Showing posts with label pregnancy. Show all posts
Showing posts with label pregnancy. Show all posts

Saturday, November 2, 2013

Hari ini...selepas sekian lama

Bila dah lama tak menulis ni...jadi kekok pulak..sampaikan nak bukak dashboard pun terkial-kial..adohai.. Banyak sangat perkara yang dilalui sepanjang tempoh tak menulis nih..macam-macam sampaikan tak boleh nak cerita lagi dah.. banyak yang berkisar pasal kerjaya..pasal mende ni dah semestinya sibuk yang teramat la..daripada tukar division, ke tukar tempat, tukar ceo, tukar HOD, tukar designation, scope of work, rezeki datang kiri dan kanan alhamdulillah, booking rumah kedua, tengok jatuh bangun orang, terpaksa stop baking hobby baking cake aku...dan sebagainya..

Kalau pasal pregnancy..ni yang sangat-sangat terpanggil untuk aku menulis pada hari ini..bukan apa..cuma nak berkongsi dengan kawan-kawan yang kat luar sana yang maybe senasib dengan aku..tapi apa yg telah berlaku kepada aku semuanya adalah perancangan Allah yang terbaik buat diriku..Setelah 6 tahun perkahwinanku akhirnya Allah anugerahkan kepadaku sesuatu yang amat bernilai untuk aku dan suami. Terima kasih Allah. Syukur alhamdulillah.

Apa yang aku telah buat dan usaha semuanya dengan izin dari-Nya. Kita hanya berusaha, berdoa dan akhirnya kita kena berserah kepada-Nya. Mungkin boleh jadi sedikit panduan untuk kawan-kawan yang tengah berusaha untuk pregnant. Tapi jangan berputus harap dengan Allah dan setiasa berdoa mohon dari Allah.

Aku cuba perkara-perkara seperti berikut:-

1. Dari tahun 2009 aku dah rujuk pakar O&G di hospital serdang untuk tujuan kesuburan. Banyak proses/ prosedur hospital yg telah aku lalui bersama suami..kami sama2 check, dapatkan nasihat doctor, testing sana sini, makan ubat dan akhirnya doctor cakap dah habis dah check dan mintak kami berusaha sendiri, sbb semuanya OK. Aku dapatkan rawatan, follow up dgn hospital serdang tu bukannya apa, sbb semua history misscarriage aku sebanyak 3 kali dulu tu semuanya ada pada diaorang. Jadi x yah cerita banyak dgn diorg semuanya ada dlm database diorang.

2. Selepas kami balik dari hospital dan kami decide berusaha cara lain pula. Perkara pertama yang aku buat ialah betulkan niat kita, jangan runsing, jgn risau, jgn tension, mesti happy dengan orang sekeliling kita especially dengan suami, jangan asyik nak usaha nak dapatkan baby sehingga kita abaikan perasaan dan kasih sayang kita pada suami. Hargai suami kita, sentiasa luahkan apa yg terbuku perasaan kita, berterus terang cerita dengan suami yg diri kita ni sunyi, sedih, rasa malu berdepan dgn org bila org tanya kita pasal baby..insyaallah suami akan faham dan kesiankan kita. Share kesedihan, kegembiraan bersama-sama suami (benda ni senang utk diucap tapi nak buat susah)

3. Baca selalu doa ni selepas solat dan masa hujan baru turun:


4. Minum air pati delima - yg ni aku sempat minum sebotol - aku minum jadikan minuman harian dan bawak bekal ke tempat kerja

5. Berbekam di belakang, lutut belakang dan depan dan kaki yg senang bengkak - kakak yg bekam tu cakap banyak asid urik dalam badan aku nih..lepas bekam belakang tak sakit, migrain dah x de, kaki pun dah tak bengkak - kalau tak tiap2 malam kena boh minyak panas sbb sakit bahagian atas belakang badan..

6. Makan Vitamin shaklee - aku makan vitamin B complex dan vitamin c, suami pun makan tapi ade tambahan utk dia - vitamin zinc

7. Berurut peranakan dengan bidan kampung - ni kena cari betul2 bidan ye..aku pergi dekat Bukit Badong, makcik ni makcik kepada adik ipar aku..

8. Berurut badan dan kaki di pusat refleksologi atas sikit dari Jusco Cheras - yg ni mmg aku puas hati sungguh recommended, charge 49.00 tapi diorg urut mcm nak tercabut tulang belakang aku..

9. Jangan minum ais dan gula - yg ni aku rasa betul kot..pesanan org tua2 kan..

10. Minum madu Biodex - 1 utk suami dan 1 utk isteri - ikut cara makan seperti yg disarankan


11. Minum air buah zuriat - buah ni aku beli di MAHA sebiji je..time tu x bwk duit byk nak beli ..tu pun org tu mcm tipu aku bagi buah yg rosak sikit kulit dia..balik umah baru nampak..lama simpan dalam peti sejuk..tp ade hikmah..sebelum ni aku pernah minum air tu tapi tak berhasil, jadi aku tanya kakak tu pura2 mcm tak tahu nak makan mcmana buah tu..pastu dia terus ckp org byk salah cara makan - dia kata kena belah dan rebus bersama2 sabut buah tu..jadi aku pun buat la mcm yg dia ckp tu..masukkan air dalam 2 cwn rebus jadikan 1 cawan..agak2 suam2 minum le..

12. Lumiglow - ni aku tgk kat internet ramai yg kata berkesan - jadi aku pun belilah satu. Sapu ikut arahan pada kotak tu..dah pakai hampir habis pastu naik gatal2 merah2 perut aku..tapi sib baik sempat pakai banyak jugak..pastu husband kata jgn pakai lagi dah..husband kesian tengok aku naik merah2 tu..yelah kan dah bahan produk tu pun dari keladi..what u aspect?


13. Minum air kosong banyak2, jaga pemakanan, ambil sayur2an dan buah2an.

14. Buat air dengan Darusshifa di Bangi - aku pergi dengan kawan aku buat air, ustaz tanya byk benda pasal aku, suami dan famili, ustaz baca2 tapi tak de apa yg tak kena dgn badan -so dia pesan suruh minum air yg di doakan dan ustaz pesan suruh tutup tingkap pintu bila nak malam. (aku mmg suka biar tingkap open je sbb nak bagi masuk udara dalam rumah - rupanya x elok)

15. Homeopathi - aku pi dgn suami dulu amik ubat homeopathi untuk kesuburan dgn Dr. Hassan di PKNS Bangi, Tingkat 1. Ubat dia kemam2 gitu..scan tgk tangan aku dan suami, dia kata peranakan aku x bersih so dia bagi ubat utk bersihkan dan bg ubt utk suami yg merokok.

16. Dan yg last sekali tu survey2 google2 sikit waktu2 yg subur dan yg sesuai untuk bersama suami (yg ni x yah le kan cerita)..

Rasanya ni jelah kot yg aku usaha untuk pregnant..tapi jangan pikir baby saja, nanti stress..enjoy your life..apa org nak ckp dengar je..be strong inside..bila org ckp yg bukan2 kalau tak tahan, ckp je alhamdulillah dalam hati...insyallah Allah mendengar doa2 org2 yg sedih..4 bulan pertama aku alah yg amat teruk, tak boleh makan, tak boleh tgk nasi, ayam dsbnya muntah je kejenya..tong sampah jadi tempat ludah aku..dlm beg ade plastik utk muntah, kemana2 kena bawak plastik - berat badan turun je, batuk aku dari mula pregnant sampailah 5 bulan tak berhenti2, nak meeting susah, malu pun ade, asyik batuk je sampai effect telinga jadi tak dengar, sakit rusuk, demam..tapi kita kena tabah dan redha dengan dugaan yg Allah bagi.. Alhamdulillah sekarang dah 7 bulan ..moga Allah permudahkan segala..Amin..Aku pun doakan pada kawan2 yg tengah berusaha tu tabah dengan dugaan yg Allah bagi..dan dipermudahkan untuk pregnant.. Amin..

Monday, April 12, 2010

12 April Appointment....

hospital lagi...

Erm hari ni half day sebelah petang sbb pergi ke hospital serdang o&g check semua menda. Sebelum balik aku bertungkus lumus settlekan report for promotion & ads IGEM utk hantar pada management. Letter of award pun aku buat tergesa2..so lebih baik besok aku teliti semua yg telah ku buat tu betul2 sebelum aku submit.

Abg sampai dekat PTM tepat pada masanya..then aku cepat2 keluar takut nanti lambat pulak. Sampai hospital pun tepat2 pukul 2.00pm. lepas byr yuran..seperti biasa nurse akan check berat n tekanan darah..tunggu kejap.pastu giliran aku pun dipanggil. doc terus suruh aku masuk bilik scan..pastu doc tanya semua menda..aku story yg aku dah keluar darah yg byk dan berketul2..masa tu mmg sakit la...sampai aku mkn ponstan..aku start describe details semua menda yg keluar..then doc ckp dah gugur semua..scan dah jadi rutin dah...dia scan rahim atas bawah..dah nipis, seluk dlm dah tutup pun..jadi mcm dah ok..cuma dia pantau lagi..doc cuma nak pastikan darah dah turun semua..Doc cakap kalau demam, sakit perut yg teruk, or darah yg keluar berbau busuk cepat2 rujuk ke hospital.. pastu doc tanya darah keluar byk lagi ker..then aku ckp dah sikit..dia kata ok...pergi amik darah utk tengok level..

Aku dengar je nasihat doctor..diorg lebih arif dlm hal ni. doc amik darah utk tgk dah kembali normal ke x keadaan aku...so that's for next week result..the next appointment is on 20/4/2010 pm.

kakak dan kakak iparku dtg melawat

Malam ahad..kak baiyah and famili dtg menjenguk aku...caring sungguh famili aku nih...siap bawa batu tungku lagi..erm tima kasih la pada semua..

kakak aku pun dtg malam sabtu..tapi aku sorang je kat umah..abg meniaga...dlm kul 11.00 kakak dan abg wan balik..kakak aku pun caring kat aku siap bawak bilis, udang kering dan kuali comel yg aku pesan..hihi..tima kasih pada semua sekali lagi..

Malam...

Cik abg mengadap bola je mlm ni...n.9 vs kedah (ulangan). Aku plak layan internet...selepas permintaan teh tariknya dipenuhi...dia dah x hirau apa dah...rasanya bom meletup pun dia buat dek je...

Malam ni tak de pe yg special pun..mkn pun makanan org sakit..abg pun pulun sekali makanan aku iaitu bilis goreng dgn halia n lada hitam..bawang putih goreng tanpa minyak..kami makan berdua..hihi.."sedapnyaar"...abg ckp..yolah tu...apa pun I love u lah abg...

Pukul 12.01mlm nanti hari jadi aku..hihi..adik aku jan dah siap2 wish dah kat aku..pukul 3.00ptg tadi...abg plak bagi hadiah special gilo...(rahsia la)..memang technical punya barang..apa pun tengkiu so much lah abg...i love u lah..

Thursday, April 8, 2010

Belum rezeki....


Aku disahkan positive pregnant bulan lepas. Happy la jugak..tapi tak la over sgt..tapi dlm hati mmg ada satu perasaan yg x dapat diluahkan dengan kata2. Cik abg pun pura2 control ayu..mcm hepi sikit..pastu hepi byk..pastu kontrol2...hehe..aku tau abg teramatlah hepi. Tapi hepi tu tak bertahan lama pun...Aku ingat lagi hari sabtu tu aku ikut abg aku meniaga dekat maeps dari pukul 3.00ptg sampai la nak dekat pukul 1.00 pagi..penat??..tak penat pun aku temankan cik abg je..bukan nya buat apa pun..aku yg berjalan2 tgk org lain meniaga sambil beli belah...time tu mmg aku x tau pun aku pregnant. Balik rumah punyalah pening pale aku ni...apa lagi..sebelum tido aku telan la ubat migraine aku...n zzzzz..

Besok pagi bangun tak hilang lagi pening tu...pastu aku makan ponstan plak...pastu ok..x pening lagi..pastu start pada petang tu aku dah start discharge brownish sikit2...aku risau gak...beli upt check2 rupanya +ve..abg bawak le aku pi klinik az-zahrah lepas balik keja..+ve gak bila wat test kat sana..tapi agak samar2.

Start pada tu, discharge tu dah mcm nak heavy..aku risau bila tau pregnant n at the same time aku bleeding..then aku rujuk o&g dekat hospital pakar..serdang. diaorg pun test mengetest mcm tu jugak..amik darah, scan atas bawah..n diorg mintak dtg lagi..amik darah lagi pada hari berikutnya..sebelum balik doc kata kalau sakit perut or sakit bahu cepat2 dtg balik..dia ckp dia suspek ectopic pregnancy..

Sabtu pagi lepas..masa dok tgh sarapan dgn abg..sakit perut bukan sikit2 punya..tak bleh bergerak langsung..sakit gilo..abg apa lagi..bawak aku terus pergi serdang..masuk emergency wad..sbb bleeding + sakit perut + pregnant..kat sana diorg tempatkan aku dekat katil sementara n masukkan air. pastu diaorg ckp doc diorg oncall doc o&g..lepas check dr o&g kata baby dah turun ke pintu rahim...dalam hati aku dah redha..tak terckp apa pun..abg kat luar lagi...lepas tu doc ckp be ready..(akan gugur)..so abg dtg dekat katil aku, then aku cerita dekat dia semua menda...dia ckp x pe..bukan rezeki kita..abg ckp yg penting aku selamat semua..petang sebelum pukul 7.00pm aku dah discharge dari hospital serdang...darah time tu turun sikit2 je..

on tuesday aku dtg kerja..tiba2 keluar menda mcm besar sikit..mcm sotong kaler putih campur2 darah..pastu keluar ketul lagi..pastu diikuti dgn darah yg byk..muka aku agak pucat time tu..aku kol abg, abg kata takpe..biar dia keluar dgn sendiri..sbb doc kata kalau next appointment (monday 12/4/2010) x keluar dia akan buat d&c. Alhamdullillah aku rasa mcm byk ketul2 keluar..

Sekarang ni aku tgh berpantang la sikit..tapi aku datang keja jugak...adik na kata "apala kak ni mc ja la"..aku kata x boleh ada benda urgent aku kena setelkan. Mlm2 dok kena boh minyak angin la, mandi air panas, pakai stoking n dapat mkn bilis goreng + bawang putih + halia..

Bila aku jadi mcm ni..abg lah yg byk bantu aku...terima kasih byk2. Peristiwa ni membuatkan abg aku lebih menyayangiku..mungkin dia juga merasai kesedihan dan kesakitan yg kulalui...

Tuesday, October 27, 2009

Adab Dimudahkan Memperoleh Anak

[DOA]


Jika ingin segera memperoleh anak, jangan lupa selalu mengamalkan dOa beRikut:

رَبِّ لَا تَذَرْنِي فَرْدًا وَأَنْتَ خَيْرُ الْوَارِثِينَ

Rabbi laa tadzaR nii faRdaw wa anta khayRul waa Ritsiin


"Ya Tuhanku janganlah Engkau membiaRkan aku hidup seORang diRi dan Engkaulah PewaRis Yang Paling Baik” (Q.S. Al-Anbiyaa : 89).


Pada akhiR dOa suatu shalat Nabi SAW beRdOa kepada Ibunya Anas bin Malik:

اللَّهُمَّ أَكْثِرْ مَالَهُ وَوَلَدَهُ وَبَارِكْ لَهُ فِيهِ

Allahumma aktsiR maa lahu wawaladahuu wabaaRiklahu fiihi


"Ya Allah! PeRbanyakkanlah haRtanya dan peRbanyakkanlah anak-anaknya seRta beRikanlah kebeRkatan kepadanya" (H.R. BukhaRi Muslim)


Maka jika dOa itu dibaca untuk diRi sendiRi atau suami istRi, kalimatnya menjadi:

اللَّهُمَّ أَكْثِرْ مَاِلي(لَنَا) وَوَلَدِي (نَا) وَبَارِكْ لي (لَنَا) فِيهِ

Allahumma aktsiR maa lii (lanaa) wawaladii (naa) wabaaRiklii (lanaa) fiihi


“Ya Allah! PeRbanyakkanlah haRtaku dan peRbanyakkanlah anak-anakku seRta beRikanlah kebeRkatan kepadaku di dalamnya”


Adab AgaR Dimudahkan MempeROleh Anak:

Kesulitan mempeROleh anak bisa disebabkan Oleh tiga faktOR : medis, psikis, dan ROhani. Jika faktORnya kaRena medis (mandul), maka satu-satunya jalan adalah mOhOn keajaiban Allah.

Jika faktORnya adalah psikis (kejiwaan dan stRess), maka baik suami maupun istRi haRus menyediakan waktu santai selama bebeRapa lama sehingga daya keRja hORmOn nORmal kembali. FaktOR ini biasanya dialami Oleh paRa pekeRja keRas atau ORang yang punya masalah beRat dan selalu tegang sehingga sulit untuk Relaks walaupun sesaat. Ketegangan amat beRpengaRuh teRhadap daya keRja hOmOn untuk bisa membuahi atau menjadi buah.

Jika faktORnya adalah ROhani (banyak maksiat dan menyeleweng) , maka jalan teRbaik adalah dengan beRtObat secaRa nasuha kepada Allah. Kemaksiatan pasti akan beRpengaRuh teRhadap ketentRaman hati. KetentRaman hati dipeRlukan dalam beRhubungan suami istRi.

Source:Tmn2syurga

Wednesday, September 16, 2009

Tips On How To Get Pregnant

How can I make it easier to conceive?



There are certain things that you can do to increase your chances of getting pregnant. Here are some tips that may help you conceive your little one! If you and your partner are having trouble getting pregnant and have not been successful after a year, follow-up with your gynecologist or a fertility specialist. As soon as you decide to start a family, make it a point to have a complete health checkup. Your doctor will then advise you what changes you need to make in your lifestyle, if any, to increase your chances of not just becoming pregnant, but also of having a healthy pregnancy.

Remember, getting pregnant means that your body will be undergoing a lot of changes, and it needs to be in the best of health to do this. It is important that you divulge your entire medical history to your doctor. Also, let your doctor know if you are taking any medication, including regular over-the-counter drugs.

1 - Have sex in the morning, since the semen has the highest sperm count then.

2 - Being overweight or underweight during pregnancy may cause problems. Try to get within 15 pounds of your ideal weight before pregnancy. Remember, pregnancy is not a time to be dieting! Don't stop eating or start skipping meals as your weight increases. Both you and your baby need the calories and nutrition you receive from a healthy diet. Be sure to consult with your doctor about your diet.

3 - Check the Body Mass Index Calculator to see if you are at a healthy level for conception.

4 - Try to have sex in the missionary position, since it deposits the sperm closest to the cervix.

5 - Stay faithful to one, uninfected and equally faithful partner to prevent the tragic consequences of a new-born with HIV or other sexually transmitted diseases. Discuss your own and your mate's sexual history (and any injected drug use) with your physician - and get tested for HIV or other infections, as appropriate. Even if you have HIV, for example, proper drug treatment can often prevent your child from becoming infected.

6 - You should not eat swordfish, shark, king mackerel or tilefish while you are pregnant or trying to become pregnant. These large, long-lived ocean fish accumulate mercury pollution as they eat smaller fish. If you then eat these fish, the mercury can accumulate in you and hurt the development of nervous system of your unborn child. The Food and Drug Administration also advises you not to eat these big fish when you're nursing a baby - and not to feed these fish to small children.

7 - Eat plenty of green, leafy vegetables AND take a multi-vitamin containing folate, or folic acid, (a B vitamin) every day, before, and during pregnancy.

8 - Avoid soft cheeses. Soft cheeses are easily contaminated by a tough bacteria called Listeria. Ordinarily, people are not affected by Listeria, but in pregnant women the bacteria can cause violent vomiting, flu-like symptoms and miscarriage. This loss can occur even before you know you're pregnant. Mexican-style soft cheeses such as queso blanco, queso fresco, queso de hoja, queso de crema and asadero are susceptible, as are other soft cheeses like feta, or goat cheese, brie, Camembert and blue-veined cheeses such as Roquefort. The Food and Drug Administration recommends that pregnant or potentially pregnant women should instead eat hard cheeses made from pasteurized milk or marked as aged for 60 days or longer.

9- Take care with all foods to food poisoning. Wash all surfaces, food and utensils thoroughly. Keep your hands clean during food preparation.

10 - To be on the safe side, some environmental health experts suggest that pregnant women - despite those infamous cravings we are supposed to get - avoid overdoing any single food or beverage in the diet. Varying your diet guards you against getting a massive dose of a problem substance, if there should be an accident that unexpectedly contaminates a particular food.

11-Pregnancy is not the time to care for a cat or take in a new one. They may harbor a parasite that causes toxoplasmosis. If you get it while pregnant, your unborn child has about a 40 percent chance of contracting it too. In early pregnancy, this can cause the child to be blind, deaf and mentally retarded. The parasite can be found in cat feces, soil and infected meats that have not been thoroughly cooked. Cats get it from eating infected birds, mice and rats. So keep your family cat indoors to reduce its chances of getting the parasite - and have someone else clean its litter box, so that you don't get it.

12 - Protect yourself from pesticides and other chemical exposures. We don't know enough about the safety of home and occupational pesticides and chemicals in pregnancy, so it is a good idea to be cautious. Ask your employer to give you copies of Material Safety Data Sheets (MSDSs) for any hazardous materials in your work, as required. A few substances of concern are lead, carbaryl (Sevin), bromine vapor, carbon disulfide, ethylene dibromide, mercury vapor and styrene and acetone used in plastic production.

13 - You can be exposed to chemicals in the air you breath, through your eyes, or in your food and water. Store chemicals in sealed containers when not in use and follow recommendations for ventilation. A major route of contamination is through your skin, so wear protective clothing and gloves. Wash off any spilled materials immediately. Wash your hands before eating and drinking.

14- If you are a farm worker, factory worker or scientist, or you have one as a husband, partner or family member, you and/or that other worker should shower at work at closing time or as soon as you/they get home. Clothes contaminated by pesticides, chemicals or metals should be washed at work, if possible. If they must be washed at home, they should be washed separately from other clothes, and as soon as possible.

15- If you are a dentist, dental assistant or hygienist or work with the anesthetic nitrous oxide (N2O) in human or veterinary medicine, you should know be cautious because this gas has been shown to cause defects in the offspring of exposed lab animals. Adequate ventilation, tests for leaks and other guidelines should be followed to limit your exposure. Women working as potters, with solder, or as home remodelers may encounter lead, which has been associated with miscarriages, stillbirths and infertility for more than 100 years. The National Institute of Occupational Safety and Health also warns of reproductive problems among women viscose rayon workers exposed to carbon disulfide (CS2) and among electronic and semi-conductor workers exposed to ethylene glycol ethers such as 2EE and 2ME.

16-If you're planning to decorate a room as a nursery, why not ask a pro or a partner to do the painting (while you go elsewhere and avoid the fumes.)

17- Avoid smoke, as well as smoking. Smoking increases the risks of an underweight baby and of stillbirth, the birth of a dead fetus. Smoking and passive smoke exposure may double the risk of a rare but devastating condition called persistent pulmonary hypertension of the newborn. In this condition, infants starve for oxygen because blood is not pumped through the lungs to the body but continues to flow as it did before birth and the activation of the lungs. Without successful surgery to correct the flow, the infant may die. Babies born to women who smoked during pregnancy are also more likely to have asthma and other respiratory problems. They also are more likely to die of sudden infant death syndrome - SIDS. SIDS reduction campaigns emphasize positioning infants on their backs for sleeping as well as keeping cigarette, cigar and pipe smoke away. Smoking has been associated with infertility issues as well.

18- Avoid x-rays, hot tubs and saunas. They pose environmental risks for pregnant women. If x-rays are needed for medical reasons, your doctor will shield your abdomen (and thereby your fetus) from the rays. The March of Dimes also suggests pregnant women try to avoid infections. Rubella (German measles) during pregnancy can cause ear, eye and heart abnormalities. You can be tested to see if you've been exposed and are immune. If not, you can get vaccinated - but then should wait three months before getting pregnant. For avoiding many infections, frequent hand-washing can help.

19- Exercise moderately. Walk, swim, ride a stationary bike and/or join in a special prenatal aerobics class three or more times a week. Even a vigorous workout is ok for most women and may help you carry your baby to full term. Not so advisable: bouncing or jerking movements, toe touches, knee bends and sit-ups. Doctors generally fo not recommend any vigorous exercise that has you lying on your back after the first three months of pregnancy. Injury-risking sports - skiing, rock-climbing, horseback riding - aren't good bets. But regular, safe exercise can make labor easier and prepare you to get back in shape afterwards.

20- Relax, too. You don't need a lot of stress during pregnancy, or before pregnancy either!

21- Take folic acid daily both before pregnancy and during the first few months of pregnancy to reduce the risk of birth defects of the brain and spine. All women who could possibly become pregnant should take a vitamin with folic acid, every day. It is also important to eat a healthy diet with fortified foods (enriched grain products, including cereals, rice, breads, and pastas) and foods with natural sources of folate (orange juice, green leafy vegetables, beans, peanuts, broccoli, asparagus, peas, and lentils).

22- Be sure to see your doctor and get prenatal care as soon as you think you're pregnant. It's important to see your doctor regularly throughout pregnancy, so be sure to keep all your prenatal care appointments.

23 - Drink extra fluids (water is best) throughout pregnancy to help your body keep up with the increases in your blood volume. Drink at least 6 to 8 glasses of water, fruit juice, or milk each day. A good way to know you're drinking enough fluid is when your urine looks like almost-clear water or is very light yellow.

24- Medical conditions/complications such as diabetes, epilepsy, and high blood pressure should be treated and kept under control. Ask your doctor about any medications that may need to be changed or adjusted during pregnancy. If you are currently taking any medications ask your doctor if it is safe to take them while you're pregnant. Also, be sure to discuss any herbs or vitamins you are taking. They are medicines, too! Discuss with your doctor all medications, prescribed and over-the-counter, that you are taking.

25- Saunas, hot tubs, and steam rooms should be avoided while you are trying to become pregnant. Excessive high heat may be harmful before and during your pregnancy.

26- Genetic testing should be done appropriately. It's important to know your family history. If there have been problems with pregnancies or birth defects in your family, report these to your doctor. Also, genetic counselors can talk with you about the information you might need in making decisions about having a family. You can call a major medical center in your area for help in finding a board-certified genetic counselor.

27-You should know when your fertile days are. Charting your fertility will let you know when you are ovulating so that you know when you are most likely to become pregnant.

Source: www.i-am-pregnant.com

Ectopic pregnancies

Early detection and treatment of ectopic pregnancies will produce better outcomes.

Ectopic pregnancy is a condition in which the fertilised egg (embryo) is implanted outside the uterine cavity. Its occurrence varies in different countries but it is estimated to occur in about one in 100 pregnancies.


Unseen: About 50% of ectopic pregnancies do not exhibit any specific symptoms.


About 95% of ectopic pregnancies occur in the fallopian tubes. It can also occur in other sites like the ovary, cervix or abdominal cavity.

An ectopic pregnancy is life-threatening as it can rupture, causing bleeding into the abdominal cavity. The earlier an ectopic pregnancy is treated, the better the outcome. Delay will lead to further damage to the fallopian tubes or other sites and if left untreated, the blood loss can result in death.

Risk factors


When an egg is released by the ovary, it travels along the fallopian tube where it is fertilised by the sperm. The lining of the fallopian tubes contain hair-like structures, called cilia, which push the embryo along into the uterine cavity where it gets embedded. If there is damage to the fallopian tubes, the cilia may be unable to perform its function, resulting in the embryo embedding in the fallopian tube itself.

These factors increase the likelihood of ectopic pregnancy:

Pelvic inflammatory disease (PID) in which the ovaries, fallopian tubes and uterus have been or are infected.

Intra-uterine contraceptive device especially when it is associated with PID.

Previous surgery on the fallopian tubes like sterilisation, its reversal or other surgery.

Previous abdominal surgery like caesarean section and fibroid removal (myomectomy).

In-vitro fertilisation (IVF). Although the embryo is placed inside the uterine cavity, it may still attach itself to the fallopian tube.

Previous ectopic pregnancy. The risk of an ectopic pregnancy increases from 1% to 10% after an ectopic pregnancy has occurred.

The risk in women aged 44 years or more is increased from 1% to 8%.

It should be noted that these risk factors are not present in many women who have an ectopic pregnancy.

Diagnosis

About 50% of women with an ectopic pregnancy have no specific symptoms apart from those associated with pregnancies such as missed period, nausea and sore breasts.

The symptoms include:

Vaginal bleeding that differs from that of the normal period in that it is lighter or darker.

Abdominal pain which is usually on one side. The pain may be severe and persistent.

Shoulder tip pain which is due to the blood in the abdominal cavity irritating the diaphragm, which has the same nerve supply as the shoulders.

Pain on passing motion or urine.

The diagnosis is made by clinical examination in most instances. A transvaginal ultrasound is helpful in diagnosis. This involves inserting the ultrasound probe into the vagina to visualise the uterus and its surroundings.

Sometimes, the diagnosis is made at laparoscopy, which is an operative procedure that involves direct visualisation of the pelvic organs through small incisions in the abdomen. This procedure is useful especially when there are no specific symptoms. After making the diagnosis at laparoscopy, a decision will be made on the mode of management.

Management

The management is influenced considerably by whether the diagnosis is made before the ectopic pregnancy has ruptured or not. The gynaecologist will discuss the various treatment options with the patient.

Surgery to remove the embryo from the abdominal cavity is the most common treatment. If there is no indication of shock, the laparoscopy approach is usually preferred. If there are changes indicating shock, a laparotomy is preferred, in which the larger incision will facilitate an expeditious stopping of the bleeding.

The part of the fallopian tube in which the embryo is located (salpingectomy) is removed or the embryo is removed through an opening in the tube (salpingotomy). If the other tube appears normal, there is no evidence that a salpingotomy is preferable to a salpingectomy. If the other tube appears diseased and there is a desire for future fertility, a salpingotomy is preferred, as a salpingectomy would mean that IVF or other assisted reproduction would be required for the next pregnancy.

Medical treatment can be provided if the ectopic pregnancy is diagnosed early. Methotrexate may be prescribed to stop the pregnancy from continuing. The women who are most suited for methotrexate treatment are those with minimal or no symptoms and a serum human chorionic gonadotrophin (hCG) below 3,000 IU/l.

The side effects of methotrexate include nausea, vomiting, sore mouth and sore eyes. About 75% of those given methotrexate will experience abdominal pain which may be difficult to differentiate from that of tubal rupture.

Expectant treatment (“Wait and see”) refers to situations where there are minimal symptoms and the pregnancy’s location is unknown.

This situation occurs when the hCG is less than 1,000 IU/l and no pregnancy, whether inside or outside the uterine cavity, is visible on transvaginal ultrasound.

Up to 60% of such pregnancies resolve spontaneously without any treatment. Regular examinations and blood tests are mandatory with expectant management, until the hCG levels are below 20 IU/l.

Surgery will have to be resorted to at any time during medical or expectant treatment should the clinical situation warrants it. Anti-D immunoglobulin will be given to all rhesus negative women with suspected or confirmed ectopic pregnancy.

Prevention

Ectopic pregnancies cannot be prevented. However, one of its major risk factors, pelvic inflammatory disease (PID), can be prevented. The primary cause of PID is sexually transmitted infections (STI), which is preventable. Regular use of the condom can prevent STIs. Knowing one’s sexual partner and having one sexual partner can also prevent STIs. Regular sexual health checks are helpful particularly if one suspects one’s sexual partner has STI and/or PID.

Dr Milton Lum is member of the board of Medical Defence Malaysia. This article is not intended to replace, dictate or define evaluation by a qualified doctor. The views expressed do not represent that of any organisation the writer is associated with.

Source: The Star,16 Sept 09.

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