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Before motherhood...

SAFE PREGNANCY
Last Updated 26 August 2016, 18:47 IST

Deciding to expand one’s family is a significant decision one makes in a lifetime. A great number of variables come into play. An all-inclusive care and guidance is paramount in embracing the new-found emotion of motherhood.

Preconception health is essential for every woman, irrespective of planning a pregnancy. It means living well, being healthy and feeling good about yourself. It is a precious gift to your babies; it means that the parents have taken those important steps to get healthy and ensure a healthier future. Such babies are less likely to be born early (premature) or have low birth weight. They are also more likely to be born without birth defects or other complex conditions.

Women who are overweight or obese are highly prone to complications during pregnancy. They have a high risk of many serious conditions, including complications during pregnancy, heart diseases and pregnancy-induced type 2 diabetes. It is every woman’s prerogative to achieve healthy weight through a healthy diet and regular exercise.

After all this, the first and the most important step is to visit your doctor and discuss your medical history, family history and any other related medical conditions. It is important to share any previous pregnancy problems, medicines that one has been taking as well as vaccinations that have been taken in the past. It is recommended that a woman start preparing for pregnancy three months prior to conceiving. Taking folic acid supplement everyday while trying to conceive and up to 12 weeks of pregnancy is advised. Folic acid
reduces the risk of the baby having a neural tube defect, such as spinal bifida — where the spinal cord of the foetus doesn’t develop normally.

Smoking during pregnancy is a big no and can some cause serious problems for the woman, such as difficulty in getting pregnant, separation of placenta from the womb, resulting in bleeding, miscarriage. Smoking is also linked to a variety of problems in the baby, like premature birth, low birth weight and breathing problems in the first six months of life. No level of alcohol has been proved safe for women trying to get pregnant. Moreover, it can reduce chances of conceiving. It is a well-established fact that drinking excessive alcohol can cause birth defects, particularly when the organs of the foetus are developing. There is also risk of mental retardation linked to alcoholism.

Medications

It is important to talk to the doctor about the medications that are to be avoided and the ones that are safe to be consumed. Do not stop any medicines that you already are on till you speak to your doctor. Also, avoid new drugs as most of them have not been tested for their impact on pregnant women and the foetus.

While what is safe is an acceptable dosage of paracetamol, the golden rule here is to always discuss and check with your obstetrician.
Tests and scans

During pregnancy, it is important to undergo certain prescribed tests to ensure the safety and proper development of the foetus. These tests are an important part of the antenatal care and help protect the health of the mother and the baby throughout the pregnancy.

Anaemia

During pregnancy, haemoglobin in the blood is important for transportation of sufficient oxygen to both the mother and the foetus. If there is an insufficiency in haemoglobin, it is called anaemia. Most pregnant women experience some level of anaemia. To prevent these problems, haemoglobin tests should be taken before and during pregnancy. A balanced diet with fruits and green leafy vegetables helps prevent anaemia.

Gestational diabetes

Gestational diabetes develops during pregnancy. And like other types of diabetes; it affects how your cells use sugar (glucose). Gestational diabetes causes high blood sugar that can affect your pregnancy and your baby’s health. It is generally diagnosed between the 24th and 28th week of pregnancy. Thus, it is important to take an Oral Glucose Challenge Test (OGCT). Normal blood glucose levels peak within 30 to 60 minutes after drinking the glucose solution. A higher than normal blood glucose level does not always mean you have gestational diabetes. In case of an abnormal OGCT, an Oral Glucose Tolerance Test (OGTT) is conducted.

Urine routine

Urine tests provide your doctor with the important knowledge of diseases and
conditions that could potentially affect the mother or the foetus. Urine tests detect sugar, protein, bacteria and ketone (fat broken down for energy instead of carbohydrates).

Ultrasound

The commonly known test during pregnancy is, of course, the ultrasound, which shows you and your doctor the position, movements and development of your baby. The first scan done at six to seven weeks of gestation will check the baby’s heartbeat. The nuchal translucency scan or NT scan is conducted between the 11th and 14th weeks. In most cases, this is combined with blood a test — Double marker test or First Trimester Screening (FTS) for increasing accuracy.

During the second trimester, an anomaly scan is performed. In the third trimester, a growth scan is performed to check for the baby’s size, amniotic fluid amount and blood flow adequacy to the baby. It is repeated around the 37th week of pregnancy.

Activity’s that are good to do

Walking
Routine activities like cleaning
your house           
Lamaze (advised and helpful during labour)      
Yoga & breathing exercises       
Activities to be avoided
Aerobics, Zumba, Lifting weights, Climbing steps, Contact sports
Food to be AVOIDED
Junk and fried food
Sweets, chocolates, pastries,
Excess rice, excess ghee/butter
Juice (Both Fresh & Tetra Pack)

(The author is consultant obstetrics & gynaecologist, Fortis Hospitals, Bengaluru)

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(Published 26 August 2016, 15:33 IST)

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