"Preeclampsia if it happens at the time of maturity, say when the pregnancy is termed beyond 34 weeks, then we deliver the mother and the baby and that should be a happy ending interms of the mother being well and the being well. Preeclampsia, I hope you understand when the mother develops high blood pressure in pregnancy and it typically happens in 20 weeks of pregnancy. So if this happens very early in pregnancy then we can extend the pregnancy to the extend we want because we want the baby to be matured when it is delivered ad we want the baby to survive on its own when it is delivered, we want to avoid the immaturities we can. There are conditions we have where the condition of the mother gets serious and we don’t want to continue the pregnancy, because counting pregnancy meaning risking the others left and at that time we are forced to deliver because ultimately the treatment of Preeclampsia is to remove the placenta, which is the trigger for the blood pressure. So to remove the placentas, we have to reeve the baby, no matter what stage the pregnancy is , if the mother’s life is at risks of the outcome of the pregnancy, the risk to the mother depends on the stage of pregnancy that she is if she is quite close to delivery, we will deliver her and not take any major risk with the mother’s life. But if she is so far from the delivery, then it means every day inside the uterus means 2 days outside the NICU, then we will try to push the pregnancy forward. So there will be a risk to the mother’s life, that we will be taking to a certain extend and similarly the baby who comes out early will go through a lot of struggle in the NICU and if it happens even before the baby is viable. The baby will not survive. So these are the risk of Preeclampsia on the other and the baby. This is one of the major worries of any mother during the pregnancy. High blood pressure in the mother also doesn’t allow the baby to grow well. So these babies are growth restricted, growth retreaded and they may run into trouble as well even though the mother is stable requiring delivery of the baby for its well being. So Preeclampsia is a delicate scenario that needs to be monitored and described on again individual basis"

"Not all adverse fetal outcomes can be detected before childbirth. Some can be detected. We do testing for thyroid, sugars so that we prevent these adverse fetal outcomes. If we know a preexisting problem in the mothers then we know there is a problem to look out for certain conditions, say for example, if a mother develops a viral infection like rubella, there are tests to see if the baby is affected and that will then predict if the baby is going to have a problem after it is being born or not. That is a rare incident. Routinely we do scans at 12 week and 5 months to check if the babies are normal. This is one of the main ways to check what is the outcome of the baby is going to be at 12 weeks we are going to do a Down’s syndrome screening, scan and blood test to see what the baby to see if the baby is normal with regards to Down’s syndrome. Again at 18 to 20 weeks, we do scan which we call as anomaly scan were we check to see if the baby is looking anatomically normal. Through our scanning doctor will do a whole lot of scans to see if the baby is normal, not all abnormalities are present at that time sometimes we see that affect the baby is growing there are some things that are not quite right as the baby is growing, but for the most part, most problems are detected, by the 5th month, and most of the tests are detected by the way of ultrasound scans"

"Gestational Diabetes implies that the person is not already diabetic and at they have developed diabetes during pregnancy. Most people who develop diabetes in pregnancy are either having a family history of diabetes. So they are prone to diabetes because of their genetics or they tend to be overweight or have a bad diet, they are people who have Gestational Diabetes and are on diet control, that is just above the upper limits of normal for sugars and the tem during pregnancy and don’t do much else just to make sure the pregnancy stays normal for the mothers and babies put on weight and on most part they have very normal pregnancy and pregnancy to come in terms of delivery and so does the baby. There are people who have diet control, and become severely diabetic during pregnancy and need medication or insulin of varying degrees to control their sugars. In such mothers the tough parts controlling the diet, checking their sugars, taking medication and it is quite distressful for the despite that there will be issues in the growth of the baby when the mother is diabetic. We never try to pull the sugars to the normal when the mother is diabetic because we are worried about developing hypoglycemia, when the sugars drop to such a level that the mother’s life is at rest. So the tendency is to run a slightly high value and bigger baby means can lead to complicated delivery and its list of problems with regards to vacuum or forceps delivery and difficulty of the shoulders coming out and if they labor and baby is little too big and delivery is not happening, they have obstructed labor and cesarean and sometimes they may require a panned cesareans. So there is an interventional delivery for these mothers may be higher other mothers who have Gestational Diabetes in mothers who don’t work on their diet and exercise and don’t come back to fitness which was talking. If they do all that, they have a lifestyle change, where we concentrate on healthy food and exercise and bring back to the normal range, then most people can have normal life. If not there will be a percentage of them going into diabetes, so this is the warning of Gestational Diabetes that they need to look at their health and focus on their health, although immediately after delivery most mothers sugars will come back to normal. It is unlikely they will be diabetes. With regards to outcome to the babies, the babies will tend to be bigger and babies who become bigger in intrauterine stage that is during pregnancy, tend to become diabetics early in their life. So this is I feel strongly about ad it is so important for mothers to control their sugars to that they have a healthy starts. We are mothers who work so hard for children and we don’t want any evil to happen to them. So think about the long term of your child and work on the fitness, controlling sugars. Complicated delivery for the baby is the baby also bears the brunt of it and it is important to keep this in mind and to optimize sugar levels"

"Meconium Staining or a normal part of the progression of pregnancy depending on which stage of pregnancy you are. If it is a thin Meconium and if you are in advanced stage of labor and baby heart rate is fine, it is alright for us to continue labor and to anticipate a normal deliver as long as the progression of labor is good and the baby is continuously monitored. Thick Meconium in very early labor tends to be a problem in early labor because it will not case labor to progress though and Meconium could at any time be a sign that the baby is not happy and the outcomes in terms of delivery depends on terms of the history of the women, whether it is the first, second pregnancy or how rapidly she is laboring, is it a normal size baby? How far is she in labor, is it looking like she will deliver quickly, how bad is meconium. So it is not an easy answer to give. It has to be individualized and even with continuous monitoring there is always a risk that there may be some aspiration of the meconium. If going forwards, there is a little distress scenario involves. So there is no one answer for that. It has to be individualized for each person’s care"

"To improve Maternal Health means if you are planning for a pregnancy, I would suggest to see the obstetrician and gynecologists that they can make an assessment of your condition and see whether there are any other deficiencies that need to be corrected. If you have not had your vaccinations up to date, they can give you that and can reduce the risk of infection during pregnancy and infection affecting the baby during pregnancy. If they can asses if you are underweight and advice you with regards to your weight and if you are overweight or diabetic then you need to try and work on your weight and correct your sugars. Ofcourse the most important thing is that you shod be exercising everyday. Pregnancy and well being is of before pregnancy, during pregnancy and after pregnancy, man, woman and child, so if it is important to start look at exercise most patients don’t do exercise before they get pregnant and they suddenly they starts thinking about this diet, fitness, exercises during pregnancy and that is the wrong way of going about. So improve your health by eating healthy and thinking about diet and exercise before your pregnancy starts"

"Maternal Health is very important for example if you have heart disease and preexisting heart disease. This will affect how the baby is going to grow and depending on the heart disease, there are ways for us to optimize the condition if they have a septal defect and you can fix that before the pregnancy and we don’t want that complication to happen. If you have heart disease, say valvular heart disease, if you are a mother with a heart problem, you have a child with a heart problem. So genetically there make an effect of mothers illness on the child. Aside from that we don’t correct the cardiac problem or if you become too sick. So early baby in an ICU having its own last of struggle. These are issues we face. Sometimes the pregnancy is compromised where the mother gets very sick and delivery maybe compromised as well and a whole lot of issues can come, other issue can be if you are hypothyroid. If you don’t fix thyroid, depending on the thyroid level, the baby’s brain development can get affected. So there is always an option for us to fix and try and sort these problems out before you get pregnant so that you can decrease the effects of maternal complications which then decrease the effect on the baby as well"