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Factors behind
high-risk pregnancy
Books
EYESIGHT
Chocolate 'lowers cholesterol’
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Factors behind high-risk pregnancy Physical characteristics:
The age, weight and height of women can be related to the risks involved during pregnancy. Girls aged 15 and younger are at an increased risk of pre-eclampsia (a type of high blood pressure that develops during pregnancy). Young women are also at an increased risk of having underweight (small-for-gestational age) or undernourished babies. Women aged 35 and older face a greater risk of developing problems such as high blood pressure, diabetes and complications during labour. Women who weigh less than 100 pounds before becoming pregnant are more likely to have small, underweight babies. Obese women are more likely to have very large babies, which may be difficult to deliver. Also, obese women are develop gestational diabetes and pre-eclampsia. Women shorter than 5 feet are more likely to have a small pelvis, which may make the movement of the foetus through the birth canal difficult during labour. Also, short women have a greater chance of having pre-term labour and a baby who has not grown as much as expected. Structural abnormalities in the reproductive organs increase the risk of a miscarriage. Examples are a double uterus or a weak cervix that tends to open as the foetus grows. Social characteristics: Being unmarried or in a lower socio-economic group increases the risk of problems during pregnancy. The reason these characteristics increase the risk is unclear, but it is probably related to other characteristics that are more common among these women. For example, these women are more likely to smoke and less likely to get a healthy diet and appropriate medical care. Problems in a previous pregnancy:
Such problems include having had a premature baby, an underweight baby, a baby that weighed more than 10 pounds, a baby with birth defects, a previous miscarriage, a late (post-term) delivery (after 42 weeks of pregnancy), Rh incompatibility that required blood transfusion to the foetus, or a delivery that required a cesarean section. If women have had a baby who died shortly after birth, they are also more likely to have problems in subsequent pregnancies. The women who had a baby with a genetic disorder or birth defect are more likely to have another baby with a similar problem. Having had six or more pregnancies increases the risk of very rapid labour and excessive bleeding after delivery. Disorders present before pregnancy
Heart disease: The women who have had heart problems before pregnancy have to be extremely careful. Pregnancy requires the heart to work harder. Consequently, pregnancy may worsen heart disease or cause the heart problem to produce symptoms for the first time. About 1 per cent of the women who had severe heart disease before becoming pregnant die as a result of pregnancy, usually because of heart failure. Heart disease in pregnant women may affect the foetus. High blood pressure: Those who have high blood pressure before they become pregnant are more likely to have potentially serious problems during pregnancy. For women whose blood pressure is higher than 150/100 mm Hg, treatment with anti-hypertensive drugs is recommended. Treatment can reduce the risk of stroke and other complications due to very high blood pressure. The writer, a senior gynaecologist, has a book to her credit.
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Books Patricia Pearson, author of A Brief History of Anxiety... Yours and Mine, worries a lot. "I fret about everything and nothing. After 9/11, a friend died and that combination had the effect of turning me into a hypochondriac. I would lie awake at night listening to a gurgling sound in my abdomen convinced I had cancer." On another occasion, she ordered 12 containers of freeze-dried vegetables after an American report warned of a possible flu epidemic and advised stockpiling food. As well as inflicting a bizarre set of phobias, anxiety has brought Pearson's life to a complete halt three times: dropping out of university, resigning from a job, and winding up addicted to anti-depressants. Now 44 and a successful journalist, novelist and married mother of two, she decided it was time to write about her lifelong struggle. "I was diagnosed with generalised anxiety disorder when I was 23 and thought it was a simple chemical imbalance. But I found out this didn't make sense. I wanted to look at what my culture was doing to me." In 2002, a World Mental Health Survey report identified anxiety as the world's most prevalent health problem, with stark differences between cultures. Anxiety is most prevalent in America, affecting 28.8 per cent of the population compared with 6.6 per cent in Mexico. In Britain, one in six people suffer from depression or chronic anxiety, affecting one in three families. Pearson realised she had a problem with anxiety when her first serious relationship came to an end in her twenties, prompting a nervous breakdown. "Up to that point, I didn't understand myself to be anxious. I indulged in a lot of what I call 'hypothetical analytical planning'. So thoughts would whirr around my brain about what I would do if, say, a tornado hit my home, the idea being that if you can foresee events you can control them. Yet when my boyfriend ended our relationship I was paralysed and I just couldn't go on." The next time she wound up in a psychiatrist's office was when she became a crime reporter. After covering the trial of a serial rapist and murderer, she could no longer cope with the stress of her job. Then, years later, after 9/11 and the death of a close friend, she was put back on anti-depressants. Looking back, she now realises there were very clear external stresses at work during each bout of severe anxiety. "There were valid causes but at the time I didn't realise, I thought it was all about me, flapping around in the bushes like a lame quail." In fact, she now sees many factors in the developed world that contribute to an individual's anxiety: ambition and a loss of control, the fear of being unable to cope, and a sense that achievement is no longer linked with merit. "When I was starting out as a writer, my anxiety was enhanced by the fact that I didn't appear to have any control over getting noticed. I had to be really sociopathic and pull all sorts of antics to get attention. You can also see this in corporate culture where being nice, decent and honourable is not going to get you a promotion, and if you are going to climb the ladder in any effective way you have to pull a lot of traps. The result is a pervasive level of unease." A Brief History of Anxiety...Yours and Mine is published by Bloomsbury USA and available on www.amazon.com — The Independent |
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Traditional sutures are the gold standard in terms of strength and effectiveness. Surgeons have excellent control over suture placement. The disadvantages are that suture placement itself inflicts trauma on tissues, especially when multiple passes are performed and they can act as a nidus for infection and incite inflammation and vascularisation, which can lead to scarring and result in uneven healing. Post-operatively, sutures can become loose and get broken, requiring additional attention for prompt removal. Effective suturing requires technical skill and prolonged operative time. It was beyond one’s imagination that human tissue could be used to seal surgical wounds but the pioneering work of Gerard Marx in 1994 with the introduction of the first fibrin glue derived from human fibrinogen, thrombin with liposome component, turned a surgeon’s dream into an incredible reality. Thereafter, fibrin sealant has found its use in various medical specialities as a hemostatic agent to arrest bleeding and seal tissues, and as an adjunct to wound healing. The present-day fibrin glue (Reliseal, Tisseel) contains human fibrinogen and human thrombin which occur naturally in blood. Both these components, when combined immediately before application, form fibrin sealant, the formation of which resembles the natural blood clotting process. Fibrin glue has been used in surgical procedures like cardiopulmonary bypass, repair of spleen and as an adjunct in the closure of anastomoses. In eye care, fibrin glue is often used for conjunctival wound closure in various ocular surgeries. It has been used for corneal transplants, pterygium surgery, to repair corneal perforations, to fix traumatic lasik flap dislocations, wound closure in retinal surgery, lid surgery, glaucoma surgery and amniotic membrane transplantation. Fibrin glue-assisted sutureless intraocular lens implantation is appropriate for eyes with deficient or absent posterior capsule, and this can be performed easily with the available IOL designs and instruments and with less surgical time. Generally, fibrin glue is most useful when you need to work with the conjunctiva. The advantages are that it is time-saving, it stops bleeding, is easy to undo and it doesn’t last forever. You can plug holes instead of stitching the edges together. Unlike sutures it does not cause irritation, neither does it need removal. Since it is manufactured from body fluids, inflammatory reaction is less likely. Nutrients can pass through the glue, feeding the donor tissue. It is patient-friendly, causing no discomfort, and does not distort vision. No toxicity or allergies have been reported and generally it is well-tolerated. The only limitation to its extensive use is that it is expensive and not as cost- effective as sutures. The writer is Chairman and Medical Director, Centre for Sight, New Delhi. Email: msachdev@bol.net.in
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Chocolate 'lowers cholesterol’
New York: Chocolate is the most widely craved food in the world. But who says that it's fattening? A new study has revealed that it lowers cholesterol level. Researchers in the United States have found that eating two chocolate bars daily not only cuts down cholesterol levels but also controls high blood pressure, the Journal of Nutrition reported in its latest edition. "Eating two dark chocolate bars a day not only lowers cholesterol, it has the unexpected effect of lowering systolic blood pressure," according to lead researcher Prof John Erdman of the University of Illinois. For the study, they recruited 49 people with slightly elevated cholesterol and normal blood pressure. Subsequently, the participants were divided into two matched groups who were given CocoaVia two types of chocolate bars — one with plant sterols and one without. The participants ate one CocoaVia formulation twice daily for four weeks, then switched to the other bar for an additional four weeks. Cholesterol levels, blood pressure, body weight, and other cardiovascular measures were tracked throughout the eight-week study. "We saw a marked differential effect on blood cholesterol, with the sterol-containing products doing better than those without sterols," co-researcher Ellen Evans was quoted by the journal as saying. The researchers attributed the drop in cholesterol levels to the plant sterols that are added to chocolate bars and the drop in blood pressure due to the substantial presence of flavanols.
— PTI
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Health Notes Melbourne: In their eagerness to promote healthy eating among their students, teachers are inadvertently driving teenage girls to develop eating disorders, a new research has warned. The study, by researchers at Loughborough University, warns that teachers are fuelling disorders such as anorexia and bulimia but making kids acutely aware of how much they weigh. John Evans, a professor of sociology of education and physical education at the university, told Britain’s the Daily Telegraph that a lot of girls “strongly believed that their illness was nurtured, exacerbated or sometimes even caused by the well-meaning action in schools”.
— ANI
Pill to prevent blood clots launched in UK
After the introduction of warfarin 50 years back, pradaxa is the first new oral pill anti-coagulant (blood thinner) in the UK. And it has an edge over its older counterpart as it does not require any check like warfarin, which had to be monitored for ensuring that it does not thin the blood too much.
— ANI
Vitamin D linked to brain function
Washington: In a definitive critical review, scientists at Children’s Hospital & Research Center, Oakland, have found convincing biological and behavioural evidence indicating a vital link between vitamin D and brain development and function. Joyce C. McCann, assistant staff scientist and Bruce N. Ames, senior scientist at Children’s Hospital, Oakland Research Institute (CHORI), have also said that there is a need for vitamin D supplementation in groups chronically deficient in this vitamin. “This critical analysis of vitamin D function and the brain is a model of careful thinking about nutrition and behaviour. One wishes that all studies of nutritional supplements or requirements were this thoughtful. Drs. McCann and Ames deftly show that while vitamin D has an important role in the development and function of the brain, its exact effects on behaviour remain unclear. Pointing to the need for further study, the authors argue for vitamin D supplementation in groups at risk”, said Gerald Weissmann, Editor-in-Chief of the FASEB Journal. — ANI
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Every pregnancy has some risks, but there are more dangers to the health of the mother and the foetus in the case of a high-risk pregnancy. The causes can be the conditions you already have or can develop. These also include being pregnant with more than one foetus, previous problem-pregnancies, and being over 35. Once you are pregnant, you may need a health care team to monitor your condition. 
Washington: