ABORTION!

Abortion is the ending of pregnancy by the removal or forcing out from the womb of a foetus or embryo before it is able to survive on its own. An abortion can occur spontaneously, in which case it is often called a miscarriage. It can also be purposely caused in which case it is known as an induced abortion. The term abortion most commonly refers to the induced abortion of a human pregnancy. The similar procedure after the foetus may be able to survive on its own is medically known as a "late termination of pregnancy"
Abortion is a crazy painful experience, it can lead to depression, infertility and a whole lot of other issues..

Modern medicine uses medications or surgical methods for induced abortion. The two medications mifepristone and prostaglandin are as effective as a surgical method in the first trimester. While the use of medications may be effective in the second trimester,surgical methods appear to have a lower risk of side effects. Birth control, including the pill and intrauterine devices can be started immediately after an abortion. Abortion in the developed world has a long history of beingamong the safest procedures in medicine when allowed bylocal law.complicated abortions can cause either long term mental health or physical problems.Unsafe abortions result in approximately 47,000maternal deaths and 5 million hospital admissions per year globally.

An estimated 44 million abortions are performed globally each year, with slightly under half of those performed unsafely.This is quite a lot. Rates of abortions have changed little between 2003 and 2008,after having previously spent decades declining as access to education regarding family planning and birth control improved.As of 2008, 40% of the world's women had access to legal induced abortions "without restriction as to reason".There are; however, limits regarding how far along in pregnant they can be performed.

Induced abortion has a long history. They have been performed by various methods, including herbal medicines, the use of sharpened tools,physical trauma, and other traditional methods since ancient times.The laws surrounding abortion, how frequently they are performed, and their cultural and religious status vary a great deal around the world. In some contexts, abortion is legal based on specific conditions, such as incest, rape,problems with the fetus, socio-economic factors or the risk to a mother's health. In many parts of the world there is prominent public controversy over the moral,ethical, and legal issues of abortion. Those who are against abortion generally state that an embryo or foetus is a human with the right to lifea nd may compare abortion to murder.Those who support abortion rights emphasize a woman's right to decide matters concerning her own body as well as emphasising human rights generally. Where do you belong?

Induced
Approximately 205 million pregnancies occur each year worldwide. Over a third are unintended and about a fifth end in induced abortion.Most abortions result from unintended pregnancies.In africa1 to 2% of abortions are done due to genetic problems in the fetus.A pregnancy can be intentionally aborted in several ways. The manner selected often depends on the individual, the gestational age of the embryo or fetus, which increases in size as the pregnancy progresses.Specific procedures may also be selected due to legality, regional availability, and doctor or patient preference.

Reasons for procuring induced abortions are typically characterized as either therapeutic or elective. An abortion is medically referred to as a therapeutic abortion when it is performed to save the life of the pregnant woman; prevent harm to the woman's physical or mental health; terminate a pregnancy where indications are that the child will have a significantly increased chance of premature morbidity or mortality or be other wise disabled; or to selectively reduce the number of fetuses to lessen health risks associated with multiple pregnancy.An abortion is referred to as an elective or voluntary abortion when it is performed at the request of the woman for non-medical reasons (your boy friend says he does not want it)Confusion sometimes arises over the term "elective" because "elective surgery" generally refers to all scheduled surgery, whether medically necessary or not.

Spontaneous (Miscarriage)
Spontaneous abortion, also known as miscarriage, is the unintentional expulsion of an embryo or fetus before the 24thweek of gestation.A pregnancy that ends before 37 weeks of gestation resulting in alive-borninfant is known as a "premature birth" or a "preterm birth".When a fetus dies in utero after viability, or during delivery, it is usually termed "stillborn".Premature births and stillbirths are generally not considered to be miscarriages although usage of these terms can sometimes overlap.

The most common cause of spontaneous abortion(miscarriage) during the first trimester is chromosomal abnormalities of the embryo or fetus,accounting for at least 50% of sampled early pregnancy losses.Other causes include vascular disease(such aslupus),diabetes, other hormonal problems, infection, and abnormalities of the uterus.Advancing maternal age and a patient history of previous spontaneous abortions are the two leading factors associated with a greater risk of spontaneous abortion.A spontaneous abortion can also be caused by accidental trauma; intentional trauma or stress to cause miscarriage is considered induced abortion or feticide.

Medical Abortion
The most common early first-trimester medical abortion regimens use mifepristone in combination with a prostaglandin analog (misoprostolorgemeprost) up to 9 weeks gestational age,methotrexatein combination with a prostaglandin analog up to 7 weeks gestation, or a prostaglandin analog alone.Mifepristone–misoprostol combination regimens work faster and are more effective at later gestational ages than methotrexate–misoprostol combination regimens, and combination regimens are more effective than misoprostol alone.This regime is effective in the second trimester.

In very early abortions, up to 7 weeks gestation, medical abortion using a mifepristone–misoprostol combination regimen is considered to be more effective than surgical abortion (vacuum aspiration), especially when clinical practice does not include detailed inspection of aspirated tissue.Early medical abortion regimens using mifepristone, followed 24–48 hours later by buccal or vaginal misoprostol are 98% effective up to 9 weeks gestational age.If medical abortion fails, surgical abortion must be used to complete the procedure

Surgical
Up to 15 weeks' gestation,suction-aspiration or vacuum aspiration are the most common surgical methods of induced abortion.Manual vacuum aspiration(MVA) consists of removing the fetus or embryo,placenta, and membranes by suction using a manual syringe, while electric vacuum aspiration(EVA) uses an electric pump. These techniques differ in the mechanism used to apply suction, in how early in pregnancy they can be used, and in whether cervical dilation is necessary.‎

MVA, also known as "mini-suction" and "menstrual extraction", can be used in very early pregnancy, and does not require cervical dilation.Dilation and curettage(D&C), the second most common method of surgical abortion, is a standard gynecological procedure performed for a variety of reasons, including examination of the uterine lining for possible malignancy, investigation of abnormal bleeding, and abortion.Curettage refers to cleaning the walls of the uterus with acurette. This is recommended and also calledsharp curettage,only when MVA is unavailable.

From the 15th week of gestation until approximately the 26th, other techniques must be used.Premature labor and delivery can be induced with prostaglandin; this can be coupled with injecting the amniotic fluidwith hypertonic solutions containingsalineorurea. After the 16th week of gestation, abortions can also be induced byintact dilation and extraction(IDX) (also called intrauterine cranial decompression), which requires surgical decompression of the fetus's head before evacuation. IDX is sometimes called "partial-birth abortion," which has beenfederally bannedabroad.

In the third trimester of pregnancy, abortion may be performed by IDX as described above, induction of labor, or by hysterotomy.Hysterotomy abortionis a procedure similar to acaesarean sectionand is performed undergeneral anesthesia. It requires a smaller incision than a caesarean section and is used during later stages of pregnancy.

First-trimester procedures can generally be performed using local anaesthesia, while second-trimester methods may require deep sedation ‎or general anaesthesia.

Abortion is sometimes attempted by causing trauma to the abdomen. The degree of force, if severe, can cause serious internal injuries without necessarily succeeding in inducing miscarriage‎

Reported methods of unsafe,self-induced abortion ‎include misuse ofmisoprostol, and insertion of non-surgical implements such as knitting needles and clothes hangers into the uterus. These methods are rarely seen in developed countries where surgical abortion is legal and available.

Safety

The health risks of abortion depend on whether the procedure is performed safely or unsafely.illegal abortions are those performed by unskilled individuals, with hazardous equipment, or in unsanitary facilities. ‎Legal abortions performed in the developed world ‎are among the safest procedures in medicine. In Nigeria, there are a lot of poorly done abortions due to our stand as a society..we frown at the idea of abortion hereby forcing these women to go to the wrong places and the wrong people to carry out these operation. This leads to complications and most times loss of life.‎

Vacuum aspirationin the first trimester is the safest method of surgical abortion, and can be performed in a ‎primary care office,abortion clinic, or hospital. Complications are rare and can include uterine perforation,pelvic infection, and retained products of conception requiring a second procedure to evacuate. Preventive antibiotics (such as doxycycline ‎or metronidazole) are typically given before elective abortion, as they are believed to substantially reduce the risk of post operative uterine infection. Complications after second-trimester abortion are similar to those after first-trimester abortion, and depend somewhat on the method chosen.

There is little difference in terms of safety and efficacy between medical abortion using a combined regimen of mifepristone and misoprostol and surgical abortion (vacuum aspiration) in early first trimester abortions up to 9 weeks gestation. ‎Medical abortion using the prostaglandin analog misoprostol alone is less effective and more painful than medical abortion using a combined regimen of mifepristone and misoprostol or surgical abortion.

Some purported risks of abortion are promoted primarily by anti-abortion groups, but lack scientific support. ‎For example, the question of a link between induced abortion and breast cancer ‎has been investigated extensively. Major medical and scientific bodies (including the World Health Organization, the US National Cancer Institute, the American Cancer Society, the Royal College of Obstetricians and Gynaecologists ‎and the American Congress of Obstetricians and Gynecologists) have concluded that abortion does not cause breast cancer, although such a link continues to be promoted by anti-abortion groups.

Similarly, evidence indicates that induced abortion does not cause mental-health problems. The American Psychological Association ‎has concluded that a single abortion is not a threat to women's mental health, and that women are no more likely to have mental-health problems after a first-trimester abortion than after carrying an unwanted pregnancy to term. Abortions performed after the first trimester because of fetal abnormalities are not thought to cause mental-health problems. Some proposed negative psychological effects of abortion have been referred to by anti-abortion advocates as a separate condition called "post-abortion syndrome", which is not recognized by any medical or psychological organization.

Unsafe abortion
Women seeking to terminate their pregnancies sometimes resort to unsafe methods, particularly when access to legal abortion is restricted. They may attempt to self-abortor rely on another person who does not have proper medical training or access to proper facilities. This has a tendency to lead to severe complications, such as incomplete abortion,sepsis, hemorrhage, and damage to internal organs.

Unsafe abortions are a major cause of injury and death among women worldwide. Although data are imprecise, it is estimated that approximately 20 million unsafe abortions are performed annually, with 97% taking place in developing countries. ‎Unsafe abortions are believed to result in millions of injuries. Estimates of deaths vary according to methodology, and have ranged from 37,000 to 70,000 in the past decade; deaths from unsafe abortion account for around 13% of all maternal deaths.To reduce the number of unsafe abortions, public health organizations have generally advocated emphasizing the legalization of abortion, training of medical personnel, and ensuring access to reproductive-health services.

The legality of abortion is one of the main determinants of its safety. Countries with restrictive abortion laws have significantly higher rates of unsafe abortion (and similar overall abortion rates) compared to those where abortion is legal and available. ‎For example, the 1996 legalization of abortion in South Africa had an immediate positive impact on the frequency of abortion-related complications, with abortion-related deaths dropping by more than 90%. In addition, a lack of access to effective contraception contributes to unsafe abortion. It has been estimated that the incidence of unsafe abortion could be reduced by up to 75% (from 20 million to 5 million annually) if modern family planning and maternal health services were readily available globally.

‎ In Nigeria here, abortion is killing uncountable numbers of teenagers and adults alike, mostly due to its illegality, WON'T IT BE RIGHT TO LEGALISE IT IN NIGERIA? pls drop your opinion here, our ladies are dieing in thousands monthly from abortions done by quacks

Please let us know your opinion.

HYMEN

Hi peeps, it's been a while I posted on this blog, any body miss me? I miss blogging anyway. I actually felt as a doctor it's easier for me to blog while on leave than at work, alas! Am wrong, blogging while working is easier for me, maybe that's due to what my blog is about(things I see personally) or due to increase in my adrenaline level while working, whichever way, I totally miss my blog.

Few days ago I did a small presentation on # HYMEN and virginity on twitter, it was a lovely conversation between me and my followers, I encourage all to pls follow me on Twitter @dr90ng,we can iron out lot of things.

Where am from we lay a lot of emphasy on virginity and retaining your hymen as a lady, may be keep it till your wedding night! What a mythical thought!!.

I once scanned a lady one time who claimed to be a virgin, she was brought to my office by her mom,15yr old I think, with body built like a 25yr old. The history as given,points to  pregnancy. On putting my probe, she's about 16wks gone, she was so surprised that I thought am scanning the wrong womb, maybe the womb I was scanning belong to her mom!.

As a good samarithan, I told the mom to excuse us so I can have a word with the daughter. Mothers! Amazing species they are. She did and I spoke with this little gem, she told me her teenage boy friend sometimes rubs his penis on her vagina, but they never had penetrative sex, and so she was sure she's a virgin, she even told me I can examine her with her mom, what a poor fellow, I felt bad  for her.

Well, enough of my chinua achebe-ing, what am I driving at? Is the hymen a real indicator of virginity? Can a virgin get pregnant with an intact hymen?

The hymen is a piece of skin covering the vaginal opening, it starts forming from the 4th month while a woman is still in her mothers womb, it partially surrounds the vaginal opening but not covering it completely such that there is a hole that remains open at all time, offcourse the hymen differs in women.
The skin of the hymen gets thicker with maturity, such that it's lighter in children and with rigorous activities like dancing, cycling, strenuous exercises it can be broken.

I am of the opinion that the hymen is not a real indicator of virginity (my opinion), I see a lot of rape cases, where doctors will be asked to confirm if the act actually occur,most of these cases are seen few days after the evil act, hence limiting the authenticity of our examinations. Most times, the hymen is never intact, this doesn't make it a rape, the lady or little girl as the case may be could have ruptured the hymen from other causes, which cannot be proven medically, at least in my country.

It will be surprising that most people don't even know where the hymen is, even the owner of this gem might not. Doctors are not left out of these ignorance. Few to most physicians don't know.

It must be said that a woman can actually get pregnant despite an intact hymen, note that intact hymen in this case is not synonymous with virginity. From the case scenario I gave above, if you have intact gem and romance the penis close to the vaginal canal without active penetration, there is a high probability that the male ejaculate can find its way into the vagina canal, resulting in pregnancy if the timing is right. I have seen cases like this.

The hymen can actually be a gift and a curse in some circumstances, e. g case of imperforate hymen. In these case there's no opening in the hymen at all, this might go unnoticed for a while till the young lady start menstruating, there will not be outward flow of the blood which can lead to other medical conditions.

As long as am not encouraging anything as per virginity or no virginity, there a few tips on stretching the hymen naturally
1.Place one lubricated fingers against the hymen gently. Work on trying to get at least the pinky finger inside. You can attempt to work up to two fingers, but remember to be gentle.
Vigorous exercise can help to stretch or even pre-break the hymen. Sports like Horseback riding, motorcycle riding and dancing are infamous for rupturing the hymen. If your partner suspects you are not a virgin, explain these facts to them.
Tampon use can help to stretch or break the hymen. Start using the smallest type and work up to the larger sizes. A small amount of sterile lubricant can ease the tampon into place. Never force a tampon into the vagina.
The first time you have intercourse, make sure your partner moistens their finger with lubricant and gently manipulates the hymen first.

There are surgeries being done to replace broken hymen, so who says u can only be a virgin once! There are claims that some drugs can actually create or repair the hymen, I have not seen any of those drugs, but the fact am writing from Nigeria can be a factor, so hit me up if you have seen any of such, or if you have any contribution towards this topic, we can all learn one or two things.

So, Mr I can only marry a virgin, good luck to you, your golden virgin just left dr90210's office!. You don't have to know (in John legends voice)

INFERTILITY?DON'T SPARE THE MAN

As an African, having children immediately after marriage is the reward of every successful marriage. A delay of signs and symptoms of pregnancy in the wife after 4 to 6months of tieing the knot will definitely result in eye brow raising from both families, each directly/indirectly pointing accusing fingers at the female, even if there are tell tale signs saying otherwise.

To avoid this, there has been a shift in marriage technique in this recent generation, the saying goes "I wan preg am before I marry am".

I run my gynae clinic once a week, seeing a minimum of 15 fresh infertility cases per clinic, 60 fresh cases per month, am just one of about 6 doctors running the clinic, we share the cases equally to increase work rate and productivity, this makes the total of fresh infertility cases to about 360 per month!.

For the sake of this awareness, I spoke with my colleagues to find out the commonest cause of infertility in couples, using my hospital as a case study, surprisingly, the male factor contributes up to 50% of infertility in this environment, the remaining shared by other factors which could be female alone or both male and female combined or unknown factors.

While in school I was thought infertility affects about 30% of males, during my housemanship I learnt infertility affect both male and female equally, few years into my practice, this is what I found, infertility in males is fast increasing by the day, infact it's getting so alarming right now.

The commonest cause of infertility in males is low sperm count, a condition called OLIGOSPERMIA. A condition diagnosed when the total number of spermatozoa in the male ejaculate is less than 20 million per one Mil.
There are various parameters to analyse in the sperm
The volume
The count
The motility
The morphology
The activity
The inactivity
Infections .

This article is not based on analysing the parameters one by one, rather it's based on general discussion on male infertility, for questions on these parameters pls drop a comment on d blog or follow us on Twitter for dms @dr90ng.

Various factors are implicated as causes of male infertility but using my direct environment as a focus, the following factors are highly implicated
Infections
Stress
Hormonal imbalance
Varicocoele
Malnutrition
Weight loss
Stock fish consumption
Smoking
Environmental factors eg ozone layer depletion.

Infection is the commonest of all patients seen,by culturing the sperm the Organisms implicated mostly are staphylococcus aureus, chlamydia and e. Coli.
Low testosterone hormone, high prolactin are the common hormonal problems seen

Recent studies shows consumption of stock fish to be a cause of male infertility in Nigeria, this poses a big problem because stock fish is of significant "stomach infrastructure" in the igbo culture.

Recent studies also point accusing fingers on the harsh environmental conditions in the Niger delta, raising the heavy metals and fossils level in the blood. A fertility expert, joint pioneer of test tube baby /In vitro Fertilisation (IVF) in Nigeria. Professor Oladapo Ashiru told the Guardian

"We have seen people who work in the
Niger Delta region. The ozone layer in that place is bad and
there is a lot of pollution. One of my students did a Ph.D
and saw that those extracts of crude oil have severe effect
on fertility of both male and female, they compromise them
severely. No oil industry will encourage that level of pollution.
"Recently too we found out that people who work in that
area if they carry out some tests they see they have some
heavy metals and oil fossils in them and those things have
the capacity to depress gametogenesis because gametes
forming is dependent on some mitochondria activities that
require oxygen, that require the best form of enzymes".

Varicocele occurs when the network of veins that leave the testis
(pampiniform plexus) become elongated and enlarged. The valves
within the pampiniform plexus when they work properly only allow
the blood to flow away from the testicle - if there is something
wrong with them, blood builds up.
Approximately 15% of men have a varicocele. A varicocele develops
over time.
It is common for the patient to experience no signs or symptoms at
all. In some cases there may be pain.
Varicocoele is commonly described as bag of worms in the testes, a condition that's is treatable by the urologist.

Most cases of male infertility are treatable depending on severity and point of diagnosis, male infertility is a broad topic, and we can only cover few at a presentation.

The use of antibiotics to treat infection, hormonal replacement for hormonal disorders, multivitamins, relief of stress,tested and researched herbal drugs, weight gain, surgery and life style modifications are the common methods used in my center to treat male infertility.

A method am researching and applying recently on my patients in male infertility treatment has to do with nutrition, most important of this nutrition is the increment in TOMATOES consumption, yes you heard me right, tomatoes!!.

It has been found that tomatoes is highly rich in the substance LYCOPENE. A bowl of tomato soup every day can help boost fertility among men, scientists claimed.

They have discovered that lycopene, which gives tomatoes their bright red colouring, can turn sperm into super-sperm.

Researchers at the University of Portsmouth studied the effect of lycopene in the diet on a random group of six healthy men, with an average age of 42. The men were asked to consume a 400g tin of Heinz cream of tomato soup every day for two weeks.

Are u a doctor? Do u have any recent findings on male infertility, do you know anyone with male infertility issue, drop your comments below, follow us on Twitter @dr90ng, like our page on Facebook https://m.facebook.com /Dr90ng. Let's talk about it.

FAKE HYMEN

This artificial hymen pill has been designed to fake
virginity by creating a real fake hymen. This fake hymen is
designed to simulate the loss of blood that occurs when
losing your virginity.
This artificial hymen pill has been used by Chinese women
for very long but is still not very well known in occident.
If you are afraid that the regular artificial hymen will not
work, or you do not feel at ease by using it, the artificial
hymen pill is the solution you need!
How it works?
Placed into the vagina, between 45 to 60 minutes before
intercourse, this artificial hymen pill will dissolve by itself,
under the influence of body heat and vaginal moisture,
and create a membrane that fakes the hymen and tighten
the vagina.
During sexual intercourse the fake membrane created by
the artificial hymen pill will break and a red liquid that
looks like blood, will spread and stain the sheets, not too
much but just the right amount, thus simulating the
breakdown of the hymen.
How it compares?
The main differences with the regular artificial hymen are:
The color of the fake blood is even more realistic.
You have to insert it between 45 to 60 minutes before
intercourse, instead of 15 to 20 minutes for the regular
artificial hymen.
It feels a lot more realistic for your partner.
How to use?
45 to 60 minutes before sexual intercourse:
1. Clean hands and vagina before using.
2. Slowly insert the pill 7cm (2.75 inches) into your vagina.
3. The pill will dissolve between 45 to 60 minutes.
4. Have sexual intercourse.
The artificial hymen pill is made of pure Chinese herbs
extract, with no side effects.
The artificial hymen pill is by far the most advanced
technology and safest existing product to fake virginity
today.
Researchers on duty.

TOBACCO AND EBOLA

A genetically Modified Organism is an Organism whose genetic material has been altered using genetic engineering  techniques. Organisms that have been modified in the past include:bacteria, yeast, insects, plants, fish and mammals.

The process started far back as 12000BC,but it's commercialization started around 1976,with companies producing and selling genetically Modified food and medicine.

The latest of this technique is modification of tobacco!. Scientists are now genetically modifying tobacco to make proteins needed to build our skin, tendons and connective tissues. This protein is called COLLAGEN. Surprisingly this protein can also be used to develop vaccines for the deadly disease like ebola.

Researchers at Mapp Biopharmaceutical created Zmapp,
an experimental drug that received positive— if still
tentative —results for helping victims of the ongoing
West African Ebola outbreak, by inserting Ebola
proteins into a plant virus. The scientists then infected
tobacco plants with the virus, triggering an immune
response. The plants began to pump out antibodies,
proteins that grab and neutralize harmful bacteria and
viruses, which the researchers collected to treat
patients suffering from Ebola. While Zmapp’s efficacy
still needs more testing, the drug provides proof of
concept that genetically modified tobacco plants can
provide huge medical benefits.
Using a similar infect-and-collect method, scientists
have engineered tobacco plants to make treatments for
other devastating diseases , vaccines for rabies and
hepatitis, as well as human collagen , which could be
used in wound care to rebuild tattered flesh.

Do you know other Organism or food that has been modified?have you consumed any modified food or product?drop a comment let us hear from you

RHESUS INCOMPATIBILITY

Discussing this topic brings mixed feelings,not because of its importance but for its complexity,it's a topic that has created arguments among medical professionals too.

Sometime last week one of my nurses sent me blood samples of her children to run in the lab of a friend. She wanted blood group and genotype test on them. The result came out with one of them having a rhesus negative group O(O-).

There are various blood grouping systems,but the common ones are the ABO system and the Rhesus groups.

In this case,both parents are rhesus positive and test result revealed one of the offspring to be negative! This puts the scientist that performed the test on a hot seat,calling a friend will be an option if he can.
The nurse got angry about the result and hell was almost let loose,if not for her maturity I probably won't be here to discuss this.

The question remains,is it possible for 2 rhesus positive parents to have a rhesus negative child?

Keep your money for paternity test in your pockets,the answer is YES!.

In this system the positive are dominant over the negative. If your
genetic type is ++ or +-, your blood type will be Rh positive. Only if
your genetic type is — will you be Rh negative. This means that if
both parents have Rh+ blood with the +- genes, they could have
children who are ++, +-, or –. In other words, their children could be
either Rh positive or Rh negative. Children who are Rh negative can
have parents who are either Rh positive or Rh negative.

Two parents who have O positive blood could easily have a child
who is O negative. In fact, most children who are O negative have
parents who are positive since the +- combination is so much more
common than the — combination.

Confused? I would be too,if I wasn't a nerdy doctor,just take away this, parents who are rhesus positive can have a rhesus negative baby. Get it?yes you do.

This last point is very important,if you are a rhesus negative lady and your husband is rhesus positive(most people are rhesus positive)once u are pregnant you will need to take an injection called RhoGam at second trimester and immediately after birth,some school of thought says only after birth is necessary.

The reason for this is that,in the first pregnancy,the blood of the rhesus positive baby you are carrying may cross to the mothers blood stream through the placenta bed and sensitize the immune system to produce antibodies that will fight the rhesus positive baby.

The first pregnancy might be issue free,resulting in a healthy baby. Subsequently,any rhesus positive baby you carry in the womb will be sensed as a foreign body by the immune system. The body fights it accordingly,causing miscarriages or habitual abortions.

The implication of this are,if you are rhesus negative any pregnancy you have/miscarriages /abortion or D&C,must be followed by intramuscular RhoGam injection or anti D,otherwise you stand a chance of frequent miscarriages and habitual abortion.

For quick reference,the following points should be noted:

• Couples who are both rhesus positive can have rhesus negative offspring

• Every rhesus negative woman MUST take RhoGam injection after delivery

• Every rhesus negative woman MUST take RhoGam injection after abortion or D&C

• Any woman with history of habitual abortion or frequent miscarriage should check are rhesus group

• A rhesus negative woman married to rhesus negative man does not need RhoGam injection.

Spread the word,have seen a lot of this in my gynae clinic,together we can change a lot.

Hypertension in pregnancy

Majority of my discussions here will be based on my real life experiences in medical field,with the challenges faced in tackling them. 
In most cases I will spare medical jargons as much as I can,while I use some for clarity and follow up in episodes to come. 
Cases of elevated blood pressures are becoming very common,in my practise, anytime am on call I see at least 2per day! Which is a lot,although my hospital is a referral center for most smaller centers around. 
Most women book with blood pressure of about 90/60 mmhg, some can have booking blood pressure of 120/80mmhg,depending on a lot of factors. 
Normal BP is measured as (systolic/diastolic) eg90/60,if the systolic goes up to 30 from the initial reading, and the diastolic up to 15 from the initial measurement,we diagnose high BP in pregnancy. 
Note that any form of  sudden elevated blood pressure from above 20weeks is very significant and your doctor must take this serious, the presence of this and protein in your urine is know as PRE-ECLAMPSIA. 
In Nigeria surprisingly majority of our learned citizens still book for antenatal with the so called traditional birth attendants,this causes a sharp increase in the morbidity and mortality rate of pregnant women, despite the efforts of lagos state gorverment in Nigeria to provide the maternal and child complex in various local government areas. 
A case I will never forget is one I saw sometimes last year, when a very beautiful lady was rushed down to our center at 36weeks gestational age,with unrelenting seizures and restlessness,with spoons and all sorts in her mouth. She was brought by her learned husband and a traditional birth attendant with the husband's mother. 
So I asked the husband where was she booked for antenatal, I was told with a nurse that has a hospital(TBA). 
Probing further I asked the TBA what happened,to my greatest suprise she said "doctor the patient was fine oh,until 2wks ago she started complaining of headache,and i gave her chloroquine injection and paracetamol,she was fine, all for them to rush her to me tonight that she has convulsions". 
I gently asked her what was the blood pressure few weeks ago?her reply! "the BP was very fine, it was just 150/110?.i shouted jesus! 
In other words,the woman has advance form of pre-eclampsia called ECLAMPSIA.She was treated accordingly and the baby delivered via cesarean section, mother and baby discharged home after 3wks of special treatment. 
The lesson learnt from here is, all pregnant women should:

--register at a good center
--ask about your booking blood pressure,and keep tabs afterwards 
--ask about your urinalysis result for protein or others
--every headache is not malaria,tell your doctor about it
--pre-eclampsia is very common in pregnancy and nobody can predict who will have it or not
--don't let anyone coherse you into making decisions on your pregnancy, you and your spouse should make informed decision(from d above example,d mother in law did) 
--bringing out the baby by the fastest route is the best treatment once eclampsia sets in,no matter the age of the pregnancy.

--endeavour to keep tab on your normal blood pressure, even before pregnancy
--some anti hypertensives are useful in treating pre eclampsia,don't reject it when your doctors give you
--no matter where you book for antenatal,always ask questions,it's your right to know,not a favour.