Obstetrics & Gynaecology 

You may notice some subtle signs of pregnancy – fatigue, nausea, frequent urination, aversions to foods that you usually love, morning sickness, breast swelling and tenderness, and a missed period if you are very regular with menstruation. A pregnancy test is a way to know for sure.

Here are a few tips for preventing some of the most common pregnancy symptoms: Vomiting and Nausea: Get up slowly in the morning as movement can make nausea worse. Don’t let your stomach empty. It is advised that you eat five or six small meals throughout the day, drink plenty of fluids, get some fresh air and avoid fatty foods that are hard to digest. Cramps in the legs: Exercise regularly, get plenty of fluids, and avoid sitting in the same position for a prolonged period. It is essential to stretch your legs before going to bed by straightening your heel first and then wiggling your toes. Massage your feet and apply heat to relieve a cramp. A backache: Wear low-heeled shoes with good arch support to avoid straining your lower back muscles. Avoid lifting heavy objects or standing for extended periods of time. Make sure your mattress is firm, and that chairs you sit in have good back support. Don’t take medications for back pain unless approved by your doctor. Try a heating pad, warm water bottle, or cold pack instead.

Typically, sex is perfectly safe during pregnancy – right up to delivery. Therefore, put aside your doubts and fears that intercourse will hurt your baby. It is essential to know that the amniotic sac, the uterus, and the mucus plug in the cervix all provide robust protection for your baby. However, sometimes, your doctor may tell you to abstain from intercourse while you’re pregnant. This is to avoid unpleasant situations if you risk premature labour, or if you suffer from placenta previa (the placenta is too close to the cervix), or if you have had vaginal bleeding during your pregnancy.

Dos: Have a healthy and balanced meal. Get all essential vitamins and minerals, leafy greens, fruits, vegetables, proteins and calcium rich food. Light to moderate exercise is recommended for a healthy pregnancy and delivery. Practice clean hygiene. Take regular showers and always wash your hands with soap before preparing food, meals, after handling raw meat and using the bathroom.

Don’ts: Paint- Let somebody else paint the baby’s room. Pregnant women shouldn’t be exposed to toxic substances and chemicals, which include paint and cleaning solvents. Get an X-ray- Get an X-ray only if necessary. It is highly advised to avoid tests like X-rays and mammograms while pregnant because they can be dangerous to your growing baby. If you need to have an X-ray, make sure that your doctor knows you are pregnant so they can take extra precautions.

The average pregnancy lasts for 280 days or approximately 40 weeks from the last menstrual cycle. So, if your last period were on 1st Jan, your due date would approximately be 7-Oct. Remember this will be an estimate and not an absolute certainty.

The average woman should gain about 1-2 kg during her first three months of pregnancy, and 0.5kg a week for the remainder of her pregnancy. If you’re at a healthy weight before pregnancy, gain between 11-16 kg during pregnancy. If you are overweight before pregnancy, gain 7-11 kg. If you are under-weight before pregnancy, gain 13-18 kg. For multiple births, consult your doctor. Usually, you should gain about 16-20 kg for twins.

For the Down’s syndrome, a screening test is conducted before the diagnostic test, as per the requirement. With the help of the screening tests, it can be determined if the babies have an increased risk of having the condition or any other chromosomal abnormalities. For the screening test, all the mothers go through the following two parts:

Blood Test – This is a double marker test in which the amount of two chemical substances present in the blood of the mother is measured. This is performed between 10th to 13th weeks of pregnancy.

Ultrasound scan – This is Nuchal Translucency (NT) scan which is performed between the 11th to 19th week of pregnancy.

After both the tests are completed, the results from both are combined with the age to estimate the probability of the unborn baby being affected by the condition.

If you are past the 13th week of pregnancy and didn’t have the double marker test conducted in the first trimester, you can have the risk assessment done through a blood test. This is known as a Quadruple marker test which can be performed between the 15th and 21st week of pregnancy.

A diagnostic test will need to be conducted for getting a definitive result on whether the baby has Down’s syndrome or not. This test is mostly conducted only when there is an increased risk of a miscarriage or pregnancy loss in the screening test.

“LOW RISK” or “SCREEN NEGATIVE” (The most common result)
If the result of the screening test was lower than the cut off value of 1:1250, it means a screen negative or low risk result. However, it doesn’t mean that there is no risk. It simply means that the probability of your baby having this condition is extremely low. If there is no other medical reason, you won’t have to undergo a diagnostic test. If you still want to get a confirmation on the genetic makeup of the baby, you can still opt for the diagnostic test.
“HIGH RISK” or “SCREEN POSITIVE” (Less than 5% i.e., 1 in 20 women)
If the result of the screening test is more than the cut off value of 1:250, it means that there is a screen positive or high risk result. After this, you will either have to go through a Non-Invasive Prenatal Testing (NIPT) or a diagnostic test. However, it is your decision to have a diagnostic test or not. The diagnostic test won’t have a risk to your pregnancy but will leave some uncertainty until the baby is born. If you decide to go through the diagnostic test, make sure that you have all the information regarding the tests. You will get a definitive answer through the diagnostic tests but there will be a small risk of miscarriage.

If none of the above options suit you, you can try the early anomaly scan that is one between the 16th and 18th week of pregnancy. Or, you can go for the routine detailed anomaly scan that is performed between the 18th and 20th week of pregnancy.

Diagnostic tests for Down’s syndrome
For Down’s syndrome, there are two diagnostic tests available:

CVS (Chorionic Villus Sampling) – In this test, the cells from the placenta are taken and analyzed to check for the condition in the fetal chromosomes. In most cases, this diagnostic test is conducted between the 10th and 13th week of pregnancy, i.e. in the first trimester. Also, the risk of miscarriage or pregnancy loss from this test is very low.

Amniocentesis – In this test, amniotic fluid sample is taken that surrounds the fetus. A needle is used to draw out this fluid from the mother’s uterus. The sample is used to analyze the fetus’s chromosomes. This test is conducted after the 15th week of pregnancy, i.e. in the second trimester. With this test also there is a low risk of miscarriage. If a couple has undergone in-vitro fertilization and they are at a higher risk of passing the genetic condition, preimplantation genetic diagnosis is performed so that the embryo can be tested for any genetic abnormalities.

No matter what your age is while being pregnant, there will always be a risk of giving birth to a baby suffering from Down’s syndrome. However, this risk increases as the age of the mother increases. All pregnant women are advised to get a screening test. About 70% of all the babies born with Down’s syndrome had younger mothers. It is up to you to make the decision of finding out if your baby has this condition or not. Having the information regarding the tests can help you make the right decision.

If your baby has been diagnosed with Down’s syndrome, there are two ways a parent can go:

Decide that they don’t want to continue the pregnancy and choose to abort. Discuss the health consequences of abortion with the doctor.

Decide that they want to have a baby. If you have selected this, you need to make a plan and prepare yourself with the extra challenges that come with raising a child with Down’s syndrome.

A premature baby would be called a baby that is born before 37 weeks of pregnancy. For various stages of premature birth, the neonatal team has different terms. To speak about your baby being born early, they can even use the word ‘preterm.’

For several factors, we admit babies into neonatal care. The essential explanations for the admission of a baby are: Born prematurely. They have low birth weight (less than 2.5Kgs). They have a particular medical condition that needs hospital care.

Maintain good hygiene. Be healthy and protect yourself from illness and this will protect your baby too. Practice social distancing. Do not have large celebrations and gatherings for cultural rituals. Meet as few people as possible. follow the local guidelines about the lockdown and other regulatory matters.

Approximately 90% pregnant women develop stretch marks as their body grows during pregnancy on the stomach, thighs, buttocks, and breasts. You can try to prevent such stretch marks by drinking lots of water to keep your skin hydrated, massage your skin with a moisturiser or oil that is high in vitamin A and vitamin E and by consuming a diet that’s rich in skin-supporting vitamins – E, C, A, and zinc.

Many young women share the same health issues. A common topic of concerns might be the following: Cramps and menstrual cycle problems, The Acne, Weight, Sexuality, Regulation of Births, For STIs Alcohol & smoking and medications, Emotional downs and ups. You are free to discuss any such issues and the intense ones too which affect your physical and mental health. The body and mind are connected, hence a healthy body equates to a happy mind and vice versa.

The most common symptoms that occurs due to fibroids include, heavy menstrual bleeding, pelvic pressure, pain, and back ache.

Yes, you may have symptoms such as weight gain, hair loss, high blood pressure, irregular periods and acne.

Many things can cause heavy menstrual bleeding. Some of the causes include the following:

Fibroids and polyps
Adenomyosis
Irregular ovulation—If you do not ovulate regularly, areas of the endometrium (the lining of the uterus) can become too thick. This condition is common during puberty and perimenopause. It also can occur in women with certain medical conditions, such as polycystic ovary syndrome (PCOS) and hypothyroidism.

Bleeding disorders—When the blood does not clot properly, it can cause heavy bleeding.

Medications—Blood thinners and aspirin can cause heavy menstrual bleeding. The copper intrauterine device (IUD) can cause heavier menstrual bleeding, especially during the first year of use.

Cancer—Heavy menstrual bleeding can be an early sign of endometrial cancer. Most cases of endometrial cancer are diagnosed in women in their mid-60s who are past menopause. It often is diagnosed at an early stage when treatment is the most effective.

Other causes—Endometriosis can cause heavy menstrual bleeding. Other causes include those related to pregnancy, such as ectopic pregnancy and miscarriage. Pelvic inflammatory disease (PID) also can cause heavy menstrual bleeding. Sometimes, the cause is not known.

If medication does not reduce your bleeding, a surgical procedure may be recommended:
Endometrial ablation destroys the lining of the uterus. It stops or reduces menstrual bleeding. Pregnancy is not likely after ablation, but it can happen. If it does, the risk of serious complications is greatly increased. You will need to use a birth control method until after menopause following endometrial ablation. Sterilization (permanent birth control) may be a good option to prevent pregnancy for women having ablation. Endometrial ablation should be considered only after medication or other therapies have not worked.

Uterine artery embolization (UAE) is used to treat fibroids. In UAE, the blood vessels to the uterus are blocked, which stops the blood flow that allows fibroids to grow.

Myomectomy is surgery to remove fibroids without removing the uterus. Hysteroscopy can be used to remove fibroids or stop bleeding caused by fibroids in some cases.

Hysteroscopy can be used to remove fibroids or stop bleeding caused by fibroids in some cases.

Hysterectomy is surgical removal of the uterus. Hysterectomy is used to treat fibroids and adenomyosis when other types of treatment have failed or are not an option. It also is used to treat e What are the common symptom of fibroids?

The most common symptoms that occurs due to fibroids include, heavy menstrual bleeding, pelvic pressure, pain, and back ache.

No, it is a permanent form of contraception for women which cannot be reversed.

Hysterectomy is recommended to treat multiple fibroids or prolapsed uterus.

The conditions that can be managed by performing hysterectomy includes:
Cervix, uterus or ovary cancer
Multiple uterine fibroids
Heavy periods
Endometriosis
Uterine prolapse
Adenomyosis