J-Rapha

INTRODUCTION:

Diabetes in pregnancy also known as diabetes during pregnancy is a condition where your blood sugar level becomes higher than normal.
It is referred to as gestational diabetes if it was first noticed during pregnancy.
Diabetes in pregnancy usually occurs when your body can not control the amount of sugar produced due to inadequate insulin in the body.

RISK FACTORS FOR DIABETES IN PREGNANCY:

• Being over weight before getting pregnant.
• Having a family member who is diabetic.
• If a person has had gestational diabetes before.
• If a person is an African – American, native America, Asian or Hispanic.
• Person has given birth to a big baby before > 3kg
• Person is above 25 years.

SYMPTOMS OF DIABETES IN PREGNANCY:

• You become more thirsty than normal.
• You become hungrier and eat more frequent than normal.
• You urinate more frequent than normal

EFFECTS ON UNBORN BABY:

• Macrosomia- which is a condition in which your baby grow so large above 4kg.
• Hypoglyceamia- which is also known as blood sugar lower than normal. this can occur to your baby shortly after birth.
• Jaundice which is yellowish discolouration of the eye or skin of the baby can also occur.


TREATMENT

Lifestyle modifications- this are measure taken by mothers to prevent and control diabetes in pregnancy and they include
• Exercising in which walking is preferable
• Weight reduction
• Reduction in carbohydrate foods and increase intake of vegetables
• Avoid late night intake of food
• Monitoring of blood glucose level at home
• Stoppage of alcohol intake

However if lifestyle modifications fails to control blood sugar level then treatment in the hospital is recommended which involve the use of insulin injections and Metformin Tablets.

INTRODUCTION

Episiotomy is a surgical procedure done to widen the vagina opening during childbirth.
It is a small straight incision done on the perineum which is the skin and muscle in between your anus and vagina.
Alternately, the incision may be done at an angle.

REASONS FOR AN EPISIOTOMY

• Your baby head and shoulder are too large to fit through your vagina opening
• You or your baby is in distress and delivery needs to be sped up
• You are unable to stop or slow your pushing
• Instrument needs to be use for your delivery


COMPLICATIONS OF EPISIOTOMY

• Infections
• Bleeding and perineal hematoma( which is a large collections of blood in the tissue)
• Painfull intercourse
• Perineal pain

EPISIOTOMY CARE AND HEALING

• After your procedure, wait for about six weeks before engaging in any activity that might rupture your stitches including using tampons, having sex and douching
• to reduce pain,
* Use pain relievers such as ibuprofen, medicated creams and local anaesthetic sprays
* Take warm cean birth at least 24hrs after giving birth
* Apply ice packs immediately after birth
• To avoid painful bowel movement, take stool softeners, drink lots of water and eat a lot of fiber
• Always wipe front to back
• Use antibacterial sanitizers on your hand before cleaning the perineal area
• Change your pad every 2 to 4hrs
• Frequent sitz baths or shallow baths that cover your vulva may help speed healing and be sure you dry off carefully when you are done. this should be done at least 24hrs after birth
• Make sure you keep the area clean and dry and avoid using toilet paper( use baby wipes as options)
• You will have your stitches check at your six weeks visit after birth and at this point your doctor or mid wife will tell you when to resume activities and can provide guidance on how to deal with incontinence.

1. SPOTTING AND BLEEDING
Whenever there is any bleeding in pregnancy, you have to know where the source is. In early pregnancy,
• spotting is usually a normal sign of pregnancy development
• If you have spotting and pain, it might mean you have an ectopic pregnancy
• . spoting or bleeding with abdominal pain could also mean you are having a miscarriage In late pregnancy,
• Bleeding could mean that your placenta is not in the proper position
• Bleeding could also mean that your placenta has separated from your womb

2. CONTRACTIONS
Contractions during late pregnancy mean labour has started and if it occurs before your delivery date it could mean preterm contractions

3. REDUCED OR NO FETAL MOVEMENTS
Between 17 and 18 weeks of pregnancy, you will start to feel your baby move. Sometimes you might notice that the baby is quiet during the day and more active at night.
IF you notice such symptom, inform your doctor.

4. SWELLING
Swelling of the feet, face and hands during the pregnancy is normal however if .
If you have a high blood pressure or headache, it could lead to convulsions

5. VAGINAL DISCHARGE
It is normal to have an increase in clear discharge during pregnancy but if there is blood stain or you have pressure or pain, tell your doctor.
During the late pregnancy, vaginal discharge could mean that your cervix is opening up early which could cause a miscarriage. Or premature delivery

6. CHILLS AND FEVER
Any kind of fever with pain has to be taken seriously especially during pregnancy.

7. HEADACHES
Headaches are a very common complaint during pregnancy\Causes include: Lack of sleep, Stress, Hypertension and malaria etc