I AM PREG­NANT

Woman's Era - - Contents -

IAM IN THE EIGHTH MONTH OF MY THIRD PREG­NANCY. I WOULD like to get a ster­il­i­sa­tion op­er­a­tion done af­ter de­liv­ery. Please tell me what is the right method and the right time to get such an op­er­a­tion done and what are the side ef­fects? I would also like to know what ex­actly is done to pre­vent con­cep­tion. Some peo­ple tell me that they take out the uterus. I would not like that for I am only 32 years old.

First of all let me en­lighten you re­gard­ing the pro­ce­dure. On both sides of the uterus are tubes called fal­lop­ian tubes that end in fin­ger- like pro­cesses called fim­bria. Th­ese hang over the ovaries, which again are present on ei­ther side of the uterus and pick up the egg when it comes out of the ovary, once in a month. The tube car­ries the egg to­wards its mid­dle and the sperms swim up to fer­til­ize it in the tube. Th­ese tubes that play sucha vi­tal role in con­cep­tion are oc­cluded dur­ing the ster­is­la­tion op­er­a­tion. The uterus is def­i­nitely not re­moved so rest as­sured on that ac­count.

The tubes are ei­ther tied and cut in the open method and cau­terised or have a tight band fit­ted over a loop on both sides dur­ing la­paro­scopic or key­hole surgery. The ex­act method and time varies from in­di­vid­ual to in­di­vid­ual. If you have to un­dergo a cae­sarean sec­tion for any rea­son the open method is best for it can be done along with the cae­sarean. Ster­il­i­sa­tion by the open method can also be done a day or two af­ter nor­mal de­liv­ery, the ad­van­tage be­ing that you will be able to rest and re­coup in the same time it is nec­es­sary for re­cov­ery from child­birth and usu­ally peo­ple have some­one to help them around that time. The dis­ad­van­tage is that it re­quires longer hospi­tal­i­sa­tion and a big­ger cut. La­paro­scopic ster­il­i­sa­tion does the en­tire pro­ce­dure through a key­hole but can be be done ear­li­est at least 4- 6 weeks af­ter de­liv­ery. An im­por­tant point to re­mem­ber is that in a small per­cent­age of cases the op­er­a­tion can fail by what­ever method it has been done.

IS IT AD­VIS­ABLE TO CLIMB STAIRS AND LIFT WEIGHTS DUR­ING preg­nancy?

If you are not ad­vised bed rest due to com­pli­ca­tions and if you live on the up­per floor, you can climb the stairs. Make sure that you do not wear heels. Take your time while climb­ing up or down the stairs. Do not haul your­self up by hold­ing the rail­ings and pulling your­self up by your arms. In­stead put each foot firmly on the next step and climb. As for weights, avoid­ing lift­ing things that are heavy. For lift­ing smaller ob­jects from the floor do not bend at the level of your waist to do so. Go near the ob­ject, lower your­self into a squat­ting po­si­tion by bend­ing your knees and then pick it up. I AM SEVEN AND A HALF MONTHS PREG­NANT. DUR­ING my last an­te­na­tal visit the doc­tor sus­pected that my baby is not grow­ing well. An ul­tra­sound con­firmed her di­ag­no­sis. What are the im­pli­ca­tions of such a sit­u­a­tion? How will it be man­aged?

Man­age­ment will de­pend upon the de­gree on in­trauter­ine growth re­tar­da­tion (IUGR). If mild you will be asked to take a high pro­tein diet, given some medicines and ad­vised bed rest at home. You will be called every cou­ple of weeks or so to mon­i­tor the growth of the baby by ul­tra­sound, colour doppler etc. If the baby is gain­ing weight, the preg­nancy will be al­lowed to con­tinue till 37-38 weeks af­ter which labour will be in­duced and the baby de­liv­ered. Ba­bies with IUGR are not al­lowed to progress till term (40 weeks) as the in­ter­nal en­vi­ron­ment is not con­ducive to their growth and they are bet­ter off out­side. This be­cause the blood ves­sels that sup­ply oxy­gen and nu­tri­ents to the baby nar­row down due to high blood pres­sure or other un­known rea­sons and the baby does not get enough of the above for his needs. If the growth re­tar­da­tion is se­vere, the pa­tient is ad­mit­ted, var­i­ous pa­ram­e­ters are mon­i­tored on a daily ba­sis and the baby is taken out as soon as he is fit enough to sur­vive out­side – usu­ally around 34 weeks of preg­nancy. With in­ten­sive care in the nurs­ery th­ese ba­bies usu­ally turn out to be fine though in some cases there might be some de­lay in their mile­stones. ● E VER SINCE MY WIFE CON­CEIVED WE HAVE BEEN BOM­BARDED with in­for­ma­tion re­gard­ing cord blood bank­ing. Con­sid­er­ing the costs in­volved, all they of­fer us is bank­ing for vary­ing pe­ri­ods of time de­pend­ing upon the amount of money we are willing to pay. I am not in­ter­ested in the re­search go­ing on and the break­throughs that may come about. What I would like to know is that in which con­di­tions are stem cells be­ing used right now.

Stem cells are of use in peo­ple suf­fer­ing from leukaemias and aplas­tic ane­mia. They have also been tried with promis­ing re­sults in sickle cell anaemia, tha­lassemia, Hodgkin’s dis­ease. So if a cou­ple has a child suf­fer­n­ing from any of the above it makes good sense to pro­duce an­other child and use his cord blood and cord to help the first child. Other con­di­tions in which they are be­ing tried are spinal cord in­juries, cir­rho­sis of the liver, Alzheimer’s dis­ease, di­a­betes, stroke and heart dis­ease.

WHAT SPE­CIAL CARE SHOULD I TAKE OF MY BREASTS DUR­ING preg­nancy?

Keep your nip­ples clean. If you feel a cer­tain de­gree of sore­ness ap­ply vase­line or cream over them fre­quently. If your nip­ples are short – which might make it dif­fi­cult for the baby to feed – ro­tate them gen­tly be­tween fore­fin­ger and thumb and ap­ply gen­tle trac­tion. Last but not least, wear a com­fort­able bra that gives proper sup­port. The pain and heav­i­ness will de­crease con­sid­er­ably once you shift from your pre-preg­nancy sized bra to a larger one. You may have to change the size fre­quently dur­ing the course of preg­nancy. – Dr Am­rinder Kaur Ba­jaj, MD.

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