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How to ensure safe pregnancy after the age of 30?

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Dr. Madhuri N Bagde

OBGYN

Practicing since :2001

Answered : 1390 Questions

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Posted on Tue, 1 Apr 2014 in Pregnancy
Question: I have missed my period and did Home Pregnancy test which came out positive. Would like to mention that I am 34 yrs old and this is my first issue. I am also obese with weight of 105 kgs. My height is 5ft 5". Please advise about my next step. What should I do to save my pregnancy?
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Answered by Dr. Madhuri N Bagde 23 minutes later
Brief Answer: Congratulations !! Detailed Answer: Hello and welcome to health care magic. Congratulations and may you have a safe pregnancy. I am Dr Madhuri and will help you. I understand from your question that you are 34 years and pregnant for the first time and also slightly over weight. The first thing that you need to do is relax and calm down as a happy mother means a happy baby. Now for the medical advice. Pregnancy after 30 years is associated with a slightly higher rate of certain conditions like diabetes, blood pressure and the baby is slightly at more risk of having genetic issues. But these can all be screened and detected early. As of now, you must get registered with an expert obstetrician. Folic acid tablets must be started as soon as possible. They help in preventing brain defects in the baby and are given to every pregnant woman. An ultrasonography must be done by 6 weeks of pregnancy to determine the well being of the baby and also to confirm the dates of pregnancy as these scans provide the most accurate dates. Get it done from an MD radiology doctor. I also suggest that since your weight is slightly on the higher side, you avoid all fat containing food as pregnancy also increases weight. Eat plenty of fruits and vegetables and take small meals every 3 -4 hours. Please do not eat sweets as these will further increase the weight. If you experience nausea and vomiting of pregnancy, tablet doxinate will help control it and can be taken after prescription by your doctor. For similar women in my clinic, I prefer to give HCG injections until 10 weeks of pregnancy as these are precious pregnancies and need extra caution. Also progesterone supplements can be used after 10 weeks to prevent abortions and preterm pains. A few investigations like a hemogram to look for hemoglobin and some routine investigations would be advised by your doctor and get them done. Also get a blood sugar test [ both fasting and after meals] to rule out any preexisting sugar intolerance. Remember that normally sugar increases in pregnancy so you will need to keep checking this every month or so. Also a blood pressure check must be kept. A few investigations will be needed to detect any anomalies in the baby. These are a nuchal thickness scan at 12 weeks, a triple or quadruple test at 16-18 weeks and an anomaly scan at 20 weeks. Discuss these with your doctor and she will guide you. A short walk in the morning and evening help tone up the body. You should be fine with this. If you have any more queries please feel to ask. I am always here to help you. I know this is too much advice but its the first time for you so I thought it my duty to explain as much as possible. Hope this helped. Thanks for using HCM Have a good day and happy pregnancy. Dr Madhuri Bagde Consultant Ob GY
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Madhuri N Bagde 24 hours later
Thank you very much for your detailed reply. Your advice is really valuable for me. However, I have certain questions which are as follows: 1. Should I avoid using stairs? Is it harmful, if I have to use? I am working, and I dont stay in flat, hence using stairs for getting up and down is a part of daily life. 2. Road jerks. is this harmful as well? For office commutation, I go by car and roads in Kolkata are very bumpy. 3. can I bend down, is this restricted? or allowed? 4. You have mentioned that I should eat fruits and vegetables. are all friuts allowed for me? like oranges, bananas.. or any specific fruit is restricted? Are all types of veggies allowed for me? 5. Can I have milk? I understand that I should avoid fatty food. 6. Chicken and eggs. Are these allowed? For fish, should I limit to small fishes ? 7. Can I do exercises or only walking? 8. Can I walk in treadmill? for about 15mins daily? Sorry, for so many questions. Actually, I am very tensed about my pregnancy. Thank you again for valuable time.
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Answered by Dr. Madhuri N Bagde 22 minutes later
Brief Answer: relax !!! Detailed Answer: Hello and thanks for the query, Please do not get tensed. Always smile and be positive. Stress is not good in pregnancy and why should you have any problems. Relax and stay calm and things will be all right. You live in a big city and all modern medical amenities are at hand. So you will do fine. Now regarding your questions: 1. avoidance of stairs: Since you have been using them daily, you must be used to them. There is no rule of 'dont use stairs'. Just exercise caution, climb slowly, if they are steep and too many take rest in between. As long as you do not have any pain or sinking sensation in lower abdomen, you can very well go through your routine work. 2. road jerks: these are unfortunate and unavoidable. Again just go slow, no sudden jerks. If the road is very bad travel may be avoided after 30 weeks as it becomes a bit more risky then. 3. bending down: slow bending has no problem till first 12 -14 weeks. After that as the uterus grows bending becomes difficult and has to be done very carefully. 4. All fruits are allowed. We advocate not to use papaya as their seeds have abortificient properties if ingested by mistake. Eat seasonal fruits. 5. Toned milk is low in fat and can be taken. 6. boiled egg white is a good source of protein and so is grilled or steamed fish. Eat one serving a day initially and can be increased to two servings as the pregnancy advances and baby grows. 7. Walking is preferable as it helps pep up the system and increase the BMI without putting undue stress on pelvic muscles. No forced walking or exercise. Do as much as you can and build up slowly, if exercise causes pain or contractions, stop it. Prolonged standing is also to be avoided. Sit intermittently. You can do work upto the point where you must not be fatigued and it must not cause abdominal or pelvic or back pain. It is up to your tolerance and capacity. If you tolerate it do it, if you do not don't is the rule. A general advice is do things that do not cause trouble and at the first indication that something is causing trouble, stop doing it. Do not wait to think about what people around you will think or say etc. First is the baby and you then others. Read good books and eat good food. Avoid contact with people having cough and cold as much as possible. Have regular antenatal check up. With this you should do well. Please do not worry. Doctors are always there to help you. Have a good day and happy pregnancy. Dr Madhuri
Above answer was peer-reviewed by : Dr. Shanthi.E
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Follow up: Dr. Madhuri N Bagde 23 hours later
Thank you very much, Dr. XXXXXXX I really appreciate your detailed answer. I would like to continue my consultation with you during my nine months of pregnancy. Although, I have consulted an expert obstetrician close to my area. She has given me more or less the same advice as you have given. But still, I would like to keep in touch with you. Your advice is really helpful and has really helped in boosting my self-confidence. Thanks again. I have few more questions which I forgot to mention. 1. For the last few days, I can see slight amount of white discharge whenever I urinate. Is this ok? 2. I always have a feeling of full stomach. I get hungry very frequently. When I eat then just after having small amount, I feel like I am full. May be because of gas, I have reported about gas to my local doctor as well. She has given Pan-D to be taken every morning empty stomach. Please advise about this. 3. During dinner time, after having my dinner (even while having dinner) I feel like vomiting or short of breath and I need to take few mins gap between eating. I don't know why this is happening. 4. Sometimes, I feel suffocated. Is this normal? 5. I have sleep problem as well. I never had this kind of problem before. I am not having sound sleep and hence not feeling fresh in the morning. Thanks a lot for your valuable time. Best Regards, XXXX
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Answered by Dr. Madhuri N Bagde 27 minutes later
Brief Answer: It is a pleasure answering your queries. Detailed Answer: Dear XXXXXXX Thanks for the appreciation, A small amount of discharge may be due to pregnancy or infection. If the discharge has a bad smell is more likely to be infection. You will need a vaginal swab test to see what it is and if it is an infection it will need treatment. The feeling of fullness, gases and early satiety are all due to hormonal changes during pregnancy. It is good that you feel hungry. Try to take small frequent meals. If there are too much gases, try to avoid food that has lot of seeds like pomegranates or tomatoes etc as they cause more gases. This is the reason I suggested a light walk twice daily as it helps one tone up the system and drive away these problems. Tablet pantop D is Ok. It has two drugs pantoprazole for acidity and domperidone for nausea. If you do not have any acidity it is better that you take only the D part that is tablet domperidone [separate tablet] as it is best to take as little medications during the first three months as possible. The vomiting during dinner can be decreased by taking tablet domeperidone or tablet doxinate 1 hour before dinner. Other measures to decrease nausea are to take a dry toast or biscuit before getting up from bed early in the morning and wake up slowly. Have less liquids at the time when nausea is most and compensate for those liquids when you feel better. Smaller meals, addition of fruits like water melon and grapes also helps. Clear soups are very good meals as they provide energy, do not tax your system and also full of nutrients. At this time, you just need meals to provide energy to your system and also small amount of nutrition to the baby. The baby is very small, so does not need much now. So there is no need to eat more now. Just eat enough to keep yourself up and the baby will be alright. Vitamin B complex with lactobacillus are also very helpful in helping to maintain the normal bacteria in our intestines and help digestion. So capsule vizylac may be used once during the noon to help control problems with dinner. The sleep problems are due to the stress that is subconsciously there. Please do not worry. I would also have all the baseline investigations like the blood tests, an ECG, and ultrasound done now so that we have data for future comparison. There are so many women conceiving at your age and getting along well so please stop worrying. These problems will go away after some time on their own, mostly after 3 months [12 weeks]. I am always here to provide answers to your questions. Take care. Dr Madhuri
Above answer was peer-reviewed by : Dr. Shanthi.E
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Follow up: Dr. Madhuri N Bagde 47 hours later
Dear Dr. XXXXXXX Sorry for my late response. I want to thank you again for your detailed reply. I have one last question for this session. Is there any restrictions for the sleeping posture.. I mean what are the "Safest Sleep Positions During Pregnancy" ? Normally, I sleep on my right side. One more thing, can I have pickles? I am not getting taste in any food nowadays, but if the food is very spicy like that of the similar taste of pickles then I am liking them.. Since I have gastric problem so I am not having much spicy food. My question is : can I have small amount of pickles sometimes, just for a change of taste? My local doctor has advised lot of blood tests which I will do next week. And USG is advised by her for the next month. I hope this is right. Is USG safe for the baby? However, I will stay in touch with you. Thanks a lot for your help. Best Regards XXXX
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Answered by Dr. Madhuri N Bagde 37 minutes later
Brief Answer: welcome back. Detailed Answer: Hello XXXXXXX and welcome, There are no restrictions to sleeping postures. After 28-30 weeks we advise to sleep as much on one or the other side as it improves blood flow to the baby. Now the baby and uterus is too small. You may sleep as you like. Eat what you like. Just avoid a lot of salt, spices and fat. If you like pickle eat it in small quantities. Home made pickle is better as it usually does not contain preservatives. Do your tests as advised. USG is very safe for the baby and it helps in determining the location of the baby, the duration of pregnancy and a small idea about the condition of the baby at present. So get it done. I am always here to answer your queries so feel free. Take care and have a safe pregnancy. Dr Madhuri.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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