Miscarriage : Term used for pregnancy that ends “by itself”, within the first 20 weeks of gestation. Most miscarriages occur during the first 13 weeks of pregnancy, and many go unnoticed, due to the fact that some women do not realize they are pregnant. It is the most common type of pregnancy loss, according to the American College of Obstetrics and Gynecology, approximately 15% of all pregnancies end in miscarriage.
The reason for miscarriage is varied and most often, the cause can not be identified. During the first trimester, the most common cause of miscarriage is chromosomal abnormality-meaning that something is not correct with the baby’s chromosomes. Other causes for miscarriage include
· Hormonal problems, infections or health problems in the mother
· Implantation of the egg into the uterine lining does not occur properly
· Smoking,druguse,malnutrition,excessive caffeine and exposure to radiation or toxic substances

Warning signs of Miscarriage:

· Mild to severe back pain
· True contractions- very painful happening every 5-20 minutes
· Brown or bright red bleeding or spotting with or without cramps
· Tissue with clot like material passing from the vagina
· Decrease in signs of pregnancy or loss of breast tenderness

If you experience any or all of these symptoms, it is very important to contact your doctor or get to a medical facility as soon as possible

How to confirm pregnancy

Urine Pregnancy Tests: A pregnancy test that uses urine
to find the hormone called Human Chorionic Gondaotrophin,
or HCG. Urine Pregnancy tests are taken two weeks after
conception, or anytime after a woman misses a period.
Most women can find these test an their local drug store.

Blood Pregnancy Tests: Blood tests can be taken
slightly earlier than urine tests. Like urine tests,
blood tests detect HCG to confirm a pregnancy.

Ultrasound: Sometimes referred to as a sonogram.
Uses sound waves to detect a gestacional sac and watch the
unborn baby. Usually an ultrasound gives an accurate
answer to the gestational age and due day.

Terms to know

Ovulation: Occurs two weeks, or an average of 14 days,
after the beginning of a woman’s last period. A woman has
a rise in her luteinizing hormone (LH) when the egg is
available for fertilization. This is the most probable time
frame to get pregnant.

Conception: When the egg is available for fertilization and
350 million sperm is released inside or near the woman’s
vaginal area, about 200 sperm will reach the egg. Of those
200 sperm, only one will actually penetrate the egg, thus
causing conception.

Gestation: How far along the fetus is, determined by the
beginning of the mother’s last period. Babies are usually
born at 40 weeks, but considered full-term from 37 weeks,
and extends to 42 weeks.

Prenatal care

What is prenatal care?
Prenatal care is the health care you get while you are pregnant.
Prenatal care can help keep you and your baby healthy. Babies of mothers who do not get prenatal care are three times more likely to have a low birth weight and five times more likely to die than those born to mothers who do get care.

Doctors can spot health problems early when they see mothers regularly. This allows doctors to treat them early. Early treatment can cure many problems and prevent others. Regular health care is best for you and your baby.

Your doctor will give you a schedule of all the doctor's visits you should have while pregnant. As your pregnancy progresses, you'll see the doctor more often. Most experts suggest you see your doctor:

*about once each month for the first six months of pregnancy
*every two weeks for the seventh and eight month of pregnancy
*every week until the baby is born

At the first visit, you should ask questions and discuss any issues related to your pregnancy. Find out all you can about how to stay healthy.

Later prenatal visits will probably be shorter. Your doctor will check on your health and make sure the baby is growing as expected. Most prenatal visits will include:

*checking the baby's heart rate
*checking your blood pressure
*checking your urine for signs of diabetes
*measuring your weight gain

While you're pregnant your doctor or midwife may suggest a number of laboratory tests, ultrasound exams, and other screening tests.
Extracted from: womenshealth.gov

Mother to be ? :Ultrasound Evaluation " A must have"

Ultrasound Evaluation during the First Trimester is an important diagnostic tool for any pregnant woman and her baby. It takes less than 30 minutes and is performed at different times during the pregnancy. It is performed via transdominal or may also be performed as a transvaginal study, it is not painful.

Helps ensure baby is healthy, it is considered safe for mother-to-be and her baby and aiding in diagnosis and treatment of a variety of medical conditions and common pregnancy complications, pregnancy ultrasound has become a “must-have diagnostic procedure”.

In early pregnancy helps to establish the site and status of the Gestational Sac which is the first element measurable and used for estimating gestational age. Useful between 5 and 8 menstrual weeks with accuracy of +/- 0.5 week . After that , the length of the embryo (crown-rump length.) is among the best documented parameters to date the pregnancy , with accuracy of +/- 3-5 days.

Some clinical Indications for First Trimester Obstetric Sonography are:

1.) Confirm ongoing pregnancy in the setting of vaginal bleeding and pain (Threaten Abortion)
2.) Establish gestation age and EDC (due date) when menstrual history inadequate.
3.) Exclusion of Ectopic pregnancy: Primarily by identification of intrauterine implantation.

It is expected that a fetal ultrasound will be performed in the first trimester of pregnancy, in the second trimester and the third, but it can be performed at different times during pregnancy, many healthcare providers perform ultrasounds at eight to 12 weeks of pregnancy to determine the actual due date by viewing the fetus and its size; at 10-13 weeks to check the development of the brain and spinal cord; at 16-20 weeks to check baby’s size, growth and likelihood of birth defects; Further scans may sometimes be done at around 32 weeks or later to evaluate fetal size (to estimate the fetal weight) and assess fetal growth. or to follow up on possible abnormalities seen at an earlier scan. Placental position is further verified, to check the amount of amniotic fluid and the baby’s overall well-being and development. The most common reason for having more scans in the later part of pregnancy is fetal growth retardation. Doppler scans may also be necessary in that situation. The total number of scans will vary depending on whether a previous scan has detected certain abnormalities that require follow-up assessment.

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Cryptomenorrhoea

It means : Hidden menstruation.

In this case the woman does mesntruate but the products cannot

escape to the exterior.

Usual reason ? : Imperforate hymen.

There is cyclical pain and swelling of the abdomen.

At the vulva a tense blue membrane will be seen when the labia

are parted and the abdominal swelling is due to a gross distension

of the vagina with the menstrual fluid (hematocolpos).

The condition can take months or years to develop to such a degree and

occasionally the patients present with acute retention of urine.

Treatment ? : Incision of the hymen

Pregnancy symptoms

Pregnancy symptoms and signs differ from woman to woman and pregnancy to
pregnancy and they depend upon the time in pregnancy ; the symptoms may
develop over a few weeks or may not be present at all. It is importan to know and
understand them because each symptom may be related to something other
than pregnancy.

The first and most common sign of pregnancy is a missed menstruation period
leading a woman to test for pregnancy or to ultrsasound study.

Some women will experience spotting secondary to implantation bleeding, ( after the embryo implants itself into the uterine wall ) it can be one of the earliest pregnancy symptoms, about 6-12 days after conception the pregnant
woman may as well experience some low abdominal cramps.

Other common symptoms and sings are:

• Nausea and often vomiting

• Tender and swollen breasts

• Food Cravings for certain foods

• Increased sensitivity to smell

• Food aversions

• Excessive salivation

• Abdominal enlargement

• Frequent Urination: Extra trips to the bathroom especially at nighttime

• Deepening color of the area surrounding the nipple ( areola ).

• Darkening of skin on the forehead, bridge of the nose, or cheekbones

• A dark line going down from the umbilicus area to the pubic area

• Constipation : Caused by hormone changes, and the growing uterus pressing against the bowel

• Feeling fatigued, exhaustion, sleepy or more tired

• Lower backaches , it is common to experience a dull backache throughout an entire pregnancy

• Headaches: Because of the sudden rise of hormones

• Basal body temperature stays high

• The proof: A positive pregnancy test or Ultrasound study

Endometriosis

Often: Causes female infertility

Endometrial tissue ( tissue that lines the inside of the uterus ) grows outside the uterus or involves the uterus ( adenomyosis ), in this case the uterus is enlarged, producing abnormall menstrual bleeding .

This tissue also attaches to other organs in the abdominal cavity and responds to your menstrual cycle hormones the same way the tissue inside your uterus responds causing an inflammation that forms scar tissue.
This tissue ( frequently as cysts containing altered blood : Called endometrioma ) may also interfere with ovulation.
It swells and thickens causing severe premenstrual pain and dysmenorrhea ( Painful menstruation.) or even pain during (dyspareunia) or after sexual intercourse.

Cause of this disorder: Unknown

It is a progressive disease that tends to get worse over time
Based on the symptoms, diagnostic findings and the stage of the disease, your physician will determine the best treatment plan which may include surgery or medication or even a combination of both.

Hydatidiform Mole

It's a complication of pregnancy
The uterus appears larger than the dates would suggest

It's a disorder of the placenta degenerated in a large
number of vesicles filled with fluid

The vesicles may be passed in the vaginal discharge

It may become malignant

Tratment: Consists of emptying the uterus

Pregnancy and Exercise

Exercise: That is one of the best things that you cand do for your body and your new comming child. Women who exercise during pregnancy are more likely to have easy labor and deliveries and faster recoveries.

During pregnancy occur some physiologic changes that affect the mothers response to exercise and for some pregnant women exercise may be more dangerous than beneficial As you know: There are anatomic changes that alter balance, flexibility, and coordination, besides there are also physiologic changes taken place in the cardiovascular, respiratory, gastrointestinal and musculoskeletal system. So as the pregnant woman body changes and her baby develops , maternal response to exercise also changes, so what she would be able to do in terms of exercise changes too

Certain exercises are less likely to result in injury for pregnant moms. Those are: Walking , Swimming ,Yoga ,Dancing , Stationary Cycling Ease Prenatal Aerobics

- Exercise during pregnancy and its benefits -

Exercise releases feel-good endorphins providing an exceptional form of stress relief and better state of mind, feeling stronger, happier and more positive

• 
  Women have increased chances of a vaginal birth and less likely to experience difficult labors
• 
  Helps minimize back pain because tones strengthen back muscles.helps improve posture and flexibility
• 
  Relieves many of the minor ailments of pregnancy
• 
  May help prevent excessive weight gain providing better body shape

Don’t exercise or stop exercising if you have:

· Been bleeding or have placenta praevia
· A ruptured amniotic membrane
· Had more than one miscarriage, stillbirth or premature baby or carrying twins or a small-for-dates baby
· High blood pressure, swollen hands and feet, or headaches
· Diabetes
· An incompetent cervix
· Anemia,
· Thyroid disease
· Breech presentation in the third trimester,
· Congestive heart failure,valvular heart disease associated
· Experience pain in the abdomen or chest
· Uterine contractions
· Irregular or rapid heartbeats
· Can't feel the baby moving

The individual circumstances such as height, weight, initial fitness levels are very important as it is to consult your healthcare provider and work in conjunction with your medical advicer from antenatal class. Do not take risks.

Advices:

• 
  Never exercise to exhaustion. If you can keep up a conversation while excersizing then it is okay, but if you are getting too out of breath means that you are working too hard. Just watch that you do not overdo - meaning heart rate or training to hard. If you have concerns that you may be overdoing, the best thing to do would be to slow down.
• 
  If you're a regular exerciser, continue with your normal exercise programme.
• 
  If you're a beginner, start some form of gentle exercise. Any excercices where physical injury is a chance are not a good idea obviously.
• 
  Go with what feels right. Everything in moderation makes sense, listen to your body and do only what you feel comfortable with.
• 
  If you are sick , have fever and not feeling well or tired, or have sore breasts there is no point in exercising.
• 
  Don't get too hot when exercising. Use clothing that allow adequate ventilation to prevent hyperthermia. Your body temperature is already higher during pregnancy. Don't exercise in very warm or humid weather or environments ; avoid saunas, steam baths and hot tubs.
  Stop exercising if you get very hot .Over-heating early in pregnancy may possibly affect your baby's neural development.
• 
  Stay hydrated and keep cool. Drink water. Prevent dehydration and hypovolemia whith adequate fluid intake during and after exercise.
• 
  Avoid activities that involve potential low-oxygen states as hiking at a high altitude or scuba diving since you may be deprived of oxygen.
• 
  Work at no more than 140 beats per minute
• 
  Make sure you get sports bra; you'll need extra support for your new shape.
• 
  Correct footwear is essential now too as the effect of relaxin on your ligaments means your joints are prone to injury.
• 
  Be careful about balance, your center of gravity changes as your belly grows.
• 
  Avoid bouncing and jerky movements especially in the third trimester.
• 
  Don't take risks , You should stop all contact sports and any exercise that risks even mild abdominal trauma.and those activities that could throw you off balance. Don't do exercises in which you could lose your balance, especially in the third trimester
• 
  Avoid exercises that involve maneuvers that can strain you, including power-lifting, leg presses, pull-ups, situps. Do weights only if your doctor recommends it; lifting heavy weights will cause you to strain.
• 
  In your second trimester, do not lie on your back, this position can impair blood flow to the placenta and so on to the baby.
  
  I hope this information will help you continue your exercise routine, healthy pregnancy and happy outcome.

COMMON PROBLEMS

INFERTILITY: Failure to conceive.
For conception the essential factors are:

1. Normal intercourse
2. Normal Semen
3. Normal Ovulation
4. Patent fallopian tubes

Failure to conceive is usually due to some fault in one of these factors.

Investigation of the couple, husband and wife should be instigated if the couple have attemptend conception for 12 month or more.

Womens health

-ANTENATAL CARE-

Purpose: Ensure maximun fitness of the mother,
thus providing the best environment for the developing child.
Further, to watch and treat early symptoms and signs of
disorder and so prevent maternal and foetal complications.

Instruction is given to the mother to prepare her for the changes in late pregnancy and for the labour.

Vaginal Discharge

It is a very common gynaecological sympton.

There is normally a small amount of discharge due to mucus secretion from the
cervical glands and the vaginal epithelium.

But.....Some disorders cause vaginal discharge:

• Cervical erosions and chronic cervicitis
• Infections of the Vagina
• Trichomonal Vaginitis
• Monilia Vaginitis
• Gonococcal Vaginitis
• Foreing Bodies

Consult your Doctor about it.

Dyspareunia

In medical terms this word means: Difficult or painful intercourse.
The cause may be physical or may lie in the patient's mental attitude towards intercourse.

Proverb

• An ounce of prevention is worth a pound of cure

The Menopause

Menopause means the cessation of regular monthly periods
The average age at which women reach the menopause is approximately 50 years
The main symptoms and sings can be attributed to a fall in the level of circulating oestrogen

THE PREMATURE BABY

A premature baby is one weighing less than 2.500 gms, irrespective of
the period of gestation

They are in danger because none of the vital organs
are fully developed

One of the hazards of prematurity is the great incidence of
respiratory difficulty .

Antenatal care is very important to ensure a safe labour

Happy New Year - 2006 -

To you and your family.
My Whishes are:

• Maximun health and well being
• Mental and Espiritual Strenght
• Fulfilment of your Mission in Life (-Dharma-)
• Projects come true
• Find true Love and Friendship
• Find the light of Universal Love (-Metta-)
• Shelter and Provision
• Sharp discernment and Intution
• Erase Unhappines, Sadness and Sufferings
• Have fun an and lot of reazons to smile