Author: Fernandez Hospital

Infant Skin Care

Fernandez Hospital Leave a comment

1

The skin is the largest organ in the human body. Besides serving as a protective barrier, it has the function of thermoregulation, UV protection, protection from invasion of microbes and external antigens, repair and regeneration of wounds and synthesis of nutrients. It also has immunological  and sensory autonomic functions. We must remember that the skin of the neonate is not the miniature of the adult skin.

Differences between adult and term or preterm neonate skin

  1. The skin of the newborn is 20 to 30% thinner than the adult skin.
  2. Newborn skin is less hydrated and has reduced natural moisturization factor compared to adult.
  3. Ratio of body surface area to weight of a term neonate is up to 5 times that of an adult and that of preterm is 7 times than of an adult.
  4. Stratum corneum or the outermost layer of skin of a preterm baby is thinner than that of a term baby.
  5. At birth, the pH of newborn skin is slightly acidic whereas the adult skin has acidic pH from 5 to 5.5. Alkaline pH predisposes to diaper dermatitis and favours colonisation of Staphylococcus aureus and Candida albicans.

2

The skin of the newborn undergoes structural and functional modifications from the first few days of life up to almost the first year to adapt to the transition from the utero wet world to the extrauterine environment. The structural and functional immaturity of the skin of a preterm baby results in increased transepidermal water loss, susceptibility to mechanical trauma, microbial invasion and percutaneous absorption of toxins. In order to reduce the morbidity associated with immature skin barrier, optimum care for the skin of a newborn is essential.

 Cleansing and cleansers

Cleansing is a process of removing dirt, sebum, micro-organisms, exfoliated corneum cells from the skin surface by a complex interaction between the skin barrier, dirt, body secretions and a surfactant. Water is a good cleanser which removes the water soluble dirt but not the fat soluble particles.

3

Cleansers are surface active substances that emulsify the fat soluble particles and convert them into water soluble matter which can be washed off with water. Today a wide variety of soaps, special soaps and liquid cleansers are available in the market.

Cleansers are classified into three categories, namely true soaps, syndet bars and combars. Soaps are fatty acids derived from animal fat or vegetable fat processed with sodium or potassium hydroxide by saponification.

True soaps are composed of long chain fatty acid-alkali salts with a pH between 9 and 10. The high alkaline nature causes dissolution of lipids from the skin surface, disruption of acid mantle and stratum corneum barrier and raises the pH of the skin, Soap precipitates in hard water producing insoluble calcium or magnesium salts that prevent foam formation. Use of soap particularly in diseases of the skin may cause dryness and irritation of the skin resulting in redness and itching.

Special additives added to the soaps have resulted in the various subsets of soaps such as superfatted soaps, transparent soaps, medicated antibacterial soaps. Superfatted soaps contain increased oil and fat which help in minimizing the dryness of skin. Transparent soaps contain glycerine and sucrose. Antibacterial soaps contain antibacterial agents such as triclosan, triclocarban. These soaps reduce the skin biofilm bacterial count by blocking the lipid synthesis in the bacterial cell wall.

Syndets or synthetic detergents are synthetically derived organic quarternary ammonium compounds or polymerized or sulfonated fatty acids. They have a pH of 5.5 to 7. They are less likely to produce dryness and irritation of the skin.

Combars are composed of alkaline soaps to which surface active agents with a pH of 9 and 10 are added. They are milder cleansers than true soaps.

Other variants of cleansers

Soapless cleansers are lotions that are primarily composed of either glycerine or propylene glycol and cetyl/steryl alcohols and they can be wiped off without using water.

Liquid cleansers with appropriate blend of anionic, non-ionic and amphoteric surfactants are available. They are milder in nature and do not disrupt the skin barrier or acid mantle.

An ideal skin cleanser is one that is mild and has minimal interaction with skin and removes all unwanted materials from the skin. It should not affect the acid mantle of skin surface. It should be colourless and fragrance free and should not irritate the skin or eyes.

Shampoos

 

Shampoos that are available in the market are soapless and consists of a principal surfactant for detergent and foaming power, secondary surfactants to improve and condition the hair and additives to complete the formulation and special effects. Formaldehyde is the most common preservative used in shampoos and does not cause any side effects due to the short contact.

Baby shampoos should be ideally fragrance free and should not cause eye irritation. Medicated shampoos with ketoconazole, tar, zinc pyrithione, salicyclic acid are available for special hair conditions.

5

Vernix Caseosa

 

It is a naturally occurring complex, lipid rich substance coating the skin surface of the fetus. It is a chalky white material with shed epithelial cells, sebum and sometimes lanugo hair.

Preterm babies have very little vernix compared to the term babies and post term babies may not have vernix.

Vernix is highly beneficial. It is a natural cleanser and moisturizer with anti-infective, antioxidant and wound healing properties. It helps in the development of acid mantle and supports the normal bacterial colonization. WHO guidelines mention that vernix should not be removed at the time of birth.

Bathing the newborn

6

WHO guidelines mention that the initial bath for term newborn should be given 6 hours after birth. Any baby who is term and weighs more than 2.5 kgs could be given bath 6 hours after birth. In term IUGR babies only sponge bath is to be given until the baby’s weight crosses 2.5 kgs. There are some studies which have advocated bath after fall of the umbilical cord. Bathing makes the baby calmer and quieter than washing with cloth or sponge. The tactile stimulation that occurs during bathing provides a pleasurable experience for the baby and promotes the bonding between the baby and the parent or the caregiver.

How to give a bath:

  • Should be given in a warm room
  • Temperature of the bathwater should not exceed 37°C
  • Check the temperature of the water before placing the baby in the bath
  • If tub bath is given, the depth of the water should be 5cm up to the hip of the baby
  • Bathtubs may be a potential source of infection hence they must always be disinfected
  • Bath duration should not exceed 5 minutes in order to prevent overhydration of the skin which may lead to easy fragility of the skin and decrease threshold for injury


Routine bathing

Routine bathing of newborns and infants does not cause any harm. Daily baths are more preferable but during winter and in the hilly regions babies may be given bath twice or thrice in a week. 

Cleansers

Use of alkaline soaps during the neonatal period is to be avoided. If possible, liquid cleansers with acidic or neutral pH may be used which will not affect the skin barrier function or acid mantle. Syndets and mild soaps may be used in infants.

Care of the diaper area

7

Diaper area is exposed to excessive hydration, occlusion, friction and maceration. Faecal ureases catalyze the breakdown of urea to ammonia, which increases the pH of the skin surface. The pH increase will contribute to the activity of faecal enzymes, proteases, ureases and lipases which are highly irritant to the skin. Water and wet cloth are the gold standards for cleansing the nappy area. Mother should be advised to use only cloth napkins which should be changed frequently. It is important to keep the area dry. After defecation, moistened cloths or cotton balls soaked in lukewarm water can be used for cleaning the area. In case diapers are used, barrier creams containing zinc oxide and petrolatum based preparation could be used. Cloth napkins are to be washed with a mild detergent in warm water and dried in sunlight. Use of antiseptics to be avoided as a routine.

Care of the umbilical cord

Umbilicus should be kept dry and clean. Lukewarm water should be used for cleaning and cord should be kept exposed to air.

Care of the scalp

Cradle cap of the scalp is common in newborns. Mineral oil can be applied to the crusts and removed after two to three hours. Baby shampoos which are free from fragrance could be useful in removal of crusts and scales. The pH of the shampoos should be close to that of tears and should not cause irritation to the eyes.

8

Baby’s hair wash is to be given after the cord falls with a frequency of twice a week after that.

Use of baby powders

9.png

Mothers should be advised to smear the powder on the hands and then gently apply on the baby’s skin. Accidental inhalation of powders could happen if applied with puffs.

Care of the skin of preterm baby

Preterm babies have immature barrier function which results in increased transepidermal water loss, increased skin permeability, impaired thermoregulation, increased percutaneous absorption and susceptibility to trauma.

There is acceleration of permeability barrier maturation following birth hence within 2 to 3 weeks post-natally, babies develop competent barriers. But in preterm born at 22 to 25 weeks it takes 8 weeks to mature. In these preterm babies acid mantle develops over 2 to 8 weeks after birth. Gentle and minimal handling of the preterm babies is to be practiced. Hand hygiene measures are to be strictly followed by the mother or health care workers.

Sponge bath with water is to be given until the baby weighs 2.5 kgs after which regular bath is advised with mild cleanser. Micropore adhesives may be used to secure IV cannulas and while removing the adhesives use guaze piece soaked with warm water. Gentle application of emollients will help reduce the dryness and maintain the barrier function. Emollients also decrease the risk for invasive infections in preterms by preventing access to deeper tissues and the bloodstream through skin portals of entry.

Emollients

10.png

Emollients are lipid containing substances that soften the skin and prevent transepidermal water loss. They help in restoration of skin barrier and thus retard further damage. Emollients contain hydrocarbon oils like petrolatum, mineral oils, paraffin and squalene. Fatty acids like lanolin acid, stearic acid and fatty alcohol like lanolin alcohol and cetyl alcohol are also used as emollients. Regular use of emollients is indicated in preterm babies. Emollients could be used in term babies with cleansers induced dryness.

Massage – Touch therapy

Touch is considered absolutely essential for growth and development of a neonate.

Lack of appropriate touch results in poor growth of the infant, delayed attachment to parent and psychological disturbances. Systematic application of touch is termed as massage. Massage promotes circulation, suppleness and relaxation of the different areas of the body and tones up the muscles. Massage results in promotion of mother-infant bonding.

Benefits of massage

11.png

  • Increases food absorption hormones such as insulin
  • Increased weight gain by increasing insulin and insulin like growth factor
  • Greater bone mineralisation and more optimal behavioural and motor responses
  • Babies become more active and alert

Oil massage

Oil massage is traditionally practiced in India. Oil enhances skin barrier function, acts as a source of warmth and nutrition and increases weight gain. Infants also showed less stress behaviour and lower cortisol levels following massage. Very low birth weight preterm neonates given oil massage showed better weight gain. Coconut oil, sunflower oil, mineral oil and synthetic oil are being used for massage. Mustard oil is recently been discouraged due to irritant and allergic contact dermatitis potential. Sunflower oil enhances the skin barrier function. Some studies have shown that olive oil can cause erythema and disruption of skin barrier function. During summer one has to avoid oil massage when baby has miliaria rubra. Oil massage should be given before bath during summer and after bath during winter.

12.png

Massage is ideally given by mother, father, grandparents or caregivers. It could be started after the 10th day of life in a well baby. Massage is to be given to babies when they are alert and active, preferably 1 to 2 hours after feed. Massage is to be done in a warm room. Mother or the caregiver has to cut their nails, and remove rings and watch. Strokes should be gentle and firm and not jerky. These gentle strokes should be given from head to foot. As the baby may not lie still, one should work with and not against the movements. Full body massage will take 15 minutes.

13.png

Comfortable signs of baby enjoying massage are happy vocal sounds like cooing, easy breathing pattern, bright-eyed look, ability to focus and take in surroundings comfortably and enjoying stretching, sucking, clasping own hands or feet.

14.png

ZIKA Virus

Fernandez Hospital Leave a comment

Introduction:

The Zika virus, a mosquito-transmitted disease, was first identified in the Zika Forest of Uganda in 1947 in the rhesus monkey. Eventually, it got transmitted to humans in 1952. This illness is transmitted by two species of mosquito — Aedes Albopictus and Aedes Aegypti. The Zika virus is similar to yellow fever, dengue, West Nile and Japanese Encephalitis viruses.

Zika_virus2.0

Image Courtesy:  https://cdn2.vox-cdn.com/thumbor/-2rkf-SyPCM17aG8xWZZnjFXh3o=/cdn0.vox-cdn.com/uploads/chorus_asset/file/5919097/Zika_virus2.0.jpg

Signs & Symptoms:

The time from incubation to exposure is not so clear but it lasts for 2-7 days.

  • The symptoms are a bit similar to dengue, usually causing mild illness which appears after some days of being bitten by an infected mosquito.
  • Mild fever, skin rashes, headache, muscle and joint pain, and pain behind the eyes may occur in an infected person.
  • Conjunctivitis, vomiting and malaise are some other symptoms of Zika virus.

 Modes of Transmission:

zika1

Image Courtesy:  http://ichef.bbci.co.uk/news/624/cpsprodpb/185B3/production/_87936799_zika_virus_cycle_624-08.png

  • Primarily, the Zika virus gets transmitted to humans through the bite of an infected Aedes mosquito, mainly Aedes Aegypti.
  • Unlike the Anopheles mosquito causing malaria which is active during night hours, the Aedes mosquito is extremely active during daytime; it can survive in both outdoor and indoor environment.
  • When a mosquito feeds on the blood of an infected person, it gets infected itself, transmitting the virus to other humans through bites.
  • Transmission through asymptomatic blood donors in whom RNA of Zika virus has been identified.
  • Possible transmission through sexual contact has also been reported.

Diagnosis:

A Zika virus infected person can be diagnosed through the following ways:

  • The presence of the Zika virus can be based on general symptoms such as mild fever, rash, conjunctivitis, pain, vomiting, uneasiness etc., Zika virus can be suspected through the patient’s place of living and history of travelling.
  • However, proper diagnosis is done by laboratory testing of blood, urine, saliva or other body fluids through the following tests:
  • PCR (Polymerase Chain Reaction) or by RT-PCR (Reverse-Transcription Polymerase Chain Reaction) for viral RNA
  • Serology Test


Treatment:

As the disease caused by Zika virus is usually mild, it does not require much medical attention. Those infected require proper rest, should drink plenty of fluids and take common medicines for fever and pain.

If the symptoms worsen, it is advisable to seek proper medical treatment. Currently, there is no vaccine or specific drugs available to fight the Zika virus.

Prevention:

To protect yourself from Zika virus, the following measures should help:

  • Avoiding mosquito bites is the best prevention.
  • Using insect repellent to kill mosquitoes.
  • Wearing light-coloured clothes that cover most parts of your body.
  • Sleeping under mosquito nets.
  • Covering water containers and emptying them from time to time


Microcephaly and Zika Virus:

Microcephaly is a neurodevelopmental disorder due to which babies are born with unusually small heads. The brains of these babies don’t develop properly during pregnancy or may stop growing in the first year of birth. Children infected with microcephaly experience problems like intellectual defects, developmental delays, hearing loss etc. It may also occur if a pregnant woman is malnourished, has diabetes or consumes alcohol.

zikagfx

Image Courtesy: http://ichef-1.bbci.co.uk/news/624/cpsprodpb/179A5/production/_87877669_zikagfx.jpg

It is found that the rate of babies born with microcephaly in the virus-affected places is rising due to the possibility of pregnant women being infected by Zika virus.

Those travelling to infected areas should take all the preventive measures. Women planning to get pregnant or already pregnant and living in the affected areas should follow the measures strictly. Others should refrain from visiting these places so they don’t get infected.

Virus Affected Zone:

As per the update till 15 February, 2016, the Centers of Disease Control and Prevention (CDC) have warned about travel in the following areas with Zika virus transmission.

  • South and Central America: Brazil, Bolivia, Colombia, Mexico, Costa Rica, Paraguay, Panama, Venezuela Ecuador, El Salvador, French Guiana, Guyana, Guatemala, Honduras, Suriname and Nicaragua
  • Caribbean: Dominican Republic, Puerto Rico, Guadeloupe, Haiti, Jamaica, Barbados, Curacao, Saint Martin, Martinique and US Virgin Islands
  • Oceania: Samoa, American Samoa and Tonga
  • Africa: Cape Verde

Urinary Problems During Pregnancy

Fernandez Hospital Leave a comment

Many women experience some unpleasant conditions during pregnancy like urine infection, urinating more frequently, constipation, haemorrhoids etc.

U1

Pic Courtesy: https://www.google.co.in/search?q=urine+infection+during+pregnancy&biw=1242&bih=606&source=lnms&tbm=isch&sa=X&sqi=2&ved=0ahUKEwi_8fHIipfKAhWOwI4KHaYYA0YQ_AUIBygC#imgrc=GudHkF4HuZi76M%3A

 

Urinary Tract Infection

Generally, urine infections are caused by bacteria from the skin, rectum or vagina which enters the urethra. There are different types of urinary tract infection, commonly known as UTI. Below are some of the urinary tract infections which occur during the time of pregnancy.

U2

Pic Courtesy: https://www.google.co.in/search?q=urine+infection+during+pregnancy&biw=1242&bih=606&source=lnms&tbm=isch&sa=X&sqi=2&ved=0ahUKEwi_8fHIipfKAhWOwI4KHaYYA0YQ_AUIBygC

Kidney Infection: Also known as pyelonephritis, kidney infection is one of the most serious complications during pregnancy period. Germs in the form of bacteria travel from the bladder up through the urethras which infect the kidneys. If not treated on time, the infection may spread on the bloodstream which becomes life-threatening at times.

Asymptomatic Bacteriuria: Sometimes, bacteria reach the urinary tract without showing any type of symptoms in pregnant women. This type of bacteria is known as asymptomatic bacteriuria. If such bacteria form in non-pregnant women then there is no problem at all. But in case of pregnant women, it needs to be treated. If asymptomatic bacteriuria is left untreated, it increases the risk of kidney infection. So, during your pregnancy, get your urine tested regularly. And if you are tested positive, you will be given oral antibiotics which are safe to consume during pregnancy period.
Cystitis or Bladder Infection: Cystitis or bladder infection is most common among women between the ages of twenty to fifty who are sexually active. In such case, bacteria form in the bladder where it multiplies which causes inflammation and other symptoms of bladder infection.

U3

Pic Courtesy: https://www.google.co.in/search?q=urine+infection+during+pregnancy&biw=1242&bih=606&source=lnms&tbm=isch&sa=X&sqi=2&ved=0ahUKEwi_8fHIipfKAhWOwI4KHaYYA0YQ_AUIBygC#imgrc=GGJD4ywPc8IFTM%3A

Symptoms of urinary tract infection

In some cases, there are no symptoms of urinary tract infection. But during your first pre-natal examination, your doctor will test for asymptomatic urine infection. And if the below mentioned symptoms arise in your pregnancy period, consult your doctor.

  • Sudden and quick urge to pee, also known as urinary urgency
  • Burning sensation or pain while urinating
  • Bloody urine
  • Foul smelling urine
  • Feeling pain in the area of pubic bone

How to avoid urinary tract infection?

If you are a pregnant woman, you can minimise the chance of getting affected with urinary tract infection by taking the following measures.

  • Drink lots of water every day to keep hydrated
  • Empty your bladder fully when you urinate. And don’t stop your urge to pee as this may lead to urine infection
  • To prevent bacteria in the stool getting near the urethra, wipe yourself from front to back after the bowel movement
  • Always keep your genital area hygienic and clean by cleaning with water and mild soap
  • During your pregnancy avoid using sprays, powders and strong hygienic wash in the genital area as it can irritate your genitals and urethra. It makes a better place for the bacteria to breed
  • To eliminate genital bacteria, urinate before and after sex
  • You can drink cranberry juice during your pregnancy as it helps in reducing the level of bacteria and stops breeding in the urinary tract
  • Stay away from having chocolate and caffeine during your pregnancy as it can irritate the bladder

Treatment of urine infection during pregnancy

There are different types of antibiotic which help to stop urine infection during pregnancy. Usually seven days course is prescribed by the doctor to treat urine infection. The antibiotic given by the doctors during the time of pregnancy are safe to consume and doesn’t have any adverse effect. So, consult your doctor and get urine test done from time to time to keep a check on urinary tract infection and get treated accordingly.

For those infecting with cystitis can drink plenty of water and flush out the bladder time to time. But it is advisable to consult your doctor if such infection occurs. However, drinking lots of water helps you keep hydrated if you have fever during your pregnancy.

Role of Each Vitamin During Pregnancy

Fernandez Hospital Leave a comment

It is very essential that your food contains different types of vitamins, minerals and other nutrients for you to stay fit and healthy. It is even more necessary in the case of pregnant women. During pregnancy, not only does the mother need different types of nutrients but you must remember the baby also receives its food from the mother. So, during pregnancy, you need to have more vitamin rich food than you did normally. At times, you have to take supplements if you don’t meet your bodily demands through food.

Different types of vitamins have varied roles in the growth of the baby. So, always consult your doctor before taking any type of vitamin supplements.

 Vitamin1

Pic Courtesy: https://www.google.co.in/search?q=Role+of+each+vitamin+while+Pregnancy+Period&biw=1242&bih=606&source=lnms&tbm=isch&sa=X&ved=0ahUKEwjFrMCttZfKAhWOVo4KHVhPAM8Q_AUIBigB#imgrc=t7xdwCzCIezmUM%3A

Vitamin2

Pic  Courtesy: https://www.google.co.in/search?q=Role+of+each+vitamin+while+Pregnancy+Period&biw=1242&bih=606&source=lnms&tbm=isch&sa=X&ved=0ahUKEwjFrMCttZfKAhWOVo4KHVhPAM8Q_AUIBigB#imgrc=ZGjCIHFclx1BCM%3A

 Vitamin A

Vitamin A is one of the main requirements for foetal development, proper functioning of the immune system and visual health. Deficiency of vitamin A can cause night blindness etc. During pregnancy, it is advisable not to consume vitamin A supplements like retinol which is a compound of vitamin A as too much of it can harm the baby. Take your doctor’s advice before taking supplements of vitamin A. Some of the best dietary sources of vitamin A are:

  • Vegetables like carrots, potatoes, pumpkin, broccoli etc
  • Milk
  • Eggs
  • Liver


Vitamin D

You need vitamin D to keep your bones and teeth healthy. But during pregnancy, the baby also needs vitamin D during its first phase of development.  Vitamin D helps your child’s teeth and bones grow. It also helps in regulating the immune system, nerves and muscles of the body. As we all know, the best source of vitamin D is sunlight, but too much of sunlight can lead to skin ageing etc. So, it is better to have vitamin D rich food and vitamin supplements during pregnancy.

Deficiency of vitamin D can soften the bones of your child and make it suffer from diseases like rickets. Some of the best sources of vitamin D are:

  • Cereal
  • Milk
  • Fatty fish


Vitamin C

Vitamin C is one of the essential vitamins during pregnancy. Vitamin C helps to form collagen in the blood vessels and during pregnancy the requirement of blood volume increases. So, a pregnant woman needs more vitamin C for the growth of the unborn baby.

During pregnancy, the average requirement of vitamin C is around 40 mg/day. But in some cases, the necessity is around 60 mg/day or more. Some best dietary sources of vitamin C are:

  • Vegetables like green bean, potato, broccoli, papaya, tomato, bell pepper etc
  • Citrus fruits
  • Strawberries


Folic Acid

Folic acid helps in the growth of the cells and prevents neural tube defects. During pregnancy, a woman needs around 600 mcg of folic acid. Some dietary sources of folic acid are:

  • Green leafy vegetables
  • Vegetables like spinach, beans, broccoli and beet
  • Fruits like strawberries and oranges
  • Fortified cereals and pastas


Vitamin E

Vitamin E helps to form red blood cells and muscles. During pregnancy, you need to have vitamin E either through dietary source or through supplements. Some of the excellent dietary sources of vitamin E are:

  • Fortified cereals
  • Vegetable oils
  • Spinach
  • Nuts


Vitamin B1 or Thiamin

Vitamin B1 or Thiamin helps in raising the energy level and regulates the nervous system, as well. It also helps in maintaining appetite and growth. Deficiency of vitamin B1 can cause diseases like beriberi. So, it is advisable to have around 1.4 mg of vitamin B1 per day when you are pregnant.

You can find good source of vitamin B1 in the following:

  • Fortified cereals
  • Wheat germ
  • Whole grain
  • Pasta
  • Eggs
  • Legumes
  • Organ meat


Vitamin B2 or Riboflavin

For better energy, good eyesight and healthy skin, vitamin B2 or riboflavin is very essential. So, during pregnancy, your body should get around 1.4 mg of vitamin B2 daily. Some dietary sources of vitamin B2 are:

  • Fortified cereals
  • Dairy products
  • Egg
  • Fish
  • Meat

Vitamin3

Pic Courtesy: https://www.google.co.in/search?q=Role+of+each+vitamin+while+Pregnancy+Period&biw=1242&bih=606&source=lnms&tbm=isch&sa=X&ved=0ahUKEwjFrMCttZfKAhWOVo4KHVhPAM8Q_AUIBigB#imgrc=rKTD6a_0SteLbM%3A

 Vitamin B3 or Niacin

Vitamin B3 or Niacin is essential for the normal functioning of the gastrointestinal tract and nervous system. It also promotes healthy skin. A pregnant woman needs 18 mg of vitamin B3 on a daily basis either through dietary source or supplements. Some sources of vitamin B3 are:

  • Fortified cereals and bread
  • High-protein food
  • Peanuts
  • Milk
  • Fish
  • Egg


Vitamin B6 or Pyridoxine

Vitamin B6 helps in forming red blood cells and getting rid of morning sickness during pregnancy. During pregnancy, a woman requires around 1.9 mg of vitamin B6 daily in any form. Some of the good dietary sources of vitamin B6 are:

  • Vegetables like cabbage, spinach, bean, broccoli and peas
  • Nuts like walnut and peanut
  • Brown rice
  • Wheat germ
  • Oats
  • Sunflower seeds
  • Chicken
  • Fish
  • Egg

It is essential to have a healthy diet during pregnancy for the proper growth of the baby. So, consult your doctor from time to time and take supplements when prescribed.

 

Diabetes After Delivery

Fernandez Hospital Leave a comment

Introduction

After the delivery of the baby, the body of the new mother starts recovering from the  phases of pregnancy and delivery. During the first week after delivery, some women manage to have normal glucose level in the blood, but some may have odd sugar level swings. Normally, blood sugar level is checked at various times before you get discharged from hospital in order to check if gestational diabetes has been resolved or not.

1

It is natural that during the first week after delivery, you will feel stressed, tired and lack of sleep. This may lead to napping at odd hours like breakfast or lunch time. Skipping meals may make your sugar level low which is really very dangerous. So, it is very essential to have healthy meals at the proper time.

In order to maintain your sugar level after delivery:

  • It is very important to get your sugar level tested frequently after six weeks of postpartum.

2

  • Weight control is very necessary to control diabetes. It also reduces the risk of gestational diabetes in the next pregnancy.
  • Following a healthy diet chart that includes vegetables, fruits and grains is extremely helpful if you have high blood sugar after childbirth.

3.jpg

  • You should continue medical care follow-ups and do all the recommended tests.
  • Exercising daily for at least 30 minutes for five days a week really helps in normalising your blood sugar level.

Pregancy Exercise

 

  • Try to do light work, have a warm bath or try walking after childbirth.
  • Breastfeeding is absolutely safe and good for women with diabetes; it also lowers the risk of Type 2 Diabetes.

Conclusion:

Normally, gestational diabetes goes away immediately after delivery. In case, if you are not totally cured of gestational diabetes immediately after childbirth, it should be cured within a few weeks or months.

After delivery you may feel mental or physical distress. Following healthy habits after delivery will reduce these issues, making you and your baby healthy.

Images Courtesy:  

http://mywwwzone.heckyeahllc.netdna-cdn.com/

http://www.aponjon.com.bd/

http://media.phillyvoice.com/

http://www.cdc.gov/

 

Umbilical Stump

Fernandez Hospital Leave a comment

What is an umbilical stump?

During pregnancy, babies receive nutrients and oxygen through the help of the placenta. The placenta is attached to the inner wall of the uterus and is connected to the unborn baby with the help of the umbilical cord. After the birth of the baby, the umbilical cord is cut in a painless manner as it is not needed after birth. Due to the absence of any nerve, neither the mom nor the baby will feel pain while the cord is cut. And this results in a short stump on the navel of the baby.

UC1

  Pic Courtesy: https://www.google.co.in/search?q=umbilical+cord+care+in+newborns&rlz=1C2LENN_enIN501&biw=1242&bih=606&site=webhp&source=lnms&tbm=isch&sa=X&sqi=2&ved=0ahUKEwjfwJy385bKAhVHTY4KHSWcDeYQ_AUIBigB#tbm=isch&q=cord+care&imgrc=ynqP9cObv0U4UM%3A

UC2

Pic Courtesy: https://www.google.co.in/search?q=umbilical+cord+care+in+newborns&rlz=1C2LENN_enIN501&biw=1242&bih=606&site=webhp&source=lnms&tbm=isch&sa=X&sqi=2&ved=0ahUKEwjfwJy385bKAhVHTY4KHSWcDeYQ_AUIBigB#tbm=isch&q=cord+care&imgrc=TwlNxdINdUSkhM%3A

How long does the umbilical stump remain on the baby’s navel?

Normally, it takes around five to fifteen days for the stump to dry up and fall. If it is kept dry, the average time taken is seven days. So, you should keep the stump dry and free from infections.

When the umbilical stump starts drying, it shrivels up and the colour changes from yellowish-green to black or brown. And after the stump dries off totally, it drops naturally. So, it is advisable not to pull the stump; let it fall by itself. You may notice blood stains on the diaper when the stump falls off; it is quite normal. So, it may take some days for the wound to heal. Sometimes, you may see some fluid drainage and bits of lumpy flesh may remain on the baby’s navel. If these fluids and fleshy lumps don’t disappear on their own, consult your child’s doctor.

UC3

Pic Courtesy: https://www.google.co.in/search?q=umbilical+cord+care+in+newborns&rlz=1C2LENN_enIN501&biw=1242&bih=606&site=webhp&source=lnms&tbm=isch&sa=X&sqi=2&ved=0ahUKEwjfwJy385bKAhVHTY4KHSWcDeYQ_AUIBigB#tbm=isch&q=cord+care&imgdii=Tv31IILxbJVUuM%3A%3BTv31IILxbJVUuM%3A%3BZzuaA8NwbjBReM%3A&imgrc=Tv31IILxbJVUuM%3A

How to take care of your newborn baby’s umbilical cord stump?

Parents should take proper care of the baby’s umbilical cord so that it dries up quickly and falls off on its own. And in order to keep the umbilical cord stump uninfected, there are various measures which you should follow.

  • You should keep the umbilical stump clean. If the umbilical stump gets sticky or dirty, you should clean it using plain water. But don’t forget to dry it with a clean and absorbent piece of cloth or fan it with paper.
  • Parents should take proper care to keep the stump dry. So, keep the umbilical stump exposed to air as much as you can which will help the base to get dry. To avoid the stump from getting covered, fold the front of the baby’s diaper. Or you can cut out some portion of the diaper in the front so that it doesn’t touch the umbilical cord. It also prevents the contents of the diaper from disturbing the umbilical stump.
  • During summer, you can dress your child in a T-shirt and diaper which will help the stump receive better air circulation. And during winter, dress your baby in loose clothes and take proper care to make the stump remain dry.
  • Till the time the stump falls off, it is advisable to give sponge bath to your baby. It will help the stump from getting wet. And after the stump falls off, you may give your child a bath in a tub of water.
  • Even if the umbilical cord looks like it is hanging by a thread, don’t try to pull it off. Let it dry and fall off naturally.
  • Till the umbilical stump of your newborn baby falls off and has healed totally, you should avoid dressing your child by covering the whole body.
  • Avoid using antiseptic without your doctor’s advice and let the umbilical stump fall off naturally.

care-of-the-newborn-15-728

Pic Courtesy: https://www.google.co.in/search?q=umbilical+cord+care+in+newborns&rlz=1C2LENN_enIN501&biw=1242&bih=606&site=webhp&source=lnms&tbm=isch&sa=X&sqi=2&ved=0ahUKEwjfwJy385bKAhVHTY4KHSWcDeYQ_AUIBigB#tbm=isch&q=cord+care&imgrc=Tv31IILxbJVUuM%3A

Signs of infection:

During the process of healing, if your baby’s stump looks a little mucky, it is quite normal. But if the following symptoms occur, it is advisable to consult your child’s doctor.

  • The umbilical stump becomes swollen, smells foul or discharges yellowish fluid.
  • The navel or the surrounding area becomes red and swollen.
  • The umbilical cord stump continuously bleeds.
  • Baby has fever or remains unwell.
  • Baby shows lack of interest while breastfeeding.

So, if you have a newborn baby, take proper care of the umbilical cord so that the stump gets dried up easily and drop off normally.

Fatigue Problems During Pregnancy

Fernandez Hospital Leave a comment

During pregnancy, most women experience extreme tiredness and fatigue. It is quite normal to feel tired during pregnancy as your body undergoes different types of changes,  and pains, aches, tender nipples etc occur. During the early and later stages of pregnancy, fatigue becomes very common. Some pregnant women experience fatigue throughout the whole pregnancy yet some don’t feel tired at all.

Fatigue1

Pic Courtesy: https://www.google.co.in/search?q=fatigue+problem+while+pregnancy+period&biw=1242&bih=606&source=lnms&tbm=isch&sa=X&ved=0ahUKEwjzl8ObqpfKAhUUB44KHUNnCvcQ_AUICCgD#imgrc=W84nL_vF9IJypM%3A

Reasons for fatigue

Though the actual reasons for fatigue during early pregnancy are not known, it is assumed that  hormonal changes are the main reason. As progesterone is known to make one tired and sluggish, rapid rise of this hormone in pregnant women make them feel more tired. The hormonal changes results in a mess of stress level with the mental state taking a toll on the rest of the body making you feel tired. At the end of the first trimester, all these symptoms reduce to a great extent. If they still continue in the second trimester, it is advisable to consult your doctor.

Moreover, most pregnant women get affected with anaemic problems. The symptom of anaemia during pregnancy is fatigue. An expectant woman needs greater amount of iron for the baby and for the blood loss during the delivery.

Some other causes of fatigue may include the stress of becoming a mother, carrying twins, vitamin D deficiency etc.

 Fatigue2

Pic Courtesy: https://www.google.co.in/search?q=fatigue+problem+while+pregnancy+period&biw=1242&bih=606&source=lnms&tbm=isch&sa=X&ved=0ahUKEwjW_LKnrJfKAhURc44KHVNaAwoQ_AUICCgD#imgrc=7khJFqVcfqx9rM%3A

Fatigue3

Pic Courtesy: https://www.google.co.in/search?q=fatigue+problem+while+pregnancy+period&biw=1242&bih=606&source=lnms&tbm=isch&sa=X&ved=0ahUKEwjW_LKnrJfKAhURc44KHVNaAwoQ_AUICCgD#tbm=isch&q=fatigue+problem+while+pregnancy+period+in+indian+women&imgrc=TQBaG0M2uFDtfM%3A

 

How long does fatigue last?

Fatigue is common in the first and third trimester, but in some cases it may occur in the second trimester, as well. You will gain more weight during the last months of pregnancy resulting in  trouble while sleeping, backache, leg cramps, heartburn etc. So, it is very natural to get tired and restless during the first three months and the last months of pregnancy.

How to reduce fatigue during pregnancy?

Though there is no prescription to reduce fatigue, doctors advise pregnant women to rest and relax.  The following tips may help you to prevent and manage fatigue during pregnancy.

  • Take rest as much as possible
  • Drink lots of fluids in order to keep hydrated
  • Take power naps in the afternoon to compensate loss of sleep at night
  • Eat small but healthy meals throughout the day which will help you gain energy
  • Do some deep-breathing exercises, some stretches or take a short walk every day
  • Include protein and iron rich food like whole grain bread, red meat, sea food, leafy vegetables
  • Go to bed early and try to get a good night’s sleep
  • Adjust your work schedule and be less busy during your pregnancy. You can ask your family to help you in household activities.

Fatigue4

Pic Courtesy: https://www.google.co.in/search?q=fatigue+problem+while+pregnancy+period&biw=1242&bih=606&source=lnms&tbm=isch&sa=X&ved=0ahUKEwjzl8ObqpfKAhUUB44KHUNnCvcQ_AUICCgD#imgrc=bri_KkBpZYz1dM%3A

Fatigue5

Pic Courtesy: https://www.google.co.in/search?q=fatigue+problem+while+pregnancy+period&biw=1242&bih=606&source=lnms&tbm=isch&sa=X&ved=0ahUKEwjW_LKnrJfKAhURc44KHVNaAwoQ_AUICCgD#tbm=isch&q=fatigue+problem+while+pregnancy+period+in+indian+women&imgrc=RMqZCwWhRdqcuM%3A

Consult your doctor if the following occur:

  • Fatigue due to extreme thirst and hunger
  • Fatigue due to sore throat, swollen glands or fever
  • Excessive fatigue along with vomiting, nausea, increased urination etc
  • Fatigue due to depression or stress
  • Fatigue even after proper rest

Though it is pretty normal to be tired during the first and last trimester of pregnancy, at times it is advisable to consult your doctor. Taking proper rest is one of the best ways to get relief from stress and tiredness during pregnancy.

Trimesterwise Tips for Expecting Moms

Fernandez Hospital Leave a comment

trimester

Pic courtesy: http://blog.cloudninecare.com/trimester-wise-pregnancy-tips/

 Having a life growing inside you is nothing less than a miracle! Experiencing the entire process month by month is simply astounding. But then pregnancy comes with its own challenges and complexities that are only experienced as the time flows in the 9-month course. This blog post offers you elaborate trimesterwise tips for expecting moms.

Before we go into the pregnancy tips, let’s have a quick look at the biological changes that take place during pregnancy.

The First Trimester (First three months)

First-Trimester-Baby-Development

 Pic courtesy: http://www.pregmed.org/the-first-trimester-of-pregnancy

The fetus has started taking human shape with all the internal organs showing up. You will experience the following changes:

  • You will feel your uterus has ascended above the pelvis region
  • You will now feel less to no morning sickness and will put on weight. Ahh! This can give you mixed feelings!!
  • The fetus has now evolved into a fully formed body with fingers, toes and ears, with the body covered with fine hair
  • You can now press your stomach to feel your baby’s movement 

The Second Trimester (3rd to 6th month)

stages-of-pregnancy-tips-facts-warnings-6-728

Pic courtesy: http://www.slideshare.net/TerroWhite/stages-of-pregnancy-tips-facts-warnings

 By now your uterus has been steadily preparing itself for labour. You will experience the following changes:

  • You will feel painless contractions known as the Braxton Hicks contractions
  • Every week you will put on 1/2 kg of weight
  • You may experience constipation and indigestion
  • Your uterus has now risen 5cm above the pelvis
  • By the 16th week, you can clearly feel your baby’s movement

The Third Trimester (6th to 9th month)

third-trimester

Pic courtesy: http://www.citranatal.com/pregnancy/third-trimester

You are now in the last phase of your pregnancy and your baby has now fully grown. You will experience the following changes:

  • Because of the consistent weight gain, you have now become breathless
  • The movement as the baby’s head drops to the pelvis — you’ll have a thud-like feeling
  • The weight of your baby should be 2.7-3.5 kg
  • You will experience difficulty in sleeping
  • Your breasts will now start secreting transparent colostrum i.e. protein-enriched pre-milk
  • Your placenta has now enlarged up to 20-25 cms and holds 1.1 ltr of amniotic fluid

TIMESTERWISE NUTRITION TIPS

First Trimester (First three months)

First-Trimester1

Pic courtesy:http://www.momjunction.com/articles/first-trimester-diet-essential-foods-you-should-include_00116232/

 Add Folic Acid to your pregnancy diet

Folic acid/Folate is Vitamin B that plays an important role in the development of baby’s skull and brain including its spinal cord.

What to eat –

  • Vegetables such as spinach, ladies finger, broccoli, cabbage
  • Pulses that include lentils, beans and chick peas
  • Others include oranges, eggs, brown rice, baked potatoes, asparagus, corn, brown breads etc.

Tip – Do not cook the above veggies, as folic acid is lost during cooking, instead boil and have them.

Add calcium to your pregnancy diet

Someone on a public health forum had posed this question – “I don’t really like milk… is it such a big deal if I don’t get enough calcium while I’m pregnant?” And the collective response was a big YES.

Calcium plays a crucial role in developing the baby’s bones, teeth, muscles, nerves and heart. When the growing baby does not get the required amount of calcium then it starts extracting it from the mother’s bones. Doctors recommend consuming 1,000 mg of calcium every day.

 What to eat –

  • Dairy products that ensure less to no fat such as low fat curd, skimmed milk
  • Green leafy veggies such as cauliflower, broccoli and watercress (Jalkumbji)
  • Dry fruits including almonds, apricots and figs (anjeer)
  • Others include tofu, small fish with edible bones, cereals and oranges

Tip – The best way to confirm calcium usage is by consuming Vitamin D. So try to eat foods rich in Vitamin D such as boiled egg, asparagus, fish etc.

Second Trimester (From 3rd to 6th month)

second 

Pic courtesy: http://www.fitmommacleanbaby.com/

 Add Vitamin C to your diet

Vitamin C helps in forming collagen. It is the most widely available protein in the human body, mostly the component of tendons, bones, cartilage and skin.

What to eat –

  • Citrus fruits including lemon, orange, grapefruits
  • Other fruits such as pumpkin, pineapple, guavas, berries, kiwi
  • Vegetables such as broccoli, spinach, sprouts, bell peppers

Add Omega-3 to your diet

Since Omega-3 (DHA) helps in the development of nervous, immune systems and brain, so it becomes highly necessary for you to start consuming foods laden with omega-3 as you enter your second trimester. 

What to eat –

  • Salmon, flax seeds, soybean, walnuts, pumpkin seeds, spinach

Add magnesium to your diet

Magnesium also largely helps in the development of baby’s bones.

What to eat –

  • Seeds such as pumpkin and sunflower seeds
  • Dry fruits such as avocado, almonds, raisins, cashews
  • Vegetables such as legumes, kidney beans
  • Other sources include banana, oatmeal, soybean and nuts

Third Trimester (From 6th to 9th month)

third-trimester

Pic courtesy: http://www.fashionlady.in/extremely-important-must-have-foods-every-trimester/17136

In this trimester, the baby grows completely so the intake of nutrition also increases. Therefore, mom needs to have an extra of 2300 calories on a daily basis.

What to eat –

Try to consume 250ml of fruit juice on a daily basis. You should also consume low fat milk/yoghurt of the same quantity. Add wholemeal toasts with low fat cheese spread to your breakfast. And if you are a non-vegetarian then you should have 40gms of meat with raw vegetables regularly.

So those were some trimesterwise tips for expecting Moms.
Hope you found this post useful!

Top 5 Tips for Pregnant Women During Winter

Fernandez Hospital Leave a comment

Winter

Courtesy: http://www.freevector.com/site_media/preview_images/FreeVector-Silhouettes-Of-Pregnant-Women.jpg

During pregnancy, every woman, particularly in India, will experience the harshness of summer and winter. While many underestimate winter in South India,  it can be challenging for expecting moms irrespective of where they reside. These top 5 tips for pregnant women during winter will surely help in taking extra care of your baby and your health.

You might be longing for winter as you’ve had enough of the scorching heat and humid days, but be prepared to experience its peculiarities especially when you’re pregnant. The following points will help you gear up for the colder months and keep you safe from woes like infections, dryness and itchiness, etc. 

Top 5 tips for pregnant women during winter

 #1 Avoid dehydration

If you thought dehydration happens only during summer then remember winter air can also be dry, making your body overheated from within. Dehydration usually occurs when the body starts losing its fluid faster than its intake. During pregnancy, dehydration can be risky as it first affects the baby.

How dehydration is risky during pregnancy?

Water in an expecting mom’s body helps to form the placenta, through which the unborn baby draws its necessary nutrients. Besides, water also helps in forming the amniotic sac in the last stage of pregnancy; therefore it  becomes extremely necessary to stay well-hydrated.

#2 Protect yourself from infections

Winter also brings assorted infections including flu, cold and sneezing. Since you are pregnant you cannot simply take any anti-allergy pills or antibiotics. The best way to avoid cold and infections is by always keeping your hands clean. Unknowingly, germs get transmitted easily through our hands when we touch our mouth and nose.

It is recommended that pregnant women should get vaccinated against influenza. It is ideal to also get a whooping cough booster vaccine, on your doctor’s advice.

#3 Go in for layering

Instead of spending a fortune on an oversized coat that is pretty useless post pregnancy, it’s better to wear winter clothes in layers. Start with lighter layers underneath and end with a bulky sweater which you remove anytime the temperature goes up.

#4 Eat healthy

No matter the season, expecting moms should always take care of their diet. Extra attention should be given to what they eat in winter. Here are some Do’s:

  • Since winter blesses us with several types of fruit, try consuming them in plenty, especially as juice to stay hydrated.
  • Try to munch on Indian gooseberry (Amla), as it’s loaded with Vitamin C which not only helps fight against infections, but also acts as anti-oxidant and saves skin from dryness.
  • Add saffron to your milk. It maintains body temperature and boosts immunity.
  • Make sure you munch on a handful of nuts regularly as they are enriched with vitamins and natural oils. Since nuts are tasty, you can easily replace oily snacks with nuts.
  • Do not hesitate to have sweets such as patti, gajak, chikki, til ke laddu etc. While gud or jaggery gives you zinc and is healthier than sugar; til is a rich source of calcium.

#5 Do not cut off your exercise

We admit, winter makes you feel lazy and during pregnancy you wouldn’t want to come out of your blanket. Exercise during pregnancy is essential. So if you are not comfortable walking in the mornings then try going out for a brisk walk around 4-5 pm. You can also join a prenatal fitness programme where you can benefit a lot and stay healthy throughout your pregnancy.

Hope you found this post on top 5 tips for pregnant women during winter useful!

 

All You Wanted to Know About Pelvic Exercises During Pregnancy

Fernandez Hospital Leave a comment

 Ex1.jpg

Pic courtesy – http://www.bepilates.org/

While pregnancy is physically demanding, exercise becomes necessary to cope with the physical as well as biological changes that affect specific areas such as muscles, joints, backbone and especially the pelvic floor. In this post, we are going to share how pelvic floor exercises during pregnancy are important since they not only help reduce pelvic pain but also ease the childbirth procedure.

Your takeaway from this blog post on pelvic floor exercises during pregnancy –

  • Where are pelvic floor muscles located
  • How to locate pelvic floor muscles
  • Why is pelvic floor exercise so important
  • How does pregnancy affect pelvic floor
  • Benefits of pelvic floor exercises
  • Types of pelvic floor muscle exercises
  • What else you should know about pelvic floor exercises

Before we jump into the workout section, let’s have a quick intro on pelvic floor –

Ex2

Pic courtesy- http://pelvicguru.com/2013/06/22/dear-crossfit-and-crossfit-gynecologist-im-appalled-theres-help-for-peeing-during-workouts/

 Where are pelvic floor muscles located?

As the name suggests, the pelvic floor muscles form the base of the pelvis.

Pelvic floor is a group of muscles, ligaments and sheet-like tissues that stretch from the front side to the back side i.e. base of your spine. These muscles are attached to the pelvis sides (the bones that we sit upon). They are also attached to the pubic bone and the coccyx i.e. tailbone. These muscles pass through the vagina, anus and urethra, as shown in the image.

What do pelvic floor muscles do?

  • They help in supporting the bladder, uterus and intestines.
  • They help in controlling bowel and bladder movement.
  • They help in sneezing, coughing and lifting heavy objects.
  • They support the spine and help during sex.

How to locate pelvic floor muscles?

Try to control your flow while urinating, and you can soon identify the muscles which help you stop the flow in the middle of urinating. However, it is not ideal to do this as an exercise as stopping the flow can affect your bladder.

Another way of identifying these muscles is by inserting two fingers into your vagina and try squeezing them. You will soon understand the mechanism.

Ex3

Pic courtesy – http://www.xft-china.com/support/detail_17_85.html

Why is pelvic floor exercise so important?

  • As already discussed above, the pelvic floor muscles support the uterus and help in bowel as well as bladder movement, so if the pelvic floor is weakened then the muscles become harder to be squeezed which affects urinating and bowel movement.
  • Weak pelvic muscles may also put you in an embarrassing situation as you may pee a little while coughing or sneezing. This further leads to a heavy dragging-like feeling because of improper bladder and womb movement.
  • Weak pelvic muscles also affect vaginal muscles.
  • Not only during pregnancy but pelvic muscles should be well maintained as post menopause hormonal changes worsen the abovementioned problems, thereby causing sagging of the uterus and bladder towards the walls of the vagina.

By regularly doing a few pelvic floor exercises, bladder weakness or prolapse symptoms are kept at bay, while reducing the pelvic pain during pregnancy and labour pain as well. 

How does pregnancy affect the pelvic floor?

The extra pounds that you put on following pregnancy exert pressure on your pelvic floor muscles, thereby leading to weakness that persists even after the childbirth. The pelvic floor tends to become weak as early as 12 weeks into your pregnancy.

As constipation is one of the common health problems for expecting moms, it can put more strain on your pelvic floor thus increasing the pelvic pain.

Benefits of doing pelvic floor exercises

  • They help in toning up the pelvic floor.
  • They help in reducing the risk of uterine/bladder prolapse.
  • They help during labour, while improving the recovery time.
  • They help in reducing post-partum discomforts such as perineal swelling and hemorrhoids.
  • They help in healing the area between anus and vagina i.e. perineum post-partum, by improving the blood circulation.
  • They help in reducing perineal tearing and the likelihood of episiotomy.
  • They help in the complete emptying of the bladder and bowel.
  • They help in maintaining the muscle tone of the vagina thereby easing the delivery process.
  • They help in preventing urinary leakage during pregnancy.

Types of pelvic floor exercises

Ex4

Pic courtesy – http://v-tightgelreviews.net/ultimate-guide-kegel-exercises/

Since your pelvic floor muscles comprise two types of fibres — fast fibres that render strength and slow fibres that render stamina; we offer you two types of pelvic exercises during pregnancy for best results.

Short squeezes in pelvic floor exercise –

  1. Sit down comfortably by slightly stretching your knees. Stretch the muscles around the back passage just as you would do to stop your bowel movement.
  2. Now do the same thing at the front, as if you are squeezing your vagina to stop urinating.
  3. Make sure the squeezes are strongly executed in as much that you feel a definite ‘let go’.
  4. These types of short squeezes should not last for more than a few seconds.
  5. Try to do three sets per day in different positions.

Long squeezes in pelvic exercises during pregnancy

  1. Sit down in the same position as you had done for short squeezes and repeat the above step. The only difference is you need to hold it for a longer time i.e. a few extra seconds. But always remember to breathe normally.
  2. Make sure in the process you’re not constricting your buttock muscles. You can stress your lower abdominal muscles a bit but don’t squeeze out your anus.
  3. Take a break of few seconds before repeating the above step. However, you should stop immediately if you feel your muscles are tired.
  4. Try to find out how long you can hold on to the squeezing, say 4 seconds. This will help you do the long squeezes better.
  5. Now when you become comfortable with the 4-second long squeeze, try to increase it to say 10 seconds. You can gradually increase the counts with each workout.

Bonus points — What else you should know about pelvic floor exercises?

It is equally important to relax pelvic floor muscles as it is to tighten and squeeze them. It is especially important when the baby starts crowning its head during second stage of labour. The pelvic muscles need to be relaxed during this stage, so as to avoid episiotomy.

Make sure you drink a lot of fluid and that you urinate only when you feel your bladder is completely full. Since the frequency of urinating increases during pregnancy, do not try to hold on for too long as it affects the bladder.

Intrauterine Insemination (IUI)

Fernandez Hospital Leave a comment

What is Intrauterine insemination ?

The technique of Intrauterine insemination (IUI) is a widely popular assisted reproductive technique due to its simplicity and affordability. The IUI procedure involves introducing washed and actively motile sperms directly into the uterine cavity (womb), at or around the time of ovulation, with the aim of increasing the chances of pregnancy. The purpose of IUI is to increase the number of active sperms reaching the egg in the fallopian tube, bypassing the vagina and cervix, thus, shortening the distance to be travelled by the sperms.

IUI is a simple procedure and can be performed whether or not the woman is receiving medication for egg formation. However, stimulation of egg development by medication does improve success rates, as more than one egg will develop. Monitoring by USG is essential to track follicular growth and to time the ovulation. Once the follicle reaches maturity, the patient is given hCG injection (human chorionic gonadotropin) for ovulation, which usually takes place within 24 to 36 hours of the injection.

IUI

Pic courtesy:  http://thefertilityblogs.com/trying-to-conceive/third-party-reproduction/what-is-an-iui/4201/


Who are eligible for IUI procedure?

To consider IUI :

  • The female partner should be ovulating normally or should be able to ovulate with medication for ovulation
  • She should have open fallopian tubes or at least one fallopian tube should be patent and

healthy

  • The male partner should have satisfactory sperm counts, motility and morphology

IUI not indicated in following conditions

  • Female partner with

– tubal block on both sides

– inability to develop eggs

– age > 40 years

– advanced stages of endometriosis

  • Male partner with azoospermia (absence of sperms in semen) or very low scores of sperm count, motility and morphology.

What is the procedure for IUI?

The total procedure has three components. One is semen collection, second is semen preparation and the third is deposition of active sperms in the uterine cavity. The entire procedure takes approximately 1 – 3 hours.

Semen collection and preparation

A short period i.e. 2 days of ejaculatory abstinence is advised prior to the scheduled IUI. At the predicted time of ovulation, the male partner is asked to collect semen into a sterile container and submit it in the laboratory for sperm preparation. Here semen analysis is performed to check for initial parameters. Then it is processed. Best quality active sperms are separated and made into a small quantity (0.25 ml). Rest of the seminal fluid containing dead sperms, bacteria and other components which can cause painful contractions of the uterus, is discarded. Post-wash active sperm count is noted for sample adequacy for insemination. Minimum count of five millions of active sperms is acceptable. Success rates are low with lower counts.

Actual IUI procedure

Once the specimen is ready, the female partner is called for IUI procedure to the insemination room. She is made to lie down on the couch with legs flexed. A speculum is introduced into the vagina to expose the cervix and it is gently cleaned. Prepared sperms are loaded into a slender semi flexible sterile catheter with a plunger. It is then passed through the cervix into the uterine cavity and the sperms are injected by pushing the plunger.

How much time does the actual IUI take and will it cause any pain?

Actual IUI (deposition of active sperms into the uterus) procedure takes only a couple of minutes. The procedure is usually painless, although 10% of the women may experience a menstrual cramp like pain. There may be a little vaginal spotting or discharge after IUI.


 

Is rest necessary after IUI?

The female partner will be asked to lie down for a few minutes after IUI (10 – 15 minutes). Then she can resume her regular activities. The sperms will not escape from the uterine cavity if she gets up.

Is intercourse advised after IUI ?

Yes, this will increase the chances of conception.

How many sittings of IUI are performed in one cycle?

Usually one single properly timed insemination is sufficient.

How many cycles of IUI are recommended?

Four to six cycles of IUI may be tried as there is no improved success seen later.

Chances of success with IUI

Average success rate ranges from 15-20 % in a single cycle. The success rates may be high in stimulated cycles and if the total sperm count is more than 20 million/ml.

What are the risks involved with IUI?

Procedure related complications are infrequent. They include infection where women can suffer with lower abdominal pain, vaginal discharge.

Hysterosalpingogram

Fernandez Hospital Leave a comment

What is Hysterosalpingogram ?

Hysterosalpingogram (HSG) is an X-ray test done to know about the patency of the fallopian tubes, which help in the transport of the egg and the fertilized embryo. It is usually done on 7th or 8th day of the menstrual cycle.

Hysterosalpingogram

Pic courtesy:   http://www.aiwhc.com/patient-education-hysterosalpingogram.html


Procedure and Instructions to be Followed for the Investigation

  1. In this test, a small amount of liquid (dye) is pushed into the uterus through a small instrument (speculum) placed in the vagina and an abdominal X-ray is taken. There can be period-like crampy pain during the procedure.
  1. To prevent pain, we advise Tab. Meftal spas to be taken with food, 1 hour before HSG and to continue it 8th hourly depending on the pain for the next two to three days.
  1. This test delineates the uterine cavity and the tubes. If the tubes are open, the dye flows out of the tubes and can be seen on the X-ray film.
  1. As this test involves pushing some liquid into the uterus, there can be a small risk of infection. In order to avoid this, we advise antibiotic Tab. Doxycycline 100 mg two times a day after food, starting from the day of HSG which has to be continued for a total of five days.
  1. Once HSG test is done, a gynaecology consultation (by appointment) with the report is advised.