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Foods You Should Avoid During Pregnancy

Foods You Should Avoid During Pregnancy

Pregnancy is a beautiful journey of creating new life, but it also comes with dietary adjustments to ensure the health of both mother and baby. While there’s a world of delicious foods to enjoy, certain items can pose risks. Those foods should be avoided during your pregnancy. A good gynecologist in South Delhi can help you prepare a list of such food items. However, here are some foods we have searched for that should be avoided during pregnancy.

What Not to Eat During Pregnancy?

Fish with High Mercury

Mercury, a heavy metal, can harm a developing baby’s nervous system. Do not eat fish high in mercury like king mackerel, shark, swordfish, and tilefish. Opt for safer options like salmon, shrimp, pollock, and cod, limiting intake to two to three servings per week.

Raw Fish and Shellfish

Raw fish and shellfish can harbor bacteria and parasites harmful to expecting mothers and their babies. This includes sushi, sashimi, ceviche, and raw oysters. Cooked versions of these foods are generally safe.

Undercooked Meat and Eggs

Similar to raw fish, undercooked meat and eggs can harbor harmful bacteria like salmonella. Ensure all meat (including poultry) is cooked thoroughly until there’s no pink in the center. Eggs should be cooked firmly with solid yolks and whites. You can consult with a pregnancy doctor in South Delhi to know the serious side effects of the condition.

Unpasteurized Dairy Products

Unpasteurized milk and milk products like cheese haven’t undergone a process to eliminate harmful bacteria. This can lead to infections like listeria, which can be serious for pregnant women. Stick to pasteurized dairy products for safety.

Soft Cheeses

Cheeses like feta, brie, camembert, gorgonzola, and blue cheese are often made with unpasteurized milk and should be avoided. Choose harder cheeses like cheddar, parmesan, or mozzarella that are pasteurized.

Deli Meats and Hot Dogs

Deli meats, hot dogs, and sausages can support the growth of listeria bacteria due to storage and processing methods. While the risk is low, it’s best to avoid them or heat them until steaming hot before consumption. However, whether you should eat such foods or not must be consulted with a good gynecologist in South Delhi.

Sprouts

Raw sprouts like alfalfa, clover, and mung bean can grow harmful bacteria like E. coli. Avoid raw sprouts entirely and opt for thoroughly cooked varieties.

Unwashed Fruits and Vegetables

Washing fruits and vegetables thoroughly removes dirt, pesticides, and bacteria that can be harmful during pregnancy.

Processed Foods

Processed foods are often high in sodium, unhealthy fats, and added sugars. While an occasional indulgence is okay, focus on a balanced diet rich in whole foods for optimal nutrition.

Excessive Caffeine and Alcohol

Limit caffeine intake from coffee, tea, and soda to 200mg per day. Alcohol consumption should be completely avoided throughout pregnancy.

For more details on the diet during pregnancy, consult Dr. Ruchi Tandon, an experienced pregnancy doctor in South Delhi.

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An Educational Guide to Advances in Contraception Technology

An Educational Guide to Advances in Contraception Technology

For decades, contraception relied heavily on the pill and a few other methods. Thankfully, the landscape is changing! Researchers are developing new options that are more convenient, user-controlled, and cater to a wider range of preferences. This blog will explore some of these exciting advancements. For details, consult a gynecologist in Greater Kailash.

Advances in Contraception

Implants and IUDs Get an Upgrade

Implants like Norplant were a game-changer, offering long-term birth control. Now, imagine an implant effective for several years that’s discreet and easily reversible. Researchers are working on such implants that release progestin, a hormone that prevents ovulation. These could be ideal for people who prefer not to think about contraception daily.

Intrauterine devices (IUDs) are another long-acting option. New IUDs in development boast extended lifespans, lasting up to a decade. Additionally, some IUDs combine hormonal action with copper, making them even more effective. A pregnancy doctor in South Delhi can help you better with the information about these devices.

User-Friendly Options on the Horizon

Imagine a birth control patch that releases hormones through the skin, lasting for weeks and easily applied at home. This is a reality in the making! Similarly, researchers are developing vaginal rings that deliver low, steady doses of hormones over several months. These options empower users with more control over their bodies and offer a discreet alternative to pills.

Male Contraception Steps Up

For far too long, the burden of contraception has primarily fallen on women. The tide is turning! Researchers are exploring various male contraceptive methods. One approach involves a gel applied topically that reduces sperm count. Another method involves a pill that suppresses sperm production. While these are still in the clinical trial phase, they offer a much-needed expansion in contraceptive options. But sooner, a gynecologist in Greater Kailash may have such an option.

Exploring New Avenues

The world of contraception isn’t limited to just hormones. Researchers are investigating innovative approaches. One area of focus is vasal gel, a non-hormonal method that blocks sperm from reaching the ejaculate. This could be a welcome alternative for people who prefer non-hormonal birth control.

Accessibility and Education Remain Key

These advancements hold immense promise for the future of family planning. However, ensuring accessibility and education is crucial. New technologies should be affordable and readily available to those who need them. Additionally, comprehensive sex education plays a vital role. A Pregnancy doctor in South Delhi can provide you with valuable information. It empowers individuals to make informed choices about their sexual health and reproductive rights.

The future of contraception is bright. With ongoing research and development, we can expect even more user-friendly, effective, and diverse options. This will empower individuals and couples to make informed decisions about their reproductive health, creating a future where family planning is accessible and convenient for everyone.

For more, consult Dr. Ruchi Tandon, an experienced Gynecologist Doctor in South Delhi.

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What Are the Signs Indicating That Labor Is Near?

What Are the Signs Indicating That Labor Is Near?

As your due date approaches, the excitement along with a touch of nervousness builds. You’re eager to meet your little one, but those last few weeks can feel like an eternity.  One way to ease the anticipation is to familiarize yourself with the signs that labor is on the horizon. Knowing the signs will make you consult with a good gynecologist in South Delhi on time. In this blog, we will talk about some signs indicating that your little one is about to come.

What Are the Signs That Tell Your Labor is Near?

Lightening: Many women experience a shift in their center of gravity as their baby descends lower into the pelvis. This can happen weeks or even hours before labor starts, and it often brings relief from heartburn but can lead to increased bathroom trips due to pressure on the bladder.

Braxton Hicks Contractions: Throughout pregnancy, you may have experienced tightenings in your belly – these are Braxton Hicks contractions. This is your body’s way of practicing for the real deal. As labor nears, these practice contractions may become more frequent and intense, but they should be irregular and not progressively stronger. If required, consult with a pregnancy doctor in South Delhi.

Losing the Mucus Plug: The cervix is sealed by a plug of mucus throughout pregnancy. This plug can dislodge with a pinkish or bloody discharge in the days or weeks leading up to labor. It’s not always a dramatic event, and sometimes the mucus plug comes away in pieces.

Your Water Breaking: This dramatic sign doesn’t happen for everyone, but in some cases, the amniotic sac surrounding the baby ruptures. This releases a gush of clear or slightly yellowish fluid. If your water breaks, contact a good gynecologist in South Delhi and head to the hospital – labor is likely imminent.

Backache Blues: Back pain is a common pregnancy woe, but as labor approaches, it may intensify and become a more constant feature. This is because your baby is positioning itself for delivery, putting pressure on your lower back.

Nesting Frenzy: The urge to clean, organize, and prepare for the baby’s arrival is a well-known pregnancy phenomenon. This “nesting instinct” can kick into high gear as labor nears, with a sudden burst of energy to get everything in order.

Decreased Appetite and Weight Gain: As your baby fills more space in your uterus, you might find yourself feeling less hungry and your weight gain may slow down or even stop.

Energy Levels: Some women experience a surge of energy in the days or weeks before labor, while others feel extra tired. Don’t fight it, listen to your body and rest when you need to.

For the best gynecological advice, consult Dr. Ruchi Tandon, an experienced pregnancy doctor in South Delhi.

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Nourishing the Miracle Within: Essential Nutritional Requirements During Pregnancy

Nourishing the Miracle Within: Essential Nutritional Requirements During Pregnancy

Pregnancy is a transformative and emotional journey. It also experiences a lot of physical and emotional changes. One crucial aspect that demands careful attention during this period is nutrition. The saying “eating for two” holds merit, but it’s not just about quantity; it’s about quality. A good pregnancy doctor in South Delhi can guide you with the proper nutritional requirements throughout the pregnancy. The right nutrients play a vital role in supporting the health and development of both the mother and the growing baby.

Nutrition During Pregnancy

Folate and Folic Acid

One of the first nutrients emphasized during pregnancy is folic acid, the synthetic form of folate. Adequate folate intake in the early stages significantly reduces the risk of neural tube defects in the developing fetus. Leafy greens, citrus fruits, and fortified grains are excellent sources of this B vitamin.

Iron

Iron is paramount for preventing anemia, a condition characterized by a deficiency of red blood cells. During pregnancy, blood volume increases, necessitating higher iron intake. Good sources include lean meats, fortified cereals, beans, and more. If you are a vegetarian, you can ask for alternatives to the Best Gynecologist in Greater Kailash. Pairing iron-rich foods with vitamin C-rich foods enhances absorption.

Calcium

Essential for the development of the baby’s bones and teeth, calcium is a mineral that pregnant women should prioritize. Dairy products, leafy greens, and fortified plant-based milk alternatives contribute to meeting calcium requirements.

Protein

Proteins are the building blocks of life and are crucial during pregnancy for the development of the baby’s organs, muscles, and tissues. Lean meats, poultry, fish, eggs, dairy, beans, and legumes are excellent sources of protein.

Omega-3 Fatty Acids

Omega-3 fatty acids, particularly DHA (docosahexaenoic acid), play a pivotal role in the development of the baby’s brain and eyes. Fatty fish like salmon, chia seeds, and walnuts have abundance of omega 3s. Omega-3 supplements, under healthcare provider guidance, can also be considered.

Vitamin D

Vitamin D is essential for calcium absorption, ensuring proper bone development in the fetus. Sun exposure, fortified dairy or plant-based milk, and fatty fish are sources of vitamin D. If needed, supplements may be recommended by the pregnancy doctor in South Delhi.

Vitamin C

Apart from supporting the immune system, vitamin C aids in the absorption of non-heme iron (found in plant-based foods). Citrus fruits excellent sources of vitamin C.

Hydration

Staying adequately hydrated is crucial during pregnancy. Water is essential for the formation of the amniotic fluid, supporting the increased blood volume, and preventing dehydration-related complications.

Fiber

Constipation is a common woe during pregnancy, and adequate fiber intake can help alleviate this issue. Whole grains, fruits, vegetables, and legumes are rich sources of fiber.

Prenatal Supplements

Despite efforts to consume a well-balanced diet, some women may find it challenging to meet all their nutritional needs solely through food. In such cases, the Best Gynecologist in Greater Kailash often recommends prenatal supplements to fill potential gaps in essential nutrients.

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Uterine Fibroids – An Educational Guide

Uterine Fibroids - An Educational Guide

Fibroids are the growth of the uterus and they are also known as Uterine Leiomyomas or Myomas. The uterus is made of muscle and the growth of fibroids happens from the muscle. Although Fibroids never cause cancer, and cannot become cancerous, they should be treated on time if you are the one have doubts about the same then, immediately contact an Infertility Specialist in Greater Kailash and get the treatment done as soon as possible.

Fibroids are common and almost 80% of women have this problem but everyone has bothersome symptoms. Treatments are available for fibroid-related issues such as pain or pressure in the pelvis, heavy bleeding while menstrual, or even infertility, or pregnancy issues.

Symptoms of Fibroids: You should know?

There are a few signs and symptoms that indicate you need instant treatment and those are:

  • Bleeding between periods
  • Painful and heavy menstrual periods can cause anemia or disrupt the normal activities of a woman
  • Uncertainty if the growth is fibroid or something other, like an ovarian tumor
  • Infertility and Pelvic pain
  • Rapid increase in fibroid growth

Symptoms of Fibroids: Noticeable

  • Menstruation Changes
  • Menstrual Pain (cramping)
  • Longer, heavy menstrual periods, or more frequent
  • Anemia
  • Vaginal bleeding at times apart from menstruation

Pressure

  • Difficulty while urinating or frequent urination
  • Abdominal Cramping
  • Constipation, difficult bowel movements, and rectal pain

Pain

  • Lower back or abdomen pain
  • While having sex
  • Infertility
  • Enlarged abdomen and uterus
  • Miscarriage

Sometimes Fibroids don’t cause any symptoms at all but they may be found while a routine check-up of pelvic or any other tests for other related issues. You should visit the Pregnancy Doctor in South Delhi to know about your vaginal problem if you have any.

Treatment of Fibroids: Is it necessary?

Drug therapy is the option when someone has fibroids. Medications might lessen the painful periods and heavy bleeding which causes sometimes because by fibroids. They might not prevent fibroid growth, and hence, surgery is required later. Drug treatment for fibroids includes a few following options:

Gonadotropin-releasing hormone agonists- These medications stop the menstrual cycle and also can shrink the fibroids. What’s more, they sometimes are used before surgery to lessen the bleeding risk.

Birth control pills and other kinds of hormonal birth control methods, these drugs are basically used for controlling painful periods with cramping and heavy bleeding as well.

Progestin- Releasing IUD, intrauterine device- This option is great for women with fibroids that don’t deform the inside part of the uterus. It lessens heavy and painful bleeding but that doesn’t treat the fibroids themselves.

As GnRH agonists have multiple side effects, they are ideal to be used for very short periods. When a woman stops taking this medicine, her fibroids commonly return to their previous size.

To stay prevent from Fibroids, you should maintain a healthy weight or have to lose weight if you are overweight. Always go with fiber-enriched foods and never smoke. You can visit Abortion Clinic in South Delhi if you have doubts about having any vaginal issues.

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How to Reduce the Risk of Gynecological Diseases?

Maintaining optimal gynecological health is crucial for women of all ages. While some gynecological diseases cannot be completely prevented, there are several proactive measures that women can take to reduce their risk. By adopting healthy lifestyle choices and prioritizing regular screenings, women can significantly minimize the chances of developing various gynecological conditions. This blog post will explore essential tips to help women protect and enhance their gynecological well-being. However, you must consult an experienced pregnancy doctor in South Delhi for proper guidance.

Practice Safe Sexual Behavior

Engaging in safe sexual behavior is paramount for preventing sexually transmitted infections (STIs) and reducing the risk of gynecological diseases. Consistent and correct use of condoms during sexual intercourse can significantly lower the chances of contracting STIs, including HIV/AIDS, chlamydia, gonorrhea, and syphilis. Additionally, getting vaccinated against the human papillomavirus (HPV) can help prevent cervical cancer, which is often caused by certain strains of this common virus.

Maintain Good Hygiene

Proper hygiene practices are crucial for preventing gynecological infections. Women should ensure that they clean the genital area daily with mild, unscented soap and water. Avoid using douches or vaginal sprays, as they can disrupt the natural balance of bacteria in the vagina and increase the risk of infections. It is also important to wipe from front to back after using the toilet to prevent bacteria from the anus reaching the vagina and causing urinary tract infections (UTIs).

Follow a Balanced Diet

A well-balanced diet is essential for overall health, including gynecological well-being. Consuming a variety of fruits, vegetables, whole grains, lean proteins, and healthy fats can provide the necessary nutrients to support a robust immune system and reduce inflammation. Additionally, maintaining a healthy weight can help decrease the risk of gynecological conditions such as polycystic ovary syndrome (PCOS) and endometrial cancer.

Engage in Regular Physical Activity

Regular exercise offers numerous benefits for women’s health, including reducing the risk of gynecological diseases. Engaging in moderate-intensity aerobic activities such as brisk walking, swimming, or cycling for at least 150 minutes per week can help maintain a healthy weight, improve circulation, and lower the risk of conditions like uterine fibroids, ovarian cysts, and endometriosis.

Quit Smoking and Limit Alcohol Consumption

Smoking and excessive alcohol consumption have been linked to an increased risk of various gynecological diseases. Women who smoke are more likely to develop cervical cancer, infertility, and experience complications during pregnancy. Similarly, excessive alcohol consumption has been associated with an increased risk of breast cancer. Quitting smoking and moderating alcohol intake can significantly reduce these risks.

Prioritize Regular Screenings and Check-ups

Regular gynecological screenings and check-ups are essential for early detection and prevention of potential health issues. Women should undergo routine Pap tests to screen for cervical cancer as their healthcare provider recommends. Mammograms should be performed regularly to screen for breast cancer, and women over 50 should also consider regular bone density tests to assess the risk of osteoporosis.

You can consult Dr. Ruchi Tandon, an experienced Gynecologist in Greater Kailash for detailed tips on maintaining your gynecological health.

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Common Orthopedic Problems in Pregnancy

Common Orthopedic Problems in Pregnancy

A woman experiences a lot of physical and emotional changes during pregnancy. To cope with them, it is important to consult the Best Gynecologist in Greater Kailash.

If we talk about physical changes in women during pregnancy, then orthopedic problems are common, and this is what we will be discussing here in the post.

Orthopedic Issues During Pregnancy

Lower Back Pain

Back pain is among the commonest orthopedic issues that a pregnant woman experiences. This is often because of the extra body weight. As a result of the growth and development of the fetus, the expecting mother gains weight. This puts pressure on the back muscles. Sometimes, the pain is severe. In such situations, having a strong back is important. So, maintain a strong back by doing exercises under the guidance of a skilled and experienced physiotherapist.

Osteitis Pubis

Another orthopedic condition that women may experience during pregnancy is osteitis pubis. It is an inflammatory condition that affects pubis symphysis. Bones at the front of the pelvis are called the pubic symphysis. Inflammation at this junction occurs because of the added weight and the position of the developing fetus. Pain associated with the condition can improve with the application of ice and heat and non-steroidal anti-inflammatory drugs (NSAIDs).

Heel Pain

Added body weight during pregnancy also causes heel pain. However, heel pain may occur because of plantar fasciitis. This is a condition characterized by the inflammation of a thick band of tissue present at the bottom of the foot. This band is called the plantar fascia and it connects the heel bone to the toes. Stabbing pain is what one experiences because of the condition which occurs during pregnancy. It is intense in the morning and the latter stages of pregnancy.

The application of ice and the use of shoe inserts may help improve the condition. In severe cases, the healthcare service provider may give cortisone shots.

Transient Osteoporosis of the Hip

This often occurs during late-term pregnancy. Transient hip osteoporosis is characterized by temporary bone loss around the hip joint. This makes the hip joint weak. The reason for the same is unknown but hormonal changes are believed to cause the same. Besides this, weight-bearing stress also contributes to the condition.

Knee Pain

Knee pain is very common in pregnancy and the reason for the same is simple i.e., added weight of carrying the baby. This is why rest is advised during pregnancy as it helps cope with knee pain by relieving pressure. This is especially true in the later stages of pregnancy as the fetus grows heavy.

To manage these conditions timely and ensure a healthy & happy pregnancy, consult an experienced doctor. Dr. Ruchi Tandon is an experienced gynecologist in South Delhi and also provides the best fibroids treatment in Greater Kailash.

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Cervical infection in women

Cervicitis

Cervicitis is an inflammation of the cervix (the end of the uterus). Cervicitis often does not cause symptoms, but if they do happen, they may include abnormal vaginal discharge, painful intercourse, or vulvar or vaginal irritation. Antibiotics successfully treat cervicitis in most cases. For other cases, laser therapy or surgery may be required.

What is cervicitis?

Cervicitis is an inflammation of the cervix (the end of the uterus). This inflammation may be acute or chronic in nature. Cervicitis might not have symptoms, or a woman with cervicitis may have abnormal vaginal discharge.

Who gets cervicitis?

Cervicitis is very common. It has been projected that more than half of all adult women will have cervicitis at some point. Women who engage in high-risk sexual behaviors and have multiple partners are at a higher risk for cervicitis. Women who have had sexually transmitted diseases, or who have partners who have had sexually transmitted diseases, are also at a higher risk for cervicitis. Sexual practices are far from the only cause of the condition, however.

What are the causes of cervicitis?

There are many causes of cervicitis. Acute cervicitis is usually caused by an infection. Chronic cervicitis is more likely from a noninfectious cause.
Infections can result from the introduction of staphylococcus or streptococcus bacteria into the uterus. The sexually transmitted diseases chlamydia and gonorrhea are also significant causes of cervicitis. It has been estimated as much as 40 percent of cases of cervicitis are related to chlamydia. Herpes simplex virus, trichomonas and mycoplasma genitalium are also sometimes a cause.

Noninfectious causes of cervicitis include exposure to chemicals or

mechanical irritation. These include:

• Chemical irritation from spermicides or douches or the latex used in condoms
• Reaction to diaphragms, cervical caps, tampons or pessaries inserted
• Radiation therapy or systemic inflammatory diseases

What are the symptoms of cervicitis?

Symptoms of cervicitis can include:

• Abnormal vaginal discharge that may be yellow, white, or gray and have an unpleasant odor. This may persist for a long period of time.
• Sexual intercourse may become painful.
• Vulvar or vaginal irritation.

Cervicitis often does not have any symptoms, however. This is one reason why women should have regular gynecological appointments. It is especially important to seek an exam if you notice any of the above symptoms and/or have had chlamydia or another sexually transmitted disease in the past.

How is cervicitis diagnosed?

If you have any of the above symptoms, or if you have engaged in high-risk sexual practices, you should see your Gynecologist for a full pelvic exam. At this exam, your Gynecologist may perform tests including a Pap smear. In this test, a swab is used to collect cells from the cervix and uterus to look for abnormalities.

Your Gynecologist will also take a sample of any vaginal discharge to test for bacteria, such as bacterial vaginosis under a microscope. Tests for the sexually transmitted diseases gonorrhea and chlamydia will also be done.

Your Gynecologist also perform a full manual pelvic exam, looking for:

• Any redness on the cervix
• Discharge
• Blood on the vagina or cervix
• Inflammation of the vaginal walls
You will lay down on an examination table with your feet in stirrups for these tests.

How is cervicitis treated?

If your Gynecologist determines that you have cervicitis, you will usually be prescribed an antibiotic to treat any bacterial infections that may be causing the condition. Women under age 25 or who engage in high-risk behaviors may be treated with antibiotics even if bacteria are not detected in the diagnosis. Some bacteria can be hard to detect but may still be present. You should abstain from intercourse until treatment is done.

Antibiotics successfully treat cervicitis in most cases. If cervicitis is not successfully treated by antibiotics, laser therapy or surgery may be required. Your Gynecologist can best determine the treatment for your cervicitis based on your age, habits, diagnostic tests, and the length of the condition.

Dr. Ruchi Tandon is a reputed Gynecologist practicing in leading hospitals in South Delhi namely Max and Apollo hospitals with over 14 years of experience in handling all kinds of Gynecological conditions including cervical and vaginal infections .

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COVID vaccine in women healthcare

Who should be vaccinated first?

As with all COVID-19 vaccines, health workers at high risk of exposure and older people should be prioritized for vaccination.

As more vaccine becomes available, additional priority groups should be vaccinated, with attention to people disproportionately affected by COVID-19 or who face health inequities.

Who else can take the vaccine?

The vaccine is safe and effective in people with known medical conditions associated with increased risk of severe disease, such as hypertension, diabetes, asthma, pulmonary, liver or kidney disease, as well as chronic infections that are stable and controlled.

Although further studies are required for immunocompromised persons, people in this category who are part of a group recommended for vaccination may be vaccinated after receiving information and counselling.

Persons living with HIV are at higher risk of severe COVID-19 disease. Known HIV-positive vaccine recipients should be provided with information and counselling.

Vaccination can be offered to people who have had COVID-19 in the past. But individuals may wish to defer their own COVID-19 vaccination for up to six months from the time of SARS-CoV-2 infection.

The vaccine can be offered to a breastfeeding woman who is part of a group recommended for vaccination (e.g. health workers); discontinuing breastfeeding after vaccination is currently not recommended.

Should pregnant women be vaccinated?

While pregnancy puts women at higher risk of severe COVID-19, very little data are available to assess vaccine safety in pregnancy.

Nevertheless, based on what we know about this kind of vaccine, we don’t have any specific reason to believe there will be specific risks that would outweigh the benefits of vaccination for pregnant women.

For this reason, those pregnant women at high risk of exposure to SARS-CoV-2 (e.g. health workers) or who have comorbidities which add to their risk of severe disease, may be vaccinated in consultation with their health care provider.

Who should not take the vaccine?

Individuals with a history of severe allergic reaction to any component of the vaccine should not take this or any other mRNA vaccine.

While vaccination is recommended for older persons due to the high risk of severe COVID-19 and death, very frail older persons with an anticipated life expectancy of less than 3 months should be individually assessed.

The vaccine should not be administered to persons younger than 18 years of age pending the results of further studies.

What’s the recommended dosage?

SAGE recommends the use of the Moderna mRNA-1273 vaccine at a schedule of two doses (100 µg, 0.5 ml each) 28 days apart. If necessary, the interval between the doses may be extended to 42 days.

Compliance with the full schedule is recommended and the same product should be used for both doses.

Is it safe?

While this vaccine has yet to be approved by WHO for an Emergency Use Listing, it has undergone review by the European Medicines Agency (EMA) and consequently meets WHO’s criteria for SAGE consideration.

The EMA has thoroughly assessed the data on the quality, safety and efficacy of the Moderna COVID-19 vaccine and authorized its use across the European Union.

SAGE recommends that all vaccinees be observed for at least 15 minutes after vaccination. Those who experience an immediate severe allergic reaction to the first dose should not receive additional doses.

Longer-term safety assessment involves continued follow up of clinical trial participants, as well as specific studies and continued surveillance of secondary effects or adverse events of those being vaccinated in the roll out.
The Global Advisory Committee on Vaccine Safety, a group of experts that provides independent and authoritative guidance to the WHO on the topic of safe vaccine use, receives and assesses reports of suspected safety events of potentially international impact.

How efficacious is the vaccine?

The Moderna vaccine has been shown to have an efficacy of approximately 92 per cent in protecting against COVID-19, starting 14 days after the first dose.

Does it work against new variants?

Based on the evidence so far, the new variants of SARS-CoV-2, including the B.1.1.7 and the 501Y.V2, do not alter the effectiveness of the Moderna mRNA vaccine. The monitoring, collection and analysis of data on new variants and their impact on the effectiveness of COVID-19 diagnostics, treatments and vaccines continues.

Dr. Ruchi Tandon is a reputed Gynecologist practicing in leading hospitals in South Delhi namely Max and Apollo hospitals with over 14 years of experience in handling all kinds of Gynecological conditions including high risk Pregnancy.

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ecurrent miscarriage or recurrent Pregnancy loss

Spontaneous pregnancy loss is a surprisingly common occurrence, with approximately 15% of all clinically recognized pregnancies resulting in pregnancy failure. Recurrent pregnancy loss (RPL) has been inconsistently defined. When defined as 3 consecutive pregnancy losses prior to 20 weeks from the last menstrual period, it affects approximately 1% to 2% of women. This review highlights the current understanding of the various etiologies implicated in RPL, including factors known to be causative, as well as those implicated as possible causative agents. The appropriate diagnostic evaluation, therapy, and prognosis are also addressed.

Spontaneous pregnancy loss is a surprisingly common occurrence. Whereas approximately 15% of all clinically recognized pregnancies result in spontaneous loss, there are many more pregnancies that fail prior to being clinically recognized. Only 30% of all conceptions result in a live birth.

Spontaneous pregnancy loss can be physically and emotionally taxing for couples, especially when faced with recurrent losses. Recurrent pregnancy loss (RPL), also referred to as recurrent miscarriage or habitual abortion, is historically defined as 3 consecutive pregnancy losses prior to 20 weeks from the last menstrual period. Based on the incidence of sporadic pregnancy loss, the incidence of recurrent pregnancy loss should be approximately 1 in 300 pregnancies. However, epidemiologic studies have revealed that 1% to 2% of women experience recurrent pregnancy loss.

Defining RPL as a clinical entity requiring diagnostic testing and therapeutic intervention rests on knowledge of the elevation of risk for subsequent fetal loss and the probability of finding a treatable etiology for the disorder. Although no reliable published data have estimated the probability of finding an etiology for RPL in a population with 2 versus 3 or more miscarriages, the best available data suggest that the risk of miscarriage in subsequent pregnancies is 30% after 2 losses, compared with 33% after 3 losses among patients without a history of a live birth. This strongly suggests a role for evaluation after just 2 losses in patients with no prior live births. An earlier evaluation may be further indicated if fetal cardiac activity was identified prior to a loss, the woman is older than 35 years, or the couple has had difficulty in conceiving.

The high baseline rate of spontaneous isolated and recurrent pregnancy losses in the general population, the lack of consistent definition for RPL, limited access to tissues allowing study of the disorder, and the remarkably good prognosis for live birth among patients with RPL combine to frustrate aims at diagnostic and therapeutic recommendations. At present, there exist a small number of accepted etiologies for RPL.These include parental chromosomal abnormalities, untreated hypothyroidism, uncontrolled diabetes mellitus, certain uterine anatomic abnormalities, and antiphospholipid antibody syndrome (APS). Other probable or possible etiologies include additional endocrine disorders, heritable and/or acquired thrombophilias, immunologic abnormalities, infections, and environmental factors. After evaluation for these causes , approximately half of all cases will remain unexplained.

Genetic Etiologies

Approximately 2% to 4% of RPL is associated with a parental balanced structural chromosome rearrangement, most commonly balanced reciprocal or Robertsonian translocations. Additional structural abnormalities associated with RPL include chromosomal inversions, insertions, and mosaicism. Single gene defects, such as those associated with cystic fibrosis or sickle cell anemia, are seldom associated with RPL.

Appropriate evaluation of RPL should include parental karyotyping. Genetic counseling is indicated in all cases of RPL associated with parental chromosomal abnormalities. Depending on the particular diagnosis, directed therapy may include in vitro fertilization with preimplantation genetic diagnosis. The use of donor gametes may be suggested in cases involving genetic anomalies that always result in embryonic aneuploidy (ie, Robertsonian translocations involving homologous chromosomes).

Anatomic Etiologies

Anatomic abnormalities account for 10% to 15% of cases of RPL and are generally thought to cause miscarriage by interrupting the vasculature of the endometrium, prompting abnormal and inadequate placentation. Thus, those abnormalities that might interrupt the vascular supply of the endometrium are thought to be potential causes of RPL. These include congenital uterine anomalies, intrauterine adhesions, and uterine fibroids or polyps. Although more readily associated with second trimester losses or preterm labor, congenital uterine anomalies also play a part in RPL.

The uterine septum is the congenital uterine anomaly most closely linked to RPL, with as much as a 76% risk of spontaneous pregnancy loss among affected patients. Other Müllerian anomalies, including unicornuate, didelphic, and bicornuate uteri have been associated with smaller increases in the risk for RPL. The role of the arcuate uterus in causing RPL is unclear. The presence of intrauterine adhesions, sometimes associated with Asherman syndrome, may significantly impact placentation and result in early pregnancy loss.

Intramural fibroids larger than 5 cm, as well as submucosal fibroids of any size, can cause RPL. Although congenital anomalies caused by prenatal exposure to diethylstilbestrol are clearly linked to RPL, this is becoming less clinically relevant as most affected patients move beyond their reproductive years.

Diagnostic evaluation for uterine anatomic anomalies should include office hysteroscopy or hysterosalpingography (HSG). Hysteroscopic resection of intrauterine adhesions and intrauterine septa are indicated if these abnormalities are identified. Patients undergoing successful hysteroscopic septum resection seem to enjoy near normal pregnancy outcomes, with term delivery rates of approximately 75% and live birth rates approximating 85%.Myomectomy should be considered in cases of submucosal fibroids or any type fibroids larger than 5 cm. Resection has been shown to significantly improve live birth rates from 57% to 93%.Myomectomy can be performed via open laparotomy, laparoscopy, or hysteroscopy.

Dr. Ruchi Tandon is a reputed Gynecologist practicing in leading hospitals in South Delhi namely Max and Apollo hospitals with over 14 years of experience in handling all kinds of Gynecological conditions including recurrent abortions.