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Double Marker Test in Pregnancy
A woman has to undergo a lot of tests during pregnancy. Some tests are conducted to ensure the good health of both the mother-to-be and the baby. Doctors usually recommend other tests if they seem to suspect any problem. The double marker test falls under the second category.
What Is a Double Marker Test?
A double marker test is a specific type of blood test that is conducted to detect any chromosomal abnormalities in the baby. Having any abnormalities in the chromosomes can lead to severe health conditions and disorders that can affect the baby’s growth within the foetus, or even later in life. With the help of this test, one can know beforehand about the presence or possibilities of certain disorders like Down’s syndrome, Edward’s syndrome, etc.
The double marker test is usually performed in the first trimester of pregnancy, i.e., between 8 and 14 weeks of pregnancy. It is generally recommended to women who are above 35 years of age because they are at a higher risk of giving birth to babies with defects. However, younger women are also asked nowadays to undergo this test, especially the ones who have a history of congenital disabilities in their family.
What Are the Advantages of Double Marker Test?
The double marker test helps detect chromosomal abnormalities in the foetus. But this is just one of the reasons for conducting this test. Some other reasons why doctors suggest this test are mentioned below:
The double marker test is a very reliable test, and most of the time, it helps detect any abnormalities or issues accurately.
In case the test results are positive, i.e., the chromosomal abnormalities are detected, further diagnostic procedures or measures can be undertaken to pinpoint the problem. This test helps identify the anomalies soon.
Doctors usually recommend an advanced test to check for Down’s syndrome or Edward’s syndrome in the baby once this test is conducted. Performing this test, helps a doctor identify a problem and provide the necessary course of treatment before it becomes too late.
In case the test results are positive, and a neurological condition is diagnosed, you can choose to terminate the pregnancy without complications, in the early stages of pregnancy.
How to Prepare for the Test
As double marker test is essentially a blood test, no specific preparations will be required from your end. However, if you are on any medications during pregnancy, inform your doctor about it. In rare cases, you might be advised to stop taking the medication until the test is undertaken. Also, if you have any allergies or medical conditions, do let your doctor know about it.
How Is This Test Performed?
The double marker test is a blood test which is performed with an ultrasound. Once the blood samples are acquired, they are observed to check the levels of the hormone free-beta hCG and pregnancy-associated plasma protein A (PAPP-A). This glycoprotein hormone is developed during the pregnancy by the placenta. The high levels of the free-beta hCG indicate a higher risk of Down’s syndrome. On the other hand, low levels of protein pose a risk of Down’s syndrome.
How Are the Test Results Interpreted?
The double marker test results usually fall into two categories: screen positive and screen negative. The results of the test do not merely depend on the blood samples but also on the age of the mother and the age of the foetus as observed during the ultrasound. All these factors work together in determining the result. The results are presented in the form of ratios. A ratio of 1:10 to 1:250 is termed as a “screen positive” result, which lies in the high-risk zone. A ratio of 1:1000 or above is termed as a “screen negative” result, which poses a low risk.
These ratios are pointers for understanding the probability of the baby suffering from a disorder. Each ratio depicts the chances of the child having a disorder, over a number of pregnancies. A 1:10 ratio means that 1 child out of 10 pregnancies has a chance of developing a disorder, which is quite high. A 1:1000 ratio means 1 child out of 1000 pregnancies will have the disorder, which is negligible.
In case the test result is positive, your doctor, based on the ratios, might recommend you further diagnostics, mainly amniocentesis or chorionic villus sampling.
What Are the Normal Values of the Test?
The normal range of the double marker test is depicted as follows.
Marker
Age
Quantity
Free-beta Human Chorionic Gonadotropin
All Age Groups
25700 to 288000 mlU per ml
Are There Any Disadvantages of Double Marker Test?
The disadvantages of this test are not known. Since doctors recommend this test only when they deem it essential, it may not be available in all the cities. If your doctor advises this test, you might have to travel to another city for the same.
What Is the Cost of the Test?
The cost of double marker test will vary across cities and hospitals. The test would cost somewhere between Rs. 1000 and Rs. 5000. The average cost of this test is about Rs. 2500 in many cities.
While pregnant, you pray for nothing more but good health of your child. To ensure that your baby is healthy and grows up to lead a normal life, you must follow a balanced diet, incorporate necessary lifestyle changes, and make the right efforts to keep yourself and the baby safe. However, there are chances that even after doing the right thing, the test results could point towards the presence of a disorder in the baby. In such a case, you should discuss with your spouse whether you want to keep the baby or not. The decision to terminate the pregnancy would obviously be hard to make, but you should consider the consequences. If you can’t come to a conclusion, consult with your doctor, he will suggest what you should do.
Also Read:
Triple Marker Test During Pregnancy
Quadruple Marker Test in Pregnancy
Screening and Diagnostic Tests in Pregnancy for Birth Defects
Sequential Test while Pregnant Read more
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30 Diwali Wishes For Your Loved Ones
Wishing friends and family on festivals has changed over the years and evolved from greeting cards to instant messaging apps. We all get Diwali wishes from everybody and in turn, we wish everyone happiness on Diwali. But if you always send the same-old Diwali wishes, it’s time you get creative and send some unique Diwali wishes or quotes to your close family and friends! We bet receiving a thoughtful Diwali wish (in the form of text also) from you will bring a smile on the face of your loved ones. So try out some of our picks to leave a memorable impression on your dear ones!
Diwali Wishes for You to Share
Diwali is around the corner, and what better way to celebrate it than sending out the classic Happy Deepavali messages to your friends and family! Here’s a quick collection of quotes for Diwali wishes you can send to your near and dear ones.
15 Diwali Wishes and Messages for Friends
Friends have a special place in our lives - they make our lives fun and interesting! This Diwali, let your friends know that you are thinking of them by sending them thoughtful Diwali wishes. If you are looking for some Diwali wishes for your best friend, then read on, because we have some specials ones too!
This is to formally announce that I have started accepting Diwali gifts in cash, cheques & credit cards. Avoid last day rush, my bestie. Send me money, now!
This Diwali, I’m sending you CASH – Care, Affection, Smile, and Hugs!
7 days
168 hours
10080 minutes
604800 seconds are left...
I think I am the first person to wish you a very HAPPY DIWALI.
Let’s celebrate the auspicious day of Diwali with fun and frolic. May this bright day bring joy and prosperity in your life. Have a great day and a great year ahead!
Let’s overcome the darkness and celebrate the victory of the good over the evil with the light of our diyas, with good faith, by praying to Goddess Lakshmi and Lord Ganesha, and with the happiness and warmth in our hearts. Diwali is a festival of lights that brings families together. And you are my family - have a Happy Diwali my friend!
Hello, my dear friend! Here’s wishing you and your family a very happy Diwali!
May the sparkling diyas and the sound of firecrackers fill your life with moments of happiness. May you have a wonderful time with your family this Diwali!
I hope this Diwali, you will be blessed with success and wealth. Have a Happy Diwali!
Best friends are those who help their friends whenever they need help. So don’t worry I am coming to your house in the evening! I will help you burst all the firecrackers you have purchased! Happy Diwali, friend!
Wishing you a very Happy Diwali! Eat ladoos and papdi, and enjoy with your family!
Wishing you a very happy and prosperous Diwali. May this festival of lights bring happiness and light in your life!
May this festival of lights, illuminate your future and you have a great life ahead. Happy Diwali!
May the sweetness of the mithais you eat this Diwali always stays in your life. Enjoy the festival of lights with your family!
Open the doors and welcome Goddess Lakshmi in your house. It’s Diwali! Have a shubh Deepavali.
I am sending out the brightest wishes for you and your family this Diwali! Hope you all have a great year ahead.
15 Diwali Wishes and Quotes for Family
Diwali is a festival which brings families together. Whether you are with your family or away from them, you can always send a sweet Diwali quote to them. Yes, you can always call them up but there is something special about sending heartfelt messages. So this Diwali, send meaningful Diwali wishes to your loved ones and let them know how much they mean to you!
May this Deepavali brings joy and prosperity in your life. Have a shubh Deepavali!
I wish that the happiness and brightness of Diwali fill our lives with joy, success, fortune and lots of time for each other.
The festival of light is full of delight,
With this text,
Let me double the charm of your Diwali night!
Happy Diwali!
I hope that you attain success and bliss on this auspicious day. Have a Happy Diwali!
May the divine light of Diwali brings peace, prosperity, and pleasure in your life.
Diwali is a festival of lights,
It is a festival that brings back sweet memories,
It is the time to spend time with family,
And you are my family. Happy Diwali!
Diwali is a festival of sweet memories,
It is a festival of lights and firecrackers,
It is a festival about eating delicious sweets,
And a festival about family.
Happy Diwali, my dearest family!
Happiness is all around and so is pollution. This Diwali, let’s not burst firecrackers, and spend some time together. Diwali is not just about bursting crackers, it is also about showing some love and care and wishing everyone out there. Happy Diwali!
Wish you all a very happy Diwali. I hope that this Diwali, we all change for the good and be better versions of ourselves!
May you get everything you want on this auspicious and pious occasion of Diwali.
To my sweet family, wishing you all a very happy Diwali. Celebrate this festival of lights by eating lots of sweets!
To dear family, happy Diwali wishes for all of you. I pray this Diwali be the best of all for you and let it bring in success in all our lives forever.
My dear family, I hope all of you are celebrating this festival by bursting crackers and eating gujiyas, mathris, and namkeen.
May Lord Ganesha and Goddess Lakshmi shower their blessings on us this Diwali. Have a happy Diwali!
May the warmth and splendor that are a part of this festival, fill your life with happiness and cheer, and bring success and prosperity in your life for the whole year. Happy Diwali!
Double the joy of this festival of lights by sending good wishes to your friends and family. Send your heartfelt wishes to everyone and make their Diwali an unforgettable one!! And here’s a Happy Diwali from us! Read more
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Cholestasis of Pregnancy: Causes & Cure
A pregnant woman faces many challenges on a regular basis, some common, and others not. The entire body can be under threat to numerous diseases when you are pregnant. This is due to the immune system being overloaded and weakened as a result of the increased production of hormones. Cholestasis during pregnancy can be a difficult disease to manage.
What is Cholestasis
Also known as obstetric cholestasis, it is an uncommon condition that occurs during pregnancy and affects the liver, causing itching in pregnancy. It results in the affected woman feeling itchy and affects one in 70 pregnant Indian women. This condition causes the blockage of the normal flow of bile in the body. Medical practitioners now prefer to call it intrahepatic cholestasis of pregnancy or ICP.
Because the flow of bile is blocked, the bile builds up in the liver. The bile then begins to leak into the bloodstream particularly the bile salts. When this happens, it makes the skin extremely itchy especially of the hands and feet. It usually manifests in the last trimester of the pregnancy. While this condition does not seem to have any long term effects on the mother’s health, it can cause severe complications for the infant.
What are the Causes of Obstetric Cholestasis (OC)?
There aren’t any clear reasons as to why cholestasis of pregnancy occurs. However, there are hypotheses that hormonal and genetic factors might play a role.
1. Hormonal Factors
Some women might be highly sensitive to the changes in hormonal levels caused due to their pregnancy. The increase in oestrogen and progesterone affects the liver in a way that slows down the bile as it flows through the tiny ducts.
2. Genetic Factors
Women who have obstetric cholestasis in their family history have more chances of developing the condition themselves. This is because it seems to be inherited though it is known to skip generations. These women may have inherited a problem in the way the bile is produced and moved through the body. While this problem does not manifest otherwise, a change in the hormone levels during pregnancy could cause the condition to flare up.
Other reasons for the development of this condition include disease, infection and certain medicines.
What are the Symptoms of Obstetric Cholestasis in Pregnancy?
The following cholestasis liver disease symptoms may be present if you are suffering from OC during your pregnancy:
Itching: This is the primary symptom of the condition and often affects the palms of your hands and the soles of your feet. The itching because of cholestasis itching will be worse at night though there will be no rash.
Jaundice: This is a rare symptom of OC. Your eyes and skin might turn yellow which is an indication of jaundice.
Dark urine : Urine passed by a pregnant woman suffering from cholestasis will be dark in colour
Light coloured stools : Stools will be lighter in colour than normal/regular stools.
Tiredness: Cholestasis can leave a pregnant woman feeling drained and out of energy.
Loss of appetite: Cholestasis affects hunger and eating schedule.
If you experience intense itching around your feet and palms, do talk to your doctor immediately. Obstetric cholestasis can cause severe complications to the health of your baby and if you have this condition, then you and your baby will be monitored closely.
Risk Factors for Obstetric Cholestasis
There are many factors that can increase the risk of the condition manifesting in pregnant women. These include:
If a woman has multiple pregnancies, she will have higher chances of developing OC.
Any previous history of liver disease or injury could increase the chances of the manifestation of OC.
Family history can be an indicator of the condition.
What are the Complications of Cholestasis of Pregnancy?
Cholestasis of pregnancy affects both the mother and baby though it affects the health of the baby more so. Here are some of the ways in which cholestasis of pregnancy can cause complications.
1. Complications for Mother
The effect of cholestasis on the mother is usually non-life threatening. The condition can temporarily affect how the body absorbs fat-soluble vitamins though this will hardly affect her nutrition. The itching usually resolves itself within a few days after delivery and the condition does not cause any long term effects on the liver.
2. Complications of unborn baby
Obstetric cholestasis causes the baby to be born prematurely though the exact reason why is unknown. The foetus has a liquid known as meconium that could leak into the amniotic fluid. If the foetus then inhales the meconium during delivery, she will have complications with her breathing. The condition could also cause foetal demise in late pregnancy. Due to the high chances of stillbirth due to obstetric cholestasis, your doctor might want to induce labour by the 37th week.
Diagnosis and Test for Cholestasis in Pregnancy
Your doctor will suggest a blood test for detecting obstetric cholestasis called liver function test or LFT. Apart from this, she could also ask for a fasting serum bile acid test. If tests are negative but the itching continues, they must be repeated.
Your doctor might also suggest an ultrasound to detect obstetric cholestasis. This could rule out gallbladder stones. Other tests to rule out abnormal liver functions like viral hepatitis, Epstein Barr virus, and cytomegalovirus are conducted before a diagnosis of OC can be made.
While all these tests may seem intimidating, you must remember that they are not complicated and are extremely useful for helping maintain the health of your baby.
What are the Treatments for Obstetric Cholestasis?
Your doctor will recommend treatments that will reduce the itching and spread of the condition and avoid the risk of stillbirth. The treatments include the following methods:
Urodeoxycholic acid is administered for the itching and to restore the liver back to normal functioning.
In cases of extreme cholestasis, your doctor will administer steroids.
The leaking bile salts will cause a loss of Vitamin K which is required for blood clotting. Thus, Vitamin K supplements can be prescribed
As soon as the baby develops lungs, your doctor will be ready to induce labour to avoid stillbirth. This is usually between week 35 and 38.
Are There Any Natural Remedies for Obstetric Cholestasis?
Many women find that relaxing provides relief. You can use the following methods, particularly at night, so that you can fall asleep easier.
Lower the temperature of the room by cranking up the air-conditioning.
Do not use a blanket and stay uncovered while you sleep.
Take a cool shower or bath right before bedtime.
Soak your hands and feet in ice water for a while.
Some women have also found that using a mild moisturising lotion has provided them with some relief. Using a lotion with menthol in it has helped others. Before you do use any lotion, have it green lighted by your doctor. Other remedies include:
Eat a healthy and balanced diet with minimal oily and fatty food to reduce the pressure on your liver.
Use only mild soaps so as to not further irritate your skin.
Wear loose clothing to let your skin breathe.
How Can You Prevent Potential Complication of Obstetric Cholestasis?
Due to the complications posed by obstetric cholestasis, your doctor might recommend close monitoring of your baby. These measures may include:
1. Non-Stress Tests and Biophysical Profile Scores
Through this test, you medical practitioner will monitor how much your baby moves at certain times and how much her heart rate increases with the movement. The scores of the biophysical profile will give your doctor information about the volume of amniotic fluid as well as foetal muscle tone and activity.
2. Inducing Early Labour
Even if all the prenatal tests offer normal results, your doctor will recommend that she induce early labour by the 37th week. Since it is near impossible to predict when foetal death can occur, it is best to opt for early delivery.
FAQs
1. Will the Mother Get Obstetric Cholestasis in Another Pregnancy?
The chances of a pregnancy with obstetric cholestasis occurring after a previous pregnancy with the condition are very high. If the condition occurs in your family, you too could have a pregnancy with this condition.
2. Will My Baby Get Delivered Early, If I Have Obstetric Cholestasis?
Since chances of stillbirth in this condition are very high, your doctor will recommend inducing labour between the 35th and 38th week. This is usually done around the 37th week.
3. What Happens after Labour & Childbirth?
Your doctor will take the following measures to ensure that yours and your little one’s health stays uncompromised after childbirth.
A vitamin K injection will be administered to your baby to ensure that she doesn’t bleed out.
You will have a follow up liver test after six to twelve weeks to check the health of your liver and rule out the presence of OC.
An ultrasound will be done to rule out gall stone formation.
You will not be given birth control pills that have oestrogen in them. Talk to your doctor about other options for contraception.
Obstetric cholestasis can be an uncomfortable condition for you, and can cause serious complications for your baby. Keep a note of all your symptoms and keep your medical practitioner in the loop. Maintain all appointments with her to ensure the safe delivery of your baby. Talk to your doctor about solutions for the itching and make sure you keep yourself stress free to relieve your discomfort. Read more
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Insomnia: Sleepless Nights during Pregnancy
Pregnancy insomnia is a common phenomenon during the third trimester. Cope with it by maintaining a proper sleep and nap routine, doing exercises and avoiding caffeine. Avoid taking any sleeping pills and cut off your alcohol intake to have a sound sleep at night during pregnancy.
A sound and comfortable sleep becomes a rare treat for a pregnant woman as she starts getting leg cramps, feels too tired to sleep, has to wake up frequently for peeing and the heavy abdomen has her tossing and turning to find the comfortable position.
This lack of sleep then leads to more tiredness and restlessness during the days and nights that follow. Here are some facts to help you deal with the problem and get a good night’s sleep:
Causes of Insomnia during Pregnancy
Painful and irritating conditions such as frequent urination, persistent heartburn, leg pains and anxiety combined with the rush of hormones makes it difficult for a pregnant woman to sleep at night.
Dealing with Insomnia during Pregnancy
Do not worry, as insomnia can't hurt you or your baby. Just let go off your worries and try to calm your mind to take as much sleep as you can.
Drive away all negative feelings, talk to your partner about it and try to sort it out during the daytime so that you can sleep tension-free at night.
Eat slowly and chew well. Take enough time at dinner and do not just eat to finish up. Maintain a pace so that you do not have to suffer from heartburn while you sleep.
Avoid having dinner too close to bedtime. A stomach full of food will make you feel energetic, and thus it will be uncomfortable for you to fall sleep.
Limit your intake of caffeine and chocolate during the day and completely avoid it after dinner or late in the evening. They tend to keep you awake.
Eat a light and healthy dinner rich in fibre that will help you sleep better till morning.
In order to cut down on your washroom visits during bedtime, try to consume most of your fluids during daytime so that you do not have to wake up in the middle of the night.
Do try some pregnancy related exercises that make you a little tired at the end of the day, but avoid doing them when you are about to hit the bed.
Try to lull yourself into sleep mode by following a bedtime ritual of having a warm water bath and drinking a cup of warm milk before you go to bed.
Follow a proper bedtime routine and try to go off to sleep and get up at the same set time every day. Read a book, listen to some soothing music, or watch a movie until drowsiness sets in.
Avoid taking any sleeping pills or alcohol to drive away your insomnia. These are dangerous during pregnancy.
So follow these tips to deal with insomnia during pregnancy and fall asleep naturally. You can use as much sleep as you can get now before the baby arrives. Read more
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An unexpected baby...
An unexpected,thrilling, painful journey of my pregnancy.
So my pregnancy was really unexpected.I got pregnant after one month of my marriage. I was stern that I was not pregnant when my mom asked me to do a pregnancy test when she noticed some of the symptoms. I had high fever which according to some local myths in my place meant pregnancy. So I did a pregnancy test and after sometime I did not see any line.This made me super happy but later it was all in vain as two faint lines started to come.My mom shared the news with my husband.But this made him sad as he felt he had some wrong to me coz we have planned to start a family after my studies.It was hard to convince my husband that I was happy to be a mom and not to feel guilty. We visited a doctor to confirm but as my Hcg result was much lower she did not gave us much hope and told to visit after one week.This really made me sad and prayed for nothing to happen.After one week we once again visited and she showed us the tiny heart which was growing inside me.Pregnancy was really a tough journey for me as I had vomiting till 7th month of my pregnancy.I was hospitalized most of the time.As the days passed I was really excited at the same time scared.Then one day as I was getting ready to walk outside my mother noticed that my dress was drenched in water.When checked my water has been broken. But I did not feel any uncomfortable. It was my 8th month.My due date was on August 14th so there was still one month left.We hadn't prepared anything. So we rushed to the hospital and I was admitted. It was on July 12th 2020.They induced labour but nothing worked.Atlast they inserted tube which was a really painful experience. Then at last after little suffering(😅😅) my baby prince came to this world July 14th.It was also a really special day for me as it was my 1st nikkah anniversary. But he was underweight which made me sad.
Now he is a 7 month old and I am really enjoying my motherhood.Though it was unexpected I am now grateful whenever I see my baby's face.😊😊 Read more
Dr Ghouse has added a new answer
Expecting Mom due in 4 months
9 hours ago
Q. hi doctor from two days i am eating milk cream with sugar and i want to burn it in my stomach I am 5 month pregnant plzz help ??
Dr Ghouse
Paediatrician
7 hours ago
A. at present weight no exercise is other than moderate walking. if there is no relief it is better you see your doctor for proper examination particularly physical examination if there is need for doing investigations to find out the problem and treatment ok
Dr Ghouse has added a new answer
Guardian of 0 children
8 hours ago
Q. I am in my 8th month of pregnancy (last week), and for some reason I am continously facing lot of fatigue. I am feeling deprived of energy and I don't have any energy to do anything. resting isn't Helping in any way and taking small walks isn't too. what can be the possible reason and how to overcome this.
Read moreDr Ghouse
Paediatrician
7 hours ago
A. yes that can be both physical and psychological problems during pregnancy ok. if there is no relief it is better you see your doctor for proper examination particularly physical examination if there is need for doing investigations to find out the problem and treatment ok
Sai Prasanthi R L has added a new answer
Trying To Conceive
6 hours ago
Q. hi,
pls advice , after hcg tigger injection can we do intercourse to conceive and till when we can do ...trying to conceive
Sai Prasanthi R L
Mom of a 10 yr 2 m old boy
6 hours ago
A. Hello dear! We understand your eagerness and concern. It is advisable to check with your consulting doctor regarding this matter. Clarify your concerns and follow your doctor’s advice. Maintain a good personal hygiene routine and a healthy lifestyle
Charul Verma has added a new answer
Mom of a 1 yr 7 m old child
4 hours ago
Q. Hello my baby is 20 months old he swallowed a earpod bur he is normal he eat as well as drink please suggest???
Charul Verma
Nutritionist
3 hours ago
A. hi mom
mostly it will be out once he passes stool
but better to show to doctor
it can be checked in x ray if required
Rashmi has added a new answer
Mom of a 1 yr 7 m old child
4 hours ago
Q. Hello my baby is 20 months old by mistake he swallowed a earpod but he is normal is eat drink plz suggest??
Rashmi
Mom of a 9 yr 7 m old girl
4 hours ago
A. It’s fine it should come out into the poop of your child within 24 to 48 hours a lot of mishaps happened with kids these days but these things since they are not edible they do not get digested which is why they come out into the motion
Dr Sameer awadhiya has added a new answer
Guardian of 0 children
2 hours ago
Q. my baby is 2 months old and she has developed a white patch on her face. What should I do?
Dr Sameer awadhiya
Paediatrician
12 mins ago
A. White spots on the body and face could be there sometimes, which maybe because of fungal infection or some conditions like pityriasis alba or some other factors some conditions are aggravated by dry skiniu, show a proper mousturisation is required. Also, maintain a proper hygiene and a proper assessment should be done to rule out any other causative factor
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Pooja Kaushal
Mom of a 1 m old girl
14 mins ago
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Mom of a 1 yr 2 m old girl
16 mins ago
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