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How can i increase the chance of Having a Healthy Pregnancy, causes of miscarriages, during pregnancy, pre-pregnancy, ivf pregnancy

Author Name: Dr. Youmee kiroung sherpa || Mentor Name: Dr. Urmila Sharma on April 21, 2020

Indian women, as compared to other ethnic groups, seem more likely to miscarry their first pregnancy or suffer from recurrent miscarriages. The occurrence of spontaneous miscarriages in India has been reported to be around 30% , with as many as 22% lost before the pregnancy has been clinically recognized.

With infertility being a great issue nowadays… maintaining a healthy pregnancy after going through great lengths for conception has become very important. But pregnancy whether conceived naturally or through medication is a great event in a woman’s life and is always precious. Hence, the question of how to improve the chance of healthy pregnancy haunts the mind of every Indian woman.

For those undergoing recurrent miscarriages ( more than 3 miscarriages back to back), pregnancy with medical risks or increased maternal age… , there are other factors and that needs to be considered and taken care of,so regular visit to the health professional is advised. But for the general population here are a few factors that can help you to attain a healthy pregnancy. We will divide it into pre-pregnancy and pregnancy do’s and don’ts.

PRE- PREGNANCY

❖ DEVELOP A PLAN:

Planning a pregnancy is extremely important as it gives us a choice to bring forth a baby as and when we are prepared for them. The decision to carry a baby should include both the couple so as to avoid the adverse effects of the intake of toxic substances and stress, which could be avoided prior to pregnancy.

❖ ADOPT A HEALTHY DIET AND LIFESTYLE:

◆ HEALTHY DIET:
A diet rich in fibre, antioxidants and minerals is recommended prior to and throughout the pregnancy.
Supplements such as folic acid 400 microgram daily is recommended 6 months prior to pregnancy to avoid neural tube defects. Vitamin B intake is recommended to prevent miscarriages.

◆ Smoking, drinking alcohol and intake of drugs are to be avoided as it may lead to sudden intra-uterine fetal death, preterm birth or various anomalies.

◆ Get a healthy weight as obesity may decrease your chances of getting pregnant and post pregnancy it may increase the risk of hypertension, preeclampsia, gestational diabetes mellitus and cesarean section.

◆ Get the medical conditions under control as it may flare up during pregnancy. Get up to date with the vaccinations like rubella & measles.

◆ Learn your family history for any congenital diseases, any case of delayed milestones either intellectually or physically.

DURING PREGNANCY

As soon as the pregnancy is evident, it is highly advisable to visit the health care professional for further guidance during pregnancy. Proper antenatal check up and a good prenatal care can ensure a healthy pregnancy and a healthy baby.

Important points are:
◆ Healthy diet along with supplements like folic acid, iron, calcium and vitamins. Caffeine intake should be limited as it may cause miscarriage.
◆ Do not use alcohol, tobacco etc.
◆ Medications taken should he provided from the health care provider only as self medication may prove harmful to the growing fetus. Medications taken prior to pregnancy should be enquired of again as it may be teratogenic.
◆ Avoid exposure to harmful and toxic substances like radiations, occupational hazards.
◆ Regular dental checkups is advised.
◆ Regular exercise or yoga is advised but heavy work should be avoided.
◆ Regular sonography during pregnancy is advised for the betterment of the fetus and mother.

And last but not the least one should know when to call or visit the doctor apart from the regular check ups:
➢ In case of pain abdomen or strong cramps,
➢ Vaginal bleeding or leaking,
➢ Dizziness or fainting,
➢ Shortness of breath,
➢ Heart palpitations,
➢ Less movement of the baby.

CAUSES OF MISCARRIAGES

EARLY (UPTO 12 WKS)
➢ Chromosomal
➢ immunological
➢ Endocrine
➢ Hematologic
➢ Thrombotic
➢ Infectious agent
➢ Teratogens
➢ Unknown

12-24 WKS
➢ Chromosomal or single gene defects
➢ Immunological
➢ Uterine
➢ Unknown

LATE ( POST 24 WKS)
➢ Single gene defect
➢ Immunological
➢ Thrombotic
➢ Cervical or uterine
➢ Unknown

These are the common cause of miscarriages and can be fairly avoided if the cause is known ,
✓ Immunological, thrombotic and infectious causes can be dealt with proper medication, injections as advised by the doctors.
✓ Cervical or uterine cause can be avoided by some surgical procedures like hysteroscopy and cerclage operations.
✓ Chromosomal or single gene defect- with the era of assisted reproduction the defects can be avoided at the embryonic stages by doing PGS/ PGD. Or if the pregnancy has progressed it can be detected with various aneuploidy screening.

Causes can be varied but the precautions to be maintained are the same, if followed diligently we can decrease the chance of miscarriage and bring forth a healthy pregnancy and a fine baby.

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