Hypothyroidism and its effect on unborn child By Dr Tulika, Motherhood Hospital, Noida

In India, thyroid diseases are quite prevalent in expecting women. It has been found that the occurrence of hypothyroidism, a condition in which the thyroid gland doesnŸ??t produce certain crucial hormones in the body, in pregnant women in India is between four and six per cent on an average. However, the similar condition affects only two to three per cent of pregnant women in western countries.

Unchecked or untreated hypothyroidism during pregnancy leads to preterm birth and low birth weight in the babies. So, itŸ??s important that a woman should get herself checked for thyroid especially during pregnancy because the fetus relies on the mother for thyroid hormones in the first few months of conception.  The thyroid hormones present in the motherŸ??s body essay an essential role in normal brain development of the unborn child and thus, deprivation of the maternal thyroid hormone due to hypothyroidism can have unalterable effects on the fetus.

Even studies have presented that those children, who were born out of hypothyroidism mothers during pregnancy, have lower IQ and impaired psycho-motor (mental and motor) development. But, fret not!  If the condition is properly controlled and treated well, then those women with hypothyroidism can also have healthier babies.

Effect of Hypothyroidism on unborn child and mother

Since the thyroid gland of the unborn child takes time to function on its own, itŸ??s completely dependent on the mother for the thyroid hormones.  Development and functioning of baby’s thyroid gland do not take place until about the end of the first trimester of pregnancy. Therefore, it’s suggested that women should start getting their thyroid disorder managed before conceiving so that impaired neurological functioning, stunted growth and physical deformities in the children can be avoided.

There is always best to plan for pregnancy and to consult with your physician to ensure your thyroid status and treatment are optimized prior to becoming pregnant and monitored throughout your pregnancy. However, if this does not happen and you find out you are pregnant, you should contact your physician immediately to arrange for increased testing of your thyroid functions and a potential change in your medication.

Untreated or poorly controlled hypothyroidism can also lead to:

Miscarriage

Premature birth

Pre-eclampsia

Stillbirth

So, it is vital for pregnant women with hypothyroidism to take the recommended thyroid medication consistently.

How is hypothyroidism treated during pregnancy?

The treatment of hypothyroidism in pregnant women is similar to that of who are non-pregnant. Doctors recommend synthetic T4 so that it compensates the presence of essential hormones in the body. The medication should be taken regularly so that a steady blood level of thyroid hormone gets adjusted within the normal range as the requirement of thyroid hormones increases during pregnancy. Therefore, it is a routine practice to monitor the blood level of the thyroid stimulating hormone (TSH) during pregnancy. Hyperthyroidism women can have healthy pregnancy by getting early prenatal care and working with their healthcare providers in the management of their disease.

Pregnancy and COVID-19: What are the risks?

We are distanced from many day-to-day habits. We are distancing ourselves from almost everyone around us. We no longer freely get along with anyone. That’s right! The wave of COVID-19 left us all in shambles. The discomforts and plights are plaguing various walks of our life. Most of our answers are unclear due to the unknown levels of COVID-19 infectivity. The scientific literature on similar pandemics in the past may help discover the effects of COVID-19 in pregnancy. COVID 19 and pregnancy risks remains a regularly explorable subject in obstetrics and gynaecology. 

How does COVID-19 affect pregnancy?

Pregnant womenmay be less likely to contract COVID-19. However, pregnancy is a phase that alters various mechanisms of the body. It modifies many systems of the body including the immune system. The way a body responds to a virulent strain of microbes including viruses may change. Therefore, alterations in the immune system may relate themselves to more complexities. The symptoms of COVID-19 in pregnancy can often become severe.

Some cases reported of COVID-19 pneumonia in pregnancy are less severe and show a good rate of recovery. Most pregnant women develop mild flulike symptoms if they contract COVID-19. A few cases involving chest pain that worsens day-by-day, however, may require immediate clinical attention. Here we explore the topic of COVID-19 and pregnancy risks in detail.

Effect of COVID-19 on foetal health

Concrete data is unavailable to cite the risk of miscarriage in the event of COVID-19 infection. The risk of miscarriage may increase in the second trimester. Foetal Growth Restriction (FGR) may be a possibility in COVID-19 infection. There’s no concrete evidence that shows that COVID-19 exposure in pregnancy may pass on the infection to the unborn. Nine women in China were tested positive for COVID-19 infection. Their nine babies, however, went on to be tested negative for the virus. A case in London contradicted the previous scenario. A pregnant lady in London tested positive for COVID-19. Her baby tested positive for the virus too.

The healthcare providers assisting the events are unable to establish the mode of transmission. It’s not clear whether the unborn falls victim to the virus in utero or shortly after he or she is born. Opinions worldwide vary as to what comes next after a pregnant lady contract the virus. A few opinions hold that the baby may not contract the virus during pregnancy. Nor may the baby fall prey to any developmental delays or defects. No persuasive evidence is available to establish a correlation between COVID-19 and its interferences in overall pregnancy. 

Effects of COVID-19 in the first trimester

Studies denote that the infection of COVID-19 may not predispose the first trimester of pregnancy to early pregnancy loss. Data on pregnant women to test positive for COVID-19 in the first trimester is still unavailable. Some anecdotes suggest that the patients infected with high fever may raise the risk of birth defects or developmental defects. Evidence to demonstrate such impacts, however, is unavailable. 

Coronavirus and pregnancy

No data suggests an increase in the risk of spontaneous abortion due to COVID-19. Evidence is still unavailable to prove the status of Coronavirus as teratogenic. The healthcare fraternity may need extensive data to demonstrate how coronavirus influences pregnancy. The infection of COVID-19 doesn’t associate itself with the clinical end of pregnancy. However, pregnant women with COVID-19 may be at increased risk of severe COVID-19. It might be prevalent especially if those infected people hail from ethnic minority backgrounds. Pre-existent conditions like Diabetes, Blood Pressure and obesity may complicate the health of pregnant women with COVID-19. 

What kinds of symptoms of COVID-19 may prevail in pregnant women?

Cough and fever may be the two most common symptoms of COVID-19 in pregnant women. In comparison with non-pregnant women in their fertility age, the pregnant and newly conceived women infected with COVID-19 may remain asymptomatic. Pregnancy during COVID 19 comes with dozens of medical responsibilities.

What are the risk factors that associate themselves with COVID-19 in pregnant women?

High body mass index is one of the most significant risk factors in pregnant women with COVID-19. Conditions that existed before their conception including diabetes and chronic hypertension may lead to developing severe symptoms of COVID-19. Studies even impute the severe symptoms of COVID-19 to advanced maternal age. Many studies warn that preeclampsia and gestational diabetes are two of the important risk factors that may occur in pregnant women.

No persuasive evidence exists to substantiate how these risk factors influence the outcomes of pregnancy with COVID-19. Women who have conceived should take care of themselves, specifically if they have pre-existent health conditions. Obstetricians should take the initiatives and educate pregnant women about risk factors and precautionary measures against them. There may be additional risk factors if you have a pregnancy-specific condition.

How should obstetric staff observe precautions during the pandemics like COVID-19?

  1. Medical facilities should generate substantial space and staff to help prevent the viruses like COVID-19 from going awry. 
  2. Help pregnant women and new mothers to observe proper precautions and protocols.
  3. Staff members should use every safety protocol and follow the guidelines as they proceed to meet pregnant women at Maternity Unit.
  4. If a staff member finds that someone has COVID-19 or someone is a PUI, he/she should initiate the most suitable infection control techniques. 

Precautions to observe by pregnant women

  1. Start practising social distancing from your home. 
  2. Stay at least 2 meters or 6 feet away from others including your family members if they have a high risk of infection.
  3. Take vaccinations and immunize yourselves against COVID-19 or other opportunistic ailments.
  4. Take even flu vaccination if your obstetrician guides you.
  5. It may not protect you from COVID-19, but it will safeguard you from flu which may complicate your pregnancy. 
  6. Use tissue each time you feel like sneezing or coughing or do so.
  7. Call your General Physician or obstetrician immediately if you encounter respiratory issues.
  8. Prefer video consultations over every other mode of clinical support. 

How can I breastfeed if I am suspected to carry COVID-19?

  1. Sanitize yourself regularly as your immediate supervisor suggests.
  2. Make sure you are using the mask each time you are around your baby. 
  3. Avoid sneezing or coughing while you carry your baby.
  4.  Sterilize the breast pump as your immediate supervisor/attendant directs.

General information and advice for all pregnant women during the coronavirus pandemic

Q. What effect does corona virus have on pregnant women?

Pregnant women do not appear to be more likely to be seriously unwell than other healthy adults if they develop the new coronavirus. It is expected the large majority of pregnant women will experience only mild or moderate cold/flu like symptoms. Cough, fever, shortness of breath, headache and loss of sense of smell are other relevant symptoms.

More severe symptoms such as pneumonia, seem to be more common in older people, those with weakened immune systems or long-term conditions. As yet, there is no evidence that pregnant women who get this infection are more at risk of serious complications than any other healthy individuals.

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Q. What effect will coronavirus have on my baby if I am diagnosed with the infection?

As this is a very new virus we are just beginning to learn about it. There is no evidence to suggest an increased risk of miscarriage.

Emerging evidence suggests that transmission from a woman to her baby during pregnancy or birth (vertical transmission) is probable. There has been a report of two cases in which this seems likely, but reassuringly the babies were both discharged from hospital and are well. In all previously reported cases worldwide, infection was found at least 30 hours after birth. It is important to emphasise that in all reported cases of newborn babies developing coronavirus very soon after birth, the baby was well.

Given current evidence, it is considered unlikely that if you have the virus it would cause problems with your babyŸ??s development, and none have been observed currently.

In China, some babies have been born prematurely to women with symptoms of coronavirus. It is unclear whether coronavirus caused these premature births, or whether it was recommended that the baby was born early for the benefit of the womenŸ??s health.

Q. What can I do to reduce my risk of catching coronavirus?

The most important thing to do is to follow government guidance. For pregnant women and the rest of their households, this includes:

  • Regular hand washing
  • Use a tissue when you or anyone in your family coughs or sneezes, discard this and wash your hands
  • Avoid contact with someone who is displaying symptoms of coronavirus. These symptoms include high temperature and/or new and continuous cough
  • Avoid non-essential use of public transport when possible
  • Work from home, where possible.
  • Avoid large and small gatherings in public spaces, noting that pubs, restaurants, leisure centres and similar venues are currently shut as infections spread easily in closed spaces where people gather together.
  • Avoid gatherings with friends and family. Keep in touch using remote technology such as phone, internet, and social media
  • Use telephone or online services to contact your DOCTOR or other essential services .

Q. I am pregnant, what do I need to do?

As a precaution, you should follow government advice about social distancing; stay away from public places and avoid anyone who has symptoms suggestive of coronavirus It is still considered necessary for pregnant women to go out for essentials, such as food shopping, exercise and to attend antenatal appointments..

Q. Should I attend my antenatal and postnatal appointments?

Yes. It is really important that you continue to attend your scheduled routine care when you are well.

10 best ways to deal with morning sickness and early pregnancy symptoms?

Morning sickness is very common in early pregnancy and is often characterised by nausea and vomiting. Some women feel sick all day long and it can significantly affect their day-to-day life. Morning sickness doesn’t put your baby at any increased risk and usually clears up by 16 to 20 weeks of your pregnancy.

There’s no sure-shot treatment morning sickness. Things you can try yourself to deal with morning sickness and early pregnancy symptoms include:

  • Take plenty of rest
  • Avoid foods or smells that make you feel sick
  • Eat something like dry toast or a plain biscuit before you get out of bed
  • Eat small, frequent meals of plain foods that are high in carbohydrates and low in fat
  • Eat cold foods rather than hot ones
  • Drink plenty of fluids, such as water
  • Eat foods or drinks containing ginger as ginger may help reduce nausea and vomiting
  • Try acupressure to get relief from the symptoms
  • Try anti-sickness medication after a consultation with your doctor
  • If your nausea and vomiting are severe, immediately seek medical attention

Book an appointment at Motherhood Hospitals. It offers a complete birthing experience to couples by hand-holding them through their journey towards parenthood. With the highest standards of clinical competency, backed by state-of-art technologies and proven protocols, Motherhood is committed to offering the best outcomes for the mother and child.

Services we offer:

Comprehensive pregnancy care by a team of highly experienced obstetricians /gynecologists, high-risk pregnancy care, 3D/4D ultrasound, anomaly early pregnancy scan, NT scan, anomaly scan, growth scan, pregnancy tests and vaccinations, maternal-foetal medicine, antenatal care, diet and nutrition by clinical dietician, exercises for pregnancy by experienced physiotherapist, antenatal workshops, Lamaze, lactation counselling, postnatal nutrition, postnatal fitness, 24×7 emergency care

How much weight should you gain during pregnancy? Is it safe to exercise during pregnancy ?

A woman who was of average weight before getting pregnant should gain 12 to 15 kg after becoming pregnant. Underweight women should gain 13 to 18 kg. Overweight women may need to gain only 7 to 12 kg during pregnancy.

In general, you should gain about 1 to 2 kg during the first three months youŸ??re pregnant and 1 kg a week during the rest of your pregnancy.

It is safe to exercise during pregnancy if you exercise with caution and don’t overdo it. A regular exercise routine throughout your pregnancy can help you stay healthy. It can improve your posture and decrease some common discomforts such as backaches and fatigue.

The safest and most productive exercises include swimming, brisk walking, indoor cycling and low-impact aerobics. These activities carry little risk of injury, benefit your entire body and can be continued until birth.

If you have never exercised regularly before, you can safely begin an exercise program during pregnancy after consulting with your gynaecologist. If you have asthma, heart disease or diabetes, exercise may not be advisable. Exercise may also be harmful if you have a pregnancy-related condition such as bleeding or spotting, low placenta, recurrent miscarriage etc.

At Motherhood hospitals, we offer exercises during pregnancy designed by highly experienced clinical physiotherapists who organise weekly Lamaze classes to keep you fit and active during your pregnancy. Book an appointment with Motherhood Hospitals. We have a team of obstetricians/gynaecologists who are highly experienced in pregnancy care and birthing. With the highest standards of clinical competency, backed by state-of-art technology and proven protocols, Motherhood is committed to offering the best outcomes for the mother and child.

We also have 24*7 obstetricians/gynaecologists for emergency care, 24*7 well-equipped ambulance services,  pregnancy care, high-risk pregnancy care, 3D/4D ultrasound, early pregnancy scan, NT scan, anomaly scan, growth scan, maternal-foetal medicine, vaccination, antenatal classes, diet and nutrition plan by clinical dietician, exercise during pregnancy designed by highly experienced physiotherapist, antenatal workshops, Lamaze, lactation counselling, postnatal nutrition, postnatal fitness, 24×7 emergency care.

Dos and don’ts of nutrition during first few weeks of pregnancy

A healthy and balanced diet during pregnancy requires fine-tuning your eating habits to ensure you are receiving enough nutrition for your own health and that of your baby. You must eat from a variety of food groups including fruits, vegetables, bread grains, protein sources and dairy products.

Fruits and Vegetables: Fruits and vegetables contain many important nutrients for pregnancy especially, vitamin C and folic acid.

Bread and Grains: A woman needs energy during pregnancy and it comes from carbohydrates. These essential ingredients are found in bread and grains. One can also get the required amount of folic acid from fortified bread and cereal.

Protein: Meat, poultry, fish, eggs and beans contain the protein, B vitamins and iron needed during pregnancy.

Dairy Products: Calcium is needed to support pregnancy as it helps build strong teeth and bones, normal blood clotting and muscle and nerve function.

Prenatal Vitamins: A daily prenatal vitamin can help fill small gaps, just in case you unintentionally do not get enough key nutrients. Consult your gynaecologist about which supplement is best for you.

Can you drink alcohol if you are pregnant?

The straightforward answer is Ÿ??noŸ??. ItŸ??s safest not to drink alcohol at all during pregnancy. Drinking alcohol during pregnancy can pose a long-term risk to your unborn baby and the more you drink, the higher the risks. ItŸ??s especially important to stay off alcohol in the first trimester, because of the risk of miscarriage.

However, if you do decide to drink while youŸ??re pregnant, limit it to one or two units of alcohol, no more than once or twice a week and never enough to get drunk.

Book an appointment with Motherhood hospitals. We have clinical dieticians highly experienced in planning a balanced diet and nutrition plan for women and their special needs during pregnancy and after pregnancy. We also have 24*7 obstetricians/gynaecologists for emergency care, 24*7 well-equipped ambulance services,?˜ pregnancy care, high-risk pregnancy care, 3D/4D ultrasound, early pregnancy scan, NT scan, anomaly scan, growth scan, maternal-foetal medicine, vaccination, antenatal classes, diet and nutrition plan by clinical dietician, exercise during pregnancy designed by highly experienced physiotherapist, antenatal workshops, Lamaze, lactation counselling, postnatal nutrition, postnatal fitness, 24×7 emergency care.

Few facts you must know if you are pregnant

Essential facts for a healthy pregnancy journey - Motherhood Hospitals India
  1. What changes happen in the uterus in the 1st month of pregnancy?

After conception, the fertilised egg travels from the fallopian tube to the womb and is implanted in the uterus lining. The uterus gets bigger and puts pressure on your bladder so you feel the need to urinate (pass water) more often.

2. How do I track my babyŸ??s development? How often should I visit the gynaecologist?

Tracking your babyŸ??s progress and development will help you understand what’s happening to your body from conception up until youŸ??re nine months pregnant and ready to welcome your new baby. In this regard, professional and medical advice is the best way to go ahead. However, there are pregnancy tracking apps which can be fun and helpful when it comes to tracking your and your babyŸ??s growth over time. You may choose one that you think is best!

The first three months of your pregnancy is probably the time of most anxiety and excitement. During this period, it is advisable to visit your gynaecologist once a week.

3. Is it safe to have sexual intercourse during pregnancy?

Sex during pregnancy is extremely safe for most women with uncomplicated, low-risk pregnancies. As long as your pregnancy is progressing normally, you can have sex as often as you like (some exceptions may include a history of miscarriage or preterm labour).

However, itŸ??s common for some women to experience bleeding during intercourse, especially in the first trimester. Such spotting or bleeding is generally nothing to worry about, but you should still mention it to your doctor.

4. Can you drink alcohol if you are pregnant?

The straightforward answer is Ÿ??noŸ??. ItŸ??s safest not to drink alcohol at all during pregnancy. Drinking alcohol during pregnancy could pose a long-term risk to your unborn baby, and the more you drink, the higher the risks. ItŸ??s especially important to stay off alcohol in the first trimester, because of the risk of miscarriage.

However, if you do decide to drink while youŸ??re pregnant, limit it to one or two units of alcohol, no more than once or twice a week, and never enough to get drunk.

Book an appointment at Motherhood Hospitals. We offer a complete birthing experience to couples by handholding them through their journey towards parenthood. With the highest standards of clinical competency, backed by state-of-the-art technology and proven protocols, Motherhood is committed to offering the best outcomes for the mother and child.

Services we offer:

 Comprehensive pregnancy care by a team of highly experienced obstetricians /gynaecologists, high-risk pregnancy care, 3D/4D ultrasound, early pregnancy scan, NT scan, anomaly scan, growth scan, pregnancy tests and vaccinations, maternal-foetal medicine, antenatal care, diet and nutrition by clinical dietician, exercises for pregnancy by experienced physiotherapist, antenatal workshops, Lamaze, lactation counselling, postnatal nutrition, postnatal fitness, 24×7 emergency care.

When do you need to see a doctor immediately during the initial days of pregnancy?

Essential Pregnancy Care: Early Pregnancy Health Tips - Motherhood Hospital India

The initial days of pregnancy are very crucial for the well-being of the mother and the overall health of the baby. See your doctor immediately if you notice:

  • Vaginal Bleeding: Some spotting is normal, but heavy bleeding could be a sign of miscarriage or ectopic pregnancy.
  • Excessive nausea and vomiting
  • High Fever: A fever greater than 101 degrees Fahrenheit during pregnancy may be serious.
  • Pain or burning during urination
  • Leg or calf pain, or swelling on one side/severe headache
  • Recurrence of chronic diseases: Women who have certain pre-existing medical conditions such as thyroid disease, diabetes, high blood pressure, asthma, and/or lupus should note any changes in their condition during pregnancy.

If you face any of the above conditions, book an appointment with Motherhood Hospitals. We have a team of obstetricians/gynaecologists who are highly experienced in pregnancy care and birthing. With the highest standards of clinical competency, backed by state-of-art technology and proven protocols, Motherhood is committed to offering the best outcomes for the mother and child.

We also have 24*7 obstetricians/gynaecologists for emergency care, 24*7 well-equipped ambulance services,  pregnancy care, high-risk pregnancy care, early pregnancy scan, NT scan, anomaly scan, growth scan, 3D/4D ultrasound, maternal-foetal medicine, vaccination, antenatal classes, diet and nutrition plan by clinical dietician, exercise during pregnancy designed by highly experienced physiotherapist, antenatal workshops, Lamaze, lactation counselling, postnatal nutrition, postnatal fitness, 24×7 emergency care.

10 things to do for a safe pregnancy and a healthy baby

During your pregnancy, you’ll get advice from everyone about how to keep yourself and your baby healthy. And choosing to stay healthy depends on you.  Below are the top 10 ways to keep you and your baby healthy.

  • See your gynaecologist as soon as your pregnancy is confirmed and keep visiting the specialist once a week for the first three months.
  • Eat a healthy, balanced diet.
  • Take folic acid for at least the first three months and vitamin D for the whole duration of your pregnancy and beyond.
  • Maintain hygiene in all aspects food, utensils, hands, etc.
  • Exercise regularly as it benefits you, and therefore your baby.
  • Cut out alcohol, quit smoking and cut down on caffeine.
  • Get adequate rest including sound sleep.
  • Attend a childbirth class. It will help you feel more prepared for delivery.
  • Check your medications: Talk to your gynaecologist before taking any medicine.
  • Track your weight: Gaining extra kilos may make it hard to lose weight later. Also, not gaining adequate weight can put the baby at risk for a low-weight birth.

Book an appointment at Motherhood Hospitals. It offers a complete birthing experience to couples by hand-holding them through their journey towards parenthood. We have a team of obstetricians/gynaecologists who are highly experienced in pregnancy care and birthing. With the highest standards of clinical competency, backed by state-of-art technology and proven protocols, Motherhood is committed to offering the best outcomes for the mother and child.

Services we offer include:

Comprehensive pregnancy care, preconception care, pregnancy care, high-risk pregnancy care, 3D/4D ultrasound, early pregnancy scan, NT scan, anomaly scan, growth scan, maternal-foetal medicine, vaccination, antenatal classes, diet and nutrition plan by clinical dietician, exercise during pregnancy designed by highly experienced physiotherapist, antenatal workshops, Lamaze, lactation counselling, postnatal nutrition, postnatal fitness, 24×7 emergency care

How to find the right gynaecologist for your pregnancy?

Maternity healthcare guide: Best gynecologist for your pregnancy - Motherhood Hospital India

Finding a gynecologist for your pregnancy can feel like a huge task. However, itŸ??s of paramount importance as your health, and your babyŸ??s health depends on it.

Get referrals: Consult your primary care doctor and friends for recommendations for a referral list. Research the doctorsŸ?? credentials and experience and ask for a consultation before finalizing the gynecologist.

Check the credentials: Check for any special certification that shows the doctor has the necessary training, skills, and experience to provide gynecologic care.

Consider the experience: Experience matters. The more experience a doctor has with a condition or procedure, the better your results are likely to be.

Research hospital quality: Your gynecologistŸ??s hospital is going to be your hospital. Therefore, consider the quality of care at the hospital because patients at top-rated hospitals have fewer complications.

Read reviews: Reading reviews about the gynecologist on what other people have to say can sometimes provide insight into how a doctor practices and how he/she delivers care.

Book an appointment at Motherhood Hospitals. It offers a complete birthing experience to couples by hand-holding them through their journey towards parenthood. We have a team of obstetricians/gynecologists who are highly experienced in pregnancy care and birthing. With the highest standards of clinical competency, backed by state-of-art technology and proven protocols, Motherhood is committed to offering the best outcomes for the mother and child.

Services we offer include:

Comprehensive pregnancy care, preconception care, pregnancy care, high-risk pregnancy care, 3D/4D ultrasound, early pregnancy scan, NT scan, anomaly scan, growth scan, maternal-foetal medicine, vaccination, antenatal classes, diet and nutrition plan by clinical dietician, exercise during pregnancy designed by highly experienced physiotherapist, antenatal workshops, Lamaze, lactation counseling, postnatal nutrition, postnatal fitness, 24×7 emergency care