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Early Pregnency

Screening For Birth Defect

Prenatal care is important to the health of both the mother & the baby. Proper screenings & examination during each trimester provide the mother with invaluable information regarding the baby’s development various screening & diagnostic options are available to assess specific risks and evaluate the development of your baby.

Test Available

Non-invasive prenatal testing uses cell free DNA collected from the expectant mothers blood. This test is recommended for patient at high risk for aneuploidy. Detection rate is 99% for Downsyndrome. This test is costly. Also because it detects gender it is legally banned in many parts of India.

A simple diagnostic test in which a sample of chorionic villi is removed from the developing placenta. This test can reveal if growing foetus has evidence of aneuploidy.

A minimal invasive screening test performed as early as 11 weeks of pregnancy in which a hormonal assessment is performed in combination with an ultrasound designed to look at clear space in tissue at the back of the baby’s growing neck called nuchal translucency. In certain cases fluid may collect in this spaces making it appear larger on USG or the laboratory test may demonstrate abnormal value suggesting an increase risk for aneuploidy cardiac defect, or other genetic syndrome.

A screening test performed between 15 & 20 weeks of pregnancy that measure the levels of alpha – fetoprotein HCG estriol and inhibrim A in mothers blood. Abnormal values are associated with chromosomal abnormalities and other complication such as neural tube defects

It is generally performed after 15 weeks of pregnancy by inserting a small needle through the mother’s abdomen into aminiotic Soc. A small amount of fluid is collected. Analysis of this fluid contains actual cell of baby and can offer information regarding potential chromosomal abnormality, birth defects and gender.

Non invasive screening procedure completed before 20 weeks of pregnancy. It gives information regarding size, weight, growth and possible birth defects or other abnormality that might complicate the pregnancy.

Any expectant mother who wishes to take screening test.
– High risk cases

  • Age above 35 years
  • Family history of genetic disorder
  • Partner is known carrier of genetic condition
  • Prior child genetic abnormality or birth defect.

Nutrition & Diet During Pregnancy
  • Small frequent meals.
  • Healthy nutritive and balanced diet.
Balanced diet means adequate amount of Carbohydrates, Protein, Fat, Vitamins & Minerals

Balanced Diet
Source of Carbohydratesbreads, cereals, rice & potatoes
Source of ProteinSource of Protein meat, fish, eggs, nuts, beans, peas & daal
Source of Protein + Vitamins + Calciummilk & dairy products
Source of Vitamins + Mineralsfresh fruits, vegetables and salads
Source of Folic Acidgreen leafy vegetables and fruits

Digestive Problem in Pregnancy

As your body prepares itself for childbirth, there may be effects on your digestive system which can result in indigestion, heartburn and constipation. These problems are normal during pregnancy and do not have any long-term effects. However, having a knowledge of how they occur, and what you can do about them, will make it easier for you to deal with them.

During pregnancy, some of the hormones produced by the body can make the muscles of the stomach and intestine relax. Relaxation of the stomach muscles will slow down the rate at which your stomach empties itself and can cause a sense of fullness and indigestion. A slowing down of your intestinal movements can result in constipation. In later stages of pregnancy, the pressure of the enlarged uterus on your stomach can also cause indigestion, heartburn and nausea.

  • You may experience a feeling of fullness and bloating, loss of appetite and regurgitation.
  • You should avoid foods that cause trouble, e.g. spicy and oily foods.
  • Try eating smaller and more frequent meals.
  • Sit up straight when eating so that there is less pressure on your stomach.

Heartburn is more than just indigestion. It is a strong burning pain in the chest due to reflux of acid from the stomach into the food pipe. To avoid heartburn:

  • Avoid eating or drinking for a few hours before bed time. An after-dinner walk may help.
  • Sleep well propped up raising the head of your bed or having plenty of pillows.
  • Keep a glass of milk handy. Drink a glass of milk in case you wake-up with a heartburn at night.

Nausea is common in early pregnancy, and is probably related to hormonal changes. Some tips: If you feel sick as you get up in the morning, get up slowly. Try eating some dry toast or biscuit before getting up.

  • Avoid foods that make you feel worse.
  • Eat small amounts often rather than large meals.
  • Drink plenty of fluids.
  • Distract yourself; try not to think too much about your nausea.
  • Wear comfortable clothes.
  • Rest and sleep whenever you can.

If you are having difficulty passing stools, the following steps can help

  • Include plenty of fibre in your diet by eating wholemeal breads, wholegrain cereal, fruit, vegetables, beans and dal.
  • Keep up your muscle tone with regular exercise.
  • Drink plenty of water
  • If you are taking an iron medication that is contributing to your constipation, talk to your doctor about changing the medication.

Exercise For Pregnancy
(Repeat each exercise slowly 20 times in the morning and evening)

Sit on the floor with your back straight, soles of your feet together, and your knees dropped comfortable. Holding your ankles, bring your pelvis (lower portion of the trunk of the body) and feet together. As you press both knees gently towards the floor using your elbows, you will feel a stretch in your inner thighs. Sit this way, back straight, knees almost touching the floor, for a few minutes several time's a day. This exercise helps to strengthen the muscles of the inner thing and pelvic floor, and improves your posture. It also keeps your pelvic joints flexible and eases delivery.

Slowly go down into a squat (sit on your heels) keeping your back straight. Try to keep your heel down placing your weight evenly. Press your elbows against your things, stretching the join (area between the things and abdomen) and thighs. Practice this several minutes a day. This is a good position for labour, and if you choose this position, your body will be ready.

Lie on your back with one hand resting your belly and the other near the small of your back. (After your fourth month, prop your shoulders with a pillow so your head is higher than your heart.) Bend your knees. Inhale to expand your belly, then exhale and draw your belly button toward the floor, continuing to use your abdominal muscles rather than your legs. Your pelvis (lower portion of the trunk of the body) may lift slightly off the floor. Hold for 1 second and release. Repeat 10 times. Work up to 3 sets of 30 repetitions. (If you become dizzy, do this exercise from a side-lying position with your back braced against a wall.)

Lie down with your knees bent and your feet flat on the floor. Slowly extend both your legs in front of you till they are completely straight, but keep your back well pressed on to the floor. Draw one knee up and then the other, without lifting your back off the floor. Then relax your legs unit they are straight. Repeat five time.

Breathing exercise can help you manage pain during labour, and can be especially helpful if the labour is prolonged. Breathing should be slow and smooth, with deep breaths. Inhale with a slow deep breath your nose at the beginning of a contraction. This will help to provide oxygen for your uterus. Exhale by letting air out like a sigh through your mouth. During a contraction, you can concentrate on each exhalation, as this will help you to relax. If you feel an urge to push during a contraction, blow out unit the urge passes. Remember to breathe in before you blow out. When the urge to push is gone, return to the breathing pattern you were using. If you don’t feel a strong urge, just continue to breathe through your contractions until the urge begins.

Ectopic Pregnancy

Ectopic pregnancy is a condition when pregnancy starts to grow outside the uterus. Normally sperm and egg meet in fallopian tube & when pregnancy takes place & start growing it moves into uterus & grows there. Rarely pregnancy does not move into uterus & start growing outside uterus ie in tube, ovary or abdomen & that is called ectopic pregnancy. This is an emergency situation, when the pregnancy grows in tube, tube cannot accomodate the pregnancy and can burst leading to pain, internal bleeding.

Ectopic Pregnancy
SymptomsAsymptomatic, Irregular spotting or scanty period, Pain in lower abdomen, Fainting episode, Sometime women comes in collapsed state
Risk FactorAge above 40, Ectopic pregnancy in past, PID or tuberculosis involving tube, Surgery of tube, Assisted reproducive technique
TreatmentSmall pregnancy prior to rupture of tube & if General condition of Female is good can be managed medically,
Large ectopic, Rupture tube or poor general condition of female or failed medical managment requires

Recurrent Pregnancy Loss

Miscarriage is very distressing condition. It is defined as loss of pregnancy before 20 weeks of pregnancy. Loss of pregnancy before 12 weeks is called Early abortion & Loss of pregnancy after 12 weeks but before 20 weeks is called late abortion. When a female has 3 consecutive pregnancy loss it is called Recurrent Pregnancy Loss.

Common Factors causing recurrent pregnancy loss are
  • Age - Older you are greater your risk of having pregnancy loss.
  • Medical disorder like thyroid & diabetes.
  • Syndromes such as antiphos pholipid syndrome & thrombophillia are not very common condition but are important cause of recurrent pregnancy loss.
  • One of the partner having any genetic defect.
  • Defect in shape of the uterus such as septum, arcuate or bicomuate uterus
  • Weak or incompetent cervix.
  • Obesity, excessive smoking, alcohol or caffine are also known factor for recurrent pregnancy loss

Various treatment option available are
  • Low dose aspirin & heparin for antiphopholipid syndrome
  • Cervical OS tightening for weak cervix
  • Hysteroscopic surgery for correcting defect in shape of uterus
  • Progesterone & HCG Injection


Some Tips for Your Labour
Tips for labour pain
Use breathing techniques to ease the pain of labour.
Do fingertip massage during your contractions. You or your partner can place the fingertips of both hands on the basal portion of your abdomen. With light pressure, bring your hands upward towards the top of your abdomen and then downward and outward to place where you began. Draw circles on your abdomen for the duration of the contraction.
During a contraction, focus your eyes on some object or spot that can help deflect your attention away from your contraction. Alternatively, you could keep your eyes closed during contraction.
Since all pains are not labour pains, you must differentiate between ”true” and ”false” labour pains. True labour pains will come at regular intervals and steadily increase in intensity. They may be accompanied by with blood. On the other hand, with “false” labour pains, the frequency of contractions will be irregular. False labour pains will not get progressively stronger, but may in fact, weaken and disappear for a while, particularly if you move around.

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