When a couple is unable to conceive within one year of marriage it is called infertility.
Infertility can be due to problems in female reproduction mechanism and or male reproductive mechanism. Female causes can be due to :
These can be diagnosed by various hormonal tests like TSH, Serum prolactin, estradiol. Uterine causes can be tested by USG, laparoscopy, hysteroscopy. Male causes of infertility are :
1) Sperm production, maturation
2) Hormonal deficiency 3) Problem in sperm conduction
4) Ejaculatory dysfunction, erectile dysfunction
Basic investigations starts with semen analysis, hormonal assay, USG of the scrotum.
Initially couples should visit the doctor rather than male and female separately. It is of utmost importance to look into the matter as a whole. CAESARIAN DELIVERY : is a surgical procedure in which baby is delivered through an incision in mothers abdomen and uterus.
It is done in response to an unforeseen complications like in :
When cervix stops dilating or the baby stops moving down the birth canal or when uterine contractions are not happening even after stimulation.
When water breaks even before the labor starts when cervix is not yet open.
When palcenta seperates from uterine wall before delivery of the baby.
In some infections like genital herpes to avoid baby getting infected.
When fetal distress is present where (extreme variation in heart beat). Sometimes caesarian sections are planned like :
Previous > C-section when there is significant risk that uterus can rapture during vaginal delivery.
Previous surgeries like myomectoms (removal of fibroids).
Short stature (less than 145cms).
If you are carrying more than one baby (some twins can be delivered vaginally like when both the babies present as vertex).
When expected weight of the baby is more like in uncontrolled diabetics.
When baby is in a breech (bottom first) or transverse (horizontal ) position.
When placenta is lying over the cervix or lower very near to cervix.
In HIV positive mothers where viral load is high. THREATENED PRE-TERM :
Onset of labor between 24-37 weeks of pregnancy is called threatened pre-term. Not always possible to explain the causes. Some of the causes are :
1) Previous pre-term birth.
2) Multiple pregnancy-twins, triplets.
3) Infections-urinary tract
4) Bleeding from uterus during pregnancy
5) Abnormalities of uterus
6) Excessive ammoniate fluid
8) Placental problems
9) Genetic problems HOW TO RECOGNIZE :
contractions which are regular and painful.
Showwhen a plug of mucus in the cervix comes away as vaginal discharge.
rupture of membranes- water leaking slowly or sudden gush of fluid from vagina.
If you are considered to be at risk of pre-term birth admission is needed for continuous observation and management. You will be offered 2 doses of steroids injection to improve lung maturity of pre-mature babies which can reduce breathing difficulties at birth.
Medications to help flow or stop labor
If your condition stabilization you will be allowed to go hence with further instructions.
If the labor cannot be stopped then vaginal or cesarean - section will be decided upon the condition of the baby. Baby may need NICU (neonatal intensive care) care. DANGER SIGNS OF PREGNANCY :
Many woman go through pregnancy with some uncomfortable symptoms. But no serious problem like nausea, heart burn, back ache and tiredness.
Some need special care and immediate care if occurring before 37 weeks of pregnancy.
Contraction that are > 4 times an hour.
Leaking of fluid from vagina
Pain, pressure or cramping in your belly
Fever, severe headache
Vision problem, severe vomiting
Less baby movements
Lot of swelling of feet, ankles, face, heads.
Pain during urination.
Vaginal discharge which is itchy, of bad odor.