Wednesday, December 2, 2020

Pregnancy After 40s Is High Risk Pregnancy

 According to studies, there are about 30% of the woman aged between the age of 40 to 44 years that experience infertility. Chances of getting pregnant in any month after crossing 40 are low. Getting pregnant after 40 years of age is possible. But at the age of 40 years you only have 5% chances of getting pregnant each month. This clearly shows that even those that will get pregnant it will take longer. After 45 years it is nearly impossible to get pregnant with your own eggs.

Comparing with the age group 30 years, they have about 20% of chances of getting pregnant each month. Women who are 15 to 34 years of age have 9% chances of infertility and women with 35 to 39 years experience 25% of infertility.

Age and Miscarriage:

Another factor that goes against women during their 40s who wants to get pregnant is the higher rate of miscarriage.  Around 34% of pregnancies end up having a miscarriage for women who are 40 to 44 years of age. And about 53 % of pregnancies end up having a miscarriage for women who have crossed 45 years of age. Even though chances of miscarriage are there but there are good chances of pregnancies to continue.

Age and Pregnancy Complications:

Older women who are in their 40s are more likely to have followed complications:

§  Miscarriage

§  Placenta praevia, in this the placenta develops in the wrong part of the uterus

§  Gestational diabetes

§  High blood pressure

§  Chances of having twins or even triplets

§  Preterm labor

§  Children with genetic conditions

Age and babies with genetic predispositions:

Women beyond 40 years are more likely to have a child with a genetic condition such as Down syndrome.  You should always be in touch with your doctor if you encounter any kind of problem.  During the screening, if something occurs then you can have diagnostic tests such as amniocentesis and chorionic villus sampling.

After the 40s if you are trying to get pregnant and if you are not pregnant even after six months then its time for evaluation.

Tuesday, November 24, 2020

Can Hepatitis Effect Pregnancy - Dr SK Gambhir

Adult viral hepatitis is the most common cause of jaundice in pregnancy. Hepatitis is the type of infection that can seriously damage your liver and if you are pregnant you can pass onto your baby. You can have one of three most common types of Hepatitis viruses A, B and C and usually, it won’t hurt your unborn baby or affect your pregnancy. If your doctor knows you have it, she can help you manage it during your pregnancy to lower the chances of any long-term liver disease for you and your baby.

Jaundice is the characteristic feature of the liver disease. The clinical signs and symptoms are indistinguishable from the various forms of hepatitis. Therefore, diagnosis requires serological tests for virus-specific diagnosis. Biochemical assessment of liver functions is also done.

Differential diagnosis includes mono-mere and EBV virus infection with liver failure, gallbladder disease, HELLP syndrome, acute fatty liver of pregnancy. The most useful tests to diagnose are urine bilirubin and urobilinogen, total and direct serum bilirubin, Alanine Aminotransferase (ALT), ALP, PT, total protein, albumin, CBC in some cases and serum ammonia.

Effects of Different Types of Hepatitis on Pregnancy

Hepatitis A

It is the most common cause of acute viral hepatitis in the general population but it is infrequently reported among pregnant women. It is transmitted via the fecal-oral route either by direct contact with the infected person or ingestion of contaminated food. Inoculation period is 15 to 40 days. It is common in developing countries owing to poor hygiene and sanitation systems. Transmission of HAV from mother to fetus is uncommon. If Hepatitis A infection

occurs in pregnant women. It can cause pre-term labor especially if infection occurs in 2nd and 3rd trimester. Hepatitis A infection is also associated with other complications like premature rupture of membranes, premature uterine contractions, and placental abruption. In some cases, fever and hypoalbuminemia can be there. If transmission occurs from mother to child, there can be meconium peritonitis and perforation of the distal ileum. An HAV vaccine is available and can be administered to the mother before traveling to endemic countries. Breastfeeding should not be discouraged. The child should be protected through the administration of immunoglobulins or the inactivated vaccine.

Hepatitis B

Of the 400 million infections with chronic HBV worldwide, 50% acquired their infection prenatally. 90% of the infected infants will become chronic carriers of Hepatitis B. It is a double-stranded DNA virus in the core particle. The incubation period is up to 180 days.

Clinical picture – in pregnancy, chronic infection is symptomatic. In acute infection, 50% asymptomatic, urticarial rash, arthralgia, arthritis, hepatomegaly and or right upper quadrant tenderness. Jaundice is less common. After acute hepatitis, 90% of patients recover completely, 10% go into chronic hepatitis. Lab markers are –HbsAg → current infection, HbcAg→ active replication, and HBV DNA→ viral load.

Effect of HBV on Pregnancy

Gestational diabetes, preterm delivery, no worsening of liver disease in pregnancy, peri-natal transmission. HbcAg positive in 70-90% of cases, HbcAg negative in 10-40% of cases without immunoprophylaxis. In the uterus, transplacental viral infection is uncommon. Viral DNA is rarely found in amniotic fluid or cord blood. Most neonatal infections are vertically transmitted by peripartum exposure. Breastfeeding is not associated with transmission. Mode of delivery

has no effect on HBV transmission. All neonates who are correctly immunized can be breastfed.

Prevention

§  Antivirals to suppress the HBV in mother to reduce vertical transmission.

§  Post-exposure prophylaxis to the infant. Active plus passive immunization is most effective to prevent vertical transmission. Protective efficacy of 95%.

§  If the liver disease is in advance stage, treatment can be given before pregnancy and during pregnancy and continued after delivery. If moderate disease, treatment before pregnancy. If good response, stop treatment during pregnancy.

§  If mild disease, treatment is given in the last trimester with B category drug with post-partum discontinuation.

§  

Hepatitis C

For women of reproductive age with known HCV infection, antiviral therapy is recommended before continuing pregnancy, whenever practical and feasible to reduce the risk of HCV infection to offspring. Women should be counseled about the benefit of anti-viral treatment prior to pregnancy.

At the first antenatal visit, HCV RNA and routine liver function tests are recommended to assess the risk of mother and child vertical transmission and degree of liver disease. HCV infected pregnant women with pruritus or jaundice have increased the risk of intrahepatic cholestasis of pregnancy. Assessment of ALT, AST and bile acids should be done. HCV infected women should be counseled about the increased risk of adverse maternal and perinatal outcomes. Antenatal and perinatal care should be coordinated with a maternal-fetal medicine

There can be pre-term delivery, low birth infants and congenital anomalies with maternal HCV infection. However, pregnant women with cirrhosis are at increased risk for the poor maternal outcomes like preeclampsia, hemorrhagic complication, and death. Pregnancy itself does not appear to negatively affect chronic HCV infection. Serum ALT level decrease during the third trimester and increases after delivery.

Breastfeeding is not a risk for HCV transmission. Studies showing similar rates of maternal infection in breastfed and bottle-fed infants. In breastfeeding women have cracked nipples, bleeding, they should refrain from breastfeeding. Women with HCV infection should have their HCV RNA evaluated approximately 9-12 months after delivery to assess for spontaneous clearance.

 

 

Monday, November 2, 2020

What’s Going On With Your Skin During And After Pregnancy?

You may experience changes in your skin and hair as your pregnancy progresses. Some women develop dark patches on the face or their skin may feel darker due to hormonal changes. If you are experiencing the same, it is best that you consult a gynaecologist or a dermatologist at the earliest. Early and timely attention can help you improve your skin.

Few common skin changes during pregnancy are:

§  Acne: After the child birth many women lose their pregnancy glow and gain unwanted acne. This occurs due to increased level of estrogens and progesterone which trigger oily skin and clogs the pores. You should consult your doctor about acne treatment.

§  The Linea Nigra: Often pregnant woman experience skin discolouration near stomach during pregnancy, this is commonly known as linea nigra. The skin discolouration disappears shortly after the delivery.

§  Dry Skin: Dry skin is common in pregnant females who have low thyroid levels during pregnancy. Dry skin can be avoided by the use of quality moisturizer and simultaneous your skin improves with time.

§  Spider and Varicose Veins: Spider and varicose veins appear by weakened valves in veins. Due to increased blood flow during pregnancy, the unwanted marks like this tend to occur. Many treatment options are available, but it is important to understand the severity of varicose veins.

§  Facial discoloration: During pregnancy and after giving birth, many women encounter dark patches of skin on their face. This condition of facial discoloration is known as chloasma and sometimes it is called as the mask of pregnancy. As your reproductive hormones rises there is increase in the melanin which further increases hyperpigmentation of skin. When your hormones start to balance themselves, then your skin patches start to fade by itself.

§  Stretch marks: As your belly size increase so does stretch marks. Use good moisturize which help to maintain stretch marks. Also by maintain healthy weight also helps to wave of stretch marks.

§  Skin tags, warts or moles: Warts and skin tags appear after dramatic weight loss. If your mole enlarges and changes its colour, you should contact your doctor.

Saturday, October 17, 2020

IVF Centre in Chandigarh

IVF is extensively more beneficial than intrauterine insemination, another regularly utilized riches system. Not at all like IUI, would it have the option to help treat in every way that really matters, such a vanity issue. In vitro plan, for the most part called IVF, is an average ineffectiveness treatment that fuses utilizing luxuriousness medications to empower the progress of different eggs. The eggs are recovered from the ovaries utilizing a little needle. They are then treated with sperm in a particular lab. The starting living things make for 3 to 5 days before at any rate one is put into the uterus. There are various IVF facilities in tricity. 

Who is a reasonable competitor for in vitro treatment? 

IVF is the best vanity treatment for basically all patients, combining those with the going with: 

· ovulation issues 

· fallopian chamber hurt/hindrance 

· endometriosis 

· pelvic bonds 

· helpless semen quality 

· unexplained barrenness 

· Drawn out pointlessness. 

It can comparatively be utilized to draw in preimplantation inborn testing (PGT) of starting living things. In any case, IVF doesn't make new eggs for patients, and if the uterus is unequipped for embeddings and passing on a pregnancy, IVF can't manage that issue. 

Helped conceptive degrees of progress (Craftsmanship), which join IVF, combine the utilization of support egg, supplier sperm and gestational transport (substitute) which can beat all things considered, all regular unproductiveness blocks. It can additionally be utilized for single individuals and other non-common family fabricating. 

IVF Achievement Rates 

Age is the central factor that most effects IVF achievement rates. Ladies more youthful than ages 35 have around a 50/50 shot of having an adolescent with their first IVF egg recovery and ensuing making life transfer(s). Ladies who don't get pregnant after the primary IVF cycle actually have an awesome credibility of getting pregnant on second, third and astonishingly more patterns of IVF.

The Does IVF Cost? 

The incomparable cost will be higher if advertiser eggs or sperm are utilized and if making lives are solidified and set away. Protection joining for IVF in the US wavers widely and stays lacking. Indeed, even with thought, controls on techniques and different restrictions sometimes acknowledge essential cash based expenses for patients.

Different riches workplaces offer IVF treatment bundles that social affair associations, for example, extraordinary IVF cycles or offer cutoff focuses on status meds to make treatment continuously reasonable.

What are the Preferences, Weaknesses, and Dangers of IVF? 

IVF is broadly more convincing than intrauterine insemination, another generally utilized status strategy. Not at all like IUI, would it have the option to help treat in every way that really matters, any sort of pointlessness issue. It can in like way offer admittance to acquired testing of early living things. Further, IVF has fundamentally more noteworthy ability to adjust different births by the utilization of single starting living being move. It is additionally generally a speedier strategy to get pregnant considering the way that achievement rates are higher. 

IVF can in like way be helpful for individuals requiring more than one youngster. Reliably extra solidified making carries on with that are not used to get the basic pregnancy can be utilized later on to attempt to have extra young people. Deficiencies are that it is a more referencing technique than IUI. IUI consolidates basically sensitive ovarian prompting, an unassuming measure of checking and an office-based IUI. 

IVF requires considerably more grounded ovarian incitation; visit every day checking, an egg recovery strategy with careful sedation, ask about office preparation and starting living being headway, consistently cryopreservation (establishing) and cutoff of incipient organisms, and early living thing move searched after by progesterone blends or suppositories. 

Choices to make 

Understanding components, for example, age, status affirmation and family restorative history will support ladies and men pick if the odds are satisfactory to attempt IVF. On the off chance that odds are extraordinarily poor, it might fit to consider the utilization of promoter eggs or sperm. Your excess office can sidestep you to working environments and different sources to get these. 

Different choices include: 

· thought of pre-treatment hereditary testing of ladies and men 

· preimplantation intrinsic testing (PGT) of the making life 

· kind of treatment cycle, number of making lives to move 

· number of early living things to solidify 

When may it be a keen idea for someone to go direct to IVF? 

Patients ought to go direct to IVF whenever the odds of pregnancy with IUI are low in any case regularly higher with IVF. These circuit fallopian chamber hurt, moderate to unprecedented endometriosis, pelvic holds and more than smooth male uselessness factor. Ladies ought to correspondingly go direct to IVF when they make some short memories range to attempt to get pregnant due to age, decreased ovarian extra or different parts when they can bear the cost of IVF, when there is an essential for PGT, and when there is a need for support eggs or a gestational carrier. 

The decision of IUI or IVF ought to be made by every patient in meet with their profitability authority. It is great if your PCP is a conceptive endocrinologist who has incorporation and can give a wide extent of treatment—ovarian acceptance, IUI, therapeutic technique and IVF. That way you will without a doubt get a reasonable inclination. 

Picking whether to search for after profitability treatment and gave this is substantial, which ones, can be trying and complex. Regardless, putting your time and cash in trying to have an infant kid fundamentally offers no more prominent prize. In case you are searching for IVF Clinic in tricity, by then you can slant toward Dr. S.K. Gambhir. She has multiyear notwithstanding experience.

 

Sunday, October 11, 2020

High Risk Pregnancy - Drskgambhir

A high-risk pregnancy is the one that threatens the health or life of the mother or her foetus. In this kind of pregnancy, one requires specialised care. Some pregnancies become high risk as they progress, while some women are at increased risk for complication even before they get pregnant for a variety of reasons. Early and regular pre-natal care helps many women have healthy pregnancies and deliveries without complications.

Risk factors for a high-risk pregnancy are-

·        Overweight and obesity:Obesity increases the risk of high blood pressure, pre-eclampsia, GDM, still birth, neural tube defects and caesarean delivery.

·        Multiple births: The risk of complications is higher in women carrying more than one foetus. Common complications are pre-eclampsia, premature labour and preterm birth. More than 93% of triplets are born at less than 37 weeks.

·        Young or old maternal age: Pregnancy in less than 18 years and more than 35 years increases the risk of pre-eclampsia and gestational hypertension.

·        Health conditions: Medical conditions such as high blood pressure, diabetes, asthma, heart disorders, breathing problems, infections and blood clotting disorders such as DVT can increase the pregnancy risk.

·        Surgical history: A history of surgery on the uterus, including multiple c-section, abdominal surgeries or surgeries for fibroid tumours, can increase pregnancy risk.

·        Pregnancy complications: Various complications that develop during pregnancy can increase risk. Examples are- abnormal placental position i.e. abruptio placenta, foetal growth less than 10th percentile (IUGR) and RH sensitisation. RH sensitisation is a serious condition in which mother’s blood group is RH-ve and foetal blood group is RH+ve.

·        Life style choices: Smoking cigarettes, drinking alcohol and using illegal drugs can put a pregnancy at risk.

·        Chronic kidney disease: Patient having chronic kidney disease with pregnancy also falls in the category of high risk.

·        HIV:Also, is a risk factor in pregnancy and it can pass to the baby before or after birth.

·        Thyroid disease: Hypothyroidism or hyperthyroidism may result in complication to the foetus.

·        Blood disorders like sickle cell anaemia – Another serious threat that increases risk factors.

 

Regular visit to your gynaecologist can ensure timely detection and best pregnancy experience.

Monday, April 20, 2020

WHICH STRATEGIES ARE HELPFUL IN PREGNANCY WITH ASTHMA?


Asthma is one of the most widely recognized clinical issues that happen during pregnancy, it tends to be possibly genuine. As indicated by the CDC, asthma influences 4—12% of ladies during childbearing age. Studies recommend that asthma confuses 7% of all things considered. About 30% of ladies with asthma report their asthma compounded while pregnant however with the correct treatment you and your infant can be better. Most strategies for controlling asthma are not destructive to your creating child and will help in the better advancement of an infant. There is no critical hazard to you and your child if your asthma is very much controlled, yet uncontrolled asthma can cause genuine complications. To search Top Gynaecologist in Tricity you have to deal with numerous things.

1.   Pregnant ladies with asthma may have a higher danger of conveying early
2.   Baby may have a low birth weight
3.   May grow hypertension and preeclampsia with serious asthma
4.   Problems may create during work
5.   There can be extreme morning ailment
6.   Effects of asthma can change from season to season and month to month of pregnancy.
7.  A parcel of hormone changes happens during pregnancy, some of them can influence the lungs.
8.   Asthma erupts generally somewhere in the range of 29 and 36 weeks of pregnancy.
9.  You and your allergist or doctor should make an arrangement of treatment depends on the seriousness of asthma and the medication which you are taking.

Your doctor ought to consistently consider the beneath referenced pointers while arranging the line of treatment during pregnancy where moms-to-be are asthmatic: 


a.       The breathed in drugs are commonly favoured in light of the fact that they have more focused on impact.
b.         It is ideal to constrain the medication however much as could reasonably be expected in the main trimester when the infant is growing, yet birth absconds with the medication are uncommon
c.          Some drugs utilized during pregnancy are fitting during work and conveyance moreover. 

DR. S.K. GAMBHIR accepts that quick acting inhalers and breathed in corticosteroids are protected to take when you are pregnant. These meds straightforwardly go into the lungs and almost no assimilated in the circulatory system and arrive at the infant in spite of the fact that birth deserts brought about by asthma drugs are uncommon your PCP will stop the measurements during the main trimester

Thursday, April 9, 2020

How to be Maintained Well-Balanced Nutritional Diet in Pregnancy?


Good nutrition is thought to help balance mood swings and it may improve labor and delivery as well. The nutritional changes that occur prior to pregnancy must be individualized based on your medical status weight and eating habits. Hence the importance of a balanced and nutritional meal is there. It is important to eat well for a healthy baby. Let's take a look at some things you should consider when choosing your Best Nutritional Diet in Pregnancy

A well-balanced nutritional diet in pregnancy should include-

·         Protein
·         Vitamin C
·         Calcium
·         Fruits and vegetables
·         Whole grains
·         Iron-rich foods
·         Adequate fat
·         Folic acid

A simple way to satisfy your nutritional needs during pregnancy is to eat a variety of foods from each group every day. The following tips can help guide you when you are making food choices.

Make one half of your plate as fruits and vegetables.

·         Switch to skimmed milk or 1%milk.
·         Make one-half of your grains as whole grains.
·         Eat fish 2-3 times a week and choose lean meat and poultry.
·         Vegetarians can get protein from a wide variety of plant-based foods such as nuts, seeds, and soya products.
·         Limit foods with empty calories like candies, chips and sugary drinks.
·         Take a vitamin supplement which contains 600 micrograms of folic acid and 27 mg of iron.

When planning your meal remember to add snacks which a good way to get extra calories. Pick snacks that have the right nutrients and low in sugars and fat. Fruits cereals and yogurt are healthy snack choices.
Nutrition education and counseling is a widely used therapy to improve the nutritional status of women during pregnancy.

Strategy includes-
·         Promoting a healthy diet.
·         Promoting adequate weight gain through sufficient and balanced protein and energy intake.
·         WHO recommendations

If you are looking for the best Gynaecologist in Chandigarh then you could consider the name of DR. SK GAMBHIR. Counseling should be done to pregnant women and non-pregnant about healthy eating and physically active during pregnancy is recommended for pregnant women to stay healthy and to prevent excessive weight gain during pregnancy, in undernourished population, nutrition education
on increasing daily energy and protein intake is recommended for pregnant women to reduce the risk of low birth weight neonates.