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Role of Estrogen in Pregnancy
One of the most common problems in pregnancy is an extreme imbalance in hormones and this imbalance can lead to numerous problems. One of the most important hormones in pregnancy is estrogen. It plays a huge role in the health and well-being of the mother as well as the development of the baby.
What is Estrogen?
The human body has numerous hormones that help with the development and maintenance of the human body. Two of these hormones are gender dominant – testosterone and estrogen. All humans have both hormones but women have estrogen as their dominant hormone (while men have testosterone as their dominant hormone).
Estrogen is usually produced in the placenta and ovaries for women. One of the most significant forms of estrogen produced by the human female body is estradiol. It is, in fact, the most important hormone for the welfare of your baby’s development. This hormone allows women to get pregnant and thereafter plays a critical role in preventing miscarriages.
What Role Does Estrogen Play During Pregnancy?
Here are some of the roles estrogen plays during pregnancy:
1. Helps Carry a Baby to Term
Estrogen is a major hormone that involves a lot of minor hormones like estradiol which was mentioned above. The estrogen hormones in women are critical as they are produced by the placenta and ovaries and play a pivotal role in seeing the pregnancy to term. They do so by maintaining the uterine lining which provides a safe space for the growth of the baby. They also help regulate other hormones like progesterone which are essential for foetal growth.
2. Impacts the Fertility Prospects of the Offspring
Studies by the University Of Maryland Medical Center show that women who are pregnant and have low estrogen levels can in turn damage the chances of their children being fertile enough to carry a child of their own, the same study shows that having too much estrogen can lead to other fertility issues and increase the chances of your child miscarrying. A balanced and healthy estrogen level will drastically improve not just the health of your child but also their chances of having children of their own.
3. Reduces Foetal Malnutrition
Estrogen is an extremely important hormone due to the fact that it plays a critical role in nourishing the developing foetus into a healthy baby that is ready to come out into the world, having a healthy level of estrogen ensures the foetus is nourished well. Having low or high estrogen during pregnancy can increase the risk of foetal malnutrition.
How is Estrogen Testing Done?
Estrogen tests are done as a part of your pregnancy quad tests, it can also be tested independently regardless of if you are pregnant or not. To test estrogen levels, doctors will draw a little blood and test the blood for components of estrogen called estriol and a protein called alpha-fetoprotein or AFP. They will also test for human chorionic gonadotropin or hCG. By measuring these three aspects through your blood, doctors can accurately gauge your estrogen levels.
Impact of Low Estrogen Level during Pregnancy
Low estrogen during pregnancy can be detrimental to the overall pregnancy and to the kids born, especially females. Low estrogen during pregnancy can lead to:
Miscarriages
Fewer eggs in the female babies born of the pregnancy
Fertility issues in the female babies born of the pregnancy
The outcome is very specific to individuals, so if you have low estrogen levels, it is recommended you talk to a doctor to understand what your specific risks and challenges.
Change in Estrogen Levels and Normal Value Range in Pregnancy
During pregnancy, your hormones will spike and fall, estrogen is no different. Doctors often recommend women don’t check their estrogen too often due to fears that they may panic without a cause. Usually, during pregnancies, doctors will access your estrogen levels regularly and provide a range that is considered healthy due to the fluctuations in the levels of hormones. Here are the normal ranges for each trimester during pregnancy.
First Trimester – 187-2498 pg/ml
Second Trimester – 1276-7193 pg/ml
Third Trimester – 6138-3461 pg/ml
It is crucial to remember that estrogen levels do fluctuate. The ranges provided above are considered safe and you can expect your estrogen levels during pregnancy week by week to radically fluctuate. Do not panic if it is within the range provided above or slightly higher or lower.
If you are concerned about your levels or estrogen and pregnancy risks due to this, we recommend you consult a doctor and ease your fears. Remember, hormonal imbalances are normal during pregnancy and hormonal imbalances can be treated with medication.
Also Read: Role of Progesterone during Pregnancy Read more
Rashmi has added a new answer
Guardian of 0 children
3 hours ago
Q. #asktheexperts what to give children when starting solids?
Rashmi
Mom of a 9 yr 8 m old girl
3 hours ago
A. After completing the time of six months you should start with dal water and rice water followed by all kind of fruits and vegetables porridge khichadi mash banana mash potato mash sweet potato dairy products and varieties made made out of ragi Suji and oats can also be given to your child
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Eating Tulsi (Holy Basil) During Pregnancy
The ancient medicinal school of Ayurveda has long upheld the benefits of tulsi. It is an active ingredient in Indian home remedies, providing relief from various conditions. However, there have been conflicting results in the research conducted with respect to holy basil and pregnancy. Read on to find out whether tulsi is recommended during pregnancy or not.
What is Tulsi (Holy Basil)?
Tulsi or holy basil is a herb that is a part of the mint group. It has green leaves with a distinct aroma, which is sweet and spicy. It is extensively used in soups and salads as a topping due to the flavour it imparts. It is widely available in Asia, Australia and can also be found in other parts of the world due to its popularity. It has also been utilised as a home remedy for various ailments in Indian households for numerous years.
Health Benefits of Eating Tulsi During Pregnancy
Some of the health benefits of eating holy basil during pregnancy are as follows:
Rich in Vitamin A
Vitamin A present in holy basil is essential for the development and growth of the foetus. It promotes the development of your baby’s heart, lungs, eyes, and the central nervous system.
Enables Bone Formation in the Foetus
Holy basil has a good amount of manganese, which supports the formation of the cartilages and bones in your baby. Manganese is also a good antioxidant that reduces the risk of cell damage in pregnant women by minimising oxidative stress in women. Oxidative stress is a process where free radicals damage cells in the body.
Increases Blood Supply
Pregnant women need excess blood to support foetal growth. The folate content in holy basil helps increase the blood supply in your body to meet the requirement during pregnancy. Folate is also found to be beneficial in preventing birth defects in the baby.
Prevents Anaemia
Tulsi is a great source of iron, which is essential to keep pregnant women energised. Iron is helps increase the haemoglobin and red blood cells(RBC) count in your blood. This can help prevent the risk of anaemia in pregnant women.
Immunity Booster
Tulsi is a good source of various vitamins and minerals, which improve immunity in pregnant women. It has a good amount of Vitamin C, Vitamin E, niacin, riboflavin, etc and minerals like potassium, zinc, manganese, copper, phosphorous, and magnesium, which can protect you and your unborn baby against infections. It will also help in the proper development of your baby.
Reduces Aches and Pains
The anti-inflammatory property of tulsi is effective in relieving any aches and pains that are common during pregnancy.
Apart from these benefits, tulsi can also reduce stress and regulate blood sugar levels. Tulsi is also a good remedy for cold and flu and strengthening your lungs.
Side Effects of Eating Tulsi During Pregnancy
Despite the many benefits, tulsi also has a few side effects that may be caused if consumed in excess. Here are some of the risks that eating tulsi may cause during pregnancy.
It is a Hypoglycaemic
Hypoglycaemic substances lower your blood sugar levels. Hence, excess consumption of tulsi during pregnancy may cause dizziness, tremors, and irritability.
It Can Cause Uterine Contractions
Tulsi is known to cause uterine contractions. This is one of the reasons why doctors advise against pregnant and lactating women eating tulsi.
It Has Blood-Thinning Effects
Tulsi is known to induce and intensify blood-thinning and cause long episodes of bleeding. Hence, it is not recommended for pregnant women who have disorders that prevent their blood from clotting effectively.
It Can Cause Various Health Issues
Tulsi contains an oil called eugenol, which can lead to harmful effects when consumed in excess. It can speed up the beating of the heart, cause burning sensations in the mouth and the throat, and also make your breathing shallow. Furthermore, it can cause dizziness, seizures, bleeding during urination, and in extreme cases, lead to a coma.
Can You Have Tulsi Tea?
While there is conflicting information about the consumption of tulsi tea during pregnancy, certain tests conducted indicate that it can help prevent indigestion, vomiting and back pain. One must note that no clinical trials have been conducted regarding these benefits. This is why doctors do not recommend the consumption of tulsi tea during pregnancy.
However, tulsi tea is also known to reduce stress by reducing the production of cortisol hormone by the adrenal glands.
Precautions to Take While Consuming Tulsi
If you would like to avail of the health benefits of holy basil during pregnancy and make it a part of your diet, you will need to take the following precautions to ensure safety for both you and your baby.
Do not consume it in excess. While there is no recommended dosage for adaptogen herbs like basil, herbalists suggest consuming only 115 ml of decoction of the herb three times a day.
Wash the herbs thoroughly before consumption to clear out bacteria or parasites that may lead to food-borne infections like toxoplasmosis and listeriosis.
Always consult a doctor before making tulsi a part of your pregnancy diet.
Tulsi has a lot of benefits that make it a great herbal supplement during pregnancy. However, since its effects on pregnant women and the foetus have not been extensively studied, many doctors recommend women to avoid over-consumption of the herb during pregnancy. In case you are considering consuming it on a regular basis, always discuss this choice with your doctor to understand how it may affect you and your baby, in order to prevent any negative effects. Read more
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Hepatitis B Infection in Pregnancy
Hepatitis is a contagious liver disease that causes inflammation of the liver. It occurs when a person is infected with Hepatitis B virus (HBV). Once infected, the virus can dwell in the person’s body for the rest of his or her life and cause chronic problems. It is important that an expecting woman gets herself tested for Hepatitis B. If the result of the HBsAg test is positive, the doctor should prescribe proper vaccines and medications to lower the risk for her unborn baby.
What is Hepatitis B?
Hepatitis B is the term used for describing inflammation of the liver, and is caused by a virus. It is usually transmitted through body fluids like blood, vaginal fluids or semen. It can be warded off sooner if you have a good immune system. Often, infected people tend to carry the virus leading them to suffer from chronic Hepatitis. It may cause serious damage to the liver. This damage can be slowed down by getting good medical care and following a healthy lifestyle. Hepatitis B may be classified into two kinds:
Acute Hepatitis B Infection
Most adults who are infected have the acute Hepatitis B infection. Their immune system can usually clear the virus from the body in about 2-3 months. In some cases, it may lead to chronic infection.
Chronic Hepatitis B Infection
When one's immune system is incapable of fighting off the acute Hepatitis infection, and it lasts for 6 months or more, it results in chronic Hepatitis B infection. This can lead to major complications such as liver cancer or cirrhosis.
Hepatitis B & Pregnancy
If you are pregnant and infected with Hepatitis B, you hold the risk of passing on the virus to your baby. To prevent such situations, a routine blood test is recommended for all pregnant women to determine the presence of Hepatitis B. A Hepatitis B reactive or HBsAg positive would mean the presence of Hepatitis B virus in the blood. In case you have the virus, there are certain vaccinations which can be administered post-delivery, which protect your baby. There are even some medications and Hepatitis B vaccines in pregnancy, for those whose virus levels are high.
How Common is Hepatitis B?
About 10-15% of the world’s population is carriers of Hepatitis B. It is quite prevalent in India where around 100,000 Indians die from Hepatitis infection every year. Besides, it is one of the major causes of liver cancers, chronic liver disease and cirrhosis.
Pregnant? Should You Be Tested for Hepatitis B?
Some studies have estimated that about 0.8-6.3% of expecting women are tested positive for Hepatitis B. In immune-competent adults, an acute Hepatitis B virus is likely to be cleared soon. But through perinatal transmission of HBV, children carry a high risk of illness like liver carcinoma and liver cirrhosis. About 90% of babies infected at delivery tend to become chronic carriers of the virus. Hence, if you are pregnant, it is necessary to get tested for Hepatitis B infection. If you are infected with HBV, you should focus on preventing transmission of the virus to your baby.
How Does HBV Spread?
Hepatitis B virus is most commonly spread if you come in contact with body fluids like blood, saliva or semen of infected persons. However, it can be difficult to detect the exact cause of HBV, for it takes a long time to showcase its signs. The most common ways in which the virus may spread are:
Medical or dental treatment in a place where sterilisation does not take place properly.
Having a blood transfusion without examining the blood for the presence of the virus.
Mother to child: A pregnant woman, who is infected with HBV, may transmit the virus to her baby during delivery or post-delivery.
Sharing of Needles: Using shared needles or syringes for injections.
Sexual contact: Having unprotected sex with a hep B-infected person.
Through needle injury to persons working in a healthcare division.
Infected blood getting in your body through some open wound or scratch.
Through contaminated needles used for piercing and tattoos.
Sharing a razor or toothbrush with an infected person.
Accidental needle sticks: It is a major concern for those working in healthcare centres and others who come in contact with human blood.
Symptoms of Hep B in Pregnancy
Many times, pregnant women are unaware that they are infected with HBV. It is because symptoms of Hepatitis B are hard to diagnose. They appear at a later stage and may be felt only vaguely. The symptoms become noticeable almost 2-3 months after being infected by the virus. Although, there are cases where some of the signs tend to come and go. Some of these include:
Abdominal pain
Fatigue
Nausea
Stomach ache
Diarrhoea
Vomiting
Loss of appetite
Jaundice
Fever
Difficulty in breathing
Effect of Hepatitis B on Pregnancy & Baby
Generally, if you are infected with Hepatitis B in pregnancy, it doesn't have any adverse effect on the unborn baby. But this depends on the viral load in your blood. If the level is high, there are slight chances of your baby getting affected before birth. In case of acute infection, there are increased chances of low birth weight and premature birth, whereas, for the mother, the possible effects of HBV infection include gestational diabetes mellitus and antepartum haemorrhage.
The baby is at utmost risk during the delivery as he is exposed to maternal blood and faeces. If the baby gets infected at that stage and goes untreated, he is at risk of developing a lifelong liver disease. Hence, it is essential that the mother gets Hepatitis B therapy while pregnant, to lower the risk of passing on the infection to the baby.
Can You Breastfeed with Hep B?
In normal cases, breastfeeding by an infected mother does not stimulate the transmission of HBV to the baby. Although HBV is found in breast milk, researchers state that it is safe for an infected mother to nurse her baby. It is because the baby is already exposed to the virus at delivery and hence, immunised at birth with hep B vaccinations. But it is strictly recommended that the mother take good care of her nipples throughout the period of breastfeeding. If the nipples crack or bleed, there arises the risk of transmitting HBV to the baby through blood. In such cases, the mother should bottle-feed the baby with either the expressed milk or formula milk until the nipples heal.
Risk of Mother to Baby Transmission
A pregnant woman is usually recommended to get HBsAg test done. For, if she is infected with HBV, there is a high risk that she may pass on the virus to the baby. There are three main ways in which transmission of HBV may take place. These are:
Transplacental Transmission of HBV In Utero
In general, it is difficult for the virus to cross the placenta in the womb. However, there are cases, when it may happen. The possible causes for intrauterine transmission of Hepatitis B virus are listed as follows:
A breach of the placental barrier
Placental infection
Transmission During Delivery
The baby is at optimum risk of catching the Hepatitis B virus from the mother during this period. The reasons for transmission of HBV during birth are:
Exposure to the cervical secretions of the infected mother
Exposure to maternal blood containing the virus
Postnatal Transmission During Care or Through Breastfeeding
Breast milk of an infected mother does not pose a risk to the infant but bleeding nipples can infect the baby. It is recommended that the mother safeguard her nipples while breastfeeding. She should ensure proper latch-on and allow the nipples to dry to avoid cracking or bleeding as HBV can be transmitted through blood.
Treatment of Hepatitis B in Pregnancy
When you are tested positive for Hepatitis B in early stages of pregnancy, doctors may recommend certain blood tests. Depending on viral load in your system and whether it’s acute Hepatitis b reactive or a chronic one, you may be prescribed a shot of the vaccine Hepatitis B immune globulin (HBIG). This vaccine contains antibodies against the Hepatitis B virus and thus, gives additional protection. In case, your condition is serious, the doctor may advise on conducting a liver biopsy, to determine if your liver has been damaged. As per the severity of your infection, you may be required to undergo following treatments:
Antiviral Medications
There are certain drugs that have been approved by the FDA for treatment of Hep B in pregnancy. These antiviral medications are prescribed when your liver is not working well enough and the peginterferon alpha 2a injection is not suitable for you. The side effects include vomiting, feeling sick and dizziness. These drugs have to be taken as per doctor’s advice.
Peginterferon Alpha 2a or Interferon Alpha 2b
It is the initial medication offered if your liver is fairly well. It is also a solution for those not willing to undergo long-term treatment. Doctors recommend it once a week for up to 48 weeks. It stimulates the immune system to fight and regain control over the HBV. It has some common side effects like fever, joint pain and other flu-like symptoms. Some may also experience chest tightness, depression and difficulty in breathing.
Liver Transplant
Liver transplant is the last option, when your liver has been severely damaged and no other treatment would work. During the liver transplant, the surgeon replaces your damaged liver with a healthy one.
Hepatitis B & Pregnancy Complications
Hepatitis B is an endemic liver infection, caused when the person is infected with Hepatitis B virus. For most adults with strong immune system, recovery is within 2-3 months. But for those women for whom the infection has lasted for about 6 months, it results into a chronic Hepatitis B. This increases the risk of permanent scarring of the liver. Certain complications may develop as indicated below:
Acute fatty liver
This condition arises when you have had the infection for a long period and the liver has been affected by cirrhosis. The increased demands on your liver during pregnancy causes this additional health issue. Sometimes this condition may escalate and become severe. In such case, you will require immediate medical intervention and may be suggested early delivery. It is recommended you pay attention to your diet and intake foods that are liver friendly.
Gallstones (cholelithiasis)
It is found among approximately 6% of pregnancies. This occurs due to change in bile salts during pregnancy. In a pregnant woman, the gallbladder slows down. As a result, the emptying process happens slowly and causes collection of bile salts for a longer duration. This condition can cause jaundice or may worsen, where removal of gall bladder becomes necessary.
Cirrhosis
Cirrhosis defines scarring of the liver and affects one in five people suffering from chronic Hepatitis B. Its symptoms get noticeable very late when extensive damage has already been done to the liver. At such a stage, it causes weight loss, sickness, itchy skin, swelling in the tummy and ankles, loss of appetite and fatigue.
Hepatocellular carcinoma or Liver cancer
One in 20 people suffering from cirrhosis have the potential to develop liver cancer. Symptoms for liver cancer include feeling sick, unexplained weight loss, jaundice and loss of appetite.
Liver failure
This condition arises when almost all the vital parts of the liver stop functioning. In such a case, liver transplant becomes mandatory to sustain life.
Fulminant Hepatitis B
In some cases, acute Hepatitis B can get elevated to a serious problem of fulminant Hepatitis B. This is a rare condition and it happen s about 1 in 100 cases. In this circumstance, the immune system itself attacks the liver and causes serious damage, requiring prompt treatment. Its symptoms include severe jaundice, delirium, collapsing and swelling of the tummy.
Precautions for Hepatitis B While Pregnant
Hepatitis B vaccines are available to guard the babies against being infected by Hepatitis B. Those are given to them as per the routine vaccination schedule for babies. Apart from the vaccinations, there are general precautionary measures to be considered. It is advisable that the following points are taken seriously, so that you can reduce the risk of getting infected.
Know the HBV status of your partner
It is highly recommended that you stay away from unprotected sex, unless you are sure that your partner is clear from all infections.
Use a latex or polyurethane condom during each intercourse
If you are unaware of the HBV status of your partner, try not to rely completely on any condom. Though condoms can reduce the transmission risk, there can be exceptions. Prefer only the branded ones and use a new one for each time.
Avoid using illicit drugs
Keep away from taking unnecessary drugs without doctor’s prescription. Even if you have to take the injection, ensure that you use a sterile needle. Do not share the used needles.
Be careful about piercings or body tattoos
If you wish to get any piercings or tattoo done on your body, prefer a reputed centre. Ask in detail about the equipment used and its cleaning methods. Make sure that sterile needles are used. If not, you should look for other options.
Don’t share personal belongings
Do not share razor blades or toothbrushes, as they might carry traces of infected blood. Any open sores, abrasions or cuts should be immediately covered with a waterproof dressing.
Enquire about Hepatitis b vaccine before your travel
When planning to travel to someplace, where Hepatitis B is common, consult your doctor regarding hep B vaccination.
Post Pregnancy Follow-Up
At the time of birth, the baby should be given two injections, which are a dose of Hepatitis B and a dose of Hepatitis B immune globulin. These shots should be administered within the first 12-hour period immediately after delivery. With these two injections, there is a 90% chance of protecting the baby against lifelong Hepatitis B infection. Apart from these doses, two more doses are given. One is given at 2-3 months of age and the next at 6 months. Babies born to an HBsAg-positive mother, should be strictly followed up for medical review. This follow-up should be timed after 2 months of initial immunisation course, which lasts for 8 to 12 months. During this follow-up, the baby's blood should be tested for presence of Hepatitis B virus. If the mother is infected, she needs to be followed up post pregnancy every 12 months. This is done to assess their viral markers and liver functioning.
Conclusion
Prenatal care to check the risk of such infections is a must for every pregnant woman. Even if they are previously vaccinated or tested, a mandatory test for the virus in the first trimester is an absolute essential. Read more
Rashmi has added a new answer
Guardian of 0 children
3 hours ago
Q. can I take gevocet m during breastfeeding
Rashmi
Mom of a 9 yr 8 m old girl
2 hours ago
A. Please check with your doctor they will be able to confirm whether you can take this medicine or or not as a Dr who have a fair idea and they will know for what thing you are willing to take this medicine so whatever doubt you have associated there be able able able to clear it up for you
Rashmi has added a new answer
Guardian of 0 children
3 hours ago
Q. can I take zanocin 200 during breastfeeding
Rashmi
Mom of a 9 yr 8 m old girl
2 hours ago
A. I’m not aware about what medicine it is for I can only tell you that these basic medicines you can take throughout your lactation it’s not a problem the medicines that you could take before your pregnancy can always be taken during the time of lactation
Rashmi has added a new answer
Guardian of 0 children
3 hours ago
Q. #asktheexpert mam iam 33 weeks now when can I expect delivery date
Rashmi
Mom of a 9 yr 8 m old girl
2 hours ago
A. The basic delivery date is normally 39 to 3 40 weeks of your pregnancy whenever you are ready for your delivery and whenever you hit your labour that’s going to be the right time for you further move your Dr is going to tell you when are you going to deliver with the help of an ultrasound
Rashmi has added a new answer
Guardian of 0 children
3 hours ago
Q. iam 33 weeks pregnant now
Rashmi
Mom of a 9 yr 8 m old girl
2 hours ago
A. What is your question associated with your pregnancy that you haven’t mentioned clearly can you please repost your question providing all the necessary details so at least I know and understand what are you willing to ask and accordingly I can give you help and assistance on that
Jennifer has added a new answer
Expecting Mom due in 3 months
1 hour ago
Q. I am 23 weeks 1 day pregnant. I was feeling the movements actively until today. Baby movements were not that good or maybe I didn’t feel it that way today. Is it a cause of concern? Should I wait for a day or two or should I go and see my gynaecologist?
Please suggest!
Read moreJennifer
Mom of 6 children
31 mins ago
A. please consult ur gynae asap.
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