by Bozhidara Georgieva

Modern medicine is by your side for a trouble-free pregnancy

It doesn't matter whether you are pregnant for the first or the third time: the joy of caring inside yourself a new life is the same, and so are the dreams about the future. The fears about the health of your unborn child are the same, as well as is your desire to give him or her the best long before he or she is introduced to the world.

Pregnancy and giving birth have been a part of women's lives since there are people on earth. But this completely natural process is full with complications that have left a heavy mark in the shape of high women and children mortality rates, which have followed humanity since its dawn.

Why is that so? Other mammals, even apes who are our closest relatives, give birth relatively easy and their babies are capable of moving by themselves soon after they come into the world. The reason is our evolutionary development. The proportionally large human brain needs a lot of time for development, but yet the child's head should be small enough to pass through the mother's birth canal. Her pelvis, on the other side, should be narrow enough, because precisely this feature allows for one of the most important traits of our species: upright walking.

This is why people give birth with hardships and difficulties. Through the millennia, each human culture has created its own, often very complicated, system of beliefs, practices and superstitions to guarantee the health and lives of the mother and child. But only when modern medicine, hygiene and developed healthcare became common, the mortality rates of women and children during birth significantly decreased. Since 1990, the mortality rates of women during labour all over the world has fallen with 45 percent, and according to UN data the children's mortality rate worldwide has decreased from 162 on 100,000 in 1950-1955 to 43 on 100,000 in 2010-2015.

Unlike her predecessors, however, the modern woman who is expecting a child suffers not from a lack of information, but of oversupply. The internet and the mass media are churning news about both ground breaking and dubious scientific discoveries, rumours and fashions with a dizzying speed. This creates stress that takes the future mother off what is most important here: the right care for the health of her baby and of herself.
Still, there are several secure things to take in consideration during pregnancy.

Lifestyle is crucial. Forget about smoking and alcohol, drink less coffee and increase your folic acid and iron intake. Forget as well the idea that pregnancy asks for physical passivity. On the contrary, moderate and non-stressing physical exercise, but only after a consultation with your doctor, will ease the back-pain, stimulate blood circulation in the legs and help you get back into shape after you give birth. Contrary to the traditional way of thinking, while you are pregnant you don't need to eat for two. Your body needs only about 300 additional calories a day, with an increased daily intake of proteins from the usual 45 grams to 70 grams.

Avoid unpasteurised dairy products, and raw fish, eggs and meat, as they can contain bacteria that could damage your child.

Follow your blood pressure and take careful notice if your child kicks enough. In case of any doubt that something is wrong, ask for medical help.

Regular check-ups with your obstetrician are an absolute must – he or she is the specialist who will take you through all the stages of your pregnancy and will help you to clarify are there any complicating factors. These include pregnancy after 35 years of age and the danger of developing gestational diabetes (the condition appears during the pregnancy and usually disappears soon after giving birth), but also problematic past pregnancies, unusual bleeding or pains, severe nausea, abuse of narcotics and alcohol in the past, intake of drugs that could affect the pregnancy, and gynaecological, STD and other diseases.

Your specialist is also the person who will decide whether you have to make additional tests and screenings for genetical disorders and pregnancy complications.

The development of modern medicine has led to the creation of early and reliable methods for diagnostics of chromosome diseases (like Down, Edwards and Patau syndromes) and possible pregnancy complications like preeclampsia (increased blood pressure during pregnancy). The quality of the screening tests depends on factors like over 90 percent recognition of chromosome diseases and under 5 percent of false positive results. The most popular screening methods at the moment are: the combined early screening in the first trimester with biochemical and ultrasound markers, and DNA screening of the fetus in the mother’s serum. The tests include the examination of factors such as the mother's age, echography and biochemical markers.

Successful diagnosis, however, is possible only when it is performed by excellently trained professionals with experience who are fluent in the latest trends in the field, like the team of O.S.C.A.R Clinic (St Petka Medical Centre) (Sofia, 15-17 General Stefan Toshev Blvd, phone: 0895 770 717; www.oscarclinic.com). The clinic uses the most advanced diagnostic methods, including screening via fetal DNA in the mother's serum, identifying 99 percent of the Down syndrome pregnancies and about 93 percent of the ones with trisomy 18 and 13. The clinic is a place where patients can consult on complications like preeclampsia, premature birth, and fetal growth retardation. The examination for preeclampsia during the first trimester is key: between 8 and 10 percent of pregnant women develop high blood pressure, which can lead to complications endangering the lives of the mother and child like eclampsia and help syndrome.

When you want to be sure about the health of your unborn child, the Bodimed laboratories (www.bodimed.com) have a solution. One of the most renowned chains for examination of medical data in Bulgaria offers PanoramaTM, a non-invasive prenatal screening on the most common fetal chromosome anomalies. The tests use the mother's blood serum in order to sequence the mother's and the fetus's genotypes, and include an error-free fetal sex determination, as well as a personalised evaluation on the risk of 21, 18, 13 trisomy (syndromes of Dawn, Edwards and Patau), monosomy Х (Turner syndrome) and microdeletion syndromes, all the way having an extremely low percentage of falsely positive results (0.7%).

The physical parameters of you and your child are important, but don't forget that we are not only our bodies. In the first signs that you are developing a depressive state of mind, ask help from your doctor.
All of these "dos" and "don'ts" look startling and even scary. But the wholesome care during your pregnancy is the least you can do for your child in order for her or him to grow up healthy and happy.


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