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SEX DURING PREGNANCY

  • My wife is three months pregnant. Is it okay for us to have sex? I feel embarrassed to ask our family doctor. We are avoiding sexual contact; but in do feel the urge sex. What do we do?

    This is one of the commonest questions posed by young parents expecting their first child. Their lack of knowledge regarding the correct method, timing, and frequency cause varied misconceptions and at times, a total withdrawal from sex. This often backfires as the women, owing to her psychological state and emotional needs, fails to understand the behavioral changes in her partner. Here’s what to expect.

    EMOTIONS ON HIGH

    During pregnancy, a woman’s mental make-up undergoes dramatic change. She becomes emotional and sometimes oversensitive. The way her needs are acknowledged (or dismissed) affects her mental state and thereby the fetus as well. If she feels that her husband is not adequately, responsive she may get irritable, insomnia and suffers from loss appetite or over-stimulated hunger.

    Most men are unaware that their behaviour often causes these emotional upheavals. Many take the easy way out and take their wife to the doctor, without realizing that she simply needs her husband her moods, feeling and anxieties.

    DISCREPANCY IN SEX DRIVES

    The changes taking place in the mother-to-be are part of her bio-logical make-up. Hormonal and chemical changes prepare her for conception, pregnancy and child-bearing. The awareness that she is pregnant creates new aspirations and sexual relations go down the priority ladder. There is, however, no such biological change in the man. He needs to make himself aware of the physical and emotional demands fatherhood, but continues to feel the urge for intercourse. In such a situation, it is essential that he does not force this one-sided need on his pregnant wife.

    FOR INTERCOURSE

    Though a woman may not have strong sexual urges, she does need warm and gentle physical contact and caressing. In the process, if she is aroused and willing, they can have intercourse too. However….

    • Avoid the missionary (man-superior) position. Woman on top position is advisable, or they both could be in a sitting position, so could be in a pressure on her abdomen and that movement is gentle.

    • Spoon position is another one. The position is when the couple life on their sides, their legs bent upwards, both facing in the same direction, with the man behind the women. It is like two spoons, one nesting inside the other. This is a very ‘gentle’ position as neither partner is putting any weight on the other, and it is particularly good for making love to a pregnant women.

    WATCH OUT FOR

    • If during missionary position, the man is one the top, his weight bears down on the woman, and without his realising, the movements can become rough. This, in turn, can disturb the fetus.

    • Intercourse should be avoided from the sixth to the twelfth week of the pregnancy as it can cause miscarriage. Sexual abstinence is recommended during the last two months of pregnancy too. At this time, if one indulges in sexual intercourse amniotic fluid leaking out.

    • During the fourth to seventh month of pregnancy, intercourse is allowed unless you are otherwise advices for medical reasons.

    • Sexual acts such as oral and anal sex should be strictly avoided.

    WORD OF CAUTION

    During pregnancy, a woman does not retain her shapely figure. It is possible that the man may be sexually drawn to other tempted to indulge in extra-marital affairs during this time. A Women’s needs during pregnancy undergo a major transition It’s certainly not right, if the husband, instead of understanding this change, enters a relationship outside marriage.

    This can be dealt with if the man is equally involved with the pregnancy. In fact, the couple can create deeper bonds during this period. Being present during sonographies, choosing the baby’s name, his/her new clothes, etc can help men grow in their new role.

    Pregnant with myths!

    Pregnancy is a time pampering, dreaming and er..myths! Almost every culture has its own myths related to pregnancy and what pregnant women should or should not do. Here, we bust some.

    Pregnant women crave pickles and ice cream

    • False. Not all women crave pickles and ice cream, but food cravings such as these are based infact. In general, food cravings can be very helpful in telling you what your body needs.

    Women who crave pickles are really craving salt and may be mineral deficient, and specifically sodium deficient. Additional minerals are particularly important in pregnancy when women’s bodies increase blood volume by up to 20 percent, so the existing minerals are diluted.

    Many women crave junk foods such as ice cream during pregnancy because junk food is associated with comfort. Sugars found I sweet foods, as well as in breads, pasta and rice cause the body to produce serotonin, which makes women feel good.

    Pregnant women who carry low will give birth to a boy and those who have pregnancy acne will give birth to a girl.

    • False. How a woman carries depends on her body type and whether she has been pregnant before, but does not reflect gender. Pregnancy acne is unrelated to gender.

    Women tend to carry lower or higher depending on their body type. Taller, thinner women appear to carry higher. Shorter and fuller women appear to carry lower. Neither has any correlation to gender. Also, in a second pregnancy, since abdominal muscles may be looser, the pregnancy may appear to be lower.

    Pregnancy acne has nothing to do with gender; it is result of natural hormonal changes.

    Pregnant women must eat for two; they must gain 25 pounds.

    • False. Thirty years ago, the average size of babies was 6 pounds. Today the average size is 8 pounds. There are many reasons for this, but one reason is over-eating, particularly unfavourable carbohydrates(bratds, pastas, rice), and not getting enough vegetables, protein and healthy fats.

    As long a s a pregnant women eats properly-and as long as her doctor is not concerned-there is not set formula for how much she must gain. Genearally, in the last trimester, the baby gains half a pound a week. So, as a general rule, if, during this time, the pregnant, women is not gaining a bit more than that, her doctor may be concerned and her dieat should be reevaluated.

    Pregnant women shouldn’t take baths.

    • False. Pregnant women should’t take hot baths. Women are told not to take baths because hot water—over 98 degrees-is unfavorable to the pregnancy. Taking a warm bath with someone to help you get in and out of the bath safely can help decrease uncomfortable welling in arms and legs, increase the amniotic fluid and help the mother relax and alleviate anxiety about the health of her baby. This is also why swimming is such a great pregnancy exercise.

    Pregnant women shouldn’t eat fish.

    • False. Although women are told not to eat fish due to eat fish due to mercury, levels and fears of food poisoning, (a) women can choose fresh fish with low mercury levels and(b) fish oil has many benefits to the baby after all, women in Japan don’t stop eating sushi!

    Mercury and food poisoning are significant concerns. Women are individuals and every pregnancy is unique. Small white fish have lower mercury levels because they have been living in the ocean for a shorter period of time. Get fresh fish and smell it. A woman’s sense of smell is heightened during pregnancy for a reason-the pregnant women’s body is helping her determine what is healthy for her baby.

    Moreover, fish oil contains helpful Omega 3 fats, which actually enhance the developing of the baby’s brain, improve the baby’s IO, make the baby a better sleeper after birth, prevent premature contractions and premature labour, prevent high blood pressure during pregnancy, and act as an anti-inflammatory that prevalent infection, if a pregnant women is uncomfortable eating fish she can visit her local health food store for fish oil supplements.

    Pregnant women shouldn’t change cat litter.

    • True. Due to a virus in cat feces called Toxoplasmosis. This virus can be very harmful to the pregnancy. But recognize that contact with kitty litter is not limited to changing the cat litter box. Since a cat walks on its litter, the virus can be tracked any where a cat walks, including its paws. Due to this, all contact with the cat must be limited and the house must be kept extra clean. Also, because much of our producer is grown outdoors where cays and other animals come in cot act with it-even if it’s organic-recognize that this virus may be present on fruits and vegetables.

    Pregnant women shouldn’t dye hair.

    • False. Sort of. Pregnant women should avoid anything chemicalized-from food to hair dye. Just like with the foods they eat, pregnant women should try to expose their bodies to as few artificial products as possible. Hair dyes are no exception.

    Pregnant women should not carry heavy items.

    • True. Nothing more than 25 pounds. The pregnant body is already burdened by additional weight, which throws of a woman’s s balance and makes her more l9okely to fall. This and other things that cause a dismissed sense of balance in pregnant woman should in pregnant women should be avoided, as a fall after the first trimester may be devastating to the pregnancy-always requiring immediate medical attention.

    All pregnant women have morning sickness.

    • False. Women and their pregnancy, hormone levels are individual. The feeling of morning sickness is often caused by a rise in the female hormone estrogen during pregnancy.

    All pregnant women have morning sickness. • False. Women and their pregnancy hormone levels are individual. The feeling of morning sickness is often caused by a rise in the female hormone estrogen during pregnancy.

    If the pregnant woman’s body already produced a high level of estrogen prior to her pregnancy, additional estrogen may cause morning sickness in the first trimester-or not. It really depends on the individual.

    Pregnant women shouldn’t drink alcohol.

    • True. Alcohol is ‘fetotoxic, ‘ which means it is poisonous to the growing baby, just one drink a day can create a noticeable problem in the pregnancy. If someone told you that one pill of a certain drug baby, would you take half that pill or even one quarter?

    WOMEN’S HEALTH


    We all know that women often neglect their own health whilst taking care of the ones around them. The fast paced urban lifestyle, coupled with a poor diet, lack of exercise and rest, is a recipe for disaster. Here disease that women over 35 year so f age need to watch out for.

    FIBROIDS

    An increasing number of women today are facing the problem of fibroids, Affecting women over the age of 35, fibroids are the most common form of non-cancerous tumours found in a woman’s reproductive system. They are essentially benign but could prove to be dangerous if unheeded. However early diagnosis followed by treatment may reduce the chances of further risk.

    Symptoms

    Some women with fibroids may have no symptoms at all while others may experience.

    • Increase in menstrual bleeding, irregular vaginal bleeding, irregular vaginal bleeding.

    • Bleeding with blood clots.

    • Pressure on the bladder causing more frequent urination.

    • Abdominal pain and discomfort.

    • Infertility

    Treatment

    A sonographic test has to be conducted in order to ascertain the growth of fibroids.

    Surgical procedures include;

    + Myomectomy: removal of the fibroids that are causing symptoms.

    +Hysterectomy: Involves a complete removal of the uterus. This can be done laparoscopically, by making several small incisions in the abdomen.

    Nonsurgical procedures include:

    + MRI focus: which helps in dissolving the lump or tumour.

    MENSTRUAL DISORDERS

    Menstrual disorders may intensify after women cross the age of 35 due to hormonal changes, intake of emergency contraceptive pills, stress, thyroid, pregnancy or abortion.

    Symptoms

    • Painful cramps during menstruation

    • Excessive bleeding.

    • Period irregularity.

    • Scanty bleeding.

    • Postmenopausal bleeding could be a sign of cancer.

    CANCER

    Cervical cancer is the most common form of cancer affecting women. India has the highest number of women suffering from this disease, in which the cells on the surface of the cervix grow uncontrollably, leading to cancer. The human papilloma virus (HPV), which is the main cause of cervical cancer, is transmitted during unprotected intercourse.

    Treatment

    A major breakthrough has been the HPV vaccine. It is usually given at after the age of 12. Breast cancer is the prevalent form of cancer among women and affects approximately one million women worldwide. Being a genetic disease, the chances of acquiring it are higher if there is a family history of breast cancer. The risk factor is highest among women who have their first child after the age of 35 and these women have an even higher risk than women who have no children,.

    Symptoms

    • A lump in the breast or an irregularity in the breast tissue.

    • Breast cancer is now commonly diagnosed by breast screening in women who he to symptoms.

    Treatment


    +Hormonal Therapy.

    +Chemotherapy.

    A hormone test or sonography may help to rule out the possibility of cancer.

    DIABETES

    Diabetes among women has been on the rise. The chances of getting type-2 diabetes increases after the age of 45. It may be due to genetic reasons or lifestyle related problems. Asia and specifically India has the largest population of diabetic patients. A sedentary lifestyle, obesity, an unhealthy diet, lack of exercise and a family history of diabetes may increase the likelihood of diabetes.

    Symptoms

    The typical symptoms of diabetes include:

    • Polyuria or severe urination.

    • Persistent fatigue.

    • Many infections associated with diabetes might be dangerous as they impair the body’s ability t fend off disease.

    Treatment

    +Oral or insulin test

    +Exercise: Regular exercise, in any form, can help reduce the risk of developing diabetes.

    +Diet: A nutritious diet can go a long way in controlling blood sugar and preventing complications.

    Delayed pregnancy is leading to an increase in uterine tumours. As many as 25 million Indian’s have them, leading to problems with pregnancy and infertility.

    More aware now, women check for fibroids before conceiving

    Like most women, Surekha Sinh went through the usual nervousness and excitement when she found out she was pregnant. But as the pregnancy progressed, she got scared---there were complications she didn’t quite understand. After she lost her premature baby her gynaecologist diagnosed fibroids—non-cancerous tumours in her uterus.

    After a myomectomy—surgical removal of fibroids—and several months of hormone therapy, Surekha conceived again. But post-delivery, she would haemorrhage for most of the month. The diagnosis; Fibroids, again. What followed, along with nursing the baby, were month’s o bleeding, treatment, medication and another myomectomy.

    Yet, the nightmare didn’t end there, she says, after her third child, the fibroids had returned. This time, they were cancerous and had affected her ovaries. Her gynaecologist advised a hysterectomy---removal of the uterus. So, at 28,Surekha had the life-changing operation. “I was advised hormone replacement therapy for 10 years. Menopause hit earlier than usual,” she says.

    Nearly 25 million Indian women are currently affected by uterine fibroids, according to a study released this year. The 16year-long country-wide research conducted by Mumbai- based fertility specialist DR Prakash Trivedi is being circulated to gynaecologists by the Federation of Obstetrics and Gynaecology Society of India (FOGSI). They hope increasing awareness among patients as well as healthcare providers will prompt more women to go for regular checks. This will help doctors diagnose the problem and suggest treatment before it is too late.

    Besides the discomfort and pain associated with it, having a fibroid can hamper pregnancy and child birth. The tumour in the uterus cannot be treated with drugs and more often than not, the fibroid needs to be surgically removed. Many times, women suffering from fibroids don’t realise that the tumour was responsible for a failed pregnancy.

    What causes fibroids is as yet not fully known. Doctors say it is genetic: The study found a 30 percent chance of women developing fibroids if anyone in the family had them. “Also, women who eat more red meat, those who are overweight, and those who have hypertension have a higher chance of developing fibroids, ’says Dr. Trivedi, who also runs the Aakar IVF centre in Mumbai.

    With more women delaying marriage and pregnancy in India, fibroids are becoming commonplace now, say doctors. “Women who put off pregnancy have a greater chance of developing fibroids,” says Dr. Ashwini Bhaleroa Gandhi, gynaecologist at the PD Hinduja Hospital “This is because of the hormone oestrogen. Which plays a role in developing fibroids.” Oral contraceptives, say doctors, reduce the chances of fibroids by regulating levels of oestrogen in the body “Research has shown that fibroids are non—cancerous and can never turn Malignant. Malignant tumours are not fibroids, they are known as fibro carcoma,” explains Dr. Trivedi.

    Not all fibroids cause as much trouble as Suarkha’s did. Like Chhaya Joshi found. Four years back she had one incidence of severe pain which promoted the 49-year-old lab technician to get it checked. Sure enough, her sonogram showed fibroids. “When I heard the word tumour, I was out of my mind with worry, but my doctor told me that the fibroid was situated just above the uterus and would cause no problems.” She says.

    Only marginally relived, Chhaya expected to have to come back to the clinic for surgery. “But so far, except a little bladder pressure and an occasional urgency in relieving myself, I have felt no pain or abnormal bleeding ever,” she says. Her fibroid, which was 5cm large in2003, is 8.7cm today. This, say doctors, is normal. A fibroid grows about half a centimeter in one year.

    A fibroid only needs to be removed if it causes severe complications like excessive pain or heavy bleeding. “This is determined by where the fibroid is situated in the uterus.” explains gynaecologist and director of Gynaecworld, Dr Duru Shah.” A fibroid in the cavity or the muscle of the uterus will probably have to be removed but one just above the uterus will cause no problem”. There are drugs that can help shrink a very large fibroid, but surgery is the only option if fibroids are to be removed. Laparoscopic or key-hole surgery is an enticing option, but can be carried out only by an experienced laparoscopic surgeon as it “required finesse of suturing,’ says Dr. Shah. “ Very often, if not properly sutured, the scar can rupture during pregnancy, casing complications,” she advises. Open surgery, on the other hand, takes much longer to heal but is ideal for those planning a baby, adds Dr. shah.

    There is a newer option too: a hysteroscopy. Unlike the laparoscopy, where a telescope and surgical equipment, is passed through a tiny cut in the abdomen in the hysteroscopy, the telescope and equipment is inserted through the vagina and the fibroid scraped out.

    If a patient has multiple fibroids which grow back even after being removed, a hysterectomy is advised. Earlier, a hysterectomy meant removal of the uterus as well as the ovaries, like in Surekha’s case. Today, however, the ovaries need not be removed, causing no hormonal imbalance. For 44-yearold Rihanna(name changed), who suffered from the pain and inconvenience of “six small fibroids and one the size of a tennis ball,” removing her uterus was the only option, she says. “I was approaching menopause, and since the hysterectomy two years ago, I have had no problems says Rihanna.

    DOWN AND OUT


    Does uttering the V-word make you wince? Gynaecologist Anita Soni tackles some of the most common vaginal woes

    THE DOS AND DON’TS BIKINI WAXING

    Models do it, actresses do it and now even the youngsters have caught onto this trend. Bikini waxing is a method of depilating public hair. As preparation, make sure your hair is not too long or too short, choose an experienced person for waxing, you could pop a pain killer (one hour before heading to the parlour) and wear comfortable cotton underwear after waxing. Some women may develop folliculitis (pimple-like boils) post waxing and may require antibiotics for the same. These are other less painful ways of maintaining hygiene---clipping hair with a sterilized scissor, shaving and laser treatment.

    DESPITE MAINATANING HYGIENE THERE’S ODOUR IN THE VAGINAL AREA

    Odour from the vagina could be due to vaginal infections that is either fungal, trichomonial or bacterial. It is generally accompanied with vaginal discharge which could be curdy white, lacy white discharge with greenish discoloration (in trichomonial infection) or thick creamish discharge as in the case of bacterial infection. All these are sexually transmitted with antifungal or antibacterial medications, Post-treatment; maintain regular hygiene by washing the area twice a day.

    SHOULD YOU BLEED THE FIRST TIME YOU HAVE SEX?

    All women have a hymen which is at the opening of the vagina. This hymen may tear in childhood during vigorous exercises, cycling, jumping or due to masturbation. If intact, the women will bleed while having sex for the first time. However bleeding does not indicate virginity in a female as it can be ruptured by other factors as well.

    YOUR SATIN UNDERWEAR GIVES YOU AN ITCHY SENSATION AROUND THE VAGINA.

    Itchy sensation around the vagina could be due to vaginal infections it could also be an allergy to satin underwear or sanitary pads. Since we live in humid climate, it is advisable to use comfortable cotton underwear. Sweat combined with synthetic material cause’s itchiness and irritation. To combat this, wash the area frequently and use unscented talcum powder.

    YOU SUFFER WHITE DISCHARGE AROUND A WEEK BEFORE PERIODS AND FEEL WEAK.

    White discharge before periods is due to progesterone effects on the cervical mucous. Around this time the vagina secretes a harmless white fluid. If the discharge does not emit a foul odour or cause itching, do not feel afraid. Many people associate it with weakness, but that is just a myth. You could say the stress that comes with P M Sing makes you feel weak.

    WEARING SANITARY PADS GIVES YOU SEVER RASHES. TAMPONS TOO ARE UNCOMFORTABLE.

    Modern day synthetic sanitary pads are known to do that. Ultrathin sanitary pads use a material that transforms menstrual blood into gel. This gives us a pseudo-dry feel and hence the less frequent change of pads. These pads, when come in constant contact with the skin, create rashes and an itchy sensation. Tampons is certainly not The way to go, as there have been cases of it causing sever vaginal infections. The way out is to use cotton sanitary pads and a frequent change every four hours.

    IS IT NORMAL TO URINATE AFTER HAVING SEX?

    The sexual act in some women may lead to a burning sensation in the vagina. This can be due to lack of lubrication or a yeast infection, both of which cause frequent urination. This condition is known as honeymoon cystitis. Here there is an infection of the urinary tract. Most cases call for a detailed gynaecological checkup for the couple.

    SMALL WHITE PIMPLES APPEAR ALL AROUND THE VAGINA. WILL IT AFFECT FUTURE SEX LIFE?

    White pimples may be due folliculitis or molluscum contagiosum. Folliculties can happen due to infection after shaving. Molluscum is a viral skin infection. Both can be treated with antibiotics. Sometimes occurrence of white pimples also symbolises herpes genitalis---an STD which calls for urgent treatment.

    Is it safe to have sex during periods?

    A common misconception is sex during periods can ease menstrual pain. Premenstrual pain. Premenstrual sexual activity does help in period pain. Sex during periods should be avoided, at least for the first two days because chances of infection during this time are high and also penetration can causes the blood to push back into the cavity.

    How to ease period cramps on a long term?

    Period cramps are normal. Cramps can be eased by mefanamic acid available at all chemists and basic over-the–counter painkillers. The mouth of the uterus of a virgin is closed tightly. Once sexually active, the pain should lessen.

    Sanitary pads or tampons—which are safer?

    Choosing pads or tampons is purely an individual preference. However, virgins should refrain from using tampons. While it may not necessarily tamper with your hymen, it could cause a teat in a more lax one. Many sexually active women find tampons more convenient since they cause no soiling on the outside but you have to change your tampons every four hours.

    Can irregular periods cause problems during sex or having babies?

    Young girls tend to have irregular cycles when they start their periods. But with age, irregular periods could become serious issue caused by thyroid or Polycystic Ovary Disease (PCOD). A stressful lifestyle can also cause an irregularity. IF the problem persists, get it treated. A problem like this could also get in the way of conceiving.

    Women use 500 chemicals on face & body every day

    London: Modern women apply over 500 chemicals daily on their face and body in the form of various beauty products every day to look beautiful, a new study claimed.

    The beauty-conscious ladies apply up to 13 products, most of which contain more than 20 ingredients, including additives that could lead to cancer and various skin problems the study problems, the study by deodorant firm Bionsen said.

    “Beauty regimes have changed dramatically from a simple ‘wash & go to daily fake tan applications, regular manicures, false lashes and hair extensions,” charlotee Smith of Bionsen was quoted as saying by the sun.

    Lipstick, the most commonly used cosmetic, contains on average 33 chemicals, body lotion 32, mascara 29, and hand moisturiser 11, the study found. Perfumes contain an average cocktail of 250 chemicals with some containing as any as 400, it found.

    Late marriage, stress trigger endometriosis

    Mumbai: As Bollywood actor Katrina Kaif got discharged on Thursday morning after endometriosis, city gynacelosgists say the condition is fast becoming an unhealthy trend among uppercrust urban women.

    With late marriages and child-bearing years, along with high levels of stress and improper eating habits, young women in cities are prone to the painful disease-which has no permanent cure. “But there is no study to suggest why some women should get the disease and not others. Most women suffering from endomtrosis suffer from pain, extra bleeding and irregular menses. Almost all have problems conceiving,” said dr. Neeta warty, the gynaecologist who treated the actor. As for the actor herself, kaitrina’s Spokesperson told TOI that she was fine.”She was discharged from Breach Candy Hospital. She had to undergo a small surgical procedure because of low hemoglobin levels in her system.”

    Endometriosis affects about 89 million young women in the reproductive age group worldwide. “About 10-15% of all women have some or the other level of endometriosis. Thirty-five out of 100 women who come to us with infertility suffer from endometriosis,” said Dr. Rishma Pai, consultant gynaecologist with Lilavati Hospital in Bandara Reclamation.

    When the tissue which lines the uterus ( endometrium) grows in abnormal locations such as the ovaries or around the uterus, the condition is called endometriosis. “Every time the woman has her menses, there is also bleeding in the tissue. So, if she has endometrioses the bleeding takes place in the abdominal cavity, from where the blood is not flushed out of the body. Over a period of time the blood accumulates in the ovaries, forming a cyst,” Sai Dr Duru Shah, who is based – kemp’s corner. Unless the cys formed in the abdomen is to big. It will not show in a sonography and thus, the only was to find out if a woman is suffering from endometriosis is before examining it laproscopically.

    Throwing up ?

    BT tells you how to deal with morning sickness…

    Pregnancy is not all about the attention you great and the glow on your face. Several women go through terrible bouts of morning sickness early in their pregnancy and about 50 per cent of women experience vomiting. While some women may be sick all day, some feel sick in the evening, and others in the evening, and others in the morning. Morning sickness usually commences in the sixth week and is known to be at its peak in the eighth and ninth week. However find that morning sickness abates after 14 weeks. Here’s how you can deal with this problem….

    Lie down

    It may sound too easy but it works. Life down, close your eyes and breathe deeply. May be all you need is a little bit of rest. Try and catch up on sleep for at least an hour during the day--- it will help you feel better.

    Take an off

    If you’re working during your pregnancy, and suffer from morning sickness, tell yourself that it really is okay to sometimes bunk work. If you feel absolutely miserable in the morning and don’t feel like getting out of bed, don’t! it’s fine to give your body a break sometimes.

    Find a scent you like

    Sometimes the most oddest things may make you feel like throwing up. Research says that morning sickness is more often than not associated with smell. The hormone, estrogen is responsible for your sense of smell and is also what you can blame for making you want to throw up when you smell something. When you realize what smell doesn’t agree with you, carry a bottle of lemon extract or any other thing that makes you feel better and sniff it whenever you start feeling nauseous.

    Drink water

    While it may seem like a task to put, anything in your tummy , the more water you drink, the more you’II hydrate your body, which will make you feel better. Not having adequate water increases nausea.

    Be prepared

    If you can’t help out stepping out of the house, make sure that you carry some essentials that will help you freshen up after you throw up. Carry a change of clothes as well as a toothbrush, toothpaste, mints and a bottle of mouthwash. If you can carry a plastic bag to vomit in, by all means carry one.

    Talk to your partner

    There’s nothing wrong in admitting to your better half that you’re feeling mistable most of the time. Sometimes it may be his after shave that might cause you to gag. Discuss it he can help and make things better

    Include ginger in your diet

    Ginger is known for its soothing qualities especially when it comes to the stomach. Add a slice of ginger to a cup of not water of your tea. Try and include it in your food as well.

    Keep yourself distracted

    While it isn’t too easy to simply take you mind off the waves of nausea that take control of your body, make a conscious effort to distract yourself when you start that familiar uncomfortable feeling creeping up on you. Go for a walk, read an interesting book or listen to your favorite music.

    Go holistic

    Acupressure wristbands apply light pressure to a spot located inside the wrist bands apply light pressure to a spot located inside the wrist that is related to nausea. Certain women say it helps them a great bit in reducing vomiting. Do some breathing exercises for a few minutes daily and ask your doctor if you can do a few basic yoga asanas.

    It’s okay to take medication

    While many people will tell you to “just deal with it,’ there is no harm in asking your doctor to prescribe you something that will help you alleviate the symptoms of morning sickness. Don’t worry about your baby being harmed, your doctor knows just what he’s giving you and the relief you feel will be good for your baby, too

    Doctors divided or ring’s appeal

    Beyond The Pill

    Latest Contraceptive/vaginal birth control ring

    USP/can be inserted just once a month, unlike the pill, which needs to be taken daily.

    BENEFITS

    Self-administration/In clinical trials in the West, 96% of women reported that the ring was easy to insert and 98% said it was easy to remove.

    Low estrogen exposure/it delivers hormones slowly and steadily, unlike the pill, which has a higher dosage of hormones.

    Fewer side-effects/As it is not taken orally, women don/t suffer from nausea, bloating or tenderness in the breasts, which are associated with pills.

    DANGERS

    Women with these conditions shouldn’t use the rings

    History of heart attack or stroke/History of blood clots in legs, lungs or eyes/History of blood clots in deep veins of legs/chest pain/Sever high blood-pressure/Diabetes with complications of the Kidneys, eyes nerves or blood vessels/Headaches with neurological symptoms/Known or suspected breast cancer or cancer of the lining of the uterus, cervix, or vagina (now or in the past)

    How it works

    The flexible, transparent ring disperses hormones throughout the ring’s core. They get absorbed through the vaginal lining into the bloodstream. Like the pill, they inhibit ovulation.

    Vaginal ring

    What Contraceptives Women use

    Not using Any-----------------------------44% Sterilisation------------------------------38% Pill-----3% Condom-------% Rhythm-----5% Withdrawal-------3% IUD (Intra Uterine Device) Mumbai: The new female contraceptive—the vaginal ring—keeps introducing estrogen and progesterone into the blood through the vaginal lining to prevent ovulation.

    Dr Rekha davar, who head the gynecology department of the state-run JJ Group of Hospitals, said, “The ring is too expensive to be accessible to the majority who need contraceptives to be accessible to the majority who need contraceptives.”The ring was introduced in India in November 2009 and costs a little less than Rs. 800.

    However, some doctors feel it is the contraceptive for the modern Indian women, Dr. Mandakini Parihar, who has clinic in Chembur and teaches at K J Somaiyya Medical school, Sion, said, “The most effective way of stabilising the population is to have woman centric contraceptive choices. While women in our country refer tubectomy (in the public sector0 and pills in the private sector), the ring offers a choice of low-hormone dosage with few side-effects.”

    Parihar said that over 20 women who visited her clinic in the past three months have converted to the ring. “They are happy with the freedom it offers vis-à-vis the contraceptive pill,” she said.

    However, a senior doctors wondered if Indian women “who don’t favour tampons would use a foreign object”.

    Seeraj Roy, of the multinational MSD, which launched the ring worldwide, said that pre-launch market research in India revealed potential “women found the idea of once-a-month use attractive. While some doctors told us they were worried about Indian women favouring a vaginal insertion, we found that modern Indian women seemed comfortable with it’

    According to Dr. Urvashi Jha, of Max Healthcare, Delhi, ”Twenty years back, the Indian woman would be scared, but now any more , we helped many women use it the first time and thereafter they were comfortable with it.”

    Dr. Duru Shah, who has a clinic at Kemp’s Corner, said that hormonal contraceptives have traditionally not been favoured by Indian women. “They are still guided by talk of the early pill, which had high doses of hormones and were feared to have caused uterine cancer, ”said Shah.

    Indeed, the three national Family Health Surveys (NFHS) done in the Indian women still depend that Indian women still depend on sterilisation. Over 38%chose sterilisation while only3% depended on pills.

    Davar said,” The market is flooded with contraceptives that have different delivery systems. It depends on what the woman is comfortable with.” She said the ring is a new version o the original pill. “It works on the same principle. But it is too expensive to get popular, ”she added.

    THE TOP 5 THREATS TO YOUR HEALTH

    Women face different health challenges compared to men. Understanding the issues helps long, healthy living. The top five health challenges faced by women relate to heart disease, breast cancer, osteoporosis, depression, and autoimmune disease.

    ? HEART DISEASE

    Considered a problem of men, heart disease is in fact a leading killer or women responsible for about 29% of death. Changing trends like increase in the number of women who smoke or use tobacco products tends to nullify the protection rendered by the female hormones. Women of all ages should take steps to reduce the risk of heart disease and practice healthy living.

    ? BREAST CANCER

    Breast cancer is the most common form of cancer and the second most common cause of cancer-related death in women. The primary causes of breast cancer are considered to be genetic and/or hormonal factors. Being overweight or obese after menopause, lack of physical activity and alcohol consumption are some risk factors for breast cancer. Advice of the general physician should be sought if there is any breast pain or any other symptom that does not go away. Women should undergo a ‘baseline’ Mammogram sometime between age 30 and 35 years. Those with a family history of breast cancer should then every year to recommend by the medical consultant.

    ? OSTEOPOROSIS

    Osteoporosis is a major public health threat that threatens a lot people, of which 68% are women. The bone mass is built up by the body until age 30. Thereafter, the focus is on maintaining bone health dependent on the behavior developed by women in their childhood, adolescent and early adult years. Women are particularly at risk after menopause. Stress , smoking, improper diet, inadequate calcium intake, inadequate exposure to sunshine, decreased vitamin D, deliveries and lack of regular exercise are all contributory to the process of osteoporosis.

    Early screening, diagnosis, and intervention is needed to prevent fractures. Those at risk and in women over 65, it is advisable to get the bone density test done.

    DEPRESSION

    ? Women are almost twice as likely as men to Seasonal affective disorder-depression in the winter months due to lower levels of sunlight is more common in women as are the symptoms of atypical depression.

    AUTOMIMMUNE DISEASES

    ? Autoimmune disease are a group of disorders in which the body’s immune system becomes misdirected. It attacks the very organs it was designed to protect. Autoimmunity is the underlying cause of more than 100 serious, nesses include lupus, thyroid disease, multiple sclerosis, and type I diabetes.

    Taken together, women are affected three times more than men by autoimmune disease. Genetic, hormonal, and environmental factors have been implicated in the development of these, disease. symptoms can be nonspecific, making proper dingoes difficult. While the disease do not usually go away the symptoms can be treated.

    WOMEN’S HEALTH IN THE NATURAL AGAING COURSE UNDERGOES CHANGES RELATIN TO THE ‘LIFE PHASE’THEY ARE IN. WE LIST A FEW HEALTH POINTRS FOR EVERY WOMAN TO FOLLOW AT EACH AGE.

    KEEP IT IN CHECK

    The human body undergoes changes with age which translate into health risks. Every decade of life makes the more susceptible to certain conditions that need to be monitored. Vigilance is the key to early diagnosis. Institution of appropriate therapy at the earliest can go a long way in preserving and maintaining good health.

    IN THE ADOLESCENT YEARS (AGES 12-20)

    Puberty sets in and menstrual cycles begin. The diet requirements changes with more caloric and nutrient requirements, especially calcium as none development peaks. Advised checks include.

    ? Blood glucose check: This screens for diabetes or hypoglycemia.

    ? Blood pressure check: A basic test almost every doctor will do.

    ? Breast exam: it is a useful screen for breast cancer. ? Complete blood count (CBC): Anemica and blood component levels can be monitored.

    ? Immunisations: The DPT, HPV and meningococcal vaccines are suggested,

    ? Pap smear: A girl should have her first Pap smear once she becomes sexually active or when she turns 18-whcihnever comes first: it screens for cervical cancer.

    ? Skin-cancer check :Visual inspection of the entire body as a check for skin cancer should be done at least every three years more if there is a family history of skin cancer or many moles)

    ? TB test: This test checks for exposure to tuberculosis and in high risk individuals should be done annually or as advised.

    ? Urinalysis: Screens for urinary tract infections and kidney disorders and kidney disorders and other disease like diabetes.

    IN THE 20S and 30S It is important to keep a watch on the weight. Putting on too much will increase the chances of developing conditions like Type II diabetes and heart disease. With skin cancer on the rise in this decade of life enlarging moles and unusual skin changes should be noted . Bone density reaches a peak in the late teens and begins to decline in the 30s.

    ANNUAL REGULAR CREENING SHOULD INCLUDE:

    ? Blood pressure check: At least every two years to keep Type II diabetes and high cholesterol in check.

    ? Baseline cholesterol screening : Keep track the “good” and “bad” cholesterol levels. Repeat every five years. If high repeat test more frequently.

    ? Electrocardiogram: A baseline ECG should be done in the 30s followed by another at age 45 to check the health of start. ? Thyroid test : The thyroid gland start causing problems and it is a advisable to have the first test at age 35 and continue every five years thereafter.

    ? Breast examination : Monthly self exams will help report any strange lumps, bumps or disfigurations.

    ? Pelvic exam and Pap smear: The first Pap rest, good screening for cervical cancer, should be done within three years of being sexually active or by age 21. After age 30, Pap smears may be done every two to three years instead of annually if three consecutive Pap test results have been normal, and if the risk for a cervical cancer is not high.

    ? Dental exams: A dental visit twice a year is desirable for teeth and gum cleanings.

    ? Baseline eye exam: A vision test at least once in the 20s is advisable.

    ? Stool screening: It is advisable to check for fecal occult blood every other year.

    Folic acid, calcium, iron, Zinc and vitamins D and B13 supplements may be advised.

    IN THE 40S AND 50S


    In this phase of life, the body stats the transition into menopause, which can last anywhere from 2 to 8 years, signs of “perimenopause,” need to be monitored. As the reproductive hormone levels fluctuate, changes in the menstrual cycles, sleep patterns, daily moods and sex drive result. The blood pressure may start to rise and bone health needs to be assessed.

    In addition to the regular examinations that are being undergone, the other screenings required are:

    ? Blood sugar test: To check for sings of diabetes, have regular fasting blood sugar tests starting at age 45 and then once every 3 years.

    ? Blood sugar test: To check for signs of diabetes, have regular fasting blood sugar tests starting at age 45 and then once every 3 years.

    ? Mammograms: the first mammogram must happen at age 40 and then as advised colon cancer, the test should start at age 50 and be performed every 10 years or more often for those at risk.

    ? Rectal exam: Also done to test for colon cancer, the test starts at age 50 and is performed every 5-10 years.

    ? Skin check: These should be done annually starting in the 40s. ? Regular eye exam: Vision checks should be done every two to four years until age 65.

    ? Adult immunisations: Flu shots are being advises annually.

    Calcium and vitamin D supplementation can help slow bones’ calcium loss.

    AGE 60 AND BEYOND


    The golden years need attention to be paid to eati9ng right, exercising right and undergoing regular medical checkups. In addition to the screenings already being undertaken some additional care is advised.

    ? Bone density test: In women over 65, osteoporosis being common it is advisable to get the bone density test done. The test may be recommended earlier if these is a risk of osteoporosis.

    ? Pelvic exams and Pap smear exam: These need to be done regularly until the age of 65-70 and there have been three normal pap tests within the last 10 years.

    ? Regular eye exam: Eye disease such as glaucoma being a common aging problem, the eyes need to be checked every one to two years after 65.

    ? Hearing test: With age haring loss also becomes more common, the hearing test. Should be done every three years or as soon as signs of hearing loss are noted.

    ? Adult immunisations: starting at age 65, it is advisable to get a pneumonia. Vitamin B12 supplementation may be

    Doctors divided or ring’s appeal

    Beyond The Pill

    Latest Contraceptive/vaginal birth control ring

    USP/can be inserted just once a month, unlike the pill, which needs to be taken daily.

    BENEFITS

    Self-administration/In clinical trials in the West, 96% of women reported that the ring was easy to insert and 98% said it was easy to remove.

    Low estrogen exposure/it delivers hormones slowly and steadily, unlike the pill, which has a higher dosage of hormones.

    Fewer side-effects/As it is not taken orally, women don/t suffer from nausea, bloating or tenderness in the breasts, which are associated with pills.

    DANGERS

    Women with these conditions shouldn’t use the rings

    History of heart attack or stroke/History of blood clots in legs, lungs or eyes/History of blood clots in deep veins of legs/chest pain/Sever high blood-pressure/Diabetes with complications of the Kidneys, eyes nerves or blood vessels/Headaches with neurological symptoms/Known or suspected breast cancer or cancer of the lining of the uterus, cervix, or vagina (now or in the past)

    How it works

    The flexible, transparent ring disperses hormones throughout the ring’s core. They get absorbed through the vaginal lining into the bloodstream. Like the pill, they inhibit ovulation.

    Vaginal ring

    What Contraceptives Women use

    Not using Any-----------------------------44% Sterilisation------------------------------38% Pill-----3% Condom-------% Rhythm-----5% Withdrawal-------3% IUD (Intra Uterine Device) Mumbai: The new female contraceptive—the vaginal ring—keeps introducing estrogen and progesterone into the blood through the vaginal lining to prevent ovulation.

    Dr Rekha davar, who head the gynecology department of the state-run JJ Group of Hospitals, said, “The ring is too expensive to be accessible to the majority who need contraceptives to be accessible to the majority who need contraceptives.”The ring was introduced in India in November 2009 and costs a little less than Rs. 800.

    However, some doctors feel it is the contraceptive for the modern Indian women, Dr. Mandakini Parihar, who has clinic in Chembur and teaches at K J Somaiyya Medical school, Sion, said, “The most effective way of stabilising the population is to have woman centric contraceptive choices. While women in our country refer tubectomy (in the public sector0 and pills in the private sector), the ring offers a choice of low-hormone dosage with few side-effects.”

    Parihar said that over 20 women who visited her clinic in the past three months have converted to the ring. “They are happy with the freedom it offers vis-à-vis the contraceptive pill,” she said.

    However, a senior doctors wondered if Indian women “who don’t favour tampons would use a foreign object”.

    However, a senior doctors wondere dif facour tampons would use a foreign object.”. Seeraj Roy, of the multinational MSD, which launched the ring worldwide, said that pre-launch market research in India revealed potential “women found the idea of once-a-month use attractive. While some doctors told us they were worried about Indian women favouring a vaginal insertion, we found that modern Indian women seemed comfortable with it’

    According to Dr. Urvashi Jha, of Max Healthcare, Delhi, ”Twenty years back, the Indian woman would be scared, but now any more , we helped many women use it the first time and thereafter they were comfortable with it.”

    Dr. Duru Shah, who has a clinic at Kemp’s Corner, said that hormonal contraceptives have traditionally not been favoured by Indian women. “They are still guided by talk of the early pill, which had high doses of hormones and were feared to have caused uterine cancer, ”said Shah.

    Indeed, the three national Family Health Surveys (NFHS) done in the Indian women still depend that Indian women still depend on sterilisation. Over 38%chose sterilisation while only3% depended on pills.

    Davar said,” The market is flooded with contraceptives that have different delivery systems. It depends on what the woman is comfortable with.” She said the ring is a new version o the original pill. “It works on the same principle. But it is too expensive to get popular, ”she added.

    Lots of anti-wrinkle creams don’t work

    A recent study revealed what we’ve feared all along—none of the 12 tested products cane close to eliminating or significantly reducing the appearances of wrinkles. So don’t bother.

    The way to lose weight is to eat less and exercise more.

    There may well be an on-trend diet to follow, from eating cabbage soup, copious amounts of grapefruit or lean protein, but more fruit and veg ,less fat with 30 minutes of exercise every day is the only way to do it. Sorry!

    If you have to ask yourself if it’s Ok to wear a mini skirt then it isn’t

    A fashion apparel study revealed that most women think the cut off point for flashing your things is 40

    Take compliments gracefully

    You never know if it’s going to be your last so don’t bat it off with an “Oh, of course I look great!”

    A salad is not lunch

    You”II end up having a double sandwich an hour later. Wholegrain will stop your tummy rumbling thanks to their fibrous content and low-glycaemic index. So go for a bowl of pasta instead (Minutes the cheese!).

    The housework can wait

    Playing with the children sharing a candle –lit meal with your man or catching up with your friends is far more fulfilling than playing the desperate housewife. Learn to love luxury

    Backpacking was fun In your 20s when you could sleep in a noisy dormitory. But a five-star hotel with room service and wifi wins hands down these days.

    You may think of your ex but….

    Facebooking him will cause too much trouble. You’II either end up disappointed that the school hunk ended up fat and bald or he’II start stalking you.

    A Saturday night alone with your TV is not a tragedy

    Rather, it’s bliss. Life is so busy It’s a rare thing to enjoy your own company.

    A night out with girlfriends is more fun than a night in with your husband

    But it’s very comforting to stay in with him the following evening

    Learn what true love is

    Not chocolates and flowers but a man who’II run looking for the nearest 24-hour chemist at 3 Am when you’ve run out of diapers and the toddler has months.

    Blokes with salt and pepper hair begin to look attractive

    Think Kabir Bedi, Geroge Clooney and Brad Pitt!

    Dating a man with kids doesn’t you off

    Instead, it makes him endearing and sensitive.

    You finally understand the secret to financial success

    Spend less than you earn, sign up to competitive utility deals, pay off your credit card bills, start a pension and tuck a bit away for a rainy day.

    Don’t bothers being ‘39’

    A huge party for your 40th is one of those fabulous memorable moments in life, just like your wedding Think presents.

    Alarming rise in fibroids ---do all need removal?

    Fibroids of uterus occur in 30 to 35 per cent of women. In USA, every 12 seconds one woman undergoes the removal of the uterus die to fibroids causing problems; In India it is nearly every three seconds. Removal of fibroids in women desiring more today cone forward for examination as well as the availability of good sonography machines. Thirty five per cent of fibroids need to treatment.

    After one caesarean section, Shobha Desai (name changed), a 31-year-old, had six fibroids up to 11 cms in size and wished to save her uterus. After a few investigations, we told her that surgery will be done by Button Hole Laparoscopy. On surgery she had nine fibroids removed Laparoscopically, was discharged within two days happy that we didn’t mention the possibility of removing the uterus or open surgery. After three years she had 11 fibroids and we showed in a live relay workshop of Laparoscopic removal that no blood transduction was needed.

    As a scientific challenge, Shobha Desai again had 13 fibroids of four to eight cms in Size removed laparoscopically by us. Removing 33 fibroids of four to 12 cms in size by laparoscopic surgery from one patient was a milestone in the world fibroid registry. She was relived of excessive bleeding and pain.

    We have found in our research out of 2,540 cases with 7,500 fibroids removed endoscopically out of 20,000 Endoscopic surgeries done in last 17 years, some important facts:

    • A first degree blood relative has six times higher risk of fibroids.

    • Red meat eaters have three times higher chances than vegetarian or fish eating women.

    • 10 mm rise in diastolic blood pressure increases the chances of fibroids by almost 10per cent .

    • Among infertile patients 27-40 percent have difficulty in conceiving itself produces a hormone-Prolactin and high aromatase, which leads to local higher levels of Estradiol. On removal of fibroids endoscopically in a patient not conceiving for more than three to five years with no obvious cause, there is a 40 per cent rise in pregnancy as well as reduced abortions.

    • In patients who opt for test tube babies---IVF, ICSI, if fibroids of more than five cm are removed, pregnancy rates increase by 50 percent.

    • The average growth rate is one cm in two years. Fibroids do not turn to Leiomyosarcoma, that is a myth. Leiomyosarcoma is a different can cerous tumour falsely thought to be a fibroid.

    Uterine artery embolisation may be useful to reduce size of fibroids. The focused ultrasound Hifu for reducing the size of fibroids does not have any proven data and is totally experimental. A few new drugs especially aromatase inhibitors and antiprolactin medicines are promising to avoid surgery, but will be extensively used only after a few years.

    An Indian gynaecologist trained by senior gynaecologists can utilise all advanced techniques, made simple and affordable not only for Indian women but also women for m abroad.

    ALL THE WORLD LOVES A WOMAN ESPECIALLY FEMALE HEALTHCARE PRODUCT MAKEARS. THE DISTINCTIVE NATURE OF WOMEN’S AILMENTS AND LOW PATIENT AWARNESS, THOUGH, POSE A MARKETING CHALLENGE. ARE COMPANIES FACING UP TO IT?DINKAR GGEORGE PINS UP THE PROGRESS CHART.

    EVES seem to make an attractive market for many. And female healthcare segment are no different. But this isn’t an easy market to tackle. Reasons ? Low patient awareness and doctors reluctance to switch treatment methods. Success in this market thus hinges a lot on marketing.

    The sub-segments of the female health-care market include gynecology—which takes the largest market chunk---anemia, migraine osteoarthritis and Alzheimer’s disease. In a detailed study on women’s disease. In a detailed study on women’s health conducted by AC Nielsen ORG-Marg (CAN ZORG), female healthcare market is valuated at Rs. 2,033 crore, based on the proportion of prescriptions. And it’s grown 11% in ’02 compared to the overall market’s 8% growth, the figures show.

    Little wonder then that a number of companies have made a beeline for it over the past two years. Domestic companies like Sun. pharmaceuticals and Zydus cadila, for instance, have been particularly aggressive. CAN ORG though says MNCs still boast maximum reach among gynecologists, with Wyeth Lederle, German Remedies and Novartis India leading the pack.

    The segment’s main attraction is the products’ relatively low price sensitivity. This is more applicable in gynecology as it has relatively fewer” me too” products. This is because brand value and technology-intensive innovations create entry barriers. Marie Helen, head, marketing, Organon India (formerly Infar India), told MarKETing, an urban woman, who spends sumptuously on cosmetics, wouldn’t sumptuously on cosmetics, wouldn’t mind paying to care for her health.

    What though sets apart the gynecological segment is substantially lower market penetration. That’s because only 52% of Indian women’re involved in their health decisions, says ACN ORG. Companies have thus oriented their marketing strategies towards building awareness.

    Companies agree market development for female healthcare products is though. Few women have access to internet or even women’s magazines. Pharmaceutical companies in India are doing the needful: by taking up patient education programmes, conducted wither on their own or through various women’s societies and NGOs, Vivek Khanvilkar, Research Director, CAN ORG, told MarKETing.

    Though direct marketing has its place, doctors still play the most effective role in educating woman. Mr. Khanvilkar says companies resort to more diagnosis-related communication in their direct selling efforts to doctors. Marketing representatives use consumer feedback to define symptoms and describe this to doctors with the visual aids.

    The products’ technical nature makes training imperative for representatives. Many gynecological products involves innovative technologies. For instance, Organon’s product Recagon, used to treat infertility, is available even as pen device.

    Convincing doctors though is a tough task. Doctors seldom experiment with pregnancy products, which have an emotional association. This brings forward the importance of brand building. A source at Sun pharmaceuticals told MarKETing that the probability of a woman consulting the same gynecologist for life is high. And once a brand name is embedded in a doctors’ mind, it isn’t easily substituted. Sun Parma’s progesterone-based brand, Susten, for instance, has been consistently growing at 50% plus, says CAN ORG.

    Gynecology-related products apart, treatments of other ailments are also growing fast. A staggering 52% of Indian women’re anemic, says the study (although few seek treatment). Haematinics or iron supplements along with tonics and protein supplements form 32% of the market, it says. Among smaller segments, slimming preparations--- a Rs 11-crore segment---grew 49% last year. An interesting figure:67% of patients treated for obesity are women, the study says.

    Innovative products and huge market potential are expected to drive growth in this segment—many more products that have succeeded internationally are yet to be launched in India. The organ management says sub-segments like contraceptives could see high growth rates in the years to come. Once small sub—segments like gynecological pain management and sliming preparations show a sizeable growth, these viral influence the overall growth of the segment.

    Bloodless victory over fibroids

    FACTS ABOUT FIBROIDS

    They are tumours that grow in the uterus. Very few of them turn out to be cancerous.

    Small Fibroids usually do not show any symptoms. But as they grow, patient starts experiencing excess menstrual bleeding, abdominal pain, lump in the bladder and bowel movement.

    Reason behind fibroids are still being researched. It is widely believed that the estrogen hormone in menstruating women can increase its growth.

    Some are also believed to be genetically predisposed

    Post menopause, fibroids often shrink or disappear.

    FIGURES:

    Recent study by Dr. Prakash Trivedi, vice president, FOGSI, who conducted research for 16 years concluded that close to 25 million women in India suffer from fibroids,

    The study also found fibroids as one of the leading reasons for causing infertility among women.

    Women who consume red meat, those who are overweight and those suffering from hypertension were found to be more prone to fibroid.

    It majority affects women between the age-group of 30-40 years.

    BENEFITS:

    Alternative to surgery and hormonal treatment

    prompt routine to routine life

    preserves the uterus and cervix

    Decrease in menstrual bleeding

    Decrease in urinary dysfunction, pelvic pain.

    DISADVANTAGES:


    Abdominal pain, cramping nausea and fever

    Feeling of heat on the abdomen

    Ineffective for tumours beyond 10 cms.

    Patient might not get relief from Hifu in which case the patients might have to take laparoscopy.

    Newly pregnant Watch what you eat

    You are never lost for advice about what to eat when you become pregnant. Don’t panic and don’t get confused. Just eat healthy, says S Jeevapoorani

    Eat healthy to get the nutrients you and your unborn baby need. Your meals should include the five basic food groups. Each day you should get the following: 6-11 servings of vegetables, 2-4 servings of fruits, 4-6 servings meat and protein foods. Foods low in fat and high in fiber are important to a healthy diet.

    Calorie requirements of a pregnant woman are mostly increased in the later half of pregnancy. The increase in requirement of calories for every trimester is as follows, 1st trimesters 10 cals/day; , 2nd trimester-90 cals/ day; 3rd trimester—200 cals/ day.

    The fat that accumulates throughout pregnancy acts as an energy reserve when the supply of calories are inadequate the fat may be used to provide the high-energy needs of the rapidly growing fetus and to spare the proteins fro tissue growth.

    You may also want to take an omega 3-supplement. In addition to the many wonderful things omega-3 fatty acids have been shown to do, including improving the health of your heart, preventing cancer, reducing hypertension, and easing symptoms of lupus and other autoimmune disease, it can also do some wonderful things for your baby. Studies have shown that omega-3 fatty acids help improve brain and eye development in the foetus and baby. Plus, extra amounts of omega-3 can help you ward off depression.

    Foods to be avoided

    When you are pregnant, it is extremely important to avoid certain foods that you may have enjoyed that you may have enjoyed pre-pregnancy.

    This is because many foods either contain harmful bacteria or environmental pollutants that negatively affects your baby. Avoid:

    ? raw eggs

    ? Caesar dressing

    ? Egg nog (unpasterurized)

    ? Cookie batter

    ? Raw milk

    ? Soft cheeses

    ? Unpasteurised juice

    ? raw seafood, especially shellfish

    Some tips to help you in the Kitchen…

    ? Avoid dented cans or jars that leak or don’t ‘pop’ when you open them.

    ? Completely defrost foods, especially meats , prior to cooking ; thaw foods in the in the refrigerator or in a plastic bag submerged in cold water: never thaw foods at room temperature.

    ? Do not freeze anything that has been defrosted

    ? Reheat food only once, and then toss it.

    ? When food shopping, avoid fish, meat and eggs that are not well ref refrigerate or kept on ice

    ? Always wash your hands after preparing food and between foods.

    ? Avoid contaminating food with each other

    ? Wash raw vegetables thoroughly, as unwashed vegetables can harbor toxoplasmosis.

    ? Avoid exposure to toxic substances and chemical such as cleaning solvents, lead and mercury, some insecticides, and paint. Pregnant women should avoid exposure to paint fumes.

    ? Drink extra fluids (water is best throught pregnancy to help your body keep up with the increases in your blood volume. Drink at least 6 to 8 glasses of water, fruit juice, or milk each day. A good way to know you’re drinking enough fluid is when your urine looks like almost-clear water or is very light yellow.

    ? Avoid X-rays. If you must have dental work or diagnostic tests, tell your dentist or physician that you are pregnant so that extra care can be taken. Weight gain or loss

    ? Studies on weight gain prove conflict suggest that women who exercise an average of four or more hours s week were less likely to experience a successful in vitro fertilization compared with women who did not exercise.

    ? According to additional researcher provided by the n Albert Einstein college of medicine in New-York, women who are normal weight and lose their pregnancy weight before conceiving again are less likely to experience problems throughout pregnancy and delivery.

    Sleeping position

    The semi-fetal sleep position is known to reduce tossing and turning as well as decrease muscle cramping by improving blood circulation and promoting proper spinal alignment.

    Travel

    The safest time to travel during pregnancy is the second trimester (13 to 28 weeks). At this time you probably feel your best and you are in the lease danger of having a miscarriage or premature labour. Avoid traveling any long distance during the last 2 or 3 weeks before your due date.

    If labour starts early, you will want to do close to home. If you have any medical or obstetric complications, such as poorly controlled diabetes, placental problems, or pregnancy-in-duced high blood pressure, your provider may recommend that you not travel at any time during pregnancy.

    The heart of a woman

    Health while numbers are not readily available, the incidence of heart related diseases in women is definitely on the rise, writes Pankaja srinivasan

    Did you know that Coronory Heart Disease (CHD) loves women?Probably not. Try this for size-in the UK an dEurope, one woman dies every six minutes of heart disease. In the US, it is one every minute. Cardiovascular disease kills a higher percentage of women than men in many parts of the world, yet the strange thing is, it is still considered a disease of men!

    A discouraging trend

    In India, there have been no conclusive studies, but the picture is not much rosier. According to cardio-thoracic surgeon P. Chandrasekar of G.Kuppuswamy Naidu Memorial Hospital (GKNM), "Our observations have been that in the 1990s, out of approximately 20 by-pass surgeries performed, one has been on a woman. Today, it is one woman in siz', he says.

    One of the reasons he cites for this rising trouble in the woman's heart is the fact that Indian women do not exercise enough and are leading sedentary lives. Stands to reason, as compared to our grandmothers we don't squat, bend, pound, haul and so on.

    Now, we have gadgets to do all that, and activity is restricted to the press of a button, or a computer key. While we are eating better, we are certainly not working it all off.

    Watch out for menopause

    While it is by no means sacrosanct, the general belief is that till she hits menopause, a woman is safe from heart disease. That is true, says J. Bhuvaneswaran, Head of Department, Cardiology, PSG Institute of Medical Sciences and Research. "Women are less vulnerable than men.That is because of the oestrogen they produce. But, after menopause, they are as much, if not more, prone to heart disease," he says.

    However, that does not entirely rule out the pre-menopausal woman. If a woman is diabetic, the pre-menopausal protection does not work, he warns,"Out of 100 women with heart trouble, 20 would be premenopausal of which 10 are diabetic".

    What about the other 10 ?"They probably have high cholesterol, blood pressure or other unspecified reasons. Women who use oral contraceptives are also at risk of hypertension that could lead to a heart problem," says the doctor."And, hormone replacement therapy offers no protection." While annual papsmears and mammograms are recommended, what about regular tests for the woman's heart? Says Rajpal K. Abhaichand(interventional cardiologist, GKNM Hospital),"Women need not have any specific test till menopause unless they have a strong family history, lipid abonormality or diabetes. If they do have one or more of theses, then tests should be carried out every year, after they turn 40."

    And, what is these tests? The standard screening test for coronary disease is a Tread Mill Test (TMT). The doctors could also recommend an Echo Cardiogram, an E.C.G., an X-ray and a blood test to check for diabetes and cholesterol. Heart disease is not reversible, but it can be checked, says Dr. Chandrasekar. How?"Maintain your weight, exercise regularly, avoid smoking, if you have to take alcohol in moderation and keep a sharp look out for diabetes and cholesterol," he says.

    And he leaves us with a far from comforting bit of information-"If a man and a woman have both suffered a heart attack, chances are, he has a better chance of surviving the year,than she does!"

    Symptoms

    *Acidity-like discomfort

    * A vague pain and discomfort one can't quite put a finger to

    *Pain following any exertion, but one that disappears with rest

    *Severe, unexplained back ache

    *Nausea

    *Extreme Fatigue

    *A jaw/throat ache

    RISK FACTORS

    * A history of heart disease in the family

    *Hypertension

    *Diabetes

    *Chewing tobacco,smoking or excessive drinking

    *High Cholesterol

    *obesity

    YOGA FOR PREGNANCY

    Regular yoga, including asanas (postures), pranayama (breathing). bandhas and medication, can result in near painless delivery, says expert Rajni Maker. Needless to say, these should be practiced under guidance of a trained supervisor. Postures such as Baddhakonasana, strengthen the reproductive organs, pelvic and spinal muscles making them strong and flexible. Mudras and bandhas (nerou-musucallr locks) stimulate the body and positively affect reproductive organs.

    Bhramari Pranayam:

    Sit in Padamasana or Vajrasana. Close your ears with your forehead, place your index fingers on the forehead and shut your ears with the remaining three fingers. Inhale through the nose in slow deep breaths. Exhale through the nostrils and make a soft hum in the throat. Repeat nine times. Brahmari tunes the neuroendocrinal system to function in a harmonious and synchronized way.

    Baddhakonasana: Sit on the floor. Bend your knees and bring heels closer to the trunk. Make soles and heels of both feet meet. Clasp toes together with your hands and push the back of the heels near the perineum. Widen the thighs and lower the knees till they touch the floor, keeping the spine erect. Hold as long as you can. This will help reduce labour pain.

    Going under the knife?

    Zeenia F Baria talks to experts about cosmetic treatments for the arms and legs

    If you thought that breast enhancements and face lifts were the only cosmetic treatments that were in demand, think again. Today plastic surgeries for arms and legs have become increasingly popular. Consultant plastic and cosmetic surgeon, Dr Milind S Wagh says that with the dawn of the 21 st century, the demand for aesthetic and cosmetic surgery has grown immensely in urban and semi-urban India. “Today it isn’t just limited to the rich and famous but also embraced enthusiastically b y the rapidly burgeoning middle class. Therefore, the commonest procedures are the torso and the face. However, there is now an increasing demand for cosmetic procedures on the arms and legs. This is partly because many people have undergone primary modifications on the torso and are noticing other areas of their body, which now appear disproportionate with the body contouring already done. The commonly requested cosmetic surgery procedures are liposuction for reduction of excess fat accumulation in the arms and arm-lifts for tightening of flab by skin.”

    “The arms are one of the areas (thighs, tummy, hips, buttocks are others), which are resistant to fat loss even after exercise. Liposuction is an excellent procedure for reshaping the arms and removing excess fat in those patients who are relatively young (up to their mid-50s) because the presence of good skin elasticity. This is done through tiny incisions in the armpits and behind the elbow and is a one day procedure in most cases,” says Dr. Wagh.

    A large number of patients also undergo liposuction on the thighs for excess skin removal. Common procedures in the legs are calf reduction by liposuction and calf augmentation by implants to increase the bulk. According to Dr.Wagh, while most patients requesting calf liposuction to reshape calves are women, the converse is true for calf implants, which are requested mostly by men. “Calf liposuction is done through tiny incisions behind the knee and is very effective in reshaping the calves to a patient’s satisfaction. This procedure also requires just a day and one can usually go back to work the next day. A snug elasticated stockinette is to be worn for four to six weeks. Any swelling of the feet is fleeting and is related to the tight stockinette rather than the procedure. Calf augmentation is done using solid silicon gel calf implants, which are placed in a dissected pocket between the skin and the muscles through a small horizontal incision behind the knee. They increase the bulk of the calves and give them a more masculine athletic appearance. Present generation calf implants are quite safe and durable. After resting for three to five days, one can go back to their daily activities, he says.”

    Aesthetic and laser surgeon, Dr Lakshyajit Dhami says that after the face, the arms and legs are the next most exposed areas of the body.”Any woman who wants to look her best will want to have perfectly shaped arms and legs since they go a long way in enhancing a person’s personality. India women mostly wear sarees and the outfit requires sculpted and shaped arms. A simple surgical procedure of liposuction can give the perfect arm-size without any over-hanging skin or fatty bulge. More often than not it is the medial or inside arm, which needs to be worked upon.

    The results of this procedure are almost immediately evident but it may take anything from three weeks to three months for the total sculpting effect to be visible. Like any surgical treatment, the patient should be medically fit for the procedure. The additional benefit of early recovery can be derived with the use of early made pressure garments, which can be easily WORN UNDER ANY CLOTHING AND NOT A HINDRANCE TO DAILY ACTIVITIES. Patients who are unhappy with their hand skin, which gives away their age can opt for fractional laser resurfacing. This painless procedure requires five to six sittings and is done on an out-patient basis and takes about 15-20 minutes to carry out without any downtime. The patient can resume normal activities immediately. Fractional resurfacing is the latest modality for rejuvenating skin from any part of the body and helps in reducing facial scars, wrinkles and skin blemishes. It also works well for stretch marks on the stomach, arms , thighs and legs,” says Dr. Dhami.

    Patients who’ve under gone severe weight loss or post-bariatric surgery, might have sagging hip or thigh skin and may require thigh and buttocks lift. These are usually carried out together with Abdominoplasty procedures and provide remarkable body figure re-contouring. According to Dr Dhami,”A patient who may have flat buttock’s and desires augmentation can be operated upon for buttocks silicone implants. The scar is hidden between hip’s cleft. Leg veins, which in its sub group includes varicose veins, reticular veins or thread veins can also be easily tackled with the help of laser. “

    Weighty Issues Are you one of those struggling to put on weight? Here are some ways to achieve your goal While realms of space has been dedicated solely to how you can knock off those unwanted pounds and lose those inches, there are also several people that want to put on a little bit of weight, and have a tough time doing so. There’s no reason to take supplements or weight-a healthy diet and some positive attitude is all that you need. First of all you need to find out if you’re suffering from a medical condition that is not allowing you to gain weight. Once you get the all clear from that, gear up to improve your diet.

    • Since gaining weight is as tough as losing it, you need to be patient to get results. Make up a diet chart to ensure that you consume more calories than what you burn.

    • The idea isn’t to eat everything that comes your way, but to eat wisely. Consume healthy foods but frequently- say three small meals and three large ones. Make sure you keep a gap of at least three hours between each meal so you can digest them properly. Never keep a five hour gap between meals.

    • If you think that to gain weight, you need to forget exercising, think again. Resistance training exercises not only help you gain muscle mass, they will also increase your metabolism. Ask a fitness trainer to give you some weight gaining exercises. Don’t forget to protein rich foods after your workout.

    • Foods that have great sources of protein include fish, low fat dairy products, milk, meats, almonds, sesame and sunflower seeds.

    • Stay away from junk and fatty foods. Consult a dietician to know which high protein foods, high carbohydrate foods and healthy fats you can include in your diet. There is another misconception that beer helps you put on weight. Besides a beer belly you’ll gain nothing else. Don’t binge on it.

    • Start your day with a healthy breakfast comprising a glass of milk and a banana or a banana milkshake, whole-grain toast, a fruit and some nuts. Stick to eating more fruit than having juices. Stick to wholegrain bread, green leafy vegetables, paneer, a chicken or fish dish, rice and dal for lunch. Eat dinner comprising of the same things albeit two hours before you hit the sack.

    • Healthy snacks to eat in between meals include fruits, cheese or chicken sandwiches, a bowl of plain or flavoured dahi or salads. Avoid fast foods like burgers, doughnuts and fried things.

    Sex-for-babies may soon be history

    IVF TO Offer Higher Success Rate Than Natural Conception

    Couples may stop having sex to conceive babies within a decade and use in vitro fertilization instead, scientists say in a new report.

    Thirty-somethings could routinely conceive babies using IVF within the next ten years because it will have become better than sex as a means of reproduction, the scientists from Australia and Europe predicted.

    Advances in IVF technology mean it will be possible to produce embryos with a success rate of virtually 100% and cultivate them in computer-controlled storage facilities.

    The couples going for IVF have a much better chance of conceiving through IVF than young adults in peak condition, who have only a one-in-four chance a month of conceiving naturally, according to the report.

    Among those over 35, the chance of natural conception falls to less than one in 10. Though modern fertility techniques have meant the healthiest couples already have a 50:50 chance of success using IVF, the authors of the new report say that this may just be the beginning.

    Gabor Vajta, an Australian vet and lead author of the report, worked with experts from the European Society of Human Reproduction and Embryology and pointed out that test-tube embryo production in cattle was 100 times more efficient than natural means of calf creation.

    There is no reason, Vajta argues, why artificial human reproduction should not also become 100 times more efficient than the traditional process of “trying for a baby”.

    “We are not quite at that stage yet, but it’s where we’re heading. Natural human reproduction is at best a fairly inefficient process. Within the next five to 10 years, couples approaching 40 will access the IVF industry first when they want to have a baby,” the London Times quoted John Yovich, a co-author of the report, as saying.

    New Test Touted As Best Indicator Of A Woman’s Egg Reserves

    An easy way to keep a tab on your biological clock?

    Mumbai: It’s a number that women who want to have a baby should perhaps know: Her AMH score that can tell how far she can delay childbirth. In an age when late motherhood is more the norm than an exception, medical advances have brought forth a simple blood test that could indicate whether or not a woman should be worried about her ticking biological clock.

    Some doctors feel that the blood test to determine the Anti-Mullerian Hormone (AMH) levels could just be the best indicator of a woman’s egg reserves. “If a woman is over 32 and wants to postpone child bearing, she should get this test done,” says infertility specialist Dr Aniruddha Malpani.”If her score is low, she may want to re-think her priorities. If it’s normal, she can postpone childbearing but repeat the test every year,’ he adds. In other words, if her AMH level drops over consecutive years she should pay attention to her biological clock.

    Twenty-nine-year-old Kranti Shah (name changed) confesses she hasn’t heard about the AMH test. “But it sounds like an easy way to settle a worrisome issue,” she says. Ovarian reserve is a measure of a women’s fertility. While tests have been available in the past as well to indicate this, doctors say that the AMH levels are by far the most accurate (see box). “The AMH test is good. It has been available in India for a year now,’ says infertility expert Dr Hrishikesh Pai, who heads the Mumbai Obstetrics Gynaeocological Society. The test is also being marketed across the world as an indicator of fertility.

    He regularly recommends it to women who come to him for infertility treatment. “ It serves as an excellent marker to decide whether a woman should be given stronger stimulation for egg production or not,” he says, adding it is a good prognostic tool to indicate whether the infertility treatment will work or not.

    But can it be used as a screening tool for women who want to decide when to get pregnant? Dr Pai is not so sure. “It is the best test to indicate ovarian reserve, but it is not a 100% marker on fertility. I wouldn’t recommend it as a stand-alone test,” he says.

    Gynaeocologist Dr Durushah says she would recommend the AMH test tp wp,am om jer 30s who is concerned about delaying motherhood. “But I would ask her to do three other tests as wel. She should undergo two blood tests-FSH (follicle stimulate test) and E2 (estradiol or sex hormone levels)- and an ultra sound scan. Only then will she get the perfect picture about her fertility,” says Dr. Shah.

    But Dr. Malpani points out that the AMH test has another plus point.”It can be done any time of the month while the other tests have to be done on specific days of the woman’s monthly period,” he says.


    AUTO-MULLERIAN HORMONE TEST

    The Auto-Mullerian Hormon (AMH) test is a blood test that can be done any time of the month. It costs roughly around Rs.1,50o and is done only at a few laboratories

    PROS: The AMH test is used to evaluate fertility potential and ovarian response in women undergoing infertility treatment. Its USP is that women, especially in their ‘30s, can use it to monitor their biological clock.

    The Auto-Mullerian Hormone is directly produced by the ovarian follicles. Its levels thus correlate to the number of follicles-these are enclosures for developing the ova-present in the ovary. Tests have shown that women with lower AMH score have lower antral follicular counts and thus produce a lower number of oocytes compared with women with higher levels.

    Results: Healthy women, below 38 years old, with normal follicular status at Day 3 of the menstrual cycle, have AMH levels of 2.0 6.8 ng/ml (14.28 48.55 pmol/L) CAUTION: As this is a relatively new test, some doctors remain skeptical. They say that the AMH test should be done along with two other blood tests-the FSH value (follicle-stimulating hormone) and the Estradiol (a measure of the sex hormone or level of the major estrogen) as well as an ultrasound scan done on the third and sixth day of their menustral cycle respectively. Four years later, blue baby gets bright smile

    Four-year-old Jordan Gracias, who was born a blue baby, was operated on August 27 by a team of doctors who had come down to Asian Heart Hospital in Bandra Kurla Complex for a week-long paediatric cardiac camp. Hordan was suffering from Rastelli. “Rastelli is a condition in which the aorta is on the far side of the heart. It was quite a complex and rare surgery. Had we not operated upon him now, his life could have been in danger or the patient would have had limited capacity for physical activity,” said Dr Abdul Rashid, who operated on Jordan.

    Eulal Gracias, Jordan’s father who works in a factory and earns only Rs.3,000 per month, was relieved when he got to know that he would have to pay only 25% of the operation amount.”We have another tow-year-old daughter. It is not easy to run a family with the money we get. If we had to pay the whole amount, I don’t know what we might have done,” said Eulal.

    “For those who cannot afford it, our hospital gives special subsidies and they have to pay only a minimal amount. The rest is taken care of by the hospital,” added Dr.Rashid.

    Premature baby starts breathing on his own

    Mumbai : The condition of the city’s ‘miracle’ baby, who has been fighting the odds since he was born prematurely at 23 weeks, is stable.

    Christened Appu by the hospital nurses, the baby was taken off oxygen after he startedbreathing on his own on Friday afternoon. Doctors are optimistic that the child, born to Borivli couple and now admitted at the Holy Family Hospital in Bandra, will staret gaining weight in the next two-three weeks. The improvement in Appu’s condition has come as a relief to his father Amar Patil.

    The three weeks since Appu’s birth have been emotionally as well financially draining for the Patils.

    “Earlier, expenses were about Rs.7,000 a day, including the cost of ventilators and medicines. Now that our son has been taken off the ventilator and is stable, the cost has come down to about Rs.4,000 a day,” said Patil. “My colleagues and relatives have been helping us with the money all this while. My wife an dI have decided to mortgage or sell all our jeweler to sustain the treatment of our son,” he said.

    Experts in the city, however, feel that couples facing multifoetal pregnancies can be better prepared for premature deliveries, so as to increase survival chances of the baby and avoid last minute glitches. In this case, it took the Patils seven hours to locate a second ventilator for the child.

    Statistics by the American College of Obstetricians and Gynecologists suggest that 55% -57% of all multiple gestations are pre-term. Of this, 49% to 63% of the babies weigh less than 2.5 kg.

    According to gynaecologist Dr Priya Alvarez of the Bhaktivedanta Hospital in Mira Road, an ideal situation would be to in utero transfer the pregnant woman to an advanced hospital with neonatal facilities before delivery.

    “For preterm babies, a doctor has to ensure that the child has medical care at hand immediately after birth,” she said, adding that the non availability of life-saving equipment or expertise can cause brain haemorrhage, mental retardation or even handicap the child for life.

    Alvarez was involved in treating the Mira Road mother who set a record of sorts last year by delivering quintuplets all alive.

    Head of neonatology at Sion Hospital, Dr. Jayashree Mondkar, said that a woman with multifoetal pregnancy should exercise extra caution in the last three months. There are higher chances of miscarriage or even complications for the mother and they should be prepared for such eventualities, she said.

    Tests during pregnancy

    There are certain tests a pregnant woman must undergo to check for potential problems that might affect her and her baby.

    There are tests for pregnancy all the way from the pre-pregnancy stage. Each test aims to make the process of becoming a mother a healthy and problem-free process.

    PRE-PREGNANCY

    The woman is advised to undergo routine tests like haemoglobin, blood sugar, thyroid tests, blood group, rubella, thallassaemia profile, HIV, hepatitis B and hepatitis C tests and urine examination which give basic information about any medical or hormonal problems which should be rectified before pregnancy. Also a sonography will rule out common problems like fibroids, endometriosis etc which may need to be treated prior to pregnancy.

    ONCE PREGNANT

    It is important to do an early sonography to determine that the pregnancy is in the womb and not in the tube (ectopic pregnancy), which can be catastrophic. This is usually a transvaginal scan (an internal sonography), which gives a very accurate picture compared to a trans-abdominal scan.

    City docs remove 24 fibroids from woman’s uterus

    Mumbai: Using a method that was invented in the city, doctors recently removed 24 fibroids, totally weighing 2.9 kg, from the uterus of a Dockyard Road resident. Sangita Singh, 31, (name changed) - who ws able to walk home within 24 hours of the surgery, is hoping that she will conceive soon. She had suffered three miscarriages in her five years of marriage.

    “What is unique about this operation is that we found 24 big and small fibroids (non-cancerous tumours), many embedded on the wall of the uterus. We not only avoided the removal of the uterus but also reconstructed the uterus wall so that she will be able to carry through her pregnancy in the future,” said gynaecologist Dr. Uddhav Raj, who along with Dr. Piyush Goyal operated on Singh at Thakur Hospital in Dadar.

    The doctors, who used a minimally invasive method, also used a specially made ‘fibro extract’ device that was made in the city.”While the other blades usually get blunt after the removal of three fibroids, this blade made it possible for us to cut all the 24 fibroids,” he said. “I had a bad experience with the previous operation that was done using a conventional method. But now, I am feeling better and confident about having a baby,” Sangeeta said.

    Embryo adoption is latest trend

    Mumbai: When Patricia Bohanon, an American teacher, flies home to Colorado on Sunday, she will carry a precious made-in India baggage; an embryo. This embryo, which was born in a petri-dish out of anonymous contributions from an Indian sperm donor and an egg donor: was transferred to Bohanon, who will deliver the Indian baby as here own in the first week of December.

    Welcome to an assisted reproduction technique that is fast gaining popularity in a world where fewer children are available for donation, and adoption norms are getting more stringent. Not surprisingly, this method is called embryo adoption or embryo donation, depending on which side one looks at it from.

    Dr. Anjali Malpani, an infertility specialist who treated Bohanon, now performs about three to four embryo adoptions a month as opposed to the random annual procedure, which was the case until a few years back. Says Dr. Malpani, “with availability of better infertility treatment techniques, embryo adoption/donation is becoming popular of late across the world.” In the US alone where embryo adoption is about a decade old, over 1,000 babies have been born using this method.

    “Adopting an embryo allows a woman, who is infertile, to experience motherhood, complete with labour pains, as against rearing an adopted child,” says another infertility expert Dr. Indira Hinduja.

    Bohanon, a 51-year-old single mother of two 30-plus women, had literally yearned for a houseful of children.”But being a single mother without a fancy income, it was impossible to adopt.” The English teacher enrolled as a foster-mother, but could n’t find a young child she could adopt. When her work took her to Vietnam and China, she explored adoption norms in those countries as well.”Vietnam closed adoption for foreigners except those who are based there for a long period. China does n’t allow single mothers to adopt. Cambodia closed adoption after corruption charges were leveled,” says Bohanon.

    WEIGH YOUR OPTION BEFORE TAKING THE CUT

    … advise medical experts in the month of International Caesarean Awareness. Priya Sugathan explores the reason behind the alarm caused by the C-section trend.

    Who would have thought that the C-section was something that mothers-to-be needed to be worry of? Synonymous with the birthing process, it’s a given that bringing a child into the world entails going through a Caesarean, but that’s where we are told to stop and look around ….

    “There are options to bring forth a child into the world. An expectant mother does not have to agree to go through a C-section every time she’s told to do that. She should be able to make informed choices about her body. And this can happen only if she’s aware of her birthing options,’ explains Dr. Ameet, Dhurandar, gynaecologist and obstetrician, when asked about the sudden need for caesarean awareness. So much so, the International Caesarean Awarness Network has devoted the month of April precisely for the reason. It’s a move that’s been welcomed by the medical world in Mumbai, including gynaecologists, mid-wives and hypnobirthing practitioners.

    It’s been a major concern ever since a recent survey conducted in the US has found 1 in every 3 woman undergoing a C- section, crossing even the accepted optimal range of 5% to 10% set by the World Health Organisation (WHO). The sharp rise to 15% is considered critical raising a false perception that may be women over the years have changed physically when it comes to birthing.

    “It all boils down to convenience-for both the mother as well as the medical staff. It’s become the easiest way to avoid natural birthing. It could be that the staff, nowadays, is not adequately trained to carry out natural birthing, which is why they resort to abdominal surgery every time.

    Caesarean should be the last resort and only for certain emergency situations,” states Ruth Malik, hypnobirthing practitioner and child birth educator.

    Malik’s observation is seconded by Manisha Gogri, childbirth educator and lactation consultant. “Not every situation around birthing merits as emergency measure like C-section. It should not be treated frivolously. A lot of myths are being established because of it, and an aura and fear created where in C-section is seen as the only solution. This happens because the woman is not aware of her birthing options and does not ask the right questions as that could save a lot of damage being done to the body through C-section,” states Gogri.

    So, when is a C-section acceptable?”Only when the situation poses to be life-threatening to either the baby or the mother, or to both. This usually happens in cases when there’s bleeding due to a dislocated placenta, then there’s no point in using the wait and watch method as the baby has lost its lifeline. Or when there are changes in the heart rate of the foetus. It also works in the case of cephalopelvic disproportion (CPD) when the baby’s head is too large for a normal vaginal delivery to take place. This is a rare occurrence. Another instance that merits a C-section is a ‘Breach baby’ during which the baby is born buttock first, instead of the regular head first position. With more and more women giving multiple births, a C-section may become applicable in such cases,” cites Gogri.

    Clearly, the word is out that the C-section should be the last option, says the medical world.”Once child birth was a family event, now it’s become ‘medicalised’. Instead of encouraging and monitoring the natural birthing process, there’s interference from the medical world which at times resort to false measures like inducing a labour and other method robbing the sanctity and joy of a mother giving birth to her child.”

    Adds Gogri, “Instead of making the woman believe that the power is in her to deliver, they are being made to feel vulnerable about their own bodies. Women should realize that and celebrate the power they’ve been given to give birth!”

    With prevalent mood amongst the birthing practitioners in the city, they are planning to extend the caesarean awareness to the month of May, which will culminate in a mela on May 4 at Bandra.

    C-section can cause

    • Maternal death

    • Emergency hysterectomy

    • Blood clots and strokes

    • Injuries during surgery

    • Longer time inhospital

    • Infection

    • Depression

    • Less contact with baby initially

    Pvt hospitals waking up to paediatric cardiac care

    While Priyank (name changed) was undergoing a rigourous open heart operation a week ago, his parents who were waiting outside the operation theatre were more relaxed than they had ever been in the 10 days since his birth. The Thane residents were all set to go to Banglore for the operation when their local doctor directed them to Kokilaben Ambani Hospital in Andheri(W).

    The hospital, which is inaugurating its paediatric heart department on Sunday, has been quietly working with babies for a month now. It has operated on 39 children so far, 26 of them newborn.”Priyank is fine and will be discharged on Saturday,” said a doctor.

    The hospital will be the newest addition to a steadily growing number of private healthcare institutes with facilities for paediatric cardiac care in the city. Incidentally, public hospitals are yet to have separate wards for children with heart problems.

    Worldwide, health planners believe there should be one, if not two paediatric heart care facilities per five million people. Considering that Mumbai has a population of 13.4 million, the city clearly needs more such centres.

    “Generally, one would take light cases initially to test the efficiency of the equipment and the team. But we have been operating upon complex cases as soon as we started. It shows that Mumbai needs more such centres,” said Dr. Suresh Rao, head of paediatric and congential heart diseases unit at the Ambani Hospital. Doctors feel that even five paediatric heart care centres, working to their full capacity would be less for a city like Mumbai.

    Roughly, 10% of infant deaths in India are due to congenital heart disease. “A delay in diagnosing and performing surgery on these patients may turn many defects inoperable,” said Dr. Abdul Rashid, cardiologist from Asian Heart Institute.

    Until a month ago, parents of a child with a heart ailment had to rush to a Chennai or Bangalore. Mumbai, with its money-spinning adult heart-care programmes had shunned paediatric heart care.

    In fact until three months back, Wockhardt Hospital, Mulund, was the only one with an active programme for children. “We perform an average of 28 operations in a month. We are also the only hospital in Maharashtra to have the nitrade oxide system (high lung pressure) facility. But with so many cases, we always have our handsful,” said Dr.Suresh Joshi, head of cardiology in Wockhardt Hospital.

    That scene may be improving. While Asian Heart Institute will hold subsidized camps every alternate month with surgeries to be conducted by a British team, BSES Hospital in Andheri has a team from hyderabad to do operations once or twice a month.”Paediatric heart disease in a neglected field and we want to do our bit. We bear all the expenses of the UK team,” said Dr. Ramakanta Panda, vice-chairman and managing director, Asian Heart Institute.

    BSES Hospital performs an average of four paediatric heart surgeries per month. “More than 95% patients are from poor families. We put them on the waiting list. If they are lucky, they get donations in a month,” said Dr.K.S. Murthy from Innova Paediatric Cardiac Care in Hyderabad.

    Who is a ‘blue’baby

    A baby born with congenital heart defect, caused due to deoxygenation of blood lending a bluish colour to the skin, is called a blue baby. The colour is most noticeable around the lips and at the tips of the fingers and toes. In blue babies, the pulmonary artery is too narrow to allow sufficient blood to pass into the lungs for oxygenation.

    Long wait in Public hospitals

    Two months after an open-heart surgery in July, 20 –month-old Sakshi Walve was discharged from Wockhardt Hospital. Sakshi, a blue baby at birth, was twice scheduled to be operated at KEM Hospital, Parel before the actual operation. But late surgery and her complications have taken a toll. “She can move her eyes, take food orally, but is otherwise stiff,” said her father Ajit Walve. The load of adult heart diseases is so high in public hospitals that paediatric cases are given short shrift, say health activists, Sakshi being a case in point.

    Hope for Children HOSPITAL MIN COST MAX COST FOR NEEDY PATIENTS Asian Heart Rs. 50,000 Rs. 2.50 L Subsidies available Kokilaben Rs. 50,000 Rs. 2.50 L Subsidies and packages available Wockhardt Rs.55,000 Rs. 2.50 L Tie-ups with charitable trusts BSES Rs.55,000 Rs. 1.50L Directs patients to charities. Every expecting mom wants her baby to be born healthy. Her health during pregnancy plays a major part in this. Dr. Aniruddha Malpani, IVF specialist an dmedical director, Malpani infertility clinic and HELP- Health Education Library for People, Mumabi stresses on the importance of pre-conception care, “The best time to start taking care of your unborn baby is even before you conceive. All that is involved is visiting your doctor before you re planning to get pregnant. The doctor normally takes a medical history, carries out a physical examination and performs some simple, inexpensive laboratory tests. This allows the doctor, duly assisted by you to identify problems and rectify them.”

    Getting vaccinated at appropriate times is also important if you are planning a pregnancy. According to Dr Duru Shah, consultant obstetrician and gynaecologist at Jaslok, Breach Candy and Shri H N Hospitals, Mumbai, amoungst the vaccines, the tetanus toxoid vaccinated for rubella and chicken pox during adolescence, you should get them before planning a pregnancy. Hepatitis B vaccine helps prevent the virus from being transmitted from the mother to the baby.

    CONDITIONS THAT CAN CROP UP DURING PREGNANCY GESTATIONAL DIABETES

    Pregnant moms at times may develop gestational diabetes in the second trimester because of the body not producing enough insulin. The good news is that gestational diabetes can be managed by eating healthy foods regular exercise and sometimes medicines under doctor’s supervision. Your blood sugar levels will return to normal soon after delivery.

    GESTATIONAL HYPERTENSION

    Some women develop high blood pressure after 20 weeks of pregnancy. It is important for you to monitor your blood pressure to prevent and detect pre-eclampsia, a severe condition that needs medical attention. Your doctor may advice ultra sounds to keep an eye on the baby’s growth. Blood pressure should return to normal within a week after you have had the baby. GROUP B STREPTOCOCCUS (GBS)

    Having GBS bacteria in the intestines or lower genital tract is normal. However, a GBS screening test in the third trimester and antibiotic treatment during labour can help protect your baby because if you are infected with GBS, you could pass it on to your unborn baby. Most babies will be born healthy but a few who get infected can get critically ill. GBS can cause early birth, stillbirth, late miscarriage and other complications.

    GERMAN MEASLESRUBELLA

    Infections such as chicken pox or rubella can cause harm to the baby. It is therefore best to stay away from people having any infectious illness or infection to protect yourself and your child or get vaccinated before you plan a pregnancy.

    HEPATITIS B

    The infection can be passed on to the baby during labour or delivery. It is therefore necessary to get tested for hepatitis B while you are pregnant. If you are a health- care worker or you are in close contact with someone who has hepatitis B, you need to get vaccinated.

    SEXUALLY TRANSMITTED DISEASES (STDS)

    Pregnant women should be aware of the potential consequences of STDs because when contracted during pregnancy, they can be life threatening. Unfortunately, you may not know until you get infected, as there may not be any signs or symptoms. If in any doubt, get yourself tested for STDs to prevent further complications.

    GENETIC PROBLEMS

    If you are over the age of 35, your baby is at a higher risk of genetic problems. Your partner and you may have to undergo chromosomal testing and then take help of genetic counselor who can guide your further.

    Tips to Remain Healthy

    • Avoid people with infections

    • Avoid eating raw or undercooked meats, wash vegetables thoroughly, wear gloves while gardening or handling soil, to prevent getting infected with an organism called Toxoplasmagondii.

    • Quit smoking. Research has shown that pregnant women who smoke re more at a risk of miscarriage. Be wary of passive smoking.

    • Give up alcohol.

    • Some medications can harm your urborn child. Take medical advise if you have to take any medicines, even vitamins, minerals, iron, folic acid or calcium supplements.

    Long-term contraceptives preferred in state: Experts.

    Mumbai: The slump in the useage of condoms in Maharashtra as a preferred choice of contraception, feel experts, may be a partial depiction of the situation. While some say the simultaneous dip in the abortion figures may indicate increasing use of the morning after pill, experts feel it may be attributed more to the growing use of sophisticated contraceptives. Also doctors and health experts feel that there is still a huge divide in contraception preference between urban and rural areas.

    “While people are showing an increased preference for intra-uterine contraceptive devises (IUCDs) in the long term, emergency contraceptives do have their market, but have not replaced the normal contraceptives,” said an expert.

    And statistics can throw results which may not be entirely representative of the exact situation and are often only indicative, say some doctors. Secretary general of the Family Planning Association of India Vishwanath Koliwad said the government should also take into consideration the sales of condoms through commercial outlets. Not every one may buy them from a government hospital or centre, he said. But, differences between methods of contraception in rural areas and cities can make it difficult to generalize preferences.

    For instance, in Mumbai, demand for IUCDs, which provide protection for 10 years, has shot up mostly among the educated. But it is not the case in rural areas, said Koliwad, who are all for vasectomy or tubectomy. Gynaecologist Dr.C.Purandare said the acceptance of IUCDs is little more than 5% in India as opposed to 60% in countries like China. It is however, gradually picking up, he said.

    In Mumbai, the preference for oral pills has been going down. Head of gynaecology department of the JJ Hospital Dr.Rakha Davar could not agree more. Oral pills have side-effects and the idea of a healthy person taking a pill every day does not go down with many, she said. For couples who have already raised a family both IUCD and sterilization can be excellent methods, she said.

    Davar added that contraceptive usage trends can vary from time to time. Condoms, however, have their dual advantage of preventing pregnancy and protecting against sexually transmitted diseases, she said. “In our state couple protection rate is way above 60% and that is a fairly good achievement,” she said.

    About the city, authorities from the Mumbai District Aids Control Society (MDACS) say increased condom usage has indeed controlled HIV/Aids to a great extend. Condom usage figures have been about 300-400% more than desired and that way the city is doing fine, said Dr.S.S.Kudalkar, project director, MDACS. Koliwad however, feels to ensure better fertility, oral pills or IUCDs should be promoted.


    FAMILY PLANNING INDICATORS FOR MAHARASTRA
    Methods 2007 2008 2009

    Sterilisation

    (Vasectomy & Tubectomy)
    3,80,921 3,82,107 3,60,484
    IUCD 2,74,466 2,67,482 2,54,014
    ORAL PILL USERS 3,12,622 2,72,623 2,74,395
    CONDOM USERS 5,56,486 4,21,038 3,65,036

    MTP(MEDICAL TERMINATION OF PREGNANCY)

       76,206   67,879    71,021


    INDICATORS FOR MUMBAI

    Methods 2004-05 2005-06 2006-07 2007-08 2008-09
    vasctomy 798 4,522 351 1,076 4,661
    Tubectomy 24,377 22,421 19,596 15,417 15,549
    IUCD 50,055 48,153 46,756 44,803 43,955
    Oral pill users 18,058 17,315 17,535 17,199 16,102
    Condom users 61,748 52,777 64,545 63,938 66,006
    (BMC figures are indicative and have been collected from all public health centres in the city and state, and some private centres)

    Common Ailments In Pregnancy

    The value of antenatal supervision is so much tested and recognized that it is needless to stress its importance. It should be borne in mind that a successful obstetric outcome depends on continued careful supervision which starts in pregnancy and ends in puerperal period.

    The minor & Common ailments that occur in the pregnancy require utmost attention and should be affectively managed for a healthy pregnancy outcome.

    Common ailments are

    1. Vomiting and Nausea 2. Oedema 3. Backache 4. Constipation 5. Increased frequency of micturition/UTI 6. Breast tenderness 7. Varicose Venins 8. Leg Cramps 1. Nausea & Vomiting

    It is a symptom related to pregnancy or may be a manifestation of some medical /Surgical/Gynaecological complications.

    Classification: A. Related to pregnancy : Simple Vomiting (emesis gravidarum or morning sickness) Hyperemsis Gravidarum

    B. Associated with pregnancy.

    Medical Causes: Intestinal infestation, UTI, hepatitis, Ketoacidosis of diabetes

    Surgical Causes: Appendicitis, peptic ulcer, intestinal obstruction

    Gynaecological: twisted ovarian tumour, red degeneration of fibroid, acute fulminating pre-eclampsia.

    Simple Vomiting: (Morning Sickness/emesis Gravidarum)

    • Patient Complains of nausea and occasional vomiting on rising in the morning. Slight vomiting is so common in early pregnancy (about 50%) that is considered as a symptom of pregnancy but it may occur at other times of the day.

    • Vomitus is Small an dclear or bile stained,

    • It does not produce any impairment of health or restrict normal activities of women.

    • Disappears by 12 th -14 th week of pregnancy

    • Causes are increased HCG levels, Oestrogen & emotional factors.

    MANAGEMENT

    a) Assurance

    b) Avoid spicy & fatty foods

    c) Advice to move the limbs for a few minutes before getting out of bed or taking a dry toast or biscuit before rising from the bad.

    d) If the simple measures fail, antiemetic drugs with plenty of glucose drink.

    HYPEREMESIS GRAVIDARUM:

    • It is a severe type of vomiting which has got deleterious effect on health of mother or incapacitates her day to day activites.

    • It is due to excess HCG, Prgesterone excess, deficiency of vit B6, Vit B1 & proteins or psychogenic factors.

    MANAGEMENT:

    • Hospitalization

    • Oral feeds to be witheld for 24 hours

    • Investigation- Urine, serum electrolytes

    • Drugs like-Promethazine 25mg, stemetil 5 mg, metachlorpromide

    • Vitamin B1, B6, B12 & Vitamin C to be given

    2. OEDEMA

    • It is due to retention of fluids due to influence of ovarian, placental or steroidal hormones.

    • It is evidenced by marked gain in weight or evidences of pre-eclampsia should be excluded

    MANAGEMENT

    • Improvement of posture.

    • Rest in hard bed

    • Massaging the back musles, analgesics and rest relieve the pain due to muscle spasm

    3. CONSTIPATION

    • Decreased G.I motility during pregnancy is due to increased progesterone, diminished physical activity and pressure of gravid uterus on the pelvic colon.

    • Regular bowel movement may be facilitated by regulation of diet taking plenty of fluids, vegetables and milk.

    • Isabgol Power – 2 teaspoons at bed time to be taken with water/warm milk.

    • Milk laxative can be taken at bed time.

    4. INCREASED FREQUENCY OF URINATIONS/UTI:

    • Causes are due to enlarging uterus & engorged vessels at the base of the bladder.

    • Symptoms disappear after 12 weeks when uterus becomes straight

    • Late in pregnancy, pressure on bladder by the huge uterus & fetal presenting part decreases bladder capacity & urination is more frequent.

    • UTI may be due to progesterone induce dilatation of ureters giving rise to reflux uropathy

    MANAGEMENT:

    • Plenty of fluids

    • Sulpha drugs to be avoided in late pregnancy due to increased risk of neonatal hyperbilirubinemia.

    a) Ampicillin 500 mg QID. b) Nitrofurantion 100 mg QID c) Cephalexin 500 mg TID d) Amoxicillin- Clavulanic acid (375mg TDS) Course of 7-10 days. 5. BREAST TENDERNESS/MASTODYNIA:- May range from tingling to frank pain due to hormonal responses of mammary ducts & alveolar system. Management-Assurance. 6. VARICOSE VEINS

    May develop in legs or vulva due to pressure by enlarging uterus on venous return from legs.

    Management:

    • Elevation of legs.

    • Elastic crepe bandage.

    • Avoid long standing

    SPECIFIC THERAPY IS CONTRAINDICATED IN PREGNANCY

    7. LEG CRAMPS :

    • It may be due to deficiency of diffusible serum calcium or elevation of serum phosphorus.

    • Supplementary Calcium therapy in tablet or syrup after the principal meals may be effective.

    • Massaging the leg, application of local heat & Vitamin B 1 (30 mg) daily may be effective.

    It’s never too old to enjoy motherhood

    Embryo Adoption Offers Infertile Women A Chance To Experience Prgnancy, Say Docs

    Mumbai: For American citizen Patricia Bohanon (51), embryo adoption was the best way to experience motherhood. But the charges in Colarado were high- an embryo would work out to over $10,000 (Rs.4.64 lakh) with a similar amount for running infertility treatment cycles.”I went online and came across the Malpani Infertility Clinic,” says Bohanon, who landed in Colaba on January 26 for an embryo adoption costing less than Rs. 1.25 lakh.

    Says infertility specialist Dr.Anjali Malpani, “Technology in infertility treatment has allowed us to freeze embryos can be adopted years after they were made.

    There also are better techniques available to allow women, even those who have undergone menopause, to carry a child.”Within two weeks, we can ensure, with tablets and an injection every day, that the woman’s endometrium- the inner lining of the uterus- is thick enough to sustain a pregnancy,” says Dr.Malpani.

    Dr. Indira Hinduja, who is credited with India’s first test-tube baby born in KEM Hospital 20 years ago, cites an emotional reason contributing to this newfound popularity of embryo donation.”If you adopt an embryo, the whole world sees you pregnant. You don’t have to publicise that it was someone’s egg and sperm. The law says that you are the biological mother as you have delivered the child. Moreover, you get to feel the baby kick, you go through labour as well as breast-feeding.”

    When a couple comes up for infertility treatment, doctors treat her medically to harvest the maximum number of eggs. Says infertility specialist Dr. Hrishikesh Pai, “We create many embryos per couple on the presumption that a couple may need to undergo many cycles to get pregnant. Many get pregnant in the first attempt and instead of throwing their other embryos, they allow us to donate them.”

    Dr.Pai, who is the vice-president of the Indian Society for Assisted Reporduction, says it is this glut of embryos in infertility clinics that is adding to the popularity of the procedure. His clinic in Lilavati Hospital has nine cans of embryos stored in liquid nitrogen. But patients like Patricia are not complaining, though she realizes an Indian baby will be difficult to pass off as her own. “I may let my child know as soon as possible that he/she was adopted, albeit in a different way.’


    ADOPTION OF A DIFFERENT KIND

    Where Do You Get Embryos From

    During IVF cycles, young women often produce many eggs, and, therefore, embryos. The supernumerary embryos are stored in liquid nitrogen at minus 196 degree Celsius. If the parents get pregnant, they often agree to donate their embryos to infertile couples.

    What is Embryo Adoption?

    It is among the latest methods of family-building, which combines assisted reproductive technology with adoption. So, instead of adopting a baby, infertile couples can instead adopt an embryo

    Confidentiality

    Embryo donation is usually treated like a closed adoption. There is no contact between the donating couple and the recipients. The recipient couple is under no obligation to inform the obstetrician that the pregnancy has been achieved through embryo adoption

    Benefits

    Unlike in traditional adoption, there is no legal process. The couple “biologically adopts” the embryo. For infertile couples, embryo adoption offers the unique opportunity to experience pregnancy

    It’s Not Surrogacy

    In surrogacy, a woman carries the child for the infertile couple. In embryo adoption, the child that the couple carries is the child they will parent.

    ‘We can’t wait to hold our baby’

    Mumbai: Vinita Rathod (48) has been on bed-rest for the last three months, but her 50 year-old husband Sanjay has never been happier. After all, Vinita is eight months pregnant.”We have been married for 30 years and been through two miscarriages and two ectopic pregnancies. We are ecstatic at the thought that within next eight weeks, we will be able to hold our first child,” says Rathod.

    Genetically speaking, the child will not have a single characteristic of either Vinita or Sanjay. The child is the result of an embryo the couple ‘adopted’ at the Malpani clinic in Colaba. “It is enough that the child will be born to Vinita and will imbibe our values,” says Sanjay.

    His family is not aware about the embryo donation. “One of my neighbours had a child through infertility treatment last year. She egged us on to try out one more time,” he says. It wan’t an easy decision though.

    The couple has been through several heartbreaks with regards to a child. Vini ta had an ectopic pregnancy early in the marriage that damaged her fallopian tube. They tried infertility treatment with a couple of doctors in the last nineties, but the pregnancies could never be sustained. “But we never really gave up on wanting a child. So, in 2007, we returned to Dr. Anjali Malpani to find out if there was any way to have a child despite our advanced ages. “

    That is when Dr. Malpani informed them about embryo donation. Didn’t he ever consider ordinary adoption?”Not really. We were So busy with the four pregnancies and treatment that there was no time to take up adoption.” Moreover, as Dr Malpani points out, the law doesn’t allow adoption of young children for those beyond 45 years of age.

    Embryo adoption is the best option for a couple like the Rathods because of the age factor.”Their embryo has come from a couple who is younger than 30 years. So it will be healthier,” says Dr. Malpani.

    And a healthy baby is what Vinita and Sanjay are praying for:

    Foods to avoid during pregnancy

    Many popular foods are potentially dangerous during pregnancy. Women who are expecting should refra in form the following. • Raw fish and shellfish, a possible source of the parasite Toxoplasma that can cause fetal blindness and brain damage.

    • Large predatory fish like swordfish, shark, king mackerel and albacore tuna (fresh or canned), which can contain risky levels of mercury. The food and Drug Administration of America says to limit albacore tuna to six ounces a week, but it is acceptable to eat up to 12 ounces a week of chunk light tuna, shrimp, salmon, Pollock and catfish.

    • Undercooked or raw meat, poultry and sea food. Use a meat thermometer and cook pork and ground beef to 160 degree; beef, veal and lamb to 145 degrees; whole poultry to 180 degrees; and chicken breasts to 170 degrees.

    • Unpasteurised milk and soft cheeses- feta, Brie, Camembert, Roquefort, queso blanco, queso fresco and Panela, unless the label says “made with pasteurized milk”. They may contain the food poisoning bacteria Listeria that can cause miscarriage, premature birth, stillbirth or fatal newborn illness.

    • Hot dogs and deli meats, unless cooked until steaming hot. These can become contaminated with Listeria after processing.

    • Refrigerated pates, meat spreads and smoked seafood (unless it is cooked before you eat it.) Canned versions are safe

    • Soft-scrambled eggs and foods like homemade salad dressing and eggnog made with raw or lightly cooked eggs. Cook eggs until the white and yolk are firm to avoid salmonella poisoning.

    • Raw sprouts, including alfalfa, clover, radish and mung bean .

    • Herbal teas and in pregnancy is unstudied. Some, like black cohosh or large amounts of chamomile tea, can raise the risk of miscarriage or premature birth.

    • Alcohol, which can cause fetal damage, including mental retardation and abnormal behavior. Although an occasional drink may be all right, no safe amount has been established.

    Docs give foetus a fighting chance

    From Diagnosis To Surgical Interventions, Foetal Medicine Has Come A Long Way

    When they look at their two-year-old daughter Avika playing with other children, Prashant and Harshita can’t help but thank god. Doctors had asked pregnancy in the eighteenth week because the foetus had a large tumour in one of her lungs.

    “The radiologist said the scan indicated a problem, that the baby might not survive. Doctors suggested an abortion,” said Prashant, who had consulted several doctors. Each had the same thing to say, except for Anita Kaul, senior consultant, foetal medicine at Indraprastha Apollo.”She was the only one who ruled out any serious complication, giving us the confidence to go ahead,” said Prashant. The tumour in Avika’s lung dissolved on its own soon after birth and now she doesn’t have any medical complications.

    Like Prashant and Harshita, many couples have been advised to terminate pregnancies because a scan indicated an abnormality. “With technological advances, we can now treat these cases in the womb,” said Anita Kaul. But foetal medicine experts said there is a lack of awareness about this branch of super-specialty medicine among the people and even doctors.

    Foetal medicine can be divided into two main branches: diagnostic and therapy. A detailed foetal scan will pick up structural and chromosomal anomalies, which would otherwise have been missed. “Regular scans often miss heart defects. We screen a foetus from head to toe. We can pick up Down’s syndrome; certain types of mental retardation after studying family history; thalassaemia major; genetic disorders etc,’ said Vandana Chaddha, consultant, centre for foetal and genetic medicine, Moolchand Medcity.

    Till a decade ago, the focus of foetal medicine experts was diagnosis. But now, experts are able to perform complicated surgical interventions to save a foetus.

    Deepika Deka, a gynaecologist at AIIMS, who started the foetal medicine unit in 1986, has performed close to 600 blood transfusions on fetuses.”If the mother is Rh-negative, her immune system treats Rh-positive foetal cells as foreign substances and makes antibodies against the foetal blood cells, lowering haemoglobin. Then we need to give O negative blood to the foetus through a transfusion,” said Dr. Deka.

    Doctors also play a crucial role in managing twins in the womb.”It is often seen that one twin gets more blood supply due to which the other is not able to grow. The twin that gets more blood supply has more amniotic fluid around it. So we balance out the amniotic fluid to up chances of survival of the other baby,” said Chaddha. In some cases, one twin bleeds into the other. “Then, we need to cauterize the umbilical cord of the abnormal twin. Using foetoscopy, we enter the uterus from the abdomen and cauterize the umbilical cord,” said Deka.


    Experts said women should come in for a scan in the early stages of their pregnancy.”We can pick up a foetal abnormality as early as the eleventh week,” said Dr.Deka. Dr.Kaul agreed, saying,”Any foetal intervention can start labour pain, so we need to be very careful. If a patient comes to us in the eighteenth week, we have little time to observe the foetus post surgical-intervention. We can’t abort a foetus after the twentieth week.”

    BABY CARE BEFORE BIRTH

    WHAT IS FOETAL MEDICINE

    A branch of medicine that involves assessment of foetal growth & its health. Foetal medicine consists of prenatal diagnosis & foetal treatment.

    CONDITIONS THAT CAN BE DETECTED

    *Structural deformity

    *Down’s syndrome

    *Rh incompatibility (different blood groups of mother and foetus)

    *Certain types of mental retardation

    *Heart defects

    *Thalassaemia major

    AVAILABLE TREATMENT

    *If the mother is Rh-negative, her immune system treats Rh-positive foetal cells like a foreign substance. To treat the condition, doctors need to give the foetus O negative blood via a transfusion.

    *If one twin is growing abnormally, doctors can cauterize the umbilical cord of the foetus

    *If one twin is getting more blood supply and has excess amniotic fluid around it, doctors can aspirate the fluid through surgical intervention

    *In case of excess fluid collection doctors can use a shunt

    *If there is cystic formation in the lungs of the foetus, needles can be used to drain out fluid

    SCREENING TESTS

    *Maternal blood tests for specific conditions

    *3D ultra sound

    *Doppler ultrasound

    *Cardiotocography, echocardiography of the foetus

    *Magnetic resonance imaging

    *Amniocentesis

    *Chorion villus sampling

    *umbilical cord sampling

    Time limit for foetal intervention 10-20 weeks

    Delhi hospitals which offer foetal medicine

    *AIIMS

    *Indraprastha Apollo

    *Moolchand Medcity

    Nutrition Nuance

    It’s a well know fact that an appropriate diet is quintessential for maintaining the health of a child. Consultant pediatrician and neonatologist Vipul Mehrotra provides some easy-to-follow nutrition tips for ensuring your child’s well being.

    India is a land of many contradictions-among them the dact that many children here either fall into the malnourished or overweight category. This indicates a resounding lack of suitable nutrition for them. The mindboggling array of junk foods has certainly been a contributing factor. After all,it’s hard to find a child who would rather munch on carrot sticks over one of the numerous munchies lining store shelves. Nevertheless, ensuring a healthy diet for your child is no rocket science. Here are some handy tips on getting your tot to eat right.

    Variety is the spice of life:

    Treat your child to different foods to discover his likes and dislikes. Variety can also be introduced by serving the food in different bowls or plates.

    No force-feeding:

    Let the child decide how much he wants to eat. Don’t make it a cumbersome routine.

    Handheld food:

    Children should be given food that they can comfortably manage oshence, he should be given foods that are rich in calories. For instance a bowl of rice contains 150 calories, by adding some butter or ghee one can increase the calorie count to 200-250.

    Home-made food:

    It’s important for the child to get used to the kind of food cooked at home. As such, they should be given foods like rice, daal an dchapatti that are cooked at home. The food can be mashed to suit the child.

    Number of meals:

    It is recommended for children to be given four meals during the course of the day.

    Avoidale food:

    Food that contains a high amount of preservatives, artificial colouring or that is cooked in repeatedly used oil should be avoided. Theories have suggested that such foods make children hyperactive and lead to poor concentration.

    Spray helps men last six times longer

    Washington: A new spray could help men last 5.5 times long during lovemaking, scientist said. People suffering from premature ejaculation (PE), treated with PSD502, a metered dose spray five minutes before sex, could last almost six times longer than those who used a placebo spray.

    The finding is based on an evaluation of a combined total of 556 (randomized) and 536 (treated) men with primary PR in the US, Canada and Europe over a three-month period, with more than 23,000 recorded exposures to PSD 502.

    Currently there no prescription therapies approved by regulators, but a US company thinks it has found an answer to make men perform better. The desensitizing drug PSD502 combines two marketed drugs-lidocaine and prilocaine-and is applied via a spray.

    “Combined results from the PSD 502 pivotal studies are very exciting and this is a significant milestone,” said Ira Sharlip, clinical trial investigator and professor of urology at the University of California, San Francisco. The exact incidence of PE is not known, as a widely accepted definition of PE has only recently become available.

    The breakthrough should help the 30% of men aged 18 to 59 who sometimes complain of premature ejaculation.

    Male sexual dysfunction is characterized by ejaculation which always or nearly always occurs within one minute of vaginal penetration; and inability to delay ejaculation on all or nearly all vaginal penetrations. The embarrassing condition can lead to serious relationship problems, which some sufferers choosing to avoid sexual intimacy altogether.

    Stork Visiting?

    Zeenia F Baria gets experts to reveal the tests during pregnancy that are a must

    While a pregnancy may be planned or sudden, you have to prepare yourself not only for the numerous changes that will occur in your body but also find out about all the tests you need to take to ensure a smooth and uneventful pregnancy.

    Gynaecologist Dr.Rishma Dhillon Pai says that while pregnancy can be a beautiful experience a woman goes through, her changing body and the baby she is nurturing, need to be cared for and checked for problems.

    “Right from the pre-pregnancy state, pre-existing problems need to be looked for and solved. Pre-pregnancy state, pre-existing problems need to be looked for and solved. Pre-pregnancy, a woman is advised to undergo routine tests like haemoglobin, blood sugar, thyroid tests, blood group, rubella, thallasemia profile, HIV, hepatitis B and hepatitis C tests and urine examination, which give basic information about any medical or hormonal problems that can be rectified before a pregnancy. A sonography will rule out problems like fibroids or endometriosis that may be needed to be treated prior to the pregnancy,” she says.

    Once pregnant, remember to get an early sonography done so as to determine the pregnancy is in the womb and not in the tube (ectopic pregnancy). “This is usually a transvaginal scan (an internal sonography), which gives an accurate picture compared to a transabdominal scan. Between 11 and 12 weeks of pregnancy, most doctors recommend a sonography to check the baby especially for nuchal translucency. This is a screening test for Down’s Syndrome,” says Dr.Pai.

    A first trimester serum screening – a blood test, which includes checking for PAPP. A and Beta HCG is also recommended at this stage. This determines the risk that the baby has for Down’s syndrome and Edwards’s syndrome as well as neural tube defects. “These are serious genetic and developmental defects in the baby and if suspected, a conclusive diagnosis can be made by doing a chorion villus biopsy where a small biopsy from the placentais taken and analysed for genetic problems. As a pregnancy advances, a detailed anomaly scan, which nowadays is often a three or four dimensional sonography, should be done at 18 weeks. This picks up abnormalities in the baby,” she says.

    As a pregnancy progresses, it is important to keep a watch on the haemoglobin, blood sugars and urine. Also, later in pregnancy a sonography with a colour Doppler is often recommended. In this the baby is studied in detail and the colour Doppler analyses the blood flow to the uterus and to the baby. If the blood going to the baby reduces or stops, it is a sign of fetal distress or leads to IUGR (Intra Uterine Growth Retardation) where there may be a need to deliver the baby urgently, probably by caesarean section. The Doppler can also pick up if the umbilical cord is wound around the baby’s neck. This may be dangerous if there are multiple tight loops of cord as the baby can get strangulated.

    Non stress test (NST) is another useful test in later pregnancy. This is a simple, non invasive test in which a transducer is placed on the mothers abdomen and an ECG type tracing of the baby’s heart beat is made. This can indicate if the baby is healthy or having distress, as it picks up the changes in baby’s heart beat with movements.

    Gynaecologist Dr.Nandita Palshetkar says that the Triple Test is a maternal blood screening test that looks for three specific substances and is performed between the 15 th and 20 th week of pregnancy although results obtained in the 16th-18th week are said to be the most accurate. The test is done to assess probabilities of potential genetic disorders and neural tube defects.

    “While all pregnant women should undergo this test, it is highly recommended for women who have a family history of birth defects, are over 35 years or older, have used harmful medications or drugs during pregnancy, have diabetes and use insulin, had a viral infection during pregnancy or have been exposed to high levels of radiation,” says Dr. Palshetkar.

    Dr.Nilesh Shah says,”An important imaging modality used during pregnancy is the Ultrasound, which works on a principle of sound waves and is extremely safe without side effects. It is the best modality for dating the duration of a pregnancy and is extremely accurate during the early stages of pregnancy. This is of great importance since if in later stages there is a lack of foetal growth, the baseline ultrasound accurate dating becomes an extremely important tool to evaluate growth retardation.”

    Simple blood test to predict menopause age

    Procedure To Help Career Women Plan Kids Before They Cease To Be Fertile.

    Doctors have devised a test that could tell young women the precise age at which they will no longer be able to have babies.

    A blood test that measures levels of a hormone produced by the ovaries could allow women as young as 20 to pinpoint within a few months when they will cease to be fertile. The procedure would be valuable to women trying to balance careers with having children. Among western women, menopause occurs on average at 51. However, about 14% of women experience it early, under the age of 45. And in Britain about 110,000 women in their thirties are going through premature menopause at any given time.

    Fahimeh Ramezani Tehrani, who led the research, said in a scientific abstract: “Our results suggest that the novel marker anti-Mullerian hormone(AMH) (produced by the ovaries) could precisely forecast the age at menopause, even in young women.”

    Tehrani analysed levels of anti-Mullerian hormone in 266 woemen aged 20-49. The hormone controls the development of the cells in the ovaries from which eggs develop. It was known that levels of the hormone vary between women and also decline with age. Scientists have suspected that changing levels are linked to the menopause but there has been insufficient data to use this knowledge as a predictive tool. By gathering data from a large number of women, Tehrani believes she has created a mathematical model that can predict the age of menopause for any woman.

    The test developed by Tehrani, a senior researcher at the Endocrine Research Centre in Tehran, which is backed by the World Health Organisation, would need to be validated in large-scale trials before it could come into common use.

    Women freezing eggs to wait for ‘Mr. Right’.

    Technique Gives Future Relationships Time To Bloom.

    London: An increasing number of women in their 30s and 40s are freezing their eggs while they continue their search for their,”Mr.Right”, say British doctors.

    “They come in their 30s or late 30s if they haven’t found the right partner,” Daily Mail quoted Srilatha Gorthi, a senior research fellow at Leeds Centre for Reproductive Medicine, as saying. The technique is now as popular with healthy women as with cancer patients and those women at risk of premature menopause.

    Simon Fishel, managing director of the 11-clinic chain, said: “women are coming in their late 30s because they are starting to feel that nothing is happening. They have fallen out of a relationship, they haven’t got a man.” The trend was brought to light by a study of women who had applied to have their eggs frozen at a Belgian clinic between July 2009-May 2010.

    Highly-educated and financially secured, these women were in their late 30s and early 40s, and had considered adoption or single motherhood before plumping to spend hundreds of pounds of IVF and egg vitrification or freezing.

    They told their doctors that they wanted to “take the pressure of the search for the right partner” and “give a future relationship more time” before bringing up the subject of kids.

    “By vitrifying their oocytes (eggs) they wanted to buy time to find the right partner and do everything they could to prevent age-related infertility. Moreover, frozen oocytes were considered as very precious goods, since even if they would meet Mr. Right in the near future, they would only use the frozen oocytes in the last instance, after trying to conceive naturally,” said Julie Nekkebroeck, from the Centre for Reproductive Medicine at the Free University of Brussels, who headed the study.

    However, other warn that egg freezing does not guarantee mother hood and pointed out that by the time a woman reaches her late 30s, the quality of her eggs deteriorate.

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