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18.04.2016


Pre-eclampsia is common in pregnancy and certain groups of patients are more at risk that others. The link below gives information on the symptoms, causes, diagnosis, treatment and complications of pre-eclampsia. Pre-eclampsia is a condition that affects some pregnant women during the second half of pregnancy (from around week 20) or immediately after delivery of their baby. Women with pre-eclampsia have high blood pressure, fluid retention (oedema) and protein in the urine (proteinuria). Some factors have been identified that could increase your chance of developing pre-eclampsia. You have an existing medical problem, for example, diabetes, kidney disease, migraines or high blood pressure. You are expecting multiple babies, such as twins or triplets (this places more strain on the placenta). My view (and the view of most doctors I know) is that there is no place for a home delivery in modern society where maternity units are available for all women. One of the most serious complications of pregnancy is a poorly understood condition known as eclampsia.
If you have preeclampsia your health care provider should carefully monitor you for signs of worsening and potential eclampsia. In the previous post, a link to brief information on the BBC site, I questioned the usefulness of acupuncture and ginger in helping morning sickness, so I have tried to find whether there is any evidence that these work. Cochrane reviews are an attempt to put medicine on an evidence base and there is was a paper in 2010 discussing ginger, acupuncture and other alternative therapies that are often recommended for pregnancy sickness. Women will continue to seek treatments for the often distressing symptoms of nausea and vomiting in pregnancy.
The difficulties in interpreting the results of the studies included in this review highlight the need for specific and clearly justified outcomes in research on interventions for nausea and vomiting in pregnancy.
It is interesting that this article seems at variance with NICE guidelines on the matter of acupressure and ginger.
Women should be informed that most cases of nausea and vomiting in pregnancy will resolve spontaneously within 16 to 20 weeks and that nausea and vomiting are not usually associated with a poor pregnancy outcome. Information about all forms of self-help and non-pharmacological treatments should be made available for pregnant women who have nausea and vomiting. When you played with your dolls as a child, and later when you learned about pregnancy and the origin of new life, you never thought for a moment it would be like this! Pregnancy hormones, circulating in the body, affect all your organs and prepare your body to sustain new life. For generations women have eaten what they felt like eating, and what was available to them throughout pregnancy and, as far as we know, mother and baby only very occasionally came to any harm. Find out about the long and complex period of growth, which turns a primitive ball of cells into a fully developed human. Ovaries and the Ovarian cycle: Women are born with their entire stocks of eggs, or ova, in place. Cell division: Within just a few hours of fertilisation the zygote will begin dividing itself and by the time it reaches the uterus, four days later, it has become a solid mass of hundreds of cells, called a morula. Implantation: Around six days after ovulation, the blastocyst will release a hormone to help it bury itself into the lining of the uterus.
Gender: The X and Y chromosomes, just two of the 46 that make up a baby, determine its gender.
This is the beginning of a long and complex period of growth, turning a primitive ball of cells into a fully developed human.
Appearance: The being that was a cluster of cells has now become prawn?shaped, and is about 4 millimetres long, and weighs less than a gram. The cells that make up the embryo are moving to their correct places and rapidly multiplying to form a more recognisable baby?shaped being. The baby’s brain grows larger in this month, and the cells and fibres become fully functioning. Strong movements are now possible from fully coordinated limbs, but these movements are becoming more constricted, as there is less space in the womb. This condition is one of the reasons why a close watch is kept on blood pressure and routine checks are made for ankle swelling and protein in the urine. Pre-eclampsia is more likely to happen during the first pregnancy than during any subsequent pregnancies.


There is an approximately 20% chance that you will develop the condition again in later pregnancies. Delivery is the treatment of choice for severe preeclampsia in an attempt to prevent eclampsia.
You can calculate your expected date of delivery, and what happens to your baby and your own body week by week throughout pregnancy from conception to delivery. This is a comprehensive article and is probably the most evidence based that there is around at the present.
They may take over-the-counter and complementary therapies, based on anecdotal or peer advice.
The range of instruments used to measure these symptoms (including those not developed for this patient group) also suggest the need for a consistent and appropriate approach to measurement, which may be addressed by the PUQE scale described above. Furthermore, I am not at all sure what the last paragraph of the quotation of the guidelines below is supposed to mean. One theory is that they are responsible for sickness, as a means of protecting the foetus from harmful substances. You can eat hard cheeses such as cheddar and parmesan, and many types of cheeses made from pasteurised milk such as cottage cheese, mozzarella, feta, cream cheese, paneer, ricotta, halloumi, and processed cheeses such as cheese spreads. There are approximately 2 million ova present at birth, and they are either released or degenerate over the woman’s fertile life.
It takes place in the outer part of the Fallopian tube, generally within one day of ovulation. The outer cells will begin joining with the small blood vessels in the uterus to form the placenta (afterbirth).
The eggs that are released every month carry only X chromosomes, while sperm carry both X and Y chromosomes.
Developments are beginning to take place, hair and skin is beginning to grow, and the feet and legs are beginning to grow, with the arms and hands growing at a faster rate. If present, these can be the warning signs of pre-eclampsia and the mother is then watched more carefully to ensure the condition does not progress to the much more dangerous condition – eclampsia.
Fortunately, with proper antenatal care clampsia is rare, however the forerunner, pre-eclampsia is very common and when detected, treatment can usually prevent progression to the full blown and much more dangerous eclampsia.
Your doctor may prescribe medication to lower high blood pressure, but you may have to deliver if your blood pressure stays high, even with medication. There is also a need to systematically measure quality of life and adverse maternal and fetal and neonatal outcomes, to ensure that studies are of most usefulness to health professionals and women seeking safe and effective treatments. It seems to imply that patients should be given knowledge of all alternative therapies for morning sickness that are not evidence based? If you have eaten any of these in error don’t worry, the chances are you and the baby will be OK, but follow a guide like the one on the link below from now on to ensure any risk is negligible. These are made with mould and they can contain listeria, a type of bacteria that can harm your unborn baby. The ovarian cycle is a woman’s reproductive cycle, lasting about 28 days, or one lunar month. Only one sperm, out of the millions that are expelled, will actually penetrate the membrane covering the ovum. Meanwhile, the inner cells begin to develop to form the embryo and the adjoining membranes.
These eggs, if fertilised by different sperm, have their own placenta and develop side by side within the uterus. An egg fertilised by an X chromosome carrying sperm will become a girl (XX) baby, while an egg fertilised by a Y chromosome will become a baby boy (XY).
The details of the body are developing; the finger and toe nails are in place and the genitals are beginning to grow, meaning that the gender of the baby is determinable from an ultrasound scan. The brain is capable of passing and receiving messages, but does not yet control the movements made by the now fully formed limbs. The baby also has a primitive immune system in place that can defend against some infections. Although most mothers and babies are delivered uneventfully, when things go wrong in pregnancy they often do so quickly, dramatically and at times unexpectedly. Wilkinson 2000 found a lack of consensus about safety of herbal treatments (including ginger) for nausea and vomiting in pregnancy in 300 non-medical sources identified in a literature review.
If so, why and how will this be done to ensure patients are not being led up the garden path by those health care professionals looking after them who themselves have a non-evidence based bee fluttering around in their bonnets about alternative medicine in pregnancy?


Although infection with listeria (listeriosis) is rare, it is important to take special precautions in pregnancy because even a mild form of the illness in a pregnant woman can lead to miscarriage, stillbirth or severe illness in a newborn baby. At about 14 days before the end of the cycle, an ovum (or egg) is released from one of the ovaries. Once this occurs the surface of the zygote (the fertilised egg) changes, making it impossible to be penetrated by any other sperm. Reflexes are also beginning to develop; the sucking, breathing and swallowing mechanisms are being rehearsed for life outside the womb.
The lungs are developing in more and more detail, and breathing is practiced so the reflex is well rehearsed for the time that air is passed through them.
The swallowing and sucking reflexes already in place are further rehearsed in preparation for life outside the womb, as is the breathing.
This highlights the necessity of health professionals providing clear guidance to women, based on systematically reviewed evidence. Dietary and behavioural strategies (eating low fat, small, frequent meals) were often recommended to all participants (in both treatment and placebo groups) within the studies in this review. Women have two egg?releasing organs, called ovaries, which release eggs alternately every month.
The second way that a multiple birth can occur is when a single, egg, fertilised by one sperm, divides and develops into two embryos. The internal organs are beginning to form, and the heart, still tiny, beats very fast, at up to twice the rate of the mother’s.
The umbilical cord is now fully mature, and the flow of nutrients and oxygenated blood from mother to baby, and the flow of waste products from baby to mother are now fully functioning. The eyes are beginning to take on more detail, the eyebrows and lashes are growing, and the insides of the eyes are sensitive to light. On the basis of this review, high-quality consistent evidence is lacking to support the accuracy or appropriateness of that advice.
This egg travels down the fallopian tubes into the uterus and begins to grow, releasing progesterone into its environment.
Once the embryo is fully embedded, another set or hormones are released to trigger a number of changes.
The baby is also able to make quite strong movements, although the mother will not feel these until a little later in the pregnancy.
It is called meconium, and is a darkly coloured substance that is passed by the baby either during or after birth. Current guidelines and other reviews often offer incomplete evidence, without comment on the quality of evidence. The effectiveness of dietary and other behavioural strategies also needs to be evaluated in good quality trials. These changes occur to make the woman’s body suitable for carrying the embryo safely.
Triplets or larger numbers of multiple embryos are formed in one of these two ways, and will either be identical or not, depending on the form of conception.
The cells that make up the embryo begin to prepare themselves to form specific parts of the body, both internal and external. The placenta is still fully active at this time, and the hormones being produced are still causing reactions in mother and baby. Health professionals’ decisions about treatments should take account of the lack of clear and consistent evidence found in this review and acknowledge that it is not possible at present to identify, with confidence, safe and effective interventions for nausea and vomiting in early pregnancy. If the egg is not fertilised, it is shed with the lining of the uterus as the period begins.
One hormone causes not only the mother’s breasts to produce milk, but also causes a swelling of the breasts of the baby, whether male or female. Once this hormone stops affecting a female baby, she may bleed lightly, in a similar way to a period, a few days after birth.



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