Many would have to differ when they’re asked to take traditional herbs for medicines.
However, many have not discovered the real reasons why herbal medication is still one among today’s better health care solution. Oriental Medicine practitioners have long used herbs for therapeutic and medicinal purposes—treating numerous ailments, varying from mild headaches to chronic pain. Now, these medicines are becoming more and more commercialized and easily accessible.
Ginseng, or in Chinese-translated word rénshēn means “essence of earth in the shape of man”, has gained huge stardom with its health benefits. While some claims are still unverified, numerous valid health benefits are known today. Panax Ginseng, the most common type and the original Chinese ginseng element, has been known to increase energy and stamina and boosts immune system. Other claims include lowering blood glucose, aid with brain performance as well as improve erectile dysfunction (ED) among men.
In a research review published in 2014, scientists analyzed sixteen previously published randomized controlled trials focusing on ginseng’s effects on blood glucose levels in people with and without diabetes. Result stated that ginseng modestly yet significantly improved fasting blood glucose in people with and without diabetes. The root of Panax ginseng, or Asian ginseng, has been used clinically to treat type 2 diabetes (Bensky D, Gamble, 1993, A: Chinese Herbal Medicine Materia Medica). Likewise, a 2005 study from the Journal of Psychopharmacology found that those among 30 healthy young students who were given Panax ginseng were less likely to experience mental fatigue during a school test. In terms of ED, a 2002 study from the Journal of Urology, which involved 45 men with erectile dysfunction, found that those who took Panax ginseng for eight weeks showed greater improvements than those given a placebo for the same time period. Thus, panax ginseng can be classified as an effective alternative treatment for treating male ED (Hong B., et. al., 2002, A double-blind crossover study evaluating the efficacy of korean red ginseng in patients with erectile dysfunction: a preliminary report).
Known as the female ginseng, Dong Quai root is an oriental age-old herbal medicine used in the ancient times for memory enhancement, sexual performance improvement, and heart health maintenance. Though these usages are well documented in the past, Dong Quai is most famous for relieving menopausal symptoms such as hot flashes and regulating menstruation blood flow. A research conducted at the University of Illinois concluded that dong quai has potential serotonin-like activity that could be used to boost mood. It is also known to support bone density. Taken as a tonic (root’s boiled or soaked in wine), it is believed to have a balancing effect on the female hormonal system as well as on increasing cell proliferation and other bone-building factors. Also, this angelic root have shown high levels of nutrients and vitamins (folic acid, biotin and vitamin B12), which clear out the blood and reduce toxicity throughout the body. After eliminating free radicals, dong quai indirectly reduces people’s risk of acquiring heart disease to cancer. Studies have also indicated that dong quai hot water extract regulates uterine and intestine contractions, relaxes the uterus and even inhibits spasms. The relaxing effect of Dong Quai is similarly useful for dysmenorrhea (Noe, Jody E., 1998, Angelica Sinensis: a Monograph. Journal of Naturopathic Medicine).
Ginkgo Biloba, one of the world’s most unique plants as it is one of the oldest tree species on the planet, was popularly used in ancient China as a food source as well as medication. A single ginkgo tree can live for thousands of years and records have shown its properties in helping improve lung function and blood circulation.
German researchers have also reviewed nine trials using the standardized Ginkgo biloba extract EGb 761which has become one of the most widely used herbal remedies for dementia and cognitive impairment. They concluded that ginkgo biloba was more effective than a placebo for improving cognition in patients with Alzheimer’s disease and dementia. It also improved activities of daily living for Alzheimer’s patients. The researchers suggested that ginkgo biloba may be just as good or better than other treatment options for patients with mild or moderate dementia.
A more recent meta-analysis of 21 trials found that compared to conventional medicines alone, ginkgo biloba in combination with conventional drugs was superior in improving cognitive and activities of daily living scores for patients with Alzheimer’s disease in just 24 weeks. It also improved thinking in people with mild cognitive impairment.
Red marks all over the athletes’ bodies participating in the Rio Olympics 2016 have been making rounds all over the internet. Most would have thought that these marks are effects of long time exposure under the sun or result of insect bites. Well both are definitely untrue. These red marks are the outcome of an ancient health treatment tradition used to treat numerous conditions—cupping.
An Olympic personality, such as world-record gold medalist swimmer Michael Phelps, has been seen sporting round marks from cupping, one of the traditional healing arts in the field of oriental medicine that’s been used in China for thousands of years.
Out of all treatments available in the modern health care industry, why would athletes resort to cupping? Ralph Reiff, a sports performance expert who have worked with members of the Olympic team, attested that the objective of their cupping is to “increase motion and get rid of subtle tissue lesions within certain areas of the body. Depending on how long you leave it the cup on one particular place, you get an infusion of fluid in that one area. That’s why you see the marks on some of the athletes. There’s an increase in blood flow to that area” (Josh Peter, USA Today Sports, August 2016, How cupping works and why Olympic athletes use it).
How Cupping Works?
During the Chinese Tang and Qing dynasties, cupping practitioners used hollowed-out animal horns for cups, and place them over particular points or meridians. Today, most oriental medicine practitioners use cups made of thick glass or plastic. Glass cups are more preferred in dry cupping as they do not break easily and allow them to see the skin and evaluate the effects of the treatment.
These glass cups are first warmed inside using a cotton-lit ball that’s soaked in alcohol. This cup warming removes all oxygen inside the cup, which then creates a vacuum. The warmed cup is then placed on the targeted area of the body and eventually pulls the skin upward as the air inside cools down. It is believed the cupping opens up skin pores, stimulates blood flow, balances the qi (the vital life force that flows through the body), and removes toxins out of the body. .
Cupping is considered relatively safe however, it could it cause some circular bruises or swelling on the areas where the cups were applied. These bruises are usually painless, however, and disappear within a few days of treatment.
For over 70 years, traditional oriental medicine, such as cupping, has been used in hospital all throughout China and other sides of the world. Some studies have alluded cupping results to a therapeutic effect through hyperemia or hemostasis. Hyperemia increases the blood flow through the body while hemostasis stops internal bleeding and keeps blood within the damaged vessel (Gao LW., 2004, Practical Cupping Therapy [in Chinese] Beijing: Academy Press).
According to clinical studies published between 1959 and 2008,—73 randomized controlled trials (RCTs), 22 clinical controlled trials, 373 case series, and 82 case reports—potential benefits on pain conditions, herpes zoster, cough and other diseases after cupping have been shown (Huijuan Cao, et al., 2010, Clinical research evidence of cupping therapy in China: a systematic literature review).
Aside from promoting relaxation, cupping has been commonly identified as one of the best alternative medicine in treating pain. A report published in Evidence-Based Complimentary and Alternative Medicine, Cupping for Treating Pain: A Systematic Review, established that cupping significantly reduced pain in people with low back issues compared to usual care treatments, showed positive effects in treating cancer pain compared with anticancer drugs and analgesics, and helped soothe pain associated with respiratory issues. Its key actions include relaxing tense muscles, easing stiffness from chronic back and neck pain, relaxing deep tissues within the body, treating migraines, body fatigue as well as rheumatism. Generally, cups used to treat pain are placed over loins, neck, back and even shoulder blades.
Many have also seen a great deal of improvement in their bodies after routinely choosing cupping. For instance, cupping is used to reduce herpes, cellulite, acne and skin inflammation. As it improves blood flow, it is also used by few as a skin toning regimen. Aside from boosting your skin health, cupping has also shown to help treat respiratory issues by accelerating remedial time of flu or common colds. Cupping helps improve immune function by moving blood and lymphatic fluid throughout the body, which is why it’s been associated with reductions in lung diseases (especially chronic coughs), allergies, infections and asthma.
However, cupping is not entirely fitting to everyone as there are several instances where it should not be done. Cupping is highly not recommended for people with inflamed skin; those who have high fever or convulsions; and those who bleed easily. It is firmly not advisable as well to pregnant women but if would want to, cups are not allowed to be placed on stomach or lower back, bony areas, such as the ridges of the spine or the shoulder blades.
Weight is an important factor when planning a pregnancy. It is ideal to be in your best possible shape when planning to have a baby. Studies have linked being overweight and obese to a number of pregnancy complications such as birth defects, miscarriage and even still birth. This also includes a medical condition such as hypertension, which endangers not only the expectant mothers but also the baby.
An infamous pregnancy medical disease prevailing globally is Gestational Diabetes (GD). Most would think that diabetes is only acquired when a number of relatives suffer from it, but no, one does not need to have a family history to develop GD. Blood sugar level changes during the day based on what food people eat, when they eat, and how much they eat. Their level and frequency of physical activity also affect blood sugar levels. GD, diabetes developed by women during pregnancy, is caused by having a higher-than-normal level of blood glucose in the blood while pregnant and their bodies cannot produce enough insulin to transport all of it to the cells. However, GD can be controlled through the help of a physician by creating a plan to lower your blood glucose as well as providing you a better and disciplined diet (Dieabetes and Pregnancy, US Department of Health and Human Services).
Targeting you and the baby
GD does not only affect expectant mothers. It is a fact that babies can acquire certain medical conditions during this stage. If uncontrolled, babies can grow very large and become overweight (more than 4 kilos). These babies contact problems when it comes to delivery as possibilities of nerve and bone injuries could happen during labor. The baby’s body, which is larger than normal, may need to be delivered through the cesarean section. These babies also have a high possibility of being overweight and/or obese during childhood and adolescence that could lead to type 2 diabetes.
There is also a possibility that the newborn’s blood sugar is too low and mothers need to immediately initiate breastfeeding to provide more glucose into the baby’s body. If you had GD, there is an increased risk that the newborn will develop jaundice—the baby’s skin may turn yellowish and white parts of the eyes may change color slightly.
While GD presents a few conditions towards babies, inevitably expectant mothers are affected. Though caesarian section might be an option in giving birth, mothers may also take longer to recover from childbirth. Oftentimes, diabetes never goes away after delivery and thus may be labeled as type 2 diabetes afterwards.
The most basic step to take control of your body and to avoid GD is to know your blood sugar level by screening how much glucose is in your blood and keep your blood sugar level under control and at a healthy range through a healthy diet and regular physical activity. Knowing what your body needs during pregnancy is a must. Obstetrician-gynecologists provides a treatment program that will assess your blood glucose level and will eventually help you to choose the right food to eat as well as the number of times you should eat. Most pregnancies, when nearing their due date, have their insulin resistance increased. OB-Gyns provide insulin shots to help them lower their blood glucose.
When planning a pregnancy, women should be looking after their overall health which most specially includes the weight before pregnancy. Becoming fitter and losing some weight, within half a year or more before becoming pregnant always pays off. Remember that GD may be only a momentary concern, but once diagnosed, it can become a lifelong concern.
You might also have to include these changes in your eating habits to help keep your blood sugar level under control (American Diabetes Association: Evidence-Based Nutrition Principles and Recommendations for the Treatment and Prevention of Diabetes and Related Complications (Position Statement), 2003):
• Eat meals and snacks (as allowed on your meal plan) on a regular schedule throughout the day. Researchers recommend that women with gestational diabetes eat at least three small-to-medium sized meals and two-to-four snacks every day.
• Eat smaller amounts of carbohydrates at each meal. Rather than eating a large amount of carbohydrate at a single meal, your health care provider may suggest that you spread out your carbohydrates throughout the day. Because eating carbohydrates directly affects your blood sugar level, eating a small amount of carbohydrate all through the day will help keep your blood sugar from rising too high after a meal.
• Add a nighttime snack to your meal plan. You may need to add a snack of one-to-two servings of carbohydrate before you go to sleep to keep your blood sugar at a healthy level overnight. Some examples of healthy snacks include: a piece of fruit, a handful of pretzels, or crackers.
Preventive medical care has become very fashionable in the last decade. It makes good sense; avoiding disease rather than waiting for it to occur and then treating it is beneficial to the patient and involves less medical intervention. It also is a money-saver, encouraging patients to lead healthier lives is cheaper for both the patient and the health care system. Prescribing the latest drugs or performing surgery can be a very expensive undertaking. These are not original thoughts; Hippocrates the ‘Father of western medicine’ who practiced in Greece twenty five centuries ago preached that clean air and water along with a good diet and exercise are the keys to healthy living. A book written by an aristocratic British lady five hundred years ago, advising new wives on how to care for their house and family includes advice on caring for themselves during pregnancy.
Those of us involved in the care of pregnant women are smiling a wry smile at all this interest in prevention, as for centuries doctors, midwives and nurses have been providing ante-natal care to pregnant mothers in order to prevent problems and to see the pregnancy conclude with a content mother and healthy baby.
The evidence is overwhelming that mothers who seek care early, attend the ante-natal clinic regularly and follow advice improve the chance of having a healthy baby than women who do not seek ante-natal care. How many visits need to be made is controversial. In many western countries pregnant women are seen by a doctor or midwife fourteen or more times during the pregnancy. On the other hand, the World Health Organization has recommended that mothers be seen at least four times. This is very minimalistic, but many mothers in Cambodia are seen less than four times. My own feeling is that about eight visits at specified times will produce the desired result of a well prepared, well monitored mother and achieve a good outcome.
The number of the visits is less important than the content. Too much emphasis can be placed on the blood tests and Ultrasound examinations. These are important but a more important part of every visit should be answering questions, removing each mother’s fears and providing instruction on such topics as the onset of labor, premature labor, baby care when to call the hospital.
Our protocols are similar to those of most good centers. At each visit we will weigh you, check your blood pressure and test your urine. We will listen to the baby’s heartbeat using a hand-held Doppler machine and may also attach a more sophisticated fetal monitor and check the heart beat for several minutes. Seeing you regularly in pregnancy we can follow the growth of the baby and note any changes in your weight, blood pressure and other factors. This is why it is ideal that mothers visit the same clinic for each visit.
I am an Obstetrician (Ob is the latin word meaning “alongside”, steti is the latin word meaning “to stand”) my role and that of my colleagues is to stand alongside our mothers. Our duty is to monitor, inform and comfort them. We aim to be much more than technical advisors.
It is best that care begins early in pregnancy. The modern pregnancy tests are so sensitive and reliable that mothers learn that they are pregnant shortly after missing a period. We “date” pregnancies from the date of the first day of the Last Menstrual Period (LMP). Make a note of this date. From this we can calculate the Estimated Date of Delivery. (EDD)
A good time for the first visit is at about 8 or 9 weeks after the LMP. At this visit we will take a full medical history and health history of the mother’s family and of the father. We will perform a general medical examination; all this is to discover if there are any health issues that will affect the pregnancy.
Several blood tests will be performed to determine the mother’s blood type, to be sure that she is not anemic and to test for the presence of several infectious diseases. An Ultrasound examination may also be performed. This is a very important scan as we can learn several important facts. We can check that the pregnancy is safely in the Uterus where it should be and that the baby is doing well. At 8 weeks we can usually see the baby’s heart beat and if we get to see this, then the chances of miscarriage are very low.
We can also measure the size of the baby. As the pregnancy grows some babies are naturally bigger than others but at this stage they are all the same size. We can measure the baby and from this calculate the expected due date of the baby with some accuracy. It is nice for the family to have this information, but more importantly it could be invaluable information later in pregnancy knowing when the baby is due. If the mother is 36 years old or over we may delay this scan until the 11th week, as at this time we can look at the neck structure of the baby as an abnormally thick neck is suggestive of Down syndrome.
You will be given advice about your diet. There is nothing very new in this information. You should eat in pregnancy the way we should all eat all the time—a well-balanced diet with an emphasis on protein and vegetables and with care not consume too much carbohydrates. High sugar drinks are a no-no and it is best to avoid alcohol. We will give you an iron and vitamin pill to take daily. This is like insurance; you absorb vitamins from your food better than from pills, if you eat well you will get all the nutrients that you and your baby need, but this will ensure that there are no gaps. The exception is Iron, as iron is not absorbed well and even with a good diet you may not get enough, the pill will give you the extra boost of Iron that you need. Apart from this Iron and Vitamin pill, you must be VERY careful what other medications you take. Every time you take a medication the baby is taking that medication too. Be sure to tell your caregiver about any medications that you are thinking of taking as some of them are not good for the baby.
Tragically, several pregnancies are miscarried. Mothers always look for a reason to blame themselves, but this sad event is often a result of the body’s quality control system. The pregnancy especially the placenta is not developing well and the body chooses to end the pregnancy. Mothers often worry believing that means that they will not be able to have a child but this is NOT so. Many mothers lose their first pregnancy and then go on to have a house full of children.
Following this the next few months are usually uneventful. At about 18-20 weeks we like to see you again and check on the size of your tummy. At 20 weeks the Uterus is usually up to your belly-button. An Ultrasound scan at this time is very important. The baby is scanned from head to toe making sure that that the baby is developing well; we call this scan the Anatomical Scan.
At about 28 weeks we do a test to be sure that your blood sugars are normal. A few patients develop the condition of Gestational (Pregnancy) Diabetes. This is not quite the same as full Diabetes as it occurs during pregnancy and goes away after birth. It is important that we know how your body is maintaining your blood sugar levels at a good level. We give you a sugar drink to drink and then test your blood sugar an hour later. If this screening test is normal we will perform a more complete study of you blood sugar metabolism. I would like to emphasize that high consumption of sugar during pregnancy is not a good thing. This is not easy, you often feel ravenously hungry and a big chocolate bar or a sugary drink looks very attractive, but baby does not share your enthusiasm.
By this time you are staring to be very BIG. One effect of this is that you get a great deal of pressure and visit the toilet more times than usually. In the last few months of pregnancy if you look at pregnant women from the side you will see that the lower back has a more pronounced curve than usual. Mothers have to stand like this or they will fall over forwards. This curvature of the spine causes a good deal of lower back especially at the end of the day and mothers find it difficult to find a position in which they feel really comfortable. Many mothers have found that yoga exercises can help with this discomfort.
During the last few weeks we like to see you regularly and check the baby’s growth and position. The third important Ultrasound scan is often performed about three weeks before your due date. This time we are checking the baby’s weight, the position of the baby, the position of the placenta and the amount of fluid.
This all sounds very regimented but it is important to monitor mother and baby during the pregnancy. In reality every pregnancy is different and the ANC may differ from one mother to another depending on many other factors. It is important that a bond form between the health care professionals and the patient and a feeling of confidence and trust is created. Each mother may have their own preferences for the delivery and in the last few visits these preferences can be discussed and notes made about your wishes.
A famous quote about teenage pregnancy, “You are worth waiting for…,” presents a profound meaning in the value of life. It doesn’t only project an effect on the possible negative outcomes such as social misery but also on the health of both mother and baby.
Teenage pregnancy is an absolutely vital issue globally. The health risks for babies are very high and there are entailing emotional and social pitfalls from families.
Let’s take a deeper look at what teenage pregnancy can do.
Over the course of a decade, almost fifty percent of high school students have already experienced sexual activities, thus contributing to unwanted pregnancies. There is a huge impact on education as a majority of these teens do not obtain high school diploma or even a degree for that matter.
Several health complications are also considered such as pre-mature labor and medical problems experienced by soon-to-be mothers. With these aggregating problems, young mothers found themselves in alcohol and drug abuse. It doesn’t only stop at that. A recent study has shown that there is a forty percent chance that daughters of teenage mothers are most likely to experience unwanted pregnancies, too.
Pregnant teens and their unborn babies have unique medical risks.
1. Lack of prenatal care
Teenage girls who are pregnant -- especially if they don’t have support from their parents -- are at risk of not getting adequate prenatal care. Prenatal care is critical, especially in the first months of pregnancy. Prenatal care screens for medical problems in both mother and baby, monitors the baby’s growth and deals quickly with any complications that may arise.
2. High blood pressure
Pregnant teens have a higher risk of getting high blood pressure -- called pregnancy-induced hypertension -- than pregnant women in their 20s or 30s. They also have a higher risk of preeclampsia. This is a dangerous medical condition that combines high blood pressure with excess protein in the urine, swelling of a mother’s hands and face, and organ damage.
However, these can easily be prevented. Like any other social and critical issues, teenage pregnancy can be corrected with the help of proper education through:
1. A comprehensive scientific sexual education
Being educated with a full science-based sexual education veers teens away from misleading sex information that media portrays in the internet or in any other medium. Logically, teens will learn the accurate information about health effects of having unwanted pregnancies during teens. Luckily, some sexual programs contain psychological and social teachings that further promote prevention and confrontations when teens are presented with sexual abuse or any sexual behavior. It also entails establishing values and self-worth. Values are the principles that we believe in and that should guide our behavior.
This program includes:
• Basics of Sexual Reproduction
• Commitment Plan
• Available contraceptive
2. Contraceptive access
Teens have the right to have access and knowledge of any contraceptives that fights teenage pregnancies. Safe sex entails a responsible individual and learning safe sex at a young age provides teens power to have informed decisions in the future.
Although it is rightful to say that abstinence is the 100% most effective method, there are available contraception types that teens should be aware of:
• Latex condoms;
• Vaginal contraception film;
• Contraception sponge;
• Birth Control pills;
• and Birth Control patch.
Pregnancy Awareness: Education on Immunization and Tests during Pregnancy | Interview with Pasteur Institut du Cambodge
Healthwise Digest (HD): What are the most common tests for pregnancy?
Institut Pasteur du Cambodge (IPC): Let’s divide these tests into two parts. First are before pregnancy, the pre- marriage stage and the second are during pregnancy. The common tests taken during pregnancy are HIV, Syphilis, Rubella, Toxoplasmosis, and blood grouping. Tests such as Hepatitis B, Hepatitis C, Mycoplasma and Chlamydiae are done after these were prescribed by physicians. For some couples, they come to take blood test when planning a pregnancy while some others only come after getting pregnant. When planning a pregnancy, we repeat all tests as well as blood grouping. Blood grouping is to avoid foeto-maternal incompatibility, when the father is Rh+positive and the mother Rh negative. We have to prevent this incompatibility and we now know how to prevent it, as sometimes this reaction could be fatal for the baby. As for thalassemia, we do a Complete Blood Count and Haemoglobin Electrophoresis. Furthermore, women who do not have any clinical history of rubella or chickenpox and are planning a pregnancy can undergo Control Serological Screening. The Commission on Specialized Safety of the French High Council for Public Health recalls any vaccination against varicella or rubella in a woman of childbearing age must be preceded by a negative pregnancy test and an effective contraception is recommended three months after each dose of vaccine.
HD: What are the specific tests for pregnancy in each semester?
IPC: All tests mentioned above, aside from the prescribed ones, are mandatory from the beginning of pregnancy. The toxoplasmosis, a disease that results from infection with the Toxoplasma gondii parasite, is primarily done to determine if there is a risk for such parasite infection during pregnancy. This parasite is transmitted through cats or consumption of raw meat. Toxoplasmosis is quite common in Cambodia but people here are not aware about this. Many doctors here are more concerned on Rubella and chicken pox. For toxoplasmosis, women who do not have any antibodies, should continue the test every month for the whole pregnancy and they should also repeat the test of rubella at least till 22nd week of pregnancy, if the screening is negative. If after this duration the mother is without rubella, they can stop taking this test. On the other hand, we also do glycosuria and albuminuria. These tests are mandatorily done every month to check if the mother is at risk of acquiring diabetes and pre-eclampsia. Sometimes, they need to check with their OB-Gyne if they have gestational diabetes especially if they have high body mass index (BMI) and other criteria which we noted high risk. We must also make monthly regular monitoring of hemoglobin to prevent anemia in pregnancy and initiate treatment with folic acid and iron.
In the 4th month, we screen for Trisomy, which is among the highest number of conditions in pregnancy. People seem to be unaware of this. As laboratory specialists, we can’t make any medical decision and it is out of scope of what to do. After finding out that there’s a trisomy case, we have to send them for a specialist doctor for further advice. For this screening test, which is non-invasive, we just take the blood sample from the mother. Since this is a genetic test, informed consent of the mother is mandatory. If it turned out positive then we need to do another test that is invasive for confirmation.
When the mother is Rh negative and the father Rh-positive, there is no risk during the first pregnancy. The risk appears after childbirth, during the passage of the child’s red blood cells in the bloodstream of the mother. In a future pregnancy, she will then produce antibodies against the red blood cells of the child. To avoid this, during childbirth, anti-D immunoglobulin injection is given immediately after delivery to the mother with Rh negative if the father has Rh positive to prevent incompatibility feto-maternal incompatibility in a further pregnancy.to the mother. In a new pregnancy, irregular antibodies screening and especially the blood group of the baby (molecular test) must to be done. For, if the baby is rhesus negative, there is no risk.
Test for Hepatitis B antigen (HBs Ag) is useful for newborn management. In case the test is positive for Hepatitis B, we must give the baby immunoglobulin (Ig) injection in the first 24 hours after labor or as soon as possible. Our Pasteur institute can provide this type of Ig. We divide the phases of infection Hepatitis B into 3 phases. According to pathophysiology, there are prenatal, perinatal and post natal. However, if the baby gets infected during prenatal, the injected Ig and hepatitis B zero will not help them. Luckily, the incident of pre-natal transmission by placenta is low. The purpose of giving Ig and hepatitis B vaccine at birth is to prevent the peri-natal and post-natal transmission from the mother towards her baby.
For the third trimester, we conduct a vaginal swab for Streptococcus group B.
HD: What are the vaccines available during pregnancy?
IPC: It is important to remember that consideration is always a safe choice. It’s the things needed to do before couples decide to have baby. First they should remember whether they have taken the vaccines before or not, and if they already had, a booster for those for some vaccines is recommended. We’re highly concerned about the viral infections we mentioned, which can cause congenital malformation. These also include Hepatitis B vaccine. Those diseases are preventable and women should check if they have antibodies against them. In case they don’t have yet, they can do Measles Mump Rubella (MMR) vaccine and Varicella vaccine. Since these are live virus vaccines, they need to get these at distance before they get pregnant.
Hepatitis B vaccine can be given during pregnancy.
During pregnancy, the following vaccines should be given according to the recommendations of the World Health Organization (WHO) and the US Center for Disease Control (US-CDC):
Tetanus Vaccine: The main purpose is to prevent neonatal tetanus in newborn baby at birth and in the mother during labor. It is recommended that pregnant women get at least 2 doses of tetanus vaccine during her pregnancy. Usually pregnant women are a bit late to start medical checkup, thus late to get the first dose of tetanus vaccine. They normally take the 1st dose during the second trimester and onwards.
Hepatitis B Vaccine: This vaccine is safe to take during pregnancy. If the expectant mother doesn’t have any antibody, she should get this vaccine.
Influenza Vaccine: The immune system during pregnancy is weak. Pregnant women are recommend to receive influenza vaccine during third trimester onwards. We have two reasons to take this at the third trimester: one is to prevent the mother from acquiring flu and second is to obtain passive immunity transferred to the fetus so that the newborn are protected from the disease before they can even get the vaccine after birth (for babies, this vaccine can be given only from age sixth months).
HD: Is there any available newborn screening test here?
IPC: Globally, it’s part of their policy to provide newborn screening, but locally we can’t afford it and there’s no possibility of doing all the tests yet. However, there are also some test we do routinely like G6PD (glucose-6-phosphate dehydrogenase) and thyroid unction test for instance. Sometime we also screen for haemopathy, depending on the case.
HD: Can you cite the services offered for pregnant women and babies here at IPC?
IPC: At IPC, we have two important services for pregnant women: vaccination and laboratory analyses. For vaccination, we have Measles-Mumps-Rubella vaccine (3 in 1), Chicken pox, Hepatitis B and Flu vaccines. Likewise, parents should consider about vaccination plan for their babies. IPC has vaccines for babies from birth till 18 years of age corresponding to routine vaccines (against 10 diseases namely tuberculosis, hepatitis B, tetanus, diphtheria, pertussis, polio, haemophilus influenzae b or Hib, measles, rubella, pneumococcus) according to the National Immunization Program of the Ministry of Health. In addition, IPC also has vaccines against rotavirus, seasonal flu, mumps, varicella, hepatitis A, typhoid fever, Japanese encephalitis, cervical cancer, meningitis and yellow fever.
HD: What important advice you can share to women if they are planning to get pregnant or if they are already pregnant?
IPC: They should have proper plan for safe pregnancy. These include regular health checkup, biological testing and immunization. The earlier a health problem is identified, the easier the problem can be managed. Don’t let vaccine preventable diseases affect you, your pregnancy and your baby.
Have you noticed how pregnancy books often illustrated moms-to-be with jubilant faces?
Yes, expecting a child is a joyful blessing in life but most would probably think that being pregnant is all but pleasure. We’ve asked mothers the most debilitating experience they have had and majority pointed out the weakening morning sickness—nausea and vomiting.
The physical and emotional impact of nausea and vomiting often results in feelings of anxiety about the effect of the symptoms to the fetus. According to a study, this symptom has a negative impact on family relationships and has major consequences on women’s working abilities (Gadsby R, Barnie-Adshead AM, Jagger C., 1993, A prospective study of nausea and vomiting during pregnancy): 47% of working women experiencing morning sickness feel that their job efficiency is reduced; 35% lose work time (mean loss of 62 working hours per woman), while 25% lose time from housework (mean loss of 32 hours per woman) (O’Brien B, Naber S., 1992, Nausea and vomiting during pregnancy: effects on the quality of women’s lives).
Morning sickness is a common symptom caused by changes in hormones in the onset of pregnancy, which may last in the first trimester. Most women think that because it’s labeled “morning”, you can only suffer from it during daybreak. Nausea with or without vomiting can happen any time of the day.
As it does not usually cause any problems for the unborn baby, severe and ongoing vomiting is worrisome and those suffering from this should immediately ask for medical attention.
Accepted… but Unproven Theories
Theory A: Morning Sickness is caused by low blood sugar
Though there are real cases of hypoglycemia during pregnancy where patients struggle, low blood sugar is not the main cause of morning sickness. It is also considered as a symptom just as nausea and vomiting.
Theory B: Morning Sickness is caused by vitamin B6 & B12 deficiency
Well, again this deficiency is not a cause of morning sickness. However, a buildup in Vitamin B provides a significant relief to expectant mothers since B6 and B12 help in magnesium absorption. Magnesium helps prevent morning sickness. While this mineral is important for bone health, it also plays a big part in your baby’s brain and nervous system development; reduces your baby’s risk of developing birth defects; and helps to maintain your and your baby’s spine and central nervous system
Theory C: Morning sickness fully protects baby from toxins
First and foremost, pregnant women are advised by their respective obstetrician-gynecologists to live a healthy lifestyle, which includes a healthful diet that is far from toxic.
Cause of Morning Sickness
One cause that contributes to morning sickness is the enlargement of the uterus during pregnancy. This enlargement pushes the stomach upwards, which makes pregnant women feel discomfort. An increased estrogen level during the early stages of pregnancy may also cause short-term nausea and vomiting. Another cause of morning sickness is gastric problems. Progesterone is a hormone that helps prepare the womb for pregnancy and protects the womb lining. As progesterone production increases, the movement in the small intestine, esophagus and stomach reduces, causing nausea. The reduction in movement occurs as a result of the muscle walls relaxing.
While morning sickness is a common symptom in pregnancy, the medical world is encouraged to provide better assistance to women experiencing it. According to the Royal College of Obstetricians and Gynecologists (RCOG), healthcare professionals should provide better support to pregnant women suffering from morning sickness.
The RCOG also provided a new guideline for healthcare professionals to assess the mental health of women dealing with the effects of morning sickness. Lead author of the RCOG new guideline Dr. Manjeet Shehmar attested that women suffering from nausea and vomiting can face a challenging time in early pregnancy and can often feel that there is a lack of understanding of their condition, they may be unable to eat healthily, have to take time off work and feel a sense of grief for loss for what they perceive to be a normal pregnancy.
Suggested diet to manage symptoms of morning sickness
Expectant women are advised not to miss or skip meals and eat smaller meals often. Fatty and spicy foods also trigger vomiting so it is better to stray from fried foods. Most importantly, avoid foods with aromas that could make women feel sick.
At 27 years old, Briya is living the time of her life. Born in Phnom Penh with two other siblings, she has not only finished her bachelor’s degree in management and human resource but also succeeded in becoming a celebrated artist she has never even dreamt before. As for her family, Briya is now married and lives with her husband and her daughter.
Her parents were not entirely enthusiastic about her joining the showbiz industry. However, because of her passion and hard work, she had convinced them eventually. After being encouraged to try out in Freshie Boy and Girl in 2008, Briya joined the popular competition and won second place. “In order for me to win the contest, I made sure that I do not only practice what my Khmer dance and modeling coaches advise but also I put a lot of effort as well,” she attested. Contracts and projects arrived instantly. Most of which are product endorsements including cosmetics, cellular phones, motorcycles and even clothing lines. Movie stints followed from one to another right after starring in “Arb Peak Mouk Sovatek Pheap” and now she has established a name for herself in the industry.
“You should also take care of your health. I make it a point to exercise at the gym for 4-5 times a week, to indulge with steam bath and to swim,” Briya pointed out. Her beauty secret includes using aloe vera by skinning the plant out, cutting it and mixing it with UHT milk. “I rub this on my skin 2-3 times per week whenever I take a bath. Aloe vera doesn’t have irritating substances that can harm your skin. I even use blend it and mix it with UHT milk for a healthful drink. I believe that by doing this, you can help cool down my body’s temperature.”
“Since it is also your magazine’s theme, I would like to share some tips regarding pregnancy and baby care. Choosing the right food is important during pregnancy in order to avoid having a cold and flu because we are not allowed to take medicine,” she specified. Normally, vegetable and water are important for every meal but for Briya she was conscious of her diet then by eating less and drinking more powdered milk for moms regularly to avoid getting fat after delivery. Aside from this, she regularly checked her health every two months with her OB-Gyne.
“I never stopped drinking milk even after I gave birth to my baby girl,” pointing out to her drinking milk (UHT milk) in the morning and before sleeping. “As for my baby, I make it a point to put balm on my daughter’s fontanel and belly. I made it a point to feed her with breast milk for a few months and carefully choose the right food for her.” Briya also wanted to share that even though nutrition is a primary concern, getting regular vaccines for her kid is also essential when it comes to her child’s health.
1 in every 80 pregnancies is affected by ectopic pregnancy. This life-threatening condition occurs when a woman’s fertilized egg gets stuck somewhere outside the uterus, such as the fallopian tube (most common), a C-section scar, an ovary, the cervix, or directly in the abdomen. When left undiagnosed, ectopic pregnancy could result in severe abdominal pain and bleeding.
But what really is an ectopic pregnancy? For some who have little knowledge of it, ectopic is simply having an “out of place” pregnancy. The embryo grows outside the uterus and may cause a rupture that could result in internal bleeding. So as much as possible, early detection is required.
Usually, ectopic pregnancy occurs in the first week of pregnancy.
Ultimate signs of Ectopic Pregnancy
Surely, your body will tell you if you are likely to be having ectopic pregnancy. There are major signs you need to watch for—abdominal pain, absence of menstrual periods, and vaginal bleeding.
Normally, you’ll be experiencing persistent and severe pain on one side of your tummy. Also, there is a present vaginal bleeding. You may also feel pain while passing urine or stools. There is a difference between and vaginal bleeding and regular menstruation. Vaginal bleeding is an erratic bleeding that can be bright or dark red color. If you don’t know whether you are pregnant but find yourself having an unusual period, it may be due to a number of causes, one of which might be an ectopic pregnancy. If bleeding is heavier or lighter than usual and prolonged or if, unlike your normal monthly period, this bleeding is slight, dark and watery; you should tell your doctor as soon as possible (The Ectopic Pregnancy Trust, 2016).
Early detection is very crucial. If ectopic pregnancy is discovered in the first few weeks, an injectable medication called methotrexate can be administered. This targets the growing cells and terminates the pregnancy.
Open surgery is safe for late diagnosis as long as the fallopian tube is not ruptured. This either involves opening up the fallopian tubes surgically and removing the embryo, or removing the tube altogether.
Ruptured Fallopian Tube
A ruptured fallopian tube is considered a medical emergency. There are various signs you’ll identify a ruptured fallopian tube—having a sudden, severe, sharp pain in the abdomen, feeling faint and dizzy, feeling or being sick, diarrhea and shoulder tip pain. Surgery should be done immediately especially if the patient is unstable and blood pressure has gone low.
A laparoscopic surgery approach may be performed for this case. Through a few small incisions, instruments are inserted into the abdomen to see and remove the ectopic pregnancy and control bleeding. In a few cases, it is required to remove the fallopian tube to control bleeding.
Avoiding Ectopic Pregnancy
There are a number of factors that increase the risk of having an ectopic pregnancy among women.
• Pelvic infection with gonorrhea or chlamydia is a major cause of tubal problems and increases the risk of ectopic pregnancy.
• Infertility provides a higher chance of ectopic pregnancy among women. This is due to an increased incidence of tubal abnormalities. You may also need to avoid fertility drugs.
• Having multiple sexual partners is associated with an increased risk of pelvic infection, and therefore an increased risk of ectopic pregnancy.
• An untreated sexually transmitted infection (STI) is also a major risk towards acquiring ectopic pregnancy
Experiencing ectopic pregnancy could trigger fear towards child planning, sadness towards own self and even guilt within the relationship. It is important to remember that that the ectopic pregnancy was not your fault and that there was nothing you could have done to prevent it happening. However, always remember to live a healthy lifestyle and consume a healthful diet.