Articles on complications of pregnancy

Effects of Smoking in Pregnancy: A Serious Threat

Dr. Sujoy Dasgupta, Gynecologist/Obstetrician
You all know that tobacco causes cancer - cancers in almost all the organs of our body.But what else? can it affect your sexual and reproductive life?In females - it causes problems in menstruation, irregular periods and abnormal amount of bleeding. In addition, it causes difficulty in having baby - by interfering with normal hormone release. Even if pregnancy occurs, the ending may not be a happy one. It is responsible for repeated pregnancy loss (repeated miscarriages), ectopic pregnancy (pregnancy outside the uterus - that cannot survive, on the other hand it can endanger the mother's life). It also causes abnormal bleeding in pregnancy by early separation of placenta (the flower) and thus endangering life of both mother and baby. It is also responsible for inadequate growth of baby inside the uterus. This can result in early delivery (premature baby), low birth weight, permanent damage to baby's brain (mental retardation) and other organs, even death of the baby before or soon after birth. Tobacco also causes early rupture of membranes during pregnancy ("breaking of water") causing preterm delivery and infection. As a result of hormonal deficiency caused by tobacco, there may be infertility and other hormonal problems like sexual dysfunction (dryness especially), discomfort in passing urine and bone pain (all due to hormone deficiency). In older women it can cause prolapse (coming down of uterus outside).In males- tobacco is responsible for low sperm count, low motility and abnormalities in sperms. The result is male infertility.It can also cause hormonal problems in males leading to sexual dysfunction and bone loss.It is responsible for erectile dysfunction and also premature ejaculation. So, the decision is yours whether to choose tobacco or to choose life.

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.

How to Cope With Skin Changes During Pregnancy

Dr. Karuna Soni, Dermatologist
You're positively glowing! You must be pregnant! While it is flattering to receive compliments like these from everyone during pregnancy, what's not so great are the other visible changes your skin undergoes when you are pregnant. Skin changes during pregnancy can be rather noticeable, but the good news is that most of these can just as easily be managed with a few simple home remedies.Here are a few for you to try out yourself:Stretch MarksThis one definitely tops the list of the skin changes pregnant women experience. There are many creams and lotions that will claim to reduce or eliminate the appearance of stretch marks entirely. However, the truth is that there is very little substance to their claims. Instead of these, you can try applying aloe vera pulp to reduce the appearance of stretch marks. You will not be able to get rid of them completely. But these marks are usually known to go away by themselves after you deliver. Being patient is the key.The Mask of PregnancyPregnant women are often known to develop dark spots, or even black patches on their face. This is also commonly known as 'the mask of pregnancy.' Using a sunscreen daily, even if you mostly stay indoors, can help you fix this problem. You can also apply things like cucumber, tomato or lime juice mixed with milk on the darkened areas for results.AcneIf you thought you were done with acne in your teenage years, think again! Many pregnant women have a relapse of acne as their hormone levels change during pregnancy. You should cleanse your skin regularly with a mild soap or face wash, using lukewarm water. If you have dry skin, use an oil free moisturizer. Avoid using topical acne creams as they are usually unsafe during pregnancy.Spider veinsThese are the small red. blue or purple veins that are easily visible through our skin. They usually appear on legs or faces. To reduce the chances of spider veins appearing, protect yourself from extremes of cold or heat. Continuous exposure to either of these can make the problem of spider veins worse.While you might also experience several other changes in your skin during your pregnancy, you can take comfort in the fact that almost all these conditions will automatically sort themselves out once you have given birth. You have exciting days ahead of you, you should keep your energies focussed on that!

High BP in Pregnancy & It's Bad Effects on Mother & Child

Dr. Himani Gupta, Gynecologist/Obstetrician
High blood pressure –BP (PIH- Pregnancy Induced Hypertension) affects  the health of both pregnant  mother and the unborn child adversely.Management with medicines, adequate rest, hospitalisation and regular visits to the Gynaecologist will help in controlling PIH, pregnancy-related high BP in most of the cases.This article will provide an insight into the complications that are associated with this clinical condition, which happens if medical advice is not followed and hypertension remains uncontrolled.One needs to understand that in severe disease, unfortunately, complications occur in spite of best and regular medical treatment of PIH- Pregnancy Induced Hypertension.Another pointer to understand is that in any one particular patient only one of the following or a combination of the complications may be present.The topic is written in easy language and terminology is such that the information provided will be useful to a large number of people. However, medical terminology is an inseparable part of this article. To make understanding simpler (  ) are used for medical terminologyEFFECTS ON THE MOTHERThe organs and systems get affected in many ways1. THE BRAINSwelling of the brain (Cerebral edema)Clinically the symptoms are-A headache- which will not get OK by taking painkiller tabletsLethargyConfusionBlurred visionIn late stagesComaFits (Eclampsia)- This is a dangerous clinical situation. It may be associated with significant brain injury and dysfunction.Changes in brain at structural level include bleeding (Hemorrhage), Blockage of blood supply (Infarction), Decreased blood flow (Ischemia), shrinkage of blood vessels (Vasospasm)These patients are prone to sudden increase in BP which may worsen their condition furtherInvestigations like CT Scan or MRI will show following featuresSwelling (Edema) of the brainFluid channels of brain get blocked (Obliteration of central ventricles)Brain matter will come out (herniate)   through its coverings-life threatening (Transtentorial herniation)2. EYES-VISUAL CHANGES AND BLINDNESSWomen will complain ofSeeing black spots before eyes (Scotomata)Seeing things as double (Diplopia)Blindness- in most of the cases, it will last for 4 hours to up to 8 days. It is reversible. The dysfunction occurs in the brain where the centre for vision lies.In some cases, partial or total blindness persists.Eyeball changes-Inner lining of eyeball gets disrupted (Retinal detachment)-one more reason of blindness-Blood supply to eyeball is stopped  retinal artery occlusion)- causes permanent blindness3. LIVER CHANGESThere may be bleeding inside the liver (Periportal haemorrhage)Blood may collect below its capsule( Subcapsular hematoma)There may be rupture of liver with dire consequencesClinically patient presents asPain in upper abdomenBlood investigation for liver function will reveal raised liver enzymes ( SGOT,SGPT)Liver complications are associated with higher death rate of pregnant woman (maternal mortality.) In rare cases, liver transplantation only will save the life of the woman.HELLP syndrome is associated with liver disorders (Hepatocellular necrosis)H (Hemolysis) EL ( Elevated Liver enzymes) LP (Low Platelets count)Patient suffering from this complication will require intensive care and may have prolonged recovery time4. KIDNEY CHANGESBlood supply to the kidneys (Renal perfusion) and its filtration process, both are reducedFactors like  blood loss, redirection of the blood to more vital organs like brain, increased blood pressure leading to widespread contraction of blood vessels (Vasospasm) are responsible for it.On a microscopic level, basic functional units of kidney like Glomeruli and Tubules are damaged.Kidneys secrete many harmful substances of the body through urine. Consequences of decreased kidney functions are many –Urine output is decreasedBlood levels of Creatinine, Uric acid and Calcium riseThe accumulated toxic substances in blood will eventually affect the mental status of the patient and she will appear dull and lethargic5. CHANGES IN BLOODDecreased platelet count (Thrombocytopenia-Platelet is a component of blood)The normal platelet count is 1.5-4-5 Lakh/ml. Platelets play a very important role in stopping the flow of blood at the site of injury or bleeding. During delivery or caesarian section, the amount of bleeding is more if platelet count is less and it puts the life of the mother in danger.If serial monitoring of blood shows a decreasing trend of platelet count, it becomes an indication for delivery. After delivery recovery of platelets will take 2-5 days.Destruction of blood (Hemolysis)- In high BP pregnant  patients, the lining of small blood vessels gets damaged.- Platelets and fibrin (blood component) get deposited on these sites to seal these sites.- Blood corpuscles get damaged while passing through these vessels.- Destruction of blood will lead to fall in Hemoglobin level (Anemia)- Microscopic slide examination of blood will show abnormal Red Blood Corpuscles (RBC) like (Schizocytosis,Spherocytosis,Reticulocytosis).Blood clotting (Coagulation) changes- There is a widespread blood clotting and blood destruction happening at a multi-organ level in these patients.- As a result blood levels of clotting factors are deranged .- The tests which are abnormal include- PT- Prothronbin Time, PTT-Partial Thromboplastin Time,Fibronectin, D-Dimers, Factor VIII, Fibrinogen etc6. HEART AND CIRCULATORY SYSTEM (CARDIOVASCULAR) CHANGES ALONG WITH LUNGS (RESPIRATORY SYSTEM)The heart is made up of two types of chambersContractile chambers to push blood out into the system-Ventricles –They are two in numbers, left and right.Receptive chambers to receive blood from the system- Atrium- They are also two in numbers, left and right.When BP is high the ventricles will need to work against more resistance. As a result of their muscle mass increases (Ventricular hypertrophy). Their lumen gets diminished in size. The final result is that fluid accumulates in lungs (Pulmonary Edema)-leading to difficulty in breathing (respiratory distress.) It also results in accumulation of fluid in the body (Edema)There are other factors too which will lead to accumulation of fluid in the lungs like injury to the lining of breathing units (Alveoli)7. LUNG CHANGESThere may be accumulation of fluid in lungs (Pulmonary edema.)Patient may have difficulty in breathing and at times may require ventilator support ( ARDS-Acute Respiratory Distress Syndrome)EFFECTS ON THE UNBORN CHILD ( FETUS )Here we will tell you about Uterus-Placenta unit’s blood supply-(Utero-placental perfusion.) Uterine artery is the main blood vessel supplying uterus and in turn to placenta and growing baby (fetus.) In a normal pregnancy, the uterus and placenta allow uterine artery to supply extra blood to it for healthy growth of baby (fetus.)In cases of high BP, both uterus and placenta will resist this extra supply, resulting in less blood available to baby (utero-placental insufficiency) which will lead to low birth weight of newborn (IUGR- Intra Uterine Growth Retardation.)At times water around baby also becomes less (Oligohydramnios.)This compromised placenta sometimes separates from its attachment to uterus prematurely, even when the patient is not in labour (Abruptio Placentae). This will lead to bleeding (Ante Partum Hemorrhage) putting life of both mother and baby in danger (Maternal mortality and IUFD-Intra Uterine Fetal Death)Preterm birth- at times it becomes necessary to deliver the pregnant woman even before her 9 months are not complete. This kind of decision is taken if all the medical management including tablets to control the BP, rest at home or even hospitalisations are failing to control the high BP of pregnancy (PIH-Pregnancy Induced Hypertension)Note from AuthorExpert and timely medical care and patient’s compliance towards taking medicines and regular check up with prescribed investigations have improved the outlook  in most of the cases . In urban settings  where the facility for ICU- Intensive Care Unit,NICU-Neonatal Intensive Care Unit for the newborn and blood banks are available, both mother and child have a good outcome.Rural areas which are yet to have these facilities have a scope for improvement towards ‘Healthy Mother-Healthy Child’ initiative.

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.

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.