Medchrome Women's Health

TLC and Discover Health both have aired the now extremely popular show “I Didn’t Know I was Pregnant.” The show, which features two or more women who endure the entire term of their pregnancy without knowing they were expecting at all. The popularity of this particular show is perhaps yet another extension of well-received reality, health-based shows like Obsessed, which features patients having strange, clinically diagnosed obsessions.

The entertainment of these shows aside, how rare is it to not know you may be expecting?

According to Dr. Kristin Bendrikson, an assistant professor of obstetrics and gynecology at the University of Southern California, being unaware of a pregnancy is extremely rare, but it isn’t particularly surprising in women who are either already overweight when they conceive, or if they happen to have very irregular or erratic periods.

There are two types of women who may be plagued by irregular periods. On the one hand, a young woman can have what is called polycystic ovarian syndrome. PCOS is one of the most common endocrine disorders affecting women–approximately 5%-10% of women aged 12-45 years old have the disorder. On the other hand, women who are experiencing a phase of perimenopausal transition are also subject to unnoticed pregnancies. Perimenopause occurs a few years before and after the final period, in which periods are light and erratic. In both instances, women may dismiss a missed period, or they may have light spotting throughout the pregnancy and mistaken that for an actual period.

A highly critical Time Magazine article about the TLC/Discovery Health Show demonstrates the more adverse effects the show may have on the popular imagination. The article notes:

 ”The cult of pregnancy today requires a lot of self-denial. Women are advised to avoid alcohol and cigarettes as well as deli meat, sushi, coffee and a million other pleasures. But the women of I Didn’t Know I Was Pregnant didn’t deny themselves anything during those nine months, had few if any symptoms and still wound up with perfect-looking babies!”

While producers of the show insist that this was not their intention, it is very important for women who are sexually active–whether or not they are on birth control–to be constantly aware of the possibility, however slim, of pregnancy. While the show always ends happily, an unexpected pregnancy in real life isn’t always so convenient. The most important thing is to be always aware of even the slightest changes in your body.

By-line:

This guest post is contributed by Tisha Dotson, who writes on the topics of medical coding certification.  She welcomes your comments at her email Id: tishadotson86@gmail.com. 

Peurperium

Puerperium is a period following child birth during which body tissues especially the pelvic organs revert back approximately to pre-pregnant state both anatomically and physiologically. Normally, it lasts for 6 weeks after delivery.

What is puerperal pyrexia?

also called childbed fever, is a  rise of temperature reaching 100.4 degree Fahrenheit  or 38 degree celcius measured orally on 2 separate occasions at 24 hours apart ( excluding first 24 hours) within first 10 days following delivery is called puerperal pyrexia.

Causes of fever during Peurperium

Puerperal Sepsis : Most common cause. It is an infection of genital tract which occurs as a complication of delivery. Peuperal pyrexia is considered to be due to genital tract infection unless proved otherwise.

Urinary tract infection

• Cystitis
• pyelonephritis

Mastitis : breast infection

Infection of cesarean section wound

Pulmonary infection

Septic pelvic thrombophlebitis

Recrudescence of malaria or pulmonary tuberculosis

Unknown causes

General readers section : Simplified

Medchrome Women's Health

Diagnosis of pregnancy can be made by some presumptive symptoms seen during early pregnancy . These subjective symptoms are common complaint of the pregnant women.

Missed Period , Absence of Menses or Amenorrhea ( Medical term) – In a women with normal reproductive health,  when period is missed , pregnancy should first come to mind.  However periodic bleeding up to 12 weeks has been reported at times. And pregnancy can occur in previously amenorrhic patient, ie lactating women and puberty.

Morning Sickness: 50% of women during their pregnancy have nausea after rising from bed. Vomiting can occur. It usually appears soon following the missed period and rarely last beyond 3^rd month. Morning sickness is more common in first pregnancy.

Increased frequency of urination- usually occurs between 8-12 weeks of pregnancy.

Breast discomfort- feeling of fullness and pricking sensation may be evident by 6-7 weeks of pregnancy.

Fatigue- a generalized fatigue is a common symptom.

Confirmatory test for Pregnancy:

Various Pregnancy test kits are now easily available in the market. These are simple to use and are very sensitive as well as specific. They detect beta HCG in urine during pregnancy.

But Consult your Doctor For Final Confirmation and Advice.

Over time, men are apt to lose 25% and women 35% of their bone mass. As quoted by Gro Harlem Brundtland “osteoporosis, as the third threat, is particularly attributable to women’s physiology”. But we have to consider that men tend to have denser bones than women anyway, and their testosterone (male sex hormone) level generally does not begin to decline significantly until after age 65. In contrast, the estrogen (female sex hormone) level in women begins to decline at about age 45. Because sex hormones play an important role in maintaining bone strength, this difference means that women are more likely than men to suffer fractures, involving especially the hip, vertebrae, long bones, and pelvis. Although osteoporosis may at times be the result of various disease processes, it is essentially a disease of aging.

Categorization of Osteoporosis:

A. Primary :

1. Postmenopausal (Decreased serum estrogen)
2. Senile (Aging and reduced physical activity)

B. Secondary :
1. Endocrine Disorders:

• Hyperparathyroidism
• Hyper/hypothyroidism
• Hypogonadism
• Pitiutary tumor
• Diabetes Mellitus type 1
• Addisons disease

2. Neoplasia:

• Multiple myeloma
• Carcinomatosis

3. GIT disturbances:

• Malabsorption
• Malnutrition
• Hepatic insufficiency

4. Drugs :

• Anticoagulant
• Corticosteroids
• Chemotherapeutics
• Anticonvulasants

5. Miscellaneous :

• Osteogenesis imperfecta
• Immobilization

According to German Anatomist/Surgeon Julius Wolff a bone is only big and strong as it has to be. This indicates the role of physical inactivity and immobilization in development of osteoporosis.

Signs and Symptoms:
Patients may not be aware of their osteoporosis until they suffer a painful fracture.

• Joint pains
• Backache
• Change in posture
• Loss of height due to repeated fractures of spine
• Dowager/Widow’s hump due to curvature of the spine at the shoulders in older people
• Hip and wrist fractures during fall
• Stress fracture during normal activity

Prevention and Treatment:

Everyone can take measures to avoid having osteoporosis when they get older. Adequate dietary calcium throughout life is an important protection against osteoporosis. Males and females require 1,000 mg per day until age 65 and 1,500 mg per day after age 65, because the intestinal tract has fewer vitamin D receptors in the elderly. A small daily amount of vitamin D is also necessary to absorb calcium from the digestive tract. Exposure to sunlight is required to allow skin to synthesize vitamin D. Therefore, you should avail yourself of the vitamin D in fortified foods such as low-fat milk and cereal. Postmenopausal women should have an evaluation of their bone density. Presently, bone density is measured by a method called dual energy X-ray absorptiometry (DEXA). This test measures bone density based on the absorption of photons generated by an X-ray tube. Soon, a blood and urine test may be able to detect the biochemical markers of bone loss, making it possible for physicians to screen all older women and at-risk men for osteoporosis.

If the bones are thin, it is worthwhile to take measures to gain bone density because even a slight increase can significantly reduce fracture risk. Regular, moderate, weight-bearing exercise such as walking or jogging is a good way to maintain bone strength . A combination of exercise and drug treatment, as recommended by a physician, may yield the best results. A wide variety of prescribed drugs that have different modes of action are available. Hormone therapy includes black cohosh, which is a phytoestrogen (estrogen made by a plant as opposed to an animal). Calcitonin is a naturally occurring hormone whose main site of action is the skeleton where it inhibits the action of osteoclasts (the cells that break down bone).

Promising new drugs include slow-release fluoride therapy and certain growth hormones. These medications stimulate the formation of new bone. Examples include Biphosphonates and Selective Estrogen Receptor Modulator (SERM).

Q: When is World Osteoporosis Day celebrated?

Ans: Every year on 27th October