Friday, 16 June 2023

Early Pregnancy Symptoms, Cravings, and When to Seek Medical Attention

Dear Moms-to-be,

Congratulations on your journey into motherhood! Pregnancy is a remarkable time filled with new experiences and emotions. As your body adapts to nurture new life, it's essential to understand the early pregnancy symptoms, cravings, and when to seek medical attention. In this comprehensive guide, we will explore the common symptoms you may encounter, how cravings may change, and when it's necessary to consult your healthcare provider.


Early Pregnancy Symptoms:


During early pregnancy, your body undergoes numerous hormonal changes, leading to various symptoms. Remember, every woman is unique, and experiences may vary. Here are some common early pregnancy symptoms to expect:


Missed Period: This is usually the first sign of pregnancy. If you have missed your period and have been sexually active, consider taking a home pregnancy test to confirm.


Fatigue: Feeling more tired than usual is a typical symptom due to increased progesterone levels. Listen to your body and rest when needed.


Nausea and Morning Sickness: Many women experience nausea, often accompanied by vomiting, during the first trimester. It can occur at any time of the day and is caused by hormonal changes. Eating small, frequent meals and staying hydrated can help alleviate symptoms.


Breast Changes: Your breasts may become tender, swollen, or more sensitive. These changes occur due to increased blood flow and hormonal fluctuations.


Frequent Urination: As your pregnancy progresses, the growing uterus puts pressure on your bladder, leading to increased urination.


Food Aversions: You may develop an aversion to certain foods or experience a heightened sense of smell. It's normal for your preferences to change during pregnancy.


Mood Swings: Hormonal fluctuations can cause mood swings, making you feel emotional and more sensitive than usual. Reach out for support and communicate your feelings with your loved ones.


Cravings and Aversions:


Pregnancy cravings are widely discussed, and they can be an exciting and amusing part of the journey. It's important to understand that cravings and aversions can vary from person to person. Some common cravings include:


Unusual Food Combinations: Craving foods that you wouldn't typically eat together, such as pickles and ice cream, is a well-known example. Embrace your unique cravings and enjoy them in moderation.


Sweet or Salty Foods: Many women develop a preference for sweet or salty treats during pregnancy. Remember to balance your diet and opt for healthier choices whenever possible.


Specific Food Types: You might crave certain fruits, dairy products, or spicy foods. Incorporate these foods into your balanced diet to satisfy your cravings.


It's important to note that not all cravings are healthy or safe. Avoid consuming raw or undercooked meats, unpasteurized dairy products, and excessive amounts of caffeine. If you experience an intense craving for non-food items (pica cravings), such as clay or dirt, it's essential to seek medical advice promptly.


When to Worry:


While most pregnancy symptoms are normal and expected, there are instances when they could indicate a potential problem. If you experience any of the following symptoms, it's crucial to consult your healthcare provider:


  1. Vaginal Bleeding: Light spotting can be normal, but heavy bleeding or persistent spotting requires immediate medical attention.


  1. Severe Abdominal Pain: Intense or persistent abdominal pain, especially if accompanied by fever or shoulder pain, could indicate an ectopic pregnancy or other complications.


  1. Severe Nausea and Vomiting: If you are unable to keep any food or liquids down, or if you experience rapid weight loss due to severe vomiting, consult your doctor.



  1. High Fever: A fever during pregnancy, especially if it is accompanied by chills, body aches, or other flu-like symptoms, should be taken seriously. Contact your healthcare provider promptly as it could indicate an underlying infection.


  1. Severe Headaches or Vision Changes: Intense, persistent headaches or changes in vision such as blurred vision, spots, or light sensitivity should not be ignored. These symptoms could be signs of conditions like preeclampsia, which require medical attention.


  1. Decreased Fetal Movement: If you notice a significant decrease in your baby's movements or if you can't feel any movement after the 24th week, contact your healthcare provider immediately. They may want to assess the baby's well-being to ensure everything is fine.


  1. Severe Swelling: While mild swelling is common in pregnancy, sudden or severe swelling in your hands, face, or legs, accompanied by rapid weight gain, could indicate preeclampsia. Notify your healthcare provider promptly.


  1. Persistent or Severe Back or Pelvic Pain: Pregnancy can cause discomfort, but persistent or severe back or pelvic pain could indicate a problem such as a urinary tract infection, preterm labor, or other complications. Seek medical advice to determine the cause.


Remember, it's always better to err on the side of caution and consult your healthcare provider if you have any concerns or questions about your pregnancy symptoms. They are there to guide and support you throughout this journey, ensuring the well-being of both you and your baby.


In conclusion, pregnancy symptoms and cravings are part of the incredible journey you are embarking upon. Understanding what is normal, enjoying your unique cravings in moderation, and recognizing when to seek medical attention are crucial for a healthy and happy pregnancy. Surround yourself with a supportive network of friends, family, and healthcare professionals who can provide the necessary guidance and reassurance throughout this special time.


Wishing you a smooth and joyful pregnancy journey!


With warm regards,

Dr Kester Efugh










Tuesday, 13 December 2022

BLEEDING PER VAGINA IN PREGNANCY(ANTEPARTUM HAEMORRHAGE); THE ROLE OF ULTRASOUND

  INTRODUCTION

Bleeding or spotting from the vagina during pregnancy can be very distressing to the woman and her family, and for good reason. It could be life-threatening.

There are many causes of bleeding from the vagina in the first trimester, ranging from implantation bleeding, threatened abortion, and inevitable abortion to incomplete abortion. It could also be due to a pregnancy occurring outside the womb (an ectopic pregnancy).

In the second and third trimesters of pregnancy, common causes of bleeding per vagina include; an abnormally  located placenta that is close to or covering the cervix (placenta praevia) and premature separation of the placenta from the wall of the uterus( abruptio placenta). 

Other causes may include;coexisting fibroids, cervical erosion, co-existing coagulopathy etc       


THE   ROLE OF ULTRASOUND

Ultrasound is a medical imaging modality that uses high frequency sound to non-invasively  visualise and examine organs within the body. It is available, relatively cheap and does not involve ionizing radiation.

However, it is heavily operator-dependent.

The role of ultrasound in bleeding per vagina in pregnancy includes answering the following questions?;

  • Diagnosis of pregnancy: Is the woman actually pregnant or not?

  •  

  • 4weeks GA 

  •    

  • 5eeeks GA


  •  If yes, what is the gestational age? Is it viable?

  • 8weeks GA   

  •  

  • 11weeks GA


  • Location of the pregnancy: Is the pregnancy within the uterus or not? If it's an ectopic pregnancy, where is it?

 Ectopic pregnancy

Ectopic pregnancy



   

Heterotopic pregnancy



  • Is There Harmoperitoneum? Is The Fetus Still Viable?

  • Haemoperitoneum


  • Is there an abortion? In threatened abortion, there maybe be subchorionic bleed, if there is, how much of it? Is the internal cervical os open?, this will make it an inevitable abortion.


  • Are there co-existing fibroids?If yes, where are they located?

Uterine fibroid coexisting with early cyesis.


     

Non-pedunculated subserous fibroid.



  • Localise the placenta.Is there placenta praevia?If yes, what is the grade?

 

Major Placenta praevia


      

Major placenta praevia(Type 4)


Vasa praevia;Vasa praevia is a rare but potentially catastrophic cause of antepartum haemorrhage.



  • Is there abruptio placenta?


Abruptio placenta



  • How is the baby doing? Is the fetal heart beating? What is the heart rate?


Answering the questions above and more is the role of ultrasound in the management of antepartum haemorrhage. It provides guidance and direction as it aids the judgement of the clinician or obstetrician.


Ultrasound in the hand of a skilled operator is an invaluable tool in the management of antepartum haemorrhage.


Dr Kester Efugh

MBBS,DFM