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Taking painkillers during pregnancy may lower the fertility of the unborn child in later life, scientists have warned.

The study identifies that these drugs may also affect the fertility of future generations, by leaving marks on DNA.

The findings add to a growing body of evidence that certain medicines, including paracetamol, should be used with caution during pregnancy.

Researchers stress that advice for pregnant women remains unchanged. Current guidelines say that, if necessary, paracetamol - also known as acetaminophen - should be used at the lowest possible dose for the shortest possible time. Ibuprofen should be avoided during pregnancy.

Scientists at the University of Edinburgh in the UK looked at the effects of paracetamol and ibuprofen on samples of human foetal testes and ovaries.

They found similar effects using several different experimental approaches, including lab tests on human tissue samples and animal studies.

Human tissues exposed to either drug for one week in a dish had reduced numbers of cells that give rise to sperm and eggs, called germ cells, the study found.

Ovaries exposed to paracetamol for one week had more than 40 per cent fewer egg-producing cells. After ibuprofen exposure, the number of cells was almost halved.

This is important because girls produce all of their eggs in the womb, so if they are born with a reduced number it could lead to an early menopause.

Painkiller exposure during development could have effects on unborn boys too, the study found. Testicular tissue exposed to painkillers in a culture dish had around a quarter fewer sperm-producing cells after exposure to paracetamol or ibuprofen.

The team also tested the effects of painkiller treatment on mice that carried grafts of human foetal testicular tissue.

These grafts have been shown to mimic how the testes grow and function during development in the womb.

After just one day of treatment with a human-equivalent dose of paracetamol, the number of sperm-producing cells in the graft tissue had dropped by 17 per cent. After a week of drug treatment, there were almost one third fewer cells.

Previous studies with rats have shown that painkillers administered in pregnancy led to a reduction in germ cells in female offspring. This affected their fertility and the fertility of females in subsequent generations.

The study, published in the journal Environmental Health Perspectives, found that exposure to paracetamol or ibuprofen triggers mechanisms in the cell that make changes in the structure of DNA, called epigenetic marks.

These marks can be inherited, helping to explain how the effects of painkillers on fertility may be passed on to future generations.

Painkillers' effects on germ cells are likely caused by their actions on molecules called prostaglandins, which have key functions in the ovaries and testes, the researchers found.

"We would encourage women to think carefully before taking painkillers in pregnancy and to follow existing guidelines - taking the lowest possible dose for the shortest time possible," said Rod Mitchell, from University of Edinburgh, who led the research.

Pregnancy can be a challenging time for women with all the emotional and physical changes their bodies go through. While there is excitement to welcome a newborn into the world, it's no secret that nine-months of morning sickness, midnight hunger pangs and mood swings can be pretty daunting too. It needs a lot of patience and care to look after the mother and the baby. While fruits are said to be nutrient-dense and cater to untimely hunger pangs, there are a bunch of them that could be avoided as they may affect pregnancy in some way or the other.According to Dr. Rahul Manchanda, Gaynae Endoscopic Surgeon PSRI, craving is one thing that strikes every woman during pregnancy due to hormonal surge but there are some fruits that are recommended to be avoided during pregnancy. Such fruits may include papaya as it could lead to early labour or miscarriage and sometimes even grapes as they contain a compound known as resveratrol that elevates hormonal imbalance during pregnancy."

According to Dr. Sadhna Singhal, Senior Consultant Gynaecologist, Sri Balaji Action Medical Institute, "fruits are always healthy and nutritious to have. But there are some fruits which should not be consumed during pregnancy as they might end up causing negative impact to the womb."

Here are some fruits that pregnant women should avoid, as suggested by the experts:

1. Pineapple

Although pineapple is a super healthy fruit, it should be kept away from pregnant women. It comprises a rich amount of bromelain that may cause the softening of the cervix that may induce early labour. Moreover, eating a lot of pineapple can cause stomach problems like diarrhoea, resulting in dehydration.

2. Grapes

Grapes have heat producing properties, which can affect both the mother and the baby. It is also the presence of a compound known as resveratrol, which is known to elevate hormonal imbalance during this period.

3. Papaya

Papaya is one of the most common fruits that are forbidden in this list. Papaya is said to promote early labour and in worst case scenario, miscarriages. Papayas, usually the unripe and semi-ripe ones are believed to be rich in latex that is known to trigger uterine contractions.

4. Bitter Melon

Bitter melon is said to be an irritant to the uterus, which can lead to premature birth or miscarriage. In fact, they contain highly toxic components like quinine, saponic glycosides and morodicine. When absorbed in the body, they can cause nausea, rash, diarrhoea and abdominal pain.

1.You must never consume fruits that are not washed properly. The presence of pesticides, mud or any residue can give rise to infections, affecting the mother and the foetus. Make sure you wash them thoroughly under running water, especially fruits that need cutting or peeling.

2.Cut away the bruised or damaged areas, as bacteria thrive in these spots, which make the mother and baby susceptible to infections.

3.As an added precaution, use a vegetable brush to remove surface dirt from the fruits.

4.Make sure you are not using detergents, soaps or bleach solutions to clean your fruits.

Fruits That You Should Eat During Pregnancy

Include more and more fruits in your diet and ensure a healthy pregnancy. Make sure you consult your gynaecologist and nutritionist to alter your diet plan to birth a healthy and happy baby.

During pregnancy, it is recommended to avoid the use of any self-treatments or over-the-counter medications to relieve vaginal itching. This can be risky for your well-being. Immediately see your healthcare provider to test for any sexually transmitted diseases or infections (STDs or STIs), which can be the cause behind vaginal itching.

Vaginal Itching Due to pH Changes

If you are experiencing vaginal itching due to normal pH changes of the vagina that occur during pregnancy, you can take a number of self-help treatments, which are efficient in relieving the itching by reducing the PH of the vagina. Here are certain ways in which you can reduce pH of the vagina:

1.Take baking soda baths. For this, prepare a paste of baking soda and water. Apply the paste on the itchy areas and wash after a few minutes. This will lower vaginal pH, giving you relief from itching

2.Having sexual intercourse is another remedy to relieve vaginal itching due to increased pH of the vagina. Male sperms are low on PH levels, thus, intercourse is recommended. But consult a doctor before having sex

3.Some women find cold compresses helpful in relieve vaginal itchingCan Over-the-counter Creams Help in Relieving Vaginal Itching?

4.Doctors do not recommend use of hydrocortisone creams as they contribute to the breakdown of the skin, increasing the itching

5.Lidocaine gel, which is a pure anaesthetic, proves to be good for relieving vaginal itching

6.Women who experience genital yeast infection sometimes use one of the over-the-counter yeast infection creams. These creams can quickly relieve the itch, as well as the other
symptoms of vaginal yeast infections

Some women use a yeast infection cream externally once or twice a day to relieve vaginal itching

How you can Prevent Vaginal Itching?

Good hygiene is the key to remain free from vaginal problems. Always keep your vaginal area clean and dry

After a bowel movement, wipe from front to back to prevent bacteria from entering the vagina
Stay away from vaginal douches

Use only fragrance-free soaps and laundry detergents
Wear loose clothes as tight clothes do not let air pass to the crotch

Avoid wearing nylon panties, wear cotton panties, especially white oness

Do not wear underwear at night as this increases airflow to the vagina

Avoid taking bubble baths or using other fragrant products on your crotch. These can cause irritation in the vagina and urinary tract. Take warm water bath instead.

The popularity of prenatal yoga has grown because of the great benefits that it has to offer for pregnant women and the baby. The benefits they pose are toning of muscles, balancing of blood circulation, regulation of metabolism and are a great way to relax. It is the ideal way of not only staying in shape but learning to hold your nerve throughout the journey.

Prenatal Yoga Tip: Ujjayi Breathing

1.Inhale and exhale through your mouth a few times. While exhaling, tone the back of the throat to constrict the passage of some air.
2. Feel as though you were fogging glasses
After you are comfortable with toning the throat with exhales, try doing it with inhales too. That will create a distinct sound. Practice and master toning of throats with both inhales and exhales.

3.If you are able to control both the inhales and exhales, the next step is to do the same while breathing through nose and the mouth close. There will still be the distinct sound, although a little muffled due to the closed mouth.

4.Learn to inhale completely to fill the lungs and exhale till the stomach cramps a bit.This is one of the first yogic techniques that you learn in Yoga classes for Pregnancy fitness.

5. Breathing fully is directly linked to deep relaxation and furthers the cause of well-being. This is essential when it comes to meeting the physical demands of labour and delivery.

6.Emotional balance can also be achieved with this breathing practice.

Prenatal Yoga Tips

Even if you are in the first trimester, drink a lot of water when performing yoga poses. This need to be done before, after and during the performance of yogic poses. This is important to keep the body hydrated

Do not take any pain or discomfort lightly while performing the yogic poses. Make slight modifications or ask your instructor to recommend a different pose.

In the second trimester, do not perform the poses that strain your joints for long. You can gradually reduce the time for holding the pose as now your joints are loosening up
Take care to be gentle when performing the yoga poses in the second trimester and use props and other supports to help you in performing the different poses.

When in third trimester, your belly is so grown that it is advisable to stick to only Ujjayi or other gentle breathing practices. Yogic poses can also be performed with caution. You can rest yourself to the wall or use a chair for support when performing the poses

Pregnant women are advised ample rest and there’s a good reason for it. In fact, pregnant women undergo constant blood pressure check up so that the doctor can monitor the pressure levels throughout pregnancy. Developing high blood pressure during pregnancy is not always harmful but it could also lead to several complications. “These days high BP during late pregnancies is very common. There is also a high possibility that women have hypertension as a pre-existing condition,” says Dr Anjali Talwalkar, obstetrics and gynecology, Kohinoor Hospital.

These are some of the symptoms that you need to watch out for:

Typically, most women develop high BP during the seventh month, usually after 20 or 24 weeks. This is the time that women need to be careful and lead as healthy a life as possible. “Some of the effects include protein loss in urine, which could lead to kidney damage. At the same time fluid retention (which is very common) can lead to swollen feet,” she adds. High BP could also lead to pre-eclampsia.

According to Dr Bilsi Mittal, MS (obstetrics and gynaecology), Wockhardt Hospital, “Pregnant women should watch out for symptoms like too much weight gain, blurring of vision, turbidity of urine, severe headaches.”

Here’s what high BP means for your growing baby:

Due to the increased pressure, it directly affects the placenta. “This makes the blood vessels shrink leading to reduced blood flow for your baby. The baby can also experience severe intrauterine growth retardation,” says Talwalkar.

She adds, “Accidental haemohrage is also a complication that women should be aware of. This causes the placenta to separate from the uterus and leads to bleeding.”

High BP can be a dangerous condition because sometimes it can also lead to termination of pregnancy. “This situation is rare but occurs if the pregnant woman’s BP doesn’t come under control with treatment,” says Dr Mittal.

So, what are some of the precautionary measures?

Controlling blood pressure is very important. “It is important for mothers-to-be to ensure that they opt for early detection, which helps in better prognosis. Be regular for antenatal visits. Always follow a low salt diet and continue regular intake of calcium and iron tablets,” says Dr Mittal. Most importantly, a mother-to-be should be supported at home and at work places to help her sail through the pregnancy smoothly.

Dr. Dr Amrut Oswal
Dr. Dr Amrut Oswal
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Dr. Yogesh Gangurde
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Dr. Sachin Rohani
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Dr. Sneha Jain
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