Teen Issues – Teen Pregnancy and Complications

Apart from the moral dilemma identified with teen pregnancy, it also is bad for both the mother and the child in numerous ways. The most rampant problem with teen pregnancy is a low-weighted-baby. Dr. Max Mongelli say that young mothers laying between the age group of 10 to 19 are likely to deliver babies with low birth weight, then older mothers with age groups of 20 to 24. 

It’s not a surprise now, how much risk an underweight infant is at. There are a number of bodily ailments which may catch up to them, like weak lungs, brain and heart functionality. These problems might surface in the new future. To measure, an underweight baby would be the one who weighs less than 5.5 lbs. Here are a few other problems manifested by teen pregnancy-

Premature Birth-
Teen mothers have a higher risk involved in premature delivery. Babies who are born early are at the pinnacle of infant deaths today. Research convey, mothers less than 20 are more likely to deliver a premature baby than a woman in their 20’s or early 30’s. 

Anemia-
Anemia is the condition caused by the deficiency of iron in one’s blood. The ailment is marked by remarkably low levels of red blood cells in the patient’s blood. Sadly, it is a serious condition and is more likely to develop in teen pregnant women. Anemia during pregnancy can surge a long list of pregnancy complications for both the mother and the infant. The risk list is composed of heavy problems like premature birth, difficulty in labor and delivery. 

Postpartum Depression-
Postpartum depression is a form of anxiety which is common in expecting women. It’s basically a mental disorder or mood swings planted by hormonal changes or overwhelming expectation by the society. Research depicts, teen mothers are more at risk as they are not mature and there are a lot of things to deal with. This syndrome is not limited to delivery but varies from any time between the initial weeks of pregnancy till the baby is completed a year. In extreme conditions, teen mothers might have suicidal tendencies and deadly thoughts of hurting herself and the bay. 

This conundrum of mental hazard is a pure subset of teen pregnancy. Affected women require serious prenatal care to combat these issues and safely keeping the mother and the child healthy. It's very important to get a physician’s attention and then plan the course of your action.

Dr. Max Mongelli tells us Ten facts about conception you may not Know

To be frank, the first 3 months of pregnancy doesn’t seem like a big deal as more emphasis is laid over the latter months. But interestingly it’s the most crucial and beautiful time of the whole phase as per Dr. Max Mongelli. 

The first 12 months marks the development of all the baby’s organs and the body structure. What’s left is just to grow and gain a healthy weight. People generally identify pregnancy as a phase of 9 months, from the day they receive the good news till the baby pops up. Actually, it’s more to pregnancy then just that. To be precise pregnancy is a 1000-day period which is accounted from the day before the conception right to the child's second birthday. It’s a crucial time which many believe is said to shape what type of adult the baby will become.

Conception is the process when the sperm meets the egg inside the female’s body. Generally, couples try to time their conception with their most fertile state, but it’s really hard to tell the exact point when it will happen. After conception, the female body undergoes many hormonal changes. These changes are the nature’s switch to adapt the body to home and nurture a child. Expert Dr. Max Mongelli shares some facts about conception period that you may not know-

• The moment a sperm fertilizes the egg, a chemical signal is passed onto all the other sperms to back off, the race has ended and the victor is crowned.

• After fertilization, the blastocyst rapidly divides and multiplies for the next 4 to 5 days till it makes its way to the womb.

• After the man ejaculates, the sperm travels all the way through the cervix, up to the uterus to the fallopian tubes where the sperm meets the egg.

• Each ovary delivers an egg alternatively. Usually, this cycle takes a month but it largely depends on the women’s genetics.

• An egg is only capable of fertilization till 12-24 hours after ovulation. After that, it dies and is discarded in the next period cycle. 

• A hormone called progesterone is responsible to prepare the uterus for the fertilized egg to implant.

• The most fertile time for a woman is just before ovulation. 
Sperm is expected to last about 3 to 5 days in a woman's body.

• If 2 eggs are fertilized by 2 separate sperms then the women will have 2 non-identical twins. And if one sperm infuses one egg and immediately splits in 2, then the women are blessed with identical twins. 

•The pituitary glands and ovaries in a woman’s body are in constant communication to achieve the suited level of hormones the body needs.

Tips for an Easier Transition to Childcare

Childcare might seem an overwhelming idea for some but if you give it a thought, the practice has been around for quite some time. Remember the time when you left your kids at a friend’s home, or called in your parents or any other relative to watch over, yes, it is practical daycare. It could be a little chaotic transition to daycare for both your child and yourself. 
Here are some tips for a smooth transitional phase-
 
●Visit the center-
Pick a day when you can visit the center with your child. Familiarize them with the caretaker, see how well do they get along and how much does your kid like the place.
 

●Communicate with your child-
Try to implant the idea of a childcare into your children’s head. Use books, tell them stories of kids attending centers, help them build a cool picture of the entire operation.

●Practice sessions-
Any kid would resist a swift transition. Kids like to be around familiar faces, try to encourage your children to befriend the caregiver. Take them to a couple of practice sessions for an hour or 2 and see how it works out.

●Give a log drop off time-
In the initial stage, you have to stay for a while. Dr. Max Mongelli suggests waiting for 20 to 30 minutes before stepping out. Give your children time to blend in with other kids before you leave.

●Send favorite stuff-
You will leave your children for quite some time in a day. So leave something that reminds them of home, Max Mongelli says any favorite item like a toy, blanket or any other item could help them ease up in the transition phase.

●Build a routine slowly-
Kids are gentle, any harsh changes for a reason they don’t understand and can be a disaster for them. Take it slowly by starting 2-3 days in a week. Continue it for a week and then extend one day every week. Soon a routine is build up, you can see a happy transition.

Check-Ups and Tests to Get During Pregnancy

Getting a positive result confirming your pregnancy is an unforgettable experience but it's only the first among a series of tests. Pregnancy occurs in phases and for each phase, there are specific tests. With the help of tests and regular checkups, congenital diseases and other severe birth defects can be identified beforehand. In addition to clinical evaluations, Dr. Max Mongelli emphasises the sheer importance of these checkups and tests that confirm whether your baby is developing properly. Gynaecologist, Dr Max Mongelli, recommends these checkups and tests for all pregnant women:
 
Blood, stool and urine test
When pregnancy is diagnosed, a checkup is performed to analyse the health situation of the mother. In addition to the blood count and glycemia, the RH factor, & HIV/AIDS tests are also performed to obtain signs of any disease that might affect the pregnancy. These diseases include- Syphilis, Rubella, Hepatitis B, etc. Stool and urine tests detect urinary tract infections and parasites.

Ultrasound test
Usually, women must take a series of four ultrasound examinations during a period of nine months. In the first trimester of pregnancy, an ultrasound test will verify the embryo count and their precise location to determine if they are in the Uterus (sometimes, the embryo may descend to the fallopian tubes.) This test is typical for a mother who is 18 to 20 weeks into pregnancy.

Gestational diabetes test
On the 24th week, a sample of blood is collected from the expecting mother to check for the blood glucose level. If the results are not satisfactory, then a gynaecologist might recommend a complete examination for the same.

Amniocentesis (15th to 20th week)
Amniocentesis investigates known genetic diseases, such as Down's syndrome by collecting a sample of amniotic fluid from the amniotic sac. It is performed between 14 and 20 weeks of pregnancy. In 72 hours, it is possible to evaluate the five major chromosomal diseases accounting for 95% of the birth defects.

Echocardiography (from 20th week onwards)
It checks the heart of the baby, if a pregnant woman has a history of heart issues or when there is a suspicion of cardiac malformation.

Cardiotocography (after the 26th week)
It checks for oscillations in the fetal heart rate to see if the baby is in distress. In the final stretch of pregnancy, this test is used to observe the regularity of uterine contractions that cause acceleration of heart beats in the baby.

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Differential effects of cigarette smoking on birth weight by maternal body mass index

Does the cigarette smoke have any impact on the birth weight of an unborn child? This question led Gynaecologist Dr Max Mongelli of the Nepean Hospital from Penrith, New South Wales, Australia and his colleague Dr G.Condous of the Early Pregnancy and Endosurgery Unit, Nepean Hospital, Sydney, New South Wales, Australia to conduct a research on soon-to-be mothers with varying body mass index all of whom were smokers.

Methods implemented in the study
This research was published on 1 October 2013 after studying an obstetric database of 13,473 live singleton pregnancies delivered at the Nepean Hospital between 1998 and 2003.

 For the purpose of this study, pregnancy characteristics included in the research were self-reported figures given by expecting mothers such as the number of cigarettes smoked, age, parity, weight, height, and BMI.

Also, the maternal body mass index was broken into three distinct categories: 

BMI<25
BMI>30
BMI 25-30

This offered the researchers a simpler understanding of the effects of cigarette smoke on the birth weight of a fetus.

Another important decision made by Dr Max Mongelli and Dr G.Condous was to perform a multivariate regression analysis for each of the three categories of maternal body mass index. This helped them identify any important predictors of the changes in fetal birth weight caused due to the adverse effect of smoking.

Results obtained from the analysis
An essential consideration made in this study was to include the mean maternal age, which was 27.2. Whereas, mean birth was 3377 g (or 7.445 lbs) with a standard deviation of 588 g, and the mean body mass index was 27.1 with a standard deviation of 6.1.

It was also found that there was no correlation between the body mass index and the number of cigarettes smoked. In fact, the regression analysis performed by Max Mongelli and G.Condous clearly displayed that for women with BMI<25, the effects of cigarette smoking on the fetal birth weight was -13.4 g per cigarette, for BMI 25-30, the effect was -12.9 g per cigarette and for BMI>30, the effect was -10.9 g per cigarette.

Conclusions from the research
The researchers found that the untoward effects of cigarette smoking on the fetal birth weight are altered by the mother's body mass index. The fetuses of obese mothers were found to be less receptive to the effect of tobacco smoke than the mothers who had a leaner body shape.

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Calculation of Pregnancy Weeks and Months

When does a woman give birth to a child? After completing 40 weeks or 9 months of pregnancy? Are  both these durations same? Women who have recently found that they are pregnant often find it very confusing to calculate their due date. Renowned obstetricians like Max Mongelli have made it easier for pregnant women to find at least approximate week and month in pregnancy. 

Calculating Pregnancy Due Date
Add 280 days (40 weeks) to the day on which your LMP (Last Menstrual Period) started. This calculation is on the basis of a normal woman who has a menstrual cycle of 28-days. Ovulation and menstrual period calculation are done as the initial 14 days of pregnancy. This is because ovulation only takes place after 14 days from the beginning of LMP. 
Dr Max Mongelli suggests that if a woman has missed her first period, she is probably four weeks pregnant. This will include 14 days of ovulation and menstruation. 

Calculating Pregnancy Weeks
LMP is used for calculating pregnancy. The first week of pregnancy begins when LMP begins. The calculation of following weeks is done in the same manner. While this might sound strange, the method is used for finding the right due date to make sure that the woman receives timely and proper medical care. 
Dr. Max Mongelli says that unless the conception is assisted, LMP is the best way to know an approximate conception and ovulation date.  

Doctors Calculating Pregnancy Weeks
There are three methods with the help of which medical professionals calculate pregnancy weeks. These methods are a physical examination, ultrasound, and LMP. A physical examination is done by a medical professional feeling the size of the uterus. 

Ultrasound involves measuring of the fetus and gestational sac. Dr. Max Mongelli mentions that ultrasound is also useful if a woman is not aware of her LMP or has irregular periods. In case of there are no major differences in the LMP and ultrasound measurements, the LMP is generally used to assume the due date. 

While there is no single method to know the exact weeks of pregnancy or the due date, the methods mentioned above have been developed after years of research and are used by the professionals all over the world to calculate pregnancy weeks and months.

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Bipolar Disorder and Pregnancy

Pregnancy can be very challenging for a woman suffering from bipolar disorder. Not just the patient but even medical professionals have to face a number of difficult choices, and every approach comes with its own set of risks. It is very important for a bipolar pregnant patient to consult with a psychiatrist as well as an obstetrician to understand the benefits and risks of bipolar medications during pregnancy. 

Bipolar disorder complications during pregnancy
It is often seen that the bipolar disorder in women can worsen at the time of pregnancy. As compared to a normal woman, new mothers or pregnant women with bipolar disorder have seven times more chances of getting admitted to a hospital. 

Renowned obstetrician Dr. Max Mongelli suggests that a lot of bipolar women stop their effective pharmacotherapy when they find that they are pregnant. However, this only exposes the woman as well as the baby to risks associated with mood-related dysfunction and bipolar relapses. As not many studies are conducted on this subject, the effects of bipolar medications on the offspring are not very clear. 

Continue bipolar medications during pregnancy
A lot of women suffering from bipolar disorder give birth to healthy babies even when they continue taking bipolar medications. However, there are a few medications which are, known to have higher congenital disability risk like heart defects, neural tube defects, or neurobehavioral problems, especially in the first trimester. 

Dr. Max Mongelli suggests that a patient should compare the risks with what untreated bipolar disorder can lead into. For instance, the mood symptoms if not treated can result in behaviours like-
•Stress
•Increased use of tobacco or alcohol
•Poor nutrition
•Poor prenatal care

Popular bipolar medications used during pregnancy 
In most cases, doctors usually suggest that the patient should continue taking some medicines and stop some. This is because the risks related to mental health on stopping medication varies between patients. Expert psychiatrists advise patients to continue taking some medications, and regular tests are advised to monitor the health of the baby and the mother. Some of the most common bipolar medications which a patient might or might not be advised to continue include-

•Antipsychotic medications like Olanzapine, Aripiprazole, or Risperidone 
•Mood stabilizers like Valproate or Carbamazepine
•Antidepressants
•ECT (Electroconvulsive Therapy) during pregnancy

No matter what a patient decides, Max Mongelli suggests that it is very important for a bipolar pregnant woman not to stop taking any medication or treating without first consulting with a psychiatrist and an obstetrician.

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