Bump To Birth

Pregnancy brings with it various skincare woes. Add to that equation your growing belly the changing weather, and you’ve got yourself a rather pesky situation. Josephine Song, global head, new product development, VLCC and co-founder, Global Vantage Innovative Group (GVig), Singapore, shares a few tips and tricks to keep your skin healthy.

Pregnancy comes with its share of ups and downs. All expectant mothers go through a magical experience, especially if you are pregnant for the first time. But for some women, it can mean months of nausea and fatigue, as well as dermatological conditions ranging from acne to hyperpigmentation.

The monsoons tend to make these dermatological conditions even worse as both the skin and hair suffer due to high humidity. Now, it’s a known fact that one’s skin is unstable as on some days it becomes extremely oily and other days it’s too dry. You never know what to expect and this instability renders your complexion dull and lifeless.

This is precisely why it’s important to care for your skin with a routine that’s suitable to your pregnancy skincare needs. However, before you do, make sure you consult the doctor and discuss the skin care regime before introducing a new  ingredient to your gamut.

While all women respond differently to skincare ingredients, taking into account individual factors like skin type and sensitivities, make sure your routine goes something like this in order to make your skin glow even more during this special time:

WASH YOUR FACE: It’s important to rid your skin of dirt at least two to three times a day, especially before you go to bed. The monsoons usually cause dirt and pollutants to lodge themselves in your pores. Use a toner if you have dry skin or an astringent if you have oily skin, to clean your pores thoroughly.

MOISTURISE: Using a good moisturiser during the day is not enough. Our skin naturally repairs itself at night and daily moisturising before you sleep will also help keep wrinkles at bay, and will ensure that your skin glows. Do make sure to moisturise during your nighttime skincare ritual.

 EXFOLIATE: Exfoliation involves the removal of the oldest dead skin cells on the skin’s outermost surface. If we don’t exfoliate, the dead skin cells stay on our skin, making your appear dull and lifeless. Moreover, this can lead to hair loss, breakouts, grimy feet, and much more. Therefore, a healthy skincare routine should always include exfoliation at least once a week.

SUN PROTECTION: Being outdoors, especially during the monsoons doesn’t necessarily mean you’re protected from the harmful rays of the sun. It’s important to take the necessary precautions to protect your delicate skin. But remember, all sunscreens are not created equal and with so many options, you can opt for one suited to your skin type and requirement. Also reapply sunscreen every four hours if you are not getting wet. Make sure to apply a generous amount. The easiest way to protect your skin is to avoid sun exposure during afternoon. This is when the energy from the sun’s UV rays is at its highest.

STAY HYDRATED: Drinking  plenty of water has multiple benefits. It’s not only a means to help transport nutrients to your baby, it’s also a great way to ensure your skin stays healthy. Moreover, dehydration is also a common problem during pregnancy, particularly during the monsoons when you  on’t usually feel thirsty. Make sure you drink at least eight to 10 glasses of water a day. On a particularly hot day, make sure you increase your water intake, depending on your state of hydration. Add lemon or cucumber to your water for a refreshing change.

EAT HEALTHY: Glowing skin is not only a result of external skincare. You must eat foods rich  in antioxidants and proteins. Add fi sh and eggs, because they stimulate collagen growth. Check with your doctor on which things to include in your diet. Adding healthy vegetables and antioxidant-rich fruits to keep your complexion glowing.

EXERCISE: Exercise not only keeps you fit and active but it also helps to get rid of toxins and keeps your skin healthy and glowing during your pregnancy. Do simple workouts like pregnancy yoga every morning to feel good and stay fresh. If you feel too lazy to work out, taking a short walk is a great option to keep you active, as well as help you sweat to stay fresh and even aids in keeping your skin healthy.

STRETCH MARKS: You’re tummy is rapidly growing and you are noticing stretch marks on your hips, tummy, thighs, arms and other areas of your body. These occur in up to 90 per cent of pregnant women is the result of your skin stretching. Stretch marks are also due to hormonal imbalance. During your pregnancy, it is vital to properly moisturise the stretch marks affected areas at least twice a day. Look for creams with vitamin E, collagen or elastin to help improve the elasticity of your skin, thereby reducing the likelihood of stretch marks.

While one’s skin can get adversely affected by the changing weather, it’s also one’s hair that can see a drastic change, especially during one’s pregnancy. The monsoon season can cause an excessive amount of hair fall and increased dandruff. And one’s hormones are all over particularly during pregnancy, it becomes important to take care of your luscious locks. Do not allow your hair to remain wet for a long time as this facilitates the growth of dandruff. Finally, make sure you check the expiry dates of the products you use to make sure you avoid skin damage, and more importantly, make sure your baby stays safe and healthy!|MB

By Dr. Shallu Kakkar , Additional Director ,Obstetrics & Gynaecology ,

Fortis La Femme ,Jaipur

Motherhood is a beautiful feeling accompanied by several physical and psychological changes due to hormones rush. These hormones not only bring structural changes in the body but also alter the functional ability of the brain. Around 50 to 80% of expectant mothers have reported having a memory lapse or concentration problems during or post delivery. Medical science defines memory loss as “amnesia”. When would-be mothers or new moms suffer from amnesia triggered by pregnancy it is called “Momnesia” or pregnant brain.

How real is Momnesia?

In a neuropsychological research, a memory performance test was run on 412 pregnant women, 272 mothers, and 386 non-pregnant females. Pregnant women experienced the worst problems in memory tasks which were more challenging. Though clinical test differs from the research studies and negates any structural changes in the brain during pregnancy, studies have proven functional changes are real. During pregnancy memory deficit is very common and real. In another scientific study, a research conducted on the MRIs of pregnant women disclosed functional connectivity in the brain is altered in pregnant and post-delivery women which makes the integrated functioning of the brainless efficient. This affects particularly those parts of the brain which are responsible for social reasoning and the ability to see other people’s perspectives.

The paucity of clinical evidence on structural changes in the brain during pregnancy has divided the neuropsychology community into two schools having different opinions about the structural changes in the brain. However, both agree on factional changes being real.

What forces the brain to work otherwise?

Hormones play the primary role to alter the functional ability of the brain during pregnancy. Studies have also pointed towards the loss of grey matter. Researchers have speculated this loss as brain subconsciously preparing for motherhood by giving up on a neural network that she doesn’t need which prepares her to bond with her baby better. However, lifestyle changes shall be given some credit too. Stress, anxiety, sleepless nights seem to be equally responsible for this disturbed functioning of the brain.

How to deal with the memory loss?

Few strategies can help in managing the situation better:

• Keeping notes of activities can sound old school but work wonder when memory is not that reliable.
• Maintain order at home, keeping things where they belong is a good practice and is very useful as practice turns any habit into a core memory.
• Try mnemonic devices. If you meet a new person, think of an association to help you remember the person’s name. For example, if you meet someone named Dahlia, associate her with the flower. Identification of flowers is an inbuilt memory that will help you save the new one in the system.
• Don’t deprive yourself of sleep. Sleep-deprived brain malfunctions more often.
• Do exercise to keep the body and mind healthy and stress-free.
• Share work burden with partner and family to avoid overworking and stress related to it.

Forgetting things is normal during pregnancy. However, visiting a doctor is advisable if incidences of memory loss are acute and rapid. Forgetfulness accompanied with other behavioural changes like feeling gloomy or loss of appetite and interest in other activities should be a clue that seeking advice from a psychiatrist will be helpful because staying happy is the goal. A happy mother raises a happy and healthy child.

Obesity during pregnancy opens up women to multiple risks, and can adversely affect the health of their baby, as well. Read on to know more, writes Dr Tanvi Tuteja-Mansukhani, consultant obgyn, Somaiya Superspeciality Hospital and assistant professor, K. J. Somaiya Medical College & Hospital

 Maternal obesity has become one of the most commonly occurring risk factors in obstetric practice. Obesity in pregnancy is usually defined as a body mass index (BMI) of 30 kg/m 2 or more at the first antenatal consultation. In total, 50 per cent of women of childbearing age are either overweight (BMI 25 to 29.9 kg/m2) or obese, with 18 per cent starting pregnancy as obese. Currently, 20 to 40 per cent of women gain more than the recommended weight during pregnancy, resulting in an increased risk of maternal and fetal complications. 18 per cent of obstetric causes of maternal deaths and 80 per cent of anesthesia complications are due to obesity, making this a cause for concern.

Effects of obesity on expectant mums:

● Women can experience high blood pressure and preeclampsia caused by being overweight.
● Obesity can result in gestational diabetes (raised blood sugars), and is said to increase the risk of type 2 diabetes and mellitus later on in life.
● Expectant mums also face problems like prolonged labour, C-section and problems with administering epidurals during a C-section.
● The after effects of pregnancy problems are, post partum hemorrhage (losing too much blood), or blood clots (deep vein thrombosis) and wound problems.

Effects of obesity on baby
● Obesity during one’s pregnancy can cause birth defects such as heart defects and neural tube defects such as spina bifida.
● During delivery, babies that weigh more than 9 pounds 15 ounces, may also increase the risk of injury.
● Being overweight during pregnancy may lead to problems such as a premature baby, miscarriage and stillbirth.
● The baby may have health problems later in life such as diabetes, heart disease, and obesity.

A balanced diet along with light exercise and maintaining a food diary is the key to a healthy pregnancy weight.

Naturally, this means consulting your doctor and nutritionist. Moreover, physical activity can help stave off excess weight gain, but talking to your doctor before you begin an exercise programme is vital. They can help you come up with a routine and answer any questions you may have. Your doctor can also refer you to a dietitian or trainer for assessment and personalised advice on healthy eating and exercise during pregnancy.

HERE’S HOW TO KEEP YOUR WEIGHT IN CHECK

Understand your caloric needs:
Your pregnancy is not the time to experiment or try out a new diet fad. These diets are often very calorie-restrictive and won’t provide your baby with the nutrients she need to stay healthy. In fact, diet fads can be extremely dangerous for your baby if they cause you to lose weight too quickly, or if they only allow you to eat a very small range of foods. Your baby needs a lot of different vitamins, and minerals, but more importantly, a healthy dose of every food group. You cannot get them on a restrictive diet. This is why when adopting a healthy pregnancy meal plan, it’s better to look at it as an overall lifestyle change, not a diet. Remember, expectant mums must ditch diet fads, avoid empty calories and unhealthy foods, eat frequent small meals, always eat healthy snacks and drink plenty of water.

Treat pregnancy as an opportunity:
Pregnancy can be a great time to start an exercise programme and adopt healthy eating habits. Pregnant women are more likely to visit their doctor on a regular basis and ask a lot of questions. They also tend to be highly motivated to change their lifestyle in order to keep their baby healthy.

Exercise:
You should start any new exercise programme slowly, and build up gradually over time. Begin with just five or 10 minutes of exercise each day. Add five more minutes the next week. Your ultimate goal is to stay active for roughly 30 to 45 minutes each day. Walking and swimming are both excellent choices for people new to exercise. They’re both gentle on the joints.

Take your vitamins:
While a healthy, balanced diet contains most of the necessary vitamins and minerals for you and your baby, taking a prenatal supplement can help fill in any gaps. Prenatal vitamins differ from an adult multivitamin. They contain more folic acid to prevent neural tube defects and more iron to help prevent anemia.

In the end…
If you’re obese, you can still have a healthy pregnancy. Try to stay active and eat healthy foods. Providing your baby with the vitamins and nutrients she needs is more important than the number on the scale. If you can’t lose weight, don’t fret. Just keep up with your healthy eating habits and moderate exercise, and try to limit weight gain.

Once you bring your baby home, there’s really no need for you to not continue your healthy living. After all, being fit is a lifestyle change, and once you’re on the track to staying healthy, these healthy eating habits and staying active only mean you’ll have more energy to keep up with your growing child. MB

By Dr. Richa Katiyar (MD – Fertility Specialist and Gynaecologist at Hope Fertility) in association with iGenetic Diagnostics

Prenatal tests and care are important for all pregnant women. However, it is all the more crucial for women who conceive after 35 years of age. The tests determine the likelihood of certain defects in the baby. This helps in counselling patients regarding decisions to continue the pregnancy and doing any additional tests required for confirmation of the diagnosis. These defects include genetic disorders like Down Syndrome, Patau Syndrome, Edward Syndrome, Sickle Cell Disease, Cystic Fibrosis, Tay-Sachs Disease, Muscular Dystrophy and Spina bifida (Neutral tube defect) among others.

Rapid advancements in medical sciences including diagnostics has resulted in better management of pregnancies, especially in older women. Healthy women deliver healthy babies. Apart from lifestyle changes for a healthy pregnancy, regular screening of the mother and foetus during pregnancy helps in timely interventions that can ensure the best outcome.

During the pregnancy, blood tests can be done to monitor the health of the mother by examining whole blood counts, and checking for sexually-transmitted diseases like HIV or Hepatitis B. Blood disorders that might potentially be detrimental to baby’s health can be determined at this time. The mother’s blood group is also reconfirmed and the Rhesus (Rh) factor is determined. If the mother is Rh negative (Rh-) and the father is Rh+, there is a chance that the baby may be Rh+. In such a case, the doctor will recommend a routine dose of anti-D immunoglobulin to avoid any complications that can be detrimental to the baby.

Additionally, there are tests scheduled at specific stages during gestation. These tests help in monitoring the pregnancy and help in better management of the pregnancy. This is particularly important if any of the parameters are not within healthy range.
First Trimester (Up to 13 Weeks of Pregnancy)

First-trimester screening includes ultrasound and maternal serum screening. Ultrasound is done to assess fetal nuchal translucency and to determine the presence of the nasal bone. Nuchal translucency screening is used to see if there is increased fluid or thickening in the back of the foetus’ neck. The nasal bone is not seen in babies with conditions like Down syndrome. This scan is generally performed between 11 and 13 weeks gestation. In this trimester, ultrasound is also used to determine the due date, examine the placenta, uterus, pelvis etc, and to diagnose an ectopic pregnancy or miscarriage.

Besides ultrasound, certain maternal serum markers are also assessed in the first trimester. In early pregnancy, abnormal levels of Pregnancy-associated plasma protein A (PAPP-A) and human chorionic gonadotropin (hCG) are associated with increased risk of birth defects. In combination with ultrasound, these maternal blood tests help predict the likelihood of birth defects like Down syndrome and Edwards syndrome.

If the results indicate any abnormality, genetic counselling and additional tests like chorionic villus sampling or amniocentesis are recommended.

Chorionic Villus Sampling (CVS)
This test is done between 10 and 13 weeks of pregnancy. It involves taking a sample of the chorionic villus from the placenta through the cervix or abdominal wall. This tissue contains the same genetic material as the foetus. This can be then be tested for genetic defects.

Second Trimester (11-24 Weeks Of Pregnancy)

Second-trimester maternal serum screening is done between 15 and 20 weeks of pregnancy and involves multiple marker screening (either triple or quadruple marker screening). Levels of Alpha-fetoprotein (AFP) that is produced by the fetal liver vary during pregnancy. Abnormal levels may indicate an incorrect due date, foetal abdominal wall defects, Down’s syndrome or some other chromosomal abnormality, the presence of more than one foetus or an open neural tube defect like spina bifida. Levels of Estriol can be an indicator of foetal health. Other markers that are screened in this trimester are Inhibin and hCG.

At this stage, ultrasound (called as 18- to 20-week scan) is also performed to reconfirm the due date, look for abnormalities in the foetus, monitor its growth and activity, check the amount of amniotic fluid and blood flow patterns, and examine the cervix.

In combination with the first-trimester screen, second-trimester tests can predict any abnormalities in the foetus. In pregnancies where ultrasound and maternal serum screening tests are abnormal, an amniocentesis may be needed for an accurate diagnosis.

Amniocentesis

Amniocentesis is generally done between 15 and 20 weeks of pregnancy by inserting a long, thin needle through the abdominal wall and into the amniotic sac. A small amount of amniotic fluid is withdrawn. This fluid contains cells from the foetus. Any genetic abnormality in the foetus can be detected using these cells. AFP can be directly measured in this sample to determine if there is an open neural tube defect.

Third Trimester (Beyond 24 weeks Of Pregnancy)

Foetal Growth Scan
This test is to be done between 28 and 32 weeks of pregnancy. This is an Ultrasound and Doppler Scan test to determine the position of the foetus, monitor foetal growth and the position of the umbilical cord, measure the quantity of amniotic fluid, examine the placenta and to conduct a biophysical profile test.

Oral Glucose Tolerance Test or the Glucose Challenge Test
This test is usually done between 24-28 weeks. It is also known as OGTT, the test evaluates the mother’s ability to absorb and use glucose (sugar). This checks gestational diabetes. Gestational diabetes can lead to preeclampsia and high blood pressure.

Just Before Labour

Amniotic Fluid Index Test: This test determines the quantity of amniotic fluid in the water bag. Amniotic fluids protect the foetus from injuries if there is any blow to the stomach. It also protects the baby from infection and also lets the digestive system of the baby grow. Low amniotic fluid levels can harm the baby’s health.

Most pregnant women make their birth plans well ahead of time to make sure everything goes smoothly during delivery. But sometimes, things do not go as planned. You may not even see a C-section coming. Your doctors may decide things for you if complications arise, or you may yourself change your mind about having a vaginal birth. Whatever may be the reason, while C-section is key to make sure that you and your baby are safe, there is always a risk of complications. Apart from the pain from abdominal surgery, you may also experience bleeding and infections. So it is better to be fully prepared. Here’s when you may need a C-section.

1. Multiple C-sections: If you have had multiple C-section deliveries in the past, you should have a repeat C-section due to the increased risk of uterine rupture. However, in many instances, it can be safe to give birth vaginally after having one C-section.

2. Baby in breech position: During pregnancy, babies move around in the uterus and should be in the head-down position by the end of 36 weeks. However, there can be an instance where the baby does not reach the position and is considered breech. While the cause of a breech baby is not always known, attempting to give birth in this position can lead to many complications.

3. Stalled labour: Your labour can stall if your contractions are not strong enough or if they slow down, your cervix may not dilate as quickly as anticipated. Your doctor might give you medications to increase the number and duration of contractions. Also, sometimes, your baby can stop descending even though you continue to have contractions. All these factors along with heightened stress due to fear of labour can cause your labour to stall and arise the need for an emergency C-section.

4. Foetal diseases: If there are issues with the baby’s heart rate or if the oxygen supply has been disrupted by a prolapsed umbilical cord, C-section can be the safest bet. Umbilical cord prolapse occurs when the cord slips down through the cervix ahead of baby and gets compressed.

5. Placenta previa: Placenta previa occurs when the placenta lies in the bottom of the uterus instead of the top or the side, blocking the baby’s way through the cervix. Attempting for a vaginal delivery with placenta previa can cause heaving bleeding posing risk for both mother and the baby.

6. Placental abruption: You will need a C-section if you experience placental abruption. Placental abruption takes place when the placenta starts to separate from the uterine wall before the baby is delivered causing bleeding and pain in the uterus. The condition can interfere with the baby’s oxygen supply and a C-section may be necessary.

7. Multiple births: You will be needing a C-section if you are having twins or more! Twins can be delivered through birth canal depending on their gestational age and estimated weight.

During pregnancy, your body needs potassium to function at its best. An essential mineral, potassium helps maintain fluid and electrolyte balance, aids in the transmission of nerve impulses, and release of energy from carbohydrates, fat and protein. The daily recommended dosage of potassium in a woman is about 4700 mg per day. Low potassium during pregnancy can cause serious adverse effects. Dr. Aruna Muralidhar, Senior Consultant Obstetrician and Gynaecologist, Fortis La Femme, Bengaluru breaks down the significance of potassium during pregnancy.

What is the significance of potassium during pregnancy?

Although the requirement of potassium does not increase during pregnancy, regular intake of potassium-rich food is important as the blood volume expands by 50 percent during pregnancy. There may also be a loss of potassium and other minerals due to pregnancy-related vomiting.

What causes low levels of potassium during pregnancy?
Low potassium is most often the result of chronic or severe vomiting or diarrhoea, or certain medications such as diuretics (medicines used for treating high blood pressure), rather than a shortage of the mineral in the diet. Low potassium can be diagnosed by a routine blood test. Irregular heartbeats can be seen on an ECG.

What happens when potassium levels are low during pregnancy?
Initial symptoms are very difficult to recognise as most of them are common during pregnancy. You may experience fatigue, swelling of the feet and ankles due to water retention, dizziness due to lower blood pressure, numbness of fingers and toes, unusual weakness in the muscles, constipation, and mood swings. You may also experience abnormal heartbeat, depression, confusion or hallucinations in severe cases.

How can low potassium during pregnancy be treated?
In the initial stages, when the deficiency is mild, increasing potassium-rich foods in the diet would suffice. Foods rich in potassium include bananas, tomato, spinach, mushroom, fish, avocados, and potatoes. Moderate deficiency may need oral potassium replacement treatment like syrups, capsules, and tablets. In very severe cases, an intravenous drip of potassium may be required for which intensive monitoring is essential.

What happens when potassium levels go up during pregnancy?
Hyperkalemia or high potassium levels during pregnancy can be dangerous. In extreme cases, this may result in a cardiac arrest. However, this is extremely rare and is likely to happen due to kidney failure or consumption of certain drugs and alcohol. Severe dehydration and type 1 diabetes mellitus may also trigger this condition.

How can hyperkalemia be treated?
Hyperkalemia is a medical emergency and needs to be treated in a hospital setting.

Keep in mind that early recognition and treatment would help avert unnecessary adverse outcomes. Regular routine check-ups during pregnancy are a must.