Sun Hospitals
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• GOD could not be everywhere and therefore He made
mothers• No other relation in this world
is as beautiful, pure & selfless as that between a mother and
her child
Pregnancy
A female undergoes many changes when she is pregnant
In this presentation
• Symptoms• Food & Diet• Self-care• Medical care• Exercise• Post delivery care
SYMPTOMS
Nausea, Vomiting & Acidity
Common in first 3 month
Have freq small meals
Take medicines regularly
Toast, biscuits to decrease nausea
Avoid oily food
Drink plenty of liquids
ConstipationCommon in pregnancyAvoid straining or sitting long time on a toilet
Drink plenty water Avoid fatty foods
Eat grain, fruits, vegetables
Dizziness
Sit Stand up slowly or you
may feel giddy
Turn to a side
Backache - postures
Leg cramps
• Occur suddenly • Mostly in last months• Massage area• Point foot & toes towards
face• Increase calcium in diet,
e.g. milk, milk products• Exercise regularly
Breast discomfort
• Tender & sensitive• Aerola darker• Increased breast size• Check for inverted nipple• Wear comfortable & supportive bra
Sleeplessness at night
• Decrease stress• Avoid tea/coffee/aerated drinks in
evening• Have a cup of warm milk before
sleeping• Have a warm bath before sleeping• Do not sleep in afternoon
Itching & Stretch marks
• Heaviness, pressure or itching sensation on tummy
• Also on breasts, bottoms, thighs• Coconut oil, Vit E oil or stretch
creams• Stretch marks fade into fine silvery
medals of motherhood
Avoid
Smoky atmosphereSmoking
Hard drinks
Avoid
Soft drinks
Lifting heavy
weights
High heels
Cravings
• Normal
• Do not eat unhealthy food
• Do not eat road-side food
• Eat frequent small meals
Mood swings• Decrease stress• Talk to friends & relatives• Explain your mood changes to your spouse• Read good books• Listen to music• Avoid horror movies,
depressing T.V. progs
Swelling of feet
• Do not keep feet hanging for long
• Rest legs on a stool/chair while sitting
• Keep a pillow below feet while sleeping
• Get urine tested
• Remove all jewellery
FOOD & DIET
Balanced diet
•You are the only source of food for your baby
• Diet should include
•Iron
•Calcium
•Proteins
•Vitamins
Proteins
Pulses, dal
Egg
Groundnut, channa, (chikki)
Milk, cheese, dahi, paneer
Dry fruits
Meat, fish
Soyabeans, flour, tofu
Cereals
Mix different cereal & pulses e.g. idli, dosa
Rotis-add soya/nachani flour to wheat flour
Dalia
Make parathas by mixing different flour like besan,
wheat or jowar e.g. mooli, gobi
Fruits & Vegetables
Rich in vitamins, fibre & minerals
2-4 servings daily
3-5 servings daily
Calcium
3 glasses of milk a
day in any form
Cheese
Curds
Paneer
Milkshakes
Buttermilk/lassi
Rasgulla
Calcium
Green leafy vegetables
Pulses esp. Ragi (nachni)
Fish
Iron
Green leafy vegetable-chutney, soup, sabzi
Raisins
Jaggery - chikki
Pulses
Fats
• Oil, ghee & sweets in small quantity
• Fats help in absorption of Vit. A, D, E, K.
• 1 tablespoon of ghee = 15gms = 135
calories
• Visible fat intake should be increased
during pregnancy and lactation to 30 gm
& 45gm resp.
Sweets
• Sweets in small quantity• Avoid sugar, use jaggery instead
Avoid tea/coff
ee, cakes,
chocolates,
mithai
Have raisins, chickoo
, honey, dates
Water & Salt
• Take at least 8 -10 glasses of water
• In case of high blood pressure - Reduce
salt intake
• Eat at regular intervals
• Do not fast or feast
Tips - Diet
• Use jaggery instead of sugar
• Steaming is best method of cooking
• Frying, reheating cause loss of nutrients
• Do not use sugar substitutes
Tips - Diet
• Avoid excess of oil/ghee in cooking
• Avoid excess of chilly & salt
• Avoid maida & sugar base products e.g. cakes, bread,
jam, jalebis
• Have a balanced diet
• Have frequent small meals
SELF CARE
When should you gain weight ?
• 1st trimester :1kg
• 2nd trimester :5kg
• 3rd trimester :5kg
• Total :11kg minimum
Cleanliness
• Trim nails regularly as they grow faster
• Bathe regularly - prevents infection• Keep vaginal area clean• Brush regularly after meals
Cleanliness
• Breast care - wear well fitting bra
• Wear low heeled shoes
• Do not wear tight clothes
• Wear clothes according to the climatic conditions
Sex & pregnancy
• Depending on your health, speak to your doctor
• Growing abdomen, increase breast sensitivity – change position
• Avoid sex if you have– Unexplained bleeding – Placenta previa (low placenta)– History of miscarriage/preterm labour– Pregnant with twins or triplets
• Sexual intercourse or breast stimulation can start
labour
Work & Pregnancy• Age (older mothers may have more
problems)• General health (anaemia, DM, high BP)• Pregnancy progress (weight of the baby, complications)• Prior pregnancy problems (bleeding, preterm, growth retardation)
Work & Pregnancy
• Type of work you do (sedentary, tours, sleep)• Hours of work (regular, irregular)• Work risk factors (travel, food habits, stress, chemical)
Pregnancy & work
• Morning sickness • Don’t skip meals • Drink lots of water• Moderate exercise• Posture at work
• Plan timely departure• Avoid taking stress• Maternity Leave• Getting enough sleep
Travel after doctors advice
• Avoid long journeys• Avoid crowded
transport
Safe in 4-6 months only
MEDICAL CARE
Medications
• Folic acid in 1-3 months
• Iron & calcium supplement - from fourth month & continued after delivery
• Injection tetanus toxoid
• Anti D in Rh negative mother
Blood Tests
• Hemoglobin• Blood group• Infection – STDs, TORCH, HIV, Hepatitis B• Diabetes• Fetal abnormalities
Urine Test • Infection• Protein
Sonography
• Age of fetus
• Abnormalities
• Placenta site
• Due date
• Weight of fetus
SEX DETERMINATION IS ILLEGAL
Immunization
• Inj. T.T.• 2 doses• After 5th month• 4 weeks apart
Doctor visits
• Once every month up to 6 months of pregnancy
• Once every 15 days in the 7th & 8th month
• Once every week in the 9th month
• In cases of any emergency
Medical emergency
• Pain may occur regularly at repeated intervals
• Leaking of watery fluids from vagina, even if there is no pain
• Swelling of feet or hands• Bleeding from vagina• Decreased/Absence of fetal
movement
Labour pains
False Labour True Labour
Timing of Contractions
Irregular, no increase in frequency
Regular, 4-6 min apart, increase in frequency
Strength of Contractions
Weak; not stronger with time
Stronger with time, feels vaginal pressure
Pain with Contractions
Felt in the front only
Starts in the back & moves to the front
Position Change & Hydration
Contractions stop/slow if you walk/lie down/ change position/ increase fluid intake
Contractions continue in spite of position changes/ increase fluid intake
Going to Hospital
• Keep your bags ready as you near delivery time
• Relax • Remove all jewellery• Remove nail polish, contact lenses• Have only light food if labour pains
have started• Carry all your reports, files and
medicines
EXERCISE
Exercise
• Walk• Under Doctor’s guidance• Yoga & Relax • Prevent fall/accidents
POST DELIVERY
Breast Feeding
• Feeding position
Breast Feeding
• Breast care – Clean areola and nipple before
and after feed– Wear well-fitting bra
• Feeding intervals – every 2 hourly
• Cracked nipples – hind milk, ghee, breast cream
Contraception
• Lactational amenorrhoea
• Spacing
• Contraceptives – condom, POP, IUCD
Contraceptive methods• Spacing methods (Temp)
– Barrier methods•Male Condoms
– IUD– Hormonal methods
•COC, Mini pill, EC, Injectable, • Terminal methods
(Perm)– Male
sterilization– Female
sterilization
Male condom
Male Condoms
• Fitted on erect penis before intercourse & to be withdrawn carefully
• Protection against pregnancy, STD, HIV
• Easily available, safe and inexpensive• Can Slip off or tear during
intercourse• Effectiveness
– Used correctly, - 90% effective – With spermicide (kills sperms) are
95% effective
Intra Uterine Device (IUD)
1st, 2nd, 3rd generation
IUD
• Most effective reversible methods of contraception
• Copper/Levonorgestrel added to the IUD
• Inserted into uterus & kept for required period (3-5 yrs),
• Safe in smoking, breast feeding • Can cause heavy menstruation,
spotting, expulsion, infection, unusual vaginal discharge
• Effectiveness – Approx . - 99%
Combined Oral Contraceptive (COC,
OCP)• 2 hormones, oestrogen &
progesterone
• Orally - 21/24 consecutive days followed by 7/4 pill-free days
• Next pack on day after the 7/4 pill-free days
• Effectiveness - more than 99%
• Not to be used while breast feeding
Combined Oral Contraceptive
• Reduces menstrual cramps and PMS (premenstrual syndrome),
• Improves menstrual regularity, lowers risk of anaemia,
• Less chances of PID (pelvic inflammatory disease).
• Long term use - decrease the incidence of ovarian and endometrial cancer
• Nausea, vomiting, weight gain, breast discomfort, moodiness, pimples, vaginal infections
New generation OCP(drospirenone+ethinyl
estradiol)• Reduces pimples, oily skin
& male pattern hair growth
• No weight gain
• No increased blood pressure
• No changes in blood glucose or cholesterol levels
Mini pill
• Only progesterone given in small doses throughout the cycle
• Effectiveness -Approximately 95%
• Can be used during breast feeding & in women with cardiac problems
• Spotting, Breakthrough bleeding
Emergency contraceptive pills
• Progesterone alone• Orally within 72 hours of unprotected
sex• Back up
– Sex without using a contraceptive, – Failure of a contraception method
(e.g. tearing of condom or having missed 2 or more contraceptive pills)
• NOT TO BE USED AS REGULAR BIRTH CONTROL
• Effectiveness– 95% effective < 24 hrs– 85% between 25 - 48 hrs – 58% if taken between 49 - 72 hours
• Safe to use for almost all women
•Nausea, vomiting, lower abdominal pain, breast
discomfort, headache
•Pregnancy due to failure/taken by pregnant
woman – No effect on foetus
•Nursing Mothers - No adverse effect on foetus
•Drug interaction - No significant interaction
EC DOES NOT CAUSE ABORTION
Emergency contraceptive pills
Injectable contraceptive
• Intramuscular single progestogen injection
• On or before 5th day of menstrual cycle, 3 monthly
• Delayed after > 5 days, barrier contraceptives to be used for 7 days
• Can be given at any time after delivery or abortion & during breast feeding
• Disruption of normal menstrual cycle, no menses, bleeding between menses, spotting
• Effectiveness - 99%
Terminal methods
Male sterilization
Piece of the tube that carries sperms is removed
Male sterilization or vasectomy
• Male is not immediately sterile & contraceptives to be used for 1st 20 ejaculations/3 months (whichever comes first) until absence of sperms
• Does not affect male sex hormone secretion
• Effectiveness – almost 100% effective
Female sterilization
• After delivery/at time of abortion/when desired
• No long term side effects• Effectiveness - 99.5%
Female sterilization
Laparoscopy Mini
Laparotomy
BEST WISHES FOR A HAPPY & HEALTHY
PREGNANCY