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Pregnancy

Fibroid Pregnancy Test

posted on June 26, 2019, 4:03 p.m.
4.5/ 5 (1 Votes)

Fibroids are tumors that grow in the uterus from muscle tissue of the same. This tumor can be as small as a pea or as larger than a grapefruit. Fibroid tumors can grow outside of the uterine wall within the uterine wall. Multiple women have several fibroids of different sizes. An estimated percentage of 40 to 60 women are diagnosed with fibroid in their entire lifetime. But it is hard to detect fibroid during pregnancy. For this reason, medical experts think that the number of known fibroid cases in pregnancy is lower than the actual occurrence of this abnormal growth in the uterus. Most of the women have been diagnosed with fibroid have normal pregnancies. But in some cases, women who have been diagnosed with fibroid associated with her pregnancy can face many challenges through it. During pregnancy, the treatment for uterine fibroid is challenging and limited because of the uterine fibroid' risk to the fetus. A fertility expert advises a pregnant woman to take bed rest and keep herself hydrated. A woman with fibroid can also be recommended mild pain relievers to help expectant mothers manage symptoms of fibroid. In some rare cases, a myomectomy can be suggested to be performed in women in the second trimester of their pregnancies. Myomectomy procedure removes a fibroid from the outside of the uterus uterine wall without damaging the uterus of a woman. This safeguards the uterine health and ensures that the respective patient is finally free from fibroids. (1) In this article, a reader will get to know about the following details: What is a Fibroid tumor? What causes uterine fibroid in a woman? How does fibroid impact pregnancy? How is uterine fibroid diagnosed in pregnancy? What are the procedures of different types of Fibroid Pregnancy test? How are fibroid treated naturally? How does fibroid cause infertility? What is a Fibroid tumor? A fibroid tumor is also known as Leiomyoma or Myoma. It is a mass of compressed muscle and fibrous tissue that grows on the wall of the uterus. Fibroid tumors occur in 50 to 80 percent of women mostly during pregnancy. There are multiple symptoms of having a fibroid tumor such as heavy vaginal bleeding, severe abdominal pain, pelvic pressure, frequent urination, and constipation. If in case a woman is experiencing severe abdominal pain or vaginal bleeding then she should talk to her infertility specialist immediately. What causes uterine fibroid in a woman? There are various aspects which surround the occurrence of uterine fibroid in a woman. But the following factors mentioned below play an important role in the development of uterine fibroid: Hormone Factors: Female reproductive hormones i.e. estrogen and progesterone are responsible for the growth of the uterine fibroid. These female hormones are proven to promote the growth of the fibroid. The cells that are present in the fibroid are stimulated when exposed to these female reproductive hormones. This is why the chances of the growth of the fibroid are very low after menopause. The increase in the growth of fibroid decreases because of the lack of reproductive hormones. Genetic Factors: It has been observed that if a family member or more is having fibroid will increase a person's chance of increasing fibroid. Many uterine fibroids accommodate changes in genes that vary from those in normal uterine muscle cells. (2) Other risk factors: According to one of the latest researches, it is observed that the uterine fibroid occurrence is higher in women of the African-American race. It is also observed that obesity plays an important role in the development of fibroids. (3) How does fibroid impact pregnancy? Many women will experience no major effects of fibroid during their pregnancy. However, some 10 to 30 percent of the women may experience or develop complications during pregnancy because of fibroid. According to the researchers, the common complication experienced by the concerned woman is the pain of fibroid during pregnancy. Most often women with fibroid measuring larger than 5 cm who are at the last stage of their pregnancy may increase the risk for other complications during pregnancy and delivery. These complications include: Intrauterine growth restriction: Intrauterine Growth Restriction (IUGR) is a term that is used to describe a condition in which the size of the fetus is smaller than expected with the referred current number of weeks of pregnancy. This is because the large fibroid may prevent a fetus from developing at a steady pace as per the requirement. It is due to decreased space in the womb of the pregnant woman. Intrauterine growth restriction is most commonly defined as a weight below the 10th percentile for gestational age. As a result of which the pregnancy can result in low weight birth of a baby. (4) Placental abruption: Placental abruption occurs when the placenta breaks away from the uterine wall because of blockage caused by a fibroid. In other words, it means that the placenta separates from the uterine wall before childbirth. It occurs most commonly in around 25 weeks of pregnancy. This declines the consumption of oxygen and vital nutrients. (5) Preterm delivery: Preterm babies are babies born alive before their delivery time of pregnancy. In case a pregnant woman is having fibroid then the pain from fibroid may lead to uterine contractions even before the predicted time of the delivery procedure. Because of which it can result in early delivery. (6) Cesarean delivery: Cesarean delivery (C-section) is a surgical procedure which is used to deliver a baby through incisions in the abdomen and uterus. Women having fibroid during pregnancy more likely require a cesarean delivery than a woman who doesn't have fibroids. (7) Breech position: In this position, the babies will move into the position of delivery a few weeks prior to birth. This will lead their head to move closer to the birth canal in the pregnant woman. When the head fails to move closer than the baby's buttocks or feet will be positioned to be delivered first. Because of the abnormal shape of the cavity, the baby will get delivered with the help of vaginal delivery. (8) Miscarriage: According to research, the chances for miscarriage are high in women who are diagnosed with fibroids. (9) How is uterine fibroid diagnosed in pregnancy? Fibroids are one of the most common tumors found during the physical exam of a woman. The healthcare provider may find the presence of firm, irregular pelvic mass during an abdominal or pelvic exam. (10) Other medical tests and procedures that are used to diagnose uterine fibroid in pregnancy are: Transvaginal ultrasound: transvaginal ultrasound is also known as an endovaginal ultrasound. It is a type of pelvic ultrasound which is used by the fertility specialists to examine female reproductive organs. Transvaginal means through the vagina i.e. this ultrasound is efficiently performed through the vagina. The transvaginal ultrasound primarily checks the status of the presence of fibroid and other similar abnormal growths which occur in the uterus, fallopian tubes, cervix, ovaries, and vagina. This ultrasound is used to have a better assess if a woman has a fibroid or not. This ultrasound test can help to establish the diagnosis as the first imaging test. (11) Magnetic Resonance Imaging (MRI): Magnetic Resonance Imaging (MRI) is a type of scan that is used with strong magnetic fields and radio waves. This procedure is used to produce a thorough image of the internal parts of the body successfully without any hassle. (12) Magnetic Resonance Imaging (MRI) imaging test does not use radiation. Instead, frequent imaging is used in this type of medical test to determine the presence of fibroid. This test helps the fertility professional to get a road map of the size, number, and location of each of the fibroid present inside the body of a woman. MRI is generally recommended before proceeding with some surgical options. Ultrasound: Ultrasound imaging uses sound waves to produce pictures of the internal parts of the body. It is used to help the fertility expert in diagnosing the cause of pain, swelling or infection in the body's internal organs. This process is also used to examine a baby in a pregnant woman. Ultrasound also helps in checking the growth status of the brain and hips of infants. (13) Additionally, to check around the overall development of the fetus the expert technician moves the ultrasound device over the abdomen of women. A fertility expert can also place the tool inside the vagina to get certain images of the uterus. (14) Saline Sonohysterography: Saline Infusion Sonohysterography is a procedure which is used to evaluate the uterus and the shape of the uterine cavity in the concerned patient. Saline Sonohysterography uses the ultrasound and sterile fluid to show the cavity in the uterus and endometrium in a well-defined manner. The fertility doctor can also see the ovaries at the time of performing the SHG procedure. The main purpose of Saline Sonohysterography is used to detect any abnormalities present in the uterus of a woman. (15) Saline sonography can be expertly performed in the clinic by inserting the fluid into the uterus. The healthcare provider can see the growth of the fibroid into the uterus by expanding the uterine cavity with the fluid. Hysteroscopy: This is a surgical procedure that is performed to gain a direct visualization of the uterine cavity. To perform this procedure perfectly the doctor inserts a small lighted telescope i.e. called a hysteroscopy. This tool is inserted through the cervix into the uterus of a woman. The fertility specialist then injects saline into the uterus by expanding the uterus cavity. Hysteroscopy allows a doctor to examine into the walls of a woman's uterus.  Hysterosonography: A Hysterosonography is a transvaginal ultrasound exam which is used to capture images of inside organs of the uterus in a woman in a well-defined manner. This is a modern technique which is utilized to evaluate uterine abnormalities in women. This is helpful for women who have difficulty in getting pregnant or experience multiple miscarriages. (16) It is also called a 'saline infusion sonogram'. It uses sterile saline to expand the uterine cavity. This makes it easier to get images of submucosal fibroid and the endometrium in a woman's body. Hysterosalpingography: Hysterosalpingography is a process in which a dye is used to highlight the uterine cavity and fallopian tubes on X-ray images. It is also used to investigate miscarriages resulting from abnormalities occurring within the uterus. This is performed to determine the presence and severity of tumor masses and uterine fibroid in a woman's body. The doctor can recommend Hysterosalpingography in case of infertility problems in a woman. Hysterosalpingography can periodically open blocked fallopian tubes which will aid the patient to become pregnant. (17) Procedures of different types of Fibroid pregnancy test: Transvaginal ultrasound: transvaginal ultrasound is also known as endovaginal ultrasound, which is a safe and straightforward procedure used by fertility experts to examine the internal organs in the female pelvic region. This procedure is performed by the fertility expert who is called a sonographer. The specialist will ask the patient to lie down by putting a hospital gown. The patient is required to bent her knees so that the procedure can be performed successfully. The specialist will then use a transducer which is slightly larger than a tampon to complete the procedure efficiently. The sonographer will cover the transducer with a condom and lubricating gel before inserting into the vagina. Once the transducer reaches accurately in its place then it will further produce sound waves that bounce off the internal organs in the woman. The sonographer will use some specific movements to bring different areas of these internal organs into focus. The transducer will expertly transmit the information to a monitor screen where the result will appear in the form of a series of images. The images transferred by the transducer make it possible for the sonographer and patient to monitor the results in real time. (18)   Hysterosalpingography: To perform this procedure efficiently the radiologist will insert a speculum into the vagina of a woman. The speculum was inserted precisely so that the cervix that is located at the back of the vagina can be seen. A woman may feel some discomfort while the process is being performed. The radiologist will then clean the cervix and may also inject a local anesthetic to decrease the discomfort which can occur during the procedure. After removing the speculum, an instrument called a cannula will be inserted into the cervix. The radiologist will then insert a dye through the cannula, which will flow into the uterus and fallopian tubes. Further, the patient will be asked to go for an X-ray. The radiologist may ask a patient to change various positions so that he/she can capture various angles of the uterus accurately. The patient may experience some pain and cramps as the dye moves through the fallopian tubes. After completion of taking X-ray, the radiologist will remove the cannula and prescribe appropriate medications to prevent the pain or infection. (19)   Hysterosonography: Hysterosonography is also known as 'sonohysterogram'. Before undergoing this procedure a fertility specialist will take a pregnancy test. One woman will not have to undergo a 'sonohysterogram' if she is pregnant or experiencing an inflammatory pelvic disorder. This process is performed when a woman is not on her period or experiencing vaginal bleeding. Hysterosonography is usually performed one week after a woman starts on her period. This is because it decreases the chance of infection which can occur after the hysterosonography procedure is completed. The procedure is performed successfully in an easy manner when a woman is on her period. Because at the time of periods the uterine lining width is the thinnest which helps a doctor identify abnormalities more efficiently. A patient is asked not to eat or drink a couple of hours prior to the commencement of the procedure. In some cases, the fertility doctor will perform a pelvic exam before pursuing Hysterosonography to check for pain or possibility of occurrence of infection. (20) How are fibroid treated naturally? Fibroids usually grow slowly and in most of the cases, they shrink on their own. This happens especially after menopause phase of a woman's life. A woman may visit any fertility specialist if she experiences any of the symptoms which indicate fibroid. Fibroids may be treated with surgery or ultrasound procedures which are already mentioned above. The surgery may generally involve removing the fibroid or the entire uterus. Fibroids can be treated at home by changing the diet and home remedies. This may help in treating fibroid and relieving symptoms of the same. The lifestyle changes which are mentioned below play an important role in the prevention of fibroid: Weight Loss: According to research, it is stated that excess weight in women of any age increases the risk of having a uterine fibroid. The reason behind this is that fat cells make high amounts of estrogen. Hence, losing weight may help a woman prevent or reduce the size of the fibroid.  Nutrition: Taking a proper nutritious diet is one of the important factors in treating fibroid. The intake of right nutrition can help a woman in maintaining a healthy weight and reduce the risk of being affected with fibroid at any stage of life.  Foods to eat: A woman should eat foods rich in fiber that helps in preventing fibroid. These foods prevent unnecessary appetite, balancing hormones, and prevent excess weight gain. A woman can also have brightly colored foods such as fruits and vegetables which have required nutrients in them. This may help in reducing inflammation and decline the risk of fibroid. The list of these foods includes dried fruit, brown rice, couscous, quinoa, fresh and dried herbs, lentils and beans.  Foods not to eat: Eating more refined carbohydrates and sugary foods may increase the effect of fibroid in a woman and affect in resulting of pregnancy. This is because these foods increase blood sugar levels. This causes your body to produce more of insulin hormone. A woman should avoid simple refined carbohydrates such as white rice, pasta, flour, corn syrup, boxed cereals, potato chips, and crackers. Vitamins and supplements: Milk and dairy products may help in reducing the risk of having a fibroid in a woman. This is because dairy products contain a high amount of calcium, magnesium, and phosphorus. Intake of these nutrients may help in preventing the growth of the fibroid. Many times vitamins may also help in reducing the growth and the size of the fibroid. On the basis of research, the risk of having fibroid may increase if a woman has low amounts of vitamin A and D in her diet and does not intake required dairy products. Herbal remedies: This may also help in treating fibroid. Herbs are potent medicine which can interact with other drugs. One should consult her doctor before taking any herbal medicine especially if she is already diagnosed with fibroid growth in her uterus. These natural treatments may help in reducing the symptoms of fibroid. Every woman should visit and consult her fertility specialist before trying any of these natural treatments of fibroid. How does fibroid cause infertility? Many women having fibroid think whether uterine fibroid can eventually lead to infertility. However, fibroid affects infertility but this varies with respect to each of the medical cases. The main factor that can have an impact on the pregnancy of the patient is the location of the fibroid. If in case the fibroid is located in certain areas of the uterine cavity then it can actually twist the shape and the size of the uterus. This can happen if the uterine fibroid grows incredibly large in size. While if in case the fibroid is placed in the wall of the uterus can also have an impact on fertility. This effect is generally far less severe in nature. Women who believe that they have symptoms which indicate uterine fibroid must visit the doctor immediately. Those women who have any family history of fibroid should surely visit a doctor on a regular basis to check if she also has the same. Unfortunately, a fibroid can grow at a rapid rate in any woman. (21) Most of the women having fibroid can get pregnant naturally.  There are multiple ways uterine fibroid can reduce the fertility of a woman:  Change in shape of the cervix: It can affect the number of sperm entering the uterus of a woman during intercourse. Changes in the shape of the uterus: This can interfere with the movement of the sperm or embryo. Blockage of Fallopian tubes: Fibroids can block the fallopian tubes of a woman that can make it hard for a woman to conceive successfully. Impact uterine cavity: Fibroids can affect the size of the lining of the uterine cavity in a negative manner which can ultimately impact the success of the pregnancy in the form of delivery of a healthy baby. Blood flow can be affected: Fibroids can affect the blood flow to the uterine cavity. This can decrease the ability of an embryo to implant into the uterine wall. Uterine fibroid is the most common issue that can affect fertility levels in several ways. Fibroids can affect sperm, egg fertilization, embryo implantation or else it can also affect pregnancy. The choice of treatment of fibroid depends on the medical case of a woman. It is usually based on the symptoms of fibroid and may help in improving overall fertility in a woman. Elawoman is one of the best healthcare platforms which helps patients right from the time of diagnosis to completion of the treatment. It has helped millions of couples in fulfilling the dream of their parenthood dream. You can get more information related to other infertility treatments by visiting www.elawoman.com. Or else you can call us on +91-8929020600 for booking an appointment with the best infertility specialist nearby.

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Pregnancy

Chorionic Villus Sampling

posted on June 26, 2019, 11:38 a.m.
4.5/ 5 (1 Votes)

Pregnancy is one of the delicate phases in a woman's life which need to be dealt with care. To make sure that the pregnancy tenure of the woman sails smoothly, it is important to make wise decisions and take proper care of the health of the pregnant woman and baby. A set of procedures performed on expectant mothers during pregnancy are called 'Prenatal Screening Tests'. It is useful in determining whether a baby is likely to have specific birth defects during the pregnancy itself. Most of these medical tests are noninvasive and does not have any harm to the mother's and baby's body. These medical tests are usually performed during the first and second trimesters of the concerned pregnancy. Although some are also performed during the third trimester of pregnancy. In this article, we will look at some screening tests including Chorionic Villus Sampling (CVS) test and Amniocentesis test along with the usage of both of these medical tests. (1) Such screening tests can only provide probability or risks that a particular condition exists. If the results are positive, diagnostic tests can provide a definitive answer. In this article, we will look at the following aspects: What is a prenatal screening test? What is the Chorionic Villus Sampling (CVS) test? What are the reasons to go for Chorionic Villus Sampling test? When is Chorionic Villus Sampling not recommended? What are the risks associated with Chorionic Villus Sampling test? What is the procedure of Chorionic Villus Sampling? What does the result of Chorionic Villus Sampling reveal? What is the cost of Chorionic Villus Sampling? Women who have a higher risk of having a child with certain conditions are usually offered additional screening tests. For example, pregnant women from regions where tuberculosis is common should go for a tuberculin skin test. If the medical practitioner recommends prenatal testing, women should ask how this test is helpful and other questions as well: How is this test helpful for patients? What will the results reveal and what will they not show? What happens if they don't get this test? What will they do with their results? How précised and are these tests? What are the risks associated with these tests? How much time is required for these tests to be conducted? What does it feel like to undergo these tests? What will the results mean for the concerned person and their family? Can they decide not to get the results even if the test has been conducted? Where should they go for these tests? Prenatal Screening Tests: Screening tests in the first trimester can begin as early as 10 weeks. These tests usually involve blood tests and an ultrasound. These tests not only help in observing for the baby’s overall development and check to see if the baby is at risk for genetic conditions, such as Down syndrome. They also check the baby for heart defects, cystic fibrosis, and other developmental problems which occurs in the baby during pregnancy. Screening tests in the second trimester are performed between 14 and 18 weeks of pregnancy. They involve blood test and ultrasound which test whether a mother is at risk for having a child with Down syndrome or neural tube defects. Chorionic Villus Sampling (CVS) test: Chorionic Villus Sampling (CVS) is an important prenatal test where a sample of tissue from the placenta is removed by the medical expert to test it. This test is done to check the chromosomal abnormalities and certain other genetic problems. The sample for the medical test can be taken through the cervix or the abdominal wall of the patient. (2) The placenta is a structure in the uterus that provides oxygen and nutrients for the growth of the baby. It also removes waste products from the baby's blood during pregnancy. The chorionic villi are one of the important parts of the female reproductive system which come out from the chorion. This chorion is formed from mesoderm tissue present in the mother. The trophoblast cells also contribute to the deriving of chorionic villi. So, they share the baby's genetic makeup. The test cannot be performed before 10 weeks of pregnancy. Chorionic villus sampling helps to understand whether a baby has a chromosomal condition, such as Down syndrome or other genetic conditions like cystic fibrosis. Although chorionic villus sampling provides valuable information about the baby's health, it's important to understand the risks and be prepared for the procedure and results as well. Reasons to Go for Chorionic Villus Sampling (CVS) Test: Chorionic Villus Sampling (CVS) is performed to get information about the baby's genetic makeup. Chorionic villus sampling is usually recommended when the test results show a major impact on the management of the pregnancy or the desire to continue the pregnancy. Chorionic villus sampling is not performed before 10 weeks of pregnancy and earlier than other prenatal diagnostic tests, such as amniocentesis. (3) One might think about chorionic villus sampling if: They had positive results from a prenatal screening test: If the medical test results of a screening test such as the first-trimester screen or prenatal cell-free DNA screening are positive or worrisome, one might opt for chorionic villus sampling to confirm or rule out a diagnosis. A woman had a chromosomal condition in a previous pregnancy: If a woman has experienced Down syndrome in a previous pregnancy or the baby was diagnosed with another chromosomal condition. Then this pregnancy might be at a slightly higher risk of being diagnosed with a genetic disorder.  At the age of 35 or older: If a woman more than 35 years old become a mother then babies born to them have a higher risk of chromosomal conditions, such as Down syndrome. History of some Genetic Condition: If someone has a family history of an explicit genetic condition, or they or their partner is a carrier of a genetic condition, then there is a higher risk of a possible diagnosis of a genetic disorder in the baby. Chorionic villus sampling not only identifies Down’s syndrome but can also be used to diagnose many other genetic conditions including single gene disorders such as Cystic Fibrosis and Tay-Sachs Disease.  Chorionic Villus Sampling (CVS) is not helpful in detecting certain birth defects, such as neural tube defects. In the case of neural tube defects, an ultrasound or genetic amniocentesis is recommended by the experts. When is Chorionic Villus Sampling (CVS) test not recommended? The doctor might caution patients against transcervical chorionic villus sampling which is done through the vagina if someone has: Vaginal or cervical infection, such as herpes Vaginal bleeding or spotting in the previous two weeks An inaccessible placenta, due to a tilted uterus or noncancerous growths in the cervix or the lower part of the uterus in a woman Have an active infection of Sexually Transmitted Diseases (STD) If a woman is carrying twins in a pregnancy Have experienced vaginal bleeding during pregnancy Diagnosed with uterine fibroid Rarely, the medical expert will recommend not to go for transabdominal chorionic villus sampling (Transabdominal CVS) which is done by the abdominal wall if: The uterus is tilted backward and placenta is located at the back of the uterus. (4) Risks associated with Chorionic Villus Sampling (CVS): Every medical test has some specific risks which need to be dealt in a smart way under the expertise of the trained medical doctors. CVS test has the following risks associated with it: Miscarriage: The chances of miscarriage after going through chorionic villus sampling is probable to be 0.22 percent. This explains that 1 in every 100 women might face miscarriage after having a CVS test. However, it is not confirmed that which miscarriages would have happened anyway, and which are due to CVS test. As per some recent researches, only a very small number of miscarriages occur after the CVS test is completed are a direct result of this test. If miscarriages happen after Chorionic villus sampling test then they occur within 3 days of the procedure. There is no evidence to suggest what one can do during this time to reduce the risk of miscarriage. (5) Rh sensitization: Chorionic villus sampling might cause some of the baby's blood cells to enter the bloodstream. If someone has Rh-negative blood and has not developed antibodies to Rh-positive blood, they will be given an injection of a blood product called Rh immune globulin after chorionic villus sampling. This will prevent their body from producing Rh antibodies that can cross the placenta and damage the baby's red blood cells. A blood test can detect if someone has begun to produce antibodies. Infection. There are very rare chances of infection by chorionic villus sampling. It might trigger a uterine infection. As per some old research papers, chorionic villus sampling might cause defects in a baby's fingers or toes. However, this risk only arises if the procedure is done before week 10 of pregnancy. One should contact their healthcare provider if these symptoms remain or get worse. (6) It is also advisable to contact the doctor if someone experiences: Fever Chills Leaking of amniotic fluid Preparation for Chorionic Villus Sampling Test: One might need to have a full bladder for chorionic villus sampling. It is advisable to check with the healthcare provider about how much fluid one might need to drink, and any other pre-test preparation that might be necessary before the test procedure appointment. The health care provider will explain the procedure and ask the concerned person to sign a consent form before the procedure begins. It is better to visit the clinic with someone for emotional support and have help who can drive home afterward. What to Expect from the CVS test?  CVS test is an indicative medical test that detects chromosome abnormalities and genetic disorders with high levels of precision which ranges up to 99%. The probabilities of detection are high for this test, but it does not measure the severity of these specific disorders. This medical test does not help to discover neural tube defects. Chorionic villus sampling is performed at the health care provider's office under the expertise of a trained and experienced medical specialist. Chorionic Villus Sampling (CVS) test procedure: First, the health care provider uses ultrasound to verify the baby's gestational age and the position of the placenta in the womb. The patient lies on their back on an examination table with their abdomen exposed. The doctor applies a special gel to their abdomen, and then use a small device known as an "ultrasound transducer". This medical device is used to show the baby's position on a monitor. Next, the doctor uses the ultrasound image as a guide and take a tissue sample from the placenta while the patient keeps lying still. This can be done through the cervix or abdominal wall of the concerned patient. (7) Transabdominal chorionic villus sampling: After cleansing the abdomen with an antiseptic, the doctor inserts a long, thin needle through the abdominal wall and into the uterus. One might notice a stinging sensation when the needle enters the skin. One might feel cramping when the needle enters the uterus. The tissue sample from the placenta withdraws into a syringe, and the needle is removed. Transcervical chorionic villus sampling: After cleansing the vagina and cervix with an antiseptic, the health care provider opens the vagina with a speculum and inserts a thin, hollow tube through the cervix. When the catheter reaches the placenta, gentle suction is used to remove a small tissue sample. After the CVS procedure: One might experience a small amount of vaginal bleeding immediately after the procedure. One can resume their normal activity level after the procedure. However, it is better to consider avoiding strenuous exercise and sexual activity for a day. Meanwhile, the tissue sample is analyzed in a lab. It may take a few days to a week or so for the declaration of results. It depends on the intricacy of the lab analysis. Contact the health care provider in case of: Fluid leaking from the vagina Heavy bleeding A Fever Uterine contractions Results of Chorionic Villus Sampling (CVS): The health care provider or a genetic counselor helps the concerned person understand their Chorionic Villus Sampling (CVS) results. Most of the times, medical test results are unclear and amniocentesis is required. Amniocentesis is another prenatal diagnostic test which is needed to clarify the diagnosis. There's a rare chance of a false-positive test with chorionic villus sampling when the test is positive, but in reality, no disease exists in the baby. It's also a noticeable point that chorionic villus sampling is not able to identify all birth defects, including spina bifida and other neural tube defects. (8) If chorionic villus sampling indicates that the baby has a chromosomal or genetic condition that can't be treated, the patients face wrenching decisions. It becomes a hard choice to decide whether to continue the pregnancy or not. During such tough times, one should look for support from their health care team and loved ones. Uncertain Results: Uncertain results are more likely to occur with CVS when compared to the results achieved with amniocentesis. The reason for this is that the CVS procedure is more likely to be contaminated with cells from the mother, occasionally making them difficult to distinguish from the baby. Also, occasionally the 'cultured' or 'grown' cells develop subtle changes from the original cells. This makes the chromosomes have a slightly different configuration and appearance, artificially creating different cells called 'pseudo-mosaics'. It is impossible to interpret these cells, making the results of the CVS inconclusive for the respective case. This would mean repeating the CVS test or having an amniocentesis test once the doctor suggests the right time for it. Injuring the Baby: When a CVS is done very early during the concerned pregnancy (less than 9 weeks of pregnancy) there is a greater chance (up to 2% or 1:50) that the baby will develop limb or facial abnormalities. It is technically possible to perform a CVS test as early as 6 to 8 weeks of pregnancy, but it is not usually recommended until after 10 weeks of the same pregnancy. CVS test done too early can cause hemorrhage effect on the baby's limbs and face, possibly leading to the baby losing fingers, toes, or part of their legs or arms. The medical term for this condition is 'limb reduction'. The possibility of this happening with a CVS test done after 10 weeks of pregnancy is quite rare, about 1: 2000 (or 0.05%).  Some caregivers do consider very early CVS in some circumstances. For example, according to Orthodox Jewish law termination of a pregnancy (or abortion) is only permitted before 40 days after the conception of the baby (or 8 weeks of pregnancy). Therefore, an early CVS test may be offered to women who feel strongly about performing the test early, being made fully aware of the increased likelihood of the baby being injured or miscarried during the pregnancy. Haemangiomas: Haemangiomas (also known as strawberry marks) are like birthmarks that are usually caused by an overgrowth of tiny blood vessels called 'capillaries' underneath the baby's skin. These create bright red (or purplish), soft, raised, spongy swellings which have a resemblance to a birthmark. Haemangiomas were more common in babies whose mother underwent CVS test during pregnancy (1.3%) when compared with early amniocentesis. (0.1%). (9) Cost of Chorionic Villus Sampling (CVS): CVS procedure cost depends on where one gets it. The role of the hospital is very important in determining the cost of a medical test or procedure. It also gets affected by whether someone has insurance or not. Many insurance plans cover at least some of the cost of CVS, but it should be checked before the treatment with the insurance company to be sure. If someone does not have insurance or their plan does not cover the procedure. Then they will have to pay for it themselves. They can get more in-depth information from their doctor’s office about Chorionic Villus Sampling (CVS) costs and available payment plans. (10) Alternative of Chorionic Villus Sampling (CVS): An alternative of CVS test is Amniocentesis test. In the Amniocentesis test, a small sample of amniotic fluid is removed for testing. This fluid surrounds the baby in the womb. This medical test is usually performed between the 15th and 18th week of pregnancy. It can also be performed later, if necessary. Amniocentesis test has a similar risk of causing a miscarriage, but the pregnancy will be at a more advanced stage before one receives the test results. So, the concerned person has less time to consider the options available for them. (11) CVS vs Amniocentesis: During pregnancy making a decision about diagnostic tests such as CVS or amniocentesis can be difficult for a couple. One needs to make this decision alone or with their partner. It may be helpful to talk through all the options with the doctor or midwife before finalizing a particular medical test. One should discuss all the options with a pediatrician and consultant geneticist or genetic nurse counselor before opting for the procedure. One may also want to know more about what is involved in ending a pregnancy and how they may feel afterward. (12) The obstetrician or midwife should discuss the following information with the concerned person: The disorders that can be detected by amniocentesis or CVS Which test would be recommended in their situation  The types of laboratory tests available and what the results will tell the concerned person The reliability of the laboratory test  Risk of having an uncertain result  The risk of miscarriage from CVS or amniocentesis including the risk in their own unit at this time  How long the results take  How the results will be revealed  What are the options if the baby is found to have a genetic disorder Difference between CVS and Amniocentesis:  In making a decision about having a diagnostic test such as CVS or amniocentesis, it is important that one has enough time and that they feel supported in the final decision. The concerned person should be given time to discuss their doubts related to the medical test and be able to request any further information. The final decision is taken after consulting the concerned doctor. (13) Name of the Test CVS Amniocentesis How is it taken? A small sample of the placenta under ultrasound guidance is taken Sample of amniotic fluid that surrounds the baby in the uterus is taken under ultrasound guidance Time of the procedure Between 10 -14 weeks of pregnancy After 15 weeks of pregnancy  Risk of miscarriage About 1 to 2 in 100 women (1-2%) may face miscarriage following the procedure About 1 in 100 women (1%) may face miscarriage following the procedure What is involved in ending the pregnancy? At this stage, it may involve a small operation to empty the womb or tablets to bring an on miscarriage When a pregnancy is ended later it involves going into labor If someone is offered tests to look for a genetic or chromosomal condition in the baby, a specialist involved in carrying out the test discusses the different options with the concerned person. It helps them make the right decision. Frequently Asked Questions (FAQs): Is amniocentesis painful?  Some of the women have given an opinion that amniocentesis gives a similar amount of discomfort which occurs in a regular blood test. One will not usually need a local anesthetic during this medical test.    Can someone have a CVS or Amniocentesis if she is pregnant with twins?  Yes, one can have a CVS or Amniocentesis if they are pregnant with twins. It is very important to know that from the respective baby's placenta the sample of placenta or fluid has been taken. If the results show one of the babies has a disorder, the concerned couple needs to know which baby is affected. The medical specialist can be consulted for the required guidance based on the results of the test. CVS or amniocentesis in multiple pregnancies is carried with a high level of expertise in ultrasound scanning by the doctors. This means one needs to be referred to a fetal medical center specialized for genetic counseling. The doctor inserts the needle twice to get samples of the placenta from each baby. In the case of the CVS test, there is a chance of getting two samples from the same baby that gives misleading results. The risk of miscarriage is more in amniocentesis with twins (1 in 56). If this happens it may lead to loss of both babies conceived with the pregnancy. (14)   Is a Chorionic Villus Sampling (CVS) test painful?  Most women are in the opinion that CVS is uncomfortable rather than painful. Some women reveal that transcervical method is like having a cervical smear taken during the test.   Is Amniocentesis better than other CVS tests? Amniocentesis is better than CVS for some women. One should undergo amniocentesis test if they have had a baby with a neural tube defect, such as spina bifida. If the concerned person or their partner has a neural tube defect then also amniocentesis is better. CVS does not test for these problems concerning fetus. Amniocentesis will be considered a better choice if the results of other tests do not come normal. CVS may be better if the concerned person or their doctor wants to know the test results during the first three months of pregnancy. Hope this article was helpful for you in getting all the information about Chorionic Villus Sampling (CVS). For more such informative articles, you can refer to Elawoman blogs. The team at Elawoman is constantly striving to make sure that infertile couples are aware of their health status associated with infertility treatments. Thousands of couples have been benefitted by Elawoman expert team's advice and suggestions with respect to planning a baby. For any assistance concerning infertility procedures, feel free and talk to the experts on the given number: +918929020600. 

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Pregnancy

Multiple Marker Test

posted on June 25, 2019, 5:45 p.m.
4.5/ 5 (1 Votes)

A multiple marker test is a blood test that measures three or four important components to find out whether the baby is at any risk for certain possible birth defects. The pregnancy of a woman produces certain components in her blood that contains information related to the baby. It is also known as Triple Marker - Second Trimester Blood. The markers measured by the test are also known by complex names such as alpha-fetoprotein (AFP). Alpha-fetoprotein is a protein produced by the baby’s liver. Also, the two hormones produced by the placenta are known as Human Chorionic Gonadotropin (HCG), and Unconjugated Estriol (uE3).  When multiple marker tests were introduced in the early 1980s then it used to measure only AFP levels which were simply known as the AFP test. Since then, the researchers have found that the combining of AFP levels reading with HCG and uE3 data work more accurately. This combination successfully assesses the risk of having a baby with any abnormalities, or Down syndrome caused by the presence of an extra copy of one chromosome in the patient. Another multiple marker test is known as 'quad screen' that measures the first three components along with the fourth component i.e. inhibin A. Adding inhibin A into the combination appears to make the test even more accurate at disclosing pregnancies at risk of Down syndrome. Most of the advanced and well- equipped labs situated across different parts of the world measure inhibin – A nowadays. (1) The result of the multiple marker test can be combined with first-trimester screening tests to give more accurate results to the patients advised to get the respective test done. Multiple marker test is more effective as compared to any other medical test. A medical expert can discuss the diagnosis with the couple as soon as he/she finds a problem. Any pregnant woman or a couple can get information related to the medical tests through this article. The article contains useful and related information linked with the prenatal tests or multiple marker tests. In this article you will get to know about the following aspects of the Multiple Marker Test:  What is a prenatal test? What are the types of a prenatal test? Why is the Multiple Marker Test Performed? Who should go for the Multiple Marker Test? What does the Multiple Marker test do? What does the result of Multiple Marker Test states? What are the reasons for further Multiple Marker testing? What if the MMS screening test shows an increased risk? What is the importance of Multiple Marker Test? Prenatal Test: Prenatal tests are the most common medical tests a pregnant woman is recommended to undergo during pregnancy. This test helps a health care provider to find out the present status of the fetus and to be a mother. A woman is suggested to undergo several important prenatal tests during pregnancy. These medical tests are important to be performed during pregnancy. The screening or multiple marker tests help in detecting any kind of defect or abnormalities in the baby. Prenatal test help in checking the below-mentioned points associated with the fetus during pregnancy:  Birth defects: These are the health conditions that are present in the baby at the time of birth. This defect changes the shape or function of one or more body parts of the fetus. Birth defects can cause problems in the overall health of the baby which might include the functioning of the body. Genetic and chromosomal conditions: These conditions are caused by changes in genes and chromosomes in the baby. A gene is a part of body cells that stores instructions so that the body can grow and function properly as per the requirement. A chromosome is the structure of cells that holds genes. Various genetic conditions include cystic fibrosis, sickle cell disease, and heart defects. One of the common chromosomal conditions is Down syndrome. Sometimes genetic and chromosomal conditions are passed from the parent to child. However, most of the times it happens on its own.  If in case certain health conditions run in the family of a couple, then it is recommended to consult their healthcare provider or genetic specialist immediately for an expert opinion. (2)  Types of prenatal testing: Prenatal testing includes first-trimester screening tests in which the medical expert will offer a blood test and an ultrasound. These two important tests are performed to measure the size of the clear space in the tissue at the back of a baby's neck effectively. There are two main types of prenatal testing which are mentioned below: Screening tests: Prenatal screening tests can identify whether the baby is more or less likely to have certain possible birth defects. Prenatal screening focuses on detecting certain genetic problems among a large population with affordable and noninvasive methods. These screening tests also include blood tests which a specific type of ultrasound and prenatal cell-free DNA screening. Prenatal screening tests are generally offered during the first or second trimester of pregnancy. The screening tests cannot make an ultimate diagnosis. The most common screening procedures include routine ultrasounds, blood tests, and blood pressure measurement. If the results of these screening tests indicate an increased risk for a genetic disorder, then the concerned health care provider will discuss certain options for a diagnostic test to confirm the diagnosis of the respective condition.  Diagnostic tests: If a screening test indicates any possible problem, then the baby of the pregnant woman is at a high risk of having genetic disorders. After knowing about the defect the couple may consider to undergo an invasive prenatal diagnostic test. This is because it is the only way to be sure of the diagnosis of the medical condition in focus. In case, the result of the screening tests indicates chorionic villus sampling and amniocentesis then it may have a slight risk of miscarriage. (3) There are three purposes of undergoing prenatal diagnosis:  To enable timely medical or surgical treatment of a condition before or after the birth of the baby  To give the couple a chance to abort a fetus having diagnosed condition  To give a couple a chance to prepare psychologically, socially, financially, and medically for having a baby with a health problem or disability Why is the Multiple Marker Test performed? The multiple marker tests are performed between weeks 15 and 20 of a woman's pregnancies. This test helps in screening any neural tube defects present in the baby growing in the womb of the pregnant woman. Neural tube defects include spina bifida or any chromosomal disorders such as 'Down syndrome' and 'Trisomy 18'. Depending on the number of aspects efficiently measured, the test also is called: The test is also known as "triple screen" or "triple marker". This is because it looks at the levels of a protein, Alpha-Fetoprotein (AFP), and two pregnancy hormones, estriol and Human Chorionic Gonadotropin (HCG). The test is also known as "quadruple screen" ("quad screen") or "quadruple marker" ("quad marker"). It is known as 'quadruple screening' because the test helps in measuring a combination of four components. This medical screening calculates a woman's individual risk based on the levels of these four basic components. The result of this screening is also based on age, weight, and race of a pregnant woman. It also depends whether the woman has diabetes, which requires insulin treatment or a number of the fetus she is carrying in her pregnancy. The accuracy of the multiple marker test increases with the greater number of markers used in this medical test. The increased number of markers also helps in identifying the possibility of having a problem efficiently. In some cases, the doctor will combine the results of the multiple marker tests along with the first-trimester screen. This will help the doctor in getting a better idea of a baby’s risk for Down syndrome and neural tube defects. (4) Who should go for this test? A multiple marker test or triple screen test is generally offered to all pregnant women, regardless of whether their pregnancy is considered at low or high risk. However, the choice of undergoing the test depends on the couple.  A pregnant woman of age 35 years or older should consider taking this screen test.  A woman should consider taking the screen test if she has any family history of birth defects, or have had a pregnancy with a birth defect.  This test is also advisable to a woman having insulin-dependent diabetes or has used any kind of medications or drugs that can cause any harm during pregnancy. Multiple marker tests can be recommended to a woman who is diagnosed with a viral infection or is exposed to high levels of radiation during pregnancy. A multiple marker test is the most accurate test when performed between the 16th and 18th weeks of the pregnancy. This medical test can be performed in the time frame of week 15 to week 20 which will provide the desired results in pregnancy. In some rare cases, experts also perform the test, up to week 22 of pregnancy. (5) What does the Multiple Marker test do? Since, multiple marker tests is a screening tool, not a diagnostic tool, this test doesn’t confirm whether the baby will or will not have a birth defect. But the test can give patients or the couple more details related to the chance of carrying a child with certain abnormalities, including the following: Down syndrome: This syndrome is caused by an extra copy of chromosome 21 in the respective patient. This condition affects the ratio of one in 733 babies. Down syndrome is characterized by mental retardation and distinct facial features. This distinct facial feature includes slanted eyes, the low-set position of ears, and a flat face. Children who have this disorder often have heart defects as well as other health problems. Trisomy 18: This syndrome is caused by an extra copy of chromosome 18. This condition affects the ratio of one in 7,000 babies. Trisomy 18 causes severe mental retardation and numerous physical defects to the fetus within the first few years of birth of the baby. Neural tube defects: The neural tube is the embryonic structure that develops into the brain and spinal cord. The brain and the spinal cord of the babies don’t grow properly in case the baby is having neural tube defects. This can also result in spina bifida which is known as open spine. This can lead to neurological problems, leg paralysis, bladder, and bowel impairment. A neural tube disorder which is also known as anencephaly i.e. a fatal condition characterized by an underdeveloped brain and skull. This kind of defect occurs in about 1 in 1,000 pregnancies.  Abdominal defects: This test results can signal a potential risk of having a rare defect of the abdominal wall, kidney, or bowel. (6) Multiple Marker Test Results: If in case a couple has undergone the multiple marker tests and has received abnormal results then there is no need to worry for the patient. Any minor change in the reports doesn’t mean that the child has a birth defect. Rather, this change or an abnormal screen indicates that the fetus should be evaluated further. If in case the results show high levels of AFP, then it is pointing to a possible risk of spina bifida or another neural tube defect. The doctor will order a detailed ultrasound to examine the fetus, including the fetal skull and spine. In addition, an ultrasound can confirm the age of the child or whether a woman is carrying multiples. Rather than this, the doctor may also refer to amniocentesis, which is the withdrawal of amniotic fluid from the uterus of the pregnant woman. (7) If in case the multiple marker screen results in low levels of AFP and estriol with high levels of HCG and inhibin-A. This indicates that the baby has an increased risk of having Down syndrome. The next step is often an ultrasound that is performed to confirm the due date of the baby. It is also performed to look for any obvious abnormalities. However, the ultrasound is not a very good test for detecting Down syndrome. This is why pregnant women are offered amniocentesis so that their chromosome testing can be done efficiently. This test is performed on the fetal cells that are found in the amniotic fluid. One must remember that the multiple marker tests are just a screen test. This test can identify many fetuses having any kind of risk for certain birth defects. A positive screen doesn’t usually mean that there’s a birth defect. But it mostly indicates that there’s a need for more evaluation. (8) What are the reasons for further testing? The triple screen is a routine screening test. This test is not an invasive procedure and poses no risks to the pregnant woman or baby. If the triple screen result is abnormal then it requires additional testing. The reasons to pursue further testing depend on the medical case of the couple. If in case a doctor recommends a couple for undergoing further tests to confirm a diagnosis then it may provide you with certain opportunities such as: A doctor may recommend a couple to pursue potential interventions that may exist i.e. fetal surgery for spina bifida A couple can begin their planning for a child with special needs A couple can start addressing anticipated lifestyle changes A couple can identify support groups and resources Rather than this, some individuals or couples may decide not to pursue testing or additional testing for multiple reasons such as: The couple is comfortable with the results no matter what the outcome is The couple can deny pursuing further tests because of their personal, moral, or religious reasons Some parents choose not to pursue any testing that may cause any risk of harming the development of the baby. It is important for a couple to discuss all the risks and benefits of testing thoroughly with their healthcare provider. The healthcare provider will help the couple in evaluating the benefits from the results that could outweigh any risks the baby from the procedure. (9) What if the MMS screening test shows an increased risk? If MMS test results show an increased risk, then a couple will be counseled by the doctor. The first step of testing is to have an ultrasound examination. In some cases, the blood test results are higher or lower than the expectations. This is because the pregnancy has not reached as far when last menstrual periods calculations are considered. In such cases, the expected due date of the delivery and the interpretation of the test may be changed after the ultrasound examination. If the risk of having Down syndrome is still high then a couple may decide to have additional screening with cell-free DNA. (10) What is the importance of Multiple Marker Test? The importance of the Multiple Marker Test are: Estriol: It is an estrogen hormone that comes from the placenta and the fetus. If in case the level of estriol is low then it may indicate that the baby may have Down’s syndrome. Down syndrome is the delay of growth, development, and intelligence due to the disorder of chromosome 21. This will be more prominent if the level of alpha-fetoprotein is low and the level of human chorionic gonadotropin is high. Human chorionic gonadotropin (HCG): This is a type of hormone which is produced by the placenta. HCG levels play an important role in pregnancy. If human chorionic gonadotropin levels are declined then it may indicate certain problems with pregnancy such as miscarriage or ectopic pregnancy. If the human chorionic gonadotropin levels are increased then it may indicate a molar pregnancy or multiple pregnancies.  Alpha-fetoprotein (AFP): This is a protein developed by the fetus. If the level of alpha-fetoprotein is raised then it may be due to potential defects in the fetus such as neural tube defects or failure of the fetus’s abdomen to close. Hence, multiple marker tests help a doctor in detecting whether the baby is suffering from any genetic disorders such as Down’s syndrome or Edward syndrome or not. Edward’s syndrome is a condition that leads to various severe developmental delays caused due to chromosome 18 abnormality. This is a very favorable method to detect any genetic defects in the baby before its birth. This test provides a probable ratio of the unborn baby having a chromosomal defect. If in case, the ratio of having a chromosomal abnormality is high then the couple should go for further tests such as amniocentesis. (11)  Pregnant women are advised by medical experts to undergo prenatal tests for having a healthy pregnancy and the ultimate birth of the baby. Multiple marker tests are one of the most suggested prenatal tests to a pregnant woman. It is a beneficial test performed to detect any kind of defect present in the fetus. Prenatal screening determines a high chance of having a baby with Down syndrome, Trisomy 18, or an open neural tube defect. Prenatal screening can also determine the chance of having any other genetic conditions and congenital anomalies in a baby during pregnancy. A pregnant woman can also get more information related to pregnancy and delivery by visiting www.elawoman.com. You can also take the assistance of best obstetricians by contacting us on +918929020600.

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Pregnancy

Anti-Mullerian Hormone (AMH) Test

posted on June 15, 2019, 4:11 p.m.
4.5/ 5 (1 Votes)

A woman's reproductive system is built with several organs which function with the assistance of several crucial hormones. AMH is one of the most important hormones which contributes to the proper working of the system in every woman. Anti-Mullerian Hormone (AMH) is a hormone secreted by cells in developing egg sacs or follicles. Anti-Müllerian hormone (AMH), also known as Müllerian-inhibiting hormone (MIH), is a glycoprotein hormone structurally related to inhibin and activin from the transforming growth factor-beta superfamily. Their key roles are in growth differentiation and folliculogenesis. In humans, the gene for AMH is AMH, on chromosome 19p 13 while the gene AMHR2 codes for its receptor on a chromosome. Anti-Mullerian Hormone (AMH) plasma levels reflect the continuous non-cyclic growth of small follicles, mirroring the size of the resting primordial follicle pool. It acts as a useful marker of ovarian reserve. AMH maybe the best endocrine marker for assessing the age-related decline of the ovarian pool in healthy women. AMH has the potential ability to predict future reproductive lifespan in women. The most accepted role for measuring AMH is before the initiation of In Vitro Fertilization (IVF) as AMH can be predictive of the ovarian response, namely poor, and hyper-responses. However, some research suggests that AMH can be used in a variety of ovarian pathological conditions. They can be used for detecting the presence of Polycystic Ovary Syndrome (PCOS), Granulosa cell tumors, and Premature Ovarian Failure. A new commercial enzyme-linked immunosorbent assay for measuring AMH levels has been developed, making results from different studies more efficient and comparable. Nevertheless, widespread clinical application awaits an international standard for Anti Mullerian Hormone, so that results using future assays can be reliably compared. (1) In this article we will look at: What are the functions of Anti Mullerian Hormone (AMH)? What is the Anti-Mullerian Hormone Test? What is AMH Test used for? What is the process involved in AMH Tests? When to get tested with AMH test? What are the factors that influence AMH levels? What is the significance of AMH Tests? What are the effects of IVF procedure with low AMH level? How to increase an AMH level in the body? Why is AMH more preferred over FSH? How is age and AMH related to each other? Functions of Anti Mullerian Hormone (AMH): Embryogenesis: In male mammals, AMH prevents the development of the Müllerian ducts into the uterus and other Müllerian structures. The effect is ipsilateral, that is each testis has the ability to suppress Müllerian development only on its own side. In humans, this action occurs during the first 8 weeks of the gestational period. If no hormone is produced from the gonads, the Müllerian ducts automatically develop. Wolffian ducts, which are responsible for male reproductive parts, automatically die. Amounts of AMH that are measurable in the blood vary by age and gender. It works by interacting with specific receptors on the surface of the cells of target tissues (anti-Müllerian hormone receptors). The best-known and most specific effect, mediated through the AMH type II receptors, including programmed cell death (apoptosis) of the target tissue (the fetal Müllerian ducts).   Ovarian Functioning: Anti Mullerian Hormone is expressed by granulosa cells of the ovary during the reproductive years. It limits the formation of primary follicles by inhibiting excessive follicular recruitment by FSH. AMH expression is often maximum in the recruitment stage of folliculogenesis which primarily occurs in the small antral, and preantral follicles. This AMH expression diminishes as follicles develop and enter the selection stage, upon which FSH expression increases. Some authorities suggest it is a measure of certain aspects of ovarian function, useful in assessing conditions such as Polycystic Ovary Syndrome (PCOS) and premature ovarian failure.   Other Functions: Anti Mullerian Hormone (AMH) production by the Sertoli cells of the testes remains high throughout childhood stage in males. However, it may decline to a certain extent during puberty and adult life. AMH has been shown to regulate the production of sex hormones and changing AMH levels may be involved in the onset of puberty in both sexes. It has also been observed in one of the latest performed medical researches that functional AMH receptors are expressed in neurons in the brains of embryonic mice. They are thought to play a crucial role in the development of gender-specific behaviors and sexually dimorphic brain development.   Pathology: Inadequate AMH activity in men may lead to Persistent Mullerian Duct Syndrome (PMDS) in which a rudimentary uterus is present and testes are usually undescended. The AMH gene or the gene for its receptor (AMH-RII) are usually abnormal. AMH measurements have also become widely used in the evaluation of testicular presence and function in infants with intersex conditions, cryptorchidism, and ambiguous genitalia. According to a study, it was found that there was a link between a hormonal imbalance in the womb and Polycystic ovary syndrome (PCOS), specifically prenatal exposure to Anti-Mullerian hormone. For the study, the researchers injected pregnant mice with AMH, so that they had a higher than normal concentration of the Anti-Mullerian Hormone. Indeed, they gave birth to daughters who later developed PCOS-like tendencies. These include conditions like delayed puberty, infertility, and erratic ovulation. To reverse it, the researchers dosed the polycystic mice with an IVF drug called cetrorelix, which made the symptoms to go away. These experiments should be confirmed in humans, but it could be the first step in understanding the relationship between Polycystic Ovary Syndrome (PCOS) and the Anti-Mullerian hormone (AMH). (2)   Blood levels: In healthy females, AMH is either just detectable in cord blood at birth. This indicates a marked rise by three months of age. AMH level falls until four years of age before rising linearly until eight years of age. It remains fairly constant from mid-childhood to early adulthood. It does not change significantly during puberty. The rise during childhood and adolescence is likely reflective of different stages of follicle development. AMH declines to undetectable levels at the menopause stage of the respective woman's life. The standard measurement of AMH follows the Generation II assay. This gives the same values as the previously used IBC assay. AMH values from the previously used Diagnostic Systems Lab (DSL) assay should be multiplied with 1.39 to conform to current standards because it used a different set of antibodies for the chosen tests. It is generally suggested that AMH should be measured only in the early follicular phase because of variation over the menstrual cycle. Also, AMH levels decrease if the individual is presently using oral contraceptives and tobacco smoking. Anti-Müllerian Hormone Tests: The level of AMH in a woman's blood is usually a very good indicator of her ovarian reserve. AMH concentrations slowly decrease with increasing age after an initial increase until early adulthood. It becomes undetectable 5 years before the woman has passed the menopause stage when the stock of primordial follicles is exhausted. There is sufficient variability in the pace of follicle pool depletion when several women are taken into consideration. The initial size of the follicle pool is reflected by a wide range of age at menopause. Individual AMH serum concentration does accurately reflect the size of the pool of antral follicles. This represents the quantity of the remaining primordial follicles. AMH is made in the reproductive tissues of both males and females. The role of AMH and whether levels are normal depending on the age and gender factor. (3) Uses of Anti-Mullerian Hormone Tests: An Anti-Mullerian Hormone (AMH) test is generally used to check a woman's ability to produce eggs that can be fertilized for pregnancy. A woman's ovaries can make thousands of eggs during her childbearing years. The number declines as a woman gets older. The levels of AMH indicates the appropriate number of potential egg cells a woman is left with, this is known as the ovarian reserve. If a woman's ovarian reserve is high, she may have a better chance of getting pregnant. She may also be able to wait for months or years before trying to get pregnant depending on the ovarian reserve of the woman. If the ovarian reserve is low, it may mean a woman will have trouble getting pregnant. In this case, she should not take very long to decide on trying to have a baby. (4) AMH tests may also be used for the following purposes: To predict the start of menopause. A time in a woman's life when her menstrual periods have stopped and she cannot conceive anymore. It usually starts when a woman is around 50 years old. In order to find out the reason for early menopause. Helps in finding out the reason for amenorrhoea, the lack of menstruation. It is most often diagnosed in girls who have not started menstruating by the age of 15 and among those women who have missed several periods. Help diagnose Polycystic Ovary Syndrome (PCOS), a hormonal disorder that is a common cause of female infertility, the inability to get pregnant. Check infants with genitals that are not clearly identified as male or female. Monitor women who have already been diagnosed with ovarian cancer. Process of AMH Tests: A health care professional firstly takes a blood sample from a vein in the patient's arm, using a small needle. After the needle is inserted, a small amount of blood is collected into a test tube or vial with care. Patients may feel some kind of discomfort when the needle is inserted by the professional or removed out after collecting the blood. The procedure usually takes less than five minutes. There is very little risk associated with a blood test. Patients may experience slight pain or bruise at the spot where the needle was put in. Most of the symptoms vanish at a quicker pace. It may not necessarily be a part of routine fertility blood testing. Patients may not need to fast or take other special actions prior to the test. The test results are very helpful in guiding which procedure one needs to choose for their respective case. To get the best overall picture of a woman's fertility, AMH testing works best when done in combination with an antral follicle count test. The doctor may advise other tests as well, particularly if patients have not undergone extensive hormonal tests. This means that they may need to undergo testing at a specific point in their cycle, even though the AMH test can be performed as and when required. Most of the researches suggest that birth control pills do not affect AMH levels in women. However, they can have an impact on the level of other hormones. The doctor may request their patients to go off of birth control for up to three months. If patients are dependent on other fertility drugs, it is important to inform the doctor before undergoing any fertility tests. (5) When to get Tested with AMH test? Getting an AMH test is most appropriate when a healthcare practitioner wants to evaluate a woman's fertility, predict the onset of menopause, confirm the presence of PCOS. The AMH test is also recommended when there is a requirement of evaluation of the cause of male characteristics in a female (also known as virilization). Sometimes, it is required prior to some assisted reproductive procedures, periodically when a woman is undergoing treatment for an AMH-producing ovarian cancer. It is helpful in suspecting that testicles of an infant boy are absent, hidden, or not functioning properly. (6) Factors influencing AMH Levels: Variation in AMH levels could also be explained by biological variance. Results may be contradictory regarding intra and inter-cycle variability of AMH levels. Some studies show these to be limited and merely represent fluctuations by chance. These could be possibly related to gradual changes in the number of antral follicles present in both ovaries. However, other studies have demonstrated substantial fluctuations in the menstrual cycle, which would argue in favor of measuring AMH levels at the early follicular phase only. Especially in young women, this fluctuation in AMH over a time period of several weeks may be quite extensive. It needs to be taken into consideration if applied in clinical conditions. It has been suggested that AMH levels remain constant under the influence of exogenous sex steroids used for contraception. In a recent large cohort study which was conducted in more than 2000 women, it was demonstrated that AMH levels decrease under current use of oral contraceptives. Such an effect was also demonstrated in other studies. Previous use of oral contraception was not associated with lower AMH levels. AMH levels may stay at the increased level even after discontinuation of oral contraceptives. Both findings support the notion of a reversible suppressive subtle effect of oral contraceptives on AMH. It was also demonstrated that under mid-luteal GnRH (Gonadotropin-releasing hormone) agonist administration AMH levels changed significantly across the initial 4 weeks. Such observations suggest that a patient is presently receiving GnRH agonist medication. For example in cancer treatment, AMH may not be a reliable marker of ovarian reserve. Finally, various other factors were recently described to influence absolute AMH concentrations, including overweight, ethnicity, Vitamin D status, polymorphisms of AMH hormone. If a patient presently has a habit of smoking then also there are high chances of having low AMH levels in the body. The clinical relevance of the given observations remains to be determined. (7) Significance of AMH Test Results: Here is some AMH levels reference: An AMH level over 3,0 ng/ml, is usually an indicator of Polycystic Ovarian Syndrome (PCOS). It means that there are lots of growing follicles in the ovaries. This potentially puts a woman at risk of Ovarian Hyperstimulation Syndrome (OHSS), if she is planning to go for Assisted Reproductive Treatment (ART). The level of AMH between 3 and 0.7 ng/ml means that ovarian reserve is normal. There may be other reasons for infertility as well. If AMH levels are normal and a woman still has not succeeded in getting pregnant, she might need further examination with the assistance of other recommended medical tests. Besides she has to improve her overall health with better nutrition, exercise, and increased relaxation. Anywhere between 0 and 0.6, ng/ml will require IVF or FSH stimulation. This score might help the doctor to understand if the patient has a low ovarian reserve. The ovarian reserve is also a potential indicator of the outcome of pregnancy treatment. With this test result, patients are most likely to receive additional treatment to increase their AMH levels. If a woman is trying to conceive, and there are no issues with sperm count, a doctor who discovers that AMH levels are optimum usually advises treatment to remove other health factors that might negatively affect the occurrence of conception. If both the patient and her partner are theoretically able to conceive, the doctor might then move on to advise additional medical treatments and lifestyle changes to improve the chances of getting pregnant. IVF procedure with Low AMH Levels: The probability of success with an In Vitro Fertilization (IVF) cycle largely depends on a woman's ovarian reserve. It also depends on her ability to produce a decent number of high-quality eggs in a cycle. In some of the abnormal cases, the high FSH levels along with low AMH levels, suggests a compromised ability of the ovaries to produce a good number of high-quality eggs. It denotes a relatively poor fertility prognosis and low probability of success with IVF procedure. AMH below 1.05 ng/ml, has been associated with extremely low pregnancy rates and many IVF centers deny treatment to women with such low levels of AMH. However, recent research suggests that even women with undetectably low AMH levels (below 0.16 ng/ml) can still conceive and successfully carry a pregnancy after she implements the suggested measures. Many women are able to carry their pregnancy to term if given proper treatment involving DHEA supplementation along with well-designed ovarian stimulation protocols. (8) Measures to increase an AMH Level: Patients with low AMH typically benefit the most from well-managed IVF protocols when performed by the infertility specialist. DHEA supplementation has been shown to be effective in improving IVF pregnancy rates in women with low AMH. Studies over the last 8-9 years have shown significant improvements in AMH levels after DHEA supplementation. Women who are reaching their late thirties saw a significant improvement in AMH concentrations after DHEA treatment, compared to older women. With the introduction of DHEA supplementation and research-driven treatment plans are modified to best suit individual patients, diagnosis and treatment are more effective for diminished ovarian reserve. An umbrella term encompassing both premature ovarian aging and natural, age-related loss of ovarian reserve. (9) AMH versus FSH levels: The FSH level is not as reliable as the AMH level for the following 3 reasons. The FSH level varies according to the menstrual cycle dates. It depends upon the estradiol level (a high estradiol level will artificially suppress a high abnormal FSH level into the normal range). It varies from cycle to cycle. It is not always reliable or dependable. An Anti-Mullerian Hormone level is a much better marker for ovarian reserve. AMH is much more stable than the FSH level. It does not vary from cycle to cycle. Even better, it can be measured on any day of the cycle. This is why most infertility specialists today prefer AMH to check ovarian reserve, rather than the old FSH level. One crucial aspect of AMH is that there are at least 2 scales and innumerable clinic definitions of what is "normal". It depends on which assay and study need to be used. One scale is ng/ml and one is pmol/l. The pmol/l scale runs from 0 to 48, the ng/ml runs from about 0-10. On the ng/ml scale, less than 2 ng/ml is considered to be a low AMH. Age and AMH level: It is important to remember that FSH levels increase as women age while AMH levels decline. In other words, normal FSH and AMH and levels vary depending on a woman’s age. For example, a normal AMH level for a woman at 41 could suggest premature ovarian aging (POA) if the same AMH level was found in a 32-year-old woman. Focusing on age-specific AMH and FSH levels is the best way to assess a woman’s ovarian reserve. It is also the best way to devise an appropriate treatment plan and estimate her IVF pregnancy chances. An AMH level can also be very useful for young women who want to check their fertility levels or want to postpone childbearing. Some women these days are postponing having a baby in order to pursue a career. The good news is that while usually, fertility does not decline too much below the age of 32, for some women the decision to postpone childbearing can prove to be one they may regret later. Fertility declines as a woman grow older and the problem is that it is not possible to predict the rate of fertility decline for an individual woman. Most women are lulled into a false sense of security if they have a regular period. They assume that if their periods are regular, this automatically means that their egg quality is very good for a successful conception. This is not always true for some women. While their egg quality is up to the mark for them to produce enough hormones to get regular periods, they may not be able to conceive. If the AMH level is low, patients might want to re-think their priorities. If it is normal, then one usually has a possible option of postponing their childbearing years. (10) Several medical tests like AMH are performed during infertility treatments which aid in the success of the same. You can take the assistance of Elawoman right from the start of your fertility treatment journey. You can also browse some of the blogs in the pregnancy section of Elawoman. You can also contact us on +918929020600 to solve your queries.

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Percutaneous Umbilical Blood Sampling (PUBS)

posted on June 15, 2019, 3:30 p.m.
4.5/ 5 (1 Votes)

Percutaneous umbilical blood sampling (PUBS) is also known as 'Cordocentesis'. It is a diagnostic procedure which is used to evaluate different kinds of fetal conditions. PUBS is generally conducted once the tenure of 18 to 19 weeks of pregnancy is going on. During the procedure of Percutaneous Umbilical Blood Sampling, a well-trained specialist uses ultrasound imaging. This helps in completing the procedure successfully by guiding a needle through the maternal abdomen and into the umbilical cord. This process helps the specialist to take a sample of fetal blood for inspection to find out the presence of any fetal conditions successfully. (1) After the procedure is completed, the blood sample can be used to diagnose a wide spectrum of any fetal conditions such as from infections to genetic disorders. (2) Confirming a suspected diagnosis before the birth of the child may offer the couple an opportunity to pursue medical interventions which is recommended for their case. PUBS is usually done by a specially trained primatologist, a doctor who specializes in the care of the fetus, especially in high-risk pregnancies. It is done as a part of diagnosing, treating, and monitoring fetal problems multiple times during pregnancy. PUBS may be taken for: Diagnosing genetic or chromosome abnormalities Checking for blood problems such as Rh disease and treating severe fetal anemia Checking oxygen levels of the fetus Checking for any infection in the fetus Giving certain medications which are good for the health of the fetus This article will help you know about certain important details related to Percutaneous Umbilical Blood Sampling process such as its advantages, disadvantages, reasons for its uses, the procedure of the same, measures a woman needs to take during or after the process. It is necessary to discuss the risks and benefits of the medical test thoroughly with the healthcare provider of your choice. The healthcare provider will help you to evaluate whether the benefits from the results could outweigh any risks from the procedure or not. You will find the required and necessary details that could help a woman undergoing PUBS successfully. In this article you will get to know about: Why is Percutaneous Umbilical Blood Sampling (PUBS) performed? What are the associated risks and complications? When is Percutaneous Umbilical Blood Sampling recommended? What can be diagnosed with PUBS? How is Percutaneous Umbilical Blood sampling is performed? What are the steps of Percutaneous Umbilical Cord Sampling (PUBS) Procedure? What are the advantages of Percutaneous Umbilical Blood Sampling? What are the disadvantages of Percutaneous Umbilical Blood Sampling? What are the important points to remember during or after PUBS procedure? Why is Percutaneous Umbilical Blood Sampling (PUBS) performed? Percutaneous Umbilical Blood Sampling (PUBS) is usually done in addition to an ultrasound and amniocentesis. This process is required in multiple cases such as: This process helps in quickly checking a baby's chromosomes for any defects or disorders The main concern of this procedure is that the baby may have another problem as the pregnant woman may be diagnosed with low platelet count or a thyroid condition which can impact the overall health of the baby. The main advantage of PUBS is its ease of performing the medical test. This test is the only way to confirm if the fetus is anemic or have a platelet disorder. This procedure works efficiently because it uses a blood sample rather than an amniotic fluid sample. Percutaneous Umbilical Blood Sampling (PUBS) also allows transfusion of blood or needed fluids into the baby while the needle is in place. (3) After declaring the results of the medical test, the medical specialist will help the patient to understand the reports. If the reports are normal then he/she would discuss the need for any follow-up appointments or continue with general obstetric appointments. But if in case the baby has any kind of infection then the specialist would explain the treatment options related to it. If the baby has severe anemia then the specialist performs blood transfusion procedure through the umbilical cord in the pregnant woman. Lastly, if the medical test results indicate that the baby has a condition that can't be treated then a woman might be faced with wrenching decisions. The medical professional asks the patient to decide whether to continue with the pregnancy or not. A woman can seek support from her family members and the team at the hospital. Associated Risks and Complications: As mentioned earlier, PUBS is an invasive diagnostic procedure in the field of infertility medicine. This test carries a number of risks and complications which are related to a number of factors from the procedure, the experience of the staff performing the test to the gestational age. However, the risks involved in each case vary according to the indications of the procedure and the medical case of the patient. (4) For example, fetuses which are structurally abnormal or had any growth deficiencies were found to be more capable of the associated risks and complications of PUBS. Percutaneous Umbilical Blood Sampling is a very complex procedure that must be done by a specially trained doctor. It is used at that stage of pregnancy when other medical tests or procedures are not effective for the respective patient's case. It can be performed for pregnancies that are of 18 weeks or later. Some of the prominently found risks include: Transient bleeding of the umbilical cord: The puncture site is most common and occurs in almost 20% of the pregnancy cases. Often the bleeding spontaneously stops within a short period of time i.e. within 1 minute in most of the patients if there are no already present complications in the patient. While in some cases, continued bleeding may prove that the fetus may have blood disorders i.e. alloimmune thrombocytopenia. Transient fetal bradycardia: In this case, the heart rate of the fetus falls below 100bpm which is the most common complication after PUBS is performed. This complication has been found to occur during or immediately after PUBS was performed in approximately 8% of pregnancy cases. Transient fetal bradycardia occurs due to puncture issues. This causes changes in the circulation thus induces reflexes and releases the substances within the fetal circulation. In most of the cases, it brings short term changes in fetal heart rate during PUBS. Till now the test has not reported any long term fetal injury except for the presence of underlying fetal disorders. However, manual compression through the maternal abdomen is recently the most preferred method of fetus revival and it is conducted by a medical professional who has expertise in the same. Failure to obtain a sample: It is also a complication occurring in few cases which may require further PUBS procedure. This could potentially increase the likelihood of fetal distress and preterm labor. Preterm labor: It may impel upon the medical team, overseeing the procedure. They must be prepared to perform an immediate emergency cesarean delivery in these cases. Fetal loss: Fetal death refers to the spontaneous intrauterine death of a baby at any time during pregnancy. (5) This is mostly found in less than 2% of cases which is attributed to a number of factors including procedural time, gestational age, underlying medical conditions, the expertise of the operator, pregnancy complications, and movement of the fetus. (6) Slowing of the baby's heart rate: The baby's heart rate might slow temporarily after cordocentesis. Passing maternal infection: If a pregnant woman has certain infections, such as hepatitis B, hepatitis C, or HIV, they might be passed to the baby. Such infections also pose to be one of the most common risks for the baby. The most common complication of PUBS procedure is a hemorrhage or bleeding, of the puncture site. It can be dangerous when the fetus is younger than 21 weeks in a pregnancy. The risk of hemorrhage is greater if the fetus has any defect that can affect its blood platelets as well. A transfusion of donor platelets is generally done in such cases to decrease the risk of bleeding. If in case, the bleeding is severe then the specialist may opt for immediate delivery as long as the fetus is old enough to survive. It may also be considered if the fetal blood volume can be restored with the help of certain medical measures. When is Percutaneous Umbilical Blood Sampling done? This procedure is generally performed when diagnostic information can't be accumulated via other tests such as amniocentesis, chorionic villus sampling (CVS), or ultrasound. However, the results of these tests were inconclusive. Percutaneous Umbilical Blood Sampling (PUBS) may also be used late in pregnancy. If in case, the woman has been exposed to a disease that could harm the fetus or when ultrasound has found the presence of a fetal abnormality, then the specialist can either suggest any treatment or else recommend to terminate the pregnancy. PUBS can be performed as early as the 18th week of the tenure of pregnancy in a woman. This is because performed before the 18th week of pregnancy the umbilical vein is too fragile for the procedure. But it's usually used later in pregnancy. The main advantage of this test is that it's less time-consuming which eases the experience with respect to the test. A doctor may recommend a woman for amniocentesis or CVS if the woman wants to check her baby whether it has a chromosomal defect or any blood disorder. It may take a few weeks to get the results of the amniocentesis test. However, compared to amniocentesis or CVS, PUBS can provide results quicker which can be advantageous for the health of the fetus. PUBS test may be worth it if a woman who is currently in her 20 weeks of pregnancy and is advised to end her pregnancy based on a finding of abnormalities or disorder in her fetus. (7) What can be diagnosed with PUBS? Percutaneous umbilical blood sampling can diagnose multiple abnormalities and disorders. Some cases that are successfully diagnosed by PUBS are: Chromosomal abnormalities: A chromosomal abnormality occurs when a baby has either the incorrect number of chromosomes or else the chromosomes are structurally flawed. These abnormalities in a fetus may translate to the development of birth defects and disorders such as Down syndrome, or miscarriage. These defects or disorders may be diagnosed with PUBS efficiently. Blood disorders: Bleeding disorders are also known as "coagulopathy" which are the conditions that can affect the body of a fetus as well as the mother. The ability to clot normally especially at the area of an injury can result in bleeding that can range from mild to severe. Bleeding disorders like anemia also affect the health of the fetus in the mother's womb. Metabolic disorders: A metabolic disorder can only occur when abnormal chemical reactions alter the normal metabolic process in the body. (8) PUBS can diagnose various infections such as toxoplasmosis and rubella which helps the pregnant woman take the required measures. This test can also help in diagnosing some causes of structural problems or intrauterine growth restriction in the woman. This procedure is also utilized to perform blood transfusions to the fetus and to regulate medication directly into the fetal blood supply. (9) How is Percutaneous Umbilical Blood sampling is performed? This procedure is performed with the help of an advanced imaging ultrasound that determines the location where the umbilical cord inserts into the placenta. The ultrasound inserts and then guides a thin needle through the abdomen and uterine walls of a woman to the umbilical cord. In this process, the needle is inserted into the umbilical cord to retrieve a small sample of the fetal blood. The sample is then sent to a well equipped and advanced medical laboratory for analysis, and the results are normally available within 72 hours after the test is performed. This procedure is similar to amniocentesis, except their objective i.e. to retrieve blood from the fetus versus amniotic fluid. (10) Steps of Percutaneous Umbilical Cord Sampling (PUBS) Procedure: PUBS is performed by the advancement of a needle within an ultrasound visual field to a targeted puncture site in the maternal body. It consists of three fundamental steps which are mentioned below: Step 1– Imaging: Imaging means an advanced imaging ultrasound which is used to determine the location of where the umbilical cord inserts into the placenta. This ultrasound image is then used to guide in PUBS procedure in order to guide a thin needle through the abdomen and uterine wall of the pregnant woman and into the umbilical vein running through the cord. This guidance leads the needle to reach the placenta for the blood sample of the fetus. Step 2 - Retrieval of Fetal Blood Sample: The needle is then inserted into the cord to take a small blood sample of a fetus. There are two main routes for retrieving fetal blood. The method used to perform this procedure is determined by the position of the placenta in the uterus. This is the point of connection with the umbilical cord. However, the ideal sample site for PUBS is located at the root of the umbilical cord. It is due to its stable fixed position which is less susceptible to disturbances caused by fetal movement. There are two techniques that can be utilized when obtaining a blood sample of the fetus i.e. freehand and needle-guided. The choice of technique depends on a number of factors including the location of the cord root and the preferences of the physician who is performing the procedure. Freehand: This technique allows lateral readjustment of needle direction once within the uterus of the pregnant woman. A transducer is used to navigate the needle to the specific sample site. It is the more preferred technique due to the increased range of movement. Needle-guided: This technique involves the insertion of a separate needle straight into the targeted puncture site for diagnosing any kind of defect or infection present in the baby. This insertion is done with the support of the transducer, which builds a fixed passage through, with a second smaller needle that passes to retrieve the sample of fetal blood. Despite permitting precise alignment of the needle track with the vessel, the range of movement is limited to a single plane of travel. It is very important to note that when a specialist is performing PUBS, he/she should know whether the mother is Rh-negative, Rh Immune-Globulin (RhIG). If in case it is present in the mother than it is administered in the mother in order to prevent the development of Rh incompatibility and further sensitization. Step 3 - Sample Analysis: After taking the blood sample of the fetus, it is then sent to an advanced medical lab. Further, the sample is screened for genetic defects and other disorders in a laboratory full of advanced technology. Preliminary to this, Betke test is performed in order to confirm that the blood sample obtained is of a fetus. The result of the test is usually available within 72 hours. However, under some circumstances, it may take a few weeks to declare the result. In the event of diagnosis or any fetal abnormalities, the specialist has to perform the most suitable procedure. Advantages of PUBS: PUBS has multiple advantages but one of the most impressive advantages is that the result of this procedure is available at a quicker rate as compared to another test. After the reports are released and the abnormalities detected are at a normal stage then it is cured with the help of a specialist or expert. Or if in case any serious abnormality or infection or any defect is detected then the pregnancy of that woman is terminated after expert opinion. Some other advantages of this procedure are stated below: PUBS is absolutely successful in detecting the presence of any genetic or chromosomal abnormalities such as Down syndrome and Edwards Syndrome. The blood sample taken via PUBS procedure is available for different types of analysis. This procedure allows knowing about the specialized information related to the health of the fetus. PUBS procedure checks and allows for treatment of serving fetal anemia or any other blood problem. This process helps in checking whether any fetal infections are present. This technique can also be used to administer certain medication directly to the baby. The results of the PUBS are available relatively soon after the procedure has taken place. Disadvantages of PUBS: PUBS also has some of the common disadvantages, which are mentioned below: It is one of the pre-natal diagnostic tests that is recognized as posing a slightly higher risk of having a miscarriage (1%-2%), infection, and temporary slowing the heartbeat of the fetus. One of its disadvantages is that it is less commonly available than Amniocentesis and Chorionic Villus Sampling (CVS) Only a few doctors have experience in performing this procedure. PUBS procedure is performed later in the pregnancy in comparison to other pre-natal diagnostic techniques such as Amniocentesis and CVS. It is unable to detect the severity of disorders detected by technique. PUBS is a highly expensive procedure when compared to other tests which are recommended for checking genetic conditions in the baby. What are the important points to remember During or After PUBS procedure? A patient should know multiple things which she should remember during or after PUBS procedure. During the procedure: A patient should take antibiotics to reduce the risk of a uterine infection prior 30 to 60 minutes of the procedure. The antibiotics are usually injected through a tube into the targeted vein. The specialist performing the procedure will use ultrasound to determine the umbilical cord’s location in the uterus of the pregnant woman. The specialist will let the patient lie on her back on an examination table, and then apply a specific gel to her belly. The professional will then use a small device which is known as an 'ultrasound transducer' to show the baby's position on the monitor attached to it. After showing the movement the healthcare provider will clean the belly. Sometimes the medication is provided to the woman to prevent discomfort during the procedure. However, this medication is not often needed. Under the guidance of an ultrasound, the healthcare provider will insert a thin, hollow needle through the abdominal wall into the uterus. A small amount of blood from a vein in the umbilical cord is removed from the patient. It will be then withdrawn into a syringe and the needle will be removed. A woman might notice a stinging sensation when the needle enters her skin, and she also might feel cramping when the needle enters her uterus. Such sensation also occurs at the time of the removal of the needle from the patient. After the procedure:- After the blood sample is taken a patient might feel cramping or else have a small amount of discomfort. The healthcare provider will use an ultrasound or an external labor monitor to track the heartbeat of the baby during pregnancy. When a woman goes home after the procedure is successfully completed then the specialist might suggest resting for the rest of the day. A woman can likely be able to resume her normal activities, most probably from the next day. If in case a woman experiences vaginal bleeding or fluid leakage then she is recommended to call her healthcare advisor immediately. (11) Percutaneous Umbilical Blood Sampling (PUBS) is one of the most effective procedures to detect any chromosomal abnormalities or genetic problems in a fetus. A pregnant woman should take care of her baby and know whether her baby is safe from all kind of infections or not. This procedure helps a baby in starting a healthy life. Some couples may decide not to have this procedure for their personal reasons. Undergoing this procedure is the personal choice of the couples who are planning babies with infertility procedures. In case they need any kind of assistance then they can visit elawoman.com. They can go through some of our blogs related to pregnancy care or delivery. You can also contact our team at +918929020600 for any expert focused medical assistance related to infertility diagnosis and treatments for the same.

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Thyroid Hormones In Pregnancy

posted on June 8, 2019, 4:49 p.m.
4.5/ 5 (1 Votes)

Thyroid hormones are released from the gland known as Thyroid. Thyroid hormones play a crucial role in the overall functioning of the body especially in that of a woman. The thyroid gland weighs about 15 gm. It is located in the neck at the front side, also known as Adam's apple. Thyroid Gland is solely responsible for the production of thyroid hormones in the body. Our brain gives specific signals to the thyroid gland to maintain the required levels of hormones for the proper functioning of the body. These hormones signals are sent by hypothalamus and pituitary glands in the brain. Thyroxine is a major thyroid hormone created by the thyroid gland. Due to inclusion and composition of four iodine atoms, Thyroxine is also called as T4. It enhances its effects by converting itself into T3 also known as Triiodothyronine. In T3, one iodine atom is removed automatically from T4. T3 usually occurs in the liver, brain, and other certain tissues. Another key hormone called Thyroid Stimulating Hormone (TSH) controls the production of T4 through the Thyroid gland. TSH is made by a pituitary gland, which is located at the base of the brain. The TSH levels depend upon the amount of T4 while transmitting into the bloodstream. The production of TSH stops when T4 production in the bloodstream elevates above a certain level. Thyroid and pituitary glands act like as a thermostat and a heater. They play an automatic function similar to a heater, and its thermostat. When the heat increases, then a thermostat starts working automatically. Thermostat eventually stops the heater from working and when it cools down, it automatically starts again. (1) In this article we will look at the below-mentioned questions to answer briefly: What is the functioning of Thyroid hormones in pregnancy? Why should one test Thyroid in pregnancy? Who should go for thyroid test? What are the types of thyroid test? Is there any non-blood thyroid test? Usually, there are four fundamental hormones of Thyroid, which regulates several organs and efficient blood flow in our body. To measure these four components, four blood tests are available to measure Thyroid problems. These four blood tests comprise of TSH, T4, T3, and T4 tests, which are widely used in cases when doctors doubt the presence of any changes in the functioning of the thyroid gland. According to experts, thyroid hormones play a crucial role in fetal development and neonatal brain. Deficiency or additional composition of these hormones also develops Hypothyroidism or Hyperthyroidism condition in our body, which has to be treated on time or before it gets worse. Functioning of the thyroid during pregnancy: Increased blood concentrations of T4-binding globulin (TBG): TBG refers to one of the proteins, which transfers thyroid hormones in the blood. It also has the highest level of T4 (Thyroxine) out of all hormones. Estrogen stimulates the TBG in the liver. A nominal rise in estrogen level during pregnancy induces and almost doubles the serum of TBG concentrations. (2) The increase in the levels of TBG lowers the level of free T4 concentration: The process raises the TSH (Thyroid-stimulating hormone) secretion by Pituitary Gland. Moreover, it also enhances the secretion and production of Thyroid hormones. These new levels of Thyroid hormones during pregnancy forces to create a new equilibrium of certain Thyroid hormones like T4 and T3. This increase in thyroid hormones increases till 20 weeks and remains until the delivery of the baby. Increase in the demand of Iodine: During pregnancy, kidneys filter more amount of Iodine for clearance. It is recommended by the World Health Organization (WHO) to intake at least 100 to 150 ug/day to 200 ug/day of iodine in the diet during pregnancy. A fair amount of iodine is required to produce fetal and maternal thyroid hormone for a healthy pregnancy. Hypothyroidism or Hyperthyroidism: This is a disorder where the thyroid gland produces an insufficient or an additional amount of hormones in different cases. This is a very common imbalance of thyroid hormones which occurs in pregnant women. Fetus disease is often seen in many pregnant women and in their fetus due to hypothyroidism or hyperthyroidism. Such conditions usually result in the delayed development of a baby during pregnancy. However, both the conditions are treated and balanced through hormonal medicines. It is recommended for the women to get regular check-ups during hypothyroidism or hyperthyroidism. It is observed in many types of research that kids born to a mother, who had severe or untreated hypothyroidism or hyperthyroidism are born with a low level of Intelligence Quotient. The human Chorionic Gonadotropin (hCG) Hormone: A woman undergoes several physiological changes during pregnancy. These changes affect the maternal thyroid function and thyroid hormone level. During pregnancy, the placenta produces a certain amount of human Chorionic Gonadotropin (hCG) Hormone. The hCG is also helpful in pregnancy testing and due to this, there is a proven significance of the two week wait period after infertility treatments. This hormone is similar and related to TSH. It also has an ability to bind the TSH hormone weakly to the TSH receptor present in the thyroid gland. During the first trimester of pregnancy, when the production of hCG is high, it may turn the thyroid gland and enforce it to produce an additional thyroid hormone (Thyroxine [T4] and Triiodothyronine [T3]). These hormones depend on each other, therefore this whole process prevents the production of TSH hormone. Due to the hindered production of TSH, a pregnant woman may develop some symptoms of hyperthyroidism. (3) It is concluded that during pregnancy, the demand for hormones increases in the thyroid gland. A pregnant woman's hormones also monitor the functioning of the fetus. A fetus acquires the ability to manage the thyroid hormones around the 12th week of pregnancy. (4) Testing of Thyroid in pregnancy: It becomes challenging to attain and sustain the pregnancy if the thyroid levels are elevated or insufficiently produced before or during pregnancy. There are several medical treatments and medicines, which may nullify the dreadful effects of thyroid at the time of ongoing pregnancy. The main problem lies in recognizing the thyroid problem in sufficient time to be treated effectively. A woman should be cautious and observe the recent adverse changes in her body including constipation, fatigue, and heat intolerance. These constitute the common reasons for an adversely affected thyroid. Evaluating these medical conditions on time saves one from severe damages which can occur inside the body. Usually, a woman with hypothyroidism found at a huge risk of miscarriage in her first trimester. Many women with mild hypothyroidism also seem to be at a menace of losing gestation until treated on time. (5) Who should be tested for the thyroid levels? It becomes controversial in the case of pregnancy to get tested with thyroid or not. Pregnancy in itself has similar symptoms of having inadequate thyroid levels. Many pregnant women get confused due to similar symptoms and avoid thyroid tests mistaking herself to be pregnant. The impact of thyroid disease over mother and baby is sensitive, so one should never delay in testing the same. A high risk of thyroid disease generates the chances of losing a baby or affecting its development until the time of delivery. Women who are facing certain prominent symptoms related thyroid should get their thyroid blood tests done on time. In fact, they should also get their TSH, and free Thyroxine blood tests performed. Generally, women with the following conditions are at higher risk of thyroid problems: (5) Women with a history of thyroid disease or thyroid autoimmunity A family history of thyroid disease A woman detected with Type 1 diabetes mellitus or any other autoimmune condition Any woman with these conditions should inform their physician before the check-up. It is more favorable for a woman to get tested before getting pregnant or right after a positive pregnancy test. Types of tests of Thyroid: Below are the tests, which can be performed to check any imbalance of thyroid hormones in the body: T4 TESTS: Thyroxine (T4) is a key hormone produced by the thyroid gland along with another key hormone Triiodothyronine (T3). They together help in controlling the energy rate in our body for usage. Mostly all the T4 and T3 hormones in the blood bind with protein. Whereas, all the rest of the hormones are free or unbound. These free T4 and T3 hormones are in a biologically active form of the thyroid hormone. Here, the test measures the amount of quantity of free T4 hormone in the body. A woman undergoes symptoms of Hypothyroidism such as dry skin, weight gain, cold intolerance, infrequent menstruation, and tiredness due to thyroid dysfunctioning. This happens when the thyroid gland does not generate adequate T4 and T3 (underactive thyroid) hormones. In case the thyroid gland produces excessive T4 and T3, the concerned person may encounter indications connected with an overactive thyroid (hyperthyroidism). Free T4 in a combination with the TSH test with the FT4 or FTI, precisely determines how the thyroid gland is functioning during pregnancy. (7) T3 TESTS: T3 normal range are mainly useful in diagnosing hyperthyroidism in the patients. It also helps in determining the severity of hyperthyroidism. It has been observed that the T3 normal range level in a woman having hyperthyroidism is high. There are also certain cases of hyperthyroid where, TSH is low, T3 is elevated and rest all hormones (FT4 or FTI) are normal. T3 is mostly performed along with the TSH and T4 hormone test, as it is the last test, which will become abnormal. In some pregnancies or while taking contraceptive pills, elevated levels of T4 and T3 exist in the patient. This is commonly due to increased levels of binding proteins due to estrogen. In such a situation, doctors find it appropriate to suggest the patient undergo TSH and free T4 thyroid evaluation tests. THYROID ANTIBODY TESTS: These are the proteins, which are made by our immune system to fight with foreign substances like bacteria and viruses. In rare cases, these antibodies start attacking its own cells, tissues, and substantial organs unknowingly. This condition is known as an autoimmune response. When antibodies of Thyroid start attacking itself known to be an autoimmune disorder of Thyroid. If this disorder is not treated on time, then it leads to severe health and Thyroid problems. In fact, these antibodies disorders turn out to be worse in pregnancy if not treated. This intends to harm the mother and fetus both. It is important to get tested with Thyroid antibodies during pregnancy if one ever had thyroid disease in her past. It is safe to take thyroid medications during pregnancy to cure these thyroid problems. (8)   Thyroglobulin (Tg): Iodine proves to be a substantial mineral for thyroid hormone synthesis. Generally, it is observed that a lot of pregnant women suffer from the deficiency of iodine. It is also widely known that improper iodine intake is one of the major causes of poor obstetric outcomes and neuro-development of a child. However, sufficient iodine in the body will maintain the serum Tg, which does not have any longer effect on thyroid in a pregnant woman. If there is any deficiency of iodine in the body, only then the Thyroglobulin (Tg) becomes relevant.   Thyroid-stimulating hormone (TSH) Test: A TSH normal range blood test measures the same hormone called Thyroid-Stimulating Hormone (TSH) and its TSH level in blood. If a woman's body starts making excessive or insufficient hormones means that the thyroid is not working appropriately. This test helps in understanding the accuracy of the functioning of the thyroid hormone. One must know if she is suffering from hyperthyroidism or hypothyroidism to get treated on time to prevent severing of the condition. (6) a. Hyperthyroidism: Excessive production of TSH hormone. It usually occurs in one in every 500 pregnant women and Its symptoms are: Anxiety Weight loss Tremors in the hands Increased heart rate Puffiness Bulging of the eyes Difficulty sleeping b. Hypothyroidism: It has occurred due to mild or scarce production of TSH hormone. It usually appears in one in every 250 pregnant women and Its symptoms are: Weight gain Tiredness Hair loss Low tolerance for cold temperatures Irregular menstrual periods Constipation Before performing the TSH test, the concerned doctor will instruct the patient about the same. They commonly ask for complete fast (with respect to water and food) before the test to check normal TSH levels. During pregnancy, numerous thyroid changes take place. These changes are not substantial but many women usually develop certain thyroid diseases during pregnancy affecting the TSH level. In some pregnancies, hyperthyroidism, and hypothyroidism exists in the respective woman even after the delivery. NON-BLOOD TESTS: RADIOACTIVE IODINE UPTAKE: Radioactive iodine (RAI) for a blood test is frequently useful in the effective treatment of hyperthyroidism and thyroid cancer. However, in the case of pregnancy, it causes severe harmful effects on mental retardation, fetal hypothyroidism, and increased malignancy risk in the infant. A test of pregnancy should always be tested before the treatment of thyroid in the reproductive age of women. RAI usually creates problems in regular menses cycles and future pregnancy. Therefore, women gone through RAI test are advised to avoid pregnancy until 6 to 12 months from the time of the test performed. RAI is strictly avoided during pregnancy, but sometimes merely useful in undetected pregnancy. RAI in rare cases given to pregnant women to test the movement of radioactive iodine cells and the type of disorder one is suffering from. RAI directly crosses the placenta quickly and reaches the fetus. In the 12th week of pregnancy, a fetus starts storing the iodine of its own. Fetal tissue and the thyroid gland are 2-4 times more sensitive to radioactive cells as compared to adult cells. Therefore, RAI is more harmful and destructive for the growing fetus with iodine deficiency. By estimating the quantity of radioactivity that is used by the thyroid gland, experts may conclude whether the gland is functioning normally or not. A high amount of RAIU is detected in people whose thyroid gland is overactive (hyperthyroidism), while a low RAIU is detected when the thyroid gland is underactive (hypothyroidism). (9) Any condition of thyroid if left untreated before pregnancy leads to hampering the ability of a woman to get pregnant, sustain pregnancy, and unexpectedly lose her pregnancy. Generally, decent numbers of adverse thyroid pregnancy conditions are treatable. The problem lies in identifying when the problem occurred in pregnancy. One must observe her health conditions and get tested regularly for her thyroid levels to take the required precautions at the right point of time. Usually, tiredness, heat intolerance, and constipation are mistaken with pregnancy symptoms, but these could be the possible symptoms of the presence or developing thyroid problems. Detecting a thyroid problem is important for pregnant women, and even more substantial for those who are planning to become pregnant. The hormones of thyroid are essential for brain development. At early gestation, the fetus or the growing baby gets his thyroid hormone from his mother's body. Subsequently, after 12 weeks the fetus starts developing his own thyroid gland and storing iodine. Iodine is highly essential to produce fetal and maternal thyroid hormone. A pregnant woman or a woman who is planning to get pregnant must ensure to consume a sufficient amount of prenatal vitamins. Intake of certain special vitamins helps in providing iodine to the fetus. The labels on the packaging must be checked thoroughly before consumption because all the vitamin tablets do not contain iodine in it. (10) Thus, thyroid hormones contribute to a great extent in the smooth functioning of a woman's body irrespective of the fact whether she is pregnant or not. To know more about pregnancy and how to cure its complication, kindly visit our website elawoman.com. You can also check our other blogs on several blood tests, medicines and infertility treatments on our website. You can also contact us on +918929020600 for more details on various medical treatments.

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Double Marker Test Procedure, Cost and Result

posted on Feb 22, 2019
4.5/ 5 (1 Votes)

There are a number of tests that a pregnant woman is recommended to undergo. Some of the tests are highly necessary to ensure the right health condition of both mother and baby. Other tests are generally recommended by doctors if they seem to suspect any problems or future issues related to pregnancy. The double marker test falls under the category of such type of tests. In this article, we will look at: What is double marker test? Why is double marker test done? How one should prepare for the double marker test? How double marker test is performed? How are the double marker test result interpreted? What are the normal values of the double marker test? What are the disadvantages of double marker test? What is the double marker test cost? 1. What Is Double Marker Test? The double marker test is a type of blood test. The goal of the test is to check for any anomalies that might be present in the chromosomal development of the baby. If a baby has any abnormalities in the chromosomes, it can result in serious health conditions and disorders. This can affect the baby’s growth within the womb, or even later in life. If there are chromosomes that can be the causing factor, one can know in advance about the presence or possibilities of certain disorders like Down’s syndrome, Edward’s syndrome and so on. This article gives you complete details about double marker test.  2. Why Is Double Marker Test Done? There are a various reasons why the double marker test is recommended. We have listed some of the reasons down below: The double marker test is a proven test that has had a considerable amount of accurate detections in case any issues or abnormalities are present. In case the results of the test are positive, further diagnostic procedures or measures can be undertaken to find the problem. Doctors frequently recommend an advanced test to check if there are chances of the baby having Down’s syndrome. If the test is conducted earlier and positive results are obtained and a neurological condition is diagnosed, one can choose to terminate the pregnancy without complications, during early stages of pregnancy. 3. How One Should Prepare for the Double Marker Test? The double marker test is a blood test. There are not any specific preparations that one needs to do before this test. In case someone is on any medication during pregnancy, it is best to let the doctor know about it. In rare cases, one might be advised to stop taking the medication until the test is done. 4. How Double Marker Test Is Performed? The double marker test procedure is quite simple. It is basically a blood test that is combined with an ultrasound. First, the blood samples are acquired, and then it is observed to check for two major elements, hormone, and protein. The hormone is the Free Beta Human Chorionic Gonadotrophin which is developed during pregnancy by placenta. The other protein is termed as PAPP-A, which stands for Pregnancy-Associated Plasma Protein A. This is another highly important protein for pregnant women. 5. How Are the Double Marker Test Result Interpreted? The double marker test results usually fall into two categories, screen positive and screen negative. These results are a consequence of many factors like the blood tests, the age of the mother, the age of the fetus as observed during the ultrasound. All of these factors are combined together while developing the result of the test. Women older than 35 years have significantly higher chances of their fetus developing neurological disorders as against younger women. The result of the double marker test is presented in the form of ratios. If the ratio is between 1:10 to 1:250, it is termed as a “screen positive” result which lies in the high-risk zone. A ratio of 1:1000 or above is termed as “screen negative” result which shows a low risk. These ratios are pointers for understanding the probability of a child suffering from any disorder. If the ratio is 1:10 that means 1 child out of 10 pregnancies has a chance of developing a disorder, which is quite high. If the ratio is 1:1000, it means 1 child out of 1000 pregnancies will have the disorder, which is very less or negligible. In case the double marker test results turn out to be positive. Based on the ratios, the doctor might recommend undertaking further diagnostics, mainly amniocentesis or chorionic villus sampling. 6. What Are the Normal Values of the Double Marker Test? The double marker test normal range in the results is given as follows: Marker Age Quantity Free Beta Human Chorionic Gonadotrophin All Age Ranges 25700 to 288000 mlU per ml 7. What Are the Disadvantages of Double Marker Test? There are also some disadvantages of the double marker test. We have listed here some of the disadvantages of the double marker test: The accuracy of the double marker test result is majorly a factor of the doctor’s skill set and the equipment used to carry out the processing. The double marker test cost is also quite expensive. Therefore, it may not be reasonable for every person to go for the test. That's why doctors recommend these tests only when it seems to be important. These tests are not available in all the cities of the country due to high costs and equipment needs. To conduct a specific test one might require traveling to another city and doing the needful. 8. What Is the Double Marker Test Cost? The double marker test cost depends on many factors. It can vary across cities and hospitals. The least double marker test cost is Rs. 1000 and the higher end can go up to even Rs. 5000 or so. The average price across many cities tends to be around Rs. 2500. In pregnancy, one wants nothing more than ensuring that their baby turns out to be healthy and ends up leading a normal life as much as possible. For this purpose, the most important factors are taking the right diet, adhering to good lifestyle choices, and making the right efforts to keep the indented mother and the baby safe and secure. Even after following all the recommended instructions, the test results could point towards the presence of a disorder in the baby. In such cases, it is necessary to have a discussion with the respective spouses and work out a solution for future parents to understand if they would want to have the child or not. Terminating the pregnancy is always an option but the focus should be on ensuring the best outcome of the situation. Hope this article was helpful to you in getting all the necessary information about double marker test. We, at Ela, would be happy to help you in getting all the necessary information on infertility issues. To know more or to solve any query about any infertility related issue, you can call on the given number: +917899912611.

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Pregnancy

C-Section - Know the Symptoms and Cost of Cesarean Delivery in India

posted on Jan. 7, 2019, 3:02 p.m.
4.8/ 5 (6 Votes)

Let’s Discuss in More Details About Cost of C-Section in India: Why Is C-Section Needed? The Process of C-Section? Post Delivery Treatment? Symptoms and Risks Associated with Cesarean Birth? Cost of C-Section in India? C-section or Cesarean section is a surgical process in which the delivery of a baby is performed through an incision in the mother's uterus and abdomen. This is normally done when the method of normal vaginal birth is risky or difficult. C-section is preferred by doctors as an emergency procedure due to complications during vaginal childbirth such as twin births, slipping of the umbilical cord from the cervix, adequate oxygen being delivered to the fetus, diabetic condition etc. Why is C-Section needed? A cesarean birth may be medically necessary because of the following reasons: When normal vaginal delivery is risky and complicated In case of twin babies or triplets Fetal emergency or concern When the fetus has certain birth defects such as hydrocephalus, or excess fluid in the brain When the fetus is in breech or transverse position in the womb Baby is too large to travel through cervix When the mother has a medical condition or contagious virus, such as herpes and HIV Mother has complicating conditions, such as Diabetes or high blood pressure The expectant mother has diabetes or a uterine condition The mother has problems with the placenta or a fibroid obstructing the cervix There are abnormalities in the placental or umbilical cord The mother previously had a surgery or given birth via cesarean delivery Process of C-Section After anesthesia is given, the doctor makes an incision across the abdomen and womb, usually horizontally, while the mother remains under an epidural or spinal anesthetic. Incision is normally between 10 and 20 centimeters (cm) in length. The doctor then gently parts the abdominal muscles and makes another incision in the uterus, which can be vertical or horizontal. Normally a horizontal incision is made in the uterus, also called transverse, which heals better and makes a VBAC much more possible. After this, the doctor suctions the baby, clamps and cuts the umbilical cord. The obstetrician then finally removes the placenta from the uterus, closes it with dissolvable stitches and seals the abdominal incision with surgical staples or stitches that can be removed painlessly after a few days. Sometimes a drape is used in order to block the view of the operation for the mother, as this could cause distress despite not being painful. Women, who have previously undergone a cesarean delivery, may be considered as candidates for vaginal birth after cesarean delivery (VBAC). However, this option may not be the best option for all women and should be discussed further with the concerned doctor. Post delivery treatment Post delivery, baby and its mother are required to stay in the hospital for 4-5 days. If the mother experiences any kind of pain, doctors can prescribe painkillers in order to alleviate the pain. Women can also experience mild blood clothing or vaginal bleeding for 4-6 weeks ahead. Proper post-operative care is necessary for mothers to recover both emotionally and physically therefore complete rest for the initial few weeks is an absolute must. Closely following the instructions provided by a doctor can ease some of the pains and make your delivery a memorable experience. Symptoms and risks associated with cesarean birth A cesarean delivery can carry many risks post delivery for both mother and child so, it is highly advised to report immediately if any symptoms or other complications occur. Speak with a health care provider and they will be able to determine if you or your baby are showing any signs of complications that would require a cesarean delivery and if it is the right option for you. The risks of cesarean delivery include the following: High fever and worsening pain Increased vaginal bleeding and redness at the incision site Swelling of the surgical incision Increased breast pain with redness or fever Pain while urinating and foul-smelling of vaginal discharge Breathing problems for the child Increased risks for future pregnancies Injury to the child during surgery Surgical injury to other organs Adhesion, hernia, and other complications of abdominal surgery Cost of C-Section in India C-section deliveries in India have gone up from reaching as high as 41% of deliveries in Kerala, and 58% in Tamil Nadu. Both rural and urban areas saw exponential growth in C Sections in private as well as public hospitals. The cost of a C-section varies widely in India accordingly; the charges can be different for a different procedure, depending on the hospital stay and anesthesia. All prices can range from about Rs. 5,000 in a government hospital to Rs. 40,000. The differences in the cost of c-sections sometimes can be attributed to the huge indirect expenses of the hospitals that include administrative and support staff etc, balanced out with the volume of surgeries done by the institution. The c-section cost a government hospital usually ranges from Rs. 5,500, while a private teaching hospital can start from Rs. 17000 and a charitable hospital can go to Rs. 30,000. In order to meet the growing demands of the economically weaker strata of the society, the government, under the RSBY scheme, reimburses hospitals sum of Rs. 500 per bed per day for government-run and private hospitals. In order to narrow down your search, we have prepared a list of the average cost of C-section according to various cities. Min and Max costs are as per an average of Government and Private hospital both. City Name Avg Cost (In Rupees) Min. Cost (In Rupees) Max. Cost (In Rupees) Ahmedabad 47351 30000 67500 Bengaluru 58011 38000 95000 Ghaziabad 57333 35000 95000 Chennai 60277 32000 150000 Hyderabad 50889 28000 150000 Jaipur 37566 22400 50000 Kolkata 54246 27000 120000 Lucknow 43000 30000 60000 Mumbai 60369 35000 150000 New Delhi 44583 26500 80000 Pune 51669 23800 75000 According to a recent analysis of national health data, the country's average Cesarean-section rates have increased considerably from 5 percent to 18 percent over the same period. Middle-income and high-income countries are reported to have higher Cesarean rates as compared to the low-income countries. Worldwide, the highest Cesarean-section rates are in middle-income countries, ranging from 40 percent to 60 percent. Many pregnancies today end in a C-section, it is complex and quite expensive. It becomes equally important for you to consult your doctor to find out the cost so that, in case you need to go in for an emergency Cesarean delivery, you are prepared. If you are a couple struggling for parenthood and facing problems related to fertility, you can approach Elawoman blog to find answers to all your problems and queries. Our service includes IVF Treatment plans, IUI process, surrogacy, Infertility treatment plans and many more. To get information on IVF specialists and hospitals to reach us at +917899912611.

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Pregnancy

Tips to Follow to Improve Food Digestion during Pregnancy

posted on Jan. 7, 2019, 2:50 p.m.
4.7/ 5 (6 Votes)

Let’s Discuss in More Details About How to Improve Food Digestion During Pregnancy: Drink a Sufficient Amount of Water Do Regular Exercise Switch to Multiple Small Meals a Day Stop Smoking and Drinking Follow a Schedule to Eat Eat Fibre Rich Foods Avoid Spicy and Fried Foods Drink Milk Everyday Do Not Eat Late at Night Maintain a Food Diary Pregnancy is considered one of the most important time in a woman’s life. There are many hormonal changes that take place in your body during this time, as you are ready to bring a new life on earth. Some of these changes can also affect your digestive system and bring discomfort. So, it is necessary to know about foods that help in digestion during pregnancy and the ones that should be avoided at any cost. Here we are discussing how to improve your digestion during pregnancy. By following the given steps you can improve your digestion during pregnancy. 1. Drink a Sufficient Amount of Water Whether you are pregnant or not, this tip is always helpful. Drinking plenty of water will always work in your favor. During pregnancy make sure that you drink clean and germs free. If the water will be contaminated then it will have many adverse effects on your body. Drinking clean and germ-free water will improve your digestive system during pregnancy. 2. Do Regular Exercise Be as normal as you can during pregnancy and perform your daily task by yourself only. Even a twenty minutes exercise as a daily routine can make the difference. Exercise can increase your metabolism rate. So, the food will not get stuck in your digestive tract. 3. Switch to Multiple Small Meals a Day When you take food in a large amount, it takes time for the digestive system to digest that food. However, if you eat in small portion, then your digestive tract will have plenty of time to digest the food, and it can also make space for the next portion. So taking small meals three to four times a day will improve your digestion during pregnancy. 4. Stop Smoking and Drinking Smoking and drinking cannot only affect you physically but mentally also. It can lead to digestive ulcers and infections. It will also affect the mental and physical development of your baby. So, for the betterment of you and your child, it is advisable to skip such habits during pregnancy. Instead, you should drink more and more water and vitamin and mineral rich liquids. 5. Follow a Schedule to Eat During pregnancy, your diet becomes the most important factor. You should follow a proper schedule to eat your food. Your digestive system becomes habitual of a schedule. It will also become easy to digest the food if you take it daily at the same time. So, make yourself available for breakfast, lunch, and dinner daily at the same time. 6. Eat Fibre Rich Foods You are pregnant or not, eating fiber-rich food will improve your metabolism anytime. Fiber-rich foods such as fruits, green vegetables, peas, and beans will help you improve your digestive system. Such foods keep moving in your digestive system tract, which results in the prevention of constipation. 7. Avoid Spicy and Fried Foods At this time you will crave for spicy foods, curries, tikka masala and all but keep in mind that they will surely affect your digestive system. Eating spicy and fatty food will always worsen the condition. If your cravings are strong and you can not stop your tongue, then just remember that you will have to bear the consequences. 8. Drink Milk Everyday Drinking milk is also an option to improve your digestion during pregnancy. However, it does not have a positive effect on everyone. Some women say that it makes their digestion worse. If milk is not a great choice for you, then you can prefer its alternatives as yogurt or ice cream. 9. Do Not Eat Late at Night Try to avoid eating late at night. It will improve your digestion during pregnancy. When you lie down, your stomach content has risen up, and it takes more time to digest your food. Make it a habit to take your dinner two hours before you are going to sleep. However, if you feel hungry afterward then you can take snacks.  10. Maintain a Food Diary You can keep a diary with you and write in it that which foods affect your digestive system. For some women, caffeinated drinks can be a cause, while for others tomato sauce can be harmful. So, by making a list of such items you can avoid them. There are also other smaller steps that you can take to improve your digestion during pregnancy like eating slowly, chewing your food well, avoid drinking while eating and wear loose fitting clothes. Changes that occur in the Digestive System During Pregnancy After knowing the steps to improve your digestive system during pregnancy, you should also know the cause of digestive problems during pregnancy. Pregnancy hormones definitely affect our digestive system. Progesterone hormone causes smooth muscle relaxation. It also causes relaxation and slowing of digestion in the stomach and the small and large intestines. The gallbladder is also affected by delayed emptying. It can increase the chances of gallstone formation. Many digestive discomforts of pregnancy like morning nausea or vomiting, constipation, and heartburn are all related to the relaxed tone and slowed action of the digestive system. The growing uterus also affects the digestive system. As the uterus grows, it can press on or even block parts of the digestive tract. This leads to slowed movement of food and constipation. Always ask your doctor before taking any medicine for this condition. Many women face appetite changes in pregnancy, including other conditions like: Increased hunger Decreased appetite Cravings Aversions Nausea and vomiting A few women develop pica which is a rare craving to eat things other than food. This includes things like dirt, clay, and coal. The craving means there is a nutritional deficiency in the body. FAQs Q. What are the digestive problems that occur during pregnancy? A. Pregnancy hormones definitely affect the digestive system. There are many digestive problems that occur during pregnancy like indigestion, belching, heartburn, constipation, hemorrhoids, and flatulence.  Q. What are the foods that can help you indigestion during pregnancy? A. List of foods that can help you fighting indigestion during pregnancy: Dairy products Legumes Sweet potatoes Salmon Eggs Broccoli and dark, leafy greens Lean Meat Fish liver oil Berries Whole grains Avocados Dries fruit Water Q. What are the foods that should be avoided during pregnancy? A. List of foods that should be avoided during pregnancy: Alcohol Processed junk foods Unpasteurized Milk, Cheese, and Fruit Juice Unwashed produce Raw sprouts Caffeine Organ meat Raw eggs Undercooked, raw and processed meat Undercooked or raw fish High- mercury fish Q. Why is the food digestion process slow during pregnancy? A. During pregnancy, the muscles of the body are all relaxed and this also includes the muscles of the intestine. Hence food moves slowly through the last phase of digestion during pregnancy causing constipation. The weight of the fetus on the colon is another reason for the slower final step of digestion. Hope this article gave you all the details about how to improve digestion during pregnancy. Follow Clanswomen blog to get all the latest updates regarding infertility, IVF and surrogacy-related information. You can also call on the given number for any pregnancy or infertility related issue +917899912611.

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How is Postnatal Care Important for Mother and Newborn Child?

posted on Jan. 7, 2019, 2:42 p.m.
4.8/ 5 (6 Votes)

Let’s Discuss in More Details About Postnatal Care for Mother and Newborn: Why Go for Postnatal Visits? When to Plan Postnatal Visits? Risks Factors During the Initial Phase of the Postnatal Period? Things to Look out for in Mothers During Postnatal Period? Things to Look out for in Newborn Babies During Postnatal Period? How to Recognize and Beat Postnatal Depression? Signs of Postnatal Depression? How to Fight Back Postnatal Blues? According to the experts, the postnatal period continues until the first six weeks after the child is born. But it can extend up to 4-6 months which means that along with the baby, the mother herself can overcome the tiring experience of pregnancy and bounce back to her healthier self on physical, mental and emotional levels. A postnatal period can be termed as the most vital period in the lives of both mother and her newborn to achieve and sustain good health in times to come. But as observed by the World Health Organization (WHO), it is also the most neglected period. However with precautions, nutritious diet, personal care, and a good support system at home, one can step into the new phase of life with the best of health and happiness. In today’s world where a modern woman is juggling between the role of being a mother and a working person, postnatal care right after giving birth often goes for a toss. But the truth is that it is of the utmost importance to regain strength and maintain good health. Postnatal care plays a pivotal role in the life of a newborn and the mother providing them with quality care. It is therefore required to focus on the overall health of the mother and the newborn right after child delivery. Postnatal Care while in the Hospital Right after the baby is born, there are certain things that need to be taken care of like: Maintaining a record of blood pressure, pulse, temperature and checking for any abnormalities. Making sure that complete placenta is out. Checking baby’s health to see he/she is free from any type of birth defects. Ensuring about the blood loss during the delivery and ruling out postpartum hemorrhage or excessive bleeding. Looking for any kind of tearing or damage to the vagina, perineum, and labia. Suturing wherever necessary. If a new mother cannot feed the baby for any reason, medication to stop milk is prescribed and for those breast feeding, baby needs to be encouraged to reach out for the nipple. Encouraging Mother and baby skin-to-skin touch. Why Go for Postnatal Visits? Although for most women and babies, this period is uncomplicated, it is still advisable to recognize any deviation from the expected recovery post delivery. Postnatal visits should be planned for the same. Postnatal care must be done at different levels including internal, external and mental. When to Plan Postnatal Visits? Your doctor schedules the number of postnatal visits. However, a minimum of 3 postnatal visits should be done. First visit: Within 1 week of the birth of the baby Second visit: 7-14 days after birth Third visit: 4-6 weeks after birth It is also important to understand the immunization schedule for the newborn. Risks Factors During the Initial Phase of the Postnatal Period Mothers and newborns are at the highest risk during the early neonatal period (right after birth to 7 days of life). Maternal deaths can occur as a result of various factors like Post Partum Hemorrhage, Sepsis, Hypertension Disorders (Preeclampsia or Eclampsia), Anemia, HIV/ AIDS, Cardio Vascular Diseases, and Obstructed Labor Neonatal deaths can occur due to Diarrhea, Tetanus, and other infections including Neonatal Sepsis, Birth Asphyxia, Prematurity and Low Birth Weight and Congenital Defects Things to look out for in mothers during Postnatal Period Fresh vaginal bleeding: A little bloody discharge in the postnatal period is absolutely normal. However active bleeding for a longer duration is a danger sign and can lead to severe anemia Fever, weakness to even step out of bed A headache, blurred vision Calf muscle pain, chest pain, difficulty breathing Swollen, red and painful breasts Problems with urination or smelly vaginal discharge Things to look out for in newborn babies during Postnatal Period Inadequate breast feeding: Mothers should be encouraged to breastfeed and the baby to suck Yellow discoloration of the skin can be neonatal jaundice and requires immediate attention Fever, repeated vomiting, no stool can result from obstruction in the gastrointestinal tract and calls for immediate intervention Hypothermia: Look for signs of a baby being cold on touch. Place the baby in skin-to-skin contact with the mother and wrap the baby in a warm blanket. Visit a doctor if the baby’s temperature does not rise Breathing: The baby is in distress if he/she is breathing for more than 60 times/min. Also look for a chest in drawing and bluish discoloration of the lips and skin. Red, swollen eyelids or pus discharge from eyes require specialized care for the baby How to Recognize and Beat Postnatal Depression? Postnatal depression is observed in many parents, especially in new mothers who have recently experienced the birth of their baby. It is usually seen in about 1 in 10 women and in the duration of one year of delivery. This kind of depression can also be seen in fathers or both the parents. It becomes essential for you to get professional help, as the symptoms may remain for months together thereby affecting your quality of life and that of the baby. In order to combat depression, self-help therapies and plans of action can completely get you rid of the worrisome and sad condition.  Signs of Postnatal Depression Many women may not even think of having postnatal depression due to the fact that it can grow at a slower pace to be observed at once. Following are the signs that may help you identify that you might be suffering from the depression: Continuous feeling of sadness and dejection Staying aloof with no interest in the outside world A feeling of tiredness and exhaustion  Sleeplessness or insomnia during night and sleepiness in day Not feeling excited about the baby Staying away from people in general Inability to make decisions Disturbing thoughts about oneself or about the baby How to Fight Back Postnatal Blues? In a usual case the postnatal blues do not stay for more than two weeks of giving birth in case, for some reason, it decides to stay, you will have to follow the below given instructions to drive it away from your system: It is advisable for the women to eat healthy, nutritious, high protein foods such as meat, egg, fish, oils, nuts, cereals, beans, vegetables, cheese, milk, to feel strong and well Start with self-care techniques such as Gentle exercises, taking time to rest, pelvic floor exercises (Kegel exercises) Find support groups and family members to talk about your feelings, changes in mood or emotional states Check for hemoglobin levels and other danger signs and follow up with your doctor whenever required Just like pregnancy, the postnatal period is also a special period and can come up with its own challenges for parents. Your preparation should not be limited to just pregnancy but it must also be in consideration to the postnatal concerns and care.

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