Dear Doctor,

I am going to be a first-time mother, and I am due for my first antenatal visit. I would like to know what common complications I should know about and strive to avoid. I have heard of high blood pressure and preeclampsia and I worry. How can I ensure that I stay healthy throughout my pregnancy and birth?

Molly

Dear Molly,

Confirmation of pregnancy is a joyous moment in a woman’s life. As such, pregnancy and subsequent childbirth are normal biological processes. But one has to be careful during the entire period of pregnancy, because any potential problem arising during pregnancy can jeopardise the health of mother and or foetus.

Abortion is a potential risk during first trimester, where due to multiple reasons, pregnancy is terminated. It is manifested as severe lower abdominal pain and bleeding. 

Any chronic problem of lungs or heart can create problems for the pregnant woman. Uncontrolled high blood pressure, diabetes, depression, peripartum cardiomyopathy and resultant heart failure, psychosis, and et cetera, are some problems which can cause complications, like intrauterine death, stillbirth, under or over weight babies with congenital abnormalities. Some pre-existing medical conditions like epilepsy, bronchial asthma, may be aggravated during pregnancy. Preeclampsia is a condition where a woman develops severe hypertension and proteins in the urine.  Uncontrolled, it can led to eclampsia, where the affected woman also starts having seizures. It is a life threatening condition, needing urgent delivery to save the life of the affected woman.

Urinary tract infection, sexually transmitted diseases, also harm the baby in many ways. Infections like toxoplasmosis, HIV, viral hepatitis B or C, can pass from mother to the unborn baby and cause health issues in the baby. Medicines used to control these chronic medical problems or cure infections can also cause congenital abnormalities in the unborn foetus.

Considering the hazards caused by these health problems during pregnancy, it is vital for any pregnant lady to be vigilant with the start of pregnancy to avoid them. It is important to be careful to avoid any trauma to the abdomen, as it carries risk of miscarriage.

High heeled shoes should be avoided, as they put the pelvis and uterus under stress and can cause an abortion. A balanced diet with plenty of fresh vegetables, fruits, nuts, fish, milk and milk products, to mention a few, keeps the body healthy. Adequate quantity of proteins, vitamin C and E, helps to improve immunity of the body, warding off infections. In presence of nausea and or vomiting, it is advisable to take frequent small meals. White sugar, excess salt, alcohol, tobacco are best avoided.

Regular physical exercise helps in keeping the body and pelvic bones healthy, weight normal, all which is useful during delivery. But it should be within limits of stamina and not tiring. Lifting or pushing weights in any form should be avoided.  It is also advisable to take adequate rest, including short day time naps.

Regular antenatal check-up helps in identifying and treating any health problem early. In case of any pre-existing health issue, treating physician should be informed about the pregnancy. Thus, any medicine likely to be harmful can be stopped or changed to a safe one.

Dr. Rachna   Pande is a  specialist in internal medicine.