Cord Complications By Dr. Anu Vinod Vij

Cord Complications: Expert Insights on Maternal-Fetal Health Guidance - Motherhood Hospital India

?˜ ?˜ ?˜ ?˜ ?˜ ?˜ ?˜ The umbilical cord is the lifeline of an unborn child from the mother. It?˜usually contains three blood vessels and is about 21Ÿ? long and is?˜responsible for supplying nutrients and oxygen from the motherŸ??s bloodstream to the infantŸ??s bloodstream, as well as supplying a blood supply to the infant and eliminating wastes. Without it, an infant cannot survive during the gestational period.?˜

Once an infant is delivered, the umbilical cord is clamped and cut, and babies begin to breathe on their own.

                However, there are several umbilical cord problems that can arise and put infants at risk for serious health problems. This article is intended to allay the anxiety which arises from certain ultrasound reports mentioning various cord positions. Some mothers are terrified by the thought of the umbilical cord wrapping around the babyŸ??s neck and the possibility of problems during delivery or even a stillbirth.

Common Umbilical Cord Problems

Umbilical Cord Prolapse

Umbilical cord prolapse is a problem that occurs when the umbilical cord drops through a motherŸ??s open cervix during labor and delivery and sometimes even before the onset of labor. This can cause the cord to get compressed between the babyŸ??s body and the rim of the cervix and hence occlude the blood supply of the baby. 

The most common risk factors for umbilical cord prolapse include:

  • Premature rupture of membranes: If the motherŸ??s water breaks too early, when the baby is still positioned high in the uterus, the umbilical cord may make its way into the birth canal before the baby can descend.
  • Long umbilical cord length
  • Low birth weight
  • Pelvic deformities
  • Low lying placenta
  • Malpresentation (e.g. breech)
  • Multiples sharing an amniotic sac: The first baby to be born may drag the cord of another through the birth canal.
  • Premature delivery
  • Uterine malformations
  • Unengaged presenting part
  • Excessive amniotic fluid (polyhydramnios): This may push the cord down before the baby.

The clearest sign of a cord prolapse is the emergence of the cord prior to the baby. However, this does not always happen, as the cord can also come down the canal alongside the baby. Signs of foetal distress, such as heart rate deceleration, also clue medical professionals into the possibility of cord prolapse.

Treatment/management of cord prolapse

Sometimes, it is possible for a physician to move the baby away from the cord, possibly with the help of forceps or a vacuum extractor (which can also be dangerous for the baby). However, this often fails, and then an emergency C-section delivery is necessary. While preparing the mother for surgery, medical professionals will often opt to push the presenting part of the baby back into the pelvis.

If Obstetricians donŸ??t detect and treat an umbilical cord prolapse quickly, the infant may be deprived of oxygen, leading to a host of medical issues, including long-term cognitive problems, cerebral palsy, and in severe instances, a stillbirth.

Short cord 

The average umbilical cord length is between 55 and 60 cm. An umbilical cord is considered short if it is 35 cm or less in length. Short umbilical cords occur in roughly 6% of pregnancies. They are risky because they can affect the growth and development of the baby as well as the outcome of the pregnancy. Short umbilical cords can lead to many complications, including:

  • Prolonged labor
  • Placental abruption
  • Hypoxic-ischemic encephalopathy (HIE)
  • Cerebral palsy
  • Intrauterine growth restriction (IUGR)
  • Umbilical cord rupture

Risk factors for short cord

Some of the risk factors for short umbilical cord include :

  • Gestational diabetes
  • Maternal low body mass index (BMI)
  • Oligohydramnios (decreased amniotic fluid)
  • Polyhydramnios (excessing amniotic fluid)
  • History of smoking during pregnancy

Signs and diagnosis of short cord

Short cord should be suspected if there is low foetal movement; this could both cause and be caused by short cord. Signs of foetal distress should also prompt medical professionals to check for short cord.

Treatment/management of short cord

If the cord is extremely short, or there are signs of foetal distress, the mother may be admitted to the hospital for inpatient monitoring prior to delivery. If she is diagnosed with placental abruption or the baby is in foetal distress, then the medical team should quickly prepare the mother for emergency C-section.

Nuchal Cord

A nuchal cord occurs when the umbilical cord becomes coiled around an infantŸ??s neck, most often in a single coil but in some cases, multiple coils. Nuchal cords occur in around 10% to 30% of all births. And a 2018 study in the American Journal of Obstetrics and Gynaecology reports that, the majority of time, babies do just fine when one is present. 

What causes nuchal cords?

Random foetal movement is the primary cause of a nuchal cord. Other factors that might increase the risk of the umbilical cord winding around a babyŸ??s neck include an extra-long umbilical cord or excess amniotic fluid that allows more foetal movement.

Nuchal cords typically are discovered at birth. Occasionally, patients ask if we can see them on ultrasound, which sometimes we can. ThereŸ??s no way yet to prevent nuchal cords or unwind them from a babyŸ??s neck in the uterus. 

When is a nuchal cord dangerous?

If the cord is looped around the neck or another body part, blood flow through the entangled cord may be decreased during contractions. This can cause the babyŸ??s heart rate to fall during contractions. Prior to delivery, if blood flow is completely cut off, a stillbirth can occur. This is however very rare, as complete occlusion of the umbilical vessels seldom occurs as they are adequately protected by the presence of a jelly like substance around them in the umbilical cord, called WhartonŸ??s Jelly. 

In the 2018 study, 12 percent of deliveries had a nuchal cord. Most babies with a nuchal cord had just a single loop around the neck. Fortunately, there was no increased risk for growth problems, stillbirth, or lower Apgar scores in this group. 

What is the possibility of stillbirth in cases of nuchal cord?

Research has found little or no connection between stillbirth and nuchal cords, although there has been some speculation about the relationship by researchers in Timisoara, Romania.

Their results were noted in the journal?˜Clinical and Experimental Obstetrics and Gynaecology and suggested nuchal cord incidents needed to be given more attention. They recommended thorough monitoring of foetal heart rates, during delivery once ultrasounds had revealed nuchal cords. They also suggested cesarean delivery when any distress was noted.

What happens during delivery?

Since the vast majority of time we donŸ??t know if a baby will have a nuchal cord, it is routine that the doctor will check the babyŸ??s neck for a nuchal cord after the babyŸ??s head is delivered. Usually the cord is loose and can be slipped over the babyŸ??s head. At times it might be too tight to easily slip over the head, and the doctor or midwife will clamp and cut the cord before the babyŸ??s shoulders are delivered. This keeps the cord from tearing away from the placenta when the rest of the babyŸ??s body is delivered. 

Umbilical Cord Knots: True Knots

Umbilical cord knots occur when a fetus maneuvers around in amniotic fluid and moves through the umbilical cord loop, creating a knot. The knot usually remains loose but can constrict and tighten during delivery. While the knot is loose, there generally isnŸ??t a need to worry, but if the knot becomes too tight and not detected and treated immediately, the infant may experience oxygen loss, decreased blood flow, and in some instances, death. During labor it can be reflected in abnormal CTG tracings or decreased or increased Foetal heart rates. 

Cord Stricture

According to the National Institutes of Health (NIH), cord stricture is a common cause of foetal death, typically during the 2nd trimester, before birth. The cause of cord stricture is unknown, yet it occurs in around 19% of foetal deaths. 

Since this type of umbilical problem is difficult to detect during the prenatal period, risk of foetal death is increased. 

Umbilical Cord Cysts

Umbilical cord cysts occur when an abnormal growth appears on the umbilical cord. The growths are classified as either false cysts (filled with fluid), or true cysts (remaining cells from foetal development). Can be detected during first trimester on USG. These are sometimes associated with chromosomal problems and anatomical defects. 

Single umbilical artery

The umbilical cord normally contains two umbilical arteries and one umbilical vein, which carry blood between the placenta and the unborn baby. Some unborn babies have only one umbilical artery. While this usually does not pose a problem to the developing baby, about 30% of infants with only one umbilical artery have some sort of congenital abnormality such as cleft lip, heart conditions, or chromosomal abnormalities if associated with other markers. If isolated, this finding is innocuous and does not warrant further testing. These babies are more prone for growth restriction in pregnancy and hence periodic growth monitoring by serial scans is necessary. 

Velamentous insertion and vasa previa

Usually the umbilical blood vessels run from the placenta, protected within the umbilical cord, to the baby. However, in 1% to 2% of pregnancies, a condition called velamentous insertion of the umbilical cord can occur. In this condition, the blood vessels travel, unprotected, across the foetal membranes before they come together into the umbilical cord. This condition may be associated with low birth weight, premature birth, and various congenital abnormalities. Velamentous insertion can cause haemorrhage from the baby during childbirth, after the foetal membranes have ruptured. If velamentous insertion is suspected, you may be advised to have a caesarean section to avoid the chance of rupture. 

Vasa previa is a complication of velamentous insertion where the umbilical blood vessels cross the foetal membranes and pass through the space between the unborn baby and the cervix. This is a very serious condition because once the foetal membranes rupture, the exposed blood vessels can tear, causing massive bleeding from the baby. This causes the babyŸ??s heart rate to slow down and puts them in grave danger. If you have vasa previa with significant vaginal bleeding, you will need to have a caesarean section in an effort to save the babyŸ??s life. 

Is SEX during pregnancy is safe? – Dr Madhuri Laha

Very common question in pregnant female mind. Most patient feels that sex may harm the baby in uterus though answer is not totally yes or no overall it is safe through out the pregnancy in uncomplicated low risk case.

Trimester Wise Guide

First Trimester – Most of the pregnant female have low libido due to associated nausea, vomiting and weakness in first trimester. Or maybe due to unplanned pregnancy patient may feel a loss of libido.

Second trimester – Most of the pregnant female are comfortable in their second trimester as they are free of nausea. Also there is an increase in libido due to engorgement of genital organs. Also, risk of abortions are low and placenta is localised in ultrasonography so doctor is more confident to allow sex during the second trimester of pregnancy.

Third trimester-Though safe, but uncomfortable for females due to the large tummy of the patient. Risk of premature labour pains are still there. The couple may try other positions during sex like a female on the top or side positions.

Conditions where sex during pregnancy to be avoided –

  • H/O abortion and miscarriages, preterm labour pain , 2nd trimester abortion due to incompetent os.
  • Cases with low lying placenta reaching or covering os, premature rupture of membranes.
  • Post coital bleeding, vaginal or cervical infection with purulent white discharge.
  • Some cases have swollen blood vessels at cervical mouth which may get ruptured during intercourse, needs doctors advice before going ahead.

When to rejoin sex after child’s birth?

  • Generally after normal vaginal delivery there is bleeding followed by lochia discharge(white and yellow) which last for more than a month. During this period sex should be avoided due to the risk of infection.

*Also there is episiotomy stitch and vaginal mucosa injury which needs time to heal of at least 20-25 days.

*Female may feel low libido during this period because of new responsibility of newborn and disturbed sleep cycle. 

*Important point to keep in mind is about the contraception because a female may get pregnant before even getting her first period after delivery.

* Barrier methods like condoms or IUCD should be used to avoid pregnancy. Barrier method also protects the female from a sexually transmitted disease so should be seriously considered in pregnancy and puerperal period.

Ultimately it is a couple’s decision and choice about the sex during and after pregnancy. Any couple can enjoy the intimacy after taking advice from the doctor.

My breastfeeding story – Mrs. Ramya

This is my breastfeeding story

Like any other new mother, I thought breastfeeding my newborn would be one of the easiest and natural things to do and no extra work was needed to be put in, especially mentally or emotionally. But was I so wrong! I found out the very second day after my baby was born that she wasn’t latching onto my breasts the right way and was losing weight because she isn’t taking in enough milk.

To me I didn’t know there was a right or a wrong and you could say I was very naive about it. I was in tears most times from the very beginning of my journey, whether be it cracked nipples, blocked ducts, milk blisters, engorgement, sore nipples etc. you name it I had it. Initially I even taught it may be because I did not have enough milk and that’s why my baby wasn’t putting weight which was not the case. I was producing enough or rather more than needed. It was at the hospital where I began expressing milk through a breast pump and I fed my baby. I had to resort to pumping because she needed it even after her direct feeds. I was producing so much milk that was way more than required.

In a way I would say I was lucky that I produced that much because even though she had a bad latch there was some milk entering her and she slowly started to gain weight. Initially she refused feeding from a feeding bottle and would drink very little through direct feeds. So, you can see I was challenged in in all sorts of ways. Then, after the third week she somehow latched onto the bottle and drank the required amount and gained so much weight that she was back on track but then she refused to get back on my breasts and thatŸ??s when my exclusively pumping journey began.

It was not easy to exclusively pump, the tears continued to roll down and it felt I couldn’t catch a break at all. There were times when I just felt defeated and decided to give her powder formula because excessive pumping was taking a toll on my mental and emotional stability. I was on the verge of getting into serious postpartum depression.

I didn’t give up though. I somehow found my strength to bounce back from these challenges just so that I could continue feeding my baby girl the best food I can give her which is a mother’s milk. From giving up in the first month I slowly pushed my giving up time to three months and then six months and now my baby is seven months old and I continue to exclusively pump.

It is because I had to make the hard choice of going against the stereotypical breast feeding. My baby has gained weight and her immune system has improved so much better. I will continue pumping till I can and until I feel it’s necessary.

Also, I am happy and proud to do this all myself and for all the milk I donated for those mommies with less milk and newborns who needed breast milk!

PS: No mommy should be obliged to forcefully go through this path. This is just my story of strength. I have found the courage to find happiness in feeding my baby girl through pumping.

Can Short Intervals between Pregnancies Increase the Risk of Preterm Birth? – Dr. Suhasini Inamdar

No doubt pregnancy is a wonderful journey, but when your babyŸ??s health is your top priority, it is essential to learn about preterm birth. After all, 33, 41,000 babies are born prematurely in India each year out of which 3, 61,600 children under the age of five die due to health condition related to preterm complications.

Please donŸ??t let these numbers spin your head because fortunately most Ÿ??preemiesŸ? or prematurely born babies grow up to be perfectly fine!

What causes Preterm Birth?

Even though preemies generally grow up to be healthy and fine,?˜ it does not hurt to learn about it, starting with these top causes:

  • Preeclampsia
  • HELLP Syndrome
  • Early Uterine Contractions
  • Multiple Births
  • A Family History of Preemies
  • Age of the Mother (a teenager or someone over 40)
  • Chronic Stress
  • Unhealthy Lifestyle (of the mother)
  • Closely Spaced Pregnancies

Can Closely Spaced Pregnancies Increase the Risk of Preterm Birth?

Well, yes!?˜ A study conducted by the Ohio Department of Health strongly agrees to it.

The study was done to learn about the influence of inadequate birth spacing on the duration of the subsequent pregnancy taking account of 4, 54,716 live births from women with two or more pregnancies over a period of six years. The time recorded from the immediate preceding birth to the subsequent conception of the next pregnancy was defined as a short interpregnancy interval or IPI by the researches. Here, women with short IPIs were divided into two distinct groups; IPI less than 12 months and IPI 12-18 months.

The results showed that in women belonging to the first group, i.e. IPI less than 12 months, 53.3% of the women (4, 54,716) had delivered the baby before completing 39 weeks. Also, the rate of preterm birth before 37 weeks of gestation was higher in these women. This study proved that mothers with shorter IPIs were more likely to give preterm delivery when compared to women with optimal birth spacing that is greater than or equal to 18 months.

Why are Closely Spaced Pregnancies not Good for You and Your Baby?

Closely spaced pregnancies are another cause of premature birth. Remember that you just had your baby and your body has gone through a lot; therefore, it needs time to recover. The more time you give, the lesser are the chances of birthing a preemie or vice versa.

Your pregnancy stresses your body, it exhausts the body of nutrients and hence the body takes time to build up the supply of protein, vitamins, and everything in between. Your body can barely support you; that is why you need to focus on restoring those levels.

Also, the vaginal canal and the bacterial balance have to restore especially if you had vaginal infections. So, if you want another baby, we suggest you wait for at least 18 months, keeping in mind your health and the health of your bundle of joy. Remember, without enough time to recover, preterm birth is highly likely.

Why Motherhood?

Motherhood Hospital provides services which include our highly accomplished clinicians, nursing care ably supported by the latest technologies and treatment protocols. With state-of-the-art NICUŸ??s, Labor Suites, Adult ICUŸ??s, Operative Rooms, Laboratory Services, and 24/7 pharmacy, Motherhood delivers the best in women, newborn and childrenŸ??s health care.

Our Obstetric services include:

  • Prenatal Check
  • Antenatal Care (before birth)
  • Intrapartum Care (during labour and delivery)
  • Postnatal Care (after birth)

Therefore, there is more than one reason to trust us! Motherhood has got your back during your entire journey of pregnancy and after that. Our team of professionals can guide you through the whole process of pregnancy from start to finish.

Book your appointment today with our experts or send us an inquiry.

ORAL CARE AND PREGNANCY- Blog by Dr. Omar Farookh

Pregnancy oral care tips by Dr. Omar - Motherhood Hospital India.

Pregnancy can lead to dental problems including gum disease and an increased risk of tooth decay.
During pregnancy increased hormonal changes can affect the body’s response to the plaque on your
Teeth. However, the demands of pregnancy can lead to particular dental problems in some women,
With proper hygiene at home and professional help from your dentist, your teeth should remain
healthy throughout pregnancy.
Dental disease can affect a developing baby
Research has found a link between gum disease in pregnant women and premature birth with low
Birth weight. Babies who are born prematurely may be at risk of a range of health conditions including
Cerebral palsy and problems with eyesight and hearing.
Estimates suggest that up to 18 out of every 100 premature births may be triggered by periodontal
disease, which is a chronic infection of the gums. Appropriate dental treatment for the expectant
mother may reduce the risk of premature birth.
Causes of dental health problems:
Gum problems The hormones associated with pregnancy can make women susceptible to gum
problems like gingivitis (gum inflammation), more likely to occur from the first trimester with
symptoms including swelling of the gums and bleeding particularly during brushing and when
flossing between teeth.
Undiagnosed or untreated periodontal disease, pregnancy may worsen this infection and can
lead to tooth loss.
Pregnancy epulis, a localized enlargement of the gum, which can bleed easily.
During pregnancy, the gum problems that occur are not due to increased plaque, but a worse
response to plaque as a result of increased hormone levels.
Tooth Decay- Some women experience unusual food cravings while they are pregnant and a
regular desire for sugary snacks may increase the risk of tooth decay.
Morning sickness- Pregnancy hormones can cause gastric reflux (regurgitating food or drink) or
the vomiting associated with morning sickness that can coat the teeth with strong stomach
acids. Repeated reflux and vomiting can damage tooth enamel and increase the risk of decay.
Dental treatment and Pregnancy: Safety Factor
The safest time to undergo dental treatment is the 2 and trimester of pregnancy. Preventive
scaling or professional cleaning of the gums and teeth, cavity fillings and annual dental check-
ups during pregnancy are not only safe but are recommended. Elective treatments such as teeth
whitening and other cosmetic procedures should be postponed until after birth. However,
sometimes emergency dental procedures like tooth extraction or a root canal treatment can be
performed under precaution and following strict protocols.
Medications: Anesthesia is an integral part of dental procedures if needed the amount of
anesthesia to be administered should be as little as possible, but enough to make the patient
comfortable, at times additional anesthesia may be required. According American Dental
Association controlled administration of local anesthesia does not cause any significant harm to

the developing baby or the mother. Certain group of antibiotics and analgesics can safely be
prescribed throughout the 9 month pregnancy period.
X-rays: Routine x-rays typically taken during annual check-ups can usually be postponed until
birth. X-rays are necessary to perform many dental procedures especially emergencies. According
to American College of Radiology, no single x-ray has a radiation dose significant enough to cause
adverse effects in a developing embryo or fetus with appropriate shielding.
Treatment Planning during Pregnancy:
1. All pre-existing dental issues need to be sorted out before planning for a child, it is
recommended.
2. If already pregnant with pre-existing dental issues, it is advised to inform the dentist about
the pregnancy, the stage of pregnancy and the due date for the delivery. This information is
very important for the dentist to plan and execute the best possible oral care.
Home oral Care:
1. Brush your teeth with fluoridated toothpaste twice daily.
2. Floss your teeth regularly and rinse your mouth with an alcohol-free mouthwash.
3. Replace the toothbrush every month and use a soft bristle toothbrush.

Gestational Diabetes

It is a state of increased sugar level which generally normalizes after childbirth.

This occurs due to increased sugar level during pregnancy which is due to decreased insulin production or insulin resistance.

Incidence Ÿ??10% of the population is affected by GDM and it is increasing due to advanced maternal age and sedentary lifestyle.

Why does it occur– During pregnancy, an organ called placenta is formed which provides food and oxygen to the baby from the mother. This also produces certain hormones which prevent the action of Insulin on sugar. This increases the sugar level in pregnant patientŸ??s blood. Our pancreas produces insulin, but as the sugar during pregnancy is already high the amount of insulin produced is not enough to metabolize sugar resulting in increased sugar level.

Risk factors for GDM

  • PCOS-Polycystic ovarian disease
  • Obese patient with BMI more than 30
  • Previous history of having diabetes during pregnancy.
  • History of diabetes in a family
  • Having the previous baby of more than 4 kg
  • History of sudden still birth or IUFD.
  • An elderly primi
  • Ethnic-origin east Asian

Screening– During pregnancy visit, the doctor asks about the history and any risk-factor, if any risk factor During pregnancy visit, the doctor asks about the history and any risk-factor, if any risk factor then glucose challenge test with 75 gm Glucon-D is done. Or GCT is done routinely at 24-28 weeks.

Then glucose challenge test with 75 gm Glucon-D is done. Or GCT is done routinely at 24-28 weeks.

Symptoms

  • Increased thirst
  • Increased urination
  • Weakness
  • Increased appetite

Sign-During check up there is increased girth of the abdomen.

Sonographic Findings

  • Abdominal circumference is more than gestational age in growth scan at 28 weeks
  • Amniotic fluid is more than 20.

Effects on mother

  • Breathing difficulty due to increased girth
  • Repeated vaginal infection
  • High blood pressure
  • Sometimes retinal detachment due to small vessel damage

Effects on baby

  • Macrosomia or big baby
  • Difficult shoulder delivery during birth
  • Inside uterus death of a baby (IUFD)
  • Post-delivery hypoglycemia of baby management
  • If GCT at 28 weeks more than 140 or above>

Strict sugar monitoring by glucometer.

The patient is asked to follow a strict low sugar diet.

Good exercise and walking.

Sonography is repeated to see fluid and growth of baby and size of a baby.

If sugar is under control, the same diet and exercise are continued or else tablet like metphormin is added to lower the sugar level or else sometimes insulin must be added.

Time of delivery: Mostly between 38-40 weeks as sugar tends to increase after.

Between 38-40 weeks induction of labor is offered.

If baby size is too big then C-section is planned.

Birth difficulty:

  • Prolonged labor
  • Shoulder dystocia (shoulder can get stuck)
  • Perineal laceration

Post-delivery care: BabyŸ??s kept in neonatal care unit and sugar monitored regularly for 24 hours. If sugar is normal baby is shifted to the mother. Baby sometimes may have respiratory distress. BabyŸ??s more prone to develop jaundice. These babies are more prone to have diabetes, so breastfeeding is very important.

For motherŸ??s the sugar is checked for 24 hours. Then after discharge sugar is checked after 6 weeks and then every 6 months. These mothers are more prone to have diabetes after 15 to 20 years.

So once diagnosed by gestational diabetes patient should follow a strict discipline and visit a Gynec, physician and dietitian.

Main causes of premature birth

Explore the reasons behind premature birth with expert guidance - Motherhood Hospital India

A normal and healthy pregnancy lasts for about 40 weeks. However, due to various factors, the labour may occur well before or after the estimated date. If the labour occurs before 37 weeks of pregnancy, the birth is considered to be premature, or preterm.

Classification:

Based on how early the baby is born, the baby is classified as:

  • Late preterm: born between 34-36 weeks of pregnancy.
  • Preterm: 24 – 34 weeks of pregnancy.
  • Extremely preterm: born before 25 weeks of pregnancy.

Causes of premature birth:

The exact cause of premature birth cannot always be identified. However, there are certain factors which contribute to an early labour. Some of these factors are:

  • Women younger than 17 and older than 35 are at an increased risk of premature delivery.
  • Having a previous premature birth.
  • Pregnancy with twins or multiples often results in preterm delivery.
  • Malnourished women are also at a higher risk of premature delivery.
  • Women suffering from chronic conditions like high blood pressure or diabetes.
  • Being underweight or overweight during pregnancy.
  • Smoking, drug abuse, or excessive consumption of alcohol during pregnancy.
  • Problems related to cervix, uterus, or placenta.
  • Physical injury, accident, or some other kind of trauma.
  • Women with a past history of miscarriages or abortions are more likely to go into labour prematurely.
  • Excessive physical, mental, or emotional stress.
  • Infections, especially in the lower genital tract often result in preterm birth.
  • Women who conceive through in-vitro fertilization have a higher chance of premature labour as compared to others.
  • An interval of fewer than six months between successive pregnancies.

Prevention of premature birth:

Premature birth poses significant health risks for the baby, which include both short-term and long-term risks. In fact, premature birth was the leading cause of infant deaths in the past when medical facilities were not developed. Though certain risk factors are beyond oneŸ??s control, one can significantly reduce the risk of preterm birth by following these tips:

  • Quit smoking before pregnancy, or as early as you can during pregnancy.
  • Avoid consumption of alcohol or drug use during pregnancy.
  • Before getting pregnant let your doctor know the medications you take, as some medications can be harmful to pregnancy and lead to premature birth.
  • Maintain a healthy weight during pregnancy.
  • Eat a nutritious diet and avoid junk food.
  • Avoid stressful or physically challenging work during pregnancy.
  • Maintain physical and social hygiene to avoid infections.

Motherhood is a one-stop solution to all your pregnancy needs and care. Our highly qualified team provides you with expert guidance during your pregnancy to avoid premature delivery and other complications. Even if a premature delivery is needed, our extremely competent team is well equipped and experienced in handling preterm babies, while providing a smooth delivery process and the utmost comfort and care to the mother.

High-Risk Pregnancy

Motherhood can be considered to be one of the most beautiful experiences in a woman’s life. It is important to ensure motherŸ??s health is taken care of that will eventually result in growth and development of the fetus. Regular antenatal care will assure a healthy and safe delivery for the mother. If adequate steps are not taken in ensuring the health of the mother and the fetus high risk concerns may set in.

What is considered a High-Risk Pregnancy?

Pregnancy can be considered as high risk if there are potential complications that could affect either you, your baby, or both. These cases require special intervention by experts and specialists to ensure that the best possible outcome occurs for both the mother and the baby. Unforeseen illnesses or preexisting diseases can complicate the pregnancy, which, in turn, puts you and your baby at risk.

High-Risk Pregnancy Factors

These are some of the factors that can classify a pregnancy as a high-risk pregnancy-
  • Teenage pregnancy and Pregnancy above the age of 35.
  • Women with previous history of repeated pregnancy losses, previous preterm delivery, previous history of preeclampsia (increase blood pressure with edema). History of gestational diabetes in the previous pregnancy or any other medical disorder including psychiatry illness.
  • History of placenta praevia, antepartum bleeding, preterm premature rupture of membranes also come under high risk category.
  • Women with preexisting conditions like Hypertension, Diabetes mellitus, Cardiac disease, Anemia, Blood Dyscrasia, Haemoglobinopathy, Platelet disorders and Liver problems.
  • Women with a history of thromboembolism (obstruction of a blood vessel by a blood clot that has become dislodged from another site in the circulation), strokes, myocardial infarction.
  • Some women who have autoimmune diseases, thyroid, other endocrine disorders, renal disorders
  • Lifestyle choices like smoking cigarettes, drinking alcohol, substance abuse and obesity.
  • Women with neurological problems like epilepsy, brain tumours, multiple sclerosis, cerebral venous thrombosis and psychiatric illness.

What You Can Do to Ensure a Safe Delivery

If you are expecting a baby or want to have one in the future, there are some guidelines to be followed for a safe, healthy pregnancy and delivery-
  • Schedule a preconception appointment Ÿ?? if you are trying to conceive, make sure that you consult your healthcare provider. If you have a medical condition or have recently been diagnosed with one, your treatment might need to be adjusted to prepare for the pregnancy.
  • Seek prenatal care regularly Ÿ?? prenatal visits can help your healthcare provider in monitoring your health and your baby’s health.
  • Have a healthy diet – youŸ??ll need more folic acid, calcium, iron and other essential nutrients during pregnancy. A daily dosage of prenatal vitamins can help as well.
  • Gaining the right amount of weight can support the health of your baby and make it easier to shed the extra pounds after your delivery.
  • Opt for a tertiary centre as all the specialty doctors at that centre will be available and that will be beneficial to both the mother and the baby.
  • Avoid risky substances such as cigarettes and drugs. Make sure that you consult your healthcare provider before you start or stop taking any medications or supplements.

Specific Symptoms to Look Out For

If you have the following signs or symptoms during your pregnancy period, be sure to consult your doctor-
  • Vaginal bleeding
  • Decreased fetal activity
  • Pain or cramps in the lower abdomen
  • Watery vaginal discharge in a gush or a trickle
  • Regular or frequent contractions Ÿ?? a tightening sensation in the abdomen area
  • Pain or burning during urination
  • Changes in vision, including blurred vision
  • Persistent headaches
To conclude high risk pregnancy should be monitored and managed in a center with facilities available for adequate maternal and fetal care. Consultant liaison with Physicians, Neonatologists, Anesthesiologist and senior Obstetricians, optimum care can be provided for the better outcome.

All you need to know about Labor Epidurals- By Dr. Shashidhar K.B

One of the biggest confusion during pregnancy is having a normal delivery or a caesarean section. Even though every woman wants to undergo the pleasant experience of natural birth, most of them can’t stick to it because of the intense, excruciating pain.

More than half of the pregnant women can deliver vaginally, but sadly due to the labor pain, only few can go through it. But darling, if you are one of those women who want to experience the natural way of childbirth, don’t you worry. There is an Epidural for you.

What is an Epidural Anesthesia?

As the name says, Epidural Anesthesia is an anesthetic injection administrated by an anesthetist into the space around the spinal nerves (lower back). The primary objective of this procedure is to stop the sensation of pain in your body.

What is Labor Epidurals?

When Epidural Anesthesia is given to control the labor pain, it is known as Labor Epidurals. It is famously used during a natural birth or virginal birth (optionally used for caesarean section) where it effectively blocks the pain from labor contractions and facilitates the energy drained mother to move and push the baby out with ease. Epidural medications fall into the category of local anesthetics and are combined with narcotics when delivered.

How does Labor Epidurals work?

When a woman undergoes through labor, the contraction of the uterus causes the pain. Nerves carry this pain associated with labor to the spinal cord where it intensifies. The Labor Epidurals (local) blocks the nerves carrying pain sensation to the spinal cord and works as a painkiller.

How Is Epidural Administered?

  1. Before an Epidural (and during the delivery) Intravenous fluids are given to maintain blood pressure. Since an Epidural injection dilates the blood vessels, it causes the blood pressure to drop suddenly.
  2. An anesthesiologist will ask the patient to sit at the edge of the bed and arch the back in a bent position. It will increase the surface area for the administration of the injection because it opens up the spine.
  3. An antiseptic lotion/liquid is applied to the area to make it sterile.
  4. The anesthesiologist first looks for area/spaces between the spines, where he/she injects a local anesthetic to numb the skin in the area to where later the Epidural needle is inserted.
  5. A hollow Epidural needle is inserted into the numb area along. With this a thin tube is threaded through the needle. The needle is then removed, and the catheter (tube) is left behind. So that the catheter doesn’t slip, it is taped to the back.
  6. Through the tube, injections are given periodically or continuously.

Are there any risks related to Labor Epidurals?

Well, everything has a negative and a positive side. So here are few of the risks related to Labor Epidurals:

  1. Epidural injection dilates the blood vessels. This causes the blood pressure to drop suddenly.
  2. Itching and rashes may occur.
  3. Since the drug will numb the region between the waist and upper legs, this numbness is felt even after the delivery (3-4 hours). Therefore you would need assistance to walk.

At Motherhood our doctors recommend you this treatment option only after a careful examination, study, and collaboration with the experts from other fields to ensure you receive the best multidisciplinary care. Therefore, there is more than just one reason to entrust us with your health.

By Dr. Shashidhar K.B., Consultant Anaesthesiologist, Motherhood Hospital, Hebbal

Book your appointment today with our experts or send us an inquiry.

Changes in human body during pregnancy

Human body undergoes enormous changes during pregnancy. It affects the body from head to toes. It is amazing how the body accommodates the baby so smoothly.

1) There is a new growth spurt in hair, glow on the face and bleeding gums because of increased estrogen in the blood.

2) Increased pigmentation on face ,neck , nipples and abdomen due to increase in melanin . This pigmentation is also known as melasma or chloasma or PREGNANCY MASK.

3) Water retention leading to puffiness of face , swelling of fingers and toes . Swelling around sciatic nerve causes pain in lower back and thigh . Contact lens users feel difficulty in their usage.

4) There is marked increase in the size of breasts as they need to get ready for nursing the baby.

5) Dryness of skin and breakage of collagen leading to stretch marks.

6) Constipation because of progesterone ,the hormone of pregnancy ,it is known to make the bowel sluggish.

7) Joints and ligaments loosen around pelvis and other places because of pregnancy hormones specially RELAXIN, this helps for accommodating baby and delivery. Loosening also results in back pain, change in gait WADDLING.

8) Increase in body temperature, heart rate and breathlessness due to increase in metabolic rate and increased cardiac output.

9) Increase in stagnation of venous blood flow leads to hemorrhoids or piles, varicose veins.

10) Acne worsens as the hormonal shift makes skin very oily.

By,

Dr. Suhasini Inamdar