Jaundice in Pregnancy-Most Common Cause -Viral Hepatitis-Complications -Management

1. Viral hepatitis is most common in poor ,unhygienic , malnourished pregnant ladies
2. 6 major types: Hepatitis -A,B,C,D,E,G
3. All are RNA viruses except Hepatitis -B which is DNA virus
4. Complications for mother : Increase severe bleeding immediately after delivery  (PostPartumHaemorrhage ),Coma ,Blood Coagulopathy, Infection , Hepatorenal syndrome,Maternal death
5. Complications to fetus: Abortions, Abnormal babies, Delivery of fetus with out completing full term , Fetal death in utero.

Management:

1. Hospitalisation
2. Bed rest
3. Isolation of the infected patient
4. High Calories ,Rich Carbohydrates food
5. Proteins to be given adequate quantity
6. Proper Hygiene ,Safe water ,Safe food is must
7. .Disposable syringe/Gloves are advised for paramedical staff to prevent contamination , infection from patient to others
8. Glucose , fruit juice ,tender coconut water, etc Liquids  to be given plenty
9. Antibiotics,those donot give overload on liver
10. Fatty food may harm jaundice  patient but not proved much
11. Drugs which cause liver toxicity should be avoided
12. lactulose-Osmatic laxative  can be given daily to clear bowel fecal contest
13. Mother  to be taken Active Immunization at 0 day , 1month ,6 months -If mother is not infective clear cut way
14. Immunoglobulins are safe in pregnancy.Hepatitis vaccines are also safe during pregnancy
15. Regular Blood tests
16. Blood /fresh frozen plasma
17. Vit-K 5mg IM -Increase PT-Helpful
18. No Role of Termination of pregnancy_canot change final result or mortality of mother.
19. Inj Ergometrine Immediately after delivey of baby to prevent post partum haemorrhage.
20. Baby of jaundice infected mother should be recived  active and passive immunisation immediately after birth.
21. No contra indication to breast feeding feeding
22. All women should be recieved Hepatitis vaccine six months prior to pregnancy.
23. Husband also has to be tested and treated or vaccinated for hepatitis

3.

Jaundice Hepatits Complicating Pregnancy ..what it is?.What are the causes ?

When pregnant is declared as jaundice patient?

1.Her serum bilirubin level should be more than normal
2.Visible yellow staining of conjunctiva,skin of other bodyparts

Why jaundice occur in pregnant women?

Causes of jaundice in pregnant lady can be grossly divided into two groups
1.Exclusively pregnancy related causes:
 A) Hyperemesis ( Exessive vomiting during first 3 months period of pregnancy)
 B) Hypertensive disorders of pregnancy like Preeclampsia ( High BP+ Albuminuria +_ Pedal edema) , Eclampsia ( Pre eclamsia + fits) , DIC ( Uncontrollable bleeding disease -High deathRates -Endotoxic shock)
 C) Liver diseases like Acute fatty liver
 D) Most Common - Intra partum choleastasis ( Pregnancy specific hepatic ,gall bladder ,Bile duct abnormality ,function, obstruction )

Second group of causes of jaundice in pregnancy which are unrelated to pregnancy are as follows
A) Most common causes : Viral hepatitis
B) Gallstone-Obstructive jaundice
C) Drugs -Isoniazide, Phenothiazine etc
D) Hemolyticjaundice-Mismatched blood transfusion ,
                                  Malaria , Infection.

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Normal Delivery Information

Please visit my other blog site which is started for giving you information about normal delivery
http://normaldelivery.blogspot.com/

General advice for pregnant lady about sleep diet exercises

Most of the pregnant ladies are anxious about somany things.they eagerly waiting for a person to clear their doubts.Gynaecologists are usually busy with emergency cases and vexed to explain small things to all pregnants.Practically not possible to clear all doubts of all pregnants ,though getting information is right of a pregnant.

Her Im giving some general tips to be implemented during pregnancy
Diet                           

• Balance diet to be taken.Extra calories are needed 350 kcal during pregnancy and 450 kcal during first six months of lactation.
• Better to take frequent meals.Instead of taking large meal ,it is advicable to divide the same quantity  to take 2-3 times.Pregnancy causes gastrits ,indigestion .less quantity with frequent meals give less discomfort to pregnant and less strain on stomach. 
• At least 2 -3 litres Water to be taken daily
• Protein rich diet like dals  , soya , beans , nuts are good food
• Green leafy vegetables to be mixed with dal then it gives good taste and health
• Fat food is also needed but 30-50g per day quantity is enough
• Bcomplex food like germinating seeds are best not only for mother but also for baby health in utero
• Milk  is rich source of calcium.It is whole food.250 ml milk to be taken at the time of breakfast and night supper.ICalcium is bone builder for baby.
• Iron utensils are best option to prepare food.It gives some extra iron to pregnant which finally prevents iron deficiency anemia .

Sleep & Exercises        

• Pregnant should take atleast 10 hours sleep.8hrs night sleep and 2 hrs afternoon.
• Those who suffers lack of sleep should not use sleeping pills .These can have warm milk which gives good sleep.
• Exercises like walking is safe in pregnancy in all trimesters 
•  Some particular yogasana( not all ) can do upto 7-8 months period of gestation. 
• Should not participate in running race or competetive sports.
• Keeping breaks in between work is enough.Can attend thier duties upto 8months
• Reading comic books , Listening pleasant music are encourajable activities.These help in good sleep.