress and anxiety.

These five positions can be adopted for wonderful sex during pregnancy:

1. Spooning can give you immense satisfaction: Spooning is the best available option if you are looking for shallow penetration. Women opt for this position especially in their third trimester when the belly is too big for any face to face action. The male has his hands free and can hence touch or stimulate you without any hindrance.
2. Try going on top to relieve exertion: When the man is on top with the woman underneath, pressure could be built up on the baby bump. To avoid such a case, the woman can go on top. This way, deeper penetration is facilitated. Both partners can see each other's faces during intercourse and the female's erogenous zones can be easily accessed by the male. For extra support, a pregnant lady could lean backwards and place her hands alongside her partner's legs.
3. You could be the doggy to avoid pressure: You could be the doggy by either leaning against the wall or by bending over on the sofa. This way your baby remains safe and your back is saved from stress too. Having sex in this position is specifically beneficial for those who have spine injuries.
4. Lying side by side to form a pair of scissors: This position will only help the man enter you at a shallow level yet it is a beautiful way of having intercourse as both of you can see each other and cuddle or kiss constantly to convey love.
5. The classic missionary pose can be redefined: The classic missionary pose can be modified to suit your needs. You could wrap your legs around your partner's waist while the two of you face each other; the male is required to kneel at the edge of the bed to adjust his thrusts properly.