Archive for category PREGNANCY
Pregnancy : pre-eclampsia
Posted by admin in ECLAMPSIA, ICONS - Books and apple, PRE-ECAMPSIA, PREGNANCY on February 27th, 2012
Pre-eclampsia is common in pregnancy and certain groups of patients are more at risk that others. This condition is one of the reasons why a close watch is kept on blood pressure and routine checks are made for ankle swelling and protein in the urine. If present, these can be the warning signs of pre-eclampsia and the mother is then watched more carefully to ensure the condition does not progress to the much more dangerous condition – eclampsia. Pre-eclampsia settles once the baby is born. If symptoms are becoming severe, the birth may be induced before term.
The link below gives information on the symptoms, causes, diagnosis, treatment and complications of pre-eclampsia.
COUNTRY : UK
Pre-eclampsia is a condition that affects some pregnant women during the second half of pregnancy (from around week 20) or immediately after delivery of their baby.
Women with pre-eclampsia have high blood pressure, fluid retention (oedema) and protein in the urine (proteinuria). If it’s not treated, it can lead to serious complications.
In the unborn baby, pre-eclampsia can cause growth problems.
Some factors have been identified that could increase your chance of developing pre-eclampsia. These are listed below.
WHO IS MOST AT RISK OF PRE-ECLAMPSIA?
It is your first pregnancy. Pre-eclampsia is more likely to happen during the first pregnancy than during any subsequent pregnancies.
It has been at least 10 years since your last pregnancy.
You have a family history of the condition. For example, your mother or sister has had pre-eclampsia.
You had pre-eclampsia in a previous pregnancy. There is an approximately 20% chance that you will develop the condition again in later pregnancies.
You are a teenager or are over 40.
You have an existing medical problem, for example, diabetes, kidney disease, migraines or high blood pressure.
You were obese at the start of your pregnancy (you had a body mass index of 30 or more).
You are expecting multiple babies, such as twins or triplets (this places more strain on the placenta).
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Eclampsia
Posted by admin in ECLAMPSIA, ICONS - Books and apple, PRE-ECAMPSIA, PREGNANCY on February 26th, 2012
The reality of pregnancy is that it is not a cuddly, twee phenomenon. Mothers nowadays should be relaxed about their pregnancy, delivery and post partum days because the chances are that everything will go well for mother and baby. However, there are many potential dangers associated with pregnancy and delivery. Although most mothers and babies are delivered uneventfully, when things go wrong in pregnancy they often do so quickly, dramatically and at times unexpectedly.
My view (and the view of most doctors I know) is that there is no place for a home delivery in modern society where maternity units are available for all women. I will probably repeat this time and again in this blog even although many might disagree.
One of the most serious complications of pregnancy is a poorly understood condition known as eclampsia. This can threaten the lives of both baby and mother. Fortunately, with proper antenatal care clampsia is rare, however the forerunner, pre-eclampsia is very common and when detected, treatment can usually prevent progression to the full blown and much more dangerous eclampsia.
COUNTRY : USA
Treatment
If you have preeclampsia your health care provider should carefully monitor you for signs of worsening and potential eclampsia. Delivery is the treatment of choice for severe preeclampsia in an attempt to prevent eclampsia. Delivering the baby relieves the condition. Prolonging the pregnancy can be dangerous to both you and your infant.With careful monitoring, the goal is to manage severe cases until 32 – 34 weeks into the pregnancy, and mild cases until 36 – 37 weeks have passed. This helps reduce complications from premature delivery.
You may be given medicine to prevent seizures (anticonvulsant). Magnesium sulfate is a safe drug for both you and your baby. Your doctor may prescribe medication to lower high blood pressure, but you may have to deliver if your blood pressure stays high, even with medication.
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Build your own pregnancy calendar
Posted by admin in ICONS - Blackboard, PREGNANCY on August 29th, 2011
Just discovered you’re pregnant?
Check out this site by the BBC. You can calculate your expected date of delivery, and what happens to your baby and your own body week by week throughout pregnancy from conception to delivery.
CALCULATE EXPECTED DATE OF DELIVERY AND BUILD YOUR OWN PREGNANCY CALENDAR
COUNTRY : UK
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Morning sickness : Acupuncture, ginger and other alternative therapies
Posted by admin in Alternative medicine, ICONS - Books and apple, PREGNANCY on August 23rd, 2011
In the previous post, a link to brief information on the BBC site, I questioned the usefulness of acupuncture and ginger in helping morning sickness, so I have tried to find whether there is any evidence that these work. In summary, the evidence is not good.
Cochrane reviews are an attempt to put medicine on an evidence base and there is was a paper in 2010 discussing ginger, acupuncture and other alternative therapies that are often recommended for pregnancy sickness. This is a comprehensive article and is probably the most evidence based that there is around at the present.
INTERVENTIONS FOR NAUSEA AND VOMITING IN EARLY PREGNANCY
COUNTRY : COLLABORATIVE – IRELAND, UK, USA
IMPLICATIONS FOR PRACTICE
Women will continue to seek treatments for the often distressing symptoms of nausea and vomiting in pregnancy. They may take over-the-counter and complementary therapies, based on anecdotal or peer advice. There are many sources of advice for women on the Internet, including peer fora. Wilkinson 2000 found a lack of consensus about safety of herbal treatments (including ginger) for nausea and vomiting in pregnancy in 300 non-medical sources identified in a literature review. This highlights the necessity of health professionals providing clear guidance to women, based on systematically reviewed evidence. On the basis of this review, high-quality consistent evidence is lacking to support the accuracy or appropriateness of that advice. Current guidelines and other reviews often offer incomplete evidence, without comment on the quality of evidence. Health professionals’ decisions about treatments should take account of the lack of clear and consistent evidence found in this review and acknowledge that it is not possible at present to identify, with confidence, safe and effective interventions for nausea and vomiting in early pregnancy.IMPLICATIONS FOR RESEARCH
The difficulties in interpreting the results of the studies included in this review highlight the need for specific and clearly justified outcomes in research on interventions for nausea and vomiting in pregnancy. The range of instruments used to measure these symptoms (including those not developed for this patient group) also suggest the need for a consistent and appropriate approach to measurement, which may be addressed by the PUQE scale described above. There is also a need to systematically measure quality of life and adverse maternal and fetal and neonatal outcomes, to ensure that studies are of most usefulness to health professionals and women seeking safe and effective treatments. We did not identify any studies of dietary or behavioural interventions. Dietary and behavioural strategies (eating low fat, small, frequent meals) were often recommended to all participants (in both treatment and placebo groups) within the studies in this review. Only one study (Ozgoli 2009) measured adherence to dietary advice. The effectiveness of dietary and other behavioural strategies also needs to be evaluated in good quality trials.
It is interesting that this article seems at variance with NICE guidelines on the matter of acupressure and ginger. Furthermore, I am not at all sure what the last paragraph of the quotation of the guidelines below is supposed to mean. It seems to imply that patients should be given knowledge of all alternative therapies for morning sickness that are not evidence based? If so, why and how will this be done to ensure patients are not being led up the garden path by those health care professionals looking after them who themselves have a non-evidence based bee fluttering around in their bonnets about alternative medicine in pregnancy?
ANTENATAL CARE : ROUTINE CARE FOR THE HEALTHY PREGNANT WOMAN
COUNTRY: UK
Nausea and vomiting in early pregnancy
Women should be informed that most cases of nausea and vomiting in pregnancy will resolve spontaneously within 16 to 20 weeks and that nausea and vomiting are not usually associated with a poor pregnancy outcome. If a woman requests or would like to consider treatment, the following interventions appear to be effective in reducing symptoms:
• non-pharmacological: − ginger
− P6(wrist)acupressure • pharmacological:
− antihistamines.
Information about all forms of self-help and non-pharmacological treatments should be made available for pregnant women who have nausea and vomiting.
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Pregnancy : Morning sickness
Posted by admin in ICONS - Blackboard, PREGNANCY on August 23rd, 2011
When you played with your dolls as a child, and later when you learned about pregnancy and the origin of new life, you never thought for a moment it would be like this! You are one of the women who suffer from “morning sickness” during pregnancy. And the morning sickness seems to be morning, noon and night sickness! Some of your friends didn’t have a problem like this. They just “glowed” and you think they were the lucky ones.
Well, here’s a comforting thought. Maybe morning sickness is “natures way” of telling you to take it easy for a while and eat what is good for the baby. This brief article from the BBC gives tips on how to cope when you can’t face food.
COUNTRY : UK
CAUSES OF MORNING SICKNESS
Pregnancy hormones, circulating in the body, affect all your organs and prepare your body to sustain new life. One theory is that they are responsible for sickness, as a means of protecting the foetus from harmful substances. In fact, there’s some research to suggest that women who experience bad sickness are less likely to miscarry, and there is some support for this in the fact the sickness generally stops when the baby’s major organs have developed.
P.S. Re the full article on the link. Yours truly has no idea what acupressure bands are, and am dubious about them. Not sure about ginger either. Will try to find out more and report back.
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Foods to avoid during pregnancy
Posted by admin in DIETS, Healthy eating in pregnancy, ICONS - Books and apple, PREGNANCY on August 22nd, 2011
For generations women have eaten what they felt like eating, and what was available to them throughout pregnancy and, as far as we know, mother and baby only very occasionally came to any harm. There are some foods that are now considered to pose varying degrees of risk. If you have eaten any of these in error don’t worry, the chances are you and the baby will be OK, but follow a guide like the one on the link below from now on to ensure any risk is negligible.
FOODS TO AVOID DURING PREGNANCY
COUNTRY: UK
Some types of cheese
Don’t eat mould-ripened soft cheese, such as brie, camembert and chevre (a type of goat’s cheese) and others with a similar rind, whether they are made using pasteurised or unpasteurised milk. You should also avoid soft blue-veined cheeses such as roquefort and gorgonzola. These are made with mould and they can contain listeria, a type of bacteria that can harm your unborn baby. Although infection with listeria (listeriosis) is rare, it is important to take special precautions in pregnancy because even a mild form of the illness in a pregnant woman can lead to miscarriage, stillbirth or severe illness in a newborn baby.
Don’t eat cheese made from unpasteurised milk. You can eat hard cheeses such as cheddar and parmesan, and many types of cheeses made from pasteurised milk such as cottage cheese, mozzarella, feta, cream cheese, paneer, ricotta, halloumi, and processed cheeses such as cheese spreads.
In summary, the foods to avoid are:
Some types of cheese
There is a whole range of cheeses that should be avoided. The risk is listeria.
Pâté
Avoid all types. The risk is listeria.
Raw or partially cooked eggs
Risk is salmonella food poisoning. Avoid all foods containing undercooked eggs e.g. home made mayonnaise.
Raw or undercooked meat
Risk is harmful bacteria such as salmonella, campylobacter, E coli 0157.
Liver products
Risk is may contain too much vitamin A.
Supplements containing vitamin A
Risk is too much vitamin A.
Some types of fish
Some types of fish may contain high levels of mercury. Others are safe. See link for details.
Raw shellfish
Uncooked shellfish may contain harmful microorganisms.
Peanuts
Risk once thought to be peanut allergy in infant. Advice has recently been changed regarding this. See link for details.
Unpasteurised milk
Only drink milk that has been pasteurised or UHT. Avoid all foods including cheeses that contain unpasteurised milk. Risk is infection.
Foods with soil on them
Wash all foods, veg and salads. Risk is microbiological contamination.
Caffeine
Risk of low birth weight. Click on link for safe amounts.
Sushi
Risk is parasites but only if not frozen first. Chech link for details.
Cold meats and smoked salmon
Risk is listeria but much lower than cheese. UK does not advise restriction but some countries do.
Alcohol
See separate post (to come soon).
FOODS TO AVOID DURING PREGNANCY
COUNTRY: UK
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