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All you need to know about Gestational Diabetes

All you need to know about Gestational Diabetes

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Did you know that gestational diabetes mellitus, also known as GMD, is one of the most common medical complications of pregnancy?

What is GMD? Why does it happen? Can you prevent it? Keep scrolling for answers.

So, let’s start with the basics. What is gestational diabetes?

Gestational diabetes is high blood sugar that develops during pregnancy and usually disappears after giving birth. Many hormones are involved in maintaining the blood sugar level. As the hormone levels fluctuate during pregnancy, they prevent the body from using insulin effectively, leading to insulin resistance. This causes  glucose  build-up in the blood instead of being absorbed by the cells. Typically, the pancreas can make additional insulin to overcome insulin resistance, but when insulin production is not enough to overcome the effect of the placental hormones, gestational diabetes results.

A study conducted by Kai Wei Lee et., found the prevalence of GDM in Asia was 11.5%. GMD can happen at any stage of pregnancy but is more common in the second or third trimester.

But why is that?

Scientists have not been able to identify the exact hormone that causes GDM in pregnant women. But, many scientific theories suggest that as the placenta grows, more and more hormones are released, which increases risk of  insulin resistance. Thus, symptoms of GMD are seen more often in the 2nd and 3rd trimesters. 

What are the symptoms of GMD?

Many women who have GMD do not show symptoms, but the most common ones are: 

  • Increased thirst
  • Urgency to pee more often
  • Dry mouth
  • Tiredness
Gestational Diabetes Causes

These symptoms are relatively common during pregnancy and not necessarily a sign of GMD. If you are pregnant and have noticed these symptoms, you should speak to a VOG doctor or a general physician, via oDoc who will provide a prescription for a lab test. You can carry out the lab tests from the comfort of you home via oLabs too. 

Who is at risk?

GMD can affect any woman, but a list of risk factors identified by scientists increases the chances of developing GMD. 

The risk factors include

  • Being overweight before pregnancy
  • Having a family  history of diabetes 
  • Being Prediabetic (if you have a blood glucose level higher than normal but not high enough to be classed as diabetic.
  • Having PCOS 
  • Being older than 25 as they are at a greater risk for developing gestational diabetes than younger women
  • Having high blood pressure, high cholesterol, heart disease, or other medical complications
  • Having  given birth to a large baby (weighing more than 9 pounds)
  • Having had a miscarriage

How does GMD affect the mother and the baby?

More often than not, women who have GMD go on to have normal pregnancies and deliver healthy babies. However, in other circumstances, GMD can lead to:

  • Macrosomia. This is where the baby grows very large as they absorb the excess glucose in the mother’s blood and convert it into fat and are deposited. This leads to difficulties during labour, causing doctors to opt for induced labour and c-section. 
  • Too much amniotic fluid (the fluid that surrounds the baby) in the womb can cause premature labour or problems at delivery, known as polyhydramnios.
  • Premature birth
  • Low blood sugar (hypoglycemia) in the baby after delivery. This happens because the mum’s high blood sugar level also causes the baby to have a high blood sugar level, and after birth, it no longer has the high level of sugar from its mother, resulting in the newborn’s blood sugar level becoming very low.
  • Obesity and type 2 diabetes later in life for babies. Babies of mothers with gestational diabetes have a higher risk of developing obesity and type 2 diabetes later in life.
  • Stillbirth. Untreated, gestational diabetes can result in a baby’s death before or shortly after birth.
  • Future diabetes for the mother. If you have gestational diabetes, you’re more likely to get it again during a future pregnancy. You also have a higher risk of type 2 diabetes as you get older.

What are the treatment options?

The American Diabetes Association recommends screening for undiagnosed type 2 diabetes at the first prenatal visit in women with diabetes risk factors. In pregnant women not known to have diabetes, GDM testing should be performed at 24 to 28 weeks of gestation. 

If you are found to have GMD, don’t worry, as it can be treated, and complications can be reduced. The doctor may ask you to monitor your blood sugar level often, exercise often, eat healthily and maybe give insulin injections if necessary. 

How is it prevented?

There are no guarantees for preventing gestational diabetes — but the more healthy habits you can adopt before pregnancy, the better.

So don’t forget to 

  • Eat healthy – Choose foods high in fibre and low in fat and calories.
  • Exercise often – Exercising before and safely during pregnancy can help protect you from developing gestational diabetes.
  • Start pregnancy at a healthy weight. If you’re planning to get pregnant, losing extra weight beforehand may help you have a healthier pregnancy.
Preventing Gestational Diabetes

If you are pregnant and experiencing any of the symptoms mentioned above or have any questions, you can speak to one of the Obstetricians, Gynaecologists or GPs on the oDoc app. Click here to download the app.

Sources 

  1. Alfadhli, E., 2015. Gestational diabetes mellitus. Saudi Medical Journal, 36(4), pp.399-406.
  2. Gestational Diabetes Mellitus (GDM). (n.d.). Johns Hopkins Medicine. Retrieved April 6, 2022, from 
  3. Gestational diabetes – Symptoms and causes. (2020, August 26). Mayo Clinic. 
  4. NHS website. (2021, November 29). Gestational diabetes. Nhs.Uk. 
  5. Lee, K.W., Ching, S.M., Ramachandran, V. et al. Prevalence and risk factors of gestational diabetes mellitus in Asia: a systematic review and meta-analysis. BMC Pregnancy Childbirth 18, 494 (2018).
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Endometriosis

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Endometriosis

Endometriosis

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No woman looks forward to “that time of the month.” Dealing with nausea, stomach cramps, mood swings, back pains and fatigue, all whilst facing that undeniable social pressure of pretending to be ‘normal’ and going about your daily activities. Because periods are a natural bodily function… right? It’s not like a cold where you would be rightfully exempted from resuming your daily tasks.

Sadly, sometimes the society we live in doesn’t accurately weigh the impact of periods on our daily functioning. A good example of this is one of the most common gynecological diseases, endometriosis, often going undetected for years because the abdominal pain it causes is dismissed as regular menstrual cramps. Endometriosis is typically a progressive condition. Therefore it’s wise to look out for signs early on and get regular checkups with your VOG to manage any symptoms you have. You can easily channel a VOG in just three taps on oDoc!

What is endometriosis?

The lining of your uterus is made up of tissue called the endometrium. When this tissue grows outside your uterus, it’s known as endometriosis. This disorder causes endometrial-like tissue to grow on your ovaries, fallopian tubes, bowel, and even tissues lining your pelvis.

Unfortunately, this endometrial-like tissue acts as endometrial tissue would — meaning that according to the hormonal changes in each stage of the menstrual cycle, it thickens, breaks down and bleeds. But because it has no way to exit your body, it becomes trapped! This triggers an inflammatory response, and the surrounding tissue becomes irritated, eventually developing scar tissue and adhesions, which are bands of fibrous tissue that can cause pelvic tissues and organs to stick to each other. This leads to pain and other complications discussed below.

Symptoms of endometriosis

Just like all the chocolates we eat on our period are unique in their own way, the endometriosis symptoms experienced by you may differ from that of someone else. Some people experience mild symptoms, but others can have moderate to severe symptoms. The severity of pain you feel doesn’t indicate the stage of the endometriosis you have. You can have a mild degree of endometriosis, but experience agonizing pain or have a severe form of it and have minimal discomfort. That is why it’s important for you to get regular gynecological exams to stay on top of your reproductive and sexual health!

Pelvic pain is the most common symptom of endometriosis. You may also have the following symptoms:

  1. Painful periods – Most women have period cramps, but endometriosis can leave you with debilitating pain. You can get cramps 1 or 2 weeks around menstruation
  2. Heavy menstrual bleeding or bleeding between periods
  1. Painful intercourse – Women might have intense, localized pain during penetration
  2. Infertility – When endometriosis affects the ovaries or fallopian tubes, it may reduce the eggs’ chance of becoming fertilized and implanting into the uterus lining
  1. Painful bowel movements and/or urination
  2. Pain in the abdomen, lower back, or thighs, often lasting throughout the cycle

It’s wise that you get regular gynecological exams, which will allow your VOG to monitor any changes. This is particularly important if you have two or more symptoms.

Endometriosis Treatment

Until endometriosis is better understood, only the symptoms can be treated without the underlying causes. Endometriosis treatment depends on your symptoms and goals.

For example, suppose your goal is to minimize the pain. In that case, you may be prescribed over-the-counter pain medications such as Ibuprofen or hormonal medicines such as the oral contraceptive pill, which can suppress the period and stop mild to moderate endometriosis from progressing. It decreases fertility by preventing the monthly growth and buildup of endometrial-like tissue, reducing the pain.

Other options are available if you wish to conceive, such as undergoing a laparoscopy. In this minimally invasive surgery, your doctor will make small incisions in the abdomen to explore and surgically remove any problematic tissue without damaging your reproductive organs. Even though the name of this surgery sounds scary, most women can go home on the same day as the operation, and it will take roughly five to seven days to recover.

However, if you don’t respond to conservative treatments, your doctor may recommend a total hysterectomy as a last resort. In this operation, your surgeon removes the uterus, fallopian tubes and in some cases, even the ovaries, depending on the severity of the disease.

Life with endometriosis

Living with endometriosis can be difficult as symptoms can significantly impact your quality of life. It may take a toll on your mental health as finding an effective treatment and dealing with the anxiety of symptoms flaring up can be emotionally taxing. It may even cause financial strain depending on the cost of your treatment plan or if your symptoms interfere with your ability to maintain a job. It may also lead to an unfulfilled sex life which may cause a bridge between you and your partner.

To improve your quality of life with endometriosis, it’s good to reduce stress by regularly partaking in leisure activities, exercising and getting adequate sleep. While endometriosis can be isolating, remember that you’re not alone. There are many ways to find support, like joining an online or in-person support group and talking to a mental health professional to work through your feelings. You can easily channel a mental health professional in simply three taps on oDoc!

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What is the pelvic floor and why is it so important?

What is the pelvic floor and why is it so important?

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When you think of exercise, you might think focusing on muscle groups such as the abs, legs, back and arms. While all those areas are important, we can’t forget to exercise the muscles that we can’t particularly see or feel. We’re talking about the pelvic floor muscles. Have you ever sneezed, coughed or laughed and found yourself peeing a little? You’re not alone! This could be due to weak pelvic floor muscles. Problems with the pelvic floor are common and could happen to anyone. Incontinence, painful sex and lower back pain are some of the challenges that can arise due to a weak pelvic floor. Here’s what you need to know!

What is the pelvic floor?

The pelvic floor comprises of muscles and connective tissues that are attached to your pelvis and are vital in supporting your bladder, urethra, intestines and rectum. In women, the pelvic floor also supports the uterus and the vagina. You could think about the pelvic floor as a shelf for your organs, so a strong shelf means a more secure support system for your organs.

How do you find pelvic floor muscles?

A good way to visualize the pelvic floor and its function is to picture these muscles at the bottom of the pelvis. When you have a full bladder and you’re trying to stop urine flow, you’re contracting the pelvic floor.

Another way to find those muscles while standing is to imagine that you need to pass gas but don’t want to let it out. The muscles you’re activating to hold it in, that is those surrounding your rectum and anus, make up part of your pelvic floor.

When engaging the pelvic floor, make sure to use all these muscles that span the bottom of your pelvis. If you only contract the muscles that stop the flow of urine but not the rectal muscles, you’re not getting a full contraction and therefore, the pelvic floor does not get strengthened. Imagine a sensation of hugging your organs from the bottom up.

It’s important to learn how to tighten and relax these muscles for optimal pelvic floor function. As you’re going about your daily routine, check in with yourself to see if you’re contracting these muscles and to what intensity.

Why is it important to maintain a strong pelvic floor?

  • Strengthening your pelvic floor allows you to better support the bladder, bowels and uterus, helping with bladder and bowel control.
  • A strong pelvic floor also protects against uterine prolapse, when the uterus loses support and bulges out of the vagina
  • For women, a strong pelvic floor can help during labor and delivery
  • Strengthening the pelvic floor can lead to better sex for both men and women. Experts say that strengthening these muscles can potentially improve erectile dysfunction issues as well as boost sexual sensation for women.

How do you strengthen your pelvic floor muscles?

Both contracting and relaxing your pelvic floor muscles is key, and not just solely focusing on contraction.

Kegel exercises help with contraction of the muscles.

  • Find the right muscles as mentioned above
  • Imagine you’re sitting on an exercise ball with a marble inside of it. Picture vacuuming up the marble using pelvic floor muscles. Tighten for 3 seconds to lift the marble.
  • Relax for 3 seconds by taking a deep breath in and feel the air pouring into your lungs, your abdomen and down to your pelvic floor like a jug of water.
  • Make sure to not tighten your abs, thighs or butt and to keep breathing instead of holding your breath
  • Do 3 sets of 10 contractions and try to incorporate this exercise throughout your day

Relax your pelvic floor by incorporating some of these movements into your exercise routines.

pelvic floor exercises

You may think pelvic health is not an important factor to consider when looking at your overall health. But a strong pelvic floor can do wonders for you when it comes to your reproductive system, your sex life and your confidence (no leakages!).

If you’re having bowel or bladder control problems or pain during sex, speak to a physiotherapist or sexual health practitioner on oDoc who can help you find the right treatment. Download the app now.

Sources:

  • 9 Things You Might Not Know About A Pelvic Floor And Why It Matters, 2021, Mind Body Green
  • 5 Pelvic Floor Exercises for Anyone and Everyone, 2021, Healthline
  • What are pelvic floor exercises, 2020, NHS
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The Second Trimester

The Second Trimester

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They say there is no better feeling than the movement of life inside of you and that is the most magical thing about the second trimester of pregnancy. You can feel the life inside you. 

By the second trimester, you probably are more used to all the changes you have been experiencing the last 12 weeks. So let’s have a look at what’s in store for the next 13 weeks of your pregnancy. 

If you haven’t read our blog on the First Trimester yet, we’d suggest you start there and then hop back to this. 

When does the second trimester of pregnancy start?

The second trimester of pregnancy starts at the beginning of week 13 and goes up all the way till the end of week 26. 

So, what changes happen to the body during the second trimester?

Breast tenderness reduces, nausea begins to cease, and adjustment to estrogen and progesterone levels occurs. Other changes that happen to your body are: 

  1. Increase in appetite as your baby starts to grow 
  2. Aches in your lower abdomen may occur as your uterus expands to make space for the abby. This puts pressure on the surrounding muscle and ligaments, causing cramps and pains. A warm bath, relaxation exercises, changing your body’s position, or pressing a hot water bottle wrapped in a towel to your lower belly can help ease the pain. 
  3. Increase in weight due to the increase in appetite
  4. The increase in weight can also cause backaches 
  5. Bleeding gums due to changes in hormone levels sending more blood to your gums, making them more sensitive and increasing the likeliness of bleeding. 
  6. Some women may experience tightening in their uterus walls for a minute or two (also known as Braxton-Hicks contractions). This is very normal and isn’t a sign of natural labour. 
  7. Further enlargement of breasts occurs as the mammary glands prep for lactation. 
  8. Congestion occurs as the mucus membranes lining your nose swells, leading to a stuffy nose. Your nose may tend to bleed more easily too.
  9. Some women may experience dizziness as the growing uterus presses against the blood vessels, reducing blood reaching your brain. 
  10. Unwanted hair growth
  11. Headaches 
  12. Increased Progesterone levels cause heartburn as it relaxes the muscle responsible for keeping acids in your stomach.
  13. Varicose veins may occur as extra blood flows through them and the growing uterus exerts additional pressure. 

Sounds a bit scary doesn’t it? But do not worry, it’s a few weeks of hardship for a lifetime of happiness. As soon as you see your little one’s face, all the hardship will be forgotten in seconds. 

It is important to note that these symptoms may or may not be experienced by all women, and the severity, occurrence and duration of these changes can change from woman to woman. 

 So, what changes does the baby go through?

It is said that the second trimester of pregnancy marks a changing point not only for the mother but for the baby too. This is when the fetus grows into a baby. All organs and systems are fully formed by the second trimester. During the second trimester, your baby will grow from around 7.5cm and weigh 30 grams in the 13th week to approximately 23cm and 820 grams by the end of the second trimester. Their heart moves 100 pints of blood a day. During the second trimester, the fetus begins to move and starts kicking. The mother can feel this, and it is known as quickening and trust me, this feeling is unmatchable. 

The baby grows eyelashes and eyebrows during the second trimester and it’s eyes and ears are formed so your baby can hear your voice when you speak. It is encouraged you speak to them to give them company. Their tiny fingers and toes separate and grow nails too. Development of reflexes such as swallowing and sucking also occurs. The baby starts reacting to external stimuli and starts interacting with the outside world while being inside

A fetus born at 24 weeks may survive in a neonatal intensive care unit.

If you experience any of the following, please seek medical help urgently.

  • Severe abdominal pain or cramping
  • Bleeding
  • Severe dizziness
  • Rapid weight gain (more than 6.5 pounds per month) or too little weight gain (less than 10 pounds at 20 weeks into the pregnancy)
  • Jaundice
  • A lot of sweating

These are signs that something could be wrong with your pregnancy. You should speak to your VOG doctor as soon as possible if you are experiencing any of the symptoms mentioned above.  

The second trimester of pregnancy is the best time to start building your birth plan. To know more about how to create your birth plan, click here. You can also consult a VOG doctor at any time and from the comfort and safety of your home via the oDoc app.

Source 

  1. Watson, S. (2010, February 4). Second Trimester of Pregnancy. WebMD. Retrieved January 11, 2022, from https://www.webmd.com/baby/guide/second-trimester-of-pregnancy#7
  2. The Second Trimester. (n.d.). Johns Hopkins Medicine. Retrieved January 11, 2022, from https://www.hopkinsmedicine.org/health/wellness-and-prevention/the-second-trimester
  3. Second trimester. (n.d.). Pregnancy Birth and Baby. Retrieved January 11, 2022, from https://www.pregnancybirthbaby.org.au/second-trimester
  4. Mayo Clinic. (2020, February 27). 2nd trimester pregnancy: What to expect. Retrieved January 11, 2022, from https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy/art-20047732?reDate=11012022
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The First Trimester

The First Trimester

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Happy, anxious, nervous, scared, overjoyed and excited. These are just a few of the emotions you may experience when you first find out you are pregnant. If it is your first time you are definitely going to feel a bit confused and will resort to googling everything related to pregnancy. We have broken down everything you need to know about the first trimester of pregnancy in this blog. 

So what is the first trimester of pregnancy?

It is the earliest phase in your pregnancy. It starts on the first day of your last period and ends on the last day of the 13th week. During your first trimester of pregnancy, a lot of changes happen to you and the baby. So keep reading to find out what is in store for you

What are the changes happening in your body?. 

Due to the hormones released by the body,, many changes will occur during pregnancy. These changes help prepare you for the 9 months of pregnancy.

first trimester of pregnancy
  1. Swelling of breasts– caused by the mammary glands enlarging to prepare for lactation as a result of increased oestrogen and progesterone hormones secretion.
  2. Peeing more often – you will start peeing more often as your uterus grows and presses against your bladder.
  3. Darken and enlarged areolas – this is the pigmented area around your nipple. They may also become covered with small, white bumps called Montgomery’s tubercles (enlarged sweat glands).
  4. Mood swings – you may begin to experience severe mood swings which is caused by the surge in hormones. 
  5. Morning sickness – occurs due to increased hormone levels that is needed to sustain the pregnancy. Contrary to the name, nausea can occur at anytime of day. 
  6. Constipation – occurs as the growing uterus presses against your rectum and intestines.
  7. Heartburn and indigestion – the increased levels of progesterone can slow the muscular contractions in our intestines. 
  8. Extreme tiredness – caused as a result of the physical and emotional demands of pregnancy. 
  9. High heart rate-  caused by the increased cardiac output to supply enough blood to both you and your baby.
  10. Slight bleeding – About 25% of pregnant women have slight bleeding during their first trimester of pregnancy. Early in the pregnancy, light spotting may be a sign that the fertilized embryo has implanted in your uterus. If you have severe bleeding please seek medical advice urgently.
  11. Weight gain – this is due to a 40-50% increase in volume of blood in the body during pregnancy and storage of fat in the body which is later used for milk production. 

It is important to note that some symptoms of pregnancy continue for several weeks or months. Others are only experienced for a short time. Some women experience many symptoms, and some experience only a few or none at all. Everyone is different but that’s to be expected -you are unique! 

Now lets have a look at the changes your baby will go through

The most development occurs during the first trimester. During the first 13 weeks, your baby develops from a fertilized egg (embryo) into a fully-formed fetus. All major organs are formed during the first trimester of pregnancy. By the end of the first trimester of pregnancy, the fetus weighs approximately 0.5 to 1 ounce and measures, on average, 3 to 4 inches in length.

Here is what exactly happens: 

(Source: Johns Hopkins Medicine)

The fetus is most vulnerable during the first 12 weeks. During this period of time, exposure to drugs, radiation, tobacco and other toxic substances can affect the formation of the major organs and body systems. 

So what do you need to know while visiting the doctor during the first trimester?

As soon as you find out you are pregnant, make an appointment with your VOG doctor so you can start caring for the baby. You should see your doctor once a month but it is better to discuss this with your VOG doctor. 

During your first visit the doctor may: 

  • perform an ultrasound to confirm the pregnancy
  • perform a Pap test
  • take your blood pressure
  • test for sexually transmitted infections, HIV, and hepatitis
  • estimate your date of delivery or “due date,” which is around 266 days from the first day of your last period
  • screen for risk factors like anemia
  • check thyroid levels
  • check your weight

If you experience any of the following please seek medical help immediately: 

  • Severe abdominal pain
  • Heavy bleeding
  • Severe dizziness
  •  Rapid weight gain or too little weight gain

It is also recommended you start building out your birth plan early on during your pregnancy. To know more about how to create your birth plan click here. You can also consult a VOG doctor at any time and from the comfort and safety of your home via the oDoc app.

 

Source

  1. Bhargava, H. D. (2020, July 16). First trimester of pregnancy: What to expect, Baby Development. WebMD. Retrieved December 15, 2021, from https://www.webmd.com/baby/guide/first-trimester-of-pregnancy#3 
  2. Healthline Media. (2017, November 9). The first trimester of pregnancy. Healthline. Retrieved December 15, 2021, from https://www.healthline.com/health/pregnancy/first-trimester#other-considerations 
  3. The first trimester. Johns Hopkins Medicine. (n.d.). Retrieved December 15, 2021, from https://www.hopkinsmedicine.org/health/wellness-and-prevention/the-first-trimester 
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