Articles on before pregnancy

Hypertension in Pregnancy

Dr. Pallavi Vasal, Gynecologist/Obstetrician
                                                                      Hypertension is defined as high blood pressure (B.P). A person has high blood pressure when the systolic pressure (the top number in BP reading) is greater than 140mmHg and the diastolic pressure (the bottom number) is greater than 90mm Hg.Hypertension can lead to many health problems. During pregnancy severe and uncontrolled hypertension can cause complications to both mother and baby.Causes of high blood pressure in pregnancy -1. Chronic hypertension - is high blood pressure that is present before the lady is pregnant or that occurs in first 20 weeks of pregnancy.2. Gestational hypertension – is high blood pressure that occurs during the second half of pregnancy that is after 20 weeks of pregnancy.3. Pre-eclampsia - is high blood pressure after 20 weeks of pregnancy associated with proteinuria (an abnormal amount of protein in the urine) . Pre-eclampsia is a serious BP disorder which can affect all the organs of a lady.The woman can present with complaints of severe headache, swelling over face and hands, changes in vision, vomiting, pain in upper abdomen or decrease urine output.The RISK of developing pre-eclampsia are more in women who -Are pregnant for the first timeHave had pre-eclampsia in previous pregnancy or have family history of pre-eclampsia.Are 40 years or olderHave multiple pregnancy (more than 1 baby in utero)Have history of chronic hypertension, kidney disease or both.Are obese IVF conceptionHave medical conditions such as diabetes, thrombophilias or lupus.RISKS  of high BP for baby -Growth restrictionPreterm deliveryPlacental abruption that is premature detachment of placenta (afterbirth) from the wall of uterusCaesarean deliveryIntra uterine deathHence it is very important for the lady who is planning to conceive or is pregnant to keep her BP within normal limits.PRECAUTIONS TO BE TAKEN FOR HIGH BP DURING PREGNANCY - Before Pregnancy-Keep the blood pressure under control. Reduce salt intake and do physical exercise. Loose weight if overweight .Lady needs to discuss with her doctor that she wants to become pregnant so that the doctor may change the medication to one which are safe in pregnancy or change the dose of medication if she is trying to conceive. 2) During Pregnancy-Take care of your diet that is a diet which is low in salts (avoid processed foods, pickles, pappad etc) and eat food rich in vitamin C, D and antioxidants.Lifestyle modifications that is exercise regularly .Walk and practice yoga if possible and keep weight gain under control.Avoid alcohol and tobaccoGo for antenatal check ups with your obstetrician and make sure that BP and urine are examined in each checkup. If the lady is feeling unwell any time during pregnancy , consult the doctor immediately.Being proactive and taking care of herself, going for regular prenatal and antenatal check ups, the lady with hypertension can deliver a healthy baby.

Pregnancy Diet: Things You Need to Know!

Dr. M.L.Kothari, Pediatrician
Foods to eatDuring pregnancy, the goal is to be eating nutritious foods most of the time, Krieger told Live Science. To maximize prenatal nutrition, she advises emphasizing the following five food groups: fruits, vegetables, lean protein, whole grains and dairy products. When counseling pregnant women, Krieger recommends they fill half their plates with fruits and vegetables, a quarter of it with whole grains and a quarter of it with a source of lean protein, and to also have a dairy product at every meal. Fruits and vegetables: Pregnant women should focus on fruits and vegetables, particularly during the second and third trimesters, Krieger said. Get between five and 10 "tennis ball"-size servings of produce every day, she said. These colorful foods are low in calories and filled with fiber, vitamins and minerals. Lean protein: Pregnant women should include good protein sources at every meal to support the baby's growth, such as meat, poultry, fish, eggs, beans, tofu, cheese, milk and nuts, Krieger said. Whole grains are an important source of energy in the diet, and they also provide fiber, iron and B-vitamins. At least half of a pregnant woman's carbohydrate choices each day should come from whole grains, such as oatmeal, whole-wheat pasta or breads and brown rice, Krieger said. Dairy: Aim for 3 to 4 servings of dairy foods a day, Krieger suggested, such as milk, yogurt and cheese, which provide good dietary sources of calcium, protein and vitamin D. In addition to a healthy diet, pregnant women also need a daily prenatal vitamin to obtain some of the nutrients that are hard to get from foods alone, such as folic acid and iron, according to ACOG. For women who take chewable prenatal vitamins, Krieger advised checking the product labels because chewables might not have sufficient iron levels in them.Foods to avoidAlcohol: Avoid alcohol during pregnancy, Krieger advised. Alcohol in the mother's blood can pass directly to the baby through the umbilical cord. Heavy use of alcohol during pregnancy has been linked with fetal alcohol spectrum disorders, a group of conditions that can include physical problems, as well as learning and behavioral difficulties in babies and children, according to the Centers for Disease Control and Prevention (CDC).Fish with high levels of mercury: Seafood such as swordfish, shark, king mackerel, and tilefish are high in levels of methyl mercury, according to the Academy of Nutrition and Dietetics, and should be avoided. Methyl mercury is a toxic chemical that can pass through the placenta and can be harmful to an unborn baby's developing brain, kidneys and nervous system. Unpasteurized food: According to the USDA, pregnant women are at high risk of getting sick from two different types of food poisoning: listeriosis, caused by the Listeriabacteria, and toxoplasmosis, an infection caused by a parasite.The CDC reports that Listeria infection may cause miscarriage, stillbirth, preterm labor, and illness or death in newborns. To avoid listeriosis, the USDA recommends forgoing the following foods during pregnancy: Unpasteurized (raw) milk and foods made from it, such as feta, Brie, Camembert, blue-veined cheeses, queso blanco and queso fresco. Pasteurization involves heating a product to a high temperature to kill harmful bacteria. Hot dogs, luncheon meats and cold cuts unless heated before eating to kill any bacteria. Store-bought deli salads, such as ham salad, chicken salad, tuna salad and seafood salad. Unpasteurized refrigerated meat spreads or pates.Raw meat: A mother can pass a Toxoplasma infection on to her baby, which can cause problems such as blindness and mental disability later in life, reports the CDC. To avoid toxoplasmosis, the USDA recommends avoiding the following foods during pregnancy: Rare, raw or undercooked meats and poultry. Raw fish, such as sushi, sashimi, ceviches and carpaccio.Raw and undercooked shellfish, such as clams, mussels, oysters and scallops.Some foods may increase a pregnant woman's risk for other types of food poisoning, including illness caused by salmonella and E. coli bacteria. Foodsafety.gov lists these foods to avoid during pregnancy, and why they pose a threat. Raw or undercooked eggs, such as soft-cooked, runny or poached eggs. Foods containing undercooked eggs, such as raw cookie dough or cake batter, tiramisu, chocolate mousse, homemade ice cream, homemade eggnog, Hollandaise sauce. Raw or undercooked sprouts, such as alfalfa, clover. Unpasteurized juice or cider.Pregnancy diet misconceptions:Morning sickness: When a mother-to-be is experiencing morning sickness, the biggest mistake she can make is thinking that if she doesn't eat, she'll feel better, Krieger said. The exact causes of morning sickness are not known, but it may be caused by hormonal changes or lower blood sugar, according to the Mayo Clinic. It can bring on waves of nausea and vomiting in some women, especially during the first three months of pregnancy. And "it's definitely not happening only in the morning," Krieger said. "It's any time of day." It's better to eat small amounts of foods that don't have an odor, since smells can also upset the stomach, she suggested.Food cravingsIt is common for women to develop a sudden urge or a strong dislike for a food during pregnancy. Some common cravings are for sweets, salty foods, red meat or fluids, Krieger said. Often, a craving is a body's way of saying it needs a specific nutrient, such as more protein or additional liquids to quench a thirst, rather than a particular food, she said. Eating for twoWhen people say that a pregnant woman is "eating for two," it doesn't mean she needs to consume twice as much food or double her calories." A woman is not eating for two during her first trimester," Krieger said. During the first three months, Krieger tells women that their calorie needs are basically the same as they were before pregnancy, because weight gain is recommended to be between 1 and 4 pounds in this early stage of pregnancy. Krieger typically advises pregnant women to add 200 calories to their usual dietary intake during the second trimester, and to add 300 calories during their third trimester when the baby is growing quickly. Weight gain during pregnancy, "Weight gain during pregnancy often has an ebb and a flow over the nine months," Krieger said. It's hard to measure where pregnancy weight is going, she said, adding that a scale does not reveal whether the pounds are going to a woman's body fat, baby weight or fluid gains. When it comes to pregnancy weight gain, Krieger advises mothers-to-be to look at the big picture: During regular prenatal checkups, focus on that the baby is growing normally rather than worrying about the number on a scale. The total number of calories needed per day during pregnancy depends on a woman's height, her weight before becoming pregnant, and how active she is on a daily basis. In general, underweight women need more calories during pregnancy; overweight and obese women need fewer of them. The Institute of Medicine (IOM) guidelines for total weight gain during a full-term pregnancy recommend that: Underweight women, who have a Body Mass Index (BMI) below 18.5, should gain 28 to 40 lbs. (12.7 to 18 kilograms). Normal weight women, who have a BMI of 18.5 to 24.9, should gain 25 to 35 lbs. (11.3 to 15.8 kg). Overweight women, who have a BMI of 25.0 to 29.9, should gain 15 to 25 lbs. (6.8 to 11.3 kg).Obese women, who have a BMI of 30.0 and above, should gain 11 to 20 lbs. (5 to 9 kg). Rate of weight gain: The IOM guidelines suggest that pregnant women gain between 1 and 4.5 lbs. (0.45 to 2 kg) total during their first trimester of pregnancy. The guidelines recommend that underweight and normal-weight women gain, on an average, about 1 pound every week during their second and third trimesters of pregnancy, and that overweight and obese women gain about half a pound every week in their second and third trimesters of pregnancy. Twins: The IOM guidelines for pregnancy weight gain when a woman is having twins are as follows:Normal weight: 37 to 54 lbs. (16.7 to 24.5 kg). Overweight: 31 to 50 lbs. (14 to 22.6 kg). Obese: 25 to 42 lbs. (11.3 to 19 kg). This article is for informational purposes only, and is not meant to offer medical advice.

Reasons Why Pregnancy Sex Is Not Only Healthy, but Why It Might Be Even Better Than Before.

Dr. Amar Deep, Homeopath
1. An easier labor and recoveryHaving an orgasm increases the contractions in your pelvic floor, which help to strengthen the muscles you’ll need for labor and after delivery.2. Less bathroom breaksFeel like you always have to pee? Frequent trips to the bathroom, even leaking when you sneeze or laugh can happen when you’re pregnant.  Plus, as your baby gets bigger and presses on your bladder, it can be even more uncomfortable. The good news is that the same muscles that you’ll be strengthening for your labor can also help with the flow of urine.3. Complication preventionAccording to a Danish study , frequent sex may help prevent pre-eclampsia. Researchers believe it’s because of a protein found in sperm that can regulate the body’s immune system. Yet because the cause of pre-eclampsia is unknown, it’s important to keep your prenatal visits and talk to your doctor about your risk.4. Lowered blood pressureAlthough your blood pressure may be lower right after having sex, it’s only temporary so the cure isn’t sex all the time. Since high blood pressure can be serious for both you and your baby, it’s important to work with your doctor on ways to prevent or control your blood pressure.5. Better orgasmsSince your body’s nerve endings are more sensitive, your nipples and clitoris are engorged, and there’s more estrogen drawing blood flow to your pelvis, it’s usually easier to achieve orgasm and they’re also longer and stronger, women who had trouble having an orgasm prior to pregnancy may now find they no longer do.  6. Improved self-esteemWith all the changes that happen during pregnancy, it can feel that your body is no longer your own. Yet having sex can help restore your body confidence and positive feelings about yourself.7. Stress reductionAlthough pregnancy is usually a happy time, it’s normal to worry about things like work, finances and how your life will change after your baby is born. Oxytocin, the love hormone that your body releases when you have an orgasm, can help to negate some of that stress and also help you sleep better.8. Improved connectionsHaving frequent sex now will help strengthen the intimate relationship and bond you have with your partner and establish a healthy habit for the future.9. Preparation for laborIf you’re full-term or past your due date, having sex won’t put you into labor,but it can help your body prepare because semen contains prostaglandins which can help ripen the cervix.

Tips for a Safe Pregnancy and Post Pregnancy Care

Dr. Sonica Chugh, Gynecologist/Obstetrician
Carrying your baby in your womb is the most beautiful experience and a precious period that a mother can enjoy in her life time. Concern for your baby’s health, well being and one’s own health is key to have a safe and healthy pregnancy.Diet during Pregnancy:Good nutrition during pregnancy ensures your baby gets the right start. Small, frequent and healthy meals containing folate, iron, calcium, zinc and omega-3 fatty acid should be taken. Plenty of water in between the meals is good for you and your baby. You don’t need to eat for two, rather your calorie intake during first six months should be more or less the same (pre pregnancy state), while increase in only 200 calorie/day during the last three months is recommended.Working women can take nuts and fruit salads as mid meal snacks and homemade lunch instead of going out to the mall or restaurant for lunch. Road travel of any kind is safe, provided, you are careful of bumpy roads and unruly traffic. You have to be more careful if there is associated high blood pressure, diabetes or history of previous premature delivery.Exercise, Meditation and Yoga:Pregnancy is not a time to start a rigorous regime or to gain or lose weight. A normal walk of 20-30 minutes without getting exhausted will help. Deep breathing exercises in fresh air are recommended. Yoga should also be a part of your life as it relaxes and calms you and your baby throughout the pregnancy. This also relieves tension and also builds up stamina by increasing circulation which enhances immunity and health. Light kegels exercises (Pelvic floor exercises) prepare you for easy child birth and labour management. Post Pregnancy Care: First 40 days are meant for you to recuperate, gain strength and bond with your baby. Resting and eating well is important during this time. Although rest may not be easy for you and with the newborn baby as you have to feed every two hours and change diapers frequently. Your mum, mum-in-law or trained maids can be of help during this period.Breastfeed exclusively for six months. You need to have a good diet during pregnancy (calories intake would increase to 330 calories/day). Therefore immediate and fast weight reduction should not be targeted. Eating healthy food will only reduce weight sensibly.Opt for moderate intensity physical activity, walk for 25-30 minutes, do abs exercise, pelvic floor exercise and stretching without resuming high impact activity post delivery. If your delivery has been uncomplicated it will help your body regain its normal strength. Gentle body massage will also help you and your baby. Do not resume your normal working routine or a heavy gym schedule immediately after delivery.

Vegetarian Pregnancy Diet

Ms. Swati Kapoor, Dietitian/Nutritionist
What’s that on the telly? It’s an angel sent from GodGrowing in my belly…!!Like a sweet pea in a pod(Malissa  Hatcher)Even though everyone will advise you to eat for two, the average woman does not need any extra calories during the first six months of pregnancy. Your body actually becomes more efficient at extracting the required energy and nutrients from your diet when you're expecting a baby. Even in the last few months, you only need about 200 extra calories per day.Many vegetarian pregnant women worry about the effect their diet may have on their developing baby during pregnancy. However, with careful meal planning, there may be no need for concern."Vegetarian pregnancy diet can provide the mother and baby with all the proper nutrients they need," says Rachele Dependahl, RD, a dietitian at Cedars-Sinai Medical Group in Beverly Hills, Calif.These nine months may be the most challenging months of your life. With your body undergoing a number of changes, you need to be extra careful about yourself as well as your surroundings. And watching your vegetarian pregnancy diet should be on top of your top list.The Pros of  Vegetarian Pregnancy Diet -There are many positive aspects to maintaining a vegetarian diet during pregnancy. For instance, vegetarian sources of protein are easier on the kidneys. And being a vegetarian can help keep tooth decay — a common problem during pregnancy — at bay. In addition, vegetarian eating, in general, lowers the risk of the following conditions:- Obesity- Hypertension- Constipation- Heart disease- Type 2 diabetes- Cancer- GallstonesAnother plus to being a vegetarian, says Martha K. Grodrian, RD, a nutrition therapist at Good Samaritan Hospital in Dayton, Ohio, is that "most vegetarian women eat fewer junk foods and a more nutritious diet."The Cons Vegetarian Pregnancy Diet -A vegetarian diet during pregnancy can be a healthy option, though it requires a little more effort."It may take more work and effective meal planning to follow a vegetarian diet that is healthy during pregnancy," says Grodrian. In general, the more foods a vegetarian omits from the diet, the more difficult it is to meet nutrient needs." However, dietary supplements may be able to fill the void.A lacto-ovo vegetarian (one who also eats dairy and eggs) can get all the nutrients she needs for a healthy pregnancy through diet and a multivitamin/mineral supplements. A vegan, on the other hand, who avoids all animal products, will need to take supplements of vitamin B12 and iron and might want to take calcium, zinc, and vitamin D, too.Vegetarian Pregnancy Diet - Nutritional GuidelinesNutritional guidelines for pregnant vegetarians are the same as for non-vegetarian women who are expecting. "All pregnant women need additional iron, calcium, folate, essential fatty acids such as DHA (which can be obtained in a vegetarian form), zinc, protein, and 200 to 300 calories more than pre-pregnancy," says Grodrian.Specifically, vegetarian pregnancy diet should include  the following:- Six to eleven  servings per day of bread, cereal, rice, and pasta (choosing whole grain when possible)- Four to five servings per day of vegetables. Four or more servings of fruits- Eight servings of milk and milk alternatives (one cup of cooked kidney beans as a milk alternative, for instance).- Three to four servings of beans and bean alternatives.- Two servings of omega-3 fats for DHA (found in flax-seed oil, walnuts, tofu, and omega-3 fortified eggs, among other places).- Fats, sweets, and junk food should be eaten sparinglyPregnant women should be careful to avoid the following foods:- Unpasteurized soft cheeses (such as brie, Camembert, and feta) and unpasteurized milk, because they carry the risk of listeriosis (a food-borne illness caused by bacteria).- Raw vegetable sprouts and fresh unpasteurized fruit and vegetable juices, which can contain bacteria like E. coli and salmonella.

3 Simple Ways to to Avoid Unwanted Pregnancy

Dr. Himani Gupta, Gynecologist/Obstetrician
1. Use protection - Prevention is always better than cureIndian social scenario is changing - Pre- marital, extramarital and living in relationships are on a riseAt times these relationships are casual and will lead to unwanted pregnancyAt the end of it, it is the female's body which will bear the brunt of physical discomfort of abortionThere are many myths in people's minds regarding use of regular contraceptive methods like oral contraceptive pills, condoms or Copper - TWhether a couple is married or unmarried when these regular contraceptive methods are used, unwanted pregnancy can be avoidedA consultation with the Gynaecologist for check up and to understand their correct use is a must and will allay your anxieties and concernsA word of caution here about Emergency Contraceptive Pill It is clear that these pills are for emergency situationsCouples in steady relationship should adopt regular contraceptive methodThese emergency pills have very high content of hormonesUsing them can make your next menses irregular, delayed and heavyThey should be taken ONLY on advice of a Gynaecologist2. Be alert - For early diagnosis of unwanted pregnancyAs soon as you have missed your periods, check yourself for pregnancyEasiest method is to do a urine pregnancy test done at home in a kit easily available at ChemistThe instructions to do the tests are also clearly written on packet Advanced tests for diagnosis of pregnancy can be done on your Gynaecologist 's advice like a test in blood known as Serum Beta HCG and sonography3. Timely treatment - See a Gynaecologist at earliestWhen we talk about unwanted pregnancy, it is clear that couple wants terminationGovernment of India has made guidelines to offer safe abortion to all who seek it, regardless of marital statusThere are two ways of undergoing abortion:A. Surgical D&C - This is traditional way and will require a day's time hospitalization.- If done in Govt approved MTP (Medical Termination of Pregnancy) center, it is safe B. Abortion by pills- If clinical situation is of early pregnancy and within the limit set by Govt of India, oral abortion pills  can be taken on advice of a Gynaecologist- There are no risks of anesthesia and surgical instrumentation in this method and no hospitalization is required

Pregnancy Diet

Ms. Swati Kapoor, Dietitian/Nutritionist
Pregnancy is the most beautiful phase in a woman's life. It brings both emotional and physiological changes as well as it also poses extra demands on the body. In this phase the body needs extra nutrition for the developing fetus, for pregnant woman herself and also the lactation period to follow. Pregnancy Diet must be full of nutrition and healthy also.Importance of Nutrition in The Diet in PregnancyThese nutritional demands have to be met for a healthy child and mother because as the week progresses the organs and other system of the fetus start developing in mother’s womb and thus the energy used to create these systems (which actually comes from the energy and nutrients in the mother's circulation, and around the lining of the womb) also starts to increase. The table below highlights the nutrients, its importance and food sources which should be included in a women's pregnancy diet -NUTRIENTSIMPORTANCEFOOD SOURCES Protein cell growth and blood productionlean meat, fish, poultry, egg whites, beans, tofuCarbohydrates daily energy productionbreads, cereals, rice, fruits, vegetablesCalcium strong bones and teeth, muscle contraction, nerve function milk, cheese, yogurt, spinachIronred blood cell production (to prevent anemia)All green leafy vegetables e.g. spinach, methi and whole-grain cerealsVitamin A healthy skin, good eyesight, growing bonescarrots, dark leafy greens, sweet potatoesVitamin C healthy gums, teeth, and bones; assistance with iron absorption citrus fruit, broccoli, tomatoes, amla, guavasVitamin B6 red blood cell formation; effective use of protein, fat, and carbohydratespork, ham, whole-grain cereals, bananasVitamin B12 formation of red blood cells, maintaining nervous system healthmeat, fish, poultry, milk(Note: vegetarians who don't eat dairy products need supplemental B12)Vitamin D healthy bones and teeth; aids absorption of calcium fortified milk, dairy products, cereals, and breadsFolic acid blood and protein production, effective enzyme function green leafy vegetables, dark yellow fruits and vegetables, beans, peas, nutsFatbody energy stores meat, whole-milk dairy products, nuts, peanut butter, margarine, vegetable oils(Note: limit fat intake to 30% or less of your total daily calorie intakeRecommended Nutrients in The Diet in PregnancyNutrientRecommendation (Extra = Above RDA)EnergyIncrease by 300 kcal (840 kJ) per day. Certain guidelines according to trimester.1st trimester (1 to 12 weeks) - 10 kcals/day 2nd trimester (13 to 27 weeks) - 90 kcals/day 3rd trimester (27 to 40 weeks) - 200 kcals /day.ProteinsExtra 15 gms per dayThiaminIncrease in line with energy; increase by 0.1 mg per dayRiboflavinNeeded for tissue growth; extra 0.3 mg per dayNiacinRegular supplementation/diet of substance. No increase required.FolateMaintain plasma levels; extra 100 µg per dayVitamin CReplenish drained maternal stores; extra 120 mg per dayVitamin DReplenish plasma levels of vitamin 10 µg per day.CalciumNeeds no increaseIronExtra 3 mg per day neededMagnesium, zinc, and copperNormal supplementation or consumption.IodineExtra 100 µg per day.Foods To Avoid During Pregnancy- Skip aerated or caffeine based beverages like coffee, tea and colas. Too much caffeine may affect the growth of baby. A recent study said that pregnant women who consume even about a cup of coffee everyday are at a higher risk of giving birth to an underweight baby.- Avoid eating foods that have been prepared with maida.- Try and cut down on eating foods that are high in sugar content.- Sea-food that is high in mercury should be strictly avoided. Swordfish, shark and king mackerel are among these. Raw fish may contain listeria, a bacteria that can cause food poisoning. While canned seafood is considered safe, skip smoked or frozen seafood like oysters, sushi, sashimi, and smoked salmon.- Unpasteurized milk may contain listeria, which can cross the placenta and lead to infection or blood poisoning in the baby. Ensure that the milk you drink is pasteurized.- Stay away from mould-ripened cheese (cheese that has a blue vein in it) like brie or camembert. Make sure you cook raw eggs. When the eggs are cooked, see that the yolk and white are firm.- Avoid the consumption of smoking and drinking in day to day routine.Healthy Pregnancy Diet Tips:-- Have a piece of fresh fruit for a mid-morning or afternoon snack, instead of reaching for chocolates or biscuits.- By carrying a small bottle of water when you are out ensures you are well hydrated, and not tempted by sugary soft drinks.- Each week, prepare a couple of meals using beans, lentils and pulses.- Add in your diet different healthy grains, such as barley, couscous or brown rice, in order to give variety to your favorite recipes.- Choose low-fat dairy productsIt is important to note that being pregnant doesn't indicate that the mother to be has to consume food for two individuals, as she is supporting a life within her. The key to a healthy pregnancy is to consume a balanced diet with light and frequent meals throughout, and to regularly take the supplements or medicines prescribed by the doctor. One should also try, and be active, for e.g., go for walks or light swimming or do pregnancy specific yoga [under supervision].

Oral Health Complications During Pregnancy

Dr. B.N. Prasad, Dentist
Recent findings have reported that oral bacteria and their by-products can possibly pass the placental barrier keeping oral health at prime importance during pregnancy. An awareness related to oral health during pregnancy cannot be neglected or avoided in order to minimize the complications.This article focuses on few points related to the necessity of oral health during pregnancy. Pregnancy comes with many responsibilities making expecting mothers more concerned about their health. However, many pregnant women may not be aware of oral health and its effect on the developing child.  Negligence of oral health is quite common during pregnancy due to lack of alertness of oral hygiene and its effect on systemic health.Moreover, pregnancy discomforts like frequent bouts of nausea, increased physical demands, weight gain or certain dental problems like pregnancy gingivitis or inflammation of gums may be dangerous to developing fetus.  Risk of oral problems during pregnancy:-Few common oral problems associated with pregnancy are as follows. Pregnancy Gingivitis: Hormonal changes during pregnancy leads to pregnancy gingivitis. It is a condition of bleeding gums, redness. Moreover inflammation, swelling and tenderness are also observed. Ignorance of such problems may lead to serious gum disease.  Frequent cleaning can avoid such dental issues. Progesterone levels are elevated during pregnancy which stimulates the production of prostaglandins and leads to inflammation of blood vessels in gums.Tooth Decay:Diet during pregnancy is of high importance. It is designed to nourish both mother and unborn baby. Diet rich in carbohydrates actually increases the risk of tooth decay. The morning sickness increases acid secretion in the mouth which is harmful to enamel. Pregnancy tumors: Overgrowth of tissue on gums in pregnant women are called as pregnancy tumors. They are noncancerous and generally observed in the second trimester of the gestation period. It is nothing but swollen gums between teeth. The bleeding and reddening of gums observed in such conditions.  Periodontal disease and preterm birth:untreated gum disease or periodontal problems can development periodontitis characterized by inflammation and infection of the gums and supporting structures of the teeth. This ultimately leads to loss of supporting material and finally the teeth themselves. A study result has revealed that there is a relation between preterm birth and presence of gum diseases in the pregnant women. The reason is not yet known. However, research study findings have evidence that oral bacteria or their byproducts can pass placental barrier. This initiate inflammatory response leading to preterm birth. Another correlation exists between the gum disease and the increased rate of pre-eclampsia, a condition of high blood pressure during pregnancy. The positive correlation suggests that gum disease may cause stress to the blood vessels of the mother, placenta and the fetus.The basic periodontal therapies like oral hygiene instructions, scaling, root planing and prophylaxis can substantially decrease the level of prostaglandin responsible for inflammatory response. The regular treatment and follow-up in pregnant women can maintain good oral health and minimize the risk of preterm birth. Dental treatment during pregnancy: The dental procedures mostly include the use of X-rays and use of anesthesia. In the case of pregnancy, these procedures can be used with precaution. Therefore, before sitting on dental chair patient should declare her pregnancy to the physician. Untreated dental infections can harm fetus as well as the mother. The emergency situations request use of dental radiographs which can’t wait. The radiation of dental x-ray is generally very low and precaution is always taken for lowest radiation exposure. A leaded apron including collar, shields can be used to prevent abdominal exposure to the x-ray radiation. Use of dental X-ray is not at all contraindicated in pregnancy when used with precaution. The use of local anesthesia is also not contraindicated in the pregnancy. A clinical trial result showed that there is no harm in the use of local anesthetics during pregnancy. It is not linked with increased risk for major medical problems like cerebral palsy, cleft lip and heart defect in newborns. The medication prescribed during dental treatment mainly includes local anesthetics, analgesics, and antibiotics. Most of them can be used with safety precautions. Each drug has its own pregnancy category which should be considered during its use. The antibiotic like tetracycline can permanently cause discoloration of developing teeth.  Prevention: Dentists can educate patients with following points to avoid problems associated with oral hygiene. The patient should declare the pregnancy to  the Dentist Follow routine oral checkup. Undergo all elective and emergency procedures. Follow good oral hygiene practice ask for a better toothpaste.In the case of morning sickness avoid sweets and snacks which increase the risk of tooth decay. Have healthy and balanced diet. Awareness of oral health during pregnancy is a must to avoid complications.

10 Things to Avoid in Pregnancy

Dr. Sujoy Dasgupta, Gynecologist/Obstetrician
Pregnancy is a journey of a woman from womanhood to motherhood. Each and every pregnancy is precious and so women usually remain anxious about their lifestyle and food habits. Most of the pregnant mothers do not hesitate to sacrifice their comfort and habit, only to keep their baby safe. Here are the few tips which describes what are the common food items that must be avoided in pregnancy.  1) Some fishesFishes are integral part of most of the non-vegetarian Indian dishes. Majority of the fishes are not harmful, rather most of them (particularly fresh water fishes) are rich in protein and omega-3 fatty acid, that helps in brain development of the baby.You must take those. But remember, always take well cooked fishes. Avoid raw fishes like “Sushi” as they are likely to contain bacteria and parasites, causing stomach upset, that can lead to early labour and even damage the baby by causing premature delivery. Avoid refrigerated and smoked sea fish and other seafood as they are likely to be infected with a harmful bacteria, called listeria. Listeria infection is notorious for causing fever and infection in mother. More importantly, it can pass into the baby causing miscarriage, serious infection and even death, either before delivery or immediately after delivery.Avoid fishes containing mercury and other pollutants,particularly, big fish like shark, shellfish,  salmon, tilefish, king mackerel etc because they contain higher levels of mercury which can harm an baby’s immature nervous system. 2) Some dairy productsWhile intake of properly pasteurized and boiled milk is highly recommended, if you can tolerate it, because of high energy, carbohydrate, protein, fat and mineral content; raw milk, unpasteurized milk should be totally avoided, as they may contain harmful bacteria, particularly listeria, as mentioned earlier. Similarly, soft cheeses should not be taken in pregnancy.  3) Alcohol and smokingExcessive alcohol in pregnancy can cause ‘fetal alcohol syndrome’, characterized by abnormalities in face, heart, brain etc and evenmental retardation. These babies are likely to have growth disturbances. . Smoking can cause miscarriage and low birth weight of the baby that may even cause still birth. Passive smoking is also equally important. So, both mother and father should avoid smoking. 4) CaffeineExcessive caffeinated food can be a cause of miscarriage. Do not take more than 2 cups (or 200 mg) of coffee per day. 5) Under-cooked meat and eggsThese can cause food poisoning, as well as listeriosis. Also, there is chance of transmission of a parasite, toxoplasma, which can cause miscarriage, still birth and abnormalities in the baby (problems in heart, brain, eye, intelligence etc). Cook eggs until the yellow and white parts are firm. It’s better to avoid restaurant foods. 6) Unwashed fruits and vegetablesThese items may carry certain bacteria that can lead to stomach upset. They are also known cause of causing listeriosis, as explained above. Avoid long refrigerated vegetables and salads made in restaurant. Raw vegetable sprouts, often taken for high minerals and protein, should be avoided as they may also harbor harmful bacterias.   7. Some juicesAvoid fresh and raw juices as they may contain harmful bacteria like listeria and even toxoplasma. Choose packaged juices as they arepasteurized and are kept under refrigeration.8. Fatty FoodsWhile some fat is needed for brain growth and energy of the baby, excess fat may cause excessive weight gain that may increase the risk of high blood pressure and even diabetes, both can affect mother and baby. Mothers with excess weight are more likely to have premature delivery, problems during delivery and infection. Again repeated cooking of fatty food should be avoided, as it is more harmful to both.9. Herbal supplementsBecause their safety during pregnancy is not known, it’s best to avoid herbal supplements during pregnancy. This also includes herbal tea. . 10. DrugsDo not take any drugs without consulting your doctors, whatever problem you are having.Even avoid excessive vitamin use as excess dose of vitamin A can damage the heart, face and brain of your baby and make it mentally handicapped. Some painkillers can cause heart defects in the baby. Some antibiotics may also be unsafe.