Dr. Onyeije’s Maternal-Fetal Medicine Blog

Things You Should Know About Pregnancy Induced Hypertension

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There are three classic signs of Pregnancy Induced Hypertension (PIH), also known as Gestational Hypertension and they are: a blood pressure of not lower than 140/90 mmhg., presence of protein in the urine and presence of generalized swelling or edema (only edema of the lower extremities is normal, edema of the face and hands is considered generalized edema).

If you observe these three signs, you will require special management to prevent the complications that can be dangerous to both you and your baby.

What exactly causes PIH is unknown, but there are factors closely associated with it that places you at greater risk of developing one.

A first time mom with no history of previous pregnancies is at risk especially if your age is below 18 or above 35 years old. If in your family, your grandmother, mother or sister had PIH, there is a higher risk that you may also develop the condition.

Mothers who have twin or multiple pregnancies that poses a greater demand on her cardiovascular system may also develop PIH. Lastly, women who have a history of kidney disease or history of high blood pressure at any time before the pregnancy is at risk of developing PIH.

There are dangerous complications associated with PIH like:

  • Preeclampsia, a condition when the blood pressure reaches as high as 160/110 mmhg. That predisposes the woman to having a seizure.
  • Eclampsia is when the woman had even one episode of seizure.
  • Severe eclampsia is when the woman experiences several episodes of seizure (this stage is already very dangerous and can be fatal to both mother and baby).
  • HELLP syndrome stands for: Hemolysis, Elevated Liver enzymes and Low Platelet. This condition will end up in a severe bleeding episode and may result to death of the mother if not managed immediately and distress or death of the baby.

PIH is a serious condition that should not be ignored; working close with your health provider is a must. PIH may develop at any stage of the pregnancy from the first trimester even after the delivery of the baby.


Link Found Between Schizophrenia And Exposure To Flu

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Recent research has found that those babies, whose mothers had the flu while pregnant, are more likely to have schizophrenia later in life.

schizophreniaIt was explained thus by Temple University psychologist Lauren Ellman – when a woman catches flu when pregnant, she produces certain immune proteins in response to the flu, and this raises the exposure of the unborn baby to those proteins, consequently raising risk of certain abnormalities of the brain, which could lead to schizophrenia.

This is not to say that all women who had the flu when pregnant had schizophrenic babies, but the risk is seen to rise.

Earlier this link between flu infection and schizophrenia was not fully understood, because for the most part, infections do not cross over from the placenta to the baby. Now it is understood that it isn’t the infection, but rather the maternal reaction to it that has the negative impact on the fetal brain.

So this is one more reason for pregnant women to practice good hygiene that is frequent hand washing, keeping away from infected people and practicing proper immunization protocols.


The Impact Of Pregnancy Stress And Anxiety On Mother And Baby

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We are only now beginning to understand the far-reaching impacts that a mother’s activities, diet, health and emotions can have on the fetus that she carries.

It isn’t just an old wives’ tale that if you are stressed, irritable and depressed during your pregnancy, some of that may impact your developing fetus, and scientists are constantly working to fathom how this works.

It could be stress and anxiety that arise out of stressful situations of life: a relationship problem or a breakup, a bereavement, domestic abuse, infidelity, etc. or there could be everyday stress such as dealing with household chores, older children and their needs or even just the feeling of being overwhelmed by the enormity of impending motherhood.

One may just be worried about the process of childbirth, pain management and recovery. It is natural to feel stressed and anxious, and a feeling of loneliness during pregnancy, even when one has the benefit of a loving partner and a support system.

The negative impact of stress during pregnancy: Risk of certain conditions such as preeclampsia (gestational hypertension or high blood pressure) increases due to stress.

There is also a higher likelihood of complications during labor and childbirth. The baby is also at higher risk of being born with a lower birth weight or preterm.

Some experts also attribute qualities of a child such as being hyperactive, temperamental, poorly behaved or having low self control to stress experienced by a mother during her pregnancy.

The reason why stress can impact a child negatively: Under stress, the human body produces the hormone cortisol, which can cross over the placental barrier to the baby.

This is not the most conducive environment for baby to develop. It is not yet fully understood how and why stress impacts the unborn child so negatively, but we do know that it is important to manage it effectively during pregnancy.

Recognizing signs of stress during pregnancy: Since there is so much at stake when you are pregnant it is important to look after yourself and watch out for these signs of depression, stress or anxiety:

  • If you feel weepy or tearful frequently and repeatedly. An occasional crying jag could just be a surge of hormones, but consistently being weepy is not OK.
  • Constantly feeling sad, inadequate or unhappy.
  • Frequent irritability or short temperedness. Having little or no patience with other children in the house or feeling anger all the time.
  • Indulging in risky behavior of any sort.


Leg Cramping During Pregnancy – Why Does It Happen And What Can I Do To Relieve It?

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Leg cramping during pregnancy is quite commonly experienced, and it is normal and harmless.

However, it is something that can be painful and inconvenient; it may even disturb sleep and interrupt times of rest. So it is important that leg cramping during pregnancy is dealt with for relief from pain and disturbance.

As every woman is different so every pregnancy is different, and while many may suffer excruciating cramping in the legs during pregnancy; others have none at all.

The cramping may be in the lower legs, or higher up in the thighs. The kind of cramping and the degree of pain experienced may also differ greatly.

So why does leg cramping during pregnancy happen? This is a common occurrence that happens as the body’s circulatory and metabolic systems undergo several changes.

In particular, the way that certain nutrients such as calcium and potassium are metabolized changes and this is thought to contribute to leg cramping during pregnancy.

Also insufficient hydration (when pregnant one should be drinking more water than before) could be one of the causes.

It could also be that the legs cramp from having to bear the extra pregnancy weight that a woman inevitably puts on during her pregnancy. Also the expanding uterus puts pressure on the blood vessels further causing discomfort.

What is Restless Legs Syndrome? While some women experience pain, others experience for the first time in their lives a condition called Restless Legs Syndrome when they are pregnant. This is characterized by a discomfort in the legs; an oddly squirmy and uncomfortable sensation that is not painful but difficult to fully describe.

It causes the one to keep moving the legs in order to get a little relief and feel somewhat more comfortable. RLS can be very disruptive; particularly a good night’s sleep may well be disturbed.

Should I worry? Usually leg cramping during pregnancy is nothing to worry about; however if there is swelling and tenderness in the legs, it is advisable to call a doctor immediately. This could be a blood clot which will require immediate attention.

Leg cramping during pregnancy could be alleviated by the following:

  • A few simple stretching and ankle rotating exercises several times a day could help. Also be as active as possible in order that your circulation is in good shape. Unless there is a medical reason not to do so, take regular exercise in the form of walks etc.
  • Long periods of standing or crossing one’s legs for long periods can also cause stress leading to cramps. Avoid that whenever possible.
  • Eat bananas. They are a good source of potassium and are easy to digest and good for you.
  • Consider taking a calcium supplement after consulting your doctor about it. A magnesium or vitamin supplement may also be indicated.
  • Drink plenty of water.
  • Use relaxation techniques like meditation.
  • Take a warm bath to relax your muscles and soothe yourself so that you are able to get a better night’s sleep.
  • Avoid getting over tired.
  • Lay down on your left side, this improves circulation.


OCD Symptoms Could Worsen During Pregnancy

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According to a new study, women may find themselves experiencing symptoms of Obsessive Compulsive Disorder (OCD) during pregnancy. Women who already have OCD may find that their symptoms get exacerbated when they become pregnant.

According to researchers, this disorder which causes sufferers to compulsively repeat actions and rituals and be preoccupied and even obsessed with germs and cleanliness could be due to hormonal changes that occur during pregnancy.

As many as 2 million American adults are estimated to have OCD, the symptoms of which may first be noted during childhood or the teenage years.

While women who have OCD may find that their symptoms worsen during their pregnancy, other women may find that they experience OCD symptoms for the first time in their life during pregnancy.

Researchers also found that those women with OCD who found their symptoms worsening during PMS, were more likely to find that their OCD got worse in pregnancy as well.

This is a hormone related subtype of OCD that may be responsible for these findings, according to the researchers and that women may have different sensitivity to reproductive hormones that may be the cause.

This may be important to note so that extra care and caution may be exercised during pregnancy and so that the attending doctor may also make the modifications to treatment as may be required.


Why Pregnant Women Should Watch Out For Diarrhea?

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Though many women experience constipation during pregnancy, many also experience the opposite problem like diarrhea during this time.

Diarrhea, which is more than three loose motions in a 24 hour period, may be caused by a virus, bacteria, or parasite of some sort and is usually not a problem that one needs to worry about.

Diarrhea is also something that resolves itself in time and needs no special medication for the most part.

However, the reason that pregnant women with diarrhea should be very careful is the fact that dehydration is a common outcome of diarrhea.

The body loses a lot of water and essential salts due to diarrhea. This is particularly true for pregnant women because they can quickly get dehydrated and this could be potentially problematic.

Oral rehydration products should be used to replenish fluids and salts lost and a doctor should be called in the following circumstances:

  • If there is any blood being passed along with the stool
  • If there is very little or no urine being passed
  • If the diarrhea does not resolve itself or persists beyond a few days
  • If the diarrhea accompanies by other symptoms such as vomiting and fever
  • If there is severe pain accompanying the diarrhea


Higher HIV Risk During Pregnancy – For Men As Well As Women

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Pregnant women are considered immune compromised; in general they are more prone to infections and their immune system does not work as efficiently as at other times. This could be due to the fact that there are major changes ongoing in the body as well as the fact that a pregnant woman’s bodily resources are concentrated on nurturing new life.

pregnant womanSo it is that women are more susceptible to HIV during their pregnancy. This is a well known fact that pregnant women are more likely to contract HIV during intercourse with an HIV positive partner.

However, research now tells us that men are even more at risk of contracting HIV if they have sexual intercourse with a pregnancy HIV + woman. This was found in a study conducted at University of Nairobi and Kenyatta National Hospital in Nairobi by Dr Nelly Mugo and her colleagues.

The study found that for women, it was sexual behavior that was an important aspect to explain this raised risk.

For men however it was found that the risk was even greater and this was put down to the fact of physiological changes to the vagina during pregnancy and perhaps to immunological changes as well. However it is thought that more research on this subject is still needed to be carried out.


Cramping During Pregnancy – What Does It Mean?

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We women associate cramping with the monthly period or perhaps the very end of the pregnancy when labor cramps start.

Cramping during pregnancy however may be another matter and is likely to cause consternation, even alarm for a lot of expecting mothers.

Some women report early pregnancy cramping, often it is something as simple as the ligaments of the uterus preparing for the baby by stretching.

When the implantation of the embryo occurs this can also cause some amount of cramping. This is normal.

Sometimes the cramping could be caused by something as innocuous as gas or constipation.

As long as the cramping is not severe and it is not experienced along with other symptoms, this is not to be worried about. If, however, the cramping of early pregnancy is accompanied by the following, it could be a sign of problems:

  • If the cramping is severe or very painful
  • If it is accompanied by bleeding
  • If it is accompanied by other discharge
  • If you experience fever, chills or other discomfort
  • If there is a feeling of lightheadedness or faintness

When cramping in early pregnancy is accompanied by one of more of the above symptoms, it could be caused by a number of worrisome problems such as infection, an ectopic pregnancy or even a miscarriage.

It could also be caused by non pregnancy related issues such as a urinary tract infection, a kidney infection, appendicitis, or pre-eclampsia. In all these cases, immediate medical attention is a must.

In normal circumstances, early pregnancy cramping should cease by the 6th week of pregnancy or so, but this time implantation should be complete.

However, it is not uncommon to feel mild cramping for reasons other than implantation, which are called round ligament pain, even later on in the pregnancy.

This may happen from time to time as the uterus stretches and then stretches some more and then yet some more to accommodate a growing baby.

There is another kind of cramping of later pregnancy which starts about the third trimester. This is known as the Braxton Hicks contraction.

These are practice contractions that come and go during the third trimester, which is the body’s way of preparing for the delivery. Actually these start of in early pregnancy but most women don’t feel them until the third trimester.

They are usually infrequent, irregular and reasonably mild. More severe or regular contractions could be the sign of preterm labor and should be reported to the doctor.

Other pregnancy cramping could be that experienced in the legs which many women experience and which can be fairly painful. This has to do with the fact that the body’s blood circulatory system has to work overtime to provide nourishment to the baby.

The legs may be coping with the extra work that the body has to do as well and may therefore cramp. Leg cramps are more common during the second and third trimesters. Mineral imbalance could also be causing leg cramping in pregnancy.


Pregnancy Increases The Risk For Everything

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Just about everything, according to some experts! It is this reason that experts urge pregnant women to be more careful about infections such as Swine Flu and others at this time.

During pregnancy, the energies and resources of the mother’s body are concentrated on offering sustenance to the little life being nurtured within. At this time, the expectant mother’s immune systems are compromised; she becomes more susceptible to infections and illnesses.

pregnancyIt isn’t just the mood swings, aches and pains and nausea that are par for the course, women can develop a number of other problems and it is all perfectly normal! Women who are pregnant will be more at risk from:

  • Gum disease, because gums get swollen and slack during this time
  • A Urinary tract infection. One must get help for a UTI quickly during pregnancy, because if left untreated it could cause a problematic kidney infection. it is one of the reasons that routine urine tests are performed during pregnancy.
  • Diabetic retinopathy, which is damage to the blood vessels in the retina if one has type 2 Diabetes, which can lead to blindness.
  • Thrush is developed by pregnant women as well as their newborn babies, in many cases. This is also due to the mother’s compromised immune system at this time.

Source: families


Pregnancy Heartburn – All Natural Ways To Deal With It

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As your pregnancy progresses, all manners of aches, pains and discomforts will manifest themselves; among them could be pregnancy heartburn.

During pregnancy, most women are chary of using any medication in the apprehension of the sort of impact that it could have on the unborn child.

As many as half of all pregnant women, may experience some amount of heartburn, so this is something that concerns a very large number of women. There are several natural ways to keep pregnancy heartburn in check.

What is Pregnancy Heartburn? Many women experience heartburn or acidity for the first time in their lives during pregnancy.

This happens when there is a burning feeling in the chest or stomach and a sour or acidic reflux from the stomach up the food pipe and sometimes even into the mouth.

Why does Pregnancy heartburn happen? This acid reflux or heartburn during pregnancy is caused by the softening of ligaments by changing hormones.

The esophageal sphincter that divides the food pipe from the stomach relaxes, allowing the contents of the stomach to flow back up.

Also imagine the amount of space that the growing baby is taking up in your abdomen, and the pressure that it is in turn placing upon the other organs, which also gives rise to pregnancy heartburn.

How can one deal with pregnancy heartburn? Some natural ways to deal with pregnancy heartburn are:

  • Identify and avoid heartburn triggers. If you find that certain foods trigger heartburn during pregnancy, avoid them.
  • Avoid spicy, fried, caffeinated food. Also avoid things with high tomato or vinegar content.
  • There are many reasons to avoid alcohol during pregnancy; avoiding heart burn is one more.
  • Rather than 3 big meals, have 6 small ones, so that your stomach does not get very full at any given time.
  • Eat slowly, chewing well. Keep a sufficient gap of time between eating and sleeping to allow the contents of the stomach to be digested properly.
  • Keep a good posture, and don’t wear tight clothes.
  • Drink plenty of water. Just make sure that the water is not drunk at mealtimes because this will stretch your stomach.
  • While sleeping, elevate your head with a larger pillow of by angling the head of the bed upward. Another alternative is to put a bolster of some sort under the head of the mattress so as to elevate it and angle it upward. This way gravity itself will help to keep pregnancy heartburn in check.
  • Make sure that you don’t gain excess weight during pregnancy; this can also lead to pregnancy heartburn or contribute to it.
  • Don’t bend forward from the waist, as this can put pressure on the stomach. Rather crouch at the knees.

If all of this does not work you may be thinking of taking over the counter medications to remedy pregnancy heartburn. This however should always be cleared with one’s doctor.

Before taking any medication during pregnancy it should always be cleared with one’s physician or caregiver.


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