Dr. Jyoti Dalal

My name is Dr. Asha Khatri. I had passed MD in 1977 and obstetrics and gynecology from Pandit LNM Medical College, Raipur with gold medal and distinction. My special interests are infertility, high risk pregnancy, delivery and endoscopy. Today I am going to share with you some important topics related to obstetric which will help you in taking the proper decision. Premarital counseling is very important because so many conditions which you are not aware of can affect your obstetric outcome.

First you should know the HIV status of both the partners because if one is HIV positive the other can get the infection from the partner and if the mother is HIV positive then the baby can get infection from the mother during pregnancy. At the time of delivery, RH factor is decided by the type of protein on the red blood cells and it is also called NTJ. Most of the people have protein or RH Factor on the red blood cells and they are said to be RH positive and those they do not have the RH factor of protein on the cells are said to be RH negative. If RH negative mother carries an RH positive fetus during pregnancy, a small amount of leak or fetal blood cells takes place into the maternal circulation during pregnancy and at the time of delivery mother's body produces antibodies to fight the RH factor on the fetal red blood cells. These antibodies cross the placenta and reach the fetus and they destroy the fetal red cells and produce a condition called hemolytic disease of the newborn. In mild cases, the baby will develop the jaundice ; In moderate cases, it is the anemia of the newborn ; and in the sever cases the baby dies inside the uterus.

There is a way to prevent the formation of her body from forming antibodies rh- globulin containing RH. Antibodies should be injected into the Rh negative mother during pregnancy and just after delivery with readymade antibodies now available. The mother's body seems no need to make her own antibodies.

Thalassemia is a genetic blood disorder affecting the red blood cells it affects 7-8% of the Indian population. Some of the high risk communities are Sindhi Punjabi's lohanas Maymans and Bhanushalis.

Two main forms of thalassemia are:

• Thalassemia minor
• Thalassemia major.

Thalassemia Minor- People with thalassemia minor generally healthy, though they may suffer from mild anemia.

Thalassemia Major- Child with thalassemia major is born when both parents are carriers of thalassemia minor. Thalassemia major is a fatal blood disorder.

A regular transfusion is essential to enable proper growth and development of the child throughout the life. Proper planning and use of 100% sure and safe method of contraception should be used to avoid the unwanted pregnancy before marriage.

Now I am going to tell you about pre-pregnancy counseling. Antenatal care begins long before the patient becomes pregnant. All the patients should visit the gynecologist before pregnancy. Those patients who are at risk of medical and offset complications should visit to know when to become pregnant. Medical complications like diabetes, hypertension, thyroid, asthma, tuberculosis during pregnancy can cause genetic disorder. If patient has genetic disorder then they can choose not to become pregnant and may decide for adoption. Follic acid should be started three months before becoming pregnant to prevent the development of neural tube defects like spinal bifida and anencellaly.

For more information you can contact me through lybrate.com

Hammer toe is a condition where the toe of the patient becomes deformed. The appearance of the toe will bear a downward curl that will make it look abnormal. This condition can mostly be seen during the childhood itself and it usually is known to affect the second or third toe on the foot. Let us find out more about the symptoms, risk factors and treatment for this condition.

• Symptoms: The sheer discomfort of walking around with a hammer toe is one of the first symptoms of the condition. The permanent damage will be visible in the way the toe curls and becomes deformed. The formation of corn or calluses is also a common symptom of this condition, while some patients may also experience the growth of claw like toes. Most patients feel pain when they are walking or running even as inflexibility sets in, which makes it difficult to flex the foot or stretch and wiggle the toes properly.
• Risk Factors: While the most common causes of the hammer toe remain an injury or even arthritis, it may be seen that those with a family history and prolonged use of high and pointed heels may be at risk more than others. This deformity can happen at birth or may progress as age catches on, depending on the risk factors at play. Also, when the patient suffers from the growth of calluses, corns and bunions that go untreated for a long time, it may manifest into a hammer toe eventually. This happens because these growths can make the layer of the skin thick and lead to a perpetual formation in the area due to the constant friction that also causes pain and discomfort. People with a high foot arch are also at risk of developing a hammer toe.
• Treatment: The orthopaedic specialist is the best person who can help with the diagnosis and treatment of this condition. While the diagnosis consists of the conduct of an X-ray to find the cause and extent of the damage, the doctor may also conduct nerve function tests to find out if any nerves have been damaged for the condition to have taken place. Also, the specialist will try to find causes like ligament injuries and other such things that could have led to the condition. Accordingly, the treatment method will be put forth. A mild hammer toe can be treated by wearing more comfortable footwear with pads to treat corns and other growths. For a severe condition, surgery is the only way out.

Ensure that you report the smallest and most persistent changes to your doctor so that treatment can take place well in time.