Test Tube Baby With Fluid In Body-OHSS

                                               Test Tube Baby With Fluid In Body-OHSS

IVF/Test tube baby is definitely a gift of science to many childless couples but it has certain limitations and side effects which we should know as patients so that we are mentally prepared at our back of mind and not in a situation of surprises.

Ovarian hyperstimulation is one such condition which can happen in some prone patients what we call as OHSS

What Is OHSS-

OHSS is a condition which mostly develops in patients of IVF but can rarely be seen in IUI/Ovulation induction cases also.In this there is fluid collection in tummy and at other areas of body adding distress

Cause and Sequence of presentation-

Causative factor is fertility drugs which are used to grow the eggs.

Generally fertility drugs are used to produce egg sac but sometimes they can cause hyper stimulation of ovaries. This happens when presence of the drugs is more than what your body can handle. As a result, the level of hormones responsible for producing eggs in the ovary increases and too much hormones cause the ovaries to get swollen or enlarged. These enlarged ovaries then start releasing chemicals into the blood stream which ultimately start leaking fluid into the body.

Sometimes that leaked fluid reaches heart, lungs and various other organs and become a serious health problem resulting in grave consequences.

T he Risk of OHSS is mainly to the women who-

At very young age

Have polycystic ovarian condition

Take higher dose of gonadotropins

Have previous history of OHSS

Low weight

Have multiple pregnancy(twins-triplets)

A history of migraines or a previous episode of OHSS

Mild OHSS – women usually experience

Mild abdominal swelling, pain or discomfort

Mild nausea

Diarrhea

Vomiting

Moderate OHSS – Most of the symptoms are same as mild OHSS but with greater intensity

Increased abdominal pain

Increased abdominal girth

Nausea

Urine is dark and very less

Vomiting & diarrhea

And sudden increase in weight

Severe OHSS –  

Intense abdominal pain

Rapid weight gain

Marked abdominal distension

Severe nausea and vomiting

Urine has stopped or very less and much darker

Respiratory difficulties

Extreme thirst

Prevention – Consult your doctor at earliest and clear all doubts esp if you have a strong history of same

How baby Grows- Happiness with concerns !!

                           How baby Grows- Happiness with concerns !!

 

Pregnancy is greatest feeling but definitely till we have a live healthy smiling baby we as parents are always worried every second.What can ease it out is if we are aware about the expected growth changes in this journey of pregnancy.

Pregnancy might leave you feeling delighted, anxious, exhilarated and exhausted — sometimes all at once. Even if you're thrilled about being pregnant, a new baby adds emotional stress to your life.

It's natural to worry about your baby's health, your adjustment to motherhood and the financial demands of raising a child. You might wonder how the baby will affect your relationship with your partner or what type of parent you'll be. If you're working, you might worry about your productivity on the job and how to balance the competing demands of family and career.You might also experience misgivings and bouts of weepiness or mood swings. Remind yourself that what you're feeling is normal.  .

How pregnancy happens-

It all starts with the fertilization of egg with the sperm in the fallopian tube so the resulting healthy embryo migrates and gets fixed in the womb of the mother to form the baby

Stages of pregnancy- There are three stages of pregnancy what we call as Trimesters.Each lasting for three months

Ist,Second and Third

Each triemester has its own significance and implications so needs to have a guided and monitored pregnancy for safe and healthy outcome

How a small uterus will accommodate a growing baby?

Nature at its perfection and nothing can beat/replace it.Pregnancy is a live example.Its one life giving another life with perfection at its peak.

As the days and weeks of pregnancy pass on, your womb will grow and the blood supply also will flourish so making ample room for the new life.Isn’t this the reason Why Mother is Equivalent to GOD

Growth chart of baby for your reference-

Gestational Age	Length (inches)	Weight (oz/lb)	Length (cm)	Mass (g)
8 weeks	0.63	0.04 oz	1.6	1
9 weeks	.9	0.07 oz	2.3	2
10 weeks	1.22	0.14 oz	3.1	4
11 weeks	1.61	0.25 oz	4.1	7
12 weeks	2.13	0.49 oz	5.4	14
13 weeks	2.19	0.81 oz	7.4	23
14 weeks	3.42	1.52 oz	8.7	43
15 weeks	3.98	2.47 oz	10.1	70
16 weeks	4.57	3.53 oz	11.6	100
17 weeks	5.12	4.94 oz	13	140
18 weeks	5.59	6.70 oz	14.2	190
19 weeks	6.02	8.47 oz	15.3	240
20 weeks	6.46	10.58 oz	16.4	300
21 weeks	10.51	12.70 oz	26.7	360
22 weeks	10.94	15.17 oz	27.8	430
23 weeks	11.38	1.10 lb	28.9	501
24 weeks	11.81	1.32 lb	30	600
25 weeks	13.62	1.46 lb	34.6	660
26 weeks	14.02	1.68 lb	35.6	760
27 weeks	14.41	1.93 lb	36.6	875
28 weeks	14.80	2.22 lb	37.6	1005
29 weeks	15.2	2.54 lb	38.6	1153
30 weeks	15.71	2.91 lb	39.9	1319
31 weeks	16.18	3.31 lb	41.1	1502
32 weeks	16.19	3.75 lb	42.4	1702
33 weeks	17.20	4.23 lb	43.7	1918
34 weeks	17.72	4.73 lb	45	2146
35 weeks	18.19	5.25 lb	46.2	2383
36 weeks	18.66	5.78 lb	47.4	2622
37 weeks	19.13	6.30 lb	48.6	2859
38 weeks	19.61	6.80 lb	49.8	3083
39 weeks	19.96	7.25 lb	50.7	3288
40 weeks	20.16	7.63 lb	51.2	3462
41 weeks	20.35	7.93 lb	51.7	3597
42 weeks	20.28	8.12 lb	51.5	3685
43 weeks	20.20	8.19 lb	51.3	3717

Contamination Transmission and IVF-Risks and Safety Issues !!

 Contamination Transmission and IVF-Risks and Safety Issues !!

IVF is showing a rising trend but with limitations of science in place.All done and said in good faith of already stressed childless couples but definitely to bestow them with a good health and a healthy baby .Definitely not at cost of acquiring any infection during this process.Besides safeguarding the health of treating team also-That’s the occupational health what we call.

Since the inception of in-vitro fertilization (IVF), questions about contamination and the transmission of infection have been raised

IVF is not contraindicated in case of HBV or HCV infection, but the decision is far more delicate 

Purpose is to highlight various infections especially grevious ones which can get acquired in process.

This will somehow effect the success rate also besides increasing transmission risk to the prospective child.

Various infectious agents can be-

Sexually transmiited diseases like Chlamydia

HIV

Hepatitis B, C,D

To add to it airborne spread also feared now of Hepatitis B

Genital Tuberculosis

Syphilis

Gonorrohea

Preventions-

Patient should give clear history

Thorough screening should be done

Universal precautions

Rule out and treat any infections before starting treatment

Full antibiotic course should be followed to avoid resistant organisms

Give detailed verbal and written instructions for semen collection

Maintain sterile zone

Chest Pain and Pregnancy- Alarming Symptoms and Prevention !!

Chest Pain and Pregnancy- Alarming Symptoms and Prevention !!

Author- Dr Richa Sharma

Pregnancy is the best feeling in the world but sometimes it may get complicated by certain alarming signs and symptoms which definitely should not be taken casually.

Here's a rundown of symptoms with underlying possible causes which can mimic pain in the chest that should set off your warning bells. But even if you don't see the source of your concern on this list, it's better to err on the side of caution and make that call than to agonize for hours.

Your body is changing so rapidly that it's hard to know whether what you're experiencing is "normal." If you're not sure whether a symptom is serious, you don't feel like yourself, or you're uneasy, trust your instincts and make the call. Your caregiver expects such calls. If there's a problem, you'll get help right away. If nothing's wrong, you'll be reassured.

And if you can't reach a caregiver on the phone, you can always go to the hospital (to labor and delivery) or the emergency room.

Chest pain causes-

Some of the reasons why you may experience chest pain are just routine parts of a normal pregnancy. Some of the most common causes of chest pain are:

·        Stress

·        Pressure of baby

·        Gastritis

·        Inflammation in lungs(Pleuritic pain)

·        Injury locally

·        Inflammation at costochondral junction

·        Engorged Breasts

·        Acute asthmatic attack

·        Myocardial Infarction(Heart Attack)

·        Clotting of blood locally

Treating Chest Pain-

You should contact your doctor on urgent basis so that proper evaluation is done to reduce pain and pin pointing the exact cause for effective management.Avoid self medication and procrastination as treatment that time may be the Golden hours of your life.Here safety comes first so appropriate interventions may be required.

Skin Disorders And Pregnancy

                                         Skin Disorders And Pregnancy

                                                               Author- Dr Richa Sharma

Skin disorders and pregnancy can go hand in hand. Many women with skin problems worry about becoming pregnant and how their health might affect them and their baby. By working with your dermatologist and your ob-gyn, you can create a treatment plan that will keep  problems under control and your baby healthy.If its minor issue then manageable but if its massive then definitely it’s a cause of concern.

Various factors which can decide its affect of pregnancy-

·        Single or both parents affected

·        Any strong family history

·        Role of genetics

·        Previous history of recurrent pregnancy losses

·        Any other associated medical problems like thyroid ,adrenals,diabetes,liver disorders

·        Any gender specific early child demise

·        Duration of illness

·        Treatment taken so far and response to it

Psoriasis and Its impact-

The biggest question that women with psoriasis have when they’re considering pregnancy is: “Should I stop my psoriasis medications?” The answer is typically yes

Its better to be careful  and avoid all those medicines which are considered as harmful to the baby and are prone to birth defects in the prospective child

These medications should be used during pregnancy only if the potential benefit outweighs the potential risk to the fetus.

Psoriasis Can Improve With Pregnancy-

The good news is that a little more than half of women with psoriasis report their psoriasis improves, without treatment, while they are pregnant.It may be due to the immunosuppressive and anti inflammatory affects on the progression of the disease.

Pregnant patients with psoriasis are at increased risks of complications

They are more prone to be overweight or obese and vice versa- reason unexplained

Indirect etiology may be because-women with psoriasis are more likely to smoke, be diagnosed as depressed, and are less likely to have taken prenatal vitamins. Obesity, smoking, and lack of prenatal vitamin intake in pregnancy are all linked to increased risk of adverse pregnancy complications.

Stress also can flare up the acute attack

Planning a pregnancy- As such psoriasis is not a contraindication for pregnancy.But Definitely it adds to stress and various biochemical and physiological changes in the body.

Role Of Genetics-

There is a genetic component to psoriasis, but it does not follow a dominant or recessive pattern of inheritance.

A third of the people with psoriasis have a family history of the disease. But that doesn’t mean a child born to someone with psoriasis will get it.

A child with one parent who has psoriasis has about a 10 percent chance of having psoriasis.

When both parents have psoriasis, chances of the child having psoriasis increase to 50 percent.

Many Thanks and Kind Regards

Dr Richa Sharma

Senior IVF consultant DELHI NCR

Post Doctoral Fellow National Board(FNBE)

Reproductive Medicine(New Delhi), Bangalore

Fellow Reproductive Medicine, Madras Medical Mission (Chennai)

MRCOG(London)

Air Travel and Safety In Pregnancy

                                               Air Travel and Safety In Pregnancy

                            

                                   Author- Dr Richa Sharma

This is a common query, pregnant ladies have in mind as whether they can travel by air.Especially when it is IVF pregnancy, one tends to take extra precautions to be on safer side.Right person to guide you is your health care provider .To add to it many factors actually decide like-

·        Duration of pregnancy

·        Previous obstetric history

·        Any high risk factors -that might be worsened by air travel or require emergency care.

·        Any history of pregnancy complications

·        Duration of travel

·        And the airlines policy

Generally, commercial air travel before week 36 of pregnancy is considered safe for women who have healthy pregnancies.  

Your health care provider might caution against air travel if you're experiencing pregnancy complications The duration of the flight also should be considered. Similarly, your health care provider and many airlines might restrict travel after 36 weeks of pregnancy.

 Precautions to be taken-

• Check the airline's policy about air travel during pregnancy. Guidelines for pregnant women might vary by carrier and destination.
•  Fasten seat belt at proper place- During the trip, fasten the lap belt under your abdomen.
•  Take occasional walks up and down the aisle. If you must remain seated, flex and extend your ankles often.
• Take aisle seat
• Avoid excessive eating and inform crew in case you have any difficulties
• Avoid wearing restrictive clothing. Use of compression stockings might help prevent blood clots.a
• Drink plenty of  clear fluids. Low humidity in the cabin can lead to dehydration.But avoid carbonated drinks
• Avoid gassy foods and drinks pre-flight .

Many Thanks and Kind Regards

Dr Richa Sharma

Senior IVF consultant DELHI NCR

Post Doctoral Fellow National Board(FNBE)

Reproductive Medicine(New Delhi), Bangalore

Fellow Reproductive Medicine, Madras Medical Mission (Chennai)

MRCOG(London)

Active and Passive Smoking -Impact On Health Of A Baby !!

Active and Passive Smoking -Impact On Health Of A Baby !!

Author- Dr Richa Sharma

Smoking or any other addictions definitely not only have ill impact on the mother but also on the prospective child.Both kinds of smoking be it active(Primary source is sufferer only) or passive(Some other person in the surroundings) are harmful and it has been claimed that passive is more dangerous for females and kids.
Smoking is a practice in which a substance is burned and the resulting smoke breathed in to be tasted and absorbed into the bloodstream. Most commonly the substance is the dried leaves of the tobacco plant.
Smoking generally has negative health effects, because smoke inhalation inherently poses challenges to various physiologic processes such as respiration. Diseases related to tobacco smoking have been shown to kill approximately half of long term smokers when compared to average mortality rates faced by non-smokers.
Smoking is one of the leading causes of preventable death globally. Male and female smokers lose an average of 13.2 and 14.5 years of life, respectively. At least half of all lifelong smokers die earlier as a result of smoking. The risk of dying from lung cancer before age 85 is 22.1% for a male smoker and 11.9% for a female current smoker, in the absence of competing causes of death.
Gross Affects Of Smoking-
Among the diseases that can be caused by smoking are –
• Vascular stenosis,
• Lung cancer,
• Heart attacks
• Chronic obstructive pulmonary disease(COPD)
• Smoking during pregnancy may cause ADHD to a fetus.
Impact on Pregnant Woman-
Quitting smoking should be the goal for every pregnant smoker.
Smoking appears to have many negative effects on fertility for both men and women, and might make it harder to become pregnant. Smoking is also linked with a greater risk of ectopic pregnancy — when the fertilized egg implants outside the uterus, usually in a fallopian tube.

Impact on baby-
Smoking during pregnancy exposes a baby to many harmful chemicals, including carbon monoxide. These chemicals limit the baby's supply of oxygen and the delivery of nutrients.
Various problems which can happen in an on going pregnancy to post delivery to a growing child are as-

• Problems with the placenta
• A reduction in birth weight
• Preterm premature rupture of amniotic sac whichleaks or breaks before week 37 of pregnancy
• Premature birth
• Certain birth defects
• Pregnancy loss
• Sudden infant death syndrome (SIDS)
• Colic
• Asthma
• Childhood obesity
• Some research also suggests that smoking during pregnancy might affect a child's emotional development, behavior and ability to learn. Smoking during pregnancy might even impair a child's own fertility.

Prevention-
Only measure is to quit straightway -cutting down or reducing frequency wont work.Early you do, Safer you and your baby will be.

Many Thanks and Kind Regards
Dr Richa Sharma
Senior IVF consultant DELHI NCR
Post Doctoral Fellow National Board(FNBE)
Reproductive Medicine(New Delhi), Bangalore
Fellow Reproductive Medicine, Madras Medical Mission (Chennai)
MRCOG(London)

Fight Or Flight- Are we getting stressed ?

                                         

                                          Fight Or Flight- Are we getting stressed ?

                                                    Author- Dr Richa Sharma

Stress is now part and parcel of life irrespective of we want it or not.Every age group has own kind of stress be it a kinder garden kid or Prime Minister of any nation.But definitely stress has many factors with it .The more we rise in life and more we get ambitious ,definitely some way or other our life gets stressed.A happy brain can keep you going and sustain long.Short cuts in life may end in some critical emergencies costing our precious lives.So be ambitous but not at stake of your health.Once we suffer mind it no one will stand by at your side even shadows vanish.

What is stress ?
Stress is a normal psychological and physical reaction to the ever-increasing demands of life.
Our brain has an alarm system such that when we face a stress ,adrenaline rush will be there. When your brain perceives a threat, it signals your body to release a burst of hormones to fuel your capacity for a response. This has been labeled the "fight-or-flight" response.

Present scenario-
As we are in continuous state of stress due to changing life style so brain hardly gets time to relax so its in continuous state of alarm and red alert so adding to our stress.To keep it relaxed we need to follow certain stress lowering measures. Many people juggle multiple responsibilities, work, home life, caregiving and relationships. Learning to identify problems and implement solutions is the key to successful stress reduction.
Here are the few basic tips for all readers-
• Monitor your stress levels daily
• Find out the stress triggers- like job pressures, relationship problems or financial difficulties. But daily hassles and demands, such as commuting, arranging child care or being overcommitted at work, also can contribute to your stress level.
• Positive events also can be stressful.
• Planning of stress management strategies.
• Seek help and support from family and friends
• Resort to daily practice of stress-reduction techniques, such as deep breathing, massage, moderate exercise,taking leisure breaks,spending quality time with family or yoga. Many people manage stress through practicing mindfulness in meditation or being in nature.
• And remember to maintain a healthy lifestyle to help manage stress — eat a healthy diet, exercise regularly and get enough sleep. Having a healthy lifestyle will help you manage periods of high stress.
Stress won't disappear from your life. And stress management isn't an overnight cure and we have to come out of our denial phase and accept whatever we are facing and solve it intelligently. But with ongoing practice and incorporation of resiliency into your lifestyle, you can learn to manage your stress level and increase your ability to cope with life's challenges.

ManyThanks and Kind Regards
Dr Richa Sharma
Senior IVF consultant DELHI NCR
Post Doctoral Fellow National Board(FNBE)
Reproductive Medicine(New Delhi), Bangalore
Fellow Reproductive Medicine, Madras Medical Mission (Chennai)
MRCOG(London)

High Blood Pressure and Pregnancy

Hypertension is the most common medical problem encountered during pregnancy, complicating 2-3% of pregnancies.Sometimes high blood pressure is present before pregnancy. In other cases, high blood pressure develops during pregnancy. For example:
• Gestational hypertension. Women with gestational hypertension have high blood pressure that develops after 20 weeks of pregnancy.
• Chronic hypertension. Chronic hypertension is high blood pressure that was present before pregnancy or that occurs before 20 weeks of pregnancy.
• Chronic hypertension with superimposed preeclampsia.This condition occurs in women with chronic high blood pressure before pregnancy who then develop worsening high blood pressure and protein in the urine or other health complications during pregnancy.
• Preeclampsia. Sometimes chronic hypertension or gestational hypertension leads to preeclampsia, a pregnancy complication characterized by high blood pressure and signs of damage to another organ system — usually after 20 weeks of pregnancy. Left untreated, preeclampsia can lead to serious — even fatal — complications for mother and baby. Previously, preeclampsia was only diagnosed if a pregnant woman had high blood pressure and protein in her urine. However, experts now know that it's possible to have preeclampsia, yet never have protein in the urine.
Preeclampsia sometimes develops without any symptoms. High blood pressure might develop slowly, but more commonly it has a sudden onset.
Monitoring your blood pressure is an important part of prenatal care because the first sign of preeclampsia is commonly a rise in blood pressure.
Various signs and symptoms are-

• Excess protein in your urine (proteinuria) or additional signs of kidney problems
• Severe headaches
• Changes in vision, including temporary loss of vision, blurred vision or light sensitivity
• Upper abdominal pain, usually under your ribs on the right side
• Nausea or vomiting
• Decreased urine output
• Decreased levels of platelets in your blood (thrombocytopenia)
• Impaired liver function
• Shortness of breath, caused by fluid in your lungs
Sudden weight gain and swelling (edema) — particularly in your face and hands — often accompanies preeclampsia.

Preventive Measures-
Taking good care of yourself is the best way to take care of your baby. For example:
• Visit your health care provider regularly throughout your pregnancy.
• Your health care provider will prescribe the safest medication at the most appropriate dose.
• Follow your health care provider's recommendations for physical activity.
• Take less of salt
• Avoid smoking, alcohol and illicit drugs. Talk to your health care provider before taking any over-the-counter medications.

Thanks and Regards

Dr Richa Sharma
 Senior IVF consultant  DELHI NCR
Post Doctoral Fellow National Board(FNBE) 
Reproductive Medicine(New Delhi), Bangalore
Fellow Reproductive Medicine, Madras Medical Mission (Chennai)
MRCOG(London) 
 

Diabetes in Pregnancy

Definition- Diabetes in pregnancy is called as Gestational Diabetes.
Implications on Your Health and baby-

It causes high blood sugar that can affect your pregnancy and your baby's health.Such pregnancy is considered as a high risk pregnancy and needs to be monitored carefully.It needs a multidisciplinary approach demanding seeking opinion of Endocrinologist.Any pregnancy complication is concerning.

Preventive measures-

Expectant moms can help control gestational diabetes by eating healthy foods, exercising and, if necessary, taking medication. Controlling blood sugar can prevent a difficult birth and keep you and your baby healthy.
Your doctor may refer you to additional health professionals who specialize in diabetes, such as an endocrinologist, a registered dietitian or a diabetes educator. They can help you learn to manage your blood sugar level during your pregnancy.

Signs and Symptoms-

If sugar is controlled then it may not cause evident signs and symptoms
Reach Doctor at earliest-rather preconceptionally only.If you develop gestational diabetes, you may need more-frequent checkups. These are most likely to occur during the last three months of pregnancy, when your doctor will monitor your blood sugar level and your baby's health.

Post Pregnancy effects-

In gestational diabetes, blood sugar usually returns to normal soon after delivery. But if you've had gestational diabetes, you're at risk for type 2 diabetes.
To make sure your blood sugar level has returned to normal after your baby is born, your health care team will check your blood sugar right after delivery and again in six weeks. Once you've had gestational diabetes, it's a good idea to have your blood sugar level tested regularly.
The frequency of blood sugar tests will in part depend on your test results soon after you deliver your baby.

Regards
Dr Richa Sharma