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Complications during Pregnancy

    What is anemia?
  • It refers to a state where the amount of blood or the hemoglobin in the blood is not sufficient to maintain the required needs.

    In a country like India most women as such are anemic and during pregnancy due to the increased need of iron further aggravate this state. There are many causes for reduced blood counts/ hemoglobin but the most common cause is due to a deficiency of iron in the diet. During each pregnancy a woman is estimated to lose around 500 mg of Iron.

    Most of the iron which a newborn gets is from the mother and a healthy baby needs 250 mg of iron in the blood for its development.

    How do I get sufficient iron in my diet?
  • Women contemplating to get pregnant must have at least consume 15mg of iron in their diet through rich food sources of iron like green leafy vegetables, jaggery, meat, beetroot etc. During pregnancy the requirement increases to around 20 mg of iron and since the diet alone is not sufficient to provide the required quantity of iron you must take supplements of iron along with an iron rich diet to prevent anemia.

    Vitamin C is another nutrient which enhances the absorption of iron so regularly consume Vitamin C rich food like citrus fruits, pineapples, Indian gooseberry ( amla ) etc to make sure that the iron you are consuming is actually getting absorbed into your diet. Anemia may lead to symptoms like breathlessness, swelling of legs, dizziness and easy fatigability. Babies born to anemic mothers are usually of low birth weight and may be born prematurely.

  • Women who have asthma may notice that pregnancy may aggravate the symptoms. In some previously normal women a pregnancy may lead to asthma. Uncontrolled asthma during pregnancy may lead to low birth weight in a baby.

    Usually tobacco smoke, pets, mould spores, dust mites, pollen, respiratory infections and exercise in cold air can trigger an attack

    How do I prevent an attack of asthma?
  • The most effective way to control asthma is to control the triggers. Knowing your asthma triggers helps!

    Keep your home dust free, vacuum all hard to reach areas where dust accumulates over a period of time like sofas, carpets etc frequently have your bed linen washed and changed.

    As far as possible keep your surroundings free from dust mites, cockroaches, indoor and outdoor moulds. Stay away from furry or feathered pets. If you have pets, keep the house free of animal dander.

    Take care of your health and immunity levels as infections like colds; sinus and flu may increase the symptoms of asthma. If your asthma is brought on by seasonal triggers such as pollen and spores, try to stay indoors or wear a protective mask when stepping outdoors. Some women find that extreme cold weather conditions or drinking cold and iced drinks trigger an attack. Take the necessary precautions and stay warm and drink fluids at room temperature.

    If exertion or exercise causes asthma, check with your doctor who will advise an alternate exercise plan for you. In some sensitive individuals, food coloring, processed/ tinned food and preservatives may trigger asthma. Be watchful of what you eat especially if you are using convenience foods.

    Strong smelling perfumes, deodorants, cleaning fluids, paints and sprays should be avoided.

    Avoid contact with fine powders such as a kitchen flour grinding mill, saw dust, finely powdered spices and talcum powder. Smoking triggers asthma. Not just tobacco smoke but even kitchen fumes, air pollution, and vehicular exhaust, smoke from fireworks, crackers, "agarbatties" or "dhoop" can be triggers. Make sure there is passage of fresh air and avoid sitting in cramped smoky areas. Stress and anxiety too may trigger an attack in some sensitive individuals. Try to stay stress free and calm. Yoga and meditation are excellent ways of controlling stress -- however make sure you see an experienced instructor who knows antenatal exercises.

    Some studies have also suggested that including apples in your diet may lower the risk of asthma.If you are already on medications for the asthma please continue it and contact the doctor to review the dose.

    Increased Blood Pressure
  • High blood pressure and protein in urine indicate a condition called Preeclampsia. Though large blood is produced extra to nourish the fetus there is fall in blood pressure due to the hormonal action; this is why some women feel "light headed" or even faint during pregnancy.

    If you are hypertensive before pregnancy you should take all the measures suggested by doctor to keep it as normal as possible.

    The reason your doctor measures your BP regularly is to build up a picture of what's normal for you. This is important, as a single high reading may prove insignificant. Perhaps you are simply stressed out or late for your appointment. If your doctor suspects your BP is raised, they will take another reading to confirm it.

    Who are at risk for high blood pressure/pre eclampsia ?
  • Young mothers under the age of 17 or older mothers aged 35 and above during their first pregnancy. Women with a history of high blood pressure or family history of hypertension.

    Women who are carrying more than one baby.

    Women who are overweight or smoke, whether before or during their pregnancy.

    Women who lack adequate nutrition or prenatal care during pregnancy.

    Women with health problems complicating a pregnancy, including heart disease, diabetes or circulatory problems.

    Swelling, including excessive swelling resulting in rapid weight gain.

    Decreased fetal movement or fetal distress.

    Prevention of preeclampsia
  • Good and healthy diet composed of fresh fruits, vegetables and grains as well as a healthy lifestyle reduce the chances of preeclampsia.

    Salt intake must be limited as high salt intake is one of the single most important factors for increased blood pressure. Regularly get your BP and urine monitored.

    If you have been diagnosed with high BP continue the medications prescribed by your doctor regularly and make sure to get sufficient bed rest.

    Rush to your hospital if you feel that you have extreme swelling of hands and feet, severe visual blurring, severe heartburn (some amount of heartburn is common during pregnancy) or a headache that does not resolve. If you have any doubts feel free to chat with our doctors online

    Ectopic Pregnancy
  • It's a pregnancy that develops outside the womb, usually in one of the fallopian tubes.

    As the pregnancy grows, it causes pain and bleeding, and if not recognized, the tube can rupture, causing internal bleeding. This is a medical emergency and can lead to death. The pregnancy itself never survives -- it can't be moved to the womb and has to be removed, Commonly found between the fourth and tenth week of pregnancy -- usually from weeks five to seven.

    The most common reason for an ectopic pregnancy is when the fallopian tube has been damaged and this causes a blockage or narrowing.

    Who are at risk of ectopics?
  • Women with a pelvic inflammatory disease as damage or scars are produced

    If you've had pelvic inflammatory disease (which is most often caused by the sexually transmitted infections (chlamydia or gonorrhea) as this can cause damage and scars the tubes where fertilization takes place.

    Women who are using an Intrauterine Device( like Copper T) for contraception are at a higher risk, also those who have had an ectopic pregnancy previously are at a higher risk of having another ectopic pregnancy.

    Women who have conditions of the pelvis or the Fallopian tubes like pelvic adhesions, endometriosis, salpingitis isthamica etc Previous surgery including a previous Caesarean puts women at a higher risk. Also women on oral contraceptives have a higher risk for developing an ectopic pregnancy; older women above 35 who may have a pregnancy are also more likely to develop one.

    Note: One-sided pain in the lower abdomen that is severe and persistent, which could be stabbing/shooting in nature could be an ectopic one of the Warning Signs that could rupture or about to rupture. A woman who experiences it and is pregnant or likely to be pregnant should be taken to a hospital immediately as it is a potential life threatening condition. Also women with vaginal bleeding, pain with vomiting, giddiness or feel faint must be taken to a hospital immediately.

    Some women may not be aware that they are pregnant so women who have the above symptoms must rush to a hospital as ectopic gestation can occur even while on contraceptives/ IUDs

    Diabetes during pregnancy (Gestational Diabetes)
  • This is a common medical condition during pregnancy which affects most women during pregnancy. The blood sugar level of the mother increases during pregnancy and can affect the baby and the mother and usually comes back to normal following delivery.

    Women who develop Diabetes during pregnancy are more likely to have complications like jaundice, still births, pre- Eclampsia, respiratory distress etc

    The baby may be unusually large and this may further increase the need for a Caesarean section.

    Who are at a risk?
  • Some women are at higher risk than others like ethnicity, obesity, age, diet, women with a history of a previous pregnancy with Gestational Diabetes etc. Some races like South Asian women are are more prone to Gestational Diabetes. In addition smoking, dietary fat and lifestyle can increase the chances of developing Gestational Diabetes.

    Extreme thirsts, getting fatigued easily, frequent trips to the rest room are symptoms of Gestational Diabetes. If you notice any of these symptoms visit your doctor. You could chat with our doctors online for any other questions related to this.

  • Most women with gestational diabetes may be required to control their blood sugar levels by just changing their dietary patterns and monitoring their diet. Some women may require to be treated with insulin. It is important to keep sugar levels in control during pregnancy to avoid the complications of Gestational Diabetes

    Jaundice in Pregnancy (Cholestasis of pregnancy)
    Jaundice is a rare condition in pregnancy and usually resolves soon after delivery. Besides having to deal with the yellow color that skin changes into, mothers with this type of jaundice also have itching of the skin which can be very bothersome.

    What are my chances of getting jaundice?
    Most women who have had their mother or a sister affected with jaundice are more likely to get it. Also those women who had jaundice in a previous pregnancy also will develop it in subsequent pregnancies.

    How will jaundice affect me or my baby?
    It may increase the incidence of a stillbirth. Also the oxygen intake for the baby may be compromised. After delivery the mother may be at a risk of bleeding.

    What is the treatment for jaundice of pregnancy?
  • Normally mothers with Cholestasis of pregnancy will just be required to avoid fried and fatty food and to follow a healthy and balanced diet. Milk and milk products have to be limited. Some mothers may be prescribed Vitamin K supplements during pregnancy.

    Itching can be relieved by the application of a calamine lotion. The mother should try to wear comfortable cotton clothes and can apply a light lotion to soothe the irritated skin. The mother should try to stop hot and humid conditions and wear long sleeves clothes which keep her cool.

    Also remember that besides jaundice of pregnancy other conditions may also cause jaundice like Hepatitis, HEELP syndrome, fatty liver, preeclampsia etc. If you notice yellow discoloration of the skin/ eyes do get yourself checked by a doctor as these conditions causing jaundice must not be mistaken for Cholestasis of pregnancy and need to be treated.

    If you have any doubts related to this feel free to chat online with our panel of doctors or call us and our team of doctors will assist you.

    Polyhydramnios (increased amniotic fluid)
  • Just like too little amniotic fluid could cause complications too much of surrounding fluid around your child also have problems

    Symptoms of polyhydramnios
  • When your tummy is too large for the date of your pregnancy, you may be having polyhydramnios. Breathlessness, constipation, heartburn tight and stretched skin.

    What could cause polyhydramnios?
  • Infections of the mother, twin/ multiple pregnancies, diabetes, congestive cardiac failure, genetic abnormalities in the baby etc. can result in increased amniotic fluid.

    How can it affect me or my baby?
  • Usually women with polyhydramnios usually go into labor early and are at risk of preterm labor. It may also increase the need for a caesarean section. There are more chances of structural abnormalities in the baby. Mothers are also at a risk of post partum hemorrhage and premature rupture of membranes.

    What is the treatment?
  • For women diagnosed with polyhydramnios treating/controlling the cause usually can treat polyhydramnios. Bed rest is essential to prevent early labor. In some women the doctor may recommend a reductive amniocentesis which is a procedure to remove the excess amniotic fluid in the womb.

    Oligohydramnios (Low amniotic fluid)
    Reduced volume of amniotic fluid in the womb is called oligohydramnios. Amniotic fluid is the fluid surrounding the baby which cushions her from trauma, protects her from infections and helps her lungs to develop. So decreased amount of this fluid will make a baby's lungs weak and in some cases even lead to fetal death. It can also cause malformations in the baby.

    How do I know if my amniotic fluid is sufficient?
    You should suspect low amniotic fluid if you feel that your womb is small for your period of pregnancy, if you can feel the baby in the womb too easily or there is leakage of body fluid.

    If you suspect low amniotic fluid ask your doctor about it. It can be confirmed by Ultrasound scanning .If you have any doubts feel free to chat with our doctors online.

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