Pharmahealthblog. Health and medical information

Haemorrhoids (Piles)

Many women are troubled by haemorrhoids (or piles). This is often worse in the later stages of pregnancy, and during actual labour. These are an extension of the varicose vein problem, and are actually distended veins in the lower part of the bowel. In some women they are very prominent and quite uncomfortable.

Eliminating constipation can often assist in a remarkable manner. Having unprocessed bran, ideally with muesli, for breakfast each day is good and effective therapy. Often, through the application of simple creams such as lanoline, a soothing result can be obtained. Sometimes clothing rubbing against the piles (which may prolapse) can be very uncomfortable, and local applications can reduce this. Sometimes the insertion of suppositories can assist in shrinking them.

But piles are essentially a mechanical problem, and nearly always they rectify themselves automatically when the confinement is over.

Excessive urination

In early pregnancy, the kidneys tend to produce more fluid than usual. This results in the desire to urinate far more often than normal. Indeed, so common is this symptom that it is often regarded as one of the early tell-tale symptoms of pregnancy.

Toward the end of the term, as the foetal head presses on the bladder, frequency is again quite common. This time it is a mechanical cause.

Both types of frequency are non-serious. They do not indicate disease and, apart from the transient nuisance factor, should be ignored.

Women are more prone to urinary-tract infections during pregnancy. This is often accompanied by the passage of unpleasant-smelling urine, aches and pains and possibly an elevated temperature. The fluid may contain blood, or be cloudy. The desire to pass the urine often occurs, and it is often accompanied by a burning sensation, and the desire to micturate again soon after. There is a lack of comfort, even though the bladder has been emptied.

It is important that urinary-tract infections be dealt with adequately, and medication may be necessary. Often a fever and pains over the bladder or in the back may accompany the other symptoms.

Tests may be carried out by the doctor to determine if infections are present. They will also indicate to him the best form of therapy for your particular infection.

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Pregnancy Tests.

With the advent a few years ago of reliable tests collectively referred to as “immuno-chemical tests,” it is now possible to obtain quick and accurate results. In fact, by using some forms of the test, an answer can be forthcoming in a matter of minutes!

Those that can be read after two minutes are claimed to be 92 per cent reliable. A similar test which occupies about two hours is said to be about 98 per cent accurate. These degrees of accuracy are very high. When teamed in with the patient’s history, the symptoms she describes and the results of the physician’s physical examination, it usually leaves very little doubt in anybody’s mind whether conception has or has not taken place.

Certain precautions are needed when carrying out the pregnancy tests. Ideally, it is a “first” specimen of urine taken during the initial act of urination for the day. The bottle should be clean and free from contamination by drugs or chemicals. (This could possibly give a false reading.) If there is any time-lapse between the time the urine is passed and the time of examination (and a few hours is most likely), the specimen should be refrigerated.

The doctor is seeking to prove the existence in the specimen of urine of a specific hormone called “H.C.G.” This is short for Human Chorionic Gonadotrophin. It is produced by the developing embryo, and actively circulates in the bloodstream. A certain amount is excreted in the urine. If it can be picked up by the use of the test, it is an almost certain guarantee of pregnancy.

However, it takes almost six weeks from the date of the last menstrual period for adequate amounts to be excreted in the urine. Therefore, if the test is carried out before the six-week period, it will most likely yield a negative result, even though the person may be pregnant.

A popular routine is to carry out the H.C.G. test at six weeks. If it indicates negative, and the patient shows many of the other signs of pregnancy, the test is carried out again seven to ten days after. A positive result is then probable, indicating pregnancy has actually occurred.

The doctor will most likely check to see what forms of medication (if any) you are taking. Certain drugs, it seems, can produce incorrect results with the immunochemical test.

The introduction of the simple and accurate immunological pregnancy tests has been a major step forward in the early accurate disgnosis of pregnancy.

New Blood Test for Pregnancy

Since the original urine test for pregnancy was worked out, a quicker and even more reliable one has been developed, and this is now widely used by doctors. In fact, pregnancy can accurately be diagnosed within twenty-four to thirty-six hours of conception. One does not even have to miss a period. It is called the radio immuno assay pregnancy test, or R.I.A. Pregnancy Test for short. Taking a blood sample, a special machine can detect extremely minute traces of H.C.G. circulating in the mother’s blood. It is far more delicate and accurate than the H.C.G. urine tests, and will undoubtedly replace it in due course.

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Normally, the average pregnancy consists of one single foetus. But about once in ninety cases, twins occur.

The rate at which triplets occur is 1 in 90 x 90 pregnancies, and quadruplets 1 in 90 x 90 x 90. This is the rate in Western lands. It is more common in Africa and Asia where a larger hereditary factor apparently plays a part.

There are two types of twins: “Binovular” twins occur when two separate eggs (or ova) are released and fertilized at the same time. Each foetus is a separate entity and is quite distinct from its fellow. “Uni-ovular” twins come from one single egg which has prematurely divided into two separate entities.

Twins are often diagnosed before their birth, but about 20 per cent are not recognized until the moment of delivery. Features which make a patient and the doctor suspect multiple births are mainly the size of the abdomen and womb which are larger than would be expected at any given time.

Sometimes two heads may be felt through the abdominal wall by the doctor’s examining hands. Frequently, the only sure way is by X-ray or ultra-sound examination of the womb. Two separate heads and bodies can be clearly detected in this manner.

Generally, multiple births proceed to term normally. But there is an increased risk of certain complications taking place, so the mother may be requested to attend more frequently for her prenatal examinations. Some cases end in premature labour.

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As pregnancy advances, more and more demands are made upon the mother’s reserves of iron. During the last twelve weeks a considerable amount of iron is transferred from the mother to the baby. It is essential that these depleted stores be made up to normal.

Even during normal non-pregnant life, women run a greater risk of having reduced stores of iron. Menstruation each month reduces the supply. Although a certain amount of this is made up during the subsequent month, it is very common for the level to be less than normal even early in pregnancy.

For this reason, the doctor usually orders a haemoglobin examination at an early date in pregnancy. The haemoglobin is the red material in the red blood cells, and iron is used in its manufacture. Unless this is present in normal amounts, the body (including the foetus) is unable to gain sufficient supplies of oxygen, and difficulties may be encountered.

With more severe forms of anaemia (as this condition is called), symptoms will appear. Fatigue ‘more than would normally be expected), shortness of breath, a pale complexion and swelling of the tissues (referred to as oedema) may occur.

These are very important symptoms, indicating an immediate need for treatment.

However, the doctor usually has taken the matter in hand well before these symptoms are likely to put in appearance.

Treatment is generally very successful. It is usually given in a form that can be taken orally. Many different forms are available. Some patients are sensitive to some iron salts, and changes are necessary. But usually a certain brand is available that is suitable and can be tolerated satisfactorily.

Sometimes another chemical called folic acid is in short supply, and this may be given in conjunction. It is also needed to keep the blood in good order.

By sticking to a sensible iron-rich eating routine, the risks of anaemia are far less.

An iron-rich diet is usually a vitamin-rich diet as well. If the mother-to-be acquires this naturally, the need for medication is often reduced.

The original blood test carried out at the first consultation is often repeated at the thirty-second and thirty-sixth weeks of pregnancy, for these are critical times when iron utilization is high. Any deficiencies must be brought back to normal as promptly as possible.

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This is a fairly rare event. It means that the fertilized egg fails to reach the womb on its journey from the ovary (from which it was released).

Instead, it settled at some part along the course of the Fallopian tube (sometimes called the oviduct). This odd occurrence seems more common in underdeveloped lands, where about one pregnancy in 150 ends up this way. In Western lands, the incidence is much lower, being about once in every 250 pregnancies.

The tubes are designed as pipes to transport the egg. They are certainly not meant to sustain foetal growth, and it is quite impossible for a pregnancy to continue there for any length of time.

So, symptoms of disaster are inevitable. It is merely a matter of time. Usually this is between the sixth and tenth weeks.

If the egg becomes implanted in the tube at the ovarian end, then a tubal abortion commonly occurs. This may be the least dramatic. The fertilized ovum simply dies, and is spontaneously aborted into the abdominal cavity.

If the egg is located more deeply along the tract of the tube, it increases in size, and gradually burrows into surrounding tissues. Often a major blood-vessel is finally eroded, and a sudden internal haemorrhage occurs. Blood may suddenly spread out into the pelvic cavity, often creating an emergency situation.

If this complication arises suddenly, and there is considerable blood loss, the patient will notice sudden severe pain in the lower abdominal area. Sudden collapse is common, and shock may occur due to the haemorrhaging. There may be some vaginal bleeding.

Urgent admission to hospital and medical attention is essential. With prompt diagnosis and surgical intervention results are usually satisfactory.

The key warning to any woman who appears to be in early pregnancy (one or two missed periods) is to seek prompt attention if there is any sudden onset of low abdominal pain. Call the doctor or get to a hospital.

In recent years, certain procedures have been claimed to increase the risk of tubal pregnancy. The use of the progestogen-only contraceptive pill (the so-called “mini-pill”) had this charge leveled at it at one stage.

Operations aimed at reconstituting the patency of blocked Fallopian tubes were claimed to be followed by an increased risk of ectopics.

One ectopic seems to increase the risk of another if a further pregnancy takes place. (The risk rises to about 10 per cent.) Only about 60 per cent of women who have sustained an ectopic become pregnant again.

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