Amniocentesis

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The foetus is surrounded by a water-like fluid known as amniotic fluid. This fluid contains the live cells of the foetus and other substances which are helpful in determining the health of the baby before birth.

Amniocentesis is a specialised medical procedure in which a small amount of amniotic fluid is taken out from the womb to perform a laboratory test. Usually, it is done between the 15th and 20th week of pregnancy. When done before 15th week of pregnancy, the chances of miscarriages or other complications increase. It is performed on those women who have the risk of genetic disorders.

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Need for amniocentesis

With the help of amniocentesis, the following things could be determined:

  • Genetic disorders or chromosomal abnormality: Genetic disorders like Down’s syndrome and sickle cell anaemia can be detected. Down’s syndrome has adverse effect on the mental and physical appearance of the baby and  in sickle cell anaemia the red cells are abnormally developed and lyse(break )easily.
  • Infection: It also helps to detect any kind of bacterial or viral infection in suspected cases

How is amniocentesis  done?

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Prior to amniocentesis, an ultrasound is performed which helps in detecting the position  and condition of the unborn baby .

Then under ultrasound guidance, a thin needle which is inserted into the uterus through the abdomen. And approximately 15 to 20 ml of amniotic fluid is withdrawn

The sample of the amniotic fluid is then tested in the laboratory.

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Risks of amniocentesis

Though amniocentesis is helpful in detecting the health of the unborn baby, it includes some risks to the mother. Following are some of the complications which may occur in pregnant women or in the baby:

  • Miscarriage: If amniocentesis is performed before 15 weeks of your pregnancy, the risk of miscarriage is higher.
  • Amniotic fluid leakage: It is very rare that the amniotic fluid leaks. And if it so happens, normally it stops within a week without having any effect on your pregnancy.
  • Injury during needle insertion: While performing amniocentesis, the unborn baby might move its leg or arm and get a little hurt. But it doesn’t cause any serious injury to the baby.
  • Transmission of infection: If you are suffering from any kind of infection like toxoplasmosis, hepatitis C or HIV, these infections may get transmitted to the foetus during amniocentesis.

Image Courtesy: www.manchesterob.com

 

Multiple Pregnancy (having more than one baby) at Fernandez Hospital

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2001-2015

One of the well-known speciality hospitals for women and babies in Hyderabad, Fernandez Hospital has been providing personalized care with a high level of professionalism since its establishment in 1948. More than one and a half lakh babies have been delivered since its inception.

Apart from single babies, the doctors at Fernandez Hospital have also very successfully delivered multiple babies. Though multiple pregnancies with twins are common, triplets and quadruplets are not only rare but also complicated cases. Maternal and neonatal morbidity and mortality, preterm birth and low birth weight are some of the complications related to multiple pregnancy. At Fernandez Hospital, if any complication arises during pregnancy they are handled very properly by skilled doctors making critical deliveries possible with normalcy.

Multiple pregnancies are known to be associated with the likelihood of pregnancy loss, preterm births, low birth weight babies and prolonged hospitalization. The expectant mother may develop high blood pressure or diabetes. In 2004, Fernandez Hospital found that there was enough evidence to support the need for a weekly special Out Patient Twins Clinic devoted to these mothers.

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The outcome of multiple pregnancy is much better with these dedicated clinics offering close monitoring and counseling. Fernandez Hospital presently provides two clinics a week as part of its obstetric care.  The Clinic screens monochorionic twins for TTTS and has successfully followed up patients post photocoagulation.During 2016, from January till October, 221 twins were delivered successfully at Fernandez Hospital. In fact, it’s a matter of pride that during this period, 8 sets of triplets and 1 set of quadruplets were also delivered. Handling such cases is not like the normal ones; they need extra monitoring along with specialists’ care and treatment. The doctors and other team members at Fernandez are so experienced and good at work that they make sure that no complications arise during childbirth and the delivery process is smooth keeping both mother and newborn healthy. The work of Fernandez Hospital doesn’t end here; proper postnatal care is taken till they are discharged from the hospital. Fernandez Hospital truly symbolises the epitome of mother and child care.

During 2016, from January till October, 221 twins were delivered successfully at Fernandez Hospital. In fact, it’s a matter of pride that during this period, 8 sets of triplets and 1 set of quadruplets were also delivered. Handling such cases is not like the normal ones; they need extra monitoring along with specialists’ care and treatment. The doctors and other team members at Fernandez are so experienced and good at work that they make sure that no complications arise during childbirth and the delivery process is smooth keeping both mother and newborn healthy. The work of Fernandez Hospital doesn’t end here; proper postnatal care is taken till they are discharged from the hospital. Fernandez Hospital truly symbolises the epitome of mother and child care.

Human Rights in Childbirth – A Global Movement A word from Dr. Evita Fernandez

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why-human-rights-in-childbirth-matter-cover-pageOver the past seven years, my views on childbirth practices have taken a 180 degree turn. Today, I am convinced we obstetricians in India need to UNLEARN a lot of what we have been taught, and we need to LISTEN more to the women we are privileged to serve.

I realized, to my horror and shame, that we have indeed been violating a woman’s human right with regard to childbirth. Every time we fail to share/offer honest evidence based information, fail to give her the freedom to make a choice, prevent her from having a birth companion, refuse to let her birth in the position she finds most comfortable, we are violating her rights.

With a birth rate of 22 million a year, India has an overwhelming volume of laboring mothers, in overcrowded, poorly staffed hospitals. With institutional deliveries being made mandatory, the majority of our women are subjected to “obstetric violence,” which translates into physical and verbal abuse by healthcare workers, who are ignorant and insensitive to woman-centered care. I admit to being that myself (ignorant and insensitive) particularly in my early years of training and as a young obstetrician. Compounding all of this is the utter lack of privacy, loss of dignity and respect. Our women, especially the voiceless poor, birth in appalling environments.

Human rights in childbirth has today become a global movement which is gaining strength, and rightly so. Women, doctors, lawyers, midwives and activists are coming together to offer solutions to help protect the basic human rights of birthing women. We in India need to wake up. All levels of health care workers involved in maternity services, need to wake up. We need to reflect, rethink, and change our attitude and understanding of childbirth practices.

Rebecca Schiller in her well researched and well written book “Why Human Rights in Childbirth Matter” says “Looking at how a society approaches childbirth, how it constructs a system around it, the rituals, the rites and the way it treats the key protagonist – the birthing woman – is akin to taking the temperature of that society. Nothing says more about the communities we live in than how they treat their most vulnerable at this extraordinary time.” – Rebecca Schiller, Why Human Rights in Childbirth Matter (Pinter & Martin Why It Matters 9)

India is hosting the International Human Rights in Childbirth Conference in February (2 – 5th) in Mumbai. I hope, it will help bring about the much needed change in attitude, practices, and more importantly, help build a network of support for women birthing in our country.

For more details about the Conference, please visit : http://www.humanrightsinchildbirth.org/event/india-2017/

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Human Rights in Childbirth – A Global Movement A word from Dr. Evita Fernandez

Fernandez Hospital Leave a comment

 

why-human-rights-in-childbirth-matter-cover-pageOver the past seven years, my views on childbirth practices have taken a 180 degree turn. Today, I am convinced we obstetricians in India need to UNLEARN a lot of what we have been taught, and we need to LISTEN more to the women we are privileged to serve.

I realized, to my horror and shame, that we have indeed been violating a woman’s human right with regard to childbirth. Every time we fail to share/offer honest evidence based information, fail to give her the freedom to make a choice, prevent her from having a birth companion, refuse to let her birth in the position she finds most comfortable, we are violating her rights.

With a birth rate of 22 million a year, India has an overwhelming volume of laboring mothers, in overcrowded, poorly staffed hospitals. With institutional deliveries being made mandatory, the majority of our women are subjected to “obstetric violence,” which translates into physical and verbal abuse by healthcare workers, who are ignorant and insensitive to woman-centered care. I admit to being that myself (ignorant and insensitive) particularly in my early years of training and as a young obstetrician. Compounding all of this is the utter lack of privacy, loss of dignity and respect. Our women, especially the voiceless poor, birth in appalling environments.

Human rights in childbirth has today become a global movement which is gaining strength, and rightly so. Women, doctors, lawyers, midwives and activists are coming together to offer solutions to help protect the basic human rights of birthing women. We in India need to wake up. All levels of health care workers involved in maternity services, need to wake up. We need to reflect, rethink, and change our attitude and understanding of childbirth practices.

Rebecca Schiller in her well researched and well written book “Why Human Rights in Childbirth Matter” says “Looking at how a society approaches childbirth, how it constructs a system around it, the rituals, the rites and the way it treats the key protagonist – the birthing woman – is akin to taking the temperature of that society. Nothing says more about the communities we live in than how they treat their most vulnerable at this extraordinary time.” – Rebecca Schiller, Why Human Rights in Childbirth Matter (Pinter & Martin Why It Matters 9)

India is hosting the International Human Rights in Childbirth Conference in February (2 – 5th) in Mumbai. I hope, it will help bring about the much needed change in attitude, practices, and more importantly, help build a network of support for women birthing in our country.

For more details about the Conference, please visit : http://www.humanrightsinchildbirth.org/event/india-2017/

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Dr. Evita Fernandez’s response on the article – “Can We Please Stop Telling Pregnant Women This?

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Original Article – “Can We Please Stop Telling Pregnant Women This?”

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I’m currently 29 weeks pregnant and have already lost track of the amount of times I’ve been told by people that ‘everything will be fine.’

Read complete article at:

Can We Please Stop Telling Pregnant Women This? | The Huffington Post

Dr.EvitaDr. Evita Fernandez’s response on the article – “Can We Please Stop Telling Pregnant Women This?”
When I was a young obstetrician and not as wise as I am today, I often spoke these lines “don’t worry- everything will be fine” believing at the time that it was. Indeed the truth.

Today, I LISTEN very very carefully to the unspoken words of the young mother before me. I do my best to understand her fears and help her work through it all. I have learnt to believe in maternal instincts; learnt to listen to women when they express a fear repeatedly. I also know that a pregnancy can go horribly wrong. Sometimes there are tell-tale signs to warn and prepare both sides. Sometimes, one does not get the luxury of time to prepare for a loss or morbidity affecting the mother or her newborn.

It is important for us obstetricians to give women the freedom to ask questions, to clarify doubts no matter how small they may appear and more importantly, to LISTEN and become aware of the unspoken fears.

May this article help us understand a different perspective. May it induce us to reflect and initiate change wherever necessary.

Lactation Techniques

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Breastfeeding is a natural process for women and provides a precious experience. However, breastfeeding your baby properly needs patience and practice to make the process enjoyable. Breastfeeding helps in building a special and intimate relationship between mother and baby. If you are a new mom, it is very essential that you know the right lactation techniques so that your baby gets fed properly.

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Proper positioning along with proper latching are the vital factors to make breastfeeding effective for both mother and baby. For the first few days, it might be a challenge for you to get the proper position for successful nursing. But as time passes, you will be able to achieve the right position which will help your baby to achieve the proper latch and feed properly. Good positioning will help you achieve the following things:

  • It will let your baby milk the breasts effectively.
  • Effective milking helps in stimulating the breasts, letting your body produce the exact amount of milk your baby needs.
  • Right positioning while breastfeeding helps in minimizing sore nipples and various other complications.

Normally, there are four positions that are used while breastfeeding a baby :

  • Traditional or cradle position: This is the most convenient position for most nursing mothers.
  • Cross-cradle position: This position is quite similar to the cradle position but the only difference is that it offers more control of the baby’s head.
  • Football or clutch hold: This position is very helpful for nursing mothers who have undergone C-section during childbirth.
  • Side-lying position: Though somewhat awkward, this position allows the mother and the baby to relax more, and even end up dozing off while breastfeeding.

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Based on the above mentioned positions, below are some lactation techniques that are helpful for breastfeeding your baby the right way:

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  • Sit comfortably on a chair with a back support and put your feet on a stool. It will help you to get a good posture, and prevent your neck and shoulders from getting strained. In this position, a proper latch could be attained allowing better breastfeeding.
  • While breastfeeding, relax your shoulders and bring your baby to your breast not your breast to your baby.
  • You should hold your baby close to you so that her nose touches your nipple, chin with your breast and bottom to your tummy.
  • While breastfeeding, provide support to your baby’s neck and shoulders with your hand so that your baby’s head does not push back.
  • You should support your breast underneath with the help of your fingers with touching the areolas and on top with your thumb.
  • While breastfeeding your baby, you should keep in mind to place the nipple at the centre of your baby’s mouth.
  • Make sure that your baby takes in not only the nipples but also areolas, as much as possible.
  • As your baby starts sucking the nipple, you can relax your shoulders but make sure to hold your baby close to you.
  • Once your baby starts learning the skills of milking, you can lie sidewise on bed with pillows around your head to support your shoulders. In this position, you can relax more while breastfeeding your baby.

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Blood Pressure During Pregnancy

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Carrying a baby in the womb and giving birth is a beautiful feeling that women get to experience. During pregnancy, it is quite natural that the blood pressure of women may fluctuate.

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Blood Pressure

The pressure at which blood is pumped throughout the body is known as blood pressure. Usually, blood pressure is measured in terms of the maximum pressure over the minimum pressure. In an adult, the normal resting blood pressure is 120/80 mm Hg (millimetres of Mercury) approximately.

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Pregnancy and Blood Pressure

When a woman conceives, there are changes in her body due to hormonal influence. Due to this, the blood pressure of the pregnant woman fluctuates. During the first and second trimester of pregnancy, blood pressure may be lower than normal.  And in some cases, blood pressure becomes higher than normal. And as time progresses, after delivery, blood pressure may return to normal.

So, it is very necessary that special attention should be given if you are suffering from high or low blood pressure during pregnancy.

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Types of High Blood Pressure During Pregnancy

  • Gestational Hypertension: When a pregnant woman develops hypertension after 20 weeks of pregnancy, and no other organs are affected, it is referred to as gestational hypertension.
  • Chronic Hypertension: When a woman has blood pressure before being pregnant or before the 20th week of pregnancy, then it is known as chronic hypertension (Pre-existing Hypertension).
  • Preeclampsia: Sometimes, gestational hypertension or chronic hypertension can lead to preeclampsia. Preeclampsia is a serious medical condition during pregnancy which is also known as toxaemia. It occurs after the 20th week of pregnancy which is characterized by high blood pressure along with signs of other organ system damage. Preeclampsia when left untreated may cause severe complications including death of the foetus.

Problems Caused Due to High Blood Pressure

High blood pressure during pregnancy, causes different types of health problems, including :

  • Fetal Growth Restriction: High blood pressure may result in slow growth of the baby, leading to low birth weight.
  • Premature Delivery: In order to prevent further complications due to high blood pressure, premature delivery may be necessitated.
  • Separation of Placenta: Due to preeclampsia, the placenta may get separated from the uterus before the baby is born. And when the placenta prematurely separates from the uterus heavy bleeding may occur which may be seen coming through the vagina. In some cases, separation of the placenta from the uterine wall may be life threatening for both the mother and the baby.
  • Eclampsia : Preeclampsia can lead to mother having seizures (fits / convulsions) that is called Eclampsia. This is life threatening for both the mother and the baby.
  • Multi-Organ Damage: Preeclampsia can affect all the organs of the mother – leading to multi-organ damage. Sometimes, any one organ like the kidney, liver or blood cell may be affected, and this may lead to premature delivery. The mother is also at risk of developing HELLP Syndrome (Hemolysis, Elevated Liver Enzymes, Low platelets).


What are the Symptoms of Preeclampsia

Preeclampsia, many times, may occur without any warning symptoms. It may be detected by your doctor during routine check-ups.

The symptoms of severe preeclampsia include:

  • Severe headache that doesn’t go away with simple painkillers
  • Problems with vision, such as blurring or flashing before the eyes
  • Severe pain just below the ribs
  • Heartburn that doesn’t go away with antacids
  • Rapidly increasing swelling of the face, hands or feet
  • Feeling very unwell.

Who is Likely to Get Preeclampsia? How to Prevent High Blood Pressure During Pregnancy:

Preeclampsia can occur in any pregnancy but you are at higher risk if:

  • Your blood pressure was high before you became pregnant
  • Your blood pressure was high in a previous pregnancy
  • You have a medical problem such as kidney problems or diabetes or a condition that affects the immune system, such as lupus.

If any of these apply to you, you should be advised to take low-dose aspirin (75 mg) once a day in pregnancy, to reduce your risk.

The importance of other factors is less clear-cut, but you are more likely to develop pre-eclampsia if more than one of the following applies:

  • This is your first pregnancy
  • You are aged 40 or over
  • Your last pregnancy was more than 10 years ago
  • You are very overweight – a BMI (body mass index) of 35 or more
  • Your mother or sister had preeclampsia during pregnancy
  • You are carrying more than one baby.

If you have more than one of these risk factors, you may also be advised to take low-dose aspirin once a day in pregnancy.

Treatment for High Blood Pressure During Pregnancy

If you are pregnant and suffering from high blood pressure, it is very necessary to seek your doctor’s advice.  Normally, a doctor may suggest the following in order to make your blood pressure normal and keep you and your baby safe.

  • Advise admission
  • Medications to lower high blood pressure
  • Offer frequent tests of your blood and urine
  • Monitor the health of the baby

So, it becomes very necessary to have regular check-ups during the gestation period. It will help you to know your health status and that of your baby. And if you are suffering from high blood pressure, your doctor will recommend certain things that you need to do.

Check-Ups and Tests to Get During Pregnancy

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It is very important for women who are pregnant to have regular check-ups either with a doctor or a midwife. There are certain types of tests and scans which are needed to be done during pregnancy. All these help in keeping track of your baby whether it is developing in a healthy way or not. Moreover, you also get to know about your health.

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For some women, pregnancy turns out to be well with no complications. But that doesn’t mean that you can skip those check-ups and tests. These procedures are not to be missed during pregnancy.

These are some of the prenatal tests and check-ups :

  • Routine Check-ups: During pregnancy, you have to visit your doctor many times for routine check-ups where certain types of urine and blood tests will be done. Your blood pressure will be checked and it will be determined through the blood and urine tests if you are suffering from gestational diabetes. All these tests are done to see if there are any problems which may create complications during pregnancy or during labour and to check the health of the baby, as well.

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  • Ultrasound: Every pregnant woman needs to do an ultrasound between 18 weeks and 21 weeks of pregnancy. This scan is known as Anomaly Scan which lets the doctor know if there is any structural deformity in the foetus. Ultrasound also helps in detecting :
  • If you are carrying a single baby or twins or more
  • The size of the baby
  • The health status of the baby
  • Position of the baby
  • Neural tube defects
  • Amniocentesis: It is a specialised procedure in which a small amount of amniotic fluid is taken from the mother’s womb. Normally, it is done between the 15th and 20th week of pregnancy and is performed on those women who have the risk of genetic disorders. It helps in assessing whether your baby has any chances of developing any birth defects or  has already developed some.

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  • Down’s Syndrome Screening: This test helps in assessing whether your baby has the risk of suffering from Down’s Syndrome.
  • CVS or Chorionic Villus Sampling: This is done for those pregnancies where the risk of the baby suffering from serious inherited disorders is higher. It is an alternative test to Amniocentesis and is done by taking a sample of cells from the placenta.

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Images Courtesy:

http://thenewageparents.com/

http://www.marchofdimes.org/

http://www.slideshare.net/

http://www.cryoviva.in/

Exercising for a Healthy Pregnancy

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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/