FOLIC ACID SUPPLEMENTATION IN PREGNENCY

Good morning friends,Today I'll explain the importance of folic acid supplementation in pregnancy.Neural tube is a structure in the developing embryo, which finally develops into the brain & spinal cord.

NEURAL TUBE DEFECTS are defects arising due to errors in development of the neural tube.The most common defects are spina bifida & anencephaly. Spina bifida is a condition where the the spinal cord of the fetus,fails to close completely. Anencephaly is a condition where a part of the brain of the fetus fails to develop.[i,ll explain these conditions elaborately, in my future posts.]

The development of the neural tube takes place in the early weeks of pregnancy.

FOLIC ACID is a water soluble B-complex vitamin,which plays a role in DNA synthesis and cell replication.Foods that are reach in folic acid are grains,green leafy vegetables,spinach,lentils,broccoli etc.

Fortification of grains has been started in United States,for a long time.This has reduced the prevalence of neural tube defects in pregnancy & also the prevalence of maternal serum alpha-feto protein[msafp-a marker for neural tube defects in pregnancy]

SUPPLEMENTATION OF FOLIC ACID DURING PREGNANCY: .4mg/day[400mcg/day].Supplementation of folic acid during pregnancy should be ideally started 3 months before conception & should be continued throughout the first trimester[the first 12 weeks]. In case of women who have a history of prior child effected by neural tube defects should take folic acid at the dose of 4mg/day.

PLEASE GO AND ATTEND PRE-CONCEPTIONAL COUNSELLING PROGRAMMES,WHEN YOU PLAN FOR A BABY.

FOE FURTHER INFORMATION ON THIS PLEASE DISCUSS THIS ISSUE WITH YOUR DOCTOR.YOU MAY ALSO VISIT THE PATIENT.CO.UK SITEhere

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HAIR CHANGES IN PREGNANCY

Morning friends, as promised I'll be continuing with postings related to pregnancy .Today i'll try to explain hair changes in pregnancy.

Hair growth consists of two main phases. ANAGEN & TELOGEN. There is also a transitional phase in between, called the CATAGEN PHASE, which indicates the end of growing phase of hair.Catagen phase lasts for 2-3 weeks.In the ANAGEN phase, growth of hair takes place.TELOGEN PHASE is the resting phase, during which hair falls off.

At any given time. about 20% of hairs are in the resting phase[telogen].During pregnancy more hairs are in the ANAGEN PHASE.[growing phase]. As a result, during pregnancy hair continues to grow,thus in many women during pregnancy hair appears to be thicker.

During pregnancy increased growth of body & fascial hair may take place[hirsuitism], due to male hormone production by ovaries & adrenal gland.

After pregnancy during the post partum period,most of the hairs are in the telogen phase.Thereby there is a tendency of the hairs to fall off. Hair loss of about 100 hairs is normal.An individual usually notices significant hair loss when about 2/5 of all hair is lost.This phase of hair loss in the post-partum period usually subside in the next 5-6 months.

There is basically no effective treatment of this problem, but one may try avoiding excessive use of hair dryers,brushes etc.

The picture has been uploaded from wikimedia commons

For further information on this you may dicuss this with your doctor, or may visit the MARCH OF DIMES sitehere

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ACNE AND PREGNANCY

Morning friends,in today's post I'll try to present a brief review of ACNE PROBLEM IN PREGNANCY.

Effect of pregnancy is varied on the presentation of acne.In some women,even the acne may subside during pregnancy.But in majority of women will experience a flare-up of acne.This flare-up may take place due to the action of progesterone,a hormone that increases during pregnancy,which increases the secretion from the glands.Acne is more common in first trimester.

Post-partum women can also have acne for the first time.[Post-gestational acne]

TREATMENT:1.Keep the area clean 2.maintain hydration. 3.Topical erythromycin.topical clindamycin,oral erythromycin may be used. 4.It's better to avoid tretinoin application.

Please don't use this drugs without proper prescription of your doctor.

FOR FURTHER INFORMATION YOU MAY CONSULT WITH YOUR DOCTOR OR VISIT THE BABYCENTER SITEhere

If you find my postings informative please subscribe.Do visit again ,good bye.[the picture has been uploaded from wikipedia commons,long live wikipedia]
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CARDIOVASCULAR CHANGES IN PREGNANCY

Good morning friends,starting from this post onwards i will try to explain some changes the human body undergoes during pregnancy.Today I'll make an attempt to explain the cardiovascular changes in pregnancy[heart & the circulatory system]

Pregnancy is a hyperdynamic state of circulation.
1.Blood volume increases by almost 40-50%.[peaks in 28-32 weeks of gestation]
2.Plasma volume increases to the tune of 40%.
3.Anemia[due to discrepapancy of the rise of blood volume & plasma volume and also due to iron deficiency]
4.Decreased oxygen carrying capacity of blood.[this is compensated by several mechanisms like increase in cardiac output,decreasing blood viscosity,vessel dilatation etc]
5.Due to the effect of estrogen & progesterone[these hormones rise during pregnancy] dilates the blood vessels so there is a fall in the resistance offered by the blood vessels[systemic vascular resistance & pulmonary vascular resistance]
6.Increase in cardiac output[peaks during 22-28 weeks of gestation].
7.Increase in stroke volume[the blood pumped by the heart with each heart beat].
8.Red blood cell volume also increases to the tune of 20%.
9.heart beat increases during pregnancy by 12-16beats/minute[this may give rise to palpitation i.e becoming conscious about your heart beat]
10.Alteration of blood pressure:Systolic blood pressure and diastolic blood pressure,both fall to a minor extent,but the changes are more marked in diastolic blood pressure.
11.Pedal edema[swelling around the ankles,which pits on application of pressure].
12.Some ECG changes.[ST-T changes]
13.some findings are also observed on auscultation of the heart[examination of the chest with a stethoscope] like murmurs,increased splitting of heart sounds,S3 gallop etc.
14.Decrease in blood viscosity.
15.Shift of the oxygen hemoglobin dissociation curve to the right.

PLEASE DISCUSS THIS ISSUES WITH YOUR DOCTOR OR FOR FURTHER INFORMATION ON THIS YOU MAY Visit here

Yes,i know i could not explain a few terms in a more simple way ,because i thought they will be a bit out of the extent of this post,but still if you find this post informative,please subscribe.
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SMOKING AND PREGNANCY

Good evening,friends.Today i'll try to explain the effects of smoking on pregnancy.smoking,in general is very damaging to the body,in the context of pregnancy it's even more dangerous.SMOKING EFFECTS BOTH THE MOTHER & THE BABY.Smoking disturbs the placental function & reduce the supply of oxygen to the baby within the womb,as the baby depends for all nutritious supplies on the mother.

Smoking reduces the fertility in both women & men.In women it may cause a delay in conception.In men ,it reduces the the sperm count,volume of semen,sperm motility thus impairing fertility in general.

EFFECT OF SMOKING IN A PREGNANT MOTHER:Smoking may cause premature delievery,premature rupture of membrane,placental abruption etc.

EFFECT OF SMOKING ON THE BABY:Smoking has a diverse of effects on the baby like preterm delievery,low birth weight,lung problems,bronchitis in early age etc.Smoking has also been related to cot death & SIDS[sudden infant death syndrome]

Passive smoking also has a damaging effect on both mother & the baby.

So,my suggestion is both the parents should stop smoking before planning for a baby.

HOW TO STOP SMOKING:Urge to stop smoking is most important.Nicotine replacement therapy[nicotine patch] is not much preffered during pregnancy.The parents should try to stop smoking by themselves,if all attempts fail,nicotine replacement therapy may be tried but after consulting with your doctor.

FOR MORE INFORMATION ON THIS,YOU SHOULD DISCUSS THIS WITH YOUR PHYSICIAN.YOU CAN ALSO VISIT CDC SITEhere
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brief overview:yeast infection of the vagina

Hi everybody and good morning.Today my discussion topic is candida infection of the vagina[also called vaginal moniliasis,vaginal yeast infection].
It is a relatively common disease.Candida has several types,but most of the disease are caused by candida albicans.The yeast resides in our skin,mouth,rectum,vagina without causing disease.But the problem occurs when candida outnumber the normal protective predominant bacteria in the vagina[Lactobacillus].
RISK FACTORS:1.Excessive antibiotic use
2.diabetes
3.pregnancy
4.diseases affecting the immune system[HIV/AIDS,LEUKEMIA,CANCER DRUGS ETC]
SYMPTOMS AND SIGNS:1.vaginal discharge[white or yellowish]
2.irritation & itching of vulva
3.pain during urination
4.pain following intercourse
5.redness of vulva
DIAGNOSIS:By WET PREP[microscopy of vaginal discharge]
TREATMENT:The drugs used are clotrimazole,miconazole,nystatin vaginal creams.Oral drugs effective are fluconazole,amphotericin B.
Usually it is completely curable.Sometimes recurrence occurs specially in immunosuppressed conditions[HIV/AIDS].Oral fluconazole is usually effectine in these conditions.
Oral drugs should not be given in pregnancy.
PREVENTION:To keep the local area dry.
Whenever you notice the aforesaid symptoms or recurrence occurs with over the counter medicines please contact your local health provider.Any further querries regarding this disease feel free to ask me.
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BRIEF OVERVIEW:BACTERIAL VAGINOSIS

Vaginitis is a disorder which presents with vaginal discharge,itching and irritation.Three most common causes of vaginitis are bacterial vaginosis,trichomoniasis and candida infection.

Today i will present a brief overview about bacterial vaginosis.Bacterial vaginosis is a disorder of alternation of the normal vaginal flora.The good bacteria of the vagina[Lactobacillus] is replaced by bad bacterias like Prevotella,mobilincus,mycoplasma hominis,Gardenella vaginalis etc.The symptoms are white vaginal discharge,vaginal irritation etc.Many women remain asymptomatic.

The diagnostic criteria are:1.whitish homogenous discharge lining the vaginal wall

2.ph>4.5 measured by narrow range ph paper.

3.CLUE CELLS[epithelial cells lined lined by bacteria]

4.fishy odour of vaginal discharge when mixedwith KOH

The gold standard test is the relative concentration of lactobacilli and the other bad bacterias in gram stain of vaginal discharge.Culture of G.vaginalis is not specific.DNA probe test for G.vaginalis may be helpful in diagnosis.Ph paper test,test for trimethylamine,prolineaminopeptidase may be helpful.

TREATMENT:Metronidazole tablet orally

Metronidazole cream

clindamycin gel

All symptomatic women should be treated

BACTERIAL VAGINOSIS AND PREGNANCY:Bacterial vaginosis causes pre-mature rupture of membrane,pre-term labour,pre-term birth.chorioamnionitis.Any pregnant women with symptoms of bacterial vaginosis should be treated.Pregnant women without symptoms,but with high risk of premature delievery should also be treated.Treatments options are metronidazole,clindamycin tablets.Clindamycin should not be given during the second half of pregnancy.

Treatment of partners is not recommended because it does not reduce recurrence of disease.

In bacterial vaginosis with HIV,the treatment is same but the disease is more persistent.

everybody should consult their respective physicians regarding this topic.Any further querries please ask me.GOOD NIGHT.

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