Causes of Different Types of Polyps

There are several types of polyps but the 3 most common include :

1. Hypertrophic polyps which are the most common and often occurs as a result of chronic gastritis.
2. Fundic gland polyps which are the second most common type of polyp and is linked to a genetic disorder known as familial adenomatous polyposis (FAP).
3. Adenomas which are linked to different types of chronic gastritis and is most likely to occur in a person with familial adenomatous polyposis. This type of stomach polyp is most likely to become cancerous.

Signs and Symptoms of Gastric Polyps

Most polyps go by unnoticed for long periods of time. It is often only discovered upon a routine upper GI endoscopy. If a polyp is large, it may cause more prominent symptoms like abdominal pain, nausea and stomach bleeding.

Since polyps can become ulcerated, it is not uncommon to experience symptoms similar to peptic ulcers. Larger polyps may even block the stomach and cause gastric outlet obstruction. This can result in vomiting, constipation and malabsorption of nutrients.

Treatment of Gastric Polyps

Surgery is the main therapeutic measure in treating polyps. There is always a chance of recurrence and patients should be closely monitored in the future. Treatment for other underlying conditions like gastritis is essential in preventing further polyps. Patients with infectious gastritis, usually caused by a chronic H.pylori infection, may find that the gastric polyps will resolve with proper treatment like H.pylori eradication therapy and acid suppressing drugs.

• First pregnancy.
• Hypertension or pre-eclampsia in previous pregnancies.
• Family history, with mother or sisters suffering from hypertension during pregnancy.
• Multiple pregnancies, such as twins.
• Women over 35.
• Women suffering from hypertension or kidney disease prior to pregnancy.

Dangers of High Blood Pressure during Pregnancy

Having high blood pressure during pregnancy can be dangerous for you and your baby.

• High blood pressure leads to less blood supply to the placenta, resulting in reduction of oxygen supply and nutrients to the baby. This may cause growth retardation and low birth weight of the baby.
• Uncontrolled hypertension may lead to preterm delivery. The preterm delivery may be spontaneous or it may become necessary to induce delivery or go for a Cesarean section as the only means of controlling the high blood pressure and complications such as pre-eclampsia and eclampsia.
• Hypertensive disorders in pregnancy can become life-threatening for mother and baby.
• Increased risk of stillbirths.
• Complications and reduced chances of survival of a preterm baby, especially if delivered long before the due date.
• Abruptio placentae is a complication which may develop as a result of hypertension. The placenta separates from the uterus before delivery and can cause severe bleeding in the mother as well as depriving the baby of oxygen and nutrients.
• Increased risk of gestational diabetes mellitus.

Importance of Prenatal Care

• Routine prenatal care is essential because most women do not have any symptoms of hypertension. Routine blood pressure monitoring and testing urine for proteins can detect many such cases and help in better management.
• A woman with known hypertension can reduce chances of complications during pregnancy by consulting her doctor prior to conception and following his advice regarding diet, exercise and medications so that her blood pressure can be brought under control.
• During pregnancy, regular prenatal checkups of known hypertensive women will help to detect and treat any problems that may occur at the earliest. These women may need more frequent checkups than others, with blood pressure, weight and urine for proteins being checked during each visit.
• Regular monitoring of the fetal heart rate and repeated ultrasonography will help to assess the well-being of the baby.

Treatment of Hypertension in Pregnancy

Treatment starts as soon as hypertension is detected.
If you already have hypertension prior to pregnancy and would like to conceive, treatment starts from then on. Your doctor will advise you about weight reduction, if necessary. Rest, proper diet (including a salt-restricted diet) and adequate exercise are important. You may continue with the antihypertensive drugs you are on or the doctor may prefer to change your medications to those most suitable for use during pregnancy.
During your prenatal visits, if your blood pressure is found to be slightly increased and your delivery date is not too near, you may be advised bed rest, either at home or in the hospital.
If the blood pressure becomes too high or symptoms of pre-eclampsia develop, the doctor may have no other choice but to deliver the baby, even if it is preterm, because that is the only definitive treatment for pre-eclampsia.
If no serious complications develop, your doctor may let you carry your pregnancy to term or may prefer to deliver the baby 2 to 3 weeks before your due date to avoid complications which are most likely to develop as you near term.

If you consistently have a systolic blood pressure of 140 or more and a diastolic blood pressure of 90 or more, you will be said to be suffering from hypertension.

Types of Hypertension in Pregnancy

During pregnancy, hypertension can be of 4 types

• Chronic hypertension (essential hypertension).
• Transient hypertension, gestational hypertension, or pregnancy-induced hypertension.
• Pre-eclampsia and eclampsia.
• Superimposed pre-eclampsia.

Chronic Hypertension (Essential Hypertension)

Chronic or essential hypertension is high blood pressure which is present before conception, before 20 weeks of pregnancy and which continues throughout pregnancy and for more than 6 weeks after delivery. Chronic hypertension, at any time, can be dangerous if not controlled properly because of the risks associated with it such as heart attacks and stroke. During pregnancy, it can affect the developing baby, causing growth retardation. If you are planning a pregnancy, it would be ideal if your blood pressure could be brought to a normal level before conception. All through your pregnancy, your blood pressure will need to be monitored carefully so that you do not develop any complications which may harm you or the baby.

Gestational Hypertension

Sometimes, you develop high blood pressure for the first time during your pregnancy, without any previous history of hypertension. This transient hypertension or gestational hypertension usually occurs after mid-pregnancy or in the first 24 hours after birth of your baby, without other signs of pre-eclampsia, but it soon returns to normal following delivery. This type of hypertension needs to be monitored very carefully because it may lead to more serious complications of pregnancy such as pre-eclampsia and eclampsia. It may not always be possible to differentiate it from pre-eclampsia and is then treated as pre-eclampsia. Its importance lies in the fact that it often develops into essential hypertension later in life.

Pre-eclampsia and Eclampsia

Pre-eclampsia is a serious complication of pregnancy where high blood pressure is present along with swelling of the body (edema), especially of the hands and face, and protein in the urine. Pre-eclampsia occurs typically in the first pregnancy, after the 20th week of pregnancy, most frequently in the third trimester, towards the end of pregnancy. This condition may be further complicated by convulsions, occurring without any other cause, when it is known as eclampsia. Both these conditions are potentially harmful for you and your baby, especially because of the risk of preterm delivery.

Superimposed Pre-eclampsia

When pre-eclampsia develops in a woman already suffering from chronic hypertension, it is known as superimposed pre-eclampsia.

With hypertension during pregnancy it is often difficult to determine whether it is essential hypertension, superimposed pre-eclampsia or pre-eclampsia because the blood pressure normally decreases in the second trimester and this decrease may mask the presence of chronic hypertension.

Symptoms of Pre-eclampsia

In most women, hypertension does not produce any symptoms.
The symptoms of pre-eclampsia may be

• Severe persistent headaches.
• Problems with vision, such as blurring or photophobia (sensitivity to light).
• Sudden weight gain over one or two days
• Swelling (edema), especially of the face and hands, present on getting out of bed in the morning.
• Abdominal pain.
• Chest pain.
• Vomiting.

You may have been overweight before you got pregnant or your obesity could be due to excessive weight gain during pregnancy. Obesity, at any time in your life, is associated with various health risks. It increases your risk of suffering from heart disease, stroke, diabetes, hypertension (high blood pressure) and arthritis. Eating disorders and depression occur quite often. Obesity may be a cause for infertility. Additional problems can arise, relating to you and your baby, once you do become pregnant.

Risks of Being Overweight/Obese During Pregnancy

So what are the risks of being overweight or obese during pregnancy?
Excess weight can cause many problems for you and your baby.

Risks for the Baby

• Recent studies have shown that obese mothers are more likely to give birth to babies with congenital heart defects and this risk increases in direct proportion to the level of obesity.
• Growth abnormalities in the baby.
• Obesity increases the risk of giving birth to a baby with neural tube defects such as spina bifida, cleft lip and cleft palate. Taking folic acid supplements may not be enough to prevent this.
• Big baby, often causing difficulty during labor and delivery.
• Birth injuries.
• Stillbirths.
• Increased chances of suffering from childhood obesity.
• Children are at increased risk of developing type 2 diabetes later in life
• Preterm delivery.

Risks for the Mother

• Gestational diabetes.
• Gestational hypertension
• Pre-eclampsia and eclampsia.
• Higher rate of early miscarriage.
• Increased risk of thromboembolism (blood clots).
• Difficult delivery.
• More chances of undergoing a Cesarean section.
• Post-operative complications.
• Postpartum infection.
• Obesity is associated with decreased incidence of breastfeeding.

Prevention of Obesity during Pregnancy

Pre-pregnancy counseling is very important to emphasize the risks of obesity during pregnancy. The need for vitamin and mineral supplements, including folic acid should be explained and screening done for hypertension and diabetes.

If you are planning a pregnancy and are overweight, it would be better for you and your baby if you try and lose weight before conception. In the pre-pregnancy stage you can try different measures for losing weight such as diet control and vigorous exercise.

There is no scope for dieting once you conceive and you will be allowed only moderate exercises such as walking or swimming once you do get pregnant. Remember, even if you are overweight or obese a certain amount of weight gain is mandatory during the nine months of pregnancy. With a healthy diet and moderate exercise you can prevent excessive weight gain during pregnancy.

In the first trimester of pregnancy you may even lose weight, often as a result of morning sickness, but that should not be a cause for concern unless the weight loss is excessive. What is more important is that from the second trimester onwards you should show a steady weight gain. This will indicate that your baby is getting the correct amount of nutrients on a regular basis.

Guidelines for Weight Gain during Pregnancy

As a rule, it is generally accepted that a weight gain between 10 and 12.5 kilograms (22 to 28 pounds) during pregnancy is adequate. However, your healthcare provider will be the best person to guide you regarding your individual requirement.

If you are overweight

You will be considered to be overweight if your BMI is between 25 and 29.9. BMI is a measure of your weight in relation to your height. However, you will still need to gain weight during pregnancy by eating a healthy diet so that you can supply the correct amount of nutrients to your baby. Dieting is not an option during pregnancy. The recommended weight gain during pregnancy for women who are overweight is usually between 7 to 11 kg (15 to 25 pounds). You have to be careful to see that you do not exceed this limit. Another point to remember is that, this weight gain should come from healthy eating and not fast foods. On an average, you should gain 0.2 to 0.3 kg (0.5 to 0.7 lb) per week from the second trimester onwards.

If you are obese

You will be considered as obese if your BMI is 30 or more. Although you are still advised to gain weight, it will be to a lesser degree – 5 to 9 kg (11 to 20 lbs). The weekly gain should be 0.2 to 0.3 kg.

If your weight is normal

If your BMI is between 18.5 and 24.9 before pregnancy, your weight is absolutely within normal limits. You should ideally gain between 11 to 16 kg (25 to 35 lbs) during pregnancy, at a rate of 0.4 to 0.5 kg (0.8 to 1 lb) per week.

If you are underweight

With BMI less than 18.5 you will be considered to be underweight. You will need to gain some extra weight during pregnancy so that your baby’s growth is adequate. A weight gain of 13 to 18 kg (28 to 40 lbs) is usually recommended, with a steady gain of 0.5 to 0.6 kg (1 to 1.3 lbs) per week being ideal.

If you are carrying twins

You will definitely need to gain more weight than normal, but it should not be double the normal amount.

You have to be careful to see that your weight gain during pregnancy is neither too much nor too little. Either can cause problems for you and your baby.

Dangers of Excessive Weight Gain during Pregnancy

• Gestational diabetes.
• Hypertension (high blood pressure).
• Pre-eclampsia and eclampsia.
• Large baby.
• Preterm delivery.
• Leg pain.
• Varicose veins.
• Latest studies suggest that babies born of obese mothers are at increased risk of developing congenital heart defects.
• Increased chances of Cesarean section.

Since it is not possible to go on a diet during pregnancy, if you do gain much more weight than recommended, you can go for simple exercises such as walking or swimming, but only after discussing with your healthcare provider. You may need to reconsider the type of food you are taking and make some diet changes.

Dangers of Less Weight Gain during Pregnancy

• Small baby with low birth weight.
• Premature baby.

A healthy diet and adequate exercise can ensure that you maintain proper weight gain throughout your pregnancy.

It may give you some consolation to know that nearly 80% of pregnant women suffer from nausea and about 50% of them also suffer from vomiting in early pregnancy. After the first trimester (first 12 weeks of pregnancy), morning sickness may not be a problem anymore for most pregnant women, but there are the unfortunate few who continue with this problem till a much later stage or even throughout pregnancy.

Nausea and vomiting starting in the third trimester of pregnancy (the last 12 weeks or so of your pregnancy), although rare, is a possibility. Reassurance from your doctor, emotional support from your partner, and frequent small meals may be all that is needed to help you cope with this problem.

What is Morning Sickness and Why does it Happen?

Although called morning sickness, the nausea and vomiting of pregnancy can overwhelm you at any time of the day. Most women have it in the mornings and recover sufficiently as the day goes by. In others, it may continue throughout the day, often aggravated by the slightest smell of food, or cooking, or any pungent smell.

Why it happens nobody can tell for sure but hormonal factors may be involved. Increase in hormones such as human chorionic gonadotropin (HCG) and estrogen in early pregnancy have been implicated in causing morning sickness. Multiple pregnancies, such as twins, may increase the chances of having morning sickness due to excess of circulating hormones. A low blood sugar or excess thyroid hormones (as in hyperthyroidism) may also play a part. If you have a tendency of vomiting in other circumstances, if you are too stressed out, or if you had this problem in your previous pregnancy, you could be a likely candidate for morning sickness in your current pregnancy.

Does Morning Sickness Harm the Baby?

Apart from making you feel miserable, nausea and vomiting in pregnancy does not really cause any harm to you or your baby unless it becomes really severe and you have dehydration and weight loss because of it. When you develop this condition, called hyperemesis gravidarum, you may be more at risk of having a pre-term labor or a low birth weight baby. However, with timely hospitalization and treatment, especially if your dehydration and weight loss can be corrected, adverse effects can usually be avoided. It has been seen that even with excessive vomiting if you can gain more than 7 kg during pregnancy, there is less chance of complications for the baby.
Uncomplicated nausea and vomiting in pregnancy may actually decrease the chances of miscarriage, but it does not follow that if you do not suffer from morning sickness you are heading for a miscarriage.

How does Breastfeeding help your Baby?

Breastfeeding has so many advantages that it will take a while to discuss all of them. We can start with

• Your baby can be fed as soon as he is hungry. No waiting period, no preparation time.
• This comes with the added advantage that the milk is ready at the correct temperature to be fed to your baby.
• No chance of infection or outside contamination of the milk.
• One of the most important benefits is the immunity against infections that you pass on to your baby through your breast milk during the first few days of his life when his immune system is yet to function properly. The thick yellowish milk secreted in the first few days after delivery is called colostrum, which is rich in immune factors that help to guard the baby against infections.
• Colostrum is also rich in nutrients that are easily digested by the baby.
• The laxative effect of colostrum allows the baby to pass stools easily.
• Respiratory infections and ear infections occur less frequently in breastfed babies.
• Diarrhea is less common and also chances of future development of inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis are much reduced.
• Babies who are breastfed are also protected to a certain degree from diseases such as asthma, diabetes, and childhood leukemia.
• The risk of allergies is reduced.
• Breastfeeding may contribute to reducing the risk of obesity later in life.
• Breastfed babies may have better brain development and have higher IQs than babies who are bottle-fed.
• Breastfeeding reduces risk of SIDS (sudden infant death syndrome).
• An irritable baby often calms down and falls asleep sooner if breastfed.

The list could go on further, but added to this are the benefits that you as a mother can get out of breastfeeding your baby.

How does Breastfeeding help You?

• You can lose weight faster after childbirth if you are breastfeeding.
• The uterus contracts faster as you breastfeed, due to the hormones secreted during lactation, and this prevents excessive bleeding immediately after and in the days following delivery.
• Cost saving – not having to buy bottles and expensive formulas, yet getting the best milk available for your baby, with the least effort.
• It helps you to bond better with your baby and makes you feel happy and relaxed.
• Chances of developing postpartum depression are less when you are breastfeeding your baby.
• There seems to be a protective effect of breastfeeding on development of breast cancer and ovarian cancer, which may be related to estrogen suppression during lactation.
• Menstruation is usually suppressed when you are breastfeeding. You have a natural form of contraception.
• Reduces risk of developing diabetes.
• Reduces risk of anemia.
• Although breastfeeding can lead to osteoporosis (decrease in bone density) if adequate diet is not taken during lactation to replace calcium loss in the milk, studies have shown that feeding your baby can actually decrease the risk of osteoporosis and fractures in later life.

How long can you Breastfeed?

The ideal situation is if you can breastfeed for six months without any supplements. A breastfed baby does not need anything else, not even water. After six months, you can start on semi-solid and solid food but you can still breastfeed your baby till one year or beyond. If for some reason you can only breastfeed for a month or so, even that will be beneficial for you and your baby in the long run.

The signs and symptoms will depend upon the type of abortion.

• In threatened abortion, the symptoms may be mild such as slight bleeding or abdominal cramping. On pelvic examination, the doctor will find a closed cervical os.
• In inevitable abortion, there is likely to be persistent and severe bleeding along with low back pain and severe abdominal cramps, which may not be reduced even with pain relievers. Rupture of membranes may cause a gush of fluid to come out of the vagina. On examination, the os will be found to be open and much dilated and some products of conception may be visible or felt.
• In incomplete abortion, there will be persistent and severe bleeding but abdominal pain and cramps are less. Some products of conception are expelled by the uterus but some are still retained within it.
• In complete abortion, since all the products of conception have come out, bleeding gradually becomes less and pain ceases too.
• In missed abortion, pain is unlikely. There may be a brownish vaginal discharge but os is closed. A missed abortion may be suspected if there is loss of symptoms of pregnancy or a decrease in size of the uterus.
• In infected abortion, there is likely to be fever, chills, foul-smelling vaginal discharge, and pelvic discomfort or pain.

What are the Warning Signs of a Miscarriage?

If you have any of the following signs you should call your doctor –

• Spotting or vaginal bleeding, even if there is no pain.
• Slight bleeding with low back pain.
• Severe bleeding with abdominal pain or cramping.
• Passage of some clot-like tissues or products of conception.
• No pain or bleeding, but passage of a gush of fluid from the vagina.

How is a Miscarriage Diagnosed?

• The doctor will diagnose a case of miscarriage by carefully listening to the history and by doing a physical examination, including a pelvic examination.
• Ultrasonography will help in a definite diagnosis.
• Blood tests – complete blood count (CBC), WBC, blood typing and Rh.
• Qualitative and quantitative HCG (human chorionic gonadotropin).

Complications of a Miscarriage

Immediate and long term complications include -

• Severe and prolonged bleeding may become life-threatening due to excessive blood loss.
• Shock.
• Infection.
• Infertility.
• Perforation of the uterus while doing a D & C.
• Injury to the bladder or intestines.
• Depression or other emotional problems.

Prevention of Miscarriage

• In most cases, miscarriage cannot be prevented, where either the cause is unknown or there is some genetic defect.
• Proper antenatal care and advice and treatment of diseases such as diabetes, hypertension or thyroid problems.
• Avoiding exposure to infectious diseases such as rubella.
• Cerclage procedure in case of incompetent cervix. Stitches are put in the cervix to prevent it from opening too early. The stitches are removed at time of delivery.
• Treating any other causative factor if identified.
• Abstaining from smoking, alcohol and drug abuse.
• Careful assessment and monitoring of women who have recurrent abortion. Starting vitamins and folic acid from at least 3 months before conception may be tried. 3 months spacing between pregnancies is also advisable.

Treatment of Miscarriage

• A threatened abortion can be treated by bed rest, avoiding intercourse and mild sedatives to prevent it from progressing to a miscarriage. Drugs containing progesterone may be of some benefit but opinion is divided about that.
• D & C (dilatation and curettage) is done to ensure removal of all the products of conception from the uterus.
• Blood transfusion may be necessary for excessive blood loss.
• Rh immunoglobulin should be give to Rh negative women after miscarriage, if indicated.
• Control of infection by antibiotics, if necessary.
• Observation for further bleeding.
• Examination of the expelled tissue to ensure complete evacuation of the uterus and to rule out hydatidiform mole.
• Emotional support.

Outlook

Chances of a normal pregnancy occurring after a miscarriage are very good.
There is no reason why you cannot try for another pregnancy after a miscarriage, although a spacing of one month is suggested.
In case of recurrent abortion, a spacing of 3 months between pregnancies is advisable.

Miscarriage brings about not only the termination of pregnancy but also a sense of loss for the would-be parents. It is normal for a woman to feel extreme sadness at this loss but it may become intermixed with feelings of guilt at being unable to continue the pregnancy. It might help you to know that in most cases, the miscarriage could not have been averted since it is nature’s way of not allowing a pregnancy to continue when it is associated with some abnormality within the fetus (usually an abnormal genetic factor). Although a miscarriage can be a very traumatic experience, there is every chance that you will go on to have another successful pregnancy in the future.

Types of Miscarriage

A miscarriage may present in different ways :

• Complete abortion – in this case, all the products of conception (the fetus, placenta and membranes) are expelled from the uterus.
• Incomplete abortion – some of the products of conception, but not all, are expelled from the uterus.
• Early abortion – miscarriage occurring before 12 weeks of pregnancy.
• Late abortion – miscarriage which occurs between 12 and 20 weeks of pregnancy.
• Threatened abortion – bleeding through the vagina may indicate that there is a chance of this pregnancy ending in a miscarriage, but in most cases the danger can be averted and it goes on to continue as a normal pregnancy. The most important sign that the doctor looks for in case of vaginal bleeding in early pregnancy is whether the os (the opening of the cervix) is closed or open. A closed os signifies a threatened abortion, where the pregnancy may be in danger, but there is a good chance that it will continue normally.
  Inevitable abortion – there may be signs of an impending abortion such as bleeding through the vagina with abdominal cramps and in this case the pregnancy cannot be saved. On examination, the doctor will find an open os, with or without some of the products of conception already protruding through the os.
• Missed abortion – despite death of the fetus, the products of conception are still retained within the uterus. This type of miscarriage may not be obvious immediately. It may be suspected when there is loss of pregnancy symptoms and can be confirmed by ultrasonography.
• Infected abortion – there is infection within the uterus or products of conception after a miscarriage.
• Recurrent or habitual abortion – when 3 consecutive pregnancies end in spontaneous abortion.

Risk Factors and Causes of Miscarriage

• Most miscarriages are associated with abnormal products of conception due to some chromosomal abnormalities (genetic defects), such as in a molar pregnancy. A molar pregnancy is an abnormal form of pregnancy where the uterus may not contain a fetus or placenta but is occupied by a hydatidiform mole which resembles a bunch of grapes.
  Blighted ovum – there is a pregnancy sac within the uterus but it does not contain a fetus.
• Ectopic pregnancy – the fertilized egg gets implanted in some other area instead of the uterus, usually in the fallopian tube.
• No cause can be found in a large number of cases.
• Pelvic infection.
• Defects in the mother’s reproductive system such as abnormalities of the uterus or cervical incompetence.
• Immunological factors.
• Hormonal problems.
• Systemic diseases such as diabetes, hypertension (high blood pressure) or thyroid problems.
• Injury – direct injury to the pregnant uterus, either accidental or as a result of physical abuse. Indirect injury may be caused by surgery (such as appendectomy) or electric shock.
• History of previous miscarriages.
• Cigarette smoking, alcohol and drug abuse.
• Increased risk in older women, especially over the age of 35.
• Infectious diseases such as rubella (German measles).
• Prenatal genetic tests such as amniocentesis or chorionic villus sampling.

You are more likely to suffer from postpartum depression and psychosis if you are going through the following situations -

• You have a family history of similar problems.
• You have a family history of psychiatric problems.
• You have suffered from depressive disorders in previous pregnancies.
• Unhappy relationship with your partner.
• The pregnancy was unwanted or you were not prepared for it.
• Events such as recent death of a loved person.
• Stillbirth or death of the newborn baby.
• Baby born with congenital defects.
• Severely ill baby.
• You have feelings of guilt that the baby’s death or illness is somehow your fault, even if that is not so.
• If you are suffering from postpartum depression, chances are that you will suffer from the same problem in your next pregnancies.
• You may be going through financial difficulties associated with loss of employment.

How can you help yourself?

• Remember that postpartum depression is a common problem and many women go through the same condition as you are doing now.
• Do not have any feelings of guilt that you are not a good mother.
• Baby blues occur as a result of changing levels of hormones in your body and is not in your control. Within a few days or so you will most likely be feeling like your old self again.
• Talk to your loved ones and your doctor if you have any concerns about your condition. They are there to support you and help you.
• Take enough rest and sleep well. You owe it to yourself and your baby.
• Your body has gone through a lot of stress during delivery and you might be breastfeeding your baby. Eating healthy nutritious food is a must.
• Read, listen to music, meet your friends. Go for walks. Try to relax.
• Join a support group to meet other mothers who may be going through the same thing.
• Follow your doctor’s advice regarding counseling and medicines.

Knowing that there is a chance of you suffering from similar problems in your next pregnancies, your doctor will be prepared to handle your condition better and the outcome will definitely be good for you and your baby in future situations.