Exercising for a Healthy Pregnancy

Introduction:

As one of the most fulfilling phases in a woman’s life, being pregnant doesn’t mean that you have to sit and relax throughout the whole pregnancy period. Yes, during your pregnancy, you may feel more tired than before. You may have backache and swollen ankles. But it is very essential for pregnant women to keep active. Exercising during pregnancy will not only help you to stay in shape but also prepare you for labour and delivery. It allows you to return to your pre-pregnancy shape faster.

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Exercising during pregnancy doesn’t mean that you have to do complicated workouts. Simple exercises daily are enough to keep you fit and active. So, in order to have a healthy pregnancy, you should consult your doctor or an experienced trainer or join classes on pregnancy exercises.

Exercising and Pregnancy:

Exercising 20-30 minutes 3 or 4 days a week can help you maintain a healthy pregnancy. Walking is one the best exercises which provides a moderate aerobic conditioning without much stress. Swimming, pedalling on stationary cycle, light aerobics and yoga are some of the good exercise choices during pregnancy.

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While exercising, it is very essential to stay hydrated. Have plenty of fluids and don’t be overheated. Exercise to the limit you are comfortable and as per your health trainer’s suggestions.

Benefits of exercising during pregnancy: 

  • Relieves backache and other discomforts
  • Increases your stamina and energy level
  • Prevents you from gaining excess weight
  • Helps you to sleep better
  • Gives a boost to your mood
  • Reduces the risk of gestational diabetes
  • Reduces constipation
  • Helps proper blood circulation
  • Gives a healthy glow to your face
  • Controls pregnancy related high blood pressure
  • Reduces the symptoms of postpartum depression


It is better not to exercise during pregnancy if you have the following problems:

  • Cervical problems
  • Heart or lung related disease
  • Vaginal bleeding
  • Previous pre-term labour
  • Threatened miscarriage


Do’s while exercising:

  • Wear comfortable and loose fitting clothes along with a supportive bra
  • Wear well-fitting sports shoes
  • Exercise on flat surface to prevent injury
  • Choose healthy food and eat at least an hour before exercise
  • Drink lots of water before, during and after exercising
  • If you are doing floor exercises, get up slowly


Don’ts while exercising:

  • Avoid exercises involving extensive hopping, bouncing, skipping and jumping
  • Avoid exercises which have chances of you falling down
  • Avoid waist twisting movements
  • Avoid exercising in hot and humid conditions
  • Don’t  hold your breath for a long time
  • Don’t do extensive exercises for long periods of time


Conclusion:

So, if you are pregnant, do moderate exercises to stay fit and healthy. Not only you, but your baby also will greatly benefit by the exercises.

Exercise daily and have a healthy pregnancy.

Images Courtesy:

http://kidshealth.org/

http://www.youngandraw.com/

http://cenobgyn.com/

 

Stork Delivers the First Baby

Dr.Evita.jpgLast night I stood silently by the side of a young mother who asked me to be present at the birth of her second baby. I re-entered a birthing room after several years. It was a privilege, to be a part of that very special, intimate circle. She chose to have the chants of the Vipassana meditation which added a spiritual dimension and left her calm.

I continue to be in awe of the mystery of birth. I never cease to be amazed by the quiet inner strength and determination of a woman, to birth. The sheer unadulterated joy she displays when she holds her baby only reiterates the power of a mother’s love.

Thank you my young mother, for drawing me back into that special spot last night.

A successful vaginal birth, following a previous Cesarean section, is a reason to celebrate. You have only reinforced my belief in women and their understanding of their own bodies.

Our first birth in Stork Home – a good beginning indeed.

– Dr. Evita Fernandez

Diabetes Before Pregnancy

Introduction:

When a woman gets pregnant, it is very essential that she is healthy and free of disease. This is one of the main factors in giving birth to a healthy baby. And, if you have diabetes before getting pregnant, then special care should be taken to control it. You should consult your doctor before getting pregnant. Otherwise, there is a possibility of the baby being born with health defects.

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Complications of diabetes before pregnancy:

Due to poor control of diabetes, some women even have miscarriages or lose their baby during childbirth. In order to prevent these complications, there is need for proper treatment to control diabetes before you get pregnant.  High glucose levels and Ketones, which are very dangerous, present in the mother pass through the baby’s placenta leading to various type of complications.

High glucose level before pregnancy, if not controlled, may result in the following complications during childbirth :

  • Miscarriage
  • Health risks to the baby
  • Premature delivery
  • Different types of birth defects
  • Low glucose level at the time of birth
  • Prolonged jaundice in the baby
  • Respiratory problems in the baby
  • Difficulty during delivery necessitating caesarean section
  • Infections in the vaginal area and urinary bladder
  • Kidney problems
  • Eye problems

How to prevent and control blood sugar level?

Babies born to mothers having diabetes are at the risk of having diabetes in later stages. The complete organs of a baby are formed within a period of 7 weeks from the date of your last menstrual period. And when you realise that you have conceived, it becomes too late to control diabetes. Since the early weeks play a crucial part in the development of the baby, controlling your blood sugar level is very important. So, it is better to get your glucose level lowered if you are planning a baby.

Proper treatment and regular check-ups reduce the risk of complications during pregnancy and after childbirth. When a woman conceives, the level of blood sugar automatically goes up.  Doing exercises, light work, taking meals and medications as prescribed by your doctor will help you balance your blood sugar levels.

Tips for women suffering with diabetes before pregnancy:

  • Plan your pregnancy
  • Control the level of blood sugar before and during pregnancy
  • Follow a proper diet chart recommended by your doctor
  • Exercise
  • Control your weight
  • Do urine and blood tests frequently
  • Avoid smoking and alcohol

Conclusion:

Treating diabetes before getting pregnant will let you and your baby enjoy good health. Make your pregnancy safe and enjoy this beautiful phase of life rather than being tense with complications.

Image source: http://previews.123rf.com/

 

Managing food allergies and intolerances in babies

Food allergies and intolerances in babies have become quite common and almost 1 in 12 babies suffer from them. So, it is very essential for mothers to take proper care of their babies regarding food. Your baby can have food allergies if you have a family history of food allergy, hay fever, asthma or eczema.

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What is food allergy?

Food allergies in babies occur when their immune system has an adverse reaction to harmless proteins in food and produces antibodies. The immune system responds to the food as toxic. It occurs immediately or after some time of having food.

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Symptoms of food allergy:

  • Redness on skin and dermatitis
  • Nasal congestion
  • Itchy eyes and mouth
  • Vomiting, diarrhoea and stomach cramps
  • Swollen face and eyelids
  • Swollen tongue and lips
  • Frequent crying and distress
  • Persistent cough, difficulty in swallowing, wheezing, shortness of breath and hoarse voice is called anaphylaxis, a severe and life-threatening food allergy

The most common foods that causes allergy in babies are:

  • Milk
  • Egg
  • Peanut

What is food intolerance?

Food intolerance in babies is caused by some substance present in the food they eat. It is not caused by the immune system responding to the food. Often, food intolerance occurs after two days of having the intolerance prone substance in food.

Symptoms of food intolerance:

  • Skin redness and dermatitis
  • Constipation
  • Diarrhoea
  • Stomach pain
  • Vomiting

The most common form of food intolerance that occurs in babies are:

  • Milk or lactose intolerance
  • Some react to strawberries
  • Tomato can also cause food intolerance

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Food allergies and intolerances in babies can be controlled in the following ways:

  • Avoid the food: It is very important to avoid the food that causes allergies and intolerance in your baby. So, you should be aware of these foods. Carefully read the food labels and see if words like ‘whey’, ‘casein’ etc. are there. Presence of such words means, having the product can lead to allergies.
  • Have an emergency plan: Parents should speak to their doctor to give them an emergency plan which will help them to recognise allergies and intolerances and if medical attention is needed or no

Diagnosing food allergies or intolerances

If you find that your baby is having a food allergy or intolerance and not getting better, you should always consult your doctor. If the allergies and intolerances are not mild, they will be cured by taking the prescribed medicines. Some tests may need to be done, as well. As mothers breastfeed their babies, they should not eat the foods that causes allergies and intolerances during the pregnancy and breasting period.

Images Courtesy:

http://weaningbaby.co.uk/

http://www.merakname.com/sut-alerjisi-nedir/

http://cdn2.momjunction.com/

Back pain during pregnancy — How to overcome it

Back pain is one of the common problems that occur during pregnancy. Most pregnant women suffer from back pain mainly due to weight gain. But this doesn’t mean you have to suffer throughout the pregnancy. Besides consulting your doctor, there are several ways (read further below) you can overcome back pain during pregnancy.

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Factors causing back pain during pregnancy:

  • Weight gain: Gaining weight during pregnancy is quite a normal phenomenon. But some women tend to gain more weight than required. The extra weight  puts a load on your spine resulting in lower backache and other complications. Moreover, the weight of the developing baby and the uterus puts pressure on the nerves and blood vessels of the pelvis and back.
  • Hormonal changes: This is another factor causing back pain in pregnant women. Due to the hormone called Relaxin, the ligaments in the pelvic area tend to relax and the joints loosen. It also loosens the ligaments supporting the spine that causes instability causing back pain.
  • Changes in posture: As you gain weight during pregnancy, the centre of gravity also changes. So, in order to be comfortable, you change your sitting postures, the way you walk etc. These changes in posture give rise to back pain.
  • Muscle separation: As time passes, the uterus starts expanding more and more. In the process, the two parallel stretches of muscle between the rib cage and pubic bone get separated along the centre seam. This process worsens backache if you are already suffering from it.
  • Emotional stress: During pregnancy, emotional stress causes tension in the back muscles which may result in back pain.

Back pain during pregnancy can lead to following:

  • Difficulty in getting up from a sitting posture
  • You may find it difficult to change positions on the bed
  • Uneasiness while walking for a longer period of time
  • Dressing and undressing may become a problem
  • Difficulty while taking a bath
  • Doing work with back pain becomes very painful

How to ease back pain during pregnancy?

Following these points can help you get rid of your back pain to a great extent:

  • Exercise: Exercising is one of the best ways to ease backache in pregnant women. Walking, cycling on stationary cycle and swimming are some of the safe exercises which you can do while pregnant. Exercising for at least 30 minutes five times a week will not only help you strengthen your body muscles but also increase your flexibility. Staying active by doing exercises and light work is the key to reducing back pain during pregnancy.

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  • Posture: Improving your posture helps in getting relief from backache. You should avoid staying in the same posture for a long period of time. While sitting you can use a cushion at the back and rest your feet on a stool. Using maternity pillows while sleeping also help to reduce backache.
  • Acupuncture: Acupuncture helps you to get rid of back pain. But it is very necessary to get it done by experienced professionals.
  • Heat and cold: To get relief from pain, you may apply cold packs or hot water bag according to your convenience. Even a warm bath can be helpful to reduce back pain.

 

Images Courtesy:

http://dmatxi.com/05/how-to-reduce-back-pain-during-pregnancy.html

www.feelingprettyremarkable.com

Staying Hydrated During Pregnancy

Everyone needs to stay hydrated for healthy living. For the body and vital organs to function properly, you need to have lots of water. And if you are pregnant, the amount of water to be taken increases to a great extent.

During pregnancy, your body needs more water to meet the demanding needs of your changing body. So, it becomes very essential for the mom-to-be to remain adequately hydrated. Moreover, water is one of the key components for breast milk and essential for proper lactation.

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How much water do you need during pregnancy?

A pregnant woman is required to have approximately three litres of fluid every day. Fluids include water, milk, fruit and vegetable juices, and other non-alcoholic refreshments. Apart from having water directly, your body receives water indirectly from fruits, vegetables, yogurt etc. So, you can have water according to the intake of other fluids, fruits and vegetables.

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Benefits of water during pregnancy:

  • As water is one of the main sources for carrying nutrients and oxygen to your organs, cells and tissues, staying hydrated during pregnancy ensures that your baby is receiving the required nutrients for proper growth.
  • It helps in preserving the required amount of amniotic fluid and helps in the kidney function of the foetus by facilitating the waste your baby’s kidney filters.
  • Drinking enough water lets you keep hydrated as dehydration during pregnancy leads to headaches, dizziness, cramps and nausea.
  • Water can help prevent constipation and haemorrhoids.
  • Drinking adequate water helps in preventing morning sickness, indigestion, acidity and heartburn.
  • Keeping hydrated means it keeps your urine diluted which not only helps in keeping all things in order but also keeps Urinary Tract Infections (UTIs) at bay.
  • During the third trimester, hydration becomes especially important as dehydration can cause contractions leading to preterm labour.

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How to know that you are hydrated?

During pregnancy, the best way to know that you are hydrated is to check the colour of your urine. If the colour is pale or straw-coloured, then you are adequately hydrated. But if it is dark, it means you need to have more water. So, keep a water bottle handy which will remind you to keep hydrated.

Images Courtesy:

http://www.pregnancyexercise.co.nz

https://www.pureitwater.com

https://www.pureitwater.com

Trimesterwise Tips for Expecting Moms

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Pic courtesy: http://blog.cloudninecare.com/trimester-wise-pregnancy-tips/

 Having a life growing inside you is nothing less than a miracle! Experiencing the entire process month by month is simply astounding. But then pregnancy comes with its own challenges and complexities that are only experienced as the time flows in the 9-month course. This blog post offers you elaborate trimesterwise tips for expecting moms.

Before we go into the pregnancy tips, let’s have a quick look at the biological changes that take place during pregnancy.

The First Trimester (First three months)

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 Pic courtesy: http://www.pregmed.org/the-first-trimester-of-pregnancy

The fetus has started taking human shape with all the internal organs showing up. You will experience the following changes:

  • You will feel your uterus has ascended above the pelvis region
  • You will now feel less to no morning sickness and will put on weight. Ahh! This can give you mixed feelings!!
  • The fetus has now evolved into a fully formed body with fingers, toes and ears, with the body covered with fine hair
  • You can now press your stomach to feel your baby’s movement 

The Second Trimester (3rd to 6th month)

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Pic courtesy: http://www.slideshare.net/TerroWhite/stages-of-pregnancy-tips-facts-warnings

 By now your uterus has been steadily preparing itself for labour. You will experience the following changes:

  • You will feel painless contractions known as the Braxton Hicks contractions
  • Every week you will put on 1/2 kg of weight
  • You may experience constipation and indigestion
  • Your uterus has now risen 5cm above the pelvis
  • By the 16th week, you can clearly feel your baby’s movement

The Third Trimester (6th to 9th month)

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Pic courtesy: http://www.citranatal.com/pregnancy/third-trimester

You are now in the last phase of your pregnancy and your baby has now fully grown. You will experience the following changes:

  • Because of the consistent weight gain, you have now become breathless
  • The movement as the baby’s head drops to the pelvis — you’ll have a thud-like feeling
  • The weight of your baby should be 2.7-3.5 kg
  • You will experience difficulty in sleeping
  • Your breasts will now start secreting transparent colostrum i.e. protein-enriched pre-milk
  • Your placenta has now enlarged up to 20-25 cms and holds 1.1 ltr of amniotic fluid

TIMESTERWISE NUTRITION TIPS

First Trimester (First three months)

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Pic courtesy:http://www.momjunction.com/articles/first-trimester-diet-essential-foods-you-should-include_00116232/

 Add Folic Acid to your pregnancy diet

Folic acid/Folate is Vitamin B that plays an important role in the development of baby’s skull and brain including its spinal cord.

What to eat –

  • Vegetables such as spinach, ladies finger, broccoli, cabbage
  • Pulses that include lentils, beans and chick peas
  • Others include oranges, eggs, brown rice, baked potatoes, asparagus, corn, brown breads etc.

Tip – Do not cook the above veggies, as folic acid is lost during cooking, instead boil and have them.

Add calcium to your pregnancy diet

Someone on a public health forum had posed this question – “I don’t really like milk… is it such a big deal if I don’t get enough calcium while I’m pregnant?” And the collective response was a big YES.

Calcium plays a crucial role in developing the baby’s bones, teeth, muscles, nerves and heart. When the growing baby does not get the required amount of calcium then it starts extracting it from the mother’s bones. Doctors recommend consuming 1,000 mg of calcium every day.

 What to eat –

  • Dairy products that ensure less to no fat such as low fat curd, skimmed milk
  • Green leafy veggies such as cauliflower, broccoli and watercress (Jalkumbji)
  • Dry fruits including almonds, apricots and figs (anjeer)
  • Others include tofu, small fish with edible bones, cereals and oranges

Tip – The best way to confirm calcium usage is by consuming Vitamin D. So try to eat foods rich in Vitamin D such as boiled egg, asparagus, fish etc.

Second Trimester (From 3rd to 6th month)

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Pic courtesy: http://www.fitmommacleanbaby.com/

 Add Vitamin C to your diet

Vitamin C helps in forming collagen. It is the most widely available protein in the human body, mostly the component of tendons, bones, cartilage and skin.

What to eat –

  • Citrus fruits including lemon, orange, grapefruits
  • Other fruits such as pumpkin, pineapple, guavas, berries, kiwi
  • Vegetables such as broccoli, spinach, sprouts, bell peppers

Add Omega-3 to your diet

Since Omega-3 (DHA) helps in the development of nervous, immune systems and brain, so it becomes highly necessary for you to start consuming foods laden with omega-3 as you enter your second trimester. 

What to eat –

  • Salmon, flax seeds, soybean, walnuts, pumpkin seeds, spinach

Add magnesium to your diet

Magnesium also largely helps in the development of baby’s bones.

What to eat –

  • Seeds such as pumpkin and sunflower seeds
  • Dry fruits such as avocado, almonds, raisins, cashews
  • Vegetables such as legumes, kidney beans
  • Other sources include banana, oatmeal, soybean and nuts

Third Trimester (From 6th to 9th month)

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Pic courtesy: http://www.fashionlady.in/extremely-important-must-have-foods-every-trimester/17136

In this trimester, the baby grows completely so the intake of nutrition also increases. Therefore, mom needs to have an extra of 2300 calories on a daily basis.

What to eat –

Try to consume 250ml of fruit juice on a daily basis. You should also consume low fat milk/yoghurt of the same quantity. Add wholemeal toasts with low fat cheese spread to your breakfast. And if you are a non-vegetarian then you should have 40gms of meat with raw vegetables regularly.

So those were some trimesterwise tips for expecting Moms.
Hope you found this post useful!

Intrauterine Insemination (IUI)

What is Intrauterine insemination ?

The technique of Intrauterine insemination (IUI) is a widely popular assisted reproductive technique due to its simplicity and affordability. The IUI procedure involves introducing washed and actively motile sperms directly into the uterine cavity (womb), at or around the time of ovulation, with the aim of increasing the chances of pregnancy. The purpose of IUI is to increase the number of active sperms reaching the egg in the fallopian tube, bypassing the vagina and cervix, thus, shortening the distance to be travelled by the sperms.

IUI is a simple procedure and can be performed whether or not the woman is receiving medication for egg formation. However, stimulation of egg development by medication does improve success rates, as more than one egg will develop. Monitoring by USG is essential to track follicular growth and to time the ovulation. Once the follicle reaches maturity, the patient is given hCG injection (human chorionic gonadotropin) for ovulation, which usually takes place within 24 to 36 hours of the injection.

IUI

Pic courtesy:  http://thefertilityblogs.com/trying-to-conceive/third-party-reproduction/what-is-an-iui/4201/


Who are eligible for IUI procedure?

To consider IUI :

  • The female partner should be ovulating normally or should be able to ovulate with medication for ovulation
  • She should have open fallopian tubes or at least one fallopian tube should be patent and

healthy

  • The male partner should have satisfactory sperm counts, motility and morphology

IUI not indicated in following conditions

  • Female partner with

– tubal block on both sides

– inability to develop eggs

– age > 40 years

– advanced stages of endometriosis

  • Male partner with azoospermia (absence of sperms in semen) or very low scores of sperm count, motility and morphology.

What is the procedure for IUI?

The total procedure has three components. One is semen collection, second is semen preparation and the third is deposition of active sperms in the uterine cavity. The entire procedure takes approximately 1 – 3 hours.

Semen collection and preparation

A short period i.e. 2 days of ejaculatory abstinence is advised prior to the scheduled IUI. At the predicted time of ovulation, the male partner is asked to collect semen into a sterile container and submit it in the laboratory for sperm preparation. Here semen analysis is performed to check for initial parameters. Then it is processed. Best quality active sperms are separated and made into a small quantity (0.25 ml). Rest of the seminal fluid containing dead sperms, bacteria and other components which can cause painful contractions of the uterus, is discarded. Post-wash active sperm count is noted for sample adequacy for insemination. Minimum count of five millions of active sperms is acceptable. Success rates are low with lower counts.

Actual IUI procedure

Once the specimen is ready, the female partner is called for IUI procedure to the insemination room. She is made to lie down on the couch with legs flexed. A speculum is introduced into the vagina to expose the cervix and it is gently cleaned. Prepared sperms are loaded into a slender semi flexible sterile catheter with a plunger. It is then passed through the cervix into the uterine cavity and the sperms are injected by pushing the plunger.

How much time does the actual IUI take and will it cause any pain?

Actual IUI (deposition of active sperms into the uterus) procedure takes only a couple of minutes. The procedure is usually painless, although 10% of the women may experience a menstrual cramp like pain. There may be a little vaginal spotting or discharge after IUI.


 

Is rest necessary after IUI?

The female partner will be asked to lie down for a few minutes after IUI (10 – 15 minutes). Then she can resume her regular activities. The sperms will not escape from the uterine cavity if she gets up.

Is intercourse advised after IUI ?

Yes, this will increase the chances of conception.

How many sittings of IUI are performed in one cycle?

Usually one single properly timed insemination is sufficient.

How many cycles of IUI are recommended?

Four to six cycles of IUI may be tried as there is no improved success seen later.

Chances of success with IUI

Average success rate ranges from 15-20 % in a single cycle. The success rates may be high in stimulated cycles and if the total sperm count is more than 20 million/ml.

What are the risks involved with IUI?

Procedure related complications are infrequent. They include infection where women can suffer with lower abdominal pain, vaginal discharge.

Hysterosalpingogram

What is Hysterosalpingogram ?

Hysterosalpingogram (HSG) is an X-ray test done to know about the patency of the fallopian tubes, which help in the transport of the egg and the fertilized embryo. It is usually done on 7th or 8th day of the menstrual cycle.

Hysterosalpingogram

Pic courtesy:   http://www.aiwhc.com/patient-education-hysterosalpingogram.html


Procedure and Instructions to be Followed for the Investigation

  1. In this test, a small amount of liquid (dye) is pushed into the uterus through a small instrument (speculum) placed in the vagina and an abdominal X-ray is taken. There can be period-like crampy pain during the procedure.
  1. To prevent pain, we advise Tab. Meftal spas to be taken with food, 1 hour before HSG and to continue it 8th hourly depending on the pain for the next two to three days.
  1. This test delineates the uterine cavity and the tubes. If the tubes are open, the dye flows out of the tubes and can be seen on the X-ray film.
  1. As this test involves pushing some liquid into the uterus, there can be a small risk of infection. In order to avoid this, we advise antibiotic Tab. Doxycycline 100 mg two times a day after food, starting from the day of HSG which has to be continued for a total of five days.
  1. Once HSG test is done, a gynaecology consultation (by appointment) with the report is advised.

Breast Cancer – Early Detection And Prevention

Breast cancer is now becoming the most common cancer in women in India. For the year 2015, there will be an estimated 1,55,000 new cases of breast cancer and about 76,000 women in India are expected to die of the disease. The gap only seems to be widening, which means, we need to work aggressively on early detection. (Statistics of Breast Cancer in India: Global Comparison)

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Pic Courtesy: http://www.discussingbreastcancer.com/breast-cancer-prevention-and-early-detection-tips/


Tips for prevention and early diagnosis

Exercise :

Women who exercise about 30 minutes, three to four times a week, can decrease the risk of breast cancer by 26%.

Breastfeeding Your Child :

Women who breastfeed their children will have reduced risk of breast cancer.

Maintaining Weight :

Women who gained 25 kgs above what they weighed after the age of 18 have 45% risk of developing breast cancer compared to women who maintained their weight.

Weight Loss After Menopause :

Women who reduced 10 kgs after menopause compared to pre-menopause weight also reduce their risk of developing breast cancer by 45%.

Avoid Alcohol :

Women who have 1 or 2 alcohol drinks a day increase their risk of breast cancer by 10%. Even moderate alcohol intake increases endogenous estrogen levels and provide a potential mechanism for breast cancer development.

Regular Screening After Age 40 :

Breast cancer, if detected early, can be cured completely. Monthly breast self-examination, yearly medical check and mammogram will detect cancer in its early stage. Monthly breast self-examination should start as early as in teens.

Eating Right :

A plant-based diet of at least two cups of a variety of vegetables or fruits is beneficial. There is evidence that minerals, vitamins, and phytochemicals in plant foods interact in different ways to boost an individual’s anticancer effects.

The top picks for cancer prevention include beans, berries, cruciferous vegetables (broccoli, cauliflower, cabbage, brussels sprouts), dark leafy green vegetables (spinach, mustard greens etc), flaxseed, garlic, grapes/grape juice, green tea, soy, tomatoes and whole grains.

Central Obesity :

Excess belly fat seems to be particularly harmful, most likely because of its effects on inflammation and its association with elevated insulin levels. So if you tend to be more “apple shaped” and carry extra weight in your belly, it is especially important to lose weight. Exercise regularly, and limit refined grains, sugar sweetened beverages, and added sugar in your diet.

Cerclage

Cerclage is a procedure wherein a suture (stitch or tape) is placed around the cervix (neck of the womb) in a purse string manner to keep the mouth of the uterus (womb) closed and avoid miscarriage. The exact cause of premature labour or late miscarriages is not clear, but they may be caused by changes in the cervix such as shortening and opening. A cervical suture helps to keep the cervix closed.

Cerclage

Pic courtesy: https://alittlebitofcancer.wordpress.com/tag/transabdominal-cerclage/

 

Types

Cerclage may be done using a suture or a tape.

  • Vaginal route – McDonald or Shirodkar
  • Abdominal route – open or laparoscopy

Shirodkar or abdominal cerclage may be advised in women who had a previously failed McDonald cerclage.

Indications

Planned (Elective): Women with previous second trimester pregnancy losses or prior cervical surgeries such as conisation/LLETZ (history-indicated) or short cervix on ultrasound examination (USG-indicated).

Rescue (Emergency): When the cervix is found to be open incidentally and the bag of membranes is exposed to the vagina.

Timing

  • It is usually done after 3rd month scan (NT scan) between 12 to 16 weeks of pregnancy.
  • It can be done laparoscopically in the interval period between pregnancies.

Hospital Stay

It can be done under regional (epidural or spinal) or general anaesthesia. The hospital stay may be 12 to 24 hours for vaginal cerclage and up to 3 days following open abdominal cerclage.

Complications

During Procedure

  • Bleeding
  • Bladder injury
  • Rupture of membranes and fluid leak

Post Procedure

  • Risk of miscarriage/premature labour
  • Infection (more for rescue cerclage)

Post Cerclage Care

Bleeding can be expected for a few days after the procedure. Physical strain and sexual intercourse must be avoided in the initial few days of recovery. Complete bed rest is not recommended. Routine antenatal care should be continued as advised.

Removal

For Vaginal Cerclage:

The suture has to be removed at 36-37 weeks of pregnancy and vaginal delivery can be allowed.

For Abdominal Cerclage:

Delivery is by planned Caesarean section at 38 weeks and the tape may be left in situ for future pregnancies. Removal of the tape may be advised in cases of premature labour, leaking/bleeding per vaginum or fetal demise, which would require additional procedures under anaesthesia.