Dr. Neharika Malhotra (Session 1)

Q & A with Dr. Neharika Malhotra (Session 1)

1. When should a pregnant woman go for her first doctor’s appointment? What should she expect from her first prenatal checkup? Ans : If a woman has missed her period and have had a positive result in a home urine pregnancy test, she must make an appointment right away. Ideally, If a woman is planning to get pregnant she must consult her doctor before conception ,so that a basic health checkup can be done and special needs relating to specific medical conditions can be taken care of like thyroid diseases, diabetes, hypertension.Additionally , folic acid supplementation is started pre-conceptionally so as to prevent neural tube defects. On your first antenatal visit, Be prepared for lots of questions ! Your doctor needs to get an accurate picture of your health, your husband’s health and both of your families’ medical histories. Here are some of the things your doctor may ask you:

  • The date of your last period. Knowing the date of your last monthly period (LMP) allows your doctor to work out your due date.
  • Previous miscarriages, terminations and births. Your ‘obstetric history’ is important and could have a bearing on how well you cope with pregnancy this time around. It may also affect how your labour is managed.
  • If you have any other gynaecological problems, such as ovarian cysts, fibroids or earlier surgery, tell your doctor.
  • Family history of disease or genetic conditions. Make sure you are aware of the medical histories of your parents and your in-laws. Screening is available at most diagnostic centres and hospitals for known genetic conditions such as thalassaemia. A family history of allergies, heart disease or certain other major medical conditions could all have a bearing on your pregnancy.
  • Lifestyle. Doctor will ask a few questions about dietary and fitness habits , whether the woman drink alcohol or smoke, as both can affect your baby’s health. It is important to know if husband smokes, because secondary smoking could harm the mother and baby.She may also give you advice about your diet or lifestyle Or she may suggest that you meet with a dietitian who will review your meal plans and advise you on how to eat well in pregnancy.

After taking detailed history, basic physical examination is done , weight, height are noted.

Blood pressure is checked and noted A per abdomen examination is done if the gestational age is more than about 12 weeks. An internal examination(per vaginal) is done if indicated. The doctor then prescribes some routine blood tests (Haemoglobin, Blood group, HIV, Hepatitis B,C, VDRL, TSH, Blood Sugar, Hb electrophoresis) and urine tests(Routine and microscopy).Additionally folic acid supplementation is prescribed in first trimester.

2. Is it important to have prenatal vitamins? Yes. It’s hard to get all the nutrients mother and baby need, even if you eat a wide variety of food, including meat, dairy products, fruits, vegetables, grains, and legumes. Most women can benefit from taking a prenatal vitamin and mineral supplement. Taking a prenatal vitamin is even more important for women with dietary restrictions, health issues, pregnancy complications or having having twins or higher multiple pregnancy. Two crucial nutrients – folic acid and iron – are almost always included in prenatal vitamins because most pregnant women don’t get enough of them from food alone. Getting enough of folic acid in the month before you conceive and very early in your pregnancy can reduce your baby’s risk of neural tube defects, such as spina bifida and anencephaly, cleft lip, cleft palate.It also reduce risk of mother having preeclampsia. Most moms-to-be don’t get enough of iron from their diet to meet their body’s increased need during pregnancy, and this can lead to iron-deficiency anemia. Preventing iron-deficiency anemia can cut your risk of preterm delivery, low birth weight, and infant mortality. Calcium and Vitamin D supplementation is also needed as the increased needs are difficult to be met through diet alone. It helps in proper bone development of fetus and prepares mother for post natal period, lactation and prevents problems like backaches.

3. Are there any restrictions on traveling while pregnant? If you have a normal, healthy pregnancy, it can be safe to travel during most of it. However, discuss your trip plans with your doctor before travelling. Avoid travel on routes with jerks, travel by bus, auto rickshaws and two wheelers because of obvious risks. In certain high-risk cases, it may be advised to stay close to home throughout your pregnancy. Second trimester – weeks 14 to 27 – is a perfect time travel. Once you’re past the first trimester, in all likelihood morning sickness will be behind you, your energy level will be higher, and your chances of miscarriage will be low. But don’t travel long distances after 36 weeks, particularly donot air travel after that time.

4. Are there any restrictions to be observed on foods? In general it is advisable to eat home cooked simple food and have a balanced diet. During pregnancy, immune system is compromised and any episode of illness is not welcomed due to unnecessary risking of mother and fetus.

 

  • Avoid consuming raw or uncooked eggs as they may contain Salmonella virus.
  • One must avoid high salt food items like namkeen, fried snacks – Samosas, Pakoras, Biscuits, Wafers, Fries, Pizza, Chips and Processed Cheese. All these food items are loaded with high salt which can cause water retention. Try not to sprinkle extra salt on the salads and raitas. It is best to eat normal salt. Avoid pickles too as they use high level of salt for preservation.
  • Avoid street foods – Street foods are generally prepared under low hygiene conditions. Second, these spicy foods can give you ingestion and heartburn.
  • Avoid Chinese food -Chinese food contains MSG – monosodium glutamate which can be harmful for the fetus development and can cause birth defects. Also soya sauce is very high in salt and may cause high blood pressure.
  • Raw uncooked / semi cooked meat /fish : If you are a non-vegetarian make sure to eat all meats like lamb, goat, beef and chicken cooked at 73 degrees Celsius.

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