Understanding Gestational Diabetes: Insights from Dr Shruthi Kalagara

Author: Dr. Shruthi Kalagara, Obstetrician – Gynecologist

Understanding Gestational Diabetes: Insights from Dr Shruthi Kalagara

Gestational diabetes mellitus (GDM) is one of the most common medical complication in pregnancy, affecting around 1 in 6 births. As a high-risk pregnancy obstetrician, I believe it’s essential to provide accurate, supportive, and comprehensive information to help expectant mothers navigate this condition with confidence and care.

What is Gestational Diabetes?

Gestational diabetes is a type of diabetes that develops exclusively during pregnancy and typically resolves after delivery. It affects how your body processes glucose, leading to elevated blood sugar levels that can impact both the mother and baby if not managed appropriately. 

Causes and Risk Factors

Hormonal changes during pregnancy play a significant role. The placenta produces hormones that can make your cells less responsive to insulin. When your pancreas can’t produce enough insulin to compensate, blood sugar levels rise, leading to GDM.

Certain factors can increase the risk of developing GDM, including:

Age: Women over the age of 35 are at higher risk.
Family or Personal History: A family history of diabetes or a previous pregnancy with GDM, previous big baby >/= 4.5kg birth weight raises the likelihood.
Obesity: Being overweight before pregnancy is a significant risk factor.
Ethnicity: Women of certain ethnic backgrounds, including South Asian, Indian, African American, and Hispanic, have a higher risk.
Polycystic Ovary Syndrome (PCOS): This condition can contribute to insulin resistance and increase the risk.
Inter-pregnancy weight gain: Increases recurrence risk.

Potential Impacts on Mother and Baby

Untreated or poorly managed gestational diabetes can lead to complications such as:

Short term and long term implications

For the Baby:
Macrosomia: Babies born larger than average, which may complicate delivery and increase the likelihood of cesarean birth.
Neonatal Hypoglycemia: Low blood sugar in the baby shortly after birth.
Neonatal Hyperbilirubinemia: Jaundice in the baby shortly after birth.
Respiratory distress in newborn.
Increased Risk of Obesity and Type 2 Diabetes: Children may be at a higher risk later in life.

For the Mother:

High Blood Pressure and Preeclampsia: GDM can elevate the risk of developing preeclampsia, a condition that can be dangerous if not managed.
Urinary tract infection/ vaginal infections
Obstetric intervention: instrumental deliveries, cesarean deliveries, postpartum hemorrhage.
Future Diabetes: Women who develop GDM have a higher risk of developing type 2 diabetes in the future.

Diagnosing Gestational Diabetes

Universal screening for GDM is typically done between 24 to 28 weeks of pregnancy using an oral glucose tolerance test (OGTT) – 75g. For women with higher risk factors, testing may be recommended earlier in pregnancy.

Managing Gestational Diabetes

The good news is that gestational diabetes can be managed effectively with the right approach:

Diet and Nutrition: A balanced diet rich in fiber, lean proteins, and complex carbohydrates helps regulate blood sugar levels. Consulting a registered dietitian can be beneficial.
Exercise: Regular, moderate exercise helps improve the body’s insulin sensitivity.
Blood Sugar Monitoring: Keeping track of your blood sugar levels is crucial to ensure they remain within the target range.
Medication: If lifestyle modifications are not enough, medications or insulin therapy may be needed.

Support and Guidance:

Dealing with a high-risk pregnancy, such as one complicated by gestational diabetes, can be overwhelming. However, with proper care, monitoring, and guidance, most women with GDM go on to have healthy pregnancies and babies. It’s vital to work closely with your healthcare team, including an obstetrician specialized in high-risk pregnancies, to create a personalized care plan.

Postpartum Care

Gestational diabetes typically resolves after birth, but it’s essential to maintain regular follow-up visits and screenings. Women with GDM should have a glucose tolerance test six weeks postpartum and continue to monitor their health in subsequent years.

Final Thoughts

Gestational diabetes is a condition that requires attention, but it doesn’t have to define your pregnancy experience. With awareness, proactive management, and support, you can enjoy a healthy and positive journey to motherhood.

For personalized care and expert advice, don’t hesitate to reach out to your obstetrician. Your health and the well-being of your baby are always the top priority.

Urinary Tract Infection (UTI) in Pregnancy

Author: Dr. Shruthi Kalagara, Obstetrician – Gynecologist

What is a Urinary Tract Infection (UTI)?

A urinary tract infection (UTI) is an infection in any part of the urinary system, including the bladder, urethra, or kidneys. UTIs are more common during pregnancy due to hormonal changes and the growing uterus putting pressure on the bladder.

Why Are UTIs a Concern in Pregnancy?

If left untreated, a UTI can lead to complications such as:

Kidney infections (pyelonephritis)
Preterm labor or low birth weight
High blood pressure or preeclampsia

Timely diagnosis and treatment are crucial to protect both mother and baby.

Symptoms of a UTI in Pregnancy

Mild UTI (Cystitis – bladder infection):

Frequent urination
Burning or pain while urinating
Cloudy, dark, or foul-smelling urine
Lower abdominal pain or discomfort

Severe UTI (Pyelonephritis – kidney infection):

High fever, chills
Flank pain (pain in the back or side)
Nausea or vomiting
Severe fatigue or feeling unwell

Causes and Risk Factors

Hormonal changes slow the flow of urine and reduce the bladder’s ability to empty completely.
The growing uterus presses on the bladder, increasing the risk of urinary stasis.
Pre-existing conditions like diabetes or a history of UTIs.
Sexual activity during pregnancy.

Diagnosis

Diagnosing a UTI is simple and safe during pregnancy:

Urine Analysis: Checks for the presence of bacteria, white blood cells, or blood in the urine.
Urine Culture: Identifies the specific bacteria causing the infection.

Treatment

UTIs during pregnancy can be effectively treated with:

Antibiotics: Safe antibiotics (e.g., amoxicillin, cephalexin, or nitrofurantoin) are prescribed to clear the infection. Always complete the full course of medication, even if symptoms improve.
Hydration: Drink plenty of water to flush bacteria out of the urinary tract.
Pain Relief: Acetaminophen may be recommended for pain or fever, under your doctor’s guidance.

Prevention Tips

Stay Hydrated: Drink at least 8–10 glasses of water daily.
Practice Good Hygiene: Wipe from front to back after urination or bowel movements to prevent bacteria from spreading.
Empty Your Bladder Frequently: Avoid holding urine for long periods, especially after sexual activity.
Wear Breathable Clothing: Cotton underwear and loose-fitting clothes help prevent bacterial growth.
Avoid Irritants: Steer clear of douches, harsh soaps, or scented products in the genital area.

Complications to Watch For:

Untreated UTI: May progress to a kidney infection, which can lead to high fever, chills, and back pain.
Preterm Labor: Severe infections can increase the risk of preterm contractions.
High Blood Pressure (Preeclampsia): Rarely, untreated infections can contribute to pregnancy complications like preeclampsia.

When to Call Your Doctor:

Contact your healthcare provider immediately if you experience:

High fever, chills, or flank pain
Persistent nausea or vomiting
Severe pain or burning during urination
Blood in the urine
Contractions or abdominal pain

FAQs:

Will a UTI harm my baby?
If treated early, a UTI is unlikely to harm your baby. Untreated UTIs can lead to complications like preterm labor or low birth weight.

Can I prevent a UTI during pregnancy?
Yes, staying hydrated, practicing good hygiene, and avoiding irritants can reduce your risk.

Are antibiotics safe during pregnancy?
Yes, most antibiotics prescribed for UTIs are safe during pregnancy and will not harm your baby when used as directed.

Conclusion

UTIs are common during pregnancy, but with early diagnosis and appropriate treatment, they can be managed effectively. Be proactive in seeking care if you notice symptoms, and follow preventive measures to reduce the risk of recurrence.

Benefits of Consuming Folic Acid Tablets For Pregnancy/During Pregnancy

Author: Dr. Tejinder Kaur

MBBS, Diploma in Hospital Administration, Diploma of National Board training, Fellowship in Reproductive Medicine

Consultant: Obstetrician & Gynaecologist at Motherhood Hospital, Mohali

Introduction:

Most doctors advise women of reproductive age to take folic acid, which does not necessarily help women get pregnant but certainly does help prevent congenital disabilities or birth defects and pregnancy complications. Folic acid becomes a significant part of any woman’s pregnancy journey. Another crucial supplement to boost a healthy pregnancy is Vitamin D.

Some women might be recommended higher doses of folic acid for pregnancy due to various medical reasons, such as neural tube defects or severe cases of anemia. Folic acid tablets are available in most pharmacies and hospitals. Women trying to conceive must have the respective folic acid dose prescribed.

Folic acid tablets for pregnancy are a vital component of prenatal care, offering a multitude of benefits for both mother and baby. Let’s take a more detailed look into why folic acid plays a crucial role during pregnancy.

What is Folic Acid?

Folic acid, a synthetic form of folate, belongs to the B-vitamin family, specifically B9. It is a crucial building block for DNA synthesis, red blood cell formation, and cell division. Essentially, folic acid aids in rapid cell growth and tissue formation, making it indispensable for fetal development.

Why is Folic Acid Essential Before and During Pregnancy?

Before conception and during early pregnancy, folic acid plays a pivotal role in preventing neural tube defects (NTDs) like spina bifida and anencephaly. NTDs occur in the early stages of pregnancy when the neural tube fails to close correctly, potentially leading to severe complications in the baby’s brain and spine. Adequate folic acid intake significantly reduces the risk of such birth defects.

When Should We Start Taking Folic Acid?

Ideally, women planning to conceive should start taking folic acid supplements at least three month before conception. Since neural tube defects develop in the early weeks of pregnancy, having sufficient folic acid in the body during this critical period is vital. However, if the pregnancy is unplanned, it’s imperative to begin folic acid supplementation as soon as possible after discovering the pregnancy.

Benefits of Consuming Folic Acid Tablets for Pregnancy

Folic acid supplements help pregnant women reduce and prevent pregnancy complications, contribute to the growth and healthy development of the fetus, and keep the new mother healthy and free of health complications, ensuring a safe pregnancy journey.

Some of the folic acid uses are listed below:

Prevents Neural Tube Defects: Neural Tube Defects are congenital disabilities or birth defects that affect the baby’s brain and spine. Taking folic acid regularly can help prevent neural tube defects, making it one of the most crucial reasons why women must take folic acid during and before pregnancy. Some of the most common neural tube defects are spina bifida (spinal cord defect), anencephaly (brain defect) and encephalocele (brain defect).
Brain Development: Another benefit of folic acid for pregnant women is that it helps form the baby’s brain nervous system and builds a solid foundation for cognitive development.
Prevents Miscarriage: Women taking folic acid supplements are at a lower risk of having a miscarriage. Folic acid can also help prevent preterm birth, as suggested in studies.
Prevents Heart Defects: Taking adequate folic acid helps during the baby’s heart development. Folic acid also lowers the risk of congenital heart defects.
Placental Development: Apart from helping in the healthy development of babies in the womb, it also aids in healthy placental development. The placenta must develop well, as it is essential for supplying oxygen and nutrients to the growing fetus or the baby.
Reduces Low Birth Weight Risk: Taking folic acid supplements reduces the risks of low birth weight. Low birth weight may be due to many reasons, including health complications for the baby.
Risk of Preeclampsia: Folic acid supplements lower the dangers of preeclampsia. Preeclampsia is a pregnancy complication that leads to high blood pressure.
Production of Red Blood Cells: The production of red blood cells during pregnancy is essential, supported by folic acid supplements. The supplements also help prevent maternal anemia during pregnancy.
Reduces the Risk of Autism: Many studies suggest that folic acid can potentially reduce the risks of having a baby in the autism spectrum. However, more research has yet to prove the same.
Risk of Cleft Lip: Taking folic acid supplements also lowers and reduces the risks of cleft lip or palate. A cleft lip or palate is when the baby’s upper lip or the palate does not join together.

How Much Folic Acid Should I Take?

Pregnant women’s recommended daily folic acid intake is 400 micrograms (mcg). However, women with certain risk factors may require higher doses, as their healthcare provider advises.

Is Folate and Folic Acid the Same?

While folate and folic acid are often used interchangeably, they are different. Folate refers to the natural form of the vitamin found in foods, while folic acid is the synthetic form used in supplements and fortified foods. Both are essential for prenatal care, with folic acid more readily absorbed by the body.

How Can I Get Enough Folic Acid?

Besides supplements, folic acid can be obtained through a balanced diet rich in folate-rich foods such as leafy greens, citrus fruits, beans, lentils, fortified cereals, and nuts. However, getting the recommended amount through diet alone is often challenging, making supplementation crucial during pregnancy.

Folic Acid Side Effects

While folic acid is generally considered safe, high doses may cause side effects such as nausea, bloating, and abdominal cramps. Sticking to the recommended dosage and consulting a healthcare provider if experiencing any adverse reactions are essential.

For a healthy pregnancy, women must take folic acid before and during pregnancy. However, most importantly, women must make sure to take some important supplements during pregnancy and include a healthy and balanced diet which includes – spinach, kale, brussels sprouts, cabbage, broccoli

beans and legumes (e.g. peas, blackeye beans), oranges and orange juice, wheat bran and other whole-grain foods, poultry, shellfish, liver, and others.

During pregnancy, women must not resort to bad habits like smoking, drinking or having too much junk food. Pregnant women must have repeated visits to their respective doctors and continue their folic acid supplements. It is not rare for doctors to recommend prenatal vitamins along with folic acid. Being candid about medical issues with the doctor becomes crucial as it helps the doctor understand and identify the correct dose the pregnant woman needs.

Women can significantly reduce the risk of congenital disabilities and complications, paving the way for a healthy pregnancy and a happy, thriving baby.

If you are on the verge of menopause or are going through menopause along with urinary symptoms, consult Dr Tejinder Kaur at the Motherhood Hospitals.

At Motherhood Hospitals, we have a team of experienced supers specialists backed by the latest infrastructure and facilities. We have the best gynecologist in Mohali. We are experts in handling complex deliveries, gynecological, and other surgeries including a range of laparoscopic surgeries.

Do make an appointment with the best woman’s care hospital in Mohali at a center closest to you. Meet with our doctors who will carry out 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. Tejinder Kaur, please book your appointment here.

Navigating Radiology: Ensuring Safe Imaging During Pregnancy

Author: Dr. Archit Singhal

MBBS, MD (Radiodiagnosis), Fellowship in Fetal Medicine,

Consultant – Fetal Medicine Specialist, Noida.

Introduction:

Pregnancy is a delicate and miraculous journey, and ensuring the well-being of both the mother and the growing fetus is of utmost importance. . According to Dr. Archit Singhal, MBBS, MD (Radiodiagnosis), Fellowship in Fetal Medicine, Consultant – Fetal Medicine Specialist, Motherhood Hospitals, Noida, frequently encounter questions about the safety of X-rays, and it’s crucial to provide accurate information to alleviate concerns and guide expectant mothers through their healthcare decisions.

Understanding X-rays:

X-rays are a form of electromagnetic radiation commonly used in medical imaging. They are invaluable tools for diagnosing and monitoring various health conditions. However, when it comes to pregnancy, the potential risks associated with ionizing radiation raise concerns.

The Risk-Benefit Analysis:

The key question is:

Are X-rays safe during pregnancy? The answer lies in a comprehensive risk-benefit analysis.

Low Dose, Low Risk:

Diagnostic X-rays, when performed with proper shielding and at the lowest possible dose, carry minimal risk to the developing fetus. Most diagnostic imaging studies use low doses of radiation, which further reduces the potential harm.

Targeted Imaging:

Radiologists and healthcare professionals always aim for precision in imaging. The focus is on capturing the necessary images while minimizing exposure to surrounding tissues. For instance, dental X-rays and some diagnostic imaging can be safely conducted with proper precautions.

Radiation Levels and Timing:

The critical factor is the timing of exposure and the radiation dose. The first trimester is the most vulnerable period for the developing fetus. Therefore, if a diagnostic test can be postponed until after the first trimester or if an alternative imaging method that doesn’t involve ionizing radiation is available, it is often recommended.

Common Scenarios:

Dental X-rays:

Routine dental X-rays, performed with lead shielding, are generally considered safe during pregnancy. It’s important to inform your dentist about your pregnancy, allowing them to take additional precautions.

Diagnostic Imaging:

In cases where diagnostic imaging is imperative for medical reasons, such as identifying a potential issue, the benefits of accurate diagnosis often outweigh the potential risks. However, alternative imaging methods, such as ultrasound or magnetic resonance imaging (MRI), might be considered, especially during the first trimester.

Conclusion:

The safety of X-rays during pregnancy is contingent on various factors, including the timing of exposure, the specific medical necessity, and the precautions taken. Open communication between the expectant mother, the referring physician, and the radiologist is paramount.

As a Radiologist and Fetal Medicine specialist, Dr. Archit Singhal believes in the power of technology to enhance our understanding of pregnancy and improve outcomes for both mothers and babies. Doppler ultrasound exemplifies this commitment, offering a window into the intricate world of fetal development and ensuring that every pregnancy is monitored with precision and care.

If you have any questions or concerns about Doppler ultrasound or prenatal care in general, feel free to reach out to Dr. Archit Singhal, Motherhood Hospitals, Noida. Remember, informed and proactive care is the key to a healthy and joyous pregnancy. please book your appointment here.

Please make an appointment with the best women’s care hospital in Noida at a center closest to you. Please meet with our doctors who will conduct the required investigations, diagnose the issue, and recommend the most appropriate treatment, enabling you to lead an active life.

Navigating Radiological Tests During Pregnancy: Ensuring Safety for Mother and Child

Author: Dr. Archit Singhal

MBBS, MD (Radiodiagnosis), Fellowship in Fetal Medicine,

Consultant – Fetal Medicine Specialist, Noida.

Introduction:

Pregnancy is a delicate and pivotal period in a woman’s life, and the well-being of both the mother and the unborn child is of utmost importance. According to Dr. Archit Singhal, MBBS, MD (Radiodiagnosis), Fellowship in Fetal Medicine, Consultant – Fetal Medicine Specialist, Motherhood Hospitals, Noida, Radiological tests, including X-rays, CT scans, and MRIs, involve exposure to ionizing radiation or strong magnetic fields, prompting apprehension among pregnant women. In this blog, we will delve into the nuances of this topic to help you make informed decisions regarding radiological tests during pregnancy.

Understanding the Concerns:

The primary concern associated with radiological tests during pregnancy revolves around potential harm to the developing fetus. Ionizing radiation has the ability to ionize atoms and molecules, potentially causing damage to DNA. However, it’s crucial to recognize that the risk depends on the type and amount of radiation, as well as the stage of pregnancy.

Trimester Matters:

The first trimester is considered the most sensitive period for fetal development. During this time, the organs and tissues are forming, making the fetus more vulnerable to the potential effects of radiation. In contrast, the second and third trimesters are generally considered to be less susceptible to radiation-related risks.

Types of Radiological Tests:

X-rays:

When possible, X-rays are usually avoided during pregnancy, especially in the abdominal and pelvic regions. However, if a diagnostic X-ray is deemed essential, abdominal shielding can be employed to minimize fetal exposure.

CT Scans:

Computed Tomography (CT) scans involve higher doses of radiation compared to X-rays. Nevertheless, if the information gained from a CT scan is crucial for diagnosis, the benefits may outweigh the potential risks. The use of shielding and adjustments to imaging protocols can minimize radiation exposure.

MRI:

Magnetic Resonance Imaging (MRI) does not use ionizing radiation but powerful magnetic fields. As of current knowledge, MRI is considered safe during pregnancy, particularly after the first trimester. However, it’s vital to inform the radiologist about the pregnancy so that appropriate safety measures can be taken.

Balancing Act:

In many cases, the decision to undergo a radiological test during pregnancy involves a delicate balance between the diagnostic benefits and potential risks. If a test is deemed necessary for accurate diagnosis and management of a health condition, healthcare providers will carefully assess the potential risks and take appropriate measures to minimize them.

Key Takeaways:

Communication is Key:

It is imperative for pregnant women to communicate their condition to their healthcare providers. This ensures that appropriate precautions are taken, and alternative imaging modalities are considered when feasible.

Informed Decision-Making:

Pregnant women and their healthcare providers should engage in open discussions about the necessity of any radiological test. The decision should be based on a thorough understanding of the potential risks and benefits.

Minimizing Exposure:

When radiological tests are unavoidable, steps such as the use of shielding, adjustments to imaging protocols, and selecting imaging modalities with lower or no ionizing radiation can help minimize fetal exposure.

Conclusion:

While caution is warranted, radiological tests can be conducted during pregnancy when necessary, provided that the potential risks are carefully evaluated and appropriate precautions are taken. Every case is unique, and decisions should be made collaboratively between the patient and healthcare provider.

Remember, a well-informed and open dialogue between the expectant mother and the healthcare team is the cornerstone of ensuring the safety and well-being of both mother and child during pregnancy.

Decoding the Wonders of Doppler Ultrasound in Pregnancy: A Radiologist’s Perspective

Author: Dr. Archit Singhal

MBBS, MD (Radiodiagnosis), Fellowship in Fetal Medicine,

Consultant – Fetal Medicine Specialist, Noida.

Pregnancy is a miraculous journey filled with anticipation and joy, but it also comes with its fair share of concerns and uncertainties. According to Dr. Archit Singhal, MBBS, MD (Radiodiagnosis), Fellowship in Fetal Medicine, Consultant – Fetal Medicine Specialist, Motherhood Hospitals, Noida, One of the crucial aspects of prenatal care is monitoring the well-being of both the mother and the growing baby. This is where Doppler ultrasound proves to be an invaluable tool, providing crucial insights that help ensure a healthy pregnancy.

Understanding Doppler Ultrasound

Doppler ultrasound is a specialized imaging technique that measures the blood flow in different parts of the body. In the context of pregnancy, it is commonly used to assess blood flow in the umbilical cord, uterus, and fetal blood vessels. The technology employs sound waves to detect and analyze the movement of red blood cells, providing real-time information about the blood circulation in the placenta and the fetus.

Why Doppler Ultrasound is Essential During Pregnancy

Monitoring Fetal Well-being:

Doppler ultrasound plays a pivotal role in assessing the well-being of the developing fetus. By evaluating blood flow in the umbilical cord and other vital vessels, healthcare professionals can ensure that the baby is receiving an adequate oxygen and nutrient supply. This is crucial for identifying and addressing any potential issues early on.

Identifying Complications:

Certain pregnancy complications, such as preeclampsia and intrauterine growth restriction (IUGR), can impact blood flow to the fetus. Doppler ultrasound helps in early detection of these complications, allowing for timely intervention and management to safeguard both the mother and the baby.

Monitoring Twin Pregnancies:

In cases of multiple pregnancies, such as twins or triplets, Doppler ultrasound becomes even more vital. It aids in monitoring the blood flow to each fetus individually, ensuring that both babies are growing at a healthy rate and receiving adequate nutrients.

Assessing Placental Function:

The placenta plays a crucial role in supplying nutrients and oxygen to the fetus. Doppler ultrasound helps in evaluating the function of the placenta by assessing blood flow in the uterine arteries. Any abnormalities in placental function can be promptly addressed to prevent complications.

The Procedure:

Doppler ultrasound is a non-invasive and safe procedure that is typically performed during routine prenatal visits. A gel is applied to the mother’s abdomen, and a handheld device called a transducer is moved over the belly to capture images and measurements.

Conclusion:

In conclusion, Doppler ultrasound is an invaluable tool in the field of prenatal care, providing essential information about blood flow and fetal well-being. Its non-invasive nature and ability to detect potential complications early make it an indispensable part of modern obstetric practice.

Demystifying VBAC – A Guide for Women Considering Vaginal Birth After Cesarean

Author: Dr. Kiran Yadav

MBBS, DGO, DNB Fellowship in laparoscopy Obstetrics and Gynaecology

Senior Consultant – Obstetrician & Gynaecology

Demystifying VBAC – A Guide for Women Considering Vaginal Birth After Cesarean:

The Rising Interest in VBAC in India: An Overview

The landscape of childbirth in India is witnessing a significant transformation with the increasing interest in Vaginal Birth After Cesarean (VBAC). According to Dr. Kiran Yadav, MBBS, DGO, DNB Fellowship in laparoscopy Obstetrics and Gynaecology, Senior Consultant – Obstetrician & Gynaecology, This option, which was once less considered, is now emerging as a preferred choice for many expectant mothers. VBAC presents an opportunity for women who have previously undergone a cesarean section to experience vaginal delivery in their subsequent pregnancies. This shift reflects a growing awareness about the potential benefits of VBAC and a desire among women to explore alternative birthing options. This article aims to demystify VBAC, providing a comprehensive guide for Indian women contemplating this route for childbirth.

Understanding VBAC’s Growing Popularity

The trend towards VBAC is indicative of a broader change in attitudes towards childbirth in India. Women are becoming more informed and are actively seeking out options that align with their personal health and birthing preferences. VBAC is being seen not just as a medical procedure, but as a part of a more holistic approach to childbirth that emphasizes the mother’s choice and autonomy. This growing trend is supported by medical advancements and a better understanding of the risks and benefits associated with VBAC. In this article, we delve into the various aspects of VBAC, offering insights and information to help women in India make informed decisions about their childbirth options.

Understanding VBAC

Defining VBAC and Its Relevance Vaginal Birth After Cesarean (VBAC) refers to giving birth vaginally after having a previous birth through a cesarean section. This option challenges the traditional notion that once a woman has a C-section, all subsequent deliveries must also be surgical (repeat LSCS). VBAC offers a possibility for women to experience natural childbirth, which can have significant benefits for both the mother and the child. The process involves careful monitoring and assessment to ensure the safety of both the mother and the baby. Understanding VBAC is essential for any woman considering this option, as it involves weighing the benefits against the potential risks.

Contrasting VBAC with Repeat Cesarean Sections

While a cesarean section is a common and safe method of delivering a baby, it is a major abdominal surgery and comes with certain risks and a longer recovery period. In contrast, VBAC allows women to avoid another surgical procedure, potentially leading to a quicker recovery and less time spent in the hospital. However, VBAC is not suitable for everyone and requires a thorough evaluation by healthcare professionals. Women considering VBAC should understand the factors that influence its feasibility, such as the type of incision made in the previous cesarean, indication of cesarean ,position of placenta and the overall health of the mother.

Benefits of VBAC

Physical and Emotional Benefits of VBAC .One of the most significant advantages of VBAC is the avoidance of major abdominal surgery, that is a repeat cesarean section. This can lead to a shorter hospital stay, quicker recovery, and less physical discomfort post-delivery. Additionally, VBAC reduces the risks associated with multiple cesarean deliveries, such as bladder or bowel injuries and complications in future pregnancies. Emotionally, VBAC can offer a more satisfying birth experience for many women. It provides them with an opportunity to actively participate in the birthing process, which can be empowering and positively impact their overall well-being.

Long-term Health Benefits for Mother and Child

VBAC not only benefits the mother in the short term but also has long-term health implications. Women who undergo VBAC have a lower risk of hemorrhage and infection compared to those who have repeat C-sections. Furthermore, VBAC can be beneficial for the child, as vaginal births are associated with a lower risk of respiratory problems and other complications that can occur more frequently in babies delivered via C-section. The opportunity for immediate skin-to-skin contact and breastfeeding is often more readily available following a vaginal birth, promoting early bonding and potential long-term benefits for the baby’s immune system and development.

Risks Associated with VBAC

Understanding the Challenges of VBAC. While VBAC offers several benefits, it’s important to acknowledge the associated risks to make an informed decision. The primary concern is the risk of uterine rupture, a rare but serious complication where the cesarean scar on the uterus tears during labor. Other potential risks include infection, injury to the mother or baby, and the possibility of an emergency C-section if complications arise. The decision to attempt a VBAC should be based on a thorough evaluation of these risks in consultation with healthcare professionals, considering the mother’s overall health, the reason for the previous C-section, and the conditions of the current pregnancy.

VBAC Risks in the Indian Context

In India, the risks associated with VBAC need to be understood in the context of the healthcare system’s capabilities and the individual’s health profile. Factors such as the availability of emergency care, the proximity to a well-equipped medical facility, and the expertise of the healthcare provider play crucial roles in managing these risks. Women should discuss their concerns and understand the specific risks related to their situation, including the likelihood of success and the potential for complications. This section will provide detailed information on these risks, particularly focusing on the Indian healthcare scenario.

Candidacy for VBAC

Criteria for VBAC Eligibility in India Determining who is a good candidate for VBAC is critical for ensuring the safety of both mother and baby. In India, the eligibility criteria for VBAC are similar to global standards but must be contextualized to local healthcare practices. Generally, women with a low-transverse incision from a previous cesarean, without a history of uterine rupture or certain types of uterine surgery, are considered potential candidates. Other factors include the reason for the previous C-section, the interval between pregnancies, and the mother’s overall health and pregnancy conditions. This section will elaborate on these criteria, helping Indian women understand if VBAC is a suitable option for them.

Assessing Individual Suitability for VBAC

Each woman’s situation is unique, and the decision to pursue VBAC should be made on an individual basis. Factors such as the type of previous cesarean incision, the number of previous C-sections, and the presence of any complicating factors like high maternal age or high birth weight of the baby are taken into account. Consulting with healthcare providers who can evaluate these factors and provide personalized advice is essential. This section will guide women through the process of assessing their suitability for VBAC, emphasizing the importance of a personalized approach in the Indian context.

Preparing for VBAC

Key Steps for a Successful VBAC Experience Preparation for VBAC involves several key steps, beginning with the selection of a healthcare provider experienced in managing VBAC cases. This includes finding a medical facility equipped to handle both VBAC and emergency C-sections. Women should ensure their complete medical history, including details of the previous cesarean, is available to their healthcare provider. Discussing VBAC during prenatal visits allows for a comprehensive assessment and formulation of a birthing plan that considers the mother’s preferences and the safety of both mother and baby.

The Role of Informed Decision-making and Support

The journey towards a successful VBAC is also supported by informed decision-making and a strong support system. Women should educate themselves about the process, potential risks, and benefits of VBAC. Support from family, friends, and healthcare providers is crucial. This section will provide practical advice on preparing for VBAC, including tips on choosing the right healthcare provider and facility, and the importance of emotional and informational support throughout the pregnancy.

VBAC in India

A Path to Empowered Childbirth In conclusion, this comprehensive exploration of VBAC in India serves as a valuable resource for women considering this option. From understanding what VBAC entails to its benefits, risks, and the inspiring stories of those who have experienced it, the aim is to provide a holistic view. The decision to opt for VBAC is deeply personal and should be made after careful consideration and consultation with healthcare providers. This article hopes to empower women with the information and insights they need to make informed choices about their childbirth experiences, ultimately contributing to their well-being and that of their families.

Dr. Kiran Yadav will respond to your query as soon as possible. For emergencies please call and reach Motherhood Hospital, Gurgaon.

At Motherhood Hospitals, we have a team of experienced supers specialists backed by the latest infrastructure and facilities. We have the best gynaecologist in Gurgaon . We are experts in handling complex deliveries, gynecological, and other surgeries including a range of laparoscopic surgeries.

Do make an appointment with the best woman care hospital in Gurgaon at a center closest to you. Please meet with our doctors who will carry out 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. Kiran Yadav, please book your appointment here

Important supplements during pregnancy

Author – Dr Ekawali Gupta MBBS, MS Degree in OBG, Consultant,

Consultant Obstetrician and Gynaecologist, Motherhood Hospital, Mohali.

Pregnancy is a miraculous journey filled with joy and challenges. One of the crucial aspects of this journey is ensuring that both the mother and the baby receive adequate nutrients for optimal health. While a balanced diet is essential, there are times when dietary intake alone may not suffice. According to Dr Ekawali Gupta , MBBS, MS Degree in OBG, Consultant Obstetrician and Gynaecologist, this article aims to shed light on the important supplements that can fill the nutritional gaps during pregnancy, especially focusing on the needs of expectant mothers in India.

Why Supplements are Necessary

Nutritional Gaps

Even with a well-balanced diet, there can be nutritional gaps that need to be filled. Pregnancy increases the demand for certain vitamins and minerals, making supplementation necessary in some cases.

Increased Needs During Pregnancy

During pregnancy, the body’s requirement for nutrients like folic acid, iron, and calcium increases significantly. Supplements can help meet these increased demands and contribute to a healthy pregnancy.

Types of Supplements

Folic Acid

Why it’s Important: Folic acid is crucial for the neural tube development of the fetus. A deficiency can lead to neural tube defects like spina bifida.
Recommended Dosage: 400 to 800 mcg per day
Sources: Leafy greens, fortified cereals, and supplements.

Iron

Why it’s Important: Iron is essential for preventing anemia, a condition that can lead to preterm birth and low birth weight.
Recommended Dosage: 27 mg per day
Sources: Lentils, beans, and iron-fortified foods.

Calcium

Why it’s Important: Calcium supports the development of the baby’s bones and teeth.
Recommended Dosage: 1000 mg per day
Sources: Dairy products, fortified plant milk, and supplements.

Vitamin D

Why it’s Important: Vitamin D works in tandem with calcium for bone health and helps in the absorption of other essential nutrients.
Recommended Dosage: 600 IU per day
Sources: Sunlight, fortified foods, and supplements.

Omega-3 Fatty Acids

Why it’s Important: Omega-3s are essential for the development of the baby’s brain and eyes.
Recommended Dosage: 200 to 300 mg per day
Sources: Fish, flaxseeds, and supplements.

Zinc

Why it’s Important: Zinc is essential for cell division and the formation of DNA and proteins.
Recommended Dosage: 11 mg per day
Sources: Nuts, whole grains, and supplements.

Magnesium

Why it’s Important: Magnesium helps in the development of strong bones and regulates blood sugar levels.
Recommended Dosage: 350 to 360 mg per day
Sources: Leafy greens, nuts, and supplements

Herbal Supplements

Popular Herbal Supplements in India

In India, herbal supplements like Ashwagandha, Shatavari, and Triphala are often recommended during pregnancy. However, it’s crucial to consult a healthcare provider before incorporating these into your regimen.

Precautions

While herbal supplements can offer various benefits, they are not regulated by medical authorities. Therefore, quality and safety can vary. Always consult your healthcare provider for personalized advice.

Consulting a Healthcare Provider

Importance of Medical Advice

Supplements should never replace a balanced diet and should only be taken under medical supervision. Overdosing on certain vitamins and minerals can have adverse effects on both the mother and the baby.

Risks of Self-Prescribing

Nutrient Imbalance

One of the primary risks of self-prescribing is creating a nutrient imbalance. For example, excessive intake of vitamin A can lead to toxicity, while an overdose of iron can cause gastrointestinal issues and even more severe health problems.

Drug Interactions

Supplements can interact with medications you may already be taking. For instance, calcium can interfere with the absorption of certain antibiotics, and some herbal supplements can interact with blood thinners.

False Sense of Security

Self-prescribing can sometimes give a false sense of security, leading individuals to neglect other essential aspects of prenatal care, such as a balanced diet, regular exercise, and routine medical check-ups.

Lack of Quality Control

Over-the-counter supplements are not strictly regulated, which means the quality, safety, and efficacy can vary significantly. There’s also the risk of contamination with harmful substances.

Delay in Seeking Professional Help

Relying solely on self-prescribed supplements can delay the consultation of healthcare providers, potentially leading to missed diagnoses or ineffective treatment plans.

Ethical Considerations

Self-prescribing during pregnancy doesn’t just affect you; it also has potential implications for the health of your unborn child. Ethically, it’s crucial to consider the risks you might be posing to another life.

Legal Risks

In some jurisdictions, self-prescribing controlled substances without a valid prescription can lead to legal consequences, adding another layer of risk to the practice.

By understanding these risks, you can better appreciate the importance of consulting a healthcare provider for a personalized supplement plan. This ensures that you’re taking the right steps for both your well-being and that of your unborn child.

Conclusion

Pregnancy is a time of joy but also a period that demands extra attention to nutrition. Supplements can play a vital role in filling nutritional gaps, but they should be taken responsibly and under medical supervision. By being informed and cautious, you can ensure a healthier pregnancy journey for both you and your baby.

If you or someone you know is dealing with inverted nipples and its associated challenges, we’re here to help. Schedule a consultation at our clinic to explore the best treatment options tailored for you.

Dr Ekawali Gupta will respond to your query as soon as possible. For emergencies please call and reach Motherhood Hospital, Mohali.

At Motherhood Hospitals, we have a team of experienced supers specialists backed by the latest infrastructure and facilities. We have the best gynaecologist in Mohali. We are experts in handling complex deliveries, gynecological, and other surgeries including a range of laparoscopic surgeries.

Do make an appointment with the best woman care hospital in Mohali at a center closest to you. Meet with our doctors who will carry out 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. Ekawali Gupta, please book your appointment here.

How to Prevent Down Syndrome During Pregnancy

Author – Dr Ekawali Gupta

MBBS, MS Degree in OBG, Consultant,

Consultant Obstetrician and Gynaecologist, Mohali.

Understanding Down Syndrome

Introduction:

Down syndrome is a genetic condition that affects a significant number of families worldwide, and India is no exception. With increasing awareness and medical advancements, there are ways to manage and even prevent the risk of having a child with Down syndrome. According to Dr Ekawali Gupta , MBBS, MS Degree in OBG, Consultant Obstetrician and Gynaecologist this blog aims to shed light on this sensitive topic and provide actionable steps for expectant mothers.

What is Down Syndrome?

Down syndrome is a genetic disorder that occurs when an individual has an extra copy of chromosome 21. This additional genetic material alters the course of development and causes the characteristics we associate with Down syndrome.

How is it Caused?

The condition is usually caused by an error in cell division, resulting in an extra full or partial copy of chromosome 21. The reasons for this abnormal cell division are still not entirely understood but are believed to be a combination of genetic and environmental factors.

Risk Factors

Understanding the risk factors associated with Down syndrome can help in taking preventive measures. Here are some of the key factors:

Maternal Age

35-39 Years: Women in this age group have a 1 in 350 chance of having a child with Down syndrome.
40-44 Years: The risk increases to 1 in 100 for women aged between 40 and 44.
45 Years and Above: For women over 45, the risk further escalates to 1 in 30.

Paternal Age

While maternal age is often highlighted, research suggests that advanced paternal age can also contribute to the risk, especially when combined with advanced maternal age.

Previous Child with Down Syndrome

If a family already has a child with Down syndrome, the risk for subsequent children increases. The recurrence risk is about 1% regardless of maternal age.

Genetic Translocation

In some cases, Down syndrome occurs due to a genetic translocation where a part of chromosome 21 attaches to another chromosome. The risk increases if either parent is a balanced carrier of the translocation.

Family History

A family history of Down syndrome or other genetic conditions can elevate the risk. Genetic counseling can provide a clearer picture of the risk based on family medical history.

Family Planning

Early Parenthood: Opting for early parenthood can be a strategic choice, especially for women, as the risk of Down syndrome increases with maternal age.
Genetic Testing Before Pregnancy: Couples with a family history of genetic disorders can opt for genetic testing even before planning a pregnancy.

Pre-implantation Genetic Diagnosis (PGD)

What is PGD?: This technique is used in conjunction with in-vitro fertilization (IVF) to screen embryos for genetic conditions.
Who Should Consider PGD?: Couples who have a high risk of passing on genetic disorders, including Down syndrome, should consider this option.
Limitations: It’s important to note that PGD can be expensive and is not 100% foolproof.

Prenatal Screening

First Trimester: Tests like the nuchal translucency scan can provide early indicators.
Second Trimester: The triple or quadruple test can further assess the risk.
Invasive Testing: In high-risk cases, doctors may recommend invasive tests like amniocentesis or chorionic villus sampling (CVS).

Consulting Healthcare Professionals

Importance of Genetic Counseling

If you’re at a higher risk of having a child with Down syndrome, consulting a genetic counselor can provide valuable insights. They can guide you through the available tests, their implications, and help you make informed decisions.

When to Consult a Doctor

If you’re planning a pregnancy or are already pregnant, it’s crucial to consult a healthcare provider for a comprehensive prenatal care plan. This is especially important for women over the age of 35 or those with a family history of genetic disorders.

Conclusion

Preventing Down syndrome is a complex issue that involves a combination of genetic, environmental, and lifestyle factors. While it’s not entirely preventable, understanding the risk factors and taking proactive steps can significantly reduce the risks. Regular prenatal check-ups, genetic counseling, and advanced screenings are essential components of a proactive healthcare approach.

Dr Ekawali Gupta will respond to your query as soon as possible. For emergencies please call and reach Motherhood Hospital, Mohali.

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

Heartburn during Pregnancy: How to Handle?

Author: Dr. Madhushree Vijayakumar

MBBS, MRCOG, FRCOG, DGO

Consultant – Obstetrician & Gynaecologist at Motherhood Hospital, Hebbal

Heartburn during Pregnancy: How to Handle?

Introduction

Heartburn, often described as a burning sensation ascending from the stomach to the chest or throat, is a prevalent discomfort encountered during pregnancy. According to Dr. Madhushree Vijayakumar MBBS, MRCOG, FRCOG, DGO, Consultant – Obstetrician & Gynaecologist at Motherhood Hospital, Hebbal, the incidence rate is significant, with a range of 17% to 45% of pregnant women grappling with this burning sensation at different stages of gestation. The journey of pregnancy brings about numerous physiological changes, one of which is the relaxation of the lower esophageal sphincter due to the hormone progesterone, paving the way for heartburn. This article endeavors to furnish a detailed guide on effectively managing heartburn during pregnancy, ensuring a comfortable experience for expectant mothers while safeguarding the baby’s health.

Understanding Heartburn

Heartburn is the result of stomach acid backflow into the esophagus—the tube that serves as a conduit for food from the mouth to the stomach. The relaxation of the lower esophageal sphincter during pregnancy, primarily due to hormonal changes, facilitates this acid backflow, often leading to heartburn. The discomfort can range from a mild, infrequent annoyance to a severe, persistent irritation, significantly impacting the quality of life of expectant mothers. As pregnancy advances, the growing uterus exerts additional pressure on the stomach, potentially exacerbating heartburn frequency and intensity. Comprehensive knowledge about the dynamics of heartburn and its relation to pregnancy is crucial for devising effective management strategies.

Common Triggers

Identifying and understanding common triggers are the first steps towards effective heartburn management:

Spicy Foods: Spices can irritate the esophagus, instigating or worsening heartburn.
Fatty and Greasy Foods: Such foods tend to linger in the stomach longer, delaying gastric emptying and creating a conducive environment for heartburn.
Caffeine and Alcohol: Both substances can cause the lower esophageal sphincter to relax, enabling stomach acid to surge into the esophagus, and causing heartburn.

Awareness of these triggers and judicious dietary choices can significantly mitigate heartburn symptoms during pregnancy.

Lifestyle Modifications

Adopting certain lifestyle modifications can significantly alleviate heartburn symptoms:

Eating Smaller, Frequent Meals: Smaller meal portions reduce stomach pressure, minimizing the likelihood of acid reflux.
Avoid Lying Down Post Meals: Waiting at least 3 hours after meals before lying down can prevent acid backflow into the esophagus.
Elevating the Upper Body While Sleeping: A slight elevation can help keep stomach acid in its rightful place, reducing heartburn occurrence.

Dietary Modifications

Tailoring the diet to include heartburn-friendly foods while avoiding triggers can offer substantial relief:

Incorporate Alkaline Foods: Alkaline foods like bananas, melons, and cauliflower can help neutralize stomach acid.
Include High-Fiber Foods: High-fiber foods like whole grains and root vegetables can aid in digestive health, potentially reducing heartburn symptoms.
Avoiding Known Triggers: Steering clear of foods and beverages that trigger heartburn is paramount.

Non-Pharmaceutical Remedies

Exploring natural remedies, always in consultation with healthcare providers, can offer additional relief:

Herbal Teas: Certain herbal teas may soothe the digestive system, although the efficacy and safety should be discussed with a healthcare provider.
Chewing Gum: Chewing gum can increase saliva production, neutralizing stomach acid.

Pharmaceutical Relief

Under medical supervision, pharmaceutical interventions can provide effective heartburn relief:

Antacids: Antacids can neutralize stomach acid, providing immediate but temporary relief.
Other Medications: Other over-the-counter or prescription medications may be recommended by healthcare providers to manage heartburn symptoms.

Coping Strategies

Employing coping strategies can help manage heartburn symptoms in daily life:

Maintaining a Heartburn Diary: Tracking food intake and heartburn occurrences can help identify personal triggers.
Seeking Professional Advice: Consulting with healthcare providers for personalized advice and treatment plans is crucial for effectively managing heartburn during pregnancy.

Conclusion

Managing heartburn during pregnancy requires a multifaceted approach encompassing lifestyle modifications, dietary adjustments, and possibly pharmaceutical interventions under medical supervision. By understanding the causes, identifying personal triggers, and adopting a tailored management plan, expectant mothers can significantly alleviate heartburn discomfort, ensuring a more comfortable and enjoyable pregnancy journey.

If you are on the verge of menopause or are going through menopause along with urinary symptoms, consult Dr. Madhushree Vijayakumar at the Motherhood Hospitals.

At Motherhood Hospitals, we have a team of experienced supers specialists backed by the latest infrastructure and facilities. We have the best gynecologist in Hebbal. We are experts in handling complex deliveries, gynecological, and other surgeries including a range of laparoscopic surgeries.

Do make an appointment with the best woman care hospital in Hebbal at a center closest to you. Meet with our doctors who will carry out 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. Madhushree Vijayakumar, please book your appointment here.