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.

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 2^nd and 3^rd 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.

 

 

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 10^th 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.

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

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.

Are You Fed-up by Searching Infertility Treatment Clinic in Chandigarh?

Offices that offer unprofitability IVF drugs hope to help couples who need treatment for desolateness. There are factors, nevertheless, that should be seen as when examining different focuses that thought in vitro readiness and different readiness medications. In the event that you are looking for Infertility Treatment Clinic in Chandigarh then you have to think about numerous things. 

A part of the components will be dependent on your energetic needs and your own individual tendencies. Various components will depend upon the kind of technique you need, the frameworks that the office speak to impressive expert in and the accomplishment rate that the middle has had with such systems.

One of the various factors that should be seen as when picking a fitting unprofitability community is the rated pace of live births per treatment cycle. This will reveal to you how productive the middle is. Another thing to check is the pace of pregnancies that are conveyed by treatment at that particular office.

While amazingly, just one out of each odd treatment of pointlessness issues can end in a successful pregnancy, you should pick an office that has a high accomplishment pace of helping couples with issues of desolateness. In case possible, it is continually a savvy thought to find how successful they are with the particular strategy that the patient will require it.

One request that you should posture to quickly when planning to pick an office for infertility IVF frameworks are about the free unproductiveness coordinating that is offered there. The unprofitability supporter's responsibility is to help couples with issues of desolateness and assist them in dealing with the extent of sentiments that go with these fruitlessness issues.

If you have the decision of picking between different focuses, by then guarantee that you investigate all of them. Aggregate as a lot of information as you can to empower you to choose a solid decision. Posture requests about the degree of various births that are conveyed from strategy at that office. The more information that you have available to you, the less strain will be put on you and your associate while having a procedure to empower you to consider.

When attempting to enlist the help of conceptive drug and treatment in searching for treatment for desolateness, couples may begin to feel overwhelmed. Not seeing most by far of what science and solution hurl at them, couples will begin to feel overwhelmed by their new experience. Chatting with and directing with a specialist before choosing a self-important decision, for instance, which treatment to pick is an insightful choice for couples to make? For Infertility Treatment Centre in Chandigarh, you can contact Dr. S.K. Gambhir.

Caesarean - Female Gynaecologist in Chandigarh

The WHO expresses that the pace of the cesarean segment ought to be 10-15%. In high-salary nations, for example, Australia, Britain, and America, 33% of all moms conceive an offspring by cesarean. Every year C-segments are significant and can spare lives. It is performed when the child is in danger. Do you need the Female Gynaecologist in Chandigarh who is a rehearsing Obstetrician also?

Birth by C-segment represents a few difficulties for a child when contrasted with babies conceived vaginally. Infants conceived by C-area are in danger for wellbeing intricacies.

1)         Babies are bound to experience issues in breathing all alone, may have other respiratory inconveniences also. With C-segment, mother and infant are probably going to have skin to skin contact. Skin to skin contact has a few versatile advantages for the newly conceived. Prescriptions that quiet the mother can influence the newly conceived's capacity to lock on and breastfeed. Medications utilized for sedation, including epidurals, cross the placental hindrance and make it increasingly hard to start bosom taking care of. Suctioning of newly conceived's mouth throat and aviation routes can likewise make it increasingly hard for bosom taking care of.

2)         Foetal gashes: There is an uncommon possibility of a child getting knick during the cut.

3)         Elective C-segment has more serious hazard for babies conceived pre-maturely: Assessed due dates depend on USG and the lady's menstrual cycle cannot be right. Children conceived between 34th and 36th seven day stretch of pregnancy is viewed as late pre-term. Being brought into the world seven days ahead of schedule can expand the danger of intricacies for the child regardless of being of comparable size and weight to full-term babies.

4)         Respiratory issues: Babies who are conceived by C-area before 39 weeks are bound to experience the ill effects of respiratory misery than babies conceived vaginally. The most recent couple of weeks in the uterus are fundamental for the advancement of lung surfactant. Being conceived before term fundamentally influences the degree of surfactant that encourages children to relax. Respiratory trouble disorder is a genuine ailment that requires treatment in the NICU.

5)         Mother-newborn child connection is probably going to be deferred: Holding, contacting and caring the child upgrades the connection between the mother and infant after birth. Limiting the partition of infants from mother decreases the worry in sound newly conceived and mother. So urge skin to skin contact among mother and infant as quickly as time permits for in any event 60 minutes. Skin to skin contact quiets the mother and her infant and assists with balancing out the infant's pulse and relaxing. The mother's body heat keeps him warm, decreases the infant's crying, stress and vitality use. Skin to skin contact likewise helps in metabolic adjustment and settles the blood glucose level. Nature readies the mother and child to require each other from a snapshot of birth. Oxytocin, the hormone that makes a ladies' uterus contract additionally makes the temperature of her bosoms rise and encourages her vibe quiet and responsive and upgrades the protective inclination.

An elevated level of adrenaline which is ordinary in babies during childbirth, makes the infant alarm and set him up to search for his mom and discover his way to her bosom. In C-area conveyance, babies are bound to be taken to the nursery for perception. They need to invest more energy in the nursery than his mom's lap. The infant is additionally without mother's milk during this period. If you are looking for the Female Gynaecologist in Chandigarh then you could consider the name of DR. SK GAMBHIR. For more information visit www.drskgambhir.com website as well. 

Ladies Specialist Doctor in Mohali -Top 5 Advantages and Care

Pregnancy is a very difficult time for all women, as it is not just physically but also mentally challenging. The mother needs good care, proper medical attention, and effective nutrient so that the newborn baby can have a healthy. A healthy baby means risk-free birth for the baby, while less risky for the mother at the delivery time. For efficient and healthy maternity care, it is important to find the best hospital. If you can ensure choosing good healthy maternity care, it is important to find the best hospital. If you are looking, LADIES SPECIALIST DOCTOR IN MOHALI, first you can ensure choosing a good maternity health care center; you can also enjoy the following benefits or care as well:

Safety for the mother and child: During pregnancy, the mother needs constant medical attention in order to avoid health-related complications during this period. After giving birth to a baby, both mother and baby require continuous and effective medical attention from experienced as well as professional doctors. Other than doctors, support staff and medical teams also have to play a major role in this. 

Safety screening test: During pregnancy, the mother has to undergo a number of screening tests. These tests are scheduled by the maternity doctor i.e. the obstetrician at regular intervals. All eminent and professional maternity hospital ensures these screening tests on the mother. The objective of these screening tests is to rule out abnormality or anomalies in the baby. The importance of these tests is that they allow for timely intervention in the possibility of an abnormal baby.

Nutritional Plan for mother: One of the most important things during pregnancy is proper nutrition for mothers. Proper nutrition comes with effective nutritional plans. Under the supervision of an expert obstetrician, pregnant women follow meticulous diet charts. Nutrition of the mother is important for the nutrition of the baby.

Emergency Care: Good maternity hospitals keep the provision for round the clock emergency care for every pregnant woman. During pregnancy, different kinds of physical problems may occur. Some of these conditions are serious, and they may need proper and secure medical treatments. 

Safe delivery of the baby: Giving birth to the baby is a very complex process, and thus an experienced team of medical professionals is required to handle the situations. For the protection of both the mother and child, safe as well as the proper delivery process has to be carried out with all aseptic precautions. For this adequate backup staff as well as doctors from other faculties such as anesthetists as well as a pediatrician are required. Well established maternity hospitals have an established team of obstetricians, anesthetists as well pediatricians to collectively manage the process of normal delivery.

Dr. SK Gambir provides the best maternity care in Chandigarh at very affordable prices, for more information about these maternity care visit website as well. 

IS IT SAFE TO USE INSECT REPELLENT WHILE I’M PREGNANT?

During pregnancy, certain types of insects’ repellents are safe both for mother and baby. You should check the product description before purchasing its safety instructions. These doctors assume a basic job in the life of a lady. To search BEST GYNAECOLOGIST IN CHANDIGARH you need to take care of many things. This is also a smart way to get protection against Zika and other mosquito-borne illnesses.

Mosquitoes tend to get more attracted to pregnant females

It is shown in studies also that mosquitoes get twice more attracted toward pregnant female than nonpregnant ones. This happens because the mosquitoes are fond of carbon dioxide and pregnant women tend to take more frequent breaths, exhaling about 21% more air therefore exhale more carbon dioxide.

Another reason why mosquitoes are more attracted to pregnant females is higher body temperature. During pregnancy, women have high bloody temperature as compared to non-pregnant women. Due to the rise in the body heat the more volatile substances are expelled from the body, which makes it easier for mosquitoes to find. In case pregnant women, if you are traveling to insect-borne diseases area then you should carry insect repellent along with you. You should not use repellent more than required and always wash it off when you get indoors.

Be informed about the ingredients in the mosquito repellents:

DEET, Picaridin, 2-Undecanone or IR3535 are the active ingredients in insect repellent that offer safe and longer protection. Apart from these products which are safe are oil of lemon and eucalyptus but they do not last long. EPA registered citronella products are safe but do not last long.

Permethrin is a type of repellent which is not safe to use on skin. They are best suited for clothes, bed nets, shoes and camping gear. You can know the effectiveness of repellent based on the percentage of DEET. The higher is the percentage the less often you need to apply. For best maternity care in Chandigarh, you can contact to DR. S.K. GAMBHIR. She is a well-reputed gynecologist in Chandigarh.

HYPNOBIRTHING VS LAMAZE?

Lamaze class approach highlights the natural and healthy child way of the birth process. Lamaze does not support or discourage the use of medicines and any routine medical interventions during the time of labor and delivery. They inform mothers to be about the options so that they can make choice or take decision for their labor and delivery. Lamaze also focuses on building up your confidence and talking about how to keep the birth of your baby safe and simple. While choosing LADIES SPECIALIST DOCTOR IN MOHALI you need to consider many things especially when you will make your first visit to the gynec a breeze.

Topics covered under the Lamaze Class:

Lamaze is a small class which consists of few sessions on following topics:

§  Breathing techniques during labor

§  Support during labor

§  Information about normal labor, birth and early postpartum care

§  Different methods to position yourself for birth and labor

§  Practicing relaxation with the help of internal and external focal points

§  Relaxation and massage techniques to ease the pain

§  Communication skills

§  Medical procedures

§  Breastfeeding

§  Healthy lifestyle choices

What is Hypnobirthing?

Hypnobirthing supports relaxed natural childbirth education approach by self-hypnosis techniques. The guide focuses on the pregnancy and birth of the child as well as pre-birth parenting and the consciousness of the pre-born baby. Hypnobirthing is a program built around an educational process which includes relaxation, visualization, special breathing, meditative practice, awareness about nutrition and positive toning of the body.

Hypnobirthing is a more comprehensive birthing class and covers following apart from regular antenatal class:

§  Breathing techniques which help in childbirth

§  How to reduce the need for medication

§  How to be confident while dealing with medical staff, what to ask them and when to ask them?

§  How to release the fears about childbirth that you might be having?

§  How to reduce the risk of needing an episiotomy during childbirth with simple massage methods.

§  How to start easy labor with simple and natural techniques?

§  How to relax and calm down yourself at the time of childbirth?

For ladies specialist doctor in Mohali you can contact to DR. S.K. GAMBHIR. She is one of the best gynaecologist in Mohali.