Pregnancy Calculator – Block The Date For The Greatest Arrival Of Your Life

Author: Dr. Sushruta Mokadam (MBBS, MD)

Consultant – Obstetrician & Gynaecologist at Motherhood Hospitals, Kharadi

Online Pregnancy Calculator

For any couple planning a family, the happiest moment is when the doctor says, “Congratulations, you are pregnant!” After this, a good amount of time is spent on discussions that involve estimating the due date. Of course, the doctor will share the date with the couple and unravel the mystery. Let’s look at the science behind the estimation of the date of delivery.

The human egg can fertilize for only 12 to 24 hours after ovulation, so the date of ovulation could be a reasonably good indicator to estimate the date of conception. Ultrasound which is used to determine the date of ovulation is not too perfect because this only suggests the gestational age. In fact an accurate date of conception is usually arrived at only with IVF (In Vitro Fertilization).

Also to be considered is that although a woman is most likely to conceive if she has had sex on the day of ovulation, pregnancy could occur from active sperm in her reproductive tract on the day of ovulation, even if the woman had intercourse five days prior to that date.

Determining the Estimated Due Date 

Estimated Due Date (EDD or EDC) is that date on which a non-induced delivery is expected to occur. This date is arrived at by taking the first day of the Last Menstrual Period (LMP) and adding 280 days

(9 months and 7 days) to it. This is the method followed by ‘pregnancy wheels’, also called a Gestation Calculator. The accuracy of the estimation of EDD in this method depends on how accurately the mother can recall the day of intercourse, assuming she has regular 28 day cycles and that ovulation and conception occurs on the 14th day of the cycle. Assumption of LMP to arrive at the due date of pregnancy may result in an overestimation of the pregnancy duration to the tune of over 2 weeks.

Coming to ultrasound, this approach considers the size of the foetus to determine the gestational age (the time since the first day of LMP). The accuracy of such an estimate of the gestational age varies. Using ultrasound to measure the foetus in the first trimester (up to and including 13 6/7 weeks of gestation) is the most accurate method to arrive at the gestational age.

Canada’s Society of Obstetricians and Gynaecologists recommends the earliest ultrasound presenting a crown rump length that indicates at least 7 weeks (or 10 mm) should be used as the benchmark to arrive at the gestational age.

In the case of Vitro Fertilization (IVF), the date of conception will be known accurately and EDD can be calculated by adding 266 days to that date.

The American College of Obstetricians and Gynaecologists recommends that the dates arrived at through ultrasound should be considered over those indicated by LMP when the variation between ultrasound and LMP is:

  • More than 5 days before 9 0/7 weeks as indicated by LMP
  • More than 7 days from 9 0/7 weeks to 15 6/7 weeks as indicated by LMP
  • More than 10 days from 16 0/7 weeks to 21 6/7 weeks as indicated by LMP
  • More than 14 days from 22 0/7 weeks to 27 6/7 weeks as indicated by LMP
  • More than 21 days after 28 0/7 weeks as indicated by LMP

There are possibilities that a foetus could have a restriction in growth leading to a risk of inaccurate dating of a small foetus.  Considering this, decisions based on ultrasonography alone (in the third-trimester) are not conclusive and the doctor has to consider the entire clinical status of the woman. This could include repeat ultrasonography to assess the correct growth in the interval.

Other methods used to estimate gestational age

Clinical Examination

For a patient with a good menstrual record in the first trimester, a simple pelvic examination has proven to be a reliable method to accurately date the pregnancy.

Doppler Ultrasonography

A foetal heart beat can be heard with a Doppler ultrasound if the gestational age of the patient is 10 to 12 weeks in most cases. This is the minimum age for the foetal heart tone to be registered.

Human Chorionic Gonadotropin Pregnancy Test

Human Chorionic Gonadotropin is detectable in the mother’s blood or urine from 6 to 14 days after fertilization (3 to 4 weeks of gestational age). The gestational age can be assessed as at least 3 to 4 weeks at the time of an hCG pregnancy test.

In case of a twin pregnancy

In case of a twin pregnancy due to an IVF procedure, the gestational age has to be considered from the date of embryo transfer. Considering the possibility of an early intrauterine growth restriction in one of the foetuses, specialists feel that it is advisable to consider assessing the gestational age using the larger foetus.

For those of you curious to access a pregnancy calculator, here’s one right here! 

We at Motherhood Hospitals have a team of experts specialising in all kinds of maternity and childbirth related issues and woman and child care – from teens to those in their post menopause years. Take an appointment with our specialist at a centre close to you and you will be assured of an accurate investigation, diagnosis and treatment. 

Book your appointment with Dr. Sushruta Mokadam for all Gynaecological issues. 

Nutrition and Exercise Until D Day – Pregnancy Tips

Healthy Pregnancy Diet

Author: Dr. Preethika Shetty MBBS, DNB, M.S (OBGY), Fellowship in Reproductive Medicine (ICOG)

Consultant – Obstetrician & Gynaecologist at Motherhood Hospitals, Kharadi – Pune

Healthy Pregnancy Diet

Maintaining good health during the weeks of pregnancy provides your baby with the nutrition it needs as it steps into the world. Doing regular exercise, following a balanced diet and keeping up with scheduled appointments with your doctor are some of the pregnancy care tips that help you to have a healthy pregnancy. Let’s learn more about the steps you could take right from the first month of pregnancy:

1. Focus on eating healthy – Inculcate a healthy and balanced diet in your regime: Here is what you could include:

  • Have five portions of fresh fruits and vegetables daily. Consume fresh fruits or fresh juices and avoid drinking packaged or canned ones. Along with this, also avoid vegetables that come packed in saltwater. Do not forget to drink plenty of water.
  • Starchy foods such as pasta, rice, bread and potatoes should make more than one-third of all the food you are eating. Furthermore, always choose whole grain variants instead of the white ones since you need plenty of fibre. Also, leave the skin on potatoes while cooking to provide more nutrition for you and your baby.
  • Have daily servings of protein from good sources like eggs, fish (two portions weekly should be oily such as mackerel, salmon or sardines), pulses, lean meat, beans, or nuts.
  • Consuming dairy foods such as yoghurt, milk and cheeses is also recommended right from the first trimester of your pregnancy.

2. Take your supplements

During your pregnancy, you and your growing baby need to have regular folic acid and Vitamin D supplements. These will be required even if you are having a well-balanced diet. Although it is recommended to eat healthily and have your daily quota of vitamins, minerals and nutrients from your diet, if you are having issues with consuming the right kind of food, talk to your doctor for all the required supplements your body might need for a healthy pregnancy.

3. Regular exercise

Regular exercise gives your body several benefits not only during pregnancy but also in post-pregnancy care. Make sure to include the following exercises during your pregnancy weeks:

  • Brisk walking
  • Yoga
  • Swimming
  • Pilates
  • Aquanatal classes

Get in touch with your exercise instructor and inform that you’re pregnant so he/ she can tailor classes or exercises specifically for you.

4. Perform pelvic floor exercises

The wide sling of muscles present at the base of your pelvis is what’s known as your pelvic floor. The functionality of these muscles is to support your bladder, vagina and back passage. During the weeks of pregnancy you may feel these muscles are getting weaker because of the extra pressure on them. To ensure adequate strength is maintained in these muscles, perform pelvic floor exercises including Kegel exercises regularly. Do take your doctor’s advice on which type of exercise best benefits you. The benefit will be experienced once you start building up to 10 long squeezes of 10 seconds followed by 10 short squeezes thrice a day.

5. Stop smoking and drinking alcohol

Regardless of the concentration, alcohol of any type will reach your baby rapidly via your bloodstream and placenta. Hence, there is no safe or minimum level of alcohol to drink during your pregnancy and one should avoid drinking to put the baby under any harm. Similarly, smoking during pregnancy can expose you and your baby to serious health problems such as miscarriage, ectopic pregnancy or placental abruption.

6. Stop caffeine intake

High caffeine content elevates the risk of stillbirth and miscarriage late in pregnancy. Hence try not to consume too much coffee, energy drinks, cola, tea or chocolates. Apart from the mentioned risks, caffeine can also contribute to having a low-birth-weight baby or premature birth.

At Motherhood Hospitals, we have a team of expert doctors, super specialists and highly trained nurses backed by the latest in infrastructure and facilities. We ensure complete care and advice to ensure a safe delivery at any of our centres. All our centres are equipped with modern equipment and the expertise to handle complex deliveries. Do take an appointment at a centre closest to you with our doctor and have a safe delivery of your baby.

If you wish to get in touch with Dr. Preethika Shetty, please book your appointment here

How Accurate Are Pregnancy Calculators

Pregnancy Weeks Calculator Online
Author: Dr. Padma Srivastava, MBBS, MD(OBG)

Consultant – Obstetrician & Gynaecologist Lullanagar, Pune

Pregnancy Weeks Calculator Online

Once you skip your period, the excitement sets in. Have you conceived? Is it finally happening? Next is a visit to the doctor, who will test you to confirm it and then calculate a date. By that time, you would definitely have come across a pregnancy calculator online, something that would be advised by friends or relatives.

So how accurate are pregnancy calculators? According to BabyCenter, an online media company, only one in twenty women deliver on their due dates. To begin with, it is important to understand that a pregnancy calculator at best offers an approximation of your delivery date based on your date of conception.
The weeks of pregnancy are dated from the first day of your last period. This actually means that in the first two weeks, you would still not have conceived. The body would just be preparing to ovulate which means, realising an egg from your ovaries.

It is indeed a logical question and one of the first any woman would ask on being informed she is pregnant – “What’s the due date?” It is important to estimate the due date as it can help you plan your pregnancy and for the baby’s arrival. From this context, a pregnancy calculator can be helpful even if it is an estimate at best and cannot be on point always. Now let’s explore how it works.

  Typically there are two methods of calculating a delivery due date. One is to estimate the date based on the last menstrual period. The second is to estimate based on the date of conception. Now, the due date based on the menstrual cycle is calculated as forty weeks from the date of the last period. The due date based on the date of conception is arrived at by adding thirty eight weeks to the exact/ approximate date of conception, which is a presumption again. The issue is that most women won’t know their exact date of conception. This makes the calculation of the delivery date an approximation. There is a possibility that the conception would not have happened on the day when the woman was sexually active and the egg could have been fertilized a day or two days later by the sperm that was lodged in the fallopian tube. Considering this variation, most healthcare specialists recommend that a calculation based on the last menstrual period is reasonably more accurate. Even with this, one can arrive at only an estimated due date. The doctor could reassess this date based on the results of an ultrasound that would indicate the size of the baby. So it is advised that you use the pregnancy calculator as a guide, but be prepared to welcome your little one anytime within one to two weeks around the due date. It could be a couple of days after the specified date too. It would be a surprise but a pleasant one, isn’t it? At Motherhood Hospitals, we have a team of gynecologists and super specialists capable of addressing a range of health issues and conditions related to women and children. Do take an appointment with our doctor at a centre close to you and you are assured of effective investigations, diagnosis and treatment enabling you to lead an active life. 
If you wish to get in touch with Dr. Padma Srivastava, please book your appointment here

Dos and Don’ts For A Safer And Healthier Pregnancy

Author: Dr. Nusrat A H, MBBS, M.S.

Consultant – Obstetrician & Gynaecologist at Bangalore, Banashankari

Becoming a mother and expecting your newborn is an overwhelming experience for a woman. This experience brings along various responsibilities that need to be followed even before the baby is born to ensure the newborn comes safe and healthy. In this segment, we’ll talk about the healthy pregnancy tips that you should focus on to take care of your unborn baby and how you can be prepared to make parenthood easier.

Start with the preconception period

Your body should be prepared mentally and physically before you look to conceive and it starts from knowing about the potential risk factors and health conditions that may affect you or your baby.
Many pregnancies take place without planning. No matter how advanced the prenatal care and medicine available are in today’s time, unplanned pregnancies come with the risk of low birth weight or preterm birth of the baby. Experts suggest women should focus on leading a healthier lifestyle before they plan to conceive, so they can avoid any risk or problems that may occur with the mother or her baby.
 

Taking care of the mother and baby’s health during pregnancy

A mother encounters a lot of doubts and questions during pregnancy – What should I eat? What are the must-haves? What do I avoid? How do I change my routine to ensure best safety and health for my baby?

Let’s talk about the important things to take care of:

Diet: There is endless advice on how much a pregnant woman should eat or avoid eating. However one needs to note that when you are “eating for two” your diet shouldn’t be doubled! In reality, it’s all about including the foods in your diet that are rich in nutrients for both mother and baby – where eating a balanced meal is enough for both.

Food items that are good for both mother and baby:

  • Fruits and vegetables
  • Grains, cereals, and wheat germ
  • Low or no-fat dairy products (milk, yoghurt)
  • Meats, poultry, and a few selective fishes

Food items that are best avoided:

  • Refrigerated meat spreads and refrigerated smoked seafood such as mackerel, salmon, or fishes that have a high concentration of mercury
  • Unpasteurised milk, juices, and cheeses such as feta or blue cheese
  • Trying new variations of herbs and plants
  • Raw sprouts

Stop smoking: Apart from damaging your body and increasing the risk of cancer and heart diseases, smoking is bad for the health of your unborn baby too. Smoking during pregnancy contributes to having a baby with low-weight or heart problems that may take place soon after birth. Along with this, the baby can suffer from cleft lip/palate, and has an elevated risk of Sudden Infant Death Syndrome (SIDS). Smoking has also been the cause of miscarriages in certain women.

Improve your oral health:  Apart from the usual dental check-ups that most women go through before getting pregnant, it is advised for them to undergo a complete oral exam during the initial stages of pregnancy. This is because pregnancy gingivitis is very common. It is a condition where gums become swollen and bleed easily. It could be the result of both poor oral hygiene and increased hormone levels during pregnancy. Though there’s little evidence to support this, gum diseases may contribute to having a baby with low birth weight.

Stop drinking Alcohol:  Lastly, drinking alcohol during pregnancy can put your baby at high risk of developing Foetal Alcohol Spectrum Disorder (FASD), which results in learning disability, behavioural issues, and abnormal facial features. This damage can take place during the earliest stages of pregnancy, even before the mother is aware that she is pregnant.

If you are looking for the best maternity hospital for normal delivery in Bangalore, then Motherhood Hospital is the answer for you. We have an excellent team of experienced super specialists backed by the latest in infrastructure. We have the expertise to handle complex deliveries, gynaecological, and various other surgeries. Do take an appointment at a centre closest to you and our doctors will make the required investigations, diagnose the issue, and recommend the most appropriate treatment – enabling you to lead an active life.


If you wish to get in touch with Dr. Nusrat A H, please book your appointment here.
 

Everything moms and moms-to-be need to prep for a post-pandemic world By Dr. Manisha Ranjan

The year that went by threw all our learnings and wisdoms handed down to us from our mothers and grandmothers, out of the window. Moms and moms to be had to learn to wing it and hone new skills to sail through the pandemic. Keeping yourself and your family safe and healthy became a challenge like no other. As we navigate back into a post pandemic world there are a million things that both moms and moms-to-be need to keep in their mind when it comes to ensuring the safety and wellbeing of themselves, their children and their soon-to-be born children. Now is the time to pause, reflect and take stock as we step into a post pandemic world. Few things to keep in mind:

The pandemic is not over

Even with the roll out of vaccinations across the globe, the pandemic is far from over. We need to continue to practise social distancing, sanitising and wearing masks while out in public places. Moms need to convey this to their children and ensure they are protected and that they follow social distancing wherever applicable. Moms-to-be need to practice extra care and precaution with the help of a support system which includes their medical practitioners, primary care givers and immediate family.

Doctor visits and check-ups

One of the most critical and important steps, is to ensure that all children below 6 are vaccinated with age appropriate vaccinations which are imperative for a child’s growth and development. Moms-to-be must also ensure that their immunisation records are up to date and be in constant touch with their doctors and attend all scans and tests as they progress with their pregnancy

Building immunity

Keeping up with our age old traditions of eating immunity boosting fruits and nutrients, it is very important that we focus on building and keeping immunity levels high as we step back into the world. A good and robust immunity helps safeguard the entire family against seasonal infections and allergies. Our body is the most important tool we possess and nourishing it adequately will help keep infections at bay.

Mental Well-being & Mindfulness

While physical health is important, the pandemic has made us unlearn a lot of things when it comes to keeping calm. Especially in case of children, families and moms-to-be. Mental well-being is as important as physical fitness, for a happy and sane mind dwells in a healthy body. The pandemic has adversely effected children as it has taken away their freedom of movement, hence it’s up to the moms to ensure that kids have a safe place at home to speak their mind and share feelings. Mindfulness is very important when it comes to both moms and moms-to-be, for stress is not good and can lead to several health complications.

Self-care

One can never stress enough on the importance of self-care for moms. Sometimes balancing home, children, family and work can get a little overwhelming and it is important for moms and/or moms-to-be to take a step back and pause. It is an old saying which holds true that the woman of the house is the glue holding everything together and we must ensure that she is happy, hale and hearty.

The world as we know is undergoing a change and we must keep up with the changing pace while keeping in mind that our fight with COVID19 is far from over. Ensuring the health and well-being of the family is of utmost importance as we step back into a semblance of our lives pre COVID.

Pregnancy & Thyroid Things to know By Dr. Madhavi Reddy

Hypothyroidism is often associated with either slow pregnancy or difficulty in conception. Untreated thyroid can cause serious repercussions and leads to either miscarriage, premature baby. It is important that thyroid diseases hyperthyroidism and hypothyroidism are both treated & monitored closely during pregnancy.  Thyroid should be managed with proper medications and regular thyroid level investigations and proper dosage of the medications. Regular monitoring of thyroid stimulating hormones & T4 levels are imperative in order to conceive. Some of the high risk factors of developing thyroid include family history of thyroid issues, autoimmune disease and thus arresting thyroid symptoms in the early stages of pregnancy is critical, so a proper treatment can be provided and can lead to a more fruitful outcome.

Symptoms of hypothyroidism

  • Weight gain & fatigue
  • Sensitivity towards cold temperature
  • Muscle cramps
  • Difficulty in concentration

It is always advisable to undergo thyroid testing before conception and keep your doctor informed incase you are on medications. As TSH lab values must be reviewed every 3 weeks during the pregnancy journey. Generally during the pregnancy thyroid hormone requirements rise to support baby and the mother. The prenatal vitamins can hinder how the body may use up thyroid hormone replacement therapy. This can be avoided by keeping a 4 Ÿ?? 5 hour gap between thyroid medicines & prenatal vitamins. The doctor must pay special attention to treat hypothyroidism during pregnancy and can lead to blood pressure, still birth, low birth weight of the baby, maternal anemia and premature delivery. Unusual symptoms can impact babyŸ??s growth and brain development.

Post pregnancy thyroid care: Once the mother gives birth postpartum thyroiditis is common and is especially critical among women with auto immune thyroid disease as this can cause severe complications. The postpartum thyroiditis develop usually in first 3 Ÿ?? 6 months after giving birth and some of the symptoms can be hard to identify as they are identical with initial struggles of becoming a new parent.

Early symptoms of postpartum thyroiditis are

  • Disrupted sleep pattern, nervousness, cranky behaviour and pounding heartbeat, fatigue etc.
  • The other symptoms that may follow are loss of energy, dry skin, constipation, aches & pains etc.

Infact hypothyroidism can also disrupt the mil production, however a hormone replacement therapy can help in curing this condition.

Things to eat & precautions for women having thyroid troubles during pregnancy

  • Eating Cruciferous veggies can help in regulating the thyroid levels. Broccoli, cauliflower, cabbage, kale etc are great
  • Food rich in iodine is avoidable
  • Lean meat for boating protein requirements are a good source
  • Light exercises like walking, pregnancy walking, meditation & breathing exercises are advisable

Maintaining right balance in nutrition and prenatal exercises and aid smooth pregnancy for women facing thyroid troubles.  Healthy lifestyle is a key factor for overcoming difficulties in this condition.

Breastfeeding And Its Countless Benefits

Motherhood: All love begins and ends there. Trust that you cherish every moment with your little bundle of joy. Every mother goes through a phase of self-doubt and wants to offer the best care possible. One of the primary aspects of caregiving is breastfeeding.

Despite the divided opinion, do you know that breast milk is undeniably the perfect nourishment that you can give to your child? The medical community globally recommends breastfeeding for the first six months that can be continued with a healthy diet of vegetables, fruits, food grains, etc.

It is a personal decision. However, we would like to help you with information related to the benefits of breastfeeding. Ultimately, it is your choice!

Some quick facts on breast milk:

1. Do you know that breast milk-fed babies have a faster recovery rate from sickness or infections when compared to formula-fed babies? 

2. Are you aware that breastfeeding reduces the crying spells in young ones and also helps them through the vaccination phase? 

3. Do you know that breastfeeding helps in comforting and soothing the baby when in pain or discomfort? 

4. Are you aware that a new-born baby would require 8-12 feeding sessions in a day? 

5. Do you know that colostrum, the yellowish, thick milk  produced in the first few days is very beneficial for your baby It is potent with antibodies. 

6. Are you aware the breast milk is easily digestible for your  baby?  

With the perfect combination of vitamins, protein, and fat, breast milk is essential for your baby’s good health and growth.

Here are some benefits: 

You will be glad to know that breastfeeding can prevent diseases such as allergies, respiratory tract infections, diabetes, etc. It’s in your hands to minimize the risks.

For better immunity and a higher IQ, breastfeeding is an easy  solution. This will help your baby will grow into a healthy and  smart child. 

Due to the beneficial gut bacteria consumed through breastfeeding, your child can maintain a healthy weight and  have a reduced risk of childhood obesity. 

In addition to the innumerable benefits ensured to your child, breastfeeding will help you in these ways: 

Do you wish to drop off the extra pounds gained during  pregnancy? Breastfeeding will help you get back to your pre pregnancy weight by burning of fat and calories. 

Minimize the risks of breast and ovarian cancer in the future. By caring for your child, you are also caring for yourself. 

Research says that mothers who breastfeed their babies are at a lower risk of depression. Breastfeeding helps in your mental and emotional well-being.  

Being diagnosed with infertility itself may distress you. You should give yourself at least 3-6 months and start preparing your body for IVF. You may have lesser time than 3-6 months. It’s best to start preparing yourself physically and emotionally for an experience lasting for months.

In a nutshell, breastfeeding is extremely beneficial to your baby and you. It is a healthy, effortless, and cost-effective way of child  care. It is a precious and most personal gift that you can give to  your child. A joyful and hassle-free motherhood experience is on  your way. Have you made the choice yet? For more information on the countless advantages of  breastfeeding, talk to our experts.

What do Braxton Hicks contractions feel like?

Braxton Hicks contractions to understanding pregnancy sensations - Motherhood Hospital India.

Braxton Hicks
contractions are spasmodic contractions and relaxations of the uterine muscle.
They are also known as false labour . They are perceived to begin on the 6th
week of gestation but are not felt at least until the second or third trimester
of pregnancy. Braxton Hicks contractions are the contractions of the uterus
that help the expectant mother’s body prepare for actual labour. They are
irregular and often painless. 

As the date of
delivery approaches faster, the Braxton Hicks contractions help soften your
cervix. Although they are the body’s way to prepare for actual labour, they
neither indicate the outset of the labour nor its signals. Braxton Hicks
contractions form a normal part of the pregnancy. Despite being uncomfortable,
women describe them as mild menstrual cramps or a tightened sensation in an
abdominal area that comes and goes. 

Some quick facts
about Braxton Hicks contractions:

  1. Braxton Hicks contractions occur predominantly during the second or third trimester of pregnancy.
  2. They are less painful than the actual labour.
  3. Braxton Hicks contractions are unpredictable unlike actual labour and do not occur at definite intervals and do not get intensified over time.
  4. Consider changing positions to mitigate the discomforts caused by Braxton Hicks contractions.
  5. Braxton Hicks contractions might not occur regularly or get closer together.
  6. Braxton Hicks contractions neither cause cervical dilatation nor culminate in childbirth.

The causes of
Braxton Hicks contractions are as below:

  1. Dehydration
  2. Regularly touched maternal abdomen
  3. Bladder distention
  4. Sexual intercourse
  5. Increase in maternal or foetal activity

Below are the home
remedies to help resolve Braxton Hicks contractions:

  1. Take a warm bath for 30 minutes
  2. Eat something
  3. Drink a glass of water or a cup of tea
  4. Change positions as needed 
  5. Take a stroll 
  6. Take rest for a while if you have been physically active

When are the
Braxton Hicks contractions a cause of worry?

You should consider
calling your doctor  if the frequency of
contractions is increasing. If the pain bothers you excessively or if the
symptoms are resembling preterm labour. 

Below are the
situations to look for if you think Braxton Hicks contractions are a cause of
concern for you:

  1. If the contractions exceed an hour
  2. If pain is not releived after the above remedies
  3. Increase in the vaginal bleeding, vaginal discharge or spotting

Braxton Hicks contractions occur in all pregnancies. Although each woman’s experience is different, most women become aware of Braxton Hicks contractions in the third trimester. The onset of Braxton Hicks contractions near the end of the third trimester of pregnancy gets often mistaken as the actual labour. The management of Braxton Hicks contractions is easy and uncomplicated. 

Stretch marks in pregnancy

Approximately 50% to 80% of women are likely to develop stretch marks in pregnancy. Miscellaneous creams are known to offer some benefit in striae gravidarum. But no reliable evidence is available to conclude that any creams or topical ointments can help prevent stretch marks. Although not an illness, stretch marks can give nervousness to many expectant mothers. Some studies indicate that women who have developed stretch marks in pregnancy can avoid getting further marks in pregnancy. 

What are stretch marks?  

Stretch mark is a scar developed when the skin stretches or shrivels abruptly. The abruptness of these changes leads to the rupture of the collagen and elastin. When the skin starts to heal, stretch marks can appear. Stretch marks may not be present on every expectant motherŸ??s body.Fluctuations in hormonal levels play a role. Stretch marks may run in families. If someone close to an expectant mother had stretch marks, such an expectant mother is more prone to develop stretch marks. 

What are the body parts most prone to develop stretch marks?

  1. Thighs
  2. Hips
  3. Bottom
  4. Chest
  5. Stomach

What are some of the most common situations to develop stretch marks?

  1. Pregnancy
  2. Growth series occurring in puberty
  3. Sudden weight gain or sudden weight loss
  4. Weight management program while undergoing rapid muscle growth

What are the risk factors identified in the development of stretch mark?

General risk factors:

  1. Body mass index
  2. High pre-pregnancy weight
  3. Family history of stretch marks
  4. High weight during the delivery
  5. High gestational weight gain
  6. Young age

Maternal risk factors in pregnancy:

  1. Low intake of water
  2. Low level of serum relaxin
  3. Increase in the abdominal and hip circumference
  4. Low level of serum vitamin C
  5. Increased body mass index at delivery

Are there any techniques to prevent the stretch marks?

Genetics, as per experts, are the causes for stretch marks. But it may not always mean that a person will get stretch marks if either of the parents has it. Maintaining a healthy body mass index could be the first effective step towards preventing stretch marks. Ample consumption of water can help prevent the possible damage caused by the stretches of the skin. 

ItŸ??s best to include the foods rich in zinc in the diet. Foods rich in Vitamin A, Vitamin C, Vitamin D such as milk, citrus and sweet potatoes can benefit in stretch marks.

Diets and exercise: 

  1. Aerobics:

Aerobic is a kind of exercise mostly known to augment the blood circulation. It assures that the nutrients needed to the skin are aptly supplied to the surface. It may lessen the severity of the stretch marks. Morning walks can help those with stretch marks to an enormous extent. Half an hour every day or at least four days of a week should be spent in aerobics. 

  • Push-ups:

Push-ups help reduce the stretch marks around the breasts. One can start push-ups and increase their inclusion as needed. 

  • Abdominal exercises:

Abdominal stretch marks can be a reason for public embarrassment. While the stretch marks on abdomen are hard to treat, sit-ups and crunches can work wonders provided they are performed regularly. 

  • Squats:

Squats are a known ally to the muscle tone in hips, thighs and butts. Even when it comes to squats, those who are new to them can start with fewer squats and go on increasing them every day. 

What are the methods to remove the stretch marks?

The efficacy and results of the removal methods may vary from person to person. The results may be satisfactory in the first few days. 

  1. Microdermabrasion 
  2. Surgical intervention
  3. Radiofrequency treatment
  4. Light therapy and laser intervention
  5. Topical medications and creams or ointments

Almond Oil:

Oils have been known for centuries to generate moisture and increase the blood flow to various areas. There is no enough evidence to demonstrate whether the combination of massage and oil prevents stretch marks or not. Bitter almond oil is used by some people to treat the expectant mothers as it doesnŸ??t pose a risk to mother or the foetus. 

Hyaluronic Acid:

There are creams available in the modern marketplace today such as Verum and Alphastria. Alphastria is a proprietary medicine with Hyaluronic Acid, Vitamin A, Vitamin E, Allantoin and Calcium Pantothenate as the main constituents. Verum is another proprietary cream that contains Vitamin E, essential fatty acids, panthenol, hyaluronic acid, elastin and menthol.

Hyaluronic acid is the constituent common in both the proprietary medicines. Hyaluronic Acid is reported to facilitate tensile resistance to mechanical pressures and palliate the atrophy by inducing fibroblast activity and collagen synthesis thereby increasing the skin volume. 

Tretinoin:

Tretinoin is a category C drug in pregnancy and therefore caution is required while administering it in patients. Patients are advised not to use it until the lactation period. Erythematous Stretch marks become less severe after Tretinoin is administered in the treatment of stretch marks. 

Centella:

Centella in combination with other ingredients is reported to help prevent stretch marks. Centella is a medicinal herb whose usage in various creams can help prevent the stretch marks or minimize their severity. Centella is a popular name for Centella Asiatica, a plant commonly found in South Asia. ItŸ??s used to treat Leprosy, Venous stasis, ulcers and eczemas. Trofolastin is a proprietary medicine containing centella extracts. 

Lasers and other light devices:

Lasers and treatments involving lasers and other light devices are becoming popular nowadays. 585-nm flashlamp-pumped pulsed-dye laser is one of the most preferred lasers to treat stretch marks. Pulsed-dye laser, Excimer Laser, 1450-nm Diode Laser and Copper-Bromide Laser are some of the other laser variants used to treat stretch marks. 

ItŸ??s mandatory to consult the obstetrics and gynaecology department or a seasoned dermatologist before administering any treatment. A gynaecologist may ask for the medical history before administering the standalone treatment or combinations. A good diet and regular exercise are the best ways to prevent stretch marks. 

Is it safe to get the COVID-19 vaccination during pregnancy?

COVID-19 in pregnancy: An overview

The government ruled that the third phase of vaccination for adults between 18 and 44 years would start soon. May 1, 2021, saw its effective outset. One of the most crucial questions at this juncture is, whether pregnant women can take it or not. Initial studies were unclear about the risk of COVID-19 in pregnancy. The studies went ahead to establish, however, that pregnant women may be at a more raised risk of severe COVID-19 than non-pregnant ones. Pregnant women may develop severe symptoms including COVID-19-specific illness warranting immediate hospitalization and ICU transfer. Details about COVID-19, the effect of the disease on pregnancy and details about COVID-19 vaccines under progress are evolving in swift phases. 

COVID-19 vaccination, pregnancy and lactation:

Pregnant and lactating women heaved a sigh of relief after the Federation of Obstetrics and
Gynaecology Societies in India (FOGSCI) unveiled their stance on how pregnant and lactating women
should plan for COVID-19 vaccination. The details by FOGSCI shed light on COVID-19 development
and vaccine safety in maternity health. The guidelines suggest that every pregnant and lactating
woman has the right to vaccinate herself. Nonetheless, it should be her wish and not something out
of subtle psychological pressure. The robust clinical benefits of vaccination for pregnant and
lactating women outweigh the presupposed risks of vaccination.

Women who are lactating also present themselves as suitable candidates since the vaccine doesn’t seem to endanger the neonate who is breastfeeding. Women should receive proper consultation and counselling. They should receive optimal emotional support from their caregivers and next of kin. Both acceptors and exempts should receive equal and fair treatment. The guidelines recommend that obstetricians and gynaecologists should promote vaccination drive in pregnant and lactating women with clinical preparations to tackle any adverse or contraindicative responses (if any).

For women who are planning to get pregnant:

Guidelines rule that women planning for pregnancy may consider administering the vaccine at any
time before confirming the pregnancy as per their convenience. No scientific literature lays any
foundations to postpone the pregnancy or treatment for taking the vaccine. The scientific literature
hasn’t yet found concrete evidence demonstrating the possibility of infertility or miscarriage due to
vaccine administration.

Menstruation:

May 1, 2021, saw the centre ruling that everyone above 18 years of age can take the vaccination.
Soon after the judgement of the centre, several women asked whether it was suitable to take
COVID-19 vaccination in pregnancy or not. Various social media platforms were thronged with
questions and comments on the subject. Women should avoid taking COVID-19 vaccines 5 days
before and after their period. The reason behind the guideline is the immune system’s futility. The
immunity in women tends to be less in periods. Their periods last for 5 days. The same 5 days
witness the endometrium shedding. The menstrual cycle is the period which witnesses the
endometrial growth to a bulky and glandular tissue layer full of blood vessels. The immunity and
everything sensitive in the female body remains healthy afterwards. And the period except 5 days
before and after periods may be safe for women to inoculate themselves.

How would the healthcare facilities address COVID-19 and its possible effects on pregnancy?

Healthcare setups should assess the contraindications of the COVID-19 vaccine in pregnancy or breastfeeding. Pregnant women may be offered vaccinationat any point in pregnancy if there are no contraindications. Individual woman’s consent and the overall knowledge that the hazards of COVID-19 infection and morbidities from COVID-19 exceed the hypotheses and presupposed risks of vaccination in pregnancy and while breastfeeding. Therefore, pregnant women shouldn’t be dissuaded from vaccination under the pretext of pregnancy or breastfeeding

COVID-19 and its effects on pregnancy:

The majority of pregnant women infected with COVID-19 may develop mild-to-moderate symptoms
with many remaining asymptomatic. International data, however, suggests that approximately 7-
11% of pregnant women need hospitalization for COVID-19-specific morbidities with about 1-4% of
them needing ICU. In comparison with non-pregnant counterparts, pregnant women with COVID-19
may be in increased need of hospitalization, intensive care and invasive ventilation.

The perils of COVID-19 in pregnant women associate itself with various risk factors. They may
include Asthma, Obesity, Existent Hypertension, Existent Diabetes and Heart Diseases. Studies even
denote that in the event of an increase in the risk of preterm birth associated with COVID-19
infection in pregnancy, it may cause increased morbidities in the premature infant.

COVID-19 vaccination in pregnancy and while breastfeeding:

Various vaccines obstetric experts administer during pregnancy suggest that we may witness an
identical efficacy for the COVID-19 vaccines in pregnant women in comparison with non-pregnant counterparts. Vaccines may generate a good immunogenic response with a good degree of efficacy
in pregnant women. While primordial clinical details on the safety and efficacy of COVID-19 vaccines
in pregnant populations are still under scrutiny, resolute surveillance finds no signs of unfavourable
prenatal or neonatal outcomes related to the administration of COVID-19 vaccines. Nonvaccinated
pregnant women may be at raised risk of COVID-19 infection and a higher risk of morbidities in the
event of infection in comparison with non-pregnant women.

Infection of COVID-19 may complicate maternal, foetal and neonatal health. Pregnancy doesn’t raise the risk of COVID-19 infection. But pregnant women who are active in sensitive areas like healthcare or social care during pandemics may be vulnerable to COVID-19 infection. Advanced maternal age, conditions that underlie and pregnant women below the poverty line may face severe COVID-19 risk. Studies denote that the COVID-19 vaccine may be the right choice provided that a proper risk assessment is done. If analysis confirms that the benefits outweigh the risks for pregnant women and foetal health, it may be recommended. 

Healthcare experts and women should consider the factors below as they set out to vaccinate themselves:

  • Time of vaccination in pregnancy
  • Perils and potential risk of any existent maternal condition (if any) which may include the possible effects of the disease on the foetal health and new-born
  • Availability of data about the administration of a vaccine in pregnancy
  • level of infectivity of the virus in the vicinity/local community.