hello viewers welcome to doctors Channel
today dr. preeti realized with us
consultant gynecologist hello Doctor
it's pleasure having a program thank you
doctor
if lady is pregnant what type of
precautions she should follow once a
patient finds out that she is pregnant
please do not wait go to the
gynecologist you nearby gynecologist
immediately and there are certain
precautions to be taken once she's
pregnant because the gynecologist will
also do a pregnancy test and then she
will confirm the pregnancy and there
will be certain things you have to
follow like diet you have to follow a
healthy diet and pregnancy this so as of
now there is nothing in particular that
a pregnant lady should avoid eating
certain kind of food you know back in
the day there was a myth where you can't
eat this kind of food you can't eat a
purple area or you can't eat a fruit but
there's nothing like that frankly now
medical textbooks there's nothing
written that you cannot eat this you
cannot eat that be healthy watch your
diet there are certain blood tests that
have to be followed and first three
months you'd be very particular about
your sexual activity try to avoid sexual
activity for the first six weeks of
pregnancy from the time you are planning
to conceive and once you have figured
out that you have conceived try to avoid
sexual activity till your first scan is
done because in the earlier stages of
pregnancy that is the first three months
of pregnancy it is a very delicate case
yeah so the mode of activity that
happens it made us a chances of abortion
or threatened abortion so we try to tell
our ladies stay away from sexual
activity for the first six weeks
following which a scan has to be done
and check if the heartbeat is there
mostly the heartbeat of the fetus comes
only after the six weeks of pregnancy so
following that you can be
relax once you see the heartbeat in the
scan and there are certain medicines
that have to be taken in pregnancy like
your folic acid medicine which is very
important please do not avoid your folic
acid medication if you have had a
previous pregnancy issues with any kind
of disorders in the baby especially any
neural disorders then always take a
folic acid preconception I know that is
before you planned pregnancy take a
folic acid tablet from the time you're
planning pregnancy yeah and once your
pregnancy is confirmed continue the
folic acid tablet and till your
gynecologist advises you that is mostly
till about the 14th to 16th week do not
miss the Foley cancer which is the most
important tablet for the baby's brain
development and neural problems yes to
take care of noodle problems then coming
to your verb lattice lot of patients
with all the blood test till the fifth
month which according to me is not
really right because starting of
pregnancy fee to the blood test then
what happens is you can pick up if there
is any problem for example say a thyroid
issue or anemia without discontinuing or
terminating the pregnancy
you can treat these causes and help the
mother have a healthy child by the end
of the pregnancy and by the end of nine
months and coming to after the third
month you have to take your iron and
calcium tablets also known as your
prenatal tablets depending on your
ethnicity like for example if you're an
Indian you'll have to take more amount
of calcium because our diet doesn't
provide that much calcium yes so please
make sure you have about half a liter of
milk in the morning half a liter of milk
in the evening what if possible if
you're lactose intolerance you don't
have to replace it with soya and please
understand that one litre milk gives you
one gram of calcium per day and you need
to have thousand mg of calcium that is
about one gram
- mhmm and then this don't expect you
you were drinking 1 liter milk and you
will get 1 gram half of it goes for a
waste into the bullet so what you have
to do is have calcium tablets everything
have ivory tablets everyday because you
have to maintain in for Indian ethnicity
you have to maintain your hemoglobin up
to 10 grams percentage okay normal
ladies when you are not pregnant 12 to
14 but when you're pregnant you have to
maintain it at 10 grams is a minimum
this helps in the healthy growth of the
fetus of the baby then when you go for
your antenatal checkups please make sure
your antenatal checkups are monthly once
up to the seventh month following which
seventh month you will have to go twice
a week month that is every 15 days and
once you enter the ninth month you will
visit your gynecologist
Wheatly and there is no set lot of
people a lot of patients ask me madam
how many scans see there are about five
scans which are mandatory scans recently
in how the baby is growing the brain
development to an extent and also it
will help me to tell you how the baby's
vital organs are okay okay
and so these five scans are mandatory
any extra scans that are going to be
done it will be only in an emergency or
if I am expecting something if I'm
expecting to see something like say
previous pregnancy she's had an issue
with the feet to some anomaly I have a
look for it in a certain time so do not
miss those five mandate three scans when
they're supposed to be done please get
them done body hygiene is very very
important in pregnancy
make sure your private areas are well
cleaned and kept dry young and travel
mostly we try to tell patients to avoid
traveling up to the fourth month because
following fourth months the pregnancy
moves a little higher into the pelvis so
what happens is it's
easier for patients to travel without
any side effects and first three months
to four months people experience a lot
of women experience a lot of nausea and
vomiting it is a part of pregnancy do
not avoid eating because a lot of ladies
I see they make anyways I'm throwing up
so might as well not eat which is very
dangerous
please take it in the stride and please
eat the more you eat the healthier your
baby is going to be and minimum weight
gain in the nine months of pregnancy is
10 to 12 kgs anything more is also not
good but no it's not it's it's okay but
don't gain too much weight because all
said and done your baby is going to not
be more than 4 to 4 point 5 kgs yeah and
the rest of the weight that you're going
to put on say you've put on about 20
kilos or 25 kilos you're going to be
stuck with it uh-huh which can lead to
diabetes which can lead to hypertension
so what you diet eat healthy eat well
your target should be to gain about 2
kgs per month these are the normal
precautions I give my patients there is
no restriction for work you can go to
work
you can work even about 10 oz a day make
sure you get about 8 hours of sleep in
the night and 1 oz rest in the afternoon
flat on a bed this is purely to avoid
back pains in post protein present
during the later months of pregnancy to
relax your muscles yeah these are the
normal precautions we give patients here
doctor in the first pregnancy if they
had any risk factors will it going to
continue for next pregnancy yes there
are certain risk factors which will
continue certain risk factors might not
continue may or may not for example say
if the patient had a abruption in the
first Pegman abruption is when somebody
gets a trauma or a very high blood
pressure the placenta separates and then
what happens is the blood supply to the
baby reduces which causes some kind of
problems to the fetus and delivery is
done
emergency there would be blood loss so
these kind of things is not necessary
that they continue into the second
pregnancy on to the next pregnancy and
certain conditions like infections or
vagina infections they might not
continue if taken now good if proper
precautions are taken in pregnancy
following a good hygiene body hygiene
and things most commonly what we see is
high blood pressure which we call as
preeclampsia yeah and then if they have
seizures it's gone as a clamp see and if
they have any diabetes these are the
normal things that we see it's called
gestational diabetes these are the
normal things that we see in pregnancy
when what people ask will it continue
and in certain cases yes it will
continue there is a good and a high
incidence of once you have it in one
pregnancy that it can happen in the next
pregnancy it increases by 10 folds from
a normal person who's not added to get
diabetes and a person who's had diabetes
in the first pregnancy it increases by
tenfold so the chances are there in that
case what they have to do is whatever
they've had previously in the previous
pregnancy there are certain blood tests
and certain precautions that they have
to take if they follow that in the next
pregnancy they can avoid it or it can be
picked up early without having any side
effects on the pregnancy doctor it can
be prevented it can be prevented certain
conditions like if they had thyroid or
BP or high BP or thyroid or if they've
had diabetes going earlier to the doctor
preconception and telling the doctor
your gynecologist that I'm planning to
conceive in that case what you can do is
go and tell your doctor that I've had
this condition in the previous pregnancy
what can I do there will be a pre
conceptional test which will be done
which will have your BP checkups which
will have your uric acid checkups and
which will have you urea checkup and
also will have your sugar check-ups if
this is all under control
then the chances of
having a smooth pregnancy with a close
watch on the patient it's good doctor
after the pregnancy is there any
contraceptive methods yes there are but
you can't use the usual contracept or
oral contraceptive pills that we
normally get over-the-counter cannot be
used for pregnancy when you're
breastfeeding the children see when
you're breastfeeding there's something
called as lactation amenorrhea which
itself acts as a contraception mm-hmm
okay but it is not 100% guaranteed okay
then again you can go on a pill called
as progesterone only pill which is very
safe when you're breastfeeding the child
mm-hmm but this should be started after
six weeks and this should be taken every
day one tablet irrespective of whether
you have bleeding or not daily one after
six weeks of delivery and you continue
it at the same time every day so the
most crucial thing is took take it and
the same time every day then we have
something called as copper T Mirena but
copper T is most commonly used in India
especially but the people can put it
even immediately post delivery but the
failure rates immediately after delivery
are very high yeah
so we wait for a few months and then we
give them a copper T option also these
are the contraceptive methods we have to
be taken immediately post delivery when
they're breastfeeding the baby young
doctor could you tell us why severe pain
occurs during the period C there are a
lot of reasons of patient can complain
about pain during periods yeah whenever
a patient complains a little bit of pain
causing uterine contractions is okay
manageable when a person comes and tells
me I'm having severe pain and the fact
that they have to go to a doctor that
itself means they have to get examined
that itself as a reason for them to get
examined they have to be investigated it
could be a fibroid it could be
adenomyosis or it could be even
endometriosis these kind of pains they
have certain
treatment each disorder has a certain
treatment fibroid and adenomyosis has a
certain type of treatment and
endometriosis has a certain type of
treatment for each one the previous
preliminary investigations have to be
done patient has to be examined as to
where exactly the pain is is it in the
back area is it in this lower abdominal
area and then treatment is done
painkillers are advisable there is no
necessity no study or anything that says
if you take painkillers during periods
it can affect your pregnancy or
fertility rate no that is a myth
actually most of the people are yes a
lot of people please I'm I request
everybody do not take the pain do not
bear the pain improve your quality of
life
there are painkillers non-steroidal
non-steroid and NSAIDs are there you can
take those which are absolutely safe and
the effect lasts only for the few are
for those few hours that you take take
the tablet and then it will be fine so
please take the painkiller under a
guidance of your doctor mm-hmm do not
take it on your own first get yourself
investigated examined and then go for
painkillers look so are there any
diagnostic methods are there to find
these cars yes yes absolutely
one by internal examination that a
doctor will do it is called a pearl
virginal and for rectal examination
secondly an ultrasound can be done to
pick it up and further you can go ahead
once you have four come with the
conclusion of their diagnosis you go
ahead with treatment depending on
whether the patient wants pregnancy or
the patient wants to just continue
without having any kind of paper
continue want to take treatment for the
pain or whether they want to plan
pregnancy if they want to plan pregnancy
and they have this kind of pain then
there is a different kind of treatment
mm-hmm and if they want to just reduce
the pain and then they're not planning
to conceive then they go with a
different type of treatment doctor
during the periods some ladies complain
with a chair breast discomfort white
occurs yes a lot of women complain of
breast discomfort before about 10 days
to 15 days before periods and it
continues and then it stops once they
start their flow then some patients
complain of only five days of pain
before periods and on the second day of
the period the pain disappears some
patients have ladies have pain
throughout 10 days before periods and
it's throughout the period and stops
only after the period has reduced in
that case you have to always rule out
any hormone imbalance or if you have
fibroadenoma of the breast also called
as the breast mouse when there is a
fibroadenoma of the press which is a non
cancerous breast lump these things you
can just take some there are some
medication for it you can take that
which will not reduce the size of the
breast lump but will definitely reduce
the pain that comes with the periods and
this can be picked up by a mammal scan
that is a breast scan yes or you can go
for a mammogram mammogram is a different
method of detecting breast lumps and a
mammal scan is a scan ultrasound machine
which picks up a breast lump doctor then
what is the treatment for lumps first
and foremost every woman should examine
her breasts once every month
self-examination there are a lot of
guides to examine your breasts if you
feel there is a lump please do not think
you are imagining it there if there is a
you feel there is a breast now go to
your doctor immediately and get a
Mammoth's can get an examination get a
mammogram whichever is feasible for you
and once you have picked up a lump any
kind of lump on your investigation go
for an FN
see FNAC is nothing but a fine needle
aspiration okay this will tell us
whether it is a malignant lump as an
ascetic arsenal of cancer lump or if it
is just a regular lung if it is a non
cancerous lump and it is causing a lot
of problem there are certain tablets
that can be taken for it if it is a
cancer Islam you have to go for
treatment immediately so whenever you
get these lumps there is no reason that
who gets a lump who doesn't get enough
if you have a family history if your
there is a family history of people
having breast lung it is more a reason
that you should get yourself checked
very on a regular basis doctor could you
tell us what is perhaps mere C now
because of the rising number of cancer
or cancer cervix cases that we are
noticing i pap smear is a screening
procedure it is a OB based procedure it
is a test it's not a procedure it is a
test that is done it hardly takes it
there's no pain it hardly takes any time
it is a smear of your cervix this is a
screening test to see if there is going
if you have any chances of cancer it
will pick up it is a screening test if
it says it is positive for malignancy
then you go for the next step if it is
negative for malignancy it is fine you
know you don't need any treatment but
also pap smear does because any
infections if a person has any
infections also pap smear picks it up so
regular pap smear is to be done before
sexual activity is started or a little
later also nearly once a pap smear is
mandatory for ladies please go for your
pap smear checkup every year once doctor
could you explain about the vaccines we
have something called as the cervical
cancer vaccine there are two types
Cervarix and the Gardasil that is a
polyvalent and quadrivalent trivalent
and a quadrivalent vaccine these are
given in three do
it over six months time over a period of
six months there are three doses for
this injections these can be taken
anytime from adolescent do your your any
age standing it and on ascent these
vaccines will definitely reduce the
occurrence of cancer and there are so it
only acts against the HPV virus human
papilloma virus this vaccine is only for
this kind of virus if the cancer is
caused by this it normally this vaccine
is for this HPV doctor is this cervical
cancers leads to modality yes
survival cancer obviously causes if it
is not taken care of
earlier the mortality rate will increase
mm-hmm doctor could you explain us about
the pregnancy died what type of food
they should take coming to your
pregnancy diet because when you are
pregnant you know the whole idea of eat
for two it doesn't really apply but eat
healthy and your normal diet your staple
diet whatever you eat every day that is
your breakfast lunch snack dinner that
should be taken along with which you
will need to take two glasses of milk
and normally people ask me patients ask
me what do i mix in listening
anything is okay from Horlicks to any
kind of dairy products for growth but
two glasses of milk is compulsory if
you're lactose intolerant we will have
to find a replacement for that for the
milk because you need above thousand mg
of calcium protein and post-delivery
when you're breastfeeding you need about
thousand 500 mg of calcium have a
healthy diet with lots of vegetables a
high-fiber diet if you eat vegetarian
food alone make sure you incorporate
some amount of green leafy vegetables
and high fibers if you eat
non-vegetarian please make sure you have
one egg a day it is good for your
protein
and also make sure you are eating good
amount of fruits this is where you get
your fiber from and try to avoid any
kind of aerated drinks a complete
avoidance of alcohol and cigarette
smoking no vine also in pregnancy doctor
pregnancy women can exercise yes I
normally advise my patients to start
their exercises from the fifth month
your regular exercise should not be more
than twenty minutes at a stretch when
you are pregnant this could be a leisure
walk to avoid any kind of excess
exercises should be avoided because it
can cause a lot of body cramping and you
can also know lifting weights I would
tell my patients to avoid lifting
weights prenatal physiotherapy exercises
are taught by physiotherapists these are
called prenatal exercises there is a set
amount of stretching of the muscles
which helps in easy normal delivery
these are something I normally tell my
patients to follow walking every day for
about at a stretch for 20 to 30 minutes
will make a lot of difference in muscles
to relax and other exercises like people
ask me can I do bridge
access a walking jogging no I do not
advise my patients to do a brisk walk
not do I love them to job I advise them
not to joke weights no I advise them to
go for prenatal exercises taught by a
professional a physiotherapist follow
only those and yoga I'm sorry I don't
have much knowledge about yoga
so I really don't tell my patients I
don't tell them to go for it or not to
go for it but physiotherapist advisor
and
exercises are definitely advisable
doctor finally what do you say about
congenital disorders congenital
disorders are something we really can't
help a patient when they come to us with
a scan saying there's a congenital
disorder we will have to see if this
congenital disorders treatable or not
treatable if it is treatable well and
good continue the pregnancy get it if we
can get the baby treated some of the
disorders can be treated when the baby
is in the uterus itself that can be
taken care of
a surgical pediatrician with an
ultrasound-guided doctors with a sow
knowledge astir these procedures when we
say congenital disorders the reason
mostly we get these congenital disorders
is one of the from the family tree
somebody has it it passes on to the next
generation having consigned - marriages
means when they are married in the same
families at the same bloodline examining
these disorders are highly so we are
very worried when somebody comes in to
us we are related before marriage we go
a little deeper into investigation okay
other than the mandatory
investigations we go with a little more
and we always ask the patients if there
is any ripken ssanghwa tea always go for
a karyotyping that is a blackness done
for the father and the mother the couple
goes for the blood test and then we can
see what are the congenital disorders
that can be passed on to the next
generation what is the percentage of it
being passed on so always if there is
any chance of consent - marriage make
sure the blood tests are done can we
prevent this doctor like I said
congenital disorders are not preventable
and we know no which pay which maybe
might have it which way we might not
have it so we can't determine before
Craig the pregnancy we cannot we cannot
tell which baby which pregnancy if the
same couple can have a one congenital
disorder baby and then they can have an
absolutely normal baby so there is no
particular couple where we can say that
a particular reason where only these
but this couple will have a congenital
disorder or this couple might not have
will not have a congenic a congenital
disorder can start in the first line
also thank you so much doctor that is
really useful information thank you I
hope you found this video useful so
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