The last week has possibly been the hardest one of the pregnancy so far. First my husband came down with a bad flu, and four days later I caught it. It's taken us both a full week to start feeling better, and our bodies have reacted in very different ways. We both felt worried about each other and tried our best to take care of each other. Whilst my husband was on medication straight away, I had to be careful due to the pregnancy, so I tried everything I could with home remedies.
The swine flu scare has reached India now, so we both got our illnesses checked out by doctors. The monsoon season is in full flow and many people have had viral infections recently. Whilst it's more risky in the first five months of pregnancy, a high temperature (anything over 102 F) is the most worrying part of a viral infection during pregnancy, so it needs to be kept down with paracetamol, cold compresses etc. For other symptoms, here is a list of home remedies that provided me with relief.
1. Relieving sore throat by sucking on raw ginger coated in honey - a good ayurvedic lozenge.
2. Relieving congestion by drinking hot tulsi (basil) tea, or lemon tea with a spoon of honey.
3. Soothing throat with hot milk mixed with turmeric, which has antiseptic and antibacterial properties.
3. Breathing hot steam with a couple of drops of Olbas oil to decongest.
4. Cold compresses and massages on the forehead area to cool the head.
Now that it's the eighth month, we have to visit the doctor every two weeks, and have our hospital bag ready for the delivery one month before the due date. I stopped my exercises for a few days during the illness, but have started them up again now.
Monday, August 3, 2009
Saturday, July 18, 2009
30 weeks' check-up
We went for our regular check-up today. Everything is more or less the same in terms of blood pressure, heart-rate, urinary protein and sugar. I have noticed an increase in discharge so the doctor's prescribed some suppositories to help reduce it - it can be a nuisance, but I'm told it tends to increase during pregnancy.
I did a clean catch of urine today (washing the area with soapy water before dipping the urine stick so that deposits from vaginal discharge don't affect the protein count in the urine - vaginal discharge, whether infected or not, always carries some protein). The stick revealed 1+ protein (it's been either trace or 1+ throughout the pregnancy, and I wanted to know if the protein was really in the urine because last time it went up to 2+). This result shows that there is a little bit of protein in the urine itself, but this is normal if it ranges between trace and 1+ because of the additional pressure around the bladder. If it starts going up from this range, and ties in with increased blood pressure and fluid retention, it can be a signal of hypertension.
This week, we were told to have a colour doppler scan to see the fluid, placenta and blood flow in the uterus. I also took my second dose of the Tetanus jab, which is supposed to protect both myself and the baby for up to 6 months after birth.
We saw the baby's face on the screen and it was really adorable, making sucking faces and twiddling its fingers. The doctor said it weighs just over one kg now.
I have noticed a few skin problems over the last month. The pigment in my skin has become quite concentrated, creating a deep brown line down my abdomen (the lina nigra). As the pigment, melanin, is more in asian skin, the natural deepening of this line as well as the nipple tissue etc. is more exaggerated. I have also had a few irritations and decided to buy some soothing oils for these things. The slight swelling around the ankles has been the same over the past month.
I did a clean catch of urine today (washing the area with soapy water before dipping the urine stick so that deposits from vaginal discharge don't affect the protein count in the urine - vaginal discharge, whether infected or not, always carries some protein). The stick revealed 1+ protein (it's been either trace or 1+ throughout the pregnancy, and I wanted to know if the protein was really in the urine because last time it went up to 2+). This result shows that there is a little bit of protein in the urine itself, but this is normal if it ranges between trace and 1+ because of the additional pressure around the bladder. If it starts going up from this range, and ties in with increased blood pressure and fluid retention, it can be a signal of hypertension.
This week, we were told to have a colour doppler scan to see the fluid, placenta and blood flow in the uterus. I also took my second dose of the Tetanus jab, which is supposed to protect both myself and the baby for up to 6 months after birth.
We saw the baby's face on the screen and it was really adorable, making sucking faces and twiddling its fingers. The doctor said it weighs just over one kg now.
I have noticed a few skin problems over the last month. The pigment in my skin has become quite concentrated, creating a deep brown line down my abdomen (the lina nigra). As the pigment, melanin, is more in asian skin, the natural deepening of this line as well as the nipple tissue etc. is more exaggerated. I have also had a few irritations and decided to buy some soothing oils for these things. The slight swelling around the ankles has been the same over the past month.
Saturday, July 4, 2009
27 weeks in
It's been a while since I last posted, and mainly that's because there hasn't been much to say...
The second trimester was quite unremarkable. The only notable change was a bit of a drastic weight gain towards the end of the 25th week.
Now that the third trimester has begun, I am beginning to notice a few more changes. First of all, my ankles are a little swollen. Keeping track of urinary protein and blood pressure is important now to keep an eye on pregnancy-induced hypertension (which around 3% of women can get).
We've finished out antenatal classes course and are going for regular check-ups. There are very few clothes in my wardrobe that fit me now, but in a way it's nice to live so simply without much choice!
Here in India, it's necessary to get a tetanus vaccine in two doses for all pregnant women. This protects the baby for about 6 months, too. It's also important to get a number of vaccinations for
the baby after delivery, including BCG, Hep B and Hep A, Polio, DPT and MMR. These are given at various ages in various doses (although the first four will probably be given at birth itself). There are lots of optional vaccines, including those for chicken pox and flu. If a woman plans to get pregnant again, she should make sure she's vaccinated against Rubella and Hep B before conceiving, because these are dangerous to a fetus. I didn't know all this until after conceiving, so I would advise getting clued up on the Dos and Don'ts of pregnancy before conception.
After an intensely hot summer here in Maharashtra, India, the monsoons have finally arrived. Great relief for everybody, especially for overheated pregnant women!
The second trimester was quite unremarkable. The only notable change was a bit of a drastic weight gain towards the end of the 25th week.
Now that the third trimester has begun, I am beginning to notice a few more changes. First of all, my ankles are a little swollen. Keeping track of urinary protein and blood pressure is important now to keep an eye on pregnancy-induced hypertension (which around 3% of women can get).
We've finished out antenatal classes course and are going for regular check-ups. There are very few clothes in my wardrobe that fit me now, but in a way it's nice to live so simply without much choice!
Here in India, it's necessary to get a tetanus vaccine in two doses for all pregnant women. This protects the baby for about 6 months, too. It's also important to get a number of vaccinations for
the baby after delivery, including BCG, Hep B and Hep A, Polio, DPT and MMR. These are given at various ages in various doses (although the first four will probably be given at birth itself). There are lots of optional vaccines, including those for chicken pox and flu. If a woman plans to get pregnant again, she should make sure she's vaccinated against Rubella and Hep B before conceiving, because these are dangerous to a fetus. I didn't know all this until after conceiving, so I would advise getting clued up on the Dos and Don'ts of pregnancy before conception.
After an intensely hot summer here in Maharashtra, India, the monsoons have finally arrived. Great relief for everybody, especially for overheated pregnant women!
Tuesday, June 2, 2009
Anomaly scan and class on assisted delivery
This week we went for the anomaly scan, which normally happens at around 22 weeks.
We saw the baby's organs developing, the hands, face, feet, heart, bladder, spine etc. The last organ to develop is the lungs, which don't mature until about 34 weeks. The hospital gave us a CD of the recording to take home.
After that, we went for our antenatal class on assisted delivery (forceps, vacuum and caesarean) and there was also a session about epidurals.
These were the main points from the class:
1. Forceps or vacuum instruments are used when pushing efforts are not adequate in releasing the baby.
2. If there is another sudden problem, like fetal distress, then an emergency caesarean is carried out, usually under spinal anaesthesia.
3. Elective caesareans are scheduled when there is a known issue like low-lying placenta, breech position of the baby (feet first), or the baby's head being too large for the mother's pelvis.
4. General anaesthesia is risky and is only given if the mother is moving around so much that spinal injection cannot be given.
5. Epidurals can be given during labour for normal delivery and are usually administered between two contractions; it requires the mother to be still for at least 10 minutes which can be difficult during labour.
6. Epidurals are the safest form of pain relief because the drug does not enter the baby's blood stream.
7. The effect of the epidural lasts 1-2 hours, after which it can be topped up.
8. Sometimes women do feel tingling in the toes, slight lowering of blood pressure and perhaps take a little longer during the pushing phase.
We saw the baby's organs developing, the hands, face, feet, heart, bladder, spine etc. The last organ to develop is the lungs, which don't mature until about 34 weeks. The hospital gave us a CD of the recording to take home.
After that, we went for our antenatal class on assisted delivery (forceps, vacuum and caesarean) and there was also a session about epidurals.
These were the main points from the class:
1. Forceps or vacuum instruments are used when pushing efforts are not adequate in releasing the baby.
2. If there is another sudden problem, like fetal distress, then an emergency caesarean is carried out, usually under spinal anaesthesia.
3. Elective caesareans are scheduled when there is a known issue like low-lying placenta, breech position of the baby (feet first), or the baby's head being too large for the mother's pelvis.
4. General anaesthesia is risky and is only given if the mother is moving around so much that spinal injection cannot be given.
5. Epidurals can be given during labour for normal delivery and are usually administered between two contractions; it requires the mother to be still for at least 10 minutes which can be difficult during labour.
6. Epidurals are the safest form of pain relief because the drug does not enter the baby's blood stream.
7. The effect of the epidural lasts 1-2 hours, after which it can be topped up.
8. Sometimes women do feel tingling in the toes, slight lowering of blood pressure and perhaps take a little longer during the pushing phase.
Sunday, May 24, 2009
Antenatal class on normal delivery
We went for our second ANC session yesterday. The session starts of with breathing and stretching exercises and is followed by a lecture on an important pregnancy topic. Yesterday's topic was 'Normal Delivery'. Here are some of the things I found most interesting about the session...
- The hospital estimates that 60-65% of its patients give birth through normal delivery (i.e. without vacuum or forceps assistance, without Caesarean section, but with an episiotomy as a routine procedure).
- A woman usually comes into the hospital when she has indications such as contraction pains, a show of blood and mucus or the breaking of the water bag, all of which signal labour.
- Around 50% of women do not have all of these happening and are assisted through some of these through injections to induce labour, artificial rupturing of the water bag etc.
- The baby's head is usually engaged in the labour position at around 36 weeks (head down towards the cervix), but this sometimes happens later or not at all, in which case intervention is required.
- The cervix dilates at around a centimetre per hour, so normal 10cm dilation typically requires 10-12 hours!
- The rate of contractions and baby's heartbeat are both checked intermittently. Internal examinations are done every couple of hours and there are stethoscopes, Dopplers or NST machines to keep tabs on baby's heartbeat.
- The baby finds labour uncomfortable too, so cooperating to make things as quick as possible is important (here the doctor explained that it's pointless to waste energy complaining about the pain, although I'm sure that's easier said than done!)
- An epidural can be given once dilation has reached 5cm. This gets rid of contraction pains but not the pains that come from pushing.
- After the cervix has become 10cm dilated (1st stage of labour), the woman is asked to bear down and push (2nd stage). The baby's head then comes to the forefront (at this point, for first and second time pregnancies, the hospital makes a perineal incision or episiotomy to faciliate the baby's exit). The baby's head comes out and then its body is pulled out.
- The baby is placed on the mother's breast. In the 3rd stage of labour, the placenta is taken out by pulling the cord and applying pressure on the abdomen. The placenta is checked for tears to ensure there is not too much bleeding.
- The incision is sown up under local anaesthetic with stitches that will eventually disolve away.
Hearing this lecture, I was silently a little scared and looked around to see if any of the other ladies showed signs of fear - they didn't, but I think most of them were probably putting on a brave face. I especially felt concerned when the doctor said that babies find labour stressful and sometimes the husband faints... I played the labour scene over and over in my head, thinking what it must feel like (will it be like the worst kind of period pain, or the worst kind of gastric cramps, or a combination of both?) After a few hours of doing this, I decided not to think about it anymore.
I guess the thing to keep in perspective will be that the experience is temporary, and there is a definite purpose behind it. That, and the breathing exercises will be important - waist level, chest level and jaw level breaths for different points during childbirth.
- The hospital estimates that 60-65% of its patients give birth through normal delivery (i.e. without vacuum or forceps assistance, without Caesarean section, but with an episiotomy as a routine procedure).
- A woman usually comes into the hospital when she has indications such as contraction pains, a show of blood and mucus or the breaking of the water bag, all of which signal labour.
- Around 50% of women do not have all of these happening and are assisted through some of these through injections to induce labour, artificial rupturing of the water bag etc.
- The baby's head is usually engaged in the labour position at around 36 weeks (head down towards the cervix), but this sometimes happens later or not at all, in which case intervention is required.
- The cervix dilates at around a centimetre per hour, so normal 10cm dilation typically requires 10-12 hours!
- The rate of contractions and baby's heartbeat are both checked intermittently. Internal examinations are done every couple of hours and there are stethoscopes, Dopplers or NST machines to keep tabs on baby's heartbeat.
- The baby finds labour uncomfortable too, so cooperating to make things as quick as possible is important (here the doctor explained that it's pointless to waste energy complaining about the pain, although I'm sure that's easier said than done!)
- An epidural can be given once dilation has reached 5cm. This gets rid of contraction pains but not the pains that come from pushing.
- After the cervix has become 10cm dilated (1st stage of labour), the woman is asked to bear down and push (2nd stage). The baby's head then comes to the forefront (at this point, for first and second time pregnancies, the hospital makes a perineal incision or episiotomy to faciliate the baby's exit). The baby's head comes out and then its body is pulled out.
- The baby is placed on the mother's breast. In the 3rd stage of labour, the placenta is taken out by pulling the cord and applying pressure on the abdomen. The placenta is checked for tears to ensure there is not too much bleeding.
- The incision is sown up under local anaesthetic with stitches that will eventually disolve away.
Hearing this lecture, I was silently a little scared and looked around to see if any of the other ladies showed signs of fear - they didn't, but I think most of them were probably putting on a brave face. I especially felt concerned when the doctor said that babies find labour stressful and sometimes the husband faints... I played the labour scene over and over in my head, thinking what it must feel like (will it be like the worst kind of period pain, or the worst kind of gastric cramps, or a combination of both?) After a few hours of doing this, I decided not to think about it anymore.
I guess the thing to keep in perspective will be that the experience is temporary, and there is a definite purpose behind it. That, and the breathing exercises will be important - waist level, chest level and jaw level breaths for different points during childbirth.
Monday, May 11, 2009
Fifth month examination
I have had a cold/flu (hard to tell which by the symptoms) for three days now. The symptoms (sore throat, stuffiness, slight temperature) were getting worse so my husband decided we had to go and see the doctor today. My husband first got this flu while we were away on a one week break in Delhi. He reacted very sharply and fast with recurring temperatures and body aches for two days before coughing and recovering within a week. When I contracted the virus four days later, my body reacted much more slowly with milder temperatures and congestion in my ears-nose-throat. I hear this gentler response happens during pregnancy to keep the baby protected from immunological reactions. Our fifth month obgyn check-up was due later this week anyway, so I thought we might as well go in a little earlier to get my symptoms checked and be on the safe side during the pregnancy.
We went to the hospital at 6.30 this morning and got home at 11! There was a lot of waiting around and a lot of things the doctor recommended we do.
Generally, the hospital follows the following procedure -
1. Report to reception and collect your medical file which was created at the first visit.
2. Go and give your history to a nurse or doctor in a side offfice. This always includes taking down weight, blood pressure, pulse, urinary protein and sugar (from a dipstick), discussing any complaints and reporting results from any samples given to the lab recently.
3. Tell reception that history is done and wait to see the doctor.
4. Enter the doctor's office with the file. She looks at the updated information, does an abdominal exam (occasionally, there is a vaginal exam depending on the patient's complaints, cirumstances or stage of pregnancy being either very early or near the due date), and prescribes necessary medicine or gives advice.
Today the doctor asked whether my temperature during this flu had gone up, as anything over 102 could be dangerous for the baby (I have been monitoring regularly and it never reached above around 101-102 or 37.5-38). Then she prescribed some paracetamol, antihistamine and cough syrup to treat symptoms of sore throat, congestion and slight cough.
I had my blood pressure, pulse and weight checked - now my wieght is 7 kg over my pre-pregnancy weight! The urine dipstick showed no sugar but did show trace levels of protein. The doctor said this was normal because there is an increase in vaginal discharge during pregnancy which may leave protein deposits; there is also more pressure on the bladder. The urine culture done last time had shown no bacteria in my urine, but I was still concerned about the protein so this time I had a vaginal swab taken to check for bacteria. The doctor said that there will always be some bacteria in the vagina, but I just wanted to check that there isn't any harmful bacteria there which could affect the baby. A hemoglobin and full urine analysis sample was also recommended today to check iron and sugar levels. So, apart from a vaginal culture, I gave urine and blood too. I had to consume some glucose and wait an hour before giving blood for this blood test. Sometimes these tests for iron and glucose levels are performed at seven months, not five.
It's very strange how sometimes the pricking of a needle used to take blood can hurt and sometimes it doesn't. The same can be said for physical examinations of the vagina. I have had three done by different people so far (not including the two sonography probes that were inserted internally to scan early pregnancy) and sometimes it all feels very uncomfortable. The vagina clenches up sometimes out of fear and you have to take a deep breath to just relax.
After all that business, just before leaving the hospital we heard the strange cry of a baby being born somewhere in a room upstairs. It was exciting and frightening all at once. The hospital has admitted patients in 25 rooms upstairs and OPD clinics downstairs, so everything is in the same quarters, including the Pathology Lab, Pharmacy and Ultraosound Clinic. They take room bookings based on delivery due dates at around 7 months.
They've recommended an anomaly scan at around 22 weeks and we're continuing with our monthly visits right now. I really hope there won't be many more tests as we've reached over halfway into the pregnancy now.
We went to the hospital at 6.30 this morning and got home at 11! There was a lot of waiting around and a lot of things the doctor recommended we do.
Generally, the hospital follows the following procedure -
1. Report to reception and collect your medical file which was created at the first visit.
2. Go and give your history to a nurse or doctor in a side offfice. This always includes taking down weight, blood pressure, pulse, urinary protein and sugar (from a dipstick), discussing any complaints and reporting results from any samples given to the lab recently.
3. Tell reception that history is done and wait to see the doctor.
4. Enter the doctor's office with the file. She looks at the updated information, does an abdominal exam (occasionally, there is a vaginal exam depending on the patient's complaints, cirumstances or stage of pregnancy being either very early or near the due date), and prescribes necessary medicine or gives advice.
Today the doctor asked whether my temperature during this flu had gone up, as anything over 102 could be dangerous for the baby (I have been monitoring regularly and it never reached above around 101-102 or 37.5-38). Then she prescribed some paracetamol, antihistamine and cough syrup to treat symptoms of sore throat, congestion and slight cough.
I had my blood pressure, pulse and weight checked - now my wieght is 7 kg over my pre-pregnancy weight! The urine dipstick showed no sugar but did show trace levels of protein. The doctor said this was normal because there is an increase in vaginal discharge during pregnancy which may leave protein deposits; there is also more pressure on the bladder. The urine culture done last time had shown no bacteria in my urine, but I was still concerned about the protein so this time I had a vaginal swab taken to check for bacteria. The doctor said that there will always be some bacteria in the vagina, but I just wanted to check that there isn't any harmful bacteria there which could affect the baby. A hemoglobin and full urine analysis sample was also recommended today to check iron and sugar levels. So, apart from a vaginal culture, I gave urine and blood too. I had to consume some glucose and wait an hour before giving blood for this blood test. Sometimes these tests for iron and glucose levels are performed at seven months, not five.
It's very strange how sometimes the pricking of a needle used to take blood can hurt and sometimes it doesn't. The same can be said for physical examinations of the vagina. I have had three done by different people so far (not including the two sonography probes that were inserted internally to scan early pregnancy) and sometimes it all feels very uncomfortable. The vagina clenches up sometimes out of fear and you have to take a deep breath to just relax.
After all that business, just before leaving the hospital we heard the strange cry of a baby being born somewhere in a room upstairs. It was exciting and frightening all at once. The hospital has admitted patients in 25 rooms upstairs and OPD clinics downstairs, so everything is in the same quarters, including the Pathology Lab, Pharmacy and Ultraosound Clinic. They take room bookings based on delivery due dates at around 7 months.
They've recommended an anomaly scan at around 22 weeks and we're continuing with our monthly visits right now. I really hope there won't be many more tests as we've reached over halfway into the pregnancy now.
Monday, April 27, 2009
Screening tests
We had our 17 weeks' check-up the other day. We wanted to get another ultrasound (the third one we've had) and, as its the second trimester, we were entitled to the Triple Test Screen, which is offered to everyone in Indian private hospitals, whether they are in a high-risk group or not.
The Triple Test screens for chromosomal defects through a blood test analysed alongside an ultrasound. We had a similar screen done in the first trimester (the First Trimester Screen), but it is done in more detail at around 18 weeks. The screen gives an indication of probabilities in relation to chromosomal diseases like Down's Syndrome and Edward's Syndrome; it does not give a final result. If the screen shows high probabilities, then it is repeated to check once again, and then amniocentesis is conducted to check the amniotic fluid surrounding the baby by extracting some of this fluid from the body (this has a low possibility of causing a miscarriage). If the fluid shows more certain indication of disease, the parents can choose termination or can prepare themselves for the extra care they will need to give to their child. In the west, the screens are usually only advised for pregnancies at high risk (e.g. mother's age over 35 or prevalence of familial genetic disease). Some people like to do the tests to have as much information as possible, even if they know the information they receive won't affect their decision to go ahead with the pregnancy. We decided to go for the ultrasound scan so we could see that the baby was ok, but we didn't choose the screening blood test because we've already decided that whatever happens now, we want to go ahead with the pregnancy. As for information, we can't even know the sex of the fetus here in India so we have to deal with the fact that we can't know everything.
In the ultrasound, we saw the baby's face profile, its arms and legs, heartbeat and stomach. It was amazing to hear its heart beating, and a little scary too. An anomaly scan can be conducted again at around 22 weeks.
The Triple Test screens for chromosomal defects through a blood test analysed alongside an ultrasound. We had a similar screen done in the first trimester (the First Trimester Screen), but it is done in more detail at around 18 weeks. The screen gives an indication of probabilities in relation to chromosomal diseases like Down's Syndrome and Edward's Syndrome; it does not give a final result. If the screen shows high probabilities, then it is repeated to check once again, and then amniocentesis is conducted to check the amniotic fluid surrounding the baby by extracting some of this fluid from the body (this has a low possibility of causing a miscarriage). If the fluid shows more certain indication of disease, the parents can choose termination or can prepare themselves for the extra care they will need to give to their child. In the west, the screens are usually only advised for pregnancies at high risk (e.g. mother's age over 35 or prevalence of familial genetic disease). Some people like to do the tests to have as much information as possible, even if they know the information they receive won't affect their decision to go ahead with the pregnancy. We decided to go for the ultrasound scan so we could see that the baby was ok, but we didn't choose the screening blood test because we've already decided that whatever happens now, we want to go ahead with the pregnancy. As for information, we can't even know the sex of the fetus here in India so we have to deal with the fact that we can't know everything.
In the ultrasound, we saw the baby's face profile, its arms and legs, heartbeat and stomach. It was amazing to hear its heart beating, and a little scary too. An anomaly scan can be conducted again at around 22 weeks.
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