Medical Conditions

In India, cervical cancer is the commonest cancer to affect women. What are the common causes of Cervical Cancer? There are various factors that increase the risk of cervical cancer; such as malnutrition, low socio-economic status, multiple sexual partners, smoking, etc. Human papilloma virus infection is also an important cause of cervical cancer there are many types of HPV. They are classified as High risk and low risk. High-risk types cause genital cancer and the low-risk types cause genital warts. HPV can spread due to skin-to-skin contact. It does not require penetrative intercourse. One can acquire the virus at any time and then it may persist in the cells for a long time. It will then induce changes in the cells that over a long period of time lead to precancerous and then cancerous changes. What is the available vaccine to prevent cervical cancer? HPV infection may not produce any symptoms. Taking vaccination against HPV can prevent cervical cancer. The vaccines contain some strains of the virus in the antigen form. These then help one to develop antibodies to the viral antigen. All women can take the vaccine. It is particularly meant for young girls who have started sexual activity. […]

It is with great pleasure that I inform all my followers that I have now attained the title of The ‘FRCOG’ After 12 years of MRCOG, the Royal College of Obstetricians and Gynaecologists in the UK does an assessment of your performance and then confers on you the title of FRCOG. i.e. fellow of the royal college. The convocation was held at Royal College in London on the 23rd of September 2011. Here I want to thank my parents for always being there for me, encouraging me and supporting me all the way through. None of this would be possible without their support. I also thank all my family members, friends, well-wishers and patients who have supported me always.

Diagnostic x-ray is a frequent source of patient anxiety in pregnancy. It is important to note that: 1. No single diagnostic x-ray procedure is enough to threaten the well being of the embryo or fetus. 2. Risk of fetal anomalies, growth restriction spontaneous abortion are not increased at exposure level of <5 rads. 3. MRI and ultrasound are safe in all stages of pregnancy. 4. Radio opaque and paramagnetic contrast agents are unlikely to cause harm; but should be used only when the benefit justifies the potential risk to the fetus. 5. Use of radio-active isotopes of iodine is contraindicated in pregnancy.

During pregnancy, it is a pregnant women’s ultimate joy to feel the baby’s movement. It further increases the bonding with the baby. Fetal movements are perceived by the women as a sensation of discrete kick, flutter, swish or roll. When will I feel the baby movement? Movements are first perceived by the mother between 18 and 20 weeks of gestation. Women in their first pregnancy may perceive movement much later than 20 weeks of pregnancy, but women who have been pregnant before may perceive fetal movements as early as 16 weeks pregnancy in the subsequent pregnancies. Fetal movements provide an indication of the integrity of the central nervous and musculoskeletal systems. The normal fetus is active and capable of physical movement, and goes through periods of both rest and sleep. The number of spontaneous movements tends to increase until the 32nd week of pregnancy. From this stage of gestation, the frequency of fetal movements plateaus until the onset of labor; however, the type of fetal movement may change as pregnancy advances in the third trimester. There is no reduction in the frequency of fetal movements in the late third trimester. How much fetal movement is normal? By term, the average […]

Most of us have certain notions and beliefs that may or may not be right. Pregnancy is one such issue where myths are common, and vary from region to region and culture to culture. Here are half a dozen pregnancy myths around the world. These are the common ‘old wives’ tales’ that are the subject of discussions in kitty parties. Let me discuss some of them here. Myth: One should not eat papaya in pregnancy. Fact: You can consume papaya. Hundreds of years ago papaya seeds were consumed to bring about termination. Ripe papaya is good for you and the baby. Myth: When you are pregnant you need to eat for two. Fact: Please don’t. Remember you will have to work double to lose that weight. It is important to just eat well balanced, healthy small frequent meals. Myth: If you crave salty foods, then you have a baby boy. Fact: Cravings in pregnancy have nothing to do with the sex of the child. There is no scientific explanation for the cravings and they probably are just secondary to the hormonal changes in the body. Myth: It is best to avoid sex during pregnancy. Fact: It is alright to have […]

Periods are a normal physiological function of the female body but there are many myths and taboos surrounding it, especially in India. These affect the social-cultural lives of the women and also the health -physical and mental. Here are a few period facts and myths. Scientifically we know that the woman makes one egg per month and the uterus makes a lining. This lining will facilitate the growth of the fetus in case the egg meets with sperm and fertilizes. When fertilization does not happen then the egg and the lining are shed off. This shedding of the lining is menstruation or the periods. But periods are considered dirty and impure. Period Facts and Myths: Myth: Women cannot enter the puja or the kitchen as she is impure. Fact: Well, this sounds like a joke. There is nothing impure. It is for this reason that many women approach a doctor to take tablets to prepone or postpone their periods during big pujas and festivals. This ideally should be avoided. Myth: Women in periods should not touch sour foods like pickles. Fact: The belief is that the body emits some smell which will turn the food bad and unedible. Till to […]

Pregnancy Vaccinations will enable the mother to develop immunity. The antibodies can pass from the mother to the baby and thereby give protection to the baby. Flu Vaccine During Pregnancy All pregnant women who are going to be pregnant in the flu season should take the influenza vaccine, irrespective of the weeks of pregnancy. Only the inactivated vaccine should be taken, live attenuated vaccine is contraindicated in pregnancy. TDAP Vaccine It is recommended to give one dose of Tdap vaccine to pregnant patients between 27 and 36 weeks irrespective of their previous vaccination status although it can be given anytime in pregnancy. If it has not been given in pregnancy, then it should be given immediately after delivery. Pregnant women who never have been vaccinated against tetanus should receive three vaccinations containing tetanus and reduced diphtheria toxoids. The recommended schedule is 0, 4 weeks and 6 through 12 months. Tdap should replace 1 dose of Td, preferably between 27 and 36 weeks gestation. Hepatitis B Pregnant women who are negative for the virus and who may be at high risk of getting infected should receive the vaccine. Ideally, all women should receive this vaccine prior to getting pregnant. Women, who […]

Obesity is increasingly common and has an impact on a wide range of issues in pregnancy. Overweight women and pregnancy is an important concern. Here is how it can be managed well during your entire pregnancy: In 1st trimester Nutritional counselling and tailor-made diet plans are important as they need quality nutrition and at the same time should not put on too much weight.They need to be screened for Glucose Intolerance / Diabetes.The baseline BP should be recorded with the correct size of the cuff.The prenatal test has lesser accuracy in obese/overweight women.The Invasive procedures (amniocentesis and CVS) are difficult to perform in obese/overweight women. The risk of pregnancy loss after these procedures is higher in women with BMI > 40. In 2nd trimester The ultrasound is done for assessing the anatomy. This is challenging as it is difficult to see fetus due to abdominal fat and therefore some abnormalities may be missed.Obese women have a higher risk of preeclampsia and diabetes. Therefore, regular assessment of the mother and baby is required. In 3rd Trimester The labor may be difficult and prolonged as the fetus may be overweight too.There are increased chances of requiring instrumental delivery (vacuum or forceps) and […]

Valentine’s day is just around the corner and I thought I can share a few tips to help you be better prepared for valentine’s day!!! Let’s call them Valentine’s Day safety tips.Roses are red,Violets are blue,Be healthy and safe,In all that you do!“Valentine’s day brings about indulgence in wine, dark chocolate and intimacy for some. Let’s talk about the favorites day favorites. Alcohol There is scientific evidence to suggest that small amounts of alcohol consumption can have benefits on heart health and can reduce the risk of heart disease. It is important to note that in all studies, the beneficial effect of wine was based on small consumption. Large quantities will have adverse effects. Of course, I am not saying that you can start drinking small amounts of alcohol to improve your heart health. Chocolate Everyone loves chocolates. But have the dark ones preferably. Dark chocolate has a higher percentage of cocoa (70%) and that contains Flavonoids which are natural antioxidants. Flavonoids in cocoa have been shown to help lower blood pressure, improve blood flow to the brain and heart, prevent blood clots, and therefore have benefits on the heart. Intimacy Intimacy is natural with that someone special. But It […]

Age has an important impact on women’s fertility. This relationship between fertility and age is called a biological clock. The fertility increases after menarche and peaks by mid-20. It then gradually falls with a sharp decrease after 35. At menopause, the fertility totally stops. At the age of 30 years, 70% of women will have a baby within one year of trying, but at 35 years only 66% will be successful and at 40 years only about 40 % may be lucky. The National Institute for Health and Clinical Excellence states that about 94 out of every 100 women aged 35 who have regular unprotected sexual intercourse will get pregnant within 3 years of trying. For women aged 38, however, only 77 out of every 100 will get pregnant. So, the best age seems to be between 20 and 35, but it is still difficult to give one answer that suits all. Here, I will share my views for different age groups: Women Fertility Age Age 20 to 25 1. A baby at this age may affect the education2. If you are working, then the career has still to take off and therefore it is easier to give time to […]

It’s totally normal to masturbate (touch yourself for sexual pleasure). Masturbation can lead to orgasm. Orgasm releases endorphins in the body that can make you feel good. It does not matter whether you have an orgasm by stimulating yourself or by having sex with your partner. Masturbation can be done irrespective of whether you have a partner or not. It is done by men and women. It is also normal if you do not masturbate. Everyone is different and there is nothing wrong either way, whether you masturbate or not. One should not feel the pressure to climax every time but in case one has a problem then one can use toys specially made to help with this process. It can have several benefits It can reduce stressIt helps people to release their sexual tension in case they don’t have a partner and or the partner is away.It helps people understand their bodies better.It is safe as you cannot get pregnant or STD with masturbation There are many myths about masturbation Myth: It can reduce fertilityReality: There is no connection Myth: You can get addicted to masturbationReality: Any amount of masturbation (once a day to once a week or occasionally) […]

Many women have a concern about whether they can put henna during pregnancy or get tattoos done. Henna (mehndi) is commonly used in India to make a design on the palms and feet especially during weddings and festivals. Women get Tattoos or permanent make-up done for various reasons, be it beauty, fashion, self-expression, or for an event. Tattoos can be permanent (last a lifetime) or temporary (last for few weeks). In either case, a needle is used to insert a colored ink into the skin. In permanent make-up, the needle is used to insert colored ink into the skin to make eyeliner, or eye-brow or highlight the lips or any other make-up. Currently, there are no inks that are approved for injecting into the skin. It is not uncommon for women to ask in an antenatal consultation whether she can get a tattoo done or apply henna during pregnancy. It is advisable to avoid tattoo during pregnancy for the following reasons 1. It involves the use of needles that have the potential of transmitting infections like HIV and Hepatitis if safe practices are not followed in the parlors. 2. One can have an allergic reaction to the ink, leading to […]

Emergency contraception –also called postcoital contraception — is a method of birth control that may be used by women who have had unprotected sex (by choice or as in rape) or used a birth control method that failed, eg. the condom tore or slipped off during sex. Emergency Contraception prevents pregnancy by interfering with ovulation. It does not cause an abortion and cannot protect from sexually transmitted infections There are 2 types of emergency contraception: 1. Contraceptive Pills2. Intra-uterine devices (IUD) There are 3 types of emergency contraceptive pills 1. Levonorgestrel containing pills: These are most popular, effective and easily available.2. Combined oral contraceptive pills: multiple tablets are required and have less efficacy and more side effects especially nausea due to high doses of estrogen.3. Ulipristal containing pills: is not yet available in India. It is just one tablet within 120 hours of unprotected sex. Here I will discuss the Levonorgestrel (LNG) containing pills as they are the most commonly used. Only one LNG pills must be taken within 72 hours of unprotected intercourse. It has a success of 90%. It acts by preventing ovulation, by preventing fertilization, and by causing changes in the endometrium such that it is not […]

Ovulation is the process by which an egg is released from the ovary. Once it is released it enters the fallopian tube. It is now ready for fertilization in case it meets the sperm. Sometimes women like to track their ovulation period so that they can time intercourse in order to increase the chances of conceiving. Some will like to track it to avoid unprotected intercourse at that time. What are the various ways to track ovulation period? Ovulation usually occurs 10 to 16 days before the period starts. Women who have regular cycles can calculate the time of ovulation. This method will not work when the cycles are not regular. Around the time of ovulation, the cervical mucus is very watery and copious. Women may have a discharge that falls like a string at that time. There is a small rise in body temperature just after ovulation. This is due to the hormone progesterone. This can be detected by a thermometer. There are various ovulation kits available in the market. They detect the Luteinizing Hormone (LH) surge that happens before ovulation. The ovulation will happen in 34 to 36 hours after the kit is positive. The kits are more […]

Walnuts are edible, delicious nuts that resemble a brain and is very useful for the development and proper functioning of the brain. Walnuts have a significant amount of proteins, vitamins, fibre, essential fatty acids. magnesium, copper, and manganese. They are also loaded with calcium, iron, zinc, and selenium. These nutrients add to the numerous advantages of walnuts. It is the richest source of antioxidants. Walnuts can be consumed raw as it is, or it can be added to various dishes in the chopped grated form. Walnuts should be consumed fully including the skin. They should be consumed in moderation. 4 to 5 walnuts a day is good enough. Too many walnuts may cause diarrhea in pregnancy. Women who have proven nut allergy should avoid eating nuts. Health Benefits of Eating Walnuts During Pregnancy Walnuts help in reducing the inflammation of blood vessels and thereby help in controlling high blood pressure during pregnancy. They help in maintaining the lipid profile during pregnancy. The antioxidants help in increasing the immunity in pregnancy. The antioxidants present in walnuts are unique as they are not found anywhere else and the skin contains 90% of the antioxidants. The omega 3 fats play an important role […]

The thyroid function plays an important role in the reproductive health of women. Thyroid disorders are an important cause of infertility, and miscarriage, and bad obstetric outcomes. Thyroid hormone plays an important role during pregnancy as it helps in the development of the foetal brain. An adequate amount of Iodine is required to make thyroid hormone and therefore iodine supplementation in the form of fortified foods (salt) is essential. Dr. Sangeeta Agrawal speaks about Thyroid during Pregnancy All women who are planning a pregnancy and those who are already pregnant should do a thyroid check as it is important to identify and treat even before one conceives. Thyroid problems can easily be tested and treated. Hypothyroidism In Pregnancy During pregnancy, the requirement for thyroid hormone increases. Women with a mild deficiency may, therefore, have mild disease and may have mild or no symptoms. Symptoms of Hypothyroidism In Pregnancy The symptoms are so common that they may be considered as normal features of pregnancy (eg. Constipation and lethargy) and therefore diagnosis can be missed. Mild hypothyroidism can also lead to miscarriage, preterm labour, increased blood pressure and associated problems in pregnancy. Treatment of Hypothyroidism In Pregnancy It is easy to treat […]

Every parent would like to have a healthy baby. In fact, if one could design one’s baby, I am sure there would be many takers for the idea. A healthy baby requires a healthy mother. Good nutrition is the foundation of good health. In special situations such as pregnancy, there is a need for special supplements. Folic Acid during pregnancy is one such supplement that plays an important role in having a healthy baby. Is folic acid supplementation necessary during pregnancy? There is enough scientific evidence to show that folic acid supplementation can help to prevent serious birth defects in your baby, especially before conception and during early pregnancy. It is crucial in the development of DNA i.e. the nuclear material of the cell. Folic acid plays an important role in cell growth and development as well as tissue formation. Folic acid, also called folate, is a B vitamin (B9) found mostly in leafy green vegetables like spinach, vegetables like cabbage and cauliflower, orange juice, and enriched grains. There is large volume of robust scientific proof that, women who gets 400 micrograms (0.4 milligrams) daily prior to conception and during early pregnancy reduce the risk that their baby will be […]

This word suddenly becomes familiar when you are pregnant. Pregnant women hear the word ‘Episiotomy’ from their friends and have a lot of worries and queries. An episiotomy is a cut that is given to you when the baby is ready to come out of the vaginal opening. It is given on the right or left side in the area between the vagina and the anus. The doctor will give a local anaesthetic and then give the cut once the area is numb. In case you already have an epidural then there is no need for a local anaesthetic. Once the placenta delivers then the doctor will suture the cut in layers with a suture material that does not need to be removed. i.e. the thread will dissolve on its own. Most patients will need an episiotomy. Why do I need Episiotomy? First time deliveryBig babyProlonged labourIf you need ventouse or forceps to deliver the babyIn case the heartbeat of the baby is slowing down and various such situations. It is safer to allow the doctor to do an episiotomy than to try delivery without the cut especially if the perineum is not stretched. If the perineum is not well […]

A caesarean section (C-Section) or a caesarean delivery (cesarean delivery) is a surgical procedure used to deliver the baby. It is done under anaesthesia. It can be done under epidural or spinal or general anaesthesia. The choice of the anaesthesia will depend on various factors and the anaesthetist will decide after consultation with the patient and the gynaecologist. A caesarean delivery (cesarean delivery) may be done as a planned procedure well in advance even before the labour pains start. This is called Elective Caesarean Section. It may be done when a woman is already in labor but for some reasons, vaginal delivery is not possible (eg. Non-progress of labor, foetal distress, cephalopelvic disproportion ) and then it is important to do the surgery. This is called an Emergency Caesarean Section. The common reasons for Elective Caesarean Delivery (Cesarean Delivery) are: Breech PresentationPrevious Caesarean ScarTransverse PresentationTwin PregnancyPresence of a Pelvic Mass such as FibroidPresence of active infection like Herpes or HIV in the motherThe placenta is covering the os, the baby is very large as is common in diabetics and sometimes it is done purely on the request of the mother. Some of the common reasons for an Emergency Caesarean Section […]

Breech means that the baby is lying with the feet in the lower part of the uterus and the head in the upper part of the uterus. The baby normally i.e. in most cases is lying with the head in the lower part of the uterus. When labor starts the head usually comes out first and the rest of the body follows. The feet come out last. During pregnancy the baby moves in the womb and therefore in early pregnancy breech position is very common. By 36 weeks most babies will take their final position and the most is with head in the pelvis area. Three in every 100 (3%) babies are breech at the end of pregnancy. Why does Breech happen? Well in most cases this is purely by chance. In some cases, there are certain factors that predispose to the baby being in the breech position. These are: Too little or too much water in the womb.The position of the placenta is lower down in the uterus and so it prevents the head from finding enough places in the lower pole of the uterus.Twins and multiple pregnancies. Breach babies may have any of the following positions: Frank Breech […]

Alcohol consumption is common in women. But when you are planning a pregnancy and when you are pregnant you need to make healthy decisions so that you have a healthy baby. A commonly asked question is: Is it okay to drink sometimes, while you are pregnant? Well, there is no correct answer as we do not know the effects of a small amount of alcohol on the fetus. Large amounts surely harm the fetus. One to two units, once or twice a week may not be harmful. Abstinence is strongly recommended in pregnancy and during lactation. Can I drink alcohol while trying to conceive? If you are planning a pregnancy then it is advisable to stop drinking. If you were drinking and now realize you are pregnant then it is not too late to stop immediately. How much alcohol is safe while pregnant? It does not matter which type of drink you take, wine, whiskey, beer or vodka. It is the quantity, the strength of alcohol and the frequency of consumption that matters. Alcohol is measured in units. One unit of alcohol is equal to half a pint of beer, one glass of wine and a single shot of vodka/rum/gin. […]

Pads, tampons, and cups are “feminine hygiene products” that are used by women across all age groups to absorb or collect the menstrual blood which is then discarded in a hygienic manner. Pads They are the commonest product used and are commonly referred to as napkins. They are worn on the underwear, some are just placed on the panty and some make stick to the panty. Pads may be one time use or reusable. The reusable ones are made of fabric that can be washed and dried. Tampons They are small plugs of cotton that can be inserted in the vagina. They will absorb menstrual blood. They have a string attached at one end which is used to pull it out so that it can be discarded. Menstrual Cups They are bell-shaped and made od silicone or rubber. They are inserted into the vagina and the menstrual blood collects inside. They need to be removed, emptied, washed and re-inserted. The advantages of tampons and cups are: They can be used during swimming and all kinds of water sports If inserted properly you cannot feel them. The Myth They can get lost inside It’s not possible as the vagina is a […]

IUD insertion is recommended when the period is just finishing, but it can be inserted all through the first half of the menstrual cycle and up to 5 days post ovulation. What is IUD The Intrauterine device – IUD is a small T shaped plastic device, which is placed inside the womb, to prevent pregnancy. It is a form of reversible contraception. It is also commonly referred to as the coil/loop/copper T/ or IUCD – intrauterine contraceptive device / intrauterine copper device. IUDs are made of plastic and copper. There is one variety of silver. On the long shaft of the T, there is a thread that is used to remove the IUD. How is IUD inserted? IUD insertion is recommended when the period is just finishing, but it can be inserted all through the first half of the menstrual cycle and up to 5 days post ovulation. The procedure for insertion requires about 5 minutes and is easily done in the consulting room. The contraceptive action starts immediately. After the procedure, the first period may be slightly more heavy and painful but usually is not an issue. The IUD prevents pregnancy by various mechanisms: They change the nature of […]

The combined oral contraceptive pills are commonly referred to as “the pill”. Which hormones are in contraceptive pills? The Pill contains two hormones – oestrogen and a progestogen. Various types of pills are available depending on the dose of the estrogen and the type of progesterone that they contain. What contraceptive pills do and how does it work? / How contraceptive pills prevent pregnancy? All pills work on the same principle. They prevent pregnancy by different mechanisms, the most important being by preventing the formation of the egg. In addition, they also thicken the cervical mucus thereby preventing the sperm from reaching the egg. It also makes the lining of the uterus unreceptive to the pregnancy. Can contraceptive pills fail? The pill is extremely effective and the failure rate is less than 0.2. This is provided it is taken properly. How contraceptive pills should be taken? Most packets of the pill contain 21 tablets. You start on the second day of the period and take for 21 days. Then you are off from tablets for one week. You restart again after this one week break for three weeks. So you are on tablets for three weeks and off for one […]

Menopause can lead to sexual problems. The hormonal deprivation (especially of estrogen) after menopause can lead to changes in the woman’s desire for sex. The lack of oestrogen can affect the texture of the vagina making it very dry. This can make sex very painful. Multiple other factors can influence sex after menopause. For Eg. Hot flashes leading to lack of sleep and therefore tirednessDepression and mood swingsBladder control issuesCoexisting medical conditions like Diabetes. The best way to tackle the problem is communication between the partners and counseling ideally by a professional therapist. Foreplay is a very important component during sex to arouse both partners and to lead to satisfaction. It is frequently ignored. How to treat vaginal dryness after menopause? The vaginal dryness can be easily treated with water-based lubricants such as KY jelly. It is not advisable to use non-water-soluble lubricants such as Vaseline, as they can weaken the latex of the condoms and can cause accidental unwanted pregnancy. They also provide a medium for the growth of bacterial infection. Vaginal Oestrogen creams are very effective and safe to use. They do not have the side effects of oral hormonal treatment. Hormone Replacement Therapy is also effective but […]

Its quite common to gain weight after menopause. Why do women gain weight after menopause? There are multiple factors. Due to lack of estrogen there are metabolic changes in the way one uses their glucose and fat. There is also fat mobilization and shift in the areas that get deposited with fat. There is increased fat deposition at the waist and hips. As one ages there is decrease in mobility and that can contribute. The BMR also declines with age and therefore after menopause one will need to increase the physical activity as compared to before to burn the same number of calories. What is the impact of increased weight on women’s overall health? Increase weight will only complicate other coexisting medical conditions like Blood Pressure, Diabetes and Osteoarthritis to name a few. What can you do to overcome weight gain problem after menopause? Exercise is the best answer. A regular disciplined schedule is advisable. Exercise benefits in multiple ways. Improves overall healthLower risk of Heart attack and osteoporosisImproves the DiabetesKeeps joints and muscles strongRelieves depression and anxiety Which exercise should you do after menopause? It is important to be active therefore do anything that you enjoy. It is ideal […]

Periods are a normal physiological function of the female body but there are many myths and taboos surrounding it, especially in India. These affect the social-cultural lives of the women and also the health -physical and mental. Scientifically we know that the woman makes one egg per month and the uterus make a lining. This lining will facilitate the growth of the fetus in case the egg meets with sperm and fertilizes. When fertilization does not happen then the egg and the lining are shed off. This shedding of the lining is menstruation or the periods. But periods are considered dirty and impure. Here are a few myths: Myth: Women cannot enter the puja or the kitchen as she is impure. Well, this sounds like a joke. There is nothing impure. It is for this reason that many women approach a doctor to take tablets to prepone or postpone their periods during big pujas and festivals. This ideally should be avoided. Myth: Women in periods should not touch sour foods like pickles. The belief is that the body emits some smell which will turn the food bad and unedible. Till to date, not a single scientific test has shown the […]

Women usually come with this question that is it okay to consume alcohol while breastfeeding. Here is what you need to do about alcohol and its impact on breastfeeding. Is drinking while breastfeeding bad? Alcohol freely distributes into milk and will pass on to the baby. Small amounts occasionally may not be harmful but frequent and excess alcohol will do harm. How long do you have to wait to breastfeed after drinking alcohol? It is advisable to avoid breastfeeding for 2-3 hours after a drink to reduce the amount transferred to the baby. Can a baby get drunk from alcohol in breast milk? Alcohol exposure may make the baby excessively drowsy and may affect the sensory and motor responses.

The First Trimester This is from the time of conception to 12 weeks.The commonest symptoms during this time are nausea, vomiting, and heartburn. These can be easily treated.The commonest problem during this time is a miscarriage i.e. pregnancy loss. This will present as abnormal vaginal bleeding per vaginum and may be associated with pain. It is diagnosed on ultrasound examination. The Second Trimester This lasts from 12 weeks to 28 weeksBy this time nausea and vomiting subside. The risk of miscarriage is reduced. The formation of the major organs is completed by 20 weeks. After that, the fetus is increasing in size. The Third Trimester This lasts from 28 weeks to 40 weeks. It is at this time that many important medical issues may surface. Anemia may worsen. One may develop pregnancy-induced high blood pressure and gestational diabetes which have implications on the health of both the mother and the fetus. It is during this time that one may go into preterm labor. There is a risk of bleeding during this time mainly due to two causes i.e. abruption and placenta previa. Manage your pregnancy well with a good lady doctor for pregnancy near you. Seek an appointment now. Common […]

Labor Pain may start any time after 37 weeks. In fact, most women will deliver before the due date. Only a small percentage actually delivers on the due date and a few will go beyond the date. Common Symptoms of Labor Are The onset of labor pains i.e. contractions that gradually increase in amplitude and frequency.Passage of thick blood-stained mucoid discharge.Breaking of the forewaters i.e. leaking of the liquor. The Common Signs of Labor Are Confirmation of the aboveDilatation of the neck of the womb i.e. cervixDescent of the presenting part of the fetus First Stage of Labor Pain This starts from the onset of labor to the time of full dilatation. The woman is admitted to the delivery suite. The monitoring of the labor process is done continuously to ensure that there is good progress. Cardiotocographic monitoring is routinely done to ensure the wellbeing of the fetus. Painless Labor In modern obstetrics, there is no place for painful labor. The timely use of epidural analgesia has made labor a memorable experience. Second Stage of Labor Pain This starts from full dilatation to the delivery of the fetus. This stage is also very crucial as prolonged second stage can lead […]

Parents of teenagers always fear the subject of sex with their children. Most parents do not feel comfortable to talk about it to their children, do not know how to start the topic and how much to tell and what to tell. Sex education conversation with teenage kids is really important. Well, it is important for parents to realize that they should discuss this subject with their teenagers as they can give correct information and help the teenagers to have that special comfort with their parents so that they do not seek advice and information from wrong or ill-informed sources. What is the right age for sex education? Parents should begin discussing sexual behaviour, sexuality, and sexual feelings when puberty starts i.e. ages of 9 to 13. The discussion need not happen all in one go. It can be done in phases as you assess the emotional maturity of your children to comprehend the information given to them. It is also important to understand that psychologically they are still too young and immature to cope with the unintended consequences that may occur with the sexual choices that they make. High school and junior college, is the platform for the young […]

PCOS (Polycystic Ovary Syndrome) is an endocrine and metabolic disorder. It is considered in any woman with acne, hirsutism, menstrual irregularity, or obesity. Signs and Symptoms of PCOS PCOS (Polycystic Ovary Syndrome) patients have a wide variety of symptoms and it varies from patient to patient. PCOS patients will have period irregularity.They usually have delayed cycles.Sometimes the absence of periods for 3 months and longer.Occasionally some patients may have heavy and frequent periods. Difficulty in getting pregnant: PCOS is the commonest cause of infertility, as patients are not able to conceive as they do not ovulate (make eggs).High levels of masculinizing hormones: This is known as hyperandrogenism. The most common signs are acne (pimples) and hirsutism (male pattern of hair growth, such as on the chin, side face and chest. Causes of PCOS The cause of PCOS is not clear. There may be genetic and hereditary factors that have a role to play. Weight and Obesity influence the severity of PCOS.Polycystic ovaries have a disturbed function and tend to produce a large number of male hormones and have low female hormones due to multiple reasons. The ovaries show multiple small cysts, but they are the premature eggs that start to […]

The anomaly scan / 20-week Sonography / mid-pregnancy scan / morphology scan During the nine months of pregnancy, a patient is advised multiple health checks and sonography. The sonography at 20 weeks is called an anomaly scan and has a special significance. Normally a 2D scan is done but in tertiary care centers and metro cities facilities for a 3D, the 4D scan is available. These can give views of the baby from different angles. It is a magical experience for the will-be parents to see their baby in this human form and helps create a bond with the baby. Is anomaly scan necessary? The scan is not mandatory, but it is advisable to do it so that any structural defects of the baby can be assessed. Is anomaly scan harmful? The anomaly scan is not harmful as the ultrasound rays do not harm the mother and the baby. It is important to emphasize that it is illegal to see and disclose the gender of the baby in India. When is an Anomaly scan done in a pregnancy? It is usually carried out between 18 and 21 weeks of pregnancy. The main purpose of this scan is to check the […]

Iron is an important mineral that is found in the human body. It is the main component of haemoglobin (Hb), which is important pigment in the red blood cells which are present in the blood. The haemoglobin (Hb) takes the oxygen from the lungs and then transports it to every cell of the body where it is released for utilization. If the iron levels are low, then the haemoglobin is low and oxygen transport is affected. Low Hb is known as anaemia. Iron Sources We get the iron from our diet. Meat is rich in iron as it contains haemoglobin from the animal’s body. The liver is particularly rich in iron. Plants sources of iron are cereals, whole grain flakes (breakfast cereals), legumes such as lentils and beans, green leafy vegetables like spinach, fenugreek, lettuce, and herbs like parsley and cress. Pregnancy In pregnancy, there are many changes that happen and are natural. There is a dilution of blood and an increase in the volume of blood in the circulation. Due to this, there is a minor drop in the Hb levels during pregnancy. In the first three months and last three months, haemoglobin levels above 11 grams per decilitre […]

A pregnant woman eagerly awaits her bundle of joy but at the same time in the corner of her heart, she has the fear of labor pains and anxiety on how it will go and how she will manage. A first-time mother is always anxious about whether she will be able to recognize the symptoms of labor and whether she will reach the maternity rooms on time. The commonest issue is recognizing these pains. All women experience Braxton Hicks contractions. How do we differentiate between false labor pains and true labor pains? Braxton Hicks Contractions These false labor contractions can begin in the second or third trimester. Contractions are painless and irregular, but the mother to be will complain of discomfort. The pain is in the lower abdomen and mainly in the front.Pain settles at times with rest and change of position. True Labor Pains Contractions are much stronger, more painful and gradually increase in duration frequency and amplitude.Labor pains do not get better with a change of position.They begin in the lower back, they then spread to the front and the lower abdomen and sometimes radiate to the legs.It can be accompanied by mucus discharge (show) and sometimes leaking […]

Pregnancy causes many changes in the body. There are many physiological changes and there are changes in the appearance. Pregnancy and weight gain is the most important issue which women deal with. Dr. Sangeeta Agrawal speak about Weight Gain during pregnancy These changes are normal and part of being pregnant. Further, the body may not return to its pre-pregnancy level again post-delivery or may take a long time and effort. Some women find it difficult to deal with them and have a negative body image which can impact their psychological well-being. Impact Of Pregnancy On Body Image Weight gain is the most important and obvious change during pregnancy. The breast and the abdomen enlarge considerably during pregnancy. Most women develop stretch marks mainly on the abdomen as it enlarges. Acne, mood swings, excessive tiredness are also common. These symptoms can bring about negative feelings in the minds of pregnant women. Managing Negative Emotions Pregnant women need a lot of loving care and rein the enforcement of positive ideas. It is important to counsel them and prepare them even before the pregnancy with the following:- The women’s body is unique and has this special gift of being able to nurture a […]

Premenstrual syndrome (PMS) is a combination of symptoms that many women get for about 5 to 10 days before their period. PMS happens in the days after ovulation because estrogen and progesterone levels begin falling dramatically if you are not pregnant. PMS symptoms go away within a few days after a woman’s period starts as hormone levels begin rising again. The symptoms vary in intensity from person to person. They may be mild and not interfere with daily routine or they may be so severe that they miss work or school. Severe PMS symptoms may be a sign of premenstrual dysphoric disorder (PMDD). Less than 5 % of the women get PMDD. Usually PMS settles after menopause. Women who have high levels of stress and women with a personal or family history of depression are more likely to get PMS. Symptoms of Premenstrual Syndrome PMS symptoms are different for every woman and can vary for the same women in different phases of life. Some common physical symptoms are bloating, flatus, tender breasts, constipation or diarrhea, cramping headache or backache, and intolerance to sound or light causing a migraine-like headache. Common emotional symptoms are mood swings, sadness, crying spells, irritability, sleep […]

Menopause and Sleep are often inter-related topics. The pre-menopause and menopause years see a lot of transition. The transition is not only in physical health but in personal life e.g. retirement, children leaving home, chronic illness in a partner, etc. These changes can deprive one of a good night’s sleep. Mood swings and hot flashes further contribute to the sleep deprivation. Sleep deprivation can make you feel tired lethargic irritable and depressed all day. How to manage menopause and sleep better? Developing healthy habits and lifestyle can help.Maintain a regular sleep schedule. i.e. Go to sleep and get up at the same time each day.Sometimes reading a book, listening to soothing music, or soaking in a warm bath can help relax and thereby fell in falling asleep. Maintain room temperature such that it is suitable for you. Regular exercise in the day or a walk after dinner can help.Avoid taking a nap in the afternoon Avoid television and use of all electronic devices just before sleepingAvoid large fatty meals just before sleeping. Avoid tea coffee and chocolates just before bedtime. Avoid drugs and alcohol Over the counter medicines. Melatonin Tablets are easily available. Melatonin is a naturally occurring hormone secreted […]

Hot flashes are the most common symptom of menopause and perimenopause. The good news is Hot Flashes Treatment is available. Many women have hot flashes, which may last from a few months to a few years after menopause. They occur due to changing estrogen levels in the body which affects the thermoregulatory system. A hot flash is a sudden feeling of a heatwave which starts in the core of the body and moves towards the head and is followed by a flushing of the face and upper body and then breaks into a sweat. It can last from few seconds to few minutes. They can occur at any time of the day but are more common at night. When they happen at night they are called night sweats. It can be severe enough to break the sleep thus leading to sleepless nights, tiredness and drowsiness the next day. What Causes Hot Flashes? Hot flashes can be triggered by various things such as stress, caffeine, alcohol, spicy foods, tight clothing, heat, and cigarette smoke. What are the lifestyle measures to manage hot flashes? Control the temperature at night with fans and air conditioning. Wear lightweight, loose-fitting cotton clothes.Yoga and meditation can […]

Many times women approach us for PCOS treatment. Women with PCOS have a hormonal imbalance and metabolic problems that may affect their overall health and appearance. What is PCOS? Polycystic ovary syndrome (PCOS), is a common health problem caused by an imbalance of reproductive hormones which affects the follicle (egg) production in the ovaries. In PCOS, the egg may not develop or may not release thereby leading to changes in periods and difficulty in conceiving. How does PCOS affect you? It affects about 5% and 10% of women between 15 and 44 years of age. Women of all races and ethnicities are at risk of hS. Various genetic and hereditary factors also contribute to PCOS. What is the cause of PCOS? The exact cause of PCOS is not known. Several factors play a role. Women with PCOS have more androgens than normal. Higher androgen levels prevent the release of an egg from the ovary during each menstrual cycle and can cause extra hair growth and acne. High levels of insulin. Women with PCOS have Insulin resistance i.e. the cells of the body do not respond to insulin as they should. The body compensates by making more insulin. These high levels […]

Pregnancy brings about a lot of changes in the body. Pregnancy Skin Care is one such topic that needs our attention. The nausea vomiting heartburn flatus and constipation are unpleasant and unwanted, but pregnancy skin glow is welcome. What Brings In Pregnancy Glow? Various factors bring about the glow of pregnancy. The pregnancy hormones bring about some changes in the skin. There is an increase in the production of oil. This can give the shine on the face. If there is too much oil, then sometimes it can result in acne. In pregnancy, there is increased blood flow to the skin. This also contributes to the glow. Skin Problems During Pregnancy There are some not so welcome changes too. Some parts of the body get darker too. The stripe of skin above and below the belly button (linea nigra) and the nipples become dark. Pre-existing moles and eczema may get worse. Some women develop a darkening of the skin of the face called melasma. It’s caused by hormones combined with sun exposure. Melasma and all other darkenings may fade in 3 to 6 months after pregnancy, but patches can reappear when exposed to the sun. Pregnancy Stretch Marks Most of […]

During pregnancy, the tummy grows very rapidly over nine months. The skin stretches but the growth is more than what the skin can cope. The outcome is pregnancy stretch marks. Therefore, long thin lines or grooves appear on the abdomen. These lines are not harmful, but they don’t look good and will not go away. Therefore, most women are not happy to have stretch marks. Stretch marks can appear due to various other reasons such as Quick weight gain, childhood growth spurts, a steroid medication, Cushing’s syndrome, and Marfan syndrome. In these cases, they can appear on various other parts of the body too such as arms, back, breasts, buttocks, hips, and shoulders. The stretch marks start off as red or pink lines and progress to purplish-blue to thinner, pale, more scar-like streaks over time. Stretch Marks Treatment It is important to remember that the stretch marks are not going to go away. They may only fade with time. But if you are conscious then you can use creams that help to camouflage. You can see a dermatologist and cosmetic surgeons for prescription medicines. They also offer various procedures such as laser therapy, microdermabrasion, cosmetic surgery, tummy tuck procedures which […]

Nausea and vomiting during pregnancy is a very common condition. It is quite commonly called morning sickness though it can occur at any time of the day. What You Should Know About Nausea During Pregnancy? It starts at about 6 weeks and usually settles by 12 to14 weeks. Very occasionally it may continue for a bit longer. It can vary in severity from person to person and even from pregnancy to pregnancy in the same woman. Some women have only nausea and may vomit just once a day. Some will have too much nausea and vomiting severe enough to prevent them from eating adequately and will influence their nutritional status. Nausea and vomiting are worse when there are multiple pregnanciesIt is worse where there is a history of heartburn, dyspepsia, and thyroid disorders.Hyperemesis gravidarum is the most severe form of nausea and vomiting of pregnancy. In this condition, vomiting is severe enough for women to lose weight and become dehydrated. They may need admission to a hospital, intravenous fluids, and medication to control the vomiting. Management Of Nausea And Vomiting In Pregnancy Try eating biscuits or crackers in the morning before you get out of bed.Take enough fluids.Avoid fried and […]

Pregnancy is a wonderful period in a woman’s life. However, along with all the happiness that it brings, it also brings a few pregnancy symptoms. These symptoms differ from woman to woman and pregnancy to pregnancy. The most common and early signs and symptoms of pregnancy are: 1- Missed Period This is the most common symptom that you should be aware of. If you have missed your period by one week, it is time for you to consider doing a home pregnancy test. Read About: When to do a home pregnancy test. 2- Nausea / Vomiting During Pregnancy Nausea and vomiting during pregnancy is a very common condition. It is quite commonly called morning sickness though it can occur at any time of the day. Read About: What you need to know about nausea/vomiting during pregnancy and tips to manage it well. 3- Tender/Swollen Breasts During the initial stages of pregnancy, you might feel tender/swollen breasts. This is due to the hormonal changes your body is going through. However, as your pregnancy grows, this might subside. 4- Fatigue During Pregnancy Fatigue is a common symptom during pregnancy. The degree of fatigue varies considerably from person to person. But generally, women […]

Rh Incompatibility in pregnancy is a concern to some women. What is Rh factor? The Rh factor is a protein that is inherited and that can be found on the surface of red blood cells. Individuals who have the protein are known as Rh-Positive and those who do not have it are called Rh-Negative. Every individual will inherit the Rh factor gene from the mother or the father. In a case where the pregnant woman is Rh-negative and the father of the baby is Rh-positive, the baby has a 50 percent or more chance of having Rh-positive blood. What is Rh Incompatibility and its impact on pregnancy? Your pregnancy gets influenced by Rh Factor only in case the mother is Rh-negative, and the fetus is Rh-positive. In this case, Rh Incompatibility will develop. If the fetus is Rh-negative, then, in that case, there is no impact. When a woman who is Rh-negative is carrying an Rh-positive fetus, there is a possibility of the fetal blood getting into the maternal bloodstream. Normally there is a barrier between maternal and fetal blood. The mixing commonly happens at the time of delivery and labor. It can happen under the following circumstances: During procedures […]

A pregnant woman has a higher risk of flu and should definitely take a flu shot. Read about the common signs, causes, precaution, and treatment of flu during pregnancy. Influenza and Pregnancy Influenza (the flu) is a viral infection that can affect almost anyone. It has a wide range of symptoms and a wide spectrum on the degree of severity of the symptoms. Common Signs And Symptoms FeverHeadacheFatigueMuscle AchesCoughingRunny Stuffy NoseSore Throat. The severity can vary widely. Some affected persons can recover within a few days without requiring prescription medicines and some may develop pneumonia and require hospitalization. Some groups have an increased risk of complications: – Age groups below 5 years and above 65 years Immunocompromised peoplePeople on steroid medicationPeople with chronic disordersPregnant women Impact On Flu During Pregnancy During pregnancy, the immunity of the pregnant woman is lower than otherwise. Therefore, they are more susceptible to get influenza and more likely to have complications. They are more likely to have preterm labor and premature rupture of membranes. The Flu virus does not cross the placenta and therefore is not likely to harm the fetus. Prevention Of Flu The virus spreads by contact with an affected individual and therefore […]

Washing your hands – very effective in Coronavirus Prevention. Coronavirus is 50-200 nanometers in size. When a person is infected then the virus can be transmitted to others by means of tiny droplets from coughs and sneezes. The droplets may dry up but the virus remains alive and active for many days on the skin, wood fabric, steel, plastic, and metal surfaces. The virus can attach to skin from any surface. Once it reaches the face it can find a way into the nose/mouth/eyes and then into the body where it will multiply and infect other cells. Coronavirus Prevention requires that we don’t come in contact with the virus. The hands are the most common site that will come in contact with the virus. Therefore, washing hands is the most important step in prevention. Washing with water alone is not enough. Soap is extremely effective and safe. All disinfectant wipes and gels that contain alcohol are effective but soap is better. Infected people should wear a mask but healthy people need not wear a mask unless they are caring for a sick relative. These 2 simple measures can be very effective in prevention. So be careful – wash your hands […]

Overactive bladder causes a sudden urge to urinate. The urge is sometimes so strong that it may be difficult to control and can lead to the involuntary loss of urine (urge incontinence). This loss of urine control can be embarrassing and affect work life and social life. Overactive bladder is also associated with increased frequency of urine during the day and needs to get up multiple times at night. Overactive bladder occurs when the muscles of the bladder contract involuntarily even when the volume of urine in the bladder is low. This involuntary contraction creates an urgent need to urinate. It can affect the quality of life and there is help available to deal with it. Therefore, it is worth discussing it with the doctor. Various factors can contribute to the overactive bladder such as: Acute urinary tract infections Diabetes Stroke and multiple sclerosisSurgeries are done on the bladder or sphincter.Consumption of alcohol, caffeine, and diuretic drugs. Diseases where there is a decline in cognitive function such as Alzheimer’s. Elderly people may have a combination of bladder storage problems and bladder-emptying issues. How to manage this situation? Voiding diary – the diary documents number of voids per day i.e. volume […]

Genital warts are a sexually transmitted infection caused by the human papillomavirus (HPV). They are small growths (single or groups), in the genital area (inside the vagina, on the vulva, cervix, and in or around the anus) or on the lips, mouth, tongue, or throat -due to oral sex). They can be tiny enough to not be seen or they can be large and look like florets of cauliflower. Both men and women can get warts. HPV passes from one to another by direct skin contact, especially during vaginal oral or anal sex. It can pass on to the baby during childbirth in case the mother has warts at the time of delivery. Not all HPV types will cause warts. All HPV infections may not necessarily cause warts. Some may build natural immunity and may not manifest warts. They may appear within a few days of infection or may take years. Genital warts may be asymptomatic or may cause itching, burning, and discomfort. Management Of Genital Warts There is no cure for HPV infection One can take a vaccine to prevent HPV. Warts can be removed by the specialist. They are removed by certain chemicals, laser, and cryotherapy. Warts In […]