PAK BIDAN

Suntikan pelalian yellow fever waktu hamil

2011-12-08T17:03:00.000-08:00

Mengikut hasil kajian penggunaan sunttikan pelalian yellow fever tidak ada kesan buruk kepada bayi. Ia tidak menyebabkan keguguran, kecacatan atau lain2 gejala waktu melahirkan dan waktu penyusuan bayi.

Overview

If you become pregnant, discuss with your doctor the benefits and risks of using Yellow Fever Vaccine during pregnancy. It is unknown if Yellow Fever Vaccine is excreted in breast milk. If you are or will be breast-feeding while you are using Yellow Fever Vaccine, check with your doctor or pharmacist to discuss the risks to your baby.

Yellow fever vaccine Pregnancy Warnings

In a study of 101 women vaccinated with the 17D-204 strain, most of whom were in the third trimester, the seroconversion rate was 38.6% compared to 81.5% for nonpregnant controls. No adverse events were reported in infants in this study and another study. No birth defects were reported by the Collaborative Perinatal Project in 3 mother-child pairs who were exposed to yellow fever vaccine during the first trimester. A report from the European Network of Teratology Information Systems concluded that there was not an association between adverse outcomes and vaccination, although the data sample was small. The rate of major malformations and abortions occurring after first trimester exposure was within expected ranges. One of 41 infants whose mothers were vaccinated during the first trimester tested positive for IgM antibodies in cord blood. No adverse sequelae were reported.

Yellow fever vaccine has been assigned to pregnancy category C by the FDA. Animal studies have not been reported. There are no large-scale controlled safety studies; however, congenital abnormalities have not been reported. The seroconversion rate to vaccines is significantly lower in pregnant women. Serologic testing should be considered to document an immune response. There is a concern that transplacental passage of the virus may occur. The theoretical risks of immunization may be outweighed by the risk of infection and complications to the mother and fetus if the mother is travelling to an area where there is a high risk of acquiring yellow fever infection. Nonimmune women should generally postpone vaccination and travel to endemic/epidemic areas during pregnancy. If travel and/or exposure is unavoidable, vaccination is preferable after the first trimester. Infants of vaccinees should be monitored for congenital infection and other possible adverse effects. Yellow fever vaccine should be given to a pregnant woman only if clearly needed. The U.S. Centers for Disease Control and Prevention (CDC) recommend postponing travel and yellow fever vaccination until 9 months after delivery. If a pregnant woman is traveling to or transiting through areas where a vaccination certificate is required but the disease is not currently a threat, the CDC advise carrying a physician's waiver along with documentation of the waiver on the immunization record.

Yellow fever vaccine Breastfeeding Warnings

There are no data on the excretion of yellow fever vaccine into human milk. There have been no reports of viral transmission to, or adverse events in nursing infants. However, there is a theoretical risk of transmission of the 17D virus to breast-feeding infants, which could result in encephalitis. The manufacturer states that nursing mothers may be vaccinated if travel to high-risk areas cannot be avoided or postponed. The U.S. Centers for Disease Control and Prevention (CDC) consider the administration of live virus vaccines compatible with breast-feeding. However, it should be remembered that neonates are too young to be vaccinated and will not be protected against infection.

Bolikah lahir normal lepas 2 kali cesar?

2011-08-16T20:48:00.000-07:00

Seorang ibu umor tiga pulohan telah melahirkan anak 3 kali, yang pertama cesarean sebab kandungan kembar, yang kedua lahir normal dan berat bayi 3.5 kg , yang ketiga cesarean sebab bayi berak dalam kandungan (fetal distress) berat bayi 3.9 kg.

Ini kandungan keempat dan sudah lapan bulan/32 minggu. Beliau hendak cuba lahir secara normal dan telah berjumpa beberapa pakar bidan dan semuanya kata perlu cesarean . Ini memang amalan semasa dikalang pakar bidan, bila sudah 2 kali cesarean , memang tidak ada pilihan mesti bedah cesarean kali ketiga. Malah mereka paksa ikat saluran fallopian (Tubal ligation).

Ramai juga yang minta yang kendalikan kelahiran secara normal lepas 2 kali cesarean , tapi saya buat penilaian teliti tentang sebab2 buat cesarean dulu, tengok saiz rongga ponggongnya cukup luas atau tidak, munkin perlu xray pelvimetry pada umur kandungan 37 minggu untuk ukur saiz rongga dan kepala bayi bolih masuk atau tidak.

Saya nasihatkan ibu2 berkenaan untuk kawal makan karbohaidret( nasi, mee, roti, kuih2 dll) gula dan semua jenis manisan. Lebihkan lauk , sayur2 dan buah2. Ini untuk mengawal berat bayi ketika lahir agar mudah lahir secara normal.

Mulai umur kandungan 37 minggu saya buat pemeriksaan vagina, untuk menilai pintu rahim samada ia mudah buka atau tidak dan kepala bayi bolih dan mudah turun atau tidak dan saya juga lakukan 'membrane sweeping' pada ketika itu . Jika saiz rongga penggong luas dan pintu rahim mudah buka dan kepala bayi bolih 'engaged' , saya syorkan cuba lahir normal. Anggaran dari pengalaman yang lepas akhirnya 50 % akan dapat lahir secara normal.

Hydroxytyrosol dalam buah zaiton antioxidant terbaik

2011-07-17T03:47:00.000-07:00

Hydroxytyrosol satu anti oxidant yang terkuat dan terbaik bolih didapati dari air buangan yang digunakan untuk memperoses buah zaiton untuk mengeluarkan minyak

The miraculous product was found almost by chance in the waters produced during the pressing of oils, which the discoverers found to contain polyphenols in concentration 300 times higher than those found in extra virgin olive oil. The hydroxytyrosol there contained has amazing free radical scavenging action accountable for the strong anti-inflammatory, antimicrobial, antiviral, anti-cancer and antithrombotic potential observed. It has been shown to be very effective in managing conditions, such as psoriasis, eczema,skin UV-induced damage, arthritis, osteoporosis, cardiovascular diseases and nervous system degeneration, and in preventing breast and colon cancer, as well as in the reduction of stress from secondary smoke.

Hydroxytyrosol derives from the hydrolysis of hydroxytyrol, also an active antioxidant compound found in olives but of very slow absorption in the gut. Contrarily, hydroxytyrosol is characterized by much higher bioavailability and even by the ability to cross the brain barrier so that it can display its antioxidantpowerin the central and peripheral nervous system.

The antioxidant capacity of hydroxytyrosol has been measured to be the second highest recorded in any plant product after garlic and is almost three times higher than grape seeds and green tea. A relative of this compound, oleuropein, is contained in high amount in the leaf of the olive tree and is present in olive leaf extract, which is used for its strong antibiotic properties. However, this is much less powerful and is more poorly absorbed into the blood stream compared to hydroxytyrosol.

By following ancient traditions of production of olive oils by Italian ancestors in the time of Magna Graecia, the pressing of the olives is currently done after the elimination of the pits in order not only to increase the sweetness and the pH of the final product, but also to remove the enzymes and fatty acids responsible of the oxidation, which consumes the beneficial components.

The extraction of such a potent supplement is done from what was before considered waste water to be eliminated. Such water from the pressing process is now saved, and the precious compound is extracted and stored in powder form of different concentrations to be used as premium dietary supplement or for production of natural skin care products. Therefore such a process produces also a gain to the environment. If this practice were to be adopted by all oil producers, it could eliminate 10.4 billion gallons of what were considered toxic waters from world liquid waste.

Khasiat Habbatus sauda ( black seeds)

2011-07-13T17:01:00.000-07:00

Maksud hadis Rasulullah ' habatus sauda adalah ubat bagi segala penyakit melainkan mati'

Habbatus Sauda banyak khasiat

Habbatus Sauda kaya dengan monosaccharide glukosa, xylosa dsb.polysaccharide
fatty acid yang tidak tepu (unsaturated essential fatty acids, EFA).
EFA tidak boleh dihasilkan oleh badan kita, oleh itu sumber utamanya ialah dari pemakanan
amino acid yang membentuk protein-karotene iaitu sumber vitamin A
kalsium, zat besi, dsb.

2. Sistem immunity

Kajian yang dilakukan di Arab Saudi mendapati, habbatus Sauda berupaya meningkatkan sistem imunisasi anda (daya melawan penyakit). Oleh itu ia mungkin penting dalam pengawalan kanser, AIDS dan penyakit-penyakit berkaitan yang lain.

3. Anti-histamine

Histamine ialah bahan yang dikeluarkan oleh sel-sel mast di dalam badan yang menyebabkan kesan-kesan allergik (alahan). Habbatus Sauda mengandungi bahan yang menghalang protein kinase C, sejenis bahan yang mencetus penghasilan histamine. Oleh kerana penghidap penyakit asma selalunya mengalami masalah alahan, habbatus Sauda mungkin baik diambil secara berterusan oleh pesakit-pesakit ini.

4. Anti-tumor

Kajian in vitro mendapati habbatus Sauda berupaya menghalang pembentukan sel-sel tumor. Oleh itu, ia baik untuk digunakan untuk membantu menghalang penyakit kanser.

5. Anti-bakteria

Penyelidikan ke atas bahan ini mendapati ia mempunyai aktiviti anti-bakteria . Habbatus Sauda didapati berupaya mengawal bakteria seperti E.coli, V.cholera dan spesies Shigella. Ini bermakna habbatus Sauda baik untuk mereka yang menghidapi beberapa jenis penyakit seperti cirit-birit dan masalah-masalah perut yang lain.

6. Anti-radang (anti-inflammation)

Habbatus Sauda didapati boleh mengurangkan radang (bengkak). Oleh itu ia baik untuk pesakit asma (mengurangkan radang dalam paru-paru), eczema (alahan yang menyebabkan gatal, kulit merah dsb.) dan arthritis (bengkak sendi).

7. Menggalakkan pengeluaran susu

Kombinasi lemak dan hormon yang didapati di dalam habbatus Sauda menyebabkan pengeluaran susu ibu yang menyusukan bayi bertambah.

Saya baru mula makan kapsiul2 Habatus sauda dan Extra virgin Olive oil , jenama 'Minsyam' - 2 biji pagi dan 2 malam, memang kesannya baik . bangun pagi rasa segar dan kurang lengoh2 dan sakit arthritis pun ada kurang. Siapa minat produk ini sila hubungi Abd Malik Faisal 019 611 4120.

Hasil Kajian Di Amerika, Nigella Sativa yang merupakan nama latin dari minyak jintan hitam, telah mendapat kejayan luar biasa sebagai makanan suplemen. Di Jerman, minyak habbasSauda telah tersedia dalam bentuk kapsul di farmasi.

Analisis ekstrak mengenai minyak dan kesan-kesannya juga telah dilakukan di Amerika dan hasilnya menunjukkan bahwa minyak kuno itu juga mujarab untuk segala macam penyakit. Para saintis Amerika telah merasa yakin bahwa kesan antibakteri dan antimikotis dari minyak habbasSaudayang merupakan obat Asia Timur dan di Asia berlangsung dalam waktu yang lama.

Para dokter di Mesir dan Cina menggunakannya untuk obat segala macam radang serta infeksi jamur. Bahkan, para ilmuwan kanker Amerika secara meyakinkan telah membuktikan bahwa minyak habbasSaudamenurunkan kadar gula. Ekstrak Nigella Sativa membantu merangsang tulang sumsum dan sel-sel kekebalan. Demkian tulisan para ilmuwan kanker Immuno-Biology Laboratory dari Carolina Selatan. Selanjutnya, produksi interferon menghasilkan sel-sel normal terhadap kesan-kesan virus sel-sel yang merusak, menghancurkan sel-sel tumor, dan meningkatkan jumlah antibodi yang menghasilkan sel-sel B.

Seluruh fungsi ini menyebabkan minyak habbasSaudasebagai calon (alternatif) yang ideal untuk pencegahan dan pengobatan kanker. Para ilmuwan Amerika telah memplubikasikan bukunya yang pertama mengenai temuan “Study Of Black Cumin Oil On Human”. Para ilmuwan di Jerman kini juga sibuk menemukan kesan-kesan minyak Mesir yang berkaitan dengan tubuh manusia.

Dr. Med. Peter Schleicher, ahli immunolog di Munich yang pada 1986 telah dinominasikan sebagai anggota termuda World Academy Scientists, menguji minyak habbasSauda di lembaganya untuk menemukan terapi baru bagi penyakit kronis dan kesan-kesannya. Temuan-temuannya indentik dengan para koleganya di Amerika.

Schleicher menyatakan bahwa dengan menggunakan minyak habbasSauda yang memiliki asam lemak tak jenuh, misalnya unoleat dan asam gammalinolen masuk ke organisme. Dengan demikian, kemungkinan mencapai sintesa kekebalan yang penting dan mengatur zat-zat yang diambil seperti dari prostaglandin E. Minyak linoleat menstabilkan membran-membran sel dan prostaglandin memiliki kesan mencegah radang. Dengan demikian, reaksi kekebalan berhenti yang menimbulkan penyakit dan bahkan merupakan awal dari penyakit kronis seperti jerawat dan demam hingga kanker.

Di samping fungsi sel yang berlebihan pada orang yang menderita alergi distabilkan, melalui zat minyak habbasSauda antibodi juga ditekan. Sistem kekebalan yang berlebihan pada kajian (ilmuwan) Amerika juga menguji bahwa sistem kekebalan yang salah dapat diatur kembali dengan kesan yang kuat dari minyak ini. Sementara itu, Scheleicher telah menguji kesan minyak ini terhadap 600 pesakit.

Sebagai hasilnya, dia meyakinkan pengobatan untuk alergi sekitar 70% dari pesakitnya. Di antara mereka adalah alergi terhadap serbuk dan debu serta jerawat dan penyakit neuro-dermatologis. Pesakit asma dan lainnya pada umumnya memiliki ketahanan yang lemah dan mudah terkena infeksi. Dari alasan itu Dr. Schleicher di Munich akan memasukkan minyak itu ke dalam pengobatan preventifnya terhadap pilek dan influenza.
Di Timur Tengah, minyak ini telah digunakan selama ribuan tahun sebagai obat untuk segala macam penyakit alergi, radang, gangguan menstruasi, tekanan moral, dan depresi, tetapi terutama terhadap bronkhitis, asma, dan neurodermatitis serta pencernaan yang buruk, bahkan impotensi.

Cara menghancurkan batu karang hempedu

2011-07-12T05:54:00.000-07:00

REMOVING GALLSTONES NATURALLY

by Dr Lai Chiu-Nan

It has worked for many. If it works for you please pass on the good news. Chiu Nan is not charging for it, so we should make it free for everyone. Your reward is when someone, through your word of mouth, benefits from the regime. Gallstones may not be everyone's concern. But they should be because we all have them. Moreover, gallstones may lead to cancer. "Cancer is never the first illness," Chiu Nan points out. "Usually, there are a lot of other problems leading to cancer.

In my research in China , I came across some materials which say that people with cancer usually have stones. We all have gallstones. It's a matter of big or small, many or few.

One of the symp tom s of gallstones is a feeling of bloatedness after a heavy meal. You feel like you can't digest the food. If it gets more serious, you feel pain in the liver area." So if you think you have gallstones, Chiu Nan offers the following method to remove them naturally.

The treatment is also good for those with a weak liver, because the liver and gallbladder are closely linked.

Regimen:
1. For the first five days, take four glasses of apple juice every day. Or eat four or five apples, whichever you prefer. Apple juice softens the gallstones. During the five days, eat normally.
2. On the sixth day, take no dinner.
3. At 6 PM, take a teaspoon of Epsom salt (magnesium sulphate) with a glass of warm water.
4. At 8 PM, repeat the same. Magnesium sulphate opens the gallbladder ducts.
5. At 10 PM, take half cup olive oil (or sesame oil) with half cup fresh lemon juice. Mix it well and drink it. The oil lubricates the stones to ease their passage.
PS. 1cup=250ml, ? cup lemon juice=3 lemons (aprox.)

The next morning, you will find green stones in your stools. "Usually they float," Chiu Nan notes. "You might want to count them. I have had people who passes 40, 50 or up to 100 stones. Very many."

"Even if you don't have any symp tom s of gallstones, you still might have some. It's always good to give your gall bladder a clean-up now and then.

Minyak zaiton kurangkan risiko angin akhmar/stroke

2011-07-11T07:17:00.000-07:00

(NaturalNews) Critical research released in the industry publication journal Neurology from the American Academy of Neurology provides evidence that regular consumption of olive oil can help lower the risk of stroke. The study examined individuals over the age of 65 that are most vulnerable to the devastating effects of a stroke. Scientists suggest that olive oil taken as part of a healthy diet can lower the life-altering risks associated with a stroke by 41% in the elderly. Based on this body of work, researchers "suggest that a new set of dietary recommendations should be issued to prevent stroke in people 65 and older."

To conduct the study, researchers examined the medical records of 7,625 aging adults 65 or older from three cities in France. Participants were in generally good health and had no prior history of stroke. Olive oil consumption was determined by use of dietary questionnaire and usage was broken down into three groups (none, moderate and intense) based on regular consumption habits. It is significant to note that virtually all olive oil consumed was extra virgin and cold pressed. This type of minimally processed oil has been found to lower the risk of heart disease in prior studies.

Participants were followed for a period of five years, and 148 strokes occurred during that time span. After considering dietary, lifestyle and medical history, researchers found that those with the highest intake of extra virgin olive oil were 41% less likely to suffer a stroke compared with those with the lowest consumption of the monounsaturated oil. In a secondary arm of this study where plasma fatty acid measurements were available, individuals with the highest oleic acid (olive oil fraction) were found to experience a 73% lower risk of stroke.

Researchers noted that olive oil consumption is associated with lowered risk of cardiovascular disease, diabetes, high blood pressure, lipid abnormalities and obesity. They stopped short of suggesting which particular elements of olive oil provide the stroke-protective mechanism. Extra virgin olive oil is known to be a rich source of natural polyphenols from the olive fruit; it alters the oxidized, sticky nature of LDL cholesterol that is implicated with plaque build-up in the arteries.

The study author from the University of Bordeaux in France, Dr. Cecilia Samieri commented, "Stroke is so common in older people and olive oil would be an inexpensive and easy way to help prevent it." The study did not specify the amount of olive oil used by those in the `intense` group that experienced the highest degree of protection from stroke. Nutritionists recommend that most people should add 1 to 2 tablespoons of extra virgin olive oil five days a week to reap the powerful health benefits of this monounsaturated oil.

Saya baru mula makan kapsiul2 Habatus sauda dan Extra virgin Olive oil , jenama 'Minsyam' - 2 biji pagi dan 2 malam, memang kesannya baik . bangun pagi rasa segar dan kurang lengoh2 dan sakit arthritis pun ada kurang. Siapa minat produk ini sila hubungi Abd Malik Faisal 019 611 4120.

Khatan bayi lelaki

2011-04-19T18:32:00.000-07:00

Kita galakkan bayi lelaki dikhatankan secepat munkin selepas lahir. Amalan ini sudah menjadi popular dinegara2 barat walau pun mereka bukan islam. Mereka telah mengetahui faedah besar dari amalan berkhatan.

Diantaranya ia bolih mencegah dari jangkitan kuman dalam saluran perkencingan dan buah zakar waktu zaman kanak2 yang mana kesan jangka panjang bolih menyebabakan kemandulan lelaki. Berkhatan juga dikatakan bolih mencegah tersebarnya kuman virus AIDS yang sering bertumpu pada kulit zakar (prepuce).

Juga dipercayai kotoran tahi pilat pada zakar lelaki yang tidak berkahatan adalah salah satu punca terjadinya kanser pangkal rahim dikalangan isteri mereka.

Waktu bayi baru lahir, prosedur berkahatn mudah dilakukan dan jangka tempoh sembuh pun cepat, anatar 5-7 hari sahaja.

Prosedur berkhatan bayi lelaki

1. Bayi dibersihkam dengan antiseptik pada kasasan kemaluanynya
2. Suntikan local anesthetic pada pangkal zakar untuk bius zakar, sering bayi menangis bila kena suntik bius. Tunggu 5 minit untuk bius berkesan.
3.Teknik khatan adalah mudah, saya gunakan alat Plasibel. (lihat gambar dibawah)
4. Kulit prepuce diguntung sedikit sehingga takuk kepala zakar.
5. Kulit dipisahkan dari kepala zakar dan tahi pilat dibersihkan.
6. Plastibel disarongkan pada kepala zakar, ada banyak saiz plastibel ikut saiz kepala zakar, penting untuk pileh saiz yang tepat supaya 'fitting'
7. Ikat dengan benang diluar kulit ikut jalur pada plastibel untuk kawal perdarahan. Penting untuk ikat kuat agar tidak terlucut.
8. Kulit prepuce digunting dan dibuang. Handle pada plastibel dipatahkan dan terdapat lubang kecil dimuncung plastibel untuk saluran air kencing bayi.
9. Tiada jagaan istimewa, jika bayi meragam pada malam pertama beri syrup panadol ikut arahan. Bila kencing atau berak dan perlu tukar lampin, bersihkan zakar saperti biasa dan pakaikan lampin baru.
10. Plasibel dan benangnya akan tanggal sendiri dalam tempoh 5-7 hari dan luka akan kering dengan sendiri.

Plastibel

Sakit bersalin berpanjangan

2011-03-25T03:33:00.000-07:00

Bila mulanya peroses labour/sakit bersalain?

Wanita ini bernyanyi ketika sakit bersalin untuk mengalih tumpuan mindanya. Kita bolih mengaji Quran untuk capai tujuan sama.

Ramai bakal2 ibu risau bila akan bermula labour, ada yang tidak sabar menanti, kalau bolih hendak secepat munkin sebab kandungan semakin jadi berat dan beban kepadanya. Untuk kehamilan sulong, seibu mesti lebih stress/tension. maklum ini pengalaman pertama , tidak tahu apa situasi yang akan dihadapi.

Masuk bulan terakhir, kuncupan rahim mula dirasai, ini dianggap sebagai warming up , ikut bahasa medical kuncupan ini digelar 'Braxton Hicks contraction' . seibu hanya rasa rahimnya mengeras tetapi tidak sakit.

Sering berlaku apa yang dipanggil 'false labour', ia itu kuncupan rahim yang disertai kesakitan, dan berlaku setengah jam sekali tetapi bila diperiksa pintu rahim masih tutup lagi. Bagi kehamilan sulong jangan tergesa2 masuk hospital walaupun tanda/show (lendir bercampur darah) sudah keluar, tunggu sakit yang datang setiap 10 minit sekali. atau jika air toban sudah pecah.

Labour dikira bermula jika sakit dari kuncupan rahim telah dirasai setiap 5-10 minit sekali dan bila diperiksa , pintu rahim sudah terbuka 2-3 cm. Awal labour, iaitu peringkat pertama digalakkan seibu berjalan2 dan sering duduk , jangan hanya terbaring sahaja.

Biasanya janka tempoh sakit bersalin ialah antara 2 - 10 jam, ada yang mudah dan cepat bersalin dan ada yang berpanjangan sehingga 20 jam.

Apakah punca2 sakit bersalin yang berpanjangan?

1. Kehamilan anak pertama, khususnya jika rongga pongong sempit khususnya jika ukuran tinggi kurang dari 150 cm, dan kedudukan kepala tidak normal.

2. Saiz bayi besar , biasanya dikaitkan dengan pengidap diabetes waktu hamil, sejarah diabetes dalam keluarga, kegemokkan dan pemakanan karbohaidret dan gula yang berlebihan

3. Kedudukan kepala bayi luar biasa ketika masuk dalam rongga ponggong - sengit / asynclitism (lihat rajah dibawah). occiput posterior (OP) atau muka dongak keatas (face to pubis), sebaiknya muka bayi menghadap kearah saluran najis ibu ketika labour dan lahir atau occiput anterior (OA). Kedudukan2 OP dan sengit kepala tersebut menyekat pejalanan kepala bayi melului rongga ponggong ibu.
Rajah Asynclitism

Rajah occiput posterior (OP)

4. Bayi songsang atau breech

5. Umur ibu melebihi 40 tahun, rahim tidak kuat kuncupannya, rongga ponggong juga bolih jadi sempit sedikit.

6. Rongga ponggong sempit atau cephalo pelvic disproportion (CPD) , kepala bayi tidak bolih masuk kedalam rongga ponggong walau pun ada kuncupan rahim yang kuat dan kerap.

7. Cervical dystocia - pintu rahim tidak bolih buka walau pun satelah berjam2 lamanya berlaku kuncupan rahim yang kuat dan kerap. Kaedaan ini munkin ada berkaitan dengan penyakit endometriosis. adenomyosis atau fibroid yang menyebabkan pintu rahim keras dan liat untuk dibuka.

Risiko labour berpanjangan serta pelan tindakan

1. Bayi bolih lemas / fetal distress. Bolih mengancam nyawa dan jika berlaku, pembedahan cesarean perlu dilakukan. Jika pintu rahim sudak terbuka 9-10 cm bila fetal distress berlaku, kelahiran secara vakum bolih dilakukan.

2. Epidural block untuk menghilangkan sakit bersalin.

3. Electronic monitoring untuk pantau kuncupan rahim dan kadar denyut jantung bayi secara terus menerus.

4. Jika kuncupan rahim tidak kuat, beri ubat pitocin melalui drip sehingga kuncupan rahim menjadi kuat dengan kekerapan 2-3 minit sekali.

5. Maternal distress atau seibu kepenatan dan keletihan tanpa tenaga untuk meneran bayi keluar. Pertolongan untuk melahirkan dengan forseps atau vakum diperlukan.

6. Jika berlaku bayi lemas/ fetal distress atau tiada kemajuan dalam pembukaan pintu rahim satelah 20 jam lamanya, ibu ditimpa maternal distress atau terkena jangkitan kuman, bayi perlu dilahirkan segera dengan pembedahan cesarean.

Dilema Pak Bidan

2011-03-18T07:22:00.000-07:00

Kadang kala kerja pak bidan stress juga , khususnya bila berdepan dengan situasi dimana pesakit dan suami yang mempunyai pandangan berlainan dan sukar mengikuti nasihat saya. Ini berkaitan cerita seorang pesakit yg baru saya sambut kelahirannya. Tujuan cerita ini hanya untuk tujuan sebagai iktibar sahaja, bukan untuk tujuan mengkritik atau menghina sesiapa.

Seorang wanita umur tiga puluhan tahun , berkahwin dengan seorang lelaki dari negara lain. Pasangan tersebut berjumpa saya kerana kehamilannya, anak sulung disyakki mengidap down syndrome dari satu ujian darah , mereka mohon pandangan saya apa nak buat tentang kandungannya, Perlukah buat ujian2 lain untuk mengesahkan diagnosis. Pendapat saya berbeza dari banyak doktor2 lain khususnya doktor bukan muslim. Walaupun kita bolih sahkan down syndrome dengan ujian khas - amniocentesis dan chromosome analysis, kita tidak dibolihkan menggugurkan kandungan. Lihat video ini

Lagipun umur kandungannya ketika berjumpa saya telah melebihi empat bulan, dimana semua organ2 tubuh badan bayi telah terbentuk. Menggugurkan adalah haram hukumnya. Mereka bersetuju dengan pendapat saya untuk meneruskan kehamilan hingga cukup bulan, dengan betawakkal kepada Allah SWT.
Mereka datang untuk prenatal check up mengikut jadual setiap bulan sehingga 7 bulan dan lepas itu setiap dua minggu sekali. Pertumbuhan bayi normal, kedudukan bayi, denyut jantung, dan uri semuanya dalam kaedaan normal sehigga bulan terakhir.

Sakit bersalin bermula pada 17/3 dan masuk ke wad bersalin pukul 2 petang dengan kekerapan kuncupan rahim setiap 5 minit tapi tidak kuat , pintu rahim baru 2-3 cm, peringkat awal labour. Saya cadangkan , masuk ubat pitocin untuk mempercepat contraction tapi mereka tidak setuju. Tidak mengapa, mereka mahu natural labour. Pukul 9 malam sakit mankin kerap dan kuat, tidak tahan sakit, mohon Epidural Block untuk hilangkan sakit, itu dilaksanakan, Electronic monitoring untuk jantung bayi mencatit kadar 150 bt/ min, itu normal tapi tracing 'flat ' menunjukkan munkin ada masalah bekalan oksijen kepada bayi (Fetal distress), Kita teruskan pemantauan ibu dan bayi; pukul 1.20 pagi membrane pecah dan air toban warna hijau pekat sebab najis bayi dan kadar denyut jantung bayi meningkat kepada 180 bt/min dan pintu rahim hanya 4 cm sahaja - ini memang tanda 'fetal distress'.

Persediaan untuk emergency cesarean terus dibuat untuk mencegah bayi mati lemas. Bilik bedah bersiap sedia, doktor bius sudah tiba dan saya dalam perjalanan kehospital pada pukul 1.45 pagi untuk melakukan pembedahan. Tiba2 labour ward sister beritahu saya pesakit dan suami enggan beri kebenaran untuk bedah. Kecoh juga staf labour ward. Saya terus menuju kelabour ward dan meriksa pesakit, memang benar semua tanda2 fetal distress memang nyata, tapi bila saya periksa vagina, pintu rahim telah buka 7 cm pada pukul 2,pagi .

Suami masih enggan untuk bedah, saya beritahu tentang risiko bayi mati lemas, dia sanggup tanggung risiko. Urusan bedah dibatalkan, saya kena tunggu dan tidur di bilik sebelah pesakit. Pukul 4 pagi nurse ketuk pintu bilek saya mengatakan pintu rahim 'fully dilated - 10 cm'. Saya terus lakukan vacuum delivery, sukar juga baayi hendak keluar, denyutan jantung bayi semankin perlahan dan lemah, stress jug kita dibuatnya. Akhirnya dapat juga keluarkan bayi, tapi flat. tidak menangis dan tidak bernafas. kita kelam kabut resuscitate bayi dengan peralatan pernafasan dan lepas itu kita kejarkan bayi ke neonatal ICU dan perlu intubation ( masuk tiub pernafasan), insyaallah setakat ini bayi dalam kaedaan memuaskan. tolong doakan.

Lepas ibu tumpah daraah pula, kehilangan 800 ml darah, saya beri rawatan sewajar untuk menghentikan perdarahan, Alhamdulillah , perdarahan berhenti dan pesakit telah pulih. Bayangkan bagaimana tegangnya situasi tersebut. Beginilah kehihupan pakar bidan yang sering dibebankan dengan tanggung jawab yang amat berat. Semoga Allah melindungi dan memberkati kita.

Mengapa perlu induction

2011-03-17T06:30:00.000-07:00

PEROSES NORMAL LABOUR

Kebanyakan kelahiran berlaku secara spontan, iaitu sakit bersalin tercetus secara tiba2 apabila sudah sampai cukup bulan atau 'term' iaitu mulai 37 hingga 40 minggu umur kandungan. Tarikh EDD biasa dikitra 40 minggu dari hari pertama haid terakhir.

Bagaimana sakit bersalin bermula ?

Sebenarnya kita tidak mengetahuai dengan tepat apa yang mecetuskan sakit bersalin. Allah maha mengetahui. Tetapi bayi yang menentukan , ia mengeluarkan sejenis kimia perangsang yang menyebabkan rahim menguncup/contraction. Diantara bahan2 tersebut ialah oxytocin dan prostaglandins dan inilah ubat2 yang kita biasa gunakan untuk 'induction of labour'

Mengapa perlu induction?

1. Melebihi tarikh jangka lahir/EDD . Jika umur kandungan antara 41-42 minggu dan masih tidak lahir, induction perlu dilakukan.
2. Bayi terancam. olih preeklampsia ( darah tinggi, albumin dalam kencing dan bengkak kaki), pertumbuhan bayi bolih terencat , nyawa ibu bolih terancam jika berlaku 'sawan beranak'/ eclamptic fit
3 .Diabetes, pertumbuhan bayi terlalu besar dan sukar lahir normal, bayi bolih mati sebelum cukup bulan
4. 'Placental insufficiency' sebab kerosakan uri - dan kesannya ialah bayi tidak membesar/rendah berat badan atau IUGR.
3. Permintaan ibu untuk tarikh lahir tertentu atau sebab2 peribadi

Induction perlu dilakukan bila bayi sudah cukup bulan iaitu antara 37-40 minggu umur kandungan dan dianggarkan berat badan bayi bila lahir melebihi 2.5 kg

INDUCED LABOUR

Bagaimana saya lakukan

Satelah membuat keputusan untuk induce, saya akan periksa vaginal(VE) untuk menilai kaedaan pintu rahim, sudah terbuka atau masih tutup, lembut atau keras - mudah buka atau tidak apabila kita mulakan ubat penguncup rahim. Kedudukan kepala bayi dan keluasan ruang rongga ponggng pun penting untuk menentukan samada kelahiran secara normal bolih berlaku atau tidak,

Masuk wad bersalin dihospital awal pagi lepas subuh. Pesakit akan diberi enema utuk mengosongkab saluran najis bagi memudahkan kepala bayi turun kedalam rongga ponggong.

Ubat perangsang kuncupan rahim.

Oxytocin/Pitocin akan diberikan secara iv drip, biasa saya mulakan 2 atau 5 units dalam sebotol air saline dan diberikan perlahan2 mulai 10 dpm dan seterusnya ditingkatkan mengikut response yang diukur dari kekerapan kuncupan rahim. Sasaran kita ialah kuncupan yang kuat selama 40-45 saat dan berlaku setiap 2-3 minit sekali.

Selain dari pitocin, ubat prostaglandin juga digunakan untuk induction,, jenama yang terkenal ialah 'cytotec', sabenarnya ubat ini sering digunakan untuk merawat gastrik, tetapi tindakan meransang kuncupan rahim amat kuat ban berkesan. Ia dimasukkan kedalam faraj dengan dos permulaan 1/4 tablet, dan bolih ditingkatkan kepada 1/2 tablet 4-6 jam kemudian jika contraction tidak bermula atau tidak kuat . Saya sendiri telah menghentikan dari menggunakan cytotec kerana kadang2 kuncupan rahim terlalu kuat dan kerap sehingga bolih mebahayakan bayi dan ibu.

ARM atau memecahkan membrane amnion bolih mempercepat kelahiran. Prosedur ini sering saya lakukan apabila contraction sudah kerap dan sederhana kuatnya, ARM dilkukan dengan alat khas dan biasanya bila pintu rahim sudah mula terbuka, 2-3 cm. Air toban dikeluarkan dan dari warnanya yang jernih , kita tahu kaedaan bayi adalah sihat, tetapi jika berwarna hijau sebab bayi telah mengeluarkan najis ini munkin tanda bayi terancam atau fetal distress.

Pengurusan labour dan kelahiran adalah saperti biasa. Labour monitoring perlu rapi denagn menggunakan peralatan elektronik untk memantau contraction dan denyutan jantung bayi.

Cara mengesan bayi lemas/fetal distress

Epidural block hilangkan sakit

2011-03-11T20:44:00.001-08:00

Ini satu kaedah untuk menyekat saraf2 yang membawa deria kesakitan dibahagian bawah tubuh seseorang dan dengan prosedur epidural ia tidak akan merasai apa2 sensasi dari bahagian rusuk kebawah sehingga hujung jari kaki.

Bebagai jenis pembedahan dalam perut dan usus, organ peranakkan, dan seluruh kaki bolih dilakukan dengan pesakit sedar sepenuhnya. aepidural block sangat berguna kepada pesakit2 dalam bidang kebidanan dan sakitpuan.

Sakit bersalin bolih dihapuskan sama sekali dan ini sangat berguna kepada yang sangat takut kepada kesakitan. Bagi yang hamil anak sulung yang mana sakit labour bolih berpanjangan, ia sangat melegakan pesakit. Begitu juga mereka yang perlu diberi ubat untuk menguatkan kuncupan rahim saperti pitocin dan badi mereka yang cuba melahirkan secara normal dengan anak songsang/breech.

Begitu jug untuk semua kaedah kelahiran yang menggunakan alat saperti forceps dan vakum, epidural memudahkan procedur kelahiran. Jikka berlaku luka atau trauma pada saluran faraj akibat kaedah kelahiran tersebut, epidural memudahkan doktor bidan menjahit/repair keatas trauma tersebut.

Jika uri terlekat dan tidak bolih dikeluarkan secara biasa (retained placenta), ia bolih dikeluarkan dengan secara selok (MRP - manual removal of placenta) tanpa perlu bius am (general naesthesia)

Penting sekali kegunaan epidural ialah untuk melakukan pembedahan cesarean dengan siibu sedar sepenuhnya dan dapat menikmati suasana kelahiran dengan mendengar tangisan bayi sejurus dikeluarkan dari perutnya. Disamping itu suami bolih hadir dalam bilek bedah dan memberi sokongan emosi dan moral, dan ia bolih terus mengazankan bayi yang baru lahir. Ia bolih ambil gambar2 kenangan disaat genting isteri bersalin dan anaknya lahir kedunia.

Tiub epidural bolih dikekalkan ditulang belakang selama 2 hari dan sering ditop up dengan ubat bius dan dengan ini siibu tidak merasi langsung post operative pain.

Doa 2 waktu hamil dan bersalin

2011-03-05T23:53:00.000-08:00

Boedoalah kepada Allah SWT agar diberkati kehamilan dan kelahiran, serta dimudahkan kelahiran dan selamat ibu dan anak.
Doa2 ini dipetik dari buku kecil bertajuk ' Panduan doa untuk sihat dan zuriat' . Karangan saya dan ustaz Shafie Jali ketika saya di LPPKN. Insya Allah saya akan cuba citak semula.

Kenangan dari Mamawana

2011-03-05T02:45:00.000-08:00

Saat itu sungguh indah ketika aku membawa Wana yg baru berusia satu bulan untuk appointment dgn doktor pakar yg telah bersusah payah menjaga kandungan ku selama 9 bulan dan beliau juga yg melakukan pembedahan caesarean utk kelahiran sulong ku iaitu Datuk Dr Hamid Arshat. Rasa bahagia ketika itu hingga tidak sabar untuk bertemu doktor kerana beliau banyak memberi nasihat, doa-doa dan zikir untuk ku amalkan sepanjang kehamilan. Beliau seorang doktor yg lemah lembut dan kaya dgn sifat kebapaan yang sungguh mulia. Terima kasih doktor.

Sedikit perkongsian, setahun sebelum berjaya mengandung mama dinasihatkan untuk menjalani operasi laparoscopy kerana darah beku di saluran fallopian. Walaupun pembedahan itu nampak simple dan sekejap sahaja tetapi selepas habis ubat bius kesakitannya sangat memuncak di mana dua hari selepas dibenarkan pulang ke rumah, perut mama masuk angin kembung spt org mengandung 9 bulan.

Perut rasa seakan nak pecah. Ketika itu segalanya sakit, baring sakit, duduk sakit, menyandar sakit, nak berdiri sakit malah berjalan nak ke toilet pun tersangat-sangat sakit hingga bernafas pun sakit. Selama seminggu perut membusung, ingat nazak menghampiri. Airmata sentiasa berlinangan kerana menahan kesakitan yang amat sangat. Tuhan sahaja yg tahu. Kakak, ibu, suami, saudara mara datang menziarah pun hanya sekadar memandang simpati.

Tiada siapa yg dapat merengankan kesakitan dan kepedihan itu. Berkat doa yg tak putus-putus, alhamdulillah mama kembali sihat dan 3 bulan selepas itu mwana disahkan mengandung anak sulong. Subhanallah ...syukur Alhamdulillah. Terlalu gembira untuk menerima anugerah keajaiban ini. Selama 9 bulan juga mama rasa seperti berjalan di awang-awangan kerana kegembiraan walhal selama 9 bulan juga sebenarnya mama tidak boleh baring bermakna selama 9 bulan mama tidur duduk menyandar. Selama 9 bulan juga tidur-tidur ayam kerana tidak selesa dengan perut yang membesar begitu cepat, diusia 3 bulan macam mengandung 6 bulan. Baru 6 bulan mengandung tetapi macam 9 bulan.

Semasa 8 bulan pula dah tak boleh berjalan, kaki membengkak dengan saiz tubuh macam Giant kata rakan2 sepejabat mama. Kini, Wana dah besar dan sedang melanjutkan pengajian di UiTM. Untuk anakanda Wana, andai membaca warkah bonda ini ketahuilah bahawa kesakitan itu sungguh indah selama kamu di dalam rahim bonda dan dewasalah menjadi Puteri Solllehah sebagaimana doa-doa yang Doktor beri untuk amalan.

Kini, semuanya Owh, So Wonderful. Life is really really wonderful. Dalam kepedihan hidup ini...... Its awesome. Benarlah AlQuran itu. Setiap dugaan dan kesabaran itu ada hikmahnya. Subhanallah. Alhamdulillah.

Ikuti link NurQaseh

Kehamilan luar rahim

2011-03-03T02:11:00.000-08:00

Tiga bulan pertama kandungan adalah waktu yang terpenting kerana ketika itu pembentukan jasad berlaku daripada sekelompok darah menjadi segumpal daging dan seterusnya berbagai anggota badan dibentuk sehinggalah roh ditiupkan kepada jasad pada peringkat empat bulan.Pada ketika itu dan seterusnya barulah janin kukuh dalam kandungan sehingga sampai waktu kelahiran.

Diantara gejala-gejala yang mungkin timbul diperingkat awal kehamilan ialah keguguran . Lebih kurang 10 hingga 15 peratus kehamilan mungkin gugur atau menjadi luar biasa seperti kehamilan anggur (molar pregnancy /hydatidiform) atau kehamilan di luar rahim.

Tanda pertama bagi kehamilan luar biasa ini ialah pendarahan yang berketul-ketul disertai kesakitan yang kuata.Pendarahan walaupun sedikit ataupun banyak ialah satu petanda yang tidak baik bagi kandungan kerana ia menunjukkan sesuatu ancaman terhadap janin tersebut.
Apabila keadaan ini berlaku kita boleh anggap kemungkinan kehamilan ini akan berterusan sehingga sempurna atau akan gugur ialah – 50 peratus. Perdarahan yang disertai dengan kesakitan perut yang amat sangat mungkin menandakan keguguran atau kandungan di luar rahim (ectopic pregnancy). Kedua-dua ini merupakan ancaman besar kepada ibu dan bayi .

Jangan pandang ringan terhadap masalah pendarahan diperingkat awal kehamilan.Langkah utama ialah untuk berjumpa dengan doktor yang terdekat.Mungkin ia seorang doktor biasa (GP) untuk mendapat nasihat atau terus berjumpa dengan doktor pakar perbidanan & sakitpuan untuk mendapatkan nasihat, atau terus masuk ke hospital untuk mendapatkan rawatan dan penyiasatan selanjutnya.

Apakah punca pendarahan?

1. Keguguran

Ini mungkinhanya ancaman sahaja (threatened abortion).Sebenarnya janin masih hidup dan boleh tumbuh lagi tetapi mungkin disebabkan oleh pendarahan daripada uri akibat daripada kuncupan rahim yang biasanya ditimbulkan oleh sebab tekananfisikal dan mental,faktor kurang hormon atau kedudukan uri yang agak dekat dengan pintu rahim.Rawatan bagi keadaan ini ialah rehat sepenuhnya, ubat hormon diberi secara suntikan atau tablet, jauhkan dari hubungan suami-isteri dan tenangkan fikiran.

Keguguran boleh menyebabkan kematian janin iaitu apa yang digelar“missed abortion”.Kadangkala pendarahan tidak banyak dan biasanya tanda-tanda hamil seperti loya dan muntah, bengkak buah dada agak berkurangan atau tiada langsung.
Bila dibuat scanning ultrasound, biasanya tiada janin dikesan dalam karung kandungan atau mungkin terdapat segumpal daging janin tetapi tanpa denyutan jantung lagi.Dalam keadaan ini (missed abortion) memerlukan rahim dicuci melalui proses D & C.

Kehamilan luar rahim

Kehamilan luar rahim yang biasanya berlakudi saluran fallopian adalah sangat merbahaya kerana ia boleh pecah dalam perut menyebabkan perdarahan yang banyak serta mengancam nyawa dan adakalanya membawa maut jika lambat bertindak.Tetapi kebanyakannya mereka terselamat jika cepat masuk kehospital dan diberi rawatan cemas secara pembedahan.

Mereka yang terdedah kepada kehamilan luar rahim terdiri daripada wanitayang sukar mengandung atau mandul, mereka yang pernah menjalani pembedahan ke atas perkakasperanakan, untuk appendix atau pada bahagian usus.Mereka yang telah mengalami jangkitan kuman pada rahim dan mereka yang pernah atau sedang menggunakan alat dalam rahim (IUCD),juga terdedah kepada risikokehamilan luar rahim.

Selain daripada perdarahan, ia juga mengalami kesakitan yang amat sangat pada bahagian perut, mengulas rasa dan mereka kadang-kadang hampir pitam akibat daripada kesakitan tersebut.

Kehamilan Luar Rahim – Pecah dan Berdarah

Pengesahan

1. Ujian kencing masih positif untuk kehamilan (positive urine pregnancy test).

2.Ujian ultrasound menunjukkan rahimnyakosong tanpa karung kandungan tetapi terdapat kesan darah dankarung kandongan di luar rahim.

3.Langkah yang perlu diambil ialah untuk menjalani pembedahan secara cemas.Setelah dibius doktor mungkin melakukan pembedahan laparoscopy untuk mengesahkan adanya darah di luar rahim dan seterusnya membuat pembedahan kecil pada perut untuk membuang kandungan yang telah pecah.

Jika berlaku pada saluran fallopian, saluran tersebut perlu dibuang sekali dan seterusnya sisa-sisa kandungan dan darah dalam perut akan dibersihkan untuk mencegah daripada masalah kesan sampingan seperti “pelvic adhesions” di kemudian hari.

Kehamilan molar/anggor

2011-02-28T17:20:00.000-08:00

Kehamilan Anggur (Molar Pregnancy/Hydatidiform)

Kehamilan kembar

2011-02-23T05:56:00.000-08:00

Identical twin - atas
Non identical twin - bawah

Identical twin - risiko pada kembar kedua, kekurangan bekalan oksijen dan makanan kerana terpaksa bersaing dapat bekalan dari satu uri.

Bolihkah kita rancang untuk hamil kembar? Biasanya ia berlaku secara kebetulan, dan meningkat peluang jika ada sejarah kembar dalam keluarga, bila makan pil subur , suntik hormon subur, buat bayi tabung uji IVF

Mencegah Premature Labour

2011-02-21T16:09:00.000-08:00

Ini satu situasi yang bolih mengacam nyawa bayi ketika lahir kerana sistem pernafasan belum kuat lagi ia mudah diserang sesak nafas menyebabkan bekalan oksijen tidak mencukupi.

Premature labor means babies born before 37 weeks of pregnancy. Premature labor accounts for seven percent of total babies born in the UK. Though the risk for the mother is little, yet for the baby it is considerable.
Though premature labor can happen to any women, but it is quite risky for the young, single or smoking women and also those who are underweight.

Causes of Premature Labor

The causes of premature labor are not clear with 40 percent of cases. The main causes include:
Pre-eclampsia
Antenatal hemorrhage
Multiple pregnancies
Foetal abnormalities or death
Cervical incompetence
Illnesses like diabetes, high blood pressure or heart disease in the mother
Stress has shown to induce labor, especially when it is sudden or severe. Many vaginal infections like gonorrhoea, trichomonas, chlamydia, and group B streptococci are considered to be associated with premature labor.
Bacterial vaginosisin, in which the acidity of the vagina is changed, is also linked with premature labor. This could be possible due the reduction of the natural defenses of the body against infection.

Premature Labor Symptoms

Knowing premature labor is a challenging task. The only absolute sign of labor is the dilation of the cervix. But by this time it is not possible to stop the birth of the babay.
The challenge with premature labour is to spot it before it gets going. The only absolute proof of labour is dilation of the cervix, but by then it's too late to stop the baby being born.
Contractions of the uterus are not a sure sign of having a labor. There are cases of contractions from week 24 of the pregnancies, which are also known as Braxton Hicks or ‘practice’. Around two-third of labor cases will not deliver within 48 hours and one out of three of these women have full gestation periods.
If there is rupture of the woman’s membrane and there is loss of amniotic fluid, there is likelihood of labor as there are risks of infection. But sometimes urine is mistakenly taken for amniotic fluid and using special testing sticks give incorrect results.
The sure symptoms that show of an imminent premature birth include:
Four or more uterine contractions in one hour, before 37 weeks gestation.
Pain or rhythmic tightening in lower abdomen or back.
A watery discharge from the vagina, which may indicate premature rupture of the membranes surrounding the baby.
Menstrual cramps or abdominal pain.
Pressure in the pelvis or the sensation that the baby has "dropped".
Vaginal spotting or bleeding.

Treatment of Premature Labor

Screening of different infections mentioned above and treating them with antibiotics can reduce premature labor. The screening process must be done before the start of labor.
For stopping contractions there are drugs which can prevent in about quarter of the cases of premature labor. But these drugs hardly work for more than 48 hours. IF the membranes are ruptured, then these drugs carry some risk. These drugs are mainly used to delay delivery till the woman can go to a hospital.
During this time, there are treatments for making the baby arrive early, like drugs that help to mature the lungs. There treatments lessen the risk of complications, reducing to half the degree of respiratory distress syndrome.

Complications of Premature Labor

Babies born after 34 weeks have their systems completely matured and there is low risk of problems arising. The labor is continued in these cases. But if it is less than 28 weeks, then the babies have to be provided with neonatal intensive care unit in a hospital.
Nowadays, science has developed dramatically and babies born after 22 or 23 weeks can be survived by the doctors. There is the risk though of these babies for battling at the beginning of their life and there could be many long-term problems.
Babies who are born prematurely have the following kinds of problems:
Respiratory distress syndrome
Retinopathy of prematurity
Necritising enterocolitis
Low blood glucose
Hypothermia
Infection
Jaundice
Death

Prevention of Premature Labor

Though there is little one can do to stop premature labor, yet there are ways to reduce the risk. These include:
Stop smoking
Keep fit and healthy
Avoid excessive stress
Get vaginal infections or discharge treated
Symptoms like swollen ankles, blood loss or fluid loss should be reported

Buasir ketika hamil

2011-02-13T21:11:00.000-08:00

BUASIR WAKTU HAMIL

Waktu hamil buasir sering berlaku jika seibu sering mengalami sembelit. Ketika hamil perjalanan darah dari kaki menuju kearah jantung agak perlahan sedikit akibat tekanan olih rahim yang kian membesar keatas saluran darah. Akibatnya timbul urat2 vena dikaki - vericose vein. Kesan yang sama berlaku pada vena2 pada dubur menyebabkan timbulnya buasir (piles, hemorrhoids)

Kaedaan ini menjadi lebih teruk bila seibu mengalami sembelit. Makan banyak buah2 dan sayuran, cereal saperti corn flakes, bran, muesli dll. Minum fiber drink saperti fybogel dll. Makanan yang mengandungi banyak serabut/fiber adalah digalakkan.

Kalau berdarah atau luka sakit, beli ubat masuk dubur/suppository saperti anusol, proctosedyl, xyloproct dll. volteran supp. bolih mengurangkan sakit dan meredakan luka. Makan ubat daflon bolih bantu kecutkan buasir.

How are hemorrhoids treated?

At-home Treatments

Simple diet and lifestyle changes often reduce the swelling of hemorrhoids and relieve hemorrhoid symptoms. Eating a high-fiber diet can make stools softer and easier to pass, reducing the pressure on hemorrhoids caused by straining.
Fiber is a substance found in plants. The human body cannot digest fiber, but fiber helps improve digestion and prevent constipation. Good sources of dietary fiber are fruits, vegetables, and whole grains.
Doctors may also suggest taking a bulk stool softener or a fiber supplement such as psyllium (Metamucil) or methylcellulose (Citrucel).
Other changes that may help relieve hemorrhoid symptoms include

drinking six to eight 8-ounce glasses of water or other nonalcoholic fluids each day
sitting in a tub of warm water for 10 minutes several times a day
exercising to prevent constipation
not straining during bowel movements

Over-the-counter creams and suppositories ( anusol , proctosedyl, xyloproct , volteran supp,dll) may temporarily relieve the pain and itching of hemorrhoids. These treatments should only be used for a short time because long-term use can damage the skin.

Medical Treatment

If at-home treatments do not relieve symptoms, medical treatments may be needed. Outpatient treatments can be performed in a doctor’s office or a hospital. Outpatient treatments for internal hemorrhoids include the following:

Rubber band ligation. The doctor places a special rubber band around the base of the hemorrhoid. The band cuts off circulation, causing the hemorrhoid to shrink. This procedure should be performed only by a doctor.
Sclerotherapy. The doctor injects a chemical solution into the blood vessel to shrink the hemorrhoid.
Infrared coagulation. The doctor uses heat to shrink the hemorrhoid tissue.

Large external hemorrhoids or internal hemorrhoids that do not respond to other treatments can be surgically removed.

³Slavin JL. Position statement of the American Dietetic Association: health implications of dietary fiber. Journal of the American Dietetic Association. 2008;108(10):1716–1731.

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What foods have fiber?

Examples of foods that have fiber include
Breads, cereals, and beansFiber
1/2 cup of navy beans 9.5 grams
1/2 cup of kidney beans 8.2 grams
1/2 cup of black beans 7.5 grams

Whole-grain cereal, cold
1/2 cup of All-Bran9.6 grams
3/4 cup of Total2.4 grams
3/4 cup of Post Bran Flakes5.3 grams
1 packet of whole-grain cereal, hot3.0 grams
(oatmeal, Wheatena)
1 whole-wheat English muffin4.4 grams

Fruits
1 medium apple, with skin3.3 grams
1 medium pear, with skin4.3 grams
1/2 cup of raspberries4.0 grams
1/2 cup of stewed prunes3.8 grams

Vegetables
1/2 cup of winter squash2.9 grams
1 medium sweet potato with skin4.8 grams
1/2 cup of green peas4.4 grams
1 medium potato with skin3.8 grams
1/2 cup of mixed vegetables4.0 grams
1 cup of cauliflower2.5 grams
1/2 cup of spinach3.5 grams
1/2 cup of turnip greens2.5 grams

Source: U.S. Department of Agriculture and U.S. Department of Health and Human Services, Dietary Guidelines for Americans, 2005.

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Points to Remember

Hemorrhoids are swollen and inflamed veins around the anus or in the lower rectum.
Hemorrhoids are not dangerous or life threatening, and symptoms usually go away within a few days.
A thorough evaluation and proper diagnosis by a doctor is important any time a person notices bleeding from the rectum or blood in the stool.
Simple diet and lifestyle changes often reduce the swelling of hemorrhoids and relieve hemorrhoid symptoms.
If at-home treatments do not relieve symptoms, medical treatments may be needed.

Catatan suhu BBT

2011-02-12T20:15:00.000-08:00

Carta suhu BBT adalah satu kaedah mengesan penetasan telor / ovulation yang paling mudah, tepat dan murah harganya.
Perlu beli alat suhu yang khas , sering digelar ovulation / fertility thermometer yang bolih dibeli difarmasi dan ia disertai dengan kertas carta kosong yang perlu diisi mengikut sukatan suhu yang diukur pagi hari, sejurus sedar dari tidur dan belum melakukan apa2 aktiviti.

How is BBT Taken and Charted?
BBT is body temperature taken in the morning before rising, moving about, or eating. To be accurate, the temperatures must be taken at the same time every day upon waking, preferably after a good night’s sleep. BBTs are measured orally with a thermometer and recorded on a chart in graph form. It is essential that the thermometer reads accurately to the 10th of a degree, so you may want to purchase a specific BBT thermometer. Any discrepancies to your normal sleep cycle or wake time should be noted so your practitioner can account for inconsistent readings.
Several factors can influence and distort BBT, including:

Irregular sleep, disruptive sleep, or travel to different time zone
Alcohol or drug consumption including antipyretic and anti-inflammatory medications or sleeping aids.

If you work swing shifts for work or have sleep difficulties, BBT charting may not be the most reliable tool for you.

The Picture Perfect BBT
BBT chart fluctuations reflect changes in a woman’s body throughout the menstrual cycle. During pre-ovulation (also known as the follicular phase) temperatures should remain fairly stable. Typically, there is a dip in BBT when lutenizing hormone (LH) surges just before ovulation and a spike in temperature shortly after ovulation. Luteal phase (post-ovulatory) temperatures should remain at least 0.4 degrees higher than follicular phase temperatures in order for implantation to be successful.
Keep in mind that most women’s BBT charts are not picture perfect, and conception can occur despite irregularities. This tool should be used as information only, not a complete diagnosis. If you tend to be more stressed out by “too much information,” BBT charting may cause more harm than good. Talk to your practitioner to decide BBT charting is right for you.

Placenta previa - uri dipintu rahim

2011-02-12T04:46:00.000-08:00

Bila uri terletak dipintu rahim , kelahiran normal tidak bolih berlaku dan jika diteruskan , ia bolih menyebabkan tumpah darah yang amat banyak dan akan mengancam nyawa kedua ibu dan bayi

Placenta previa

Pregnancy in which the placenta grows in the lowest part of the womb (uterus) and covers all or part of the opening to the cervix.

The placenta is the organ that nourishes the developing baby in the womb.

Causes, incidence, and risk factors

During pregnancy, the placenta moves as the uterus stretches and grows. In early pregnancy, a low-lying placenta is very common. But as the pregnancy progresses, the growing uterus should "pull" the placenta toward the top of the womb. By the third trimester, the placenta should be near the top of the uterus, leaving the opening of the cervix clear for the delivery.

Sometimes, though, the placenta remains in the lower portion of the uterus, partly or completely covering this opening. This is called a previa.

There are different forms of placenta previa:

Marginal: The placenta is against the cervix but does not cover the opening.
Partial: The placenta covers part of the cervical opening.
Complete: The placenta completely covers the cervical opening.

Placenta previa occurs in 1 out of 200 pregnancies. It is more common in women who have:

Abnormally developed uterus
Many previous pregnancies
Multiple pregnancy (twins, triplets, etc.)
Scarring of the uterine wall caused by previous pregnancies, cesareans, uterine surgery, or abortions

Women who smoke or have their children at an older age may also have an increased risk. Possible causes of placenta previa include:

Abnormal formation of the placenta
Abnormal uterus
Large placenta
Scarred lining of the uterus (endometrium)

Symptoms

The main symptom of placenta previa is sudden, painless vaginal bleeding that often occurs near the end of the second trimester or beginning of the third trimester. In some cases, there is severe bleeding, or hemorrhage. The bleeding may stop on its own but can start again days or weeks later.

There may be uterine cramping with the bleeding. Labor sometimes starts within several days after heavy vaginal bleeding. However, in some cases, bleeding may not occur until after labor starts.

See: Vaginal bleeding in pregnancy

Signs and tests

Your health care provider can diagnose placenta previa with an ultrasound exam. Most cases of placenta previa are identified by routine ultrasound during pregnancy.

Treatment

Treatment depends on various factors:

How much bleeding you had
Whether the baby is developed enough to survive outside the uterus
How much of the placenta is covering the cervix
The position of the baby
The number of previous births you have had
Whether you are in labor

Many times the placenta moves away from the cervical opening before delivery.

If the placenta is near the cervix or is covering a portion of it, you may need to reduce activities and stay on bed rest. Your doctor will order pelvic rest, which means no intercourse, no tampons, and no douching. Nothing should be placed in the vagina.

If there is bleeding, however, you will most likely be admitted to a hospital for careful monitoring.

If you have lost a lot of blood, blood transfusions may be given. You may receive medicines to prevent premature labor and help the pregnancy continue to at least 36 weeks. Beyond 36 weeks, delivery of the baby may be the best treatment.

If your blood type is Rh-negative, you will be given anti-D immunoglobulin injections.

Your health care providers will carefully weigh your risk of ongoing bleeding against the risk of an early delivery for your baby.

Women with placenta previa most likely need to deliver the baby by cesarean section. This helps prevent death to the mother and baby. An emergency c-section may be done if the placenta actually covers the cervix and the bleeding is heavy or very life threatening.

Expectations (prognosis)

Placenta previa is most often diagnosed before bleeding occurs. Careful monitoring of the mother and unborn baby can prevent many of the significant dangers.

The biggest risk is that severe bleeding will require your baby to be delivered early, before major organs, such as the lungs, have developed.

Most complications can be avoided by hospitalizing a mother who is having symptoms, and delivering by C-section.

Complications

Risks to the mother include:

Death
Major bleeding (hemorrhage)
Shock

There is also an increased risk for infection, blood clots, and necessary blood transfusions.

Prematurity (infant is less than 36 weeks gestation) causes most infant deaths in cases of placenta previa. The baby may lose blood if the placenta separates from the wall of the uterus during labor. The baby also can lose blood when the uterus is opened during a C-section delivery.

Calling your health care provider

Call your health care provider if you have bleeding from the vagina at any point in your pregnancy. Placenta previa can be dangerous to both you and your baby.

Prevention

This condition is not preventable.

Bayi lemas / fetal distress

2011-02-12T02:55:00.000-08:00

Apakah punca2 bayi lemas ketika sakit bersalin?

Tanda utama ialah kadar denyut jantung menurun ke 120 beat/min kebawah atau melebihi 180 bt/min atau FH tracing menunjukkan 'flat' tanpa turun naik, dan air toban berwarna hijau bercampur najis bayi. Lebih lagi lihat video ini.

What is Fetal Distress?

The theory of fetal distress is this:

Neurological damage occurs when the baby's brain is deprived of oxygen. Lack of oxygen to the brain can be recognized by patterns in the baby's heart rate.
When the baby's heart rate pattern demonstrates a lack of oxygen (fetal distress) it is necessary for the baby to be born immediately.
To recognize changes in oxygenation, the baby's heart rate will be monitored, probably with an electronic fetal monitor (EFM) during labor for indications of fetal distress.

Waktu pantang lepas bersalin

2011-02-11T23:05:00.000-08:00

Ada kah patang larang yang diamalkan olih ibubapa dan nenek moyang kita membawa faedah atau lebih banyak mudharat?
PEKEJ SET LEPAS BERSALIN

Luka waktu bersalin

2011-02-11T22:26:00.000-08:00

Second-degree vaginal tear

Second-degree vaginal tears involve vaginal tissue (vaginal mucosa) and the perineal muscles — the muscles between the vagina and anus that help support the uterus, bladder and rectum. Second-degree tears typically require stitches and heal within a few weeks.
To ease discomfort while you're recovering:

Sit on a hard surface or padded ring.
Squat — rather than sit — on the toilet. Pour warm water over your vulva as you're passing urine, and rinse yourself afterward. Press a clean pad firmly against the wound when you bear down for a bowel movement. Guna SITZ BATH
Cool the wound with an ice pack, or place a chilled witch hazel pad between a sanitary napkin and the wound. Guna FEMEPAD
Take pain relievers or stool softeners as recommended by your health care provider.

Third-degree vaginal tear

Third-degree vaginal tears involve the vaginal tissues, perineal muscles and the muscle that surrounds the anus (anal sphincter). These tears sometimes require surgical repair and may take six weeks to heal.
To ease discomfort while you're recovering:

Sit on a hard surface or padded ring. Guna SITZ BATH
Squat — rather than sit — on the toilet. Pour warm water over your vulva as you're passing urine, and rinse yourself afterward. Press a clean pad firmly against the wound when you bear down for a bowel movement.
Cool the wound with an ice pack, or place a chilled witch hazel pad between a sanitary napkin and the wound. Guna FEMEPAD
Take pain relievers or stool softeners as recommended by your health care provider.

Kecerdaan ketika bersalin kadangkali tidak bolih dielakkan khususnya jika kelahiran perlu pertolongan forceps atau vakum. jika bayi terlalu besar kedudukan kepala singit ( OP, asynclitism)
Untuk percepat sembuh luka faraj , sila gunakan set POST DELVERY HEALING SET

Perdarahan waktu bersalin

2011-02-11T22:12:00.000-08:00

Perdarahan waktu bersalin mengancam nyawa ibu

Hemorrhage is not something that we want to think about when it comes to giving birth. In fact, 95% of births will not have a problem with hemorrhage. However it is important to know the risk factors for hemorrhage and discuss your personal risk factors with your doctor or midwife.
Postpartum hemorrhage is defined as a loss of blood in the postpartum period of more than 500 mL. The average, spontaneous vaginal birth will typically have a 500 mL blood loss. In cesarean births the average blood loss rises to 800-1000 mL. There is a greater risk of hemorrhage in the first 24 hours after the birth, called primary postpartum hemorrhage. A secondary hemorrhage occurs after the first 24 hours of birth.
There are certain risk factors that make a postpartum hemorrhage more likely to happen:

Multiple Gestation
Large baby
Polyhydramnios
Multipartity (particularly grand multiparity, more than 5 term pregnancies)
Prolonged labor (uterine inertia)
Labor augmented with Pitocin
General Anesthesia
Placenta Previa
Abruptio Placentae
Magnesium Sulfate infusion

These risk factors can make it more likely but are not certain indicators of hemorrhage. Knowing that there are greater risks for some may make certain precautions more necessary than for low risk women. In the majority of cases the cause of hemorrhage is uterine atony, meaning that the uterus is not contracting enough to control the bleeding at the placental site. Other reasons for a hemorrhage would include retained placental fragments (possibly including a placenta accreta), trauma of some form, like a cervical laceration, uterine inversion or even uterine rupture, and clotting disorders.
If hemorrhage does occur there are several steps which can be taken to treat the bleeding, steps used depend on the reason for the bleeding:

Uterine massage
Have the mother in the trendelenberg position (Feet above heart)
Give oxygen
Ensure two large IV sites are available
Give Medications (Several types: Pitocin, methergine, hemabate)
Consider surgery including ligation of Uterine and Hypogastric arteries and/or hysterectomy (removal of the uterus)

Preventing Hemorrhage All women will receive care to help prevent hemorrhage after the birth of their baby. Immediately following the birth of the baby, signs of placental separation will be watched for to know when the placenta is ready to be delivered. A placenta that does not deliver spontaneously is a risk factor for postpartum hemorrhage.
Some hospitals and birth centers choose to give every woman a routine injection of pitocin to help prevent hemorrhage and to help ensure that the placenta comes quickly and easily. However, many choose a more natural route, which is to wait and see if there is a bleeding problem. Many also encourage the American Academy of Pediatrics recommendation of breastfeeding beginning as soon as possible after birth. This allows the mother to secrete her own oxytocin to help contract the uterus and expel the placenta.
Massaging the uterus is also done to help expel clots of blood. It is also used to check the tone of the uterus and ensure that it is clamping down to prevent excessive bleeding. Poor tone of the uterus at this point is what causes 70% of the cases of postpartum hemorrhage. This can be uncomfortable to painful. Be sure to utilize any and all relaxation and breathing techniques and not tense your abdominal muscles. If it is too painful, medications can also be used. This will be done with decreasing frequency after the birth, as your bleeding slows.
Ensuring your bladder is empty will also help you avoid hemorrhage. Simply emptying the bladder in any manner can do this. Women who have not used regional anesthesia can usually use the restroom themselves within the hour after birth. Those who had regional anesthesia can use the restroom or bedpan in varying time increments, but usually within an hour of the anesthesia wearing off, unless a cesarean was performed. Catheterization can also be of benefit here, including both the indwelling catheter (usually done for cesareans and those with major urethral trauma) or what is called an "in/out" or "straight cath" to drain the urine and allow the bladder to not impede the uterus.
Talking to your practitioner to see which after birth protocol he or she uses and what might be best for your situation can go a long way in helping you to understand your personal risk factors and prevention strategy for postpartum hemorrhage.

Cara mudah bersalin

2011-02-11T22:01:00.000-08:00

Setengah wanita mudah melalui kelahiran tanpa kesakitan yang terok dan berpanjangan, manakala yang lain memang perlu merintangi cabaran kesakitan yang kuat dan berpanjangan. Bagaimana cara untuk atasi.
Alhamdulillah isteri saya mudah melahirkan 5 anak saya dan mengalami sakit bersalain selama satu jam sahaja. Anak2 dan menantu perempuan pun mudah melahirkan anak , tapi sakit lebih lama lagi 4-6 jam. dan mereka tidak memerlukan apa2 ubat penawar sakit. Munkin faktor baka dan keturunan ada memainkan peranan.

Tip untuk mudahkan bersalin
Tanya emak kita atau saudara mara dan kawan yang pernah bersalin .
Ketenangan fikran dan kemantapan mental dan emosi sangat penting.
Kuatkan iman dan sentiasa bertawakkal kepada Allah SWT setelah kita berusaha.
Sokongan moral dan emosi dari suami dan ibu sangat penting.
Banyak baca quran dqn bibir sentiasa berzikir menyebut dan memuji Allah.
Bualan terakhir kandungan - buat exercise, jalan selam 30 minit lepas makan malam, sambil buat breathing exercise. Pelajari teknik breathing exercise. penting untuk tahan sakit dan meneran bila kepala bayi keluar.
Makan banyak buah2 dan sayur2, buah papaya, jambu, timbikai , apple, oren, nenas pun bolih.
Hubungan sex pun bolih diteruskan kerana ia membantu buka pintu rahim.
Air selusuh - dari bacaan quran, surah yaasin, ayat kursi dll
Air suam yang direndam 'akar fatimah' ini biasa dibeli diMekah atau Medinah, juga mula diminum dibulan terakhir.
Waspada produk2 yang dikatakan mudahkan bersalin, kerana mereka yang makan sering dilanda tumpah darah yang banyak ketika bersalin.

Penawar sakit bersalin
Alhamadulillah sebahagian besar dari wanita muslim daya ketahanan sakit adalah tinggi. Ini bermakna mereka kurang memerlukan bantuan ubat penawar sakit. Ini disebabkan mereka kuat iman dan banyak bertawakkal kepada AllahSWT. Bacaan 'suhanallah' memang ada kesan untuk mengurangkan sakit atau meringkan bebanan.. Baca fatiha, ayat kursi, 3 qul, berulang2 kali. atau baca mana2 surah alquran - surah mariam mithalnya. Terus menerus berzikir.
Amalkan doa2 ini

Birth simulation on model

Jahit pintu rahim cegah gugur

2011-02-11T21:49:00.000-08:00

Setengah wanita megalami keguguran berulang kali , yang sering berlaku sekitar 4-6 bulan kandungan. Punca berlaku demikian ialah pintu rahim longgar - cervical incompetence. Pintu rahim perlu dijahit sekitar 3 bulan hamil - kaedah ini digelar Shirodkar suture atau cervical cerclage

Cervical incompetence is basically a cervix that is too weak to stay closed during a pregnancy. Therefore resulting in a premature birth and possibly the loss of the baby, because of the shortened gestational length. It is believed that cervical incompetence is the cause of 20 - 25 % of all second trimester losses. This incompetence generally shows up in the early part of the second trimester, but possibly as late as the early third trimester.
It is generally categorized as premature opening of the cervix without labor or contractions. Diagnosis can be made either manually or with ultrasonography. The use of ultrasonography has been very helpful with the diagnosis, and is made when the cervical os (opening) is greater than 2.5 cm, or the length has shortened to less than 20 mm. Sometimes funneling is also seen, this is where the internal portion of the cervix, internal os (portion of the cervix closer to the baby) has begun to efface. The external os will be unaffected if diagnosed in time. Factors that increase the likelihood of suffering from an incompetent cervix are:

DES exposure
Cervical Trauma
Hormonal influences
Congenitally short cervix
Forced D & C
Uterine anomalies

If you are diagnosed after a second trimester loss or prior to pregnancy it is suspected that you will have problems with the strength of your cervix, a cerclage (stitching the cervix closed) can be performed prophylactically at approximately 14-16 weeks. It is said that the earlier you have the cerclage performed the more likely the pregnancy is to continue.

Diabetes ketika hamil

2011-02-11T21:34:00.000-08:00

Setengah wanita mengidap diabetes waktu hamil sahaja, mereka ada potensi dapat gestational diabetes kerana, sejarah keluarga atau keturunan yang ada diabetes, obesity/kegemokkan and pengidap PCOS.

Gestational diabetes

Glucose intolerance during pregnancy

Gestational diabetes is high blood sugar (diabetes) that starts or is first diagnosed during pregnancy.

Causes, incidence, and risk factors

Pregnancy hormones can block insulin from doing its job. When this happens, glucose levels may increase in a pregnant woman's blood.

You are at greater risk for gestational diabetes if you:

Are older than 25 when you are pregnant
Have a family history of diabetes
Gave birth to a baby that weighed more than 9 pounds or had a birth defect
Have sugar (glucose) in your urine when you see your doctor for a regular prenatal visit
Have high blood pressure
Have too much amniotic fluid
Have had an unexplained miscarriage or stillbirth
Were overweight before your pregnancy

Symptoms

Usually there are no symptoms, or the symptoms are mild and not life threatening to the pregnant woman. Often, the blood sugar (glucose) level returns to normal after delivery.

Symptoms may include:

Blurred vision
Fatigue
Frequent infections, including those of the bladder, vagina, and skin
Increased thirst
Increased urination
Nausea and vomiting
Weight loss in spite of increased appetite

Signs and tests

Gestational diabetes usually starts halfway through the pregnancy. All pregnant women should receive an oral glucose tolerance test between the 24th and 28th week of pregnancy to screen for the condition. Women who have risk factors for gestational diabetes may have this test earlier in the pregnancy.

Once you are diagnosed with gestational diabetes, you can see how well you are doing by testing your glucose level at home. The most common way involves pricking your finger and putting a drop of your blood on a machine that will give you a glucose reading.

Treatment

The goals of treatment are to keep blood sugar (glucose) levels within normal limits during the pregnancy, and to make sure that the growing baby is healthy.

WATCHING YOUR BABY

Your health care provider should closely check both you and your baby throughout the pregnancy. Fetal monitoring to check the size and health of the fetus often includes ultrasound and nonstress tests.

A nonstress test is a very simple, painless test for you and your baby. A machine that hears and displays your baby's heartbeat (electronic fetal monitor) is placed on your abdomen. When the baby moves, the baby's heart rate normally increases 15 - 20 beats above its regular rate.
Your health care provider can compare the pattern of your baby's heartbeat to movements and find out whether the baby is doing well. The health care provider will look for increases in the baby's normal heart rate occurring within a certain period of time.

DIET AND EXERCISE

The best way to improve your diet is by eating a variety of healthy foods. You should learn how to read food labels, and check them when making food decisions. Talk to your doctor or dietitian if you are a vegetarian or on some other special diet.

In general, your diet should be moderate in fat and protein and provide controlled levels of carbohydrates through foods that include fruits, vegetables, and complex carbohydrates (such as bread, cereal, pasta, and rice). You will also be asked to cut back on foods that contain a lot of sugar, such as soft drinks, fruit juices, and pastries.

You will be asked to eat three small- to moderate-sized meals and one or more snacks each day. Do not skip meals and snacks. Keep the amount and types of food (carbohydrates, fats, and proteins) the same from day to day.

Your doctor or nurse will prescribe a daily prenatal vitamin. They may suggest that you take extra iron or calcium. Talk to your doctor or nurse if you're a vegetarian or are on some other special diet.
Remember that "eating for two" does not mean you need to eat twice as many calories. You usually need just 300 extra calories a day (such as a glass of milk, a banana, and 10 crackers).

For details on what you should eat, see: Diabetes diet - gestational

If managing your diet does not control blood sugar (glucose) levels, you may be prescribed diabetes medicine by mouth or insulin therapy. You will need to monitor your blood sugar (glucose) levels during treatment.

Most women who develop gestational diabetes will not need diabetes medicines or insulin, but some will.

Expectations (prognosis)

Most women with gestational diabetes are able to control their blood sugar and avoid harm to themselves or their baby.

Pregnant women with gestational diabetes tend to have larger babies at birth. This can increase the chance of problems at the time of delivery, including:

Birth injury (trauma) because of the baby's large size
Delivery by c-section

Your baby is more likely to have periods of low blood sugar (hypoglycemia) during the first few days of life.

Mothers with gestational diabetes have an increased risk for high blood pressure during pregnancy.

There is a slightly increased risk of the baby dying when the mother has untreated gestational diabetes. Controlling blood sugar levels reduces this risk.

High blood sugar (glucose) levels often go back to normal after delivery. However, women with gestational diabetes should be watched closely after giving birth and at regular doctor's appointments to screen for signs of diabetes. Many women with gestational diabetes develop diabetes within 5 - 10 years after delivery. The risk may be increased in obese women.

Complications

Delivery-related complications due to the infant's large size
Development of diabetes later in life
Increased risk of newborn death and stillbirth
Low blood sugar (glucose) or illness in the newborn

Calling your health care provider

Call your health care provider if you are pregnant and you have symptoms of diabetes.

Prevention

Beginning prenatal care early and having regular prenatal visits helps improve your health and the health of your baby. Knowing the risk factors for gestational diabetes and having prenatal screening at 24 - 28 weeks into the pregnancy will help detect gestational diabetes early.

If you are overweight, decreasing your body mass index (BMI) to a normal range before you get pregnant will decrease your risk of developing gestational diabetes.

References

Toxemia kehamilan

2011-02-11T21:25:00.000-08:00

Preclamptic toxemia atau PET adalah satu situasi ketika hamil dimana tekanan darah naik tinggi, kencing mengandungi albumin, dan kaki bengkak/edema

Bahaya darah tinggi dan keracunan kehamilan

Masalah darah tinggi dan keracunan kehamilan (pre-eclampsia) biasa berlaku mulai kehamilan tujuh bulan.Kadang-kala kita tidak menjangka siapa yang akan terkena penyakit ini, tetapi bagi mereka yang hamil pertama kalinya, ataupun mereka yang terlalu gemuk dan mengidap penyakit kencing manis, ataupun memang pernah mengidap penyakit darah-tinggi dan buah pinggang adalah di antara mereka yang terdedah kepada masalah ini.

Pemeriksaan 'antenatal' setiap bulan, selepas tujuh bulan dua minggu sekali dan bulan terakhir seminggu sekali,adalah sangat penting untuk mengesan keadaan penyakit darah tinggi dan keracunan (toxemia) kehamilan.Setiap kali ibu hamil datang ke klinik di antara pemeriksaan yang dilakukan ke atasnya ialah mengukur tekanan darah, mengukur timbang beratnya dan juga memeriksa air kencingnya untuk gula dan albumin.

Ini sangat penting untuk tujuan mengesan penyakit keracunan (toxemia) kehamilan yang biasanya ditandakan dengan bengkak kaki, timbang berat yang naik secara mendadak, sembab muka dan apabila diukur tekanan darah didapati terlalu tinggi iaitu melebihi 140/90 mm Hg dan air kencingnya mengandungi albumin.

Apakah risiko kepada ibu?

Toxemia kehamilan boleh mengancam nyawa ibu jika ia tidak terkawal khususnya apabila tekanan darahnya meningkat mungkin melebihi 180/110 mm Hg dan apabila air kencing ibu tersebut mengandungi banyak albumin iaitu mungkin + + + + . Ibu juga merasa pening, mungkin gelap mata dan hampir pitam dan rasa kesakitan pada bahagian ulu hati.Jika keadaan begini berlaku kadang-kala ibu boleh terkena serangan sawan (eclampsia).

Sawan ini sangat merbahaya pada ibu kerana ini menandakan pendarahan mungkin telah berlaku dalam otak ibu (cerebral haemorrhage), atau bekalandarah kepada otak telah terganggu akibat daripada kuncupan saluran darah tersebut dan biasanya otak telah dipenuhi dengan cecair (cerebral adema).Risiko kematian ibu adalah sangat tinggi dalam keadaan begini khususnya mereka yang telah tidak sedarkan diri (coma).

Dalam keadaan begini doktor perlu melakukan pembedahan caesarean untuk mengeluarkan bayi tanpa mengira umur atau akibat kepada bayi tersebut sama ada boleh hidup atau tidak demi untuk menyelamatkan nyawa ibu.Apabila bayi dan uri telah dikeluarkan melalui pembedahan, biasanya penyakit ini akan reda dengan cepatnya dan hanya inilah yang boleh menyelamatkan nyawa ibu setelah diserang dengan sawan tersebut.

Dalam kes yang kurang teruk doktor boleh mengawal penyakit toxemia ini dengan memasukkan ibu tersebut ke hospital untuk berehat sambil mengawal tekanan darahnya, air kencingnya dan pertumbuhan bayi melalui ujian-ujian klinikal , ukuran timbang berat dan juga ujian ultrasound yang dilakukan berulangkali untuk mengetahui samaada pertumbuhan bayi masih berlaku atau tidak.

Jika tidak ada pertumbuhan bayi dan bayi mungkin terancam nyawanya, dan dijangka bayi boleh hidup apabila dilahirkan, maka langkah yang sewajar ialah untuk melakukan pembedahan cesarean untuk menyelamatkan bayi.

Jika keadaan darah tinggi dan toxemia ini sangat sederhana dan tidak ada tanda-tanda ia mengancam ibu dan bayi, setakat berehat dan diberi rawatan dengan ubat untuk mengurangkan tekanan darah, kawalan pemakanan untuk mengurangkan karbohidrat, minyak dan garam dalam makanan.

Rehat adalah sangat penting untuk mengawal penyakit darah tinggi ini.Biasanya jika keadaan ini boleh dikawal dan pertumbuhan dan nyawa bayi tidak terancam, maka kelahiran secara normal boleh dilakukan dengan memaksa sakit bersalin (induced labour)pada umur kehamilan antara 37 hingga 38 minggu.Kelahirantidak boleh lambatkan kerana uri boleh rosak dan dengan itu bekalan oxygen dan makanan pada bayi boleh terjejas menyebabkan kematian bayi dalam rahim.

Apakah punca sebenar bagi toxemia dan darah tinggi?

Punca yang sebenar tidak diketahui, tetapi mungkin dalam darah pesakit yang mengidap toxemia ini terdapat banyak jenis racun yang boleh menyebabkan darah tinggi dan merosakkan organ-organ badan khususnya otak dan hati.

Racun-racun ini adalah dikeluarkan oleh uri (placenta).Mengapa uri mengeluarkan racun, tidaklah diketahui dan mengapa sesetengah wanita keluarkan racun ini dan yang lainnya tidak, ini pun tidak diketahui.Mungkin ia merupakan satu reaksi untuk menolak uri tersebut.

Uri dibentuk sebahagiannya daripada baka suami, tubuh isteri cuba menolaknya dan dengan ini timbullah reaksi dengan mengeluarkan racun.Bagaimana ia berlaku tidaklah diketahui.Biasanya selepas kelahiran bayi dan uri telah sempurna dikeluarkan, keracunan akan lesap dan tekanan darah turun ke tahap normal dengan cepat. Perkara-perkara yang boleh mengelakkan kejadian ini ialah dengan amalan makanan yang seimbang, memakan vitamin Folik Asid yang terus-menerus antara 5mghingga 10 mg setiap hari dari awal kandungan hingga akhir.

Mengawal berat badan supaya ia tidak melebihi had biasa,berat badan sepatutnya tidak boleh melebihi 15 kilo bagi keseluruhan kehamilan.Bagi panduan para ibu yang hamil, lima bulan pertama berat badan patut meningkat satu kilo sebulan dan empat bulan terakhir dua kilo sebulan menjadikan jumlahnya lebih kurang 13 kilo di akhir kehamilan.

Kerehatan dan ketenangan juga memainkan peranan penting untuk mengelakkan masalah darah tinggi dan keracunan.Bagi mereka yang tenangrohnya serta kuat iman mungkin kurang tededah kepada ancaman toxemia, sebab itu saya sentiasa menasihati ibu-ibu yang hamil untuk membaca Al Quran dari awal kehamilan dan tidak melupakan segala suruhan Allah seperti solat, berpuasa dan sering melakukan amalan zikir, bertasbih, bertasmid dan lain lain untuk mengingati Allah.Memang amalan amalan ini boleh mengurangkan ketegangan fisikal dan mental .

Signs and Symptoms of PET:

Mild PET: In mild cases of PET, blood pressure is persistently at and above 140/90 mmHg but below 160/110 mmHg. There may be edema and/or proteinuria.
Severe PET: In severe cases of PET, blood pressure lies at /above 160/110mmHg. There may be edema all over the body including the face. Grade III Proteinuria is almost always present. The patient may complain of other grave symptoms like headache, giddiness, pain in the upper part of the abdomen (epigastric pain), vomiting, various eye symptoms, and sometimes decrease in the volume of urine (oliguria).
All types of PET: In both mild and severe cases, the patient is usually carrying her first pregnancy and is more than 20 weeks pregnant, usually more than 28 weeks.
Excessive Weight Gain: There may be abnormal weight gain. Pressure Symptoms: Pressure symptoms like breathlessness and palpitation can occur due to the excessive weight gain.

Tests in PET

Blood : Haemoglobin level and serum Uric Acid levels.
Urine : The total quantity of urine; presence of protein in the urine.
Eyes : The fundus of the eye has to be checked for any changes caused by hypertension.

Complications of PET:

Eclampsia: The most important complication is eclampsia which is PET complicated with convulsions or fits. Cerebral hypoxia (lack of oxygen in the brain) and cerebral edema due to high blood pressure are the main causes.
Placental Abruption: Placental Abruption i.e. bleeding into the base of the placenta leading to fetal death is another important complication.
Chronic Hypertension: Some patients may develop chronic hypertension after delivery.

Management / Treatment of Pre-eclamptic Toxaemia (PET)
Mild PET :

Bed rest: Bed rest should be taken for at least 8 hours at night and 2 hours during the day. She should also lie down in bed on her left side during the other hours as much as possible. Rest causes decrease in hypertension, decrease in oedema, increases the placental blood flow.
Diet and Salt Restriction: Pregnancy Diet should be nutritious with adequate fluid intake. Salt is restricted to 5 mg per day instead of 10 mg per day as advised in normal pregnancy.
Medicines: Anti-hypertensive and sedative drugs are prescribed.
Regular monitoring: Regular monitoring of blood pressure, fluid intake and output chart; urine for protein; weight increase; check up of eyes; blood tests.
Regular fetal monitoring The rate and rhythm of the fetal heart sound and number of fetal movements per day is monitored.
Delivery of the baby: Pregnancy is terminated at 37 weeks after checking for fetal maturity by USG. If cervix is soft and inducible, then labor is induced. If fetus is deemed to be at risk and cervix firmly closed , elective caesarian section should be done.

Severe PET :

Total Bed rest: The patient is advised total bed rest, rising from bed only to go to the bathroom. Sometimes in very severe cases, she may even have to use the bed pan.
Immediate hospital admission: She is admitted in the hospital immediately as soon as she is diagnosed as a a severe case of pre-eclamptic toxaemia. This ensures constant monitoring of the vital parameters.
Medicines: Drugs to control convulsions, hypertension and maintain urine output are prescribed.

Rancang anak pintar

2011-02-11T21:15:00.000-08:00

Rangsangan mental bayi dalam rahim bolih menyediakan bayi untuk jadi pintar.

Kita semua bercita2 untuk mendapatkan 'zuriatan toiiba' iaitu anak yang sihat, normal tanpa cacat, pintar, mulia akhlaknya dan soleh. Untuk mencapai cita2 murni ini kita perlu berusaha dan terus berdoa memohon kepada Allah SWT.

Pemakan ibu yang berkhasiat dan berzat adalah sangat penting. Ambil makanan yang segar tanpa diperoses, diawet atau bekukan. Banyakkan buah2 dan sayur2. Perotin dari lauk2 saperti daging , ayam ikan dan makanan laut atau dari kacang2 soya dan produk2 dari susu adalah sangat penting untuk membina sel2 dan tisyu otak.

What is prenatal stimulation?

Prenatal stimulation is a technique that uses various stimuli such as; sound, (especially musical sounds and a mother’s voice), movement, pressure, vibrations, and light to communicate with the baby before birth. The baby learns to recognize and respond to the different stimuli, which encourages physical, mental, and sensory development.

What are the benefits of prenatal stimulation? Does it really work?

Studies by leading child development researchers such as Thomas R. Verny and Rene Van de Carr have revealed that stimulated babies exhibit enhanced visual, auditory, linguistic, and motor development. In general, they sleep better, are more alert, confident, and content than infants who were not stimulated. They also show superior learning capacity and calm down when they hear familiar sounds they heard while in the womb.
Babies that were stimulated by their mothers before birth showed greater confidence, were more active at birth, and experienced better success at breastfeeding.
Stimulated babies and their families showed more intense bonding and greater family cohesion. Prenatal stimulation provides a lasting foundation for loving communication and healthy parent-child relationships.

Can prenatal stimulation improve IQ and raise intelligence?

A number of studies have shown that yes, prenatal stimulation does seem to have a favorable effect on intelligence and IQ. One example is the study "Project Family" conducted by Dr. Beatriz Manrique. Stimulated babies tested at the age of 3, on average, scored 14 IQ points higher on the Stanford-Binet scale than children who were not stimulated.
On average, stimulated infants consistently scored higher than the non-stimulated control group on the Brazelton scale for neurological development and behavior, and the Bayley scale for mental and motor development.
Most importantly, prenatal stimulation techniques teach parents how to provide a safe, loving and exciting environment that will encourage their child to learn and grow.

When should I begin stimulating my baby?

Babies can benefit from stimulation as early as the third month of pregnancy. At this point, they begin to perceive spatial orientation and tactile stimuli.
Babies develop sensory and motor skills at different stages during pregnancy, so it is important to introduce stimuli only after the baby has developed sufficiently to sense and respond. The "Make Way for Baby!"™ video program explains in detail when the baby acquires each capability and when you can begin each new stimulation exercise for optimal benefit.

Is music good stimulation for my baby?

Yes. Once babies develop hearing in the fifth month, music is excellent for aural stimulation and to soothe the baby.
However, mothers can give their babies the emotional benefits of music even before hearing develops at five months. Mothers who set aside time to relax daily by listening to music also help their babies feel calmer and happier. Pregnant women and babies share hormones, so there is a close connection between the emotional well-being of the mother and that of the child she carries.

Is over-stimulation a concern?

While over-stimulation may not harm the baby, it can cause confusion and undermine the benefits you are trying to achieve. When babies becomes overwhelmed by too much stimulation, they stop responding. Moderate levels of stimulation produce optimal results.
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Punca kecacatan bayi

2011-02-11T15:34:00.000-08:00

Semoga kita dijauhkan Allah dari kecacatan ini
PUNCA CACAT BAYI

Cegah Kecacatan bayi !

Makan ubat folik asid 5-10 mg. Setiap hari dua bulan sebelum dan terus- menerus hingga akhir kandungan.

Tentukan yang anda sudah mendapat pelalian terhadap Rubella.

Jangan cuba gugurkan kandungan dengan apa cara pun.

Jika gagal bayi boleh cacat. Jangan makan ubat-ubat seperti tranquilizer, ubat kanser tanpa nasihat doktor. Jika ada sejarah kecacatan dalam kekuarga, dapatkan khidmat ‘ genetic counselling’. Jauhkan hamil jika umur melebihi 45 tahun.

Berserah dan tawakkal kepada Allah s.w.t. Berdoalah setiap masa untuk mendapat zuriat yang cemerlang: ‘Rabbi habli miladunka zuriatan tayiba, inaka sami u doa’. ‘Ya Allah kurniakanlah kami zuriat yang terbaik, sesungguhnya Kau mendengar doa kami’.Lakukan suruhan Allah tanpa lalai, banyakkan membaca Quran, berzikir dan bertasbih sentiasa. Bacakan surah Fatihah, 3 'Qul', dan ayat 'Qursi' kepada bayi dalam kandungan setiap malam sebelum tidur.Mengikut orang tua-tua ketika isteri hamil, suami janganlah memburu, menganiyai atau membunuh binatang. Kononnya amalan ini boleh menyebabkan anak yang dikandung isteri akan lahir cacat.Tidak perlu jalani ujian-ujian untuk mengesan janin cacat, kerana jika benar demikian , undang-ujian negara dan hukum islam tidak membenarkan menggugurkan kandungan walaupun janin cacat.

Congenital Abnormalities

The cause of 40-60% of congenital anomalies in humans is unknown. These are referred to as sporadic, a term that implies an unknown cause, random occurrence regardless of maternal living conditions,^[4] and a low recurrence risk for future children. For 20-25% of anomalies there seems to be a "multifactorial" cause, meaning a complex interaction of multiple minor genetic anomalies with environmental risk factors. Another 10-13% of anomalies have a purely environmental cause (e.g. infections, illness, or drug abuse in the mother). Only 12-25% of anomalies have a purely genetic cause. Of these, the majority are chromosomal anomalies.^[5]
Genetic causes of congenital anomalies include inheritance of abnormal genes from the parents, as well as new mutations in one of the germ cells that gave rise to the fetus.
Environmental causes of congenital anomalies are referred to as teratogenic. These are generally problems with the mother's environment. Teratogens can include dietary deficiencies, toxins, or infections. For example, dietary deficiency of maternal folic acid is associated with spina bifida. Ingestion of harmful substances by the mother (e.g., alcohol, mercury, or prescription drugs such as phenytoin) can cause recognizable combinations of birth defects.
Several infections which a mother can contract during pregnancy can also be teratogenic. These are referred to as the TORCH infections.

[edit] Teratogens

The greatest risk of a malformation due to environmental exposure to a teratogen (terato = monster, gen = producing) between the third and eighth week of gestation. Before this time, any damage to the embryo is likely to result in fatality, and the baby will not be born. After eight weeks, the fetus and its organs are more developed and less sensitive to teratogenic incidents.
The type of congenital anomaly is also related to the time of exposure to a teratogen. For instance, the heart is susceptible from three to eight weeks, but the ear is susceptible from a slightly later time to about twelve weeks.
Many common skin care ingredients can be absorbed through the skin in small amounts, where they can enter the bloodstream and pass into the fetus's circulation.^{[citation needed]}
Infection in the mother early in the third week may cause fetal cardiac damage. An infection in the eleventh week is less likely to damage the heart, but the baby may be born deaf. A common cause of congenital deafness of children in particular is a measles infection in the mother.

Jagaan antenatal/waktu hamil

2011-02-11T15:20:00.000-08:00

Jagaan waktu hamil (antenatal) adalah sangat penting untuk menentukan kesihatan dan keselamatan ibu dan anak.

Ikuti jadaul untuk datang keklinik ibu dan anak

MAKANAN UNTUK TINGKAT IMMUNITY

Ujian dan Pengesan kehamilan

2011-02-11T15:14:00.000-08:00

Bila haid terlambat datang, langkah utama ialah buat ujian kehamilan (UPT) , ambil air kencing pertama pagi dan uji dengan alat home test yang bolih dibeli dari farmasi.

Buat ultrasound scan dalam usia kehamilan dua bulan.

Awal kehamilan, persediaan

2011-02-11T15:03:00.000-08:00

Persediaan untuk hamil dari sgi fizikal dan memtal

Gejala, alahan dan simptom2 awal hamil

Makanan berkhasiat, supplement vitamin dan logam

PEKEJ SET LEPAS BERSALIN

Pertumbuhan bayi dalam rahim

2011-02-10T19:32:00.000-08:00

Satu mu'jizah Allah , dari setitis nutfah menjadi alaqah dan mugdah , akhirnya jadi janin dan lahir seorang bayi yang sempurna sifat.

Ikuti link ini untuk dapatkan gambar2 pertumbuhan bayi dalam rahim
Pertumbuhan bayi dalam rahim

Video pertumbuhan bayi

Pertumbuhan minggu ke minggu

Pertumbuhan bayi

Scan janin awal kandungan

2011-02-01T17:30:00.000-08:00

Di peringkat awal kehamilan, (baru missed period 5-7 hari) ujian kencing pertama pagi untuk UPT home test ( bolih dibeli dari farmasi) adalah cara pengesahan kehamilan. Ketika itu jika buat vaginal scan(TVS) akan nampak karung kehamilan saja, janin belum kelihatan. Bila sudah delay 2 minggu, iaitu umur kehamilan 6 minggu , TVS akan dapat kesan janin dan denyutan jantung bayi.

Gambar scan 7-8 minggu kehamilan. Kelihatan segumpal daging (mugdah - Quran) , dalam imej scan putih warna disekelilingi hitam (air toban) . Ditengah putih akan kelihatan denyut jantung.

Kehamilan 12 minggu - sudah ada bentuk janin, organ2 tangan dan kaki sudah sempurna. Bayi akan kelihatan bergerak2 tapi belum dirasai olih ibunya.
Scan awal kandungan juga bolih mengira umur kehamilan dan tarikh jangka lahir (EDD) khas untuk mereka yang haid tidak teratur.

Jika berlaku perdarahan atau sakit kuat saperti senggugut pada ari2 - tiga kemunkinan 1). Ancaman gugur 2) kehamilan luar rahim (ectopic) 3) Hamil anggur ( molar)

Mssed abortion - tanda berdarah, scan karung kehamilan tidak bulat, irregular, lebih kecil dari umur kehamilan, janin tak bentuk , tiada denyut jantung

Ectopic pregnancy. karung kandungan kelihatan diluar rahim biasanya disaluran fallopio.rahim saiz normal , tiada karung kehamilan perlu bedah segera untuk cegah karung pecah didalam perut dan perdarahan didalam.

Molar pregnancy - tandanya berdarah. Scanning tidak ada karung kehamilan hanya kelihatan macam awan atau ribut salji. Perlu buat D&C dan pantau darah untuk menyukat hormon Beta HCG

Sesiapa hendak buat scan awal kehamilan untuk tentukan bayi hidup atau tidak , sila hubungi klinik 03-20941115

Cyst ovary waktu hamil

2011-01-25T06:40:00.000-08:00

Kebanyakan cyst ovary waktu hamil adalah jenis ' corpus luteal cyst' iaitu bekas karung telor yang tidak pecah, dan ia biasanya mengandungi air. Sampai satu ketika, biasanya kehamilan 5 bulan cyst ini akan pecah dengan sendiri dan air akan diserap olid badan. Saya nasihatkan lebih baik jangan bedah untuk buang cyst waktu hamil kerana ia bolih mencetuskan keguguran. melainkan ian menyebabkan kesakitan yang amat sangat macam sakit appendix.

Penawar Sakit Bersalain

2011-01-24T16:05:00.000-08:00

Sakit bersalain adalah rahmat Allah SWT khusus untuk kaum hawa bagi tujuan menghapus dosa. Bersalin adalah saperti pergi berjihad dan jika kita sabar dan sentiasa mengingati dan berzikir pada Allah, insyaallah ganjaran baginya ialah syurga dan dosanya hapus bila selesai bersalin. Jangan sia2kan peluang keemasan ini.

Entonox - sedut gas untuk penawar sakit

Epidural Block

Bayi Songsang Breech

2011-01-24T16:04:00.000-08:00

Kedudukan bayi biasa belum stabil lagi sehingga lapan bulan kandungan (32 minggu). Jangan buat apa2 untuk pusingkan bayi. Waktu malam becakap dengan bayi untuk turunkan kepala, bayi akan mendengar dan munkin akan response. Pada 32 minggu jika masih songsang dan tidak ada uri menghalang (placenta previa), saya sering cuba pusingkan (ECV) tapi cara gentle tanpa paksaan.

Kelahiran breech/songsang melalui faraj membawa sedikt risiko kepada bayi, iaitu lemas yg munkin bolih membawa kepada kematian bayi. Olih itu ia tidak bolih dikendalikan olih mereka yang kurang mahir. Kebolihan dan kemahiran menyambut kelahiran bayi songsang/breech dianggap sebagai ukuran kepandaian pakar bidan tersebut. Ianya satu seni dan bila kita lihat segala pergerakkan untuk menyambut bayi dengan memegang kedua belah kaki dan menarik bayi keluar dari saluran faraj serta dengan gerakan memusing badan bayi untuk mengeluarkan kedua belah tangan , ia saperti satu kemahiran yang unik. Apabila kedua tangan telah keluar, kepal bayi perlu dikeluarkan, inilah saat yang paling cemas. Salah satu dari dua teknik bolih digunakan, pertama kepala ditarik keluar dengan alat forceps atau kedua dengan teknik yang digelar MSV yang saya biasa genakan tanpa forceps.

LIHAT GAMBAR2 KELAHIRAN BREECH

Merancang jantina bayi

2011-01-23T05:29:00.000-08:00

Kita merancang Allah menentukan. Semuanya bolih dirancang termasuk jantina bayi. Kesluruhan kadar kejayaan 70%. Tiga bulan sebelum mencuba buat segala persiapan, untuk kesan waktu subur/ovulation. dan panduan jenis pemakanan dimulakan awal2 lagi.

Mencatit suhu 'Basal Body Temperature' - BBT Chart - sila ikuti link ini

Merancang Jantina

Merancang Jantina Bayi ?

Merancang anak lelaki

Petua yang saya berikan tidak boleh dijamin sepenuhnya keberhasilannya. Mungkin dengan izin Allah s.w.t. anda akan mencapai 70% kejayaan.

Sebenarnya benih lelaki menjadi penentu jantina bayi kerana benih-benih tersebut ada yang membawa keromosom X dan Y. Sedangkan telur/benih isteri hanya membawa keromosm X. Bergantung mana yang bercantum – XY (anak lelaki) – XX (anak perempuan).

Ciri-ciri benih lelaki berbeda – benih Y lebih cergas dan laju begerak tetapi lebih cepat mati berbanding dengan benih X yang lambat bergerak tetapi hidup lebih lama. Benih Y lebih tahan dalam cecair yang beralkali , sedangkan benih X lebih tahan dalam cecair asid.

Untuk mencuba anak lelaki, ikuti garis panduan berikut:

1.Makanan yang asid seperti buah-buahan limau, nanas, mangga, cuka, minuman gas perlu dijauhkan selama 2 bulan sebelum mencuba. Makanan laut adalah digalakkan, zat-zat logam kalsium dan magnesium juga diperlukan.

2.Persetubuhan pada waktu subur iaitu pada hari penetasan telur isteri ( ovulation) adalah penting. Untuk mengetahui tentang kaedah-kaedah mengesan waktu penetasan telor, Lihat carta BBT diatas sebagai panduan,

3.Menukarkan cecairan faraj kepada beralkali dengan melakukan ‘douching’ atau basuh dalam faraj dengan satu alat khas. 20 ml. Air bikarbonet dimasukkan kedalam faraj lebih kurang 2 jam sebelum mengadakan persetubuhan. Cecair bikarbonet (sodium bicarbonate ) boleh dibeli dari farmasi.

4.Kaedah suntikan benih lelaki ( artificial insemination) setelah air mani suami menjalani proses ‘layering’, atau menjalani rawatan bayi tabung uji (IVF) dan dipilih embryo yang telah disahkan lelaki untuk dimasukkan kedalam rahim. Kedua-dua kaedah tersebut tidak dibolehkan jika hanya untuk tujuan mendapatkan anak lelaki. Tetapi diperbolehkan jika sabit ada penyakit baka bila melahirkan anak perempuan.

Merancang anak perempuan

Kaedah-kaedah yang digunakan adalah sama dari segi prinsipnya. Ikutilah garis panduan berikut;

1.Digalakkan memakan makanan yang berasid seperti limau, asam , nenas, cuka, air minuman bergas dan lain lain. Pantang memakan makanan laut.

2.Persetubuhan dilakukan lepas habis haid , selang sehari , sehingga hari penetasan telur isteri (ovulation). Jangan bersetubuh selama 5 hari mulai dari hari ovulation, yang boleh dikesan dengan ujian-ujian subur. Sila lihat carta BBT diatas untuk kesan hari ovulation,

3.Melakukan ‘douching’ dengan menggunakan cecair asid (very dilute lactacyd) 2 jam sebelum persetubuhan dilakukan.

Kita hanya merancang, Allah swt yang akan menetukan. Allah yang memberi rezeki kepada maanusia dan setiap pemberian Allah kita terima dengan syukur Alhamdulillah, dan ia mengandungi hikmat dan nikmat yang tertentu.

Bila boleh tahu ?

Ujian Ultrasound pada kebiasaannya boleh mengesan jantin bayi dalam umur kandungan antara 5-6 bulan.

Bolehkah merancang anak kembar

Dalam keadaan biasa satu kembar akan berlaku daripada 80 kehamilan. Kejadian kandungan kembar sedikit dipengaruhi oleh baka dan keturunan.

Wanita-wanita yang sedang menjalani rawatan kesuburan, peluang dapat anak kembar bagi mereka yang makan pil subur (clomiphene) ialah antara 5-10% , sedangkan mereka yang menerima suntikan homon subur atau menjalani rawatan bayi tabung uji, peluang dapat anak kembar ialah 20-30%.

Anda boleh mencuba rawatan tersebut, tetapi rawatan suntikan hormon subur membawa risiko kembar sampai lapan yang akhirnya akan gugur.

Makanan terbaik untuk pembentukan otak.

Protin adalah zat makanan asas bagi pembentukan otak bayi dalam kandungan. Ia boleh didapati dari berbagai sumber pemakanan diantaranya daging lembu atau kambing, ayam, ikan dan lain-lain jenis makanan laut, tauhu dan tempe (dari kacang soya), kacang hijau, susu dan produk-produk darinya, telur dan lain-lain.

Dari semua itu, ikan dan makanan dari kacang soya dan susu merupakan sumber protin yang mudah hazam dan diserap ke dalam saluran darah dan seterusnya dibekalkan kepada bayi dalam kandungan. Ada yang percaya makan lebih makanan dari kacang soya menghasilkan kulit bayi yang cantik ! Mungkin benar?

Minyak ikan dipercayai juga penting bagi pembentukkan otak bayi. Makanlah minyak dan telur ikan dalam kadar yang lebih dari biasa mulai kandungan 5 bulan keatas. Amalan meratah ikan dan tahu juga baik bagi wanita-wamita hamil !

The Shettles Method

Is it really the method "best supported by scientific evidence", or just an urban legend?

The Shettles method is the world's best known gender selection method, achieving fame in the million copy bestseller How to Choose the Sex of Your Baby. Dr. Landrum Shettles claimed a 75% to 90% success rate for his simple, at-home method, which advises how to time intercourse to conceive a boy or a girl. (See the survey results for timing of ovulation and intercourse.)

The Shettles Theory

Shettles theorized that the two different types of sperm, X-chromosome-bearing sperm and Y-chromosome-bearing sperm, had different properties.

Y-Bearing Sperm
(Male-Producing)

Smaller, round-headed
Faster
More fragile, shorter-lived

X-Bearing Sperm
(Female-Producing)

Larger, oval-headed
Slower
More resilient, longer-lived

Shettles hoped that these properties could be used to choose a baby's sex.

Under ideal conditions, the Y-sperm's faster speed should prevail, winning the race to the egg and conceiving a boy.
Under less than ideal conditions, fewer of the fragile Y-sperm will survive. The X-sperm's resiliance and staying power should win the day, conceiving a girl.

Shettles Advantages and Disadvantages

Shettles Advantages

FREE, except the Shettles book, and any ovulation tracking supplies you might choose to buy.
An at-home method you can use in the privacy of your own home. Conception occurs naturally, and few people have ethical or moral objections.
If you are trying for a boy, the Shettles method will guide you to optimum fertility, making it easier to conceive.

Shettles Disadvantages

To use the Shettles method, you must learn to detect ovulation, which requires some practice and a little dedication. However, this is really something every woman should know about anyway.
If you are trying for a girl, Shettles advises avoiding intercourse on your peak days of fertility, which can make it very difficult to get pregnant at all.
There is no scientific evidence to support the Shettles method, and some studies have disproved it.

Before You Try Shettles: Ovulation Tracking

Dr. Shettles believed that correctly timing intercourse was the most important factor in choosing to conceive a boy or girl. This means you must learn to detect when you ovulate, and spend a few cycles practicing until you are not only able to determine when ovulation has occurred, but to predict when it is about to occur.

The O+12 Method to Conceive a Girl

O+12 (pronounced "oh plus twelve") is a method for conceiving a girl. The method advises intercourse about 12 hours after ovulation to conceive a girl. Thus the name O (for ovulation) plus 12 hours. O+12 is contrary to the Shettles method, which predicts a boy will be conceived on the day ovulation. (Note to boy-seekers: O+12 is a method for attempting to conceive a girl only.)

O+12 Background

The O+12 method wasn't developed by a doctor, or published in a book. It was proposed by an Australian mother, a Shettles devotee who had six sons before stumbling on the idea that a girl might be conceived by timing intercourse just after ovulation, contrary to Shettles' advice. After giving birth at last to a daughter, she shared her method with other mothers, many of whom were successful in conceiving a daughter as well. Then the method reached the Internet, and here we are. Click here to read Kynzi's story.

O+12 Theory

The O+12 theory was developed by examining the "New Zealand Study" published in 1984. The study was carried out to test the Shettles theory, by carefully monitoring participants to determine the time of ovulation. (Just think... the baby girls born in that study are now old enough to become mothers themselves, and perhaps are today wondering how to choose the sex of their baby.)
The researchers concluded that the results "clearly refute" the Shettles theory, because most conceptions that occurred 3 to 5 days before ovulation were boys, not girls, as Shettles claimed. Kynzi noticed that the only day on which more girls than boys were conceived was the day following ovulation.
In addition to the New Zealand Study, some information was evidently uncovered indicating that the ratio of female-to-male sperm was greater if a man abstained from ejaculation for a period of time.

The O+12 Key: Pinpointing Ovulation

Before getting into the detailed instructions for O+12, it's enough to say that a successful O+12 attempt depends on being able to pinpoint ovulation. Most of us have spent our entire lives completely unaware of the invisible drama of ovulation that occurs inside our body each cycle. Be prepared to spend some time learning about how your body works (you will be fascinated and enlightened!) and learning how to detect your body's subtle signals that ovulation is imm"inent. Your guide is Taking Charge of Your Fertility, and you mig"ht also want the OvuSoft Fertility Software to go along with it.

O+12 Instructions

The father must not ejaculate for at least 7 days before intercourse (and preferably longer). That didn't say "no sex", it said "no ejaculation", so you better keep an eye on him in the shower. Try to get him to abstain from the first day of your cycle.
The reason for this is that since female sperm supposedly live longer, an "old" batch of sperm should have more female than male sperm (about 2% more, according to some data).
Have intercourse once only, 8 to 20 hours after ovulation. Start counting the 8-20 hours when...
- Any sharp O pain has subsided.
- Your CM begins to change from EWCM to creamy or sticky.
- Your cervix begins to become less soft and high.
Wait to have intercourse until you have seen your BBT shift up. (See the tips below for more information.)
Do NOT have intercourse again until you are sure you are no longer fertile. Use a condom or wait until you are sure you are no longer fertile before having intercourse again, because that "fresh" batch of sperm will be more likely to have more male sperm.
- You are past your fertile stage when you have had THREE high temperatures on your BBT chart.
Optional guidelines. Along with O+12, many also try:
- The girl diet
- Supplements (calcium and magnesium, cranberry)
- Douching before intercourse with a lemon douche (mix the fresh-squeezed juice of 1/2 lemon with an equal part of water, and insert with the empty bottle from a regular store-bought douche).

O+12 Tips

Pinpointing ovulation down to the hour is the key to O+12, and it's not easy. Most ovulation detection methods are just designed to determine the day of ovulation, which is generally good enough to achieve (or avoid) pregnancy. For O+12, we have to be ovulation experts.

Tip #1: Practice, practice, practice!

Track your ovulation indicators for several practice cycles. Many times, the time of ovulation can only be determined in hindsight. Practice cycles will give you confidence that you know when ovulation is occurring, and will also give you something to compare to when you're ready to make your attempt.

Tip #2: Use as many ovulation indicators as you can!

No matter how regular you are, or how many cycles you practice, each cycle is different. Gather as many clues as you can to determine the real moment of ovulation. Ovulation indicators include basal body temperature (BBT), cervical mucus (CM), cervical position (CP), saliva ferning, and ovulation prediction kit (OPK) testing. The great book Taking Charge of Your Fertility explains in detail how to use these methods to determine ovulation.

Tip #3: Watch your CM and your CP.

Your cervical mucus will usually change within hours of ovulation, changing from EWCM to creamy or sticky. Start counting the hours when your CM has started to change, and your cervix is not very high and soft.

Tip #4: Take your basal body temperature effectively.

Basal body temperature is a reliable method for detecting that ovulation is truly past, so make sure to take your temp carefully, and wait to have intercourse until you have seen your BBT shift up. However, taking your BBT once per day can only tell you that ovulation has occurred within the last 24 hours -- and by then you may be too far past ovulation to actually conceive, because the egg only lives about 24 hours. You may want to try also taking a second BBT temp in the evening. It will not be as accurate as your morning "at rest" temp, but if you take it at the same time every night after the same routine you will be able to see a pattern. Taking your BBT in the evening in addition to the morning should help you detect ovulation within the last 12 hours.

Note that your body temperature will be different in the evening -- you can't compare your morning and evening BBT's to each other. You can only compare your morning temps with previous morning temps, and evening temps with previous evening temps.

Tip #5: Take note of O pain.

O pain (ovulation pain, or mittelschmerz) can be pinpoint the exact time of ovulation -- but it can also fool you, because a little random twinge you would have ignored at any other time can mislead you if you're looking for ovulation to occur. Not everyone has O pain, and if you do, it may not be in every cycle. O pain tips:

Chart any O pain you experience in your practice cycles, and note how it correlates with your other symptoms. You may notice that O pain occurs at about the same time of day that your previous period began.
Recognize the different kind of O pains: A dull achiness before ovulation, a sharp pain at ovulation, and crampiness after ovulation.
The pain should come from toward your side (not from the center) and may be only on one side.

Tip #6: Use OPKs as advance warning only.

A positive ovulation prediction kit is a sure sign that ovulation is going to occur, but it does not give you an accurate prediction of when; it might be anywhere from 12 to 36 hours. When you get your first truly positive OPK, begin watching your other ovulation indicators (BBT, CM, CP, O pains) to determine exactly when ovulation is occurring.

Lydia Pinkham's Herbal Compound
For Conceiving a Girl

During July 2003, discussion on several boards began about the posibility that taking Lydia Pinkham's Herbal Compound, an herbal dietary supplement, could favor conceiving a daughter.

About Lydia Pinkham

Lydia Pinkham's Herbal Compound was originally the famous Lydia Pinkham's Vegetable Compound, a patent medicine tonic used to treat "female complaints" and infertility in the Victorian age. Lydia Pinkham's tonic made her rich and famous, and her story is quite interesting. The idea that Lydia Pinkham's (LP) compound might help to conceive a girl came from an alert board member who noted two girl pregnancies where the mothers were using LP, and investigated to find a total of 8 pregnancies where the mother was taking LP. She found that 7 of those 8 pregnancies resulted in girls. One mother had two girls while taking LP, and a boy without it.
Curiously, I don't know if Lydia Pinkham herself had daughters, although there are many mentions of her sons and granddaughters.

Theory About Lydia Pinkham's

If LP does make it more likely to conceive a girl, why? Here are some ideas that have been offered.

When tested with pH strips, the tonic is quite acidic (a pH of 2). An acidic environment, according to Shettles, is more hostile to sperm and only the hardier female sperm are likely to survive.
Black cohosh and other LP ingredients may balance estrogen levels (lower estrogen levels if you are estrogen dominant, or raise it if you are low in estrogen). Some believe that low-estrogen levels make it likely to conceive a girl, and women who are estrogen dominant (higher estrogen levels than progesterone) are more likely to conceive a boy.

Using Lydia Pinkham's to Conceive a Girl

I strongly advise you to consult your doctor before using a dietary supplement that could be harmful while you are trying to conceive. The ingredients in LP have not been evaluated by the FDA. Please see the Ingredients and Warnings page.

Take as directed on the package, or you may try 1/2 dosage.
Some have reported dizziness or nausea. Also, do not take any of the herbs in the compound separately or in other forms, as this could cause you to consume too much of it.
Begin taking LP on cycle day 1 and STOP on the day you ovulate.
Cycle day 1 is the day you begin your period. The advice to stop on the day you ovulate is due to the effect of Black Cohosh of causing uterine contractions, which may prevent the fertilized egg from implanting in the womb. You may also want to use natural progesterone creams after ovulation, to reduce high estrogen levels and assist with implantation.
Watch carefully for signs of ovulation.
You may ovulate earlier or later when using LP. Be sure monitor carefully for your ovulation indicators, so that you'll know when to stop taking LP and of course when to time intercourse!

Meningkatkan susu ibu

2011-01-19T22:16:00.000-08:00

ALL ABOUT BREAST FEEDING

Persediaan ketika hamil untuk penyusuan bayi adalah penting. Ibu hamil perlu makan yang berzat dan berkhasiat , lebihkan perotin dari ikan , daging lembu atau ayam, sayur2 dan buah2.
Buah dada perlu dituam dengan tuala yang direndam dalam air suam dan seterusnya diurut dari arah luar menuju ke puting. Bersihkan puting dari daki2 supaya saluran susu tidak tersumbat.

Ubat untuk meningkatan susu ibu ialah Motilium atau Maxalon satu biji , makan 3 kali sehari selama 2 minggu. Bagi mereka yang cuba menyusukan anak angkat makan selama sebulan dulu. Penting untuk bayi mengisap puting susu ibu. Makan sayur daun turi dengan keledek merah, masak air atau lemak dua kali seminggu ketika dalam penyusuan bayi

Ubat herbal FENUGREEK bolih bantu tingkat susu

Bedah cesar mengapa?

2011-01-19T21:54:00.000-08:00

Bolihkah lahir normal lepas cesar?
Ramai yang masih bolih bersalin normal selepas bedah cesar dengan syarat rongga tulang ponggong tidak sempit.

Perdarahan placenta previa

2011-01-19T21:51:00.000-08:00

Pendarahan Akhir Kandungan

Pendarahan di akhir kandungan

Perdarahan di peringkat akhir kehamilan mulai tujuh bulan kandungan biasanya menandakan salah satu daripada tiga perkara.

1. Uri pada pintu rahim
2. Accidental haemorrhage
3. Incidental bleeding

1.Uri pada pintu rahim (placenta previa)

Uri yang pada pintu rahim boleh menyebabkan pendarahan yang banyak, kadang-kala sampai boleh mengancam nyawa ibu dan bayi.Dengan ujian ultrasound yangdilakukan ketika ibu melawat doktor pakar perbidanan, biasanya kedudukan uri dapat dikesan samaada di tempat biasa iaitu di bahagian atas rahim atau di bahagian luar biasa iaitu di pangkal rahim .

Langkah-langkah tertentu perlu diambil setelah dikesan kedudukan uri tersebut untuk mencegah berlakunya perdarahan yang banyak khususnya apabila kehamilan mencapai ke peringkat lapan bulan atau lebih.

Kedudukan uri dibawah 'placenta previa' merangkumi dua jenis, pertama ialah dimana uri menutupi pintu rahim sepenuhnya 'placenta previa major' dan keadaan ini boleh menyebabkan pendarahan yang banyak apabila berlakunya kuncupan rahim khususnya di peringkat akhir kehamilan.

Kuncupan rahim sering disebabkan oleh kepenatan, tekanan mental dan penyakit jangkitan kuman khususnya pada pundi kencing atau bahagian tubuh yang lain.

Apabila berlaku perdarahan ibu mesti terus masuk ke hospital kerana biasanya pembedahan cesarean secara cemas perlu dilakukan untuk menyelamatkan ibu dan nyawa bayi tersebut.

'Placenta previa minor' ialah apabila uri hanya terletak pada bahagian bawah rahim tetapi tidak menutupi langsung pintu rahim.Keadaan begini tidaklah begitu mengancam dan biasanya tidaklah menyebabkan perdarahan yang banyak sangat.Adakalanya dalam keadaanini kelahiran normal masih boleh dilakukan.

2. Accidental haemorrhage (abruptio placenta)

Ini bermakna pendarahanberlaku dalam rahim di belakang uri dan keadaan ini sangatlah merbahaya kerana pendarahan di luar adalah sedikit tetapi banyak berlaku di dalam rahim menyebabkan rahim itu sangat keras dan membesar.

Keadaan ini sangat merbahaya dan mengancam nyawa bayi dan ibu.Jika terlambat kadang-kala bayi telah mati dalam perut sebelum ibu sampai ke hospital.Dalam keadaan yang sangat teruk, ibu tersebut juga boleh meninggal kerana bila keadaan ini berlaku ibu sebenarnya berdarah dengan banyaknya dalam rahim dan perdarahan tidak boleh dikawal kerana semua sel-sel pembekuan darah (platelets) telah habis terperangkap dalam bekuan darah dalam rahim.

Keadaan ini digelar dengan nama 'disseminated intra-vascular coagulation' iaitu satu keadaan yang amat merbahaya kerana pendarahan bukan sahaja berlaku dalam rahim tetapi di semua organ-organ dalam badan khususnya hati dan otak.Keadaan inilah yang boleh membawa maut kepada ibu tersebut.

Kelahiran mesti dilakukan secara cemas untuk menyelamatkan ibu, mungkin yang paling selamat sekali ialah dengan pembedahan cesarean.Transfusi darah serta lain-lain cecair untuk menggantikan cecair, logam dan sel-sel pembekuan perlu dilakukan dengan banyak dan cepat.

3) Pendarahan 'incidental'

Ini mungkin disebabkan pintu rahim yang luka (erosion) atau dijangkati kuman, atau saluran darah yang pecah dari sekeliling pintu rahim ataupun saluran faraj.Keadaan ini tidak begitu membahayakan ibu dan bayi tetapi ini adalah satu keadaan yang juga memerlukan perhatian.

Perlu dipastikan bahawa sebab-sebab utama seperti 'placenta previa' dan 'abruptio placenta' tidak berlaku dengan melakukan pemeriksaan faraj serta ujian ultrasound.Tiada rawatan yang khusus untuknya melainkan rehat.

Mencegah keguguran

2011-01-19T21:40:00.000-08:00

Mencegah keguguranBagi kebanyakan orang hamil untuk mencapai cukup bulan (37-40 minggu) tidak menjadi masalah. Lebih kurang 10-15% akan mengalami keguguran dan sebahagian besar daripada mereka yang berlaku dalam 3 bulan pertama. Keguguran berlaku sekali pun sudah cukup untuk menyebabkan trauma mental, dan jika ia terus di berulang, ia sangat buruk padahnya dan boleh merosakkan perkahwinan anda. Saya mempunyai pesakit yang telah hamper 10-12 kali keguguran diperingkat awal kehamilan.
Biasanya, saya akan melaksanakan penilaian yang sangat berhati-hati, pemeriksaan secara menyeluruh dan penyiasatan makmal yang berkaitan untuk mencari apa-apa punca keguguran. Ada kala saya dapat mengenal pasti punca-merta, tetapi kadang-kadang saya tidak boleh kerana ia mungkin disebabkan oleh kecacatan genetik / kromosom atau mungkin terdapat mutiple faktor-faktor berinteraksi.
Walau bagaimanapun, baru-baru ini saya mendapati bahawa kadar kejayaan saya dalam merawat keadaan ini telah meningkat dengan ketara, dan saya cuba untuk menganalisis sebab di sebalik kejayaan ini. Saya gunakan beberapa pendekatan rawatan saintifik. Jika saya mengesan sebarang penyakit dalam rahim atau ovari, seperti endometriosis dengan rahim retroverted, fibroid, ovari polisistik,rawatan secara pembedahan akan jadi pilihan. Beberapa jenis jangkitan kuman iaitu TORCHES - Toxoplasmosis, rubella, CMV virus,herpes simples dan syphillis adalah dikaitakn dengan kejadian keguguran yang berulang2. Rawatan sewajar dengan antibiotik dan supplement untuk meningkatkan immunity/ketahanan badan perlu dilaksanakan.
Lain-lain terapi tertumpu pada meningkatkan imuniti pesakit dengan memberikan beberapa penggalak imun dan tambahan. segar makanan / diet kesuburan. Saya percaya bahawa salah satu faktor dia menyebabkan keguguran ialah immunty/ketahanan yang rendah dan toksin berlebihan di dalam tubuh, Langkah2 memberikan antioksidan dan vitamin C, E dos tinggi akan dapat membantu.
Kaedah lain terapi memperbaiki persekitaran pesakit dengan tujuan mengurangkan tekanan fizikal dan mental esp kerja-kerja yang berkaitan, mengurangkan pendedahan kepada toksin luaran, bahan kimia pencemar dan berbahaya.
Cuba ikuti langkah-langkah:
1Jumpa pakar gyne anda dengan seberapa segera . apabila anda terlambat datang haid , buat ujian kencing untuk mengesahkan kehamilan. '
2. Menahan diri daripada hubungan seksual sehingga mendapat nasihat daripada doctor anda.
3. Hormon sokongan-mempercayai bahawa salah satu faktor yang menyebabkan awal keguguran kekurangan progesteron . Saya biasanya memberi pesakit yang berulang kali gugur, hormon progesteron dalam bentuk suntikan atau tablet dalam 3 bulan pertama kehamilan.
4. Saya memberi multivitamin saperti obimin, asid folik, Vit C 1gm dan Vit E 400-800 IU setiap hari.
5. Penggalak imun -Jintan Hitam (habbatus Sauda), antioksidan yang diperoleh daripada ekstrak buah-buahan dan sayur-sayuran. Baru2 ini saya juga beri Livovid iaitu sijenis supplement untuk membersihkan 'toxins dalam badan.
6. Bagi orang-orang yang gemuk dan mempunyai PCOS Saya akan beri mereka Metformin 500mg. Kurangkan karbohidrat dan gula. .Jauhkan fast dan junk foods.
7.Rehat adalah amat penting. Kurangkan aktiviti2 fizikal dan mental., Jauhkan kerunsingan. Berehat sebanyak2, jika perlu masuk hospital untukberehat di atas katil, sekurang-kurangnya tinggal di rumah.
8.Jauhkan racun serangga atau semburan pewangi atau kimia
9. Kurangkan Caffein dan juga teh, mengapa tidak mencuba air kelapa.
10 kedudukan Mudah ketika berbaring menyiarap jika anda mempunyai rahim yang retroverted dan belum lagi diperbetulkan, meletakkan 2 bantal di bawah perut anda. Luangkan 10-15 minit pada kedudukan itu pada kira-kira 10-11 pagi.dan pukul 3-4 petang dan setengah jam sebelum tidur.
11 Akhirnya - banyak Relaksasi, dan untuk umat Islam, membaca quran, zikir dan doa. Positif dalam pemikiran, menghilangkan segala bentuk negatif.

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