PREMATURE MENOPAUSE
SYMPTOMS AND COMPLICATIONS
T h e c o m
m o n p r o b l e m s t h a t a r e a s s o c i -
a t e d
w i t h
n o r m a l
p r e g n a n c y
m a y
b e
m o r e
s e v e r e
i n
a m u l t i p l e
p r e g n a n c y
T h e r e i s a l s o a n i n c r e a s e d r i s k o f s e v e r e
m
o r n i n g
s i c k n e s s ,
a n a e m ia ,
a n d
a n te -
p a rtu m h a e m o rrh a g e . H y p e rte n s io n
( h i g h
b l o o d
p r e s s u r e ) ,
p o ly h y d ra m n io s
( a n
e x c e s s
o f
a m n i o t i c
f l u i d ) ,
p o s tp a rtu m
h a e m o rrh a g e ,
a n d
m a lp re s e n ta tio n
( a b n o r -
m a l
p o s i t i o n i n g
o f a f e t u s
j u s t
b e f o r e
b i r t h )
a l l
o c c u r
m
o r e
f r e q u e n t l y
i n
a
m u l t i p l e p r e g n a n c y .
P re m a tu rity
i s a c o m -
m o n
c o m p l i c a t i o n ,
a n d
t h e
w e i g h t
o f
e a c h b a b y i s u s u a l l y l e s s t h a n t h e w e i g h t
o f a
s i n g l e
b a b y .
C a e s a re a n s e c tio n
i s
r e q u i r e d m o r e f r e q u e n t l y t h a n f o r s i n -
g l e p r e g n a n c i e s .
DIAGNOSIS AND TREATMENT
D u r i n g
t h e
w o m
a n ’s
a n t e n a t a l
e x a m -
i n a t i o n , t h e d o c t o r o r m i d w i f e m a y b e
a b l e t o f e e l m o r e t h a n
o n e f e t u s ,
a n d
m a y f i n d
t h a t
t h e
a b d o m e n
i s
l a r g e r
t h a n e x p e c t e d f o r t h e s t a g e o f g e s t a t i o n .
T h e d o c t o r o r m i d w i f e m a y a l s o b e a b l e
t o h e a r m
o r e t h a n o n e f e t a l h e a r t b e a t
w h e n l i s t e n i n g t h r o u g h a s t e t h o s c o p e .
U l t r a s o u n d
s c a n n i n g
m a y
b e
u s e d
t o
c o n f i r m t h e d i a g n o s i s .
T h e w o m a n i s a d v i s e d t o t a k e m o r e
r e s t
d u r i n g p r e g n a n c y a n d t o i n c r e a s e
h e r i n t a k e
o f p r o t e i n .
S u p p l e m e n t s
o f
iro n
a n d
f o lic a c id
a r e a l s o r e c o m m e n d e d
i n
o r d e r
t o
p r e v e n t
i r o n - d e f i c i e n c y
a n a e m i a i n t h e m
o t h e r a n d
n e u ra l tu b e
d e fe c ts
i n t h e f e t u s e s , r e s p e c t i v e l y .
p re g n a n c y te s ts
T e s t s
o n
u r i n e
o r
b l o o d p e r f o r m e d
t o
d e t e r m i n e w h e t h e r a w o m a n i s p r e g n a n t .
P r e g n a n c y t e s t i n g k i t s a r e a v a i l a b l e o v e r
t h e c o u n t e r f r o m p h a r m a c i e s .
A l l k i t s
a r e
d e s i g n e d t o t e s t f o r t h e
p r e s e n c e
o f
h u m a n c h o r io n ic g o n a d o -
t ro p h in
( H C G ) i n a s a m p l e o f u r i n e . T h i s
h o r m o n e i s n o r m a l l y p r o d u c e d o n l y b y
a d e v e l o p i n g p l a c e n t a ; t h e t e s t s a r e e x -
t r e m e l y
a c c u r a t e
( a b o u t
9 7
p e r
c e n t
a c c u r a t e f o r a p o s i t i v e r e s u l t a n d 8 0 p e r
c e n t a c c u r a t e f o r a n e g a t i v e r e s u l t )
a n d
c a n b e r e l i a b l y u s e d f r o m t h e f i r s t d a y o f
a m i s s e d p e r i o d . T h e t e s t c a n , h o w e v e r ,
m i s d i a g n o s e p r e g n a n c y i n c a s e s o f
h yd a -
tid ifo rm m o le ,
d u e t o v e r y h i g h H C G l e v e l s .
D i f f e r e n t b r a n d s o f t e s t v a r y , b u t a l l
i n v o l v e i n t r o d u c i n g a s a m p l e o f u r i n e
t o a t e s t s t i c k t h a t h a s b e e n t r e a t e d w i t h
a c h e m i c a l t h a t r e a c t s w i t h H C G .
B lo o d
te s ts
f o r
d e t e c t i n g
p r e g n a n c y
c a n
b e
u s e d f r o m 9 t o 1 2 d a y s a f t e r c o n c e p t i o n
( e v e n b e f o r e a p e r i o d i s m i s s e d ) .
p re m a tu re a g in g s y n d ro m e
S e e
p r o g e r ia .
p re m a tu re e ja c u la tio n
S e e
e ja c u la t io n , d is o r d e r s of.
p re m a tu re m e n o p a u s e
M e n o p a u s e
( c e s s a t i o n
o f o v u l a t i o n a n d
m e n s t r u a t i o n )
t h a t
o c c u r s
b e f o r e
t h e
a g e o f 4 0 . P r e m a t u r e m e n o p a u s e c a n b e
c a u s e d b y a n y d i s o r d e r o r t r e a t m e n t i n
MULTIPLE PREGNANCY
About one pregnancy in 80 is multiple (e.g. twins or triplets). The rate is highest
among women in their 30s. Problems arise more often in multiple pregnancies
than in single pregnancies. For example, twins are much more likely than single
babies to be born prematurely.
Amniotic sacs
Fetal heads
Ultrasound scan
revealing twins
U l t r a s o u n d s c a n n i n g
of the
woman’s uterus can reveal the
presence of twins within the first
several weeks of pregnancy.
Here, two fetal heads and a limb
that belongs to the fetus on the
right can be seen.
w h i c h
t h e
o v a r i e s
a r e
d e s t r o y e d
o r
r e m o v e d o r o v a r i a n f u n c t i o n s a r e p e r -
m a n e n t l y d i s r u p t e d
(r a d io t h e ra p y
o f t h e
p e l v i c
r e g i o n ,
f o r
e x a m p l e ) .
H o rm o n e
re p la c e m e n t t h e ra p y
c a n
r e l i e v e
s y m p -
t o m s a n d r e d u c e t h e r i s k o f
o s t e o p o ro s is
( l o s s o f b o n e t i s s u e ) . F o r w o m e n w h o
w a n t
t o
c o n c e i v e ,
in v itro f e rtiliz a t io n
( I V F ) i s p o s s i b l e , u s i n g d o n o r e g g s .
PREGNANCY TEST KIT
The pregnancy test shown here is
one of a variety that are available
over the counter at chemist’s shops,
allowing pregnancy testing to be
carried out at home. All of the kits
test for the presence of the hormone
human chorionic gonadotropin
(HCG) in a sample of urine. HCG is
normally produced only by a
developing placenta, which
makes the tests very accurate,
even if they are carried out
early in a pregnancy.
Resultw indow
_
Chemically
treated part
of teststick
Urine
I
The indicator stick is dipped into a
container of urine (as shown here).
Alternatively, the user can place it directly into
the urine flow while passing urine normally.
Testfunction
indicator
Resultwindow
Testfunction
indicator
HCG indicator
2
The first line that becomesvisible in the
resultwindow showsthatthe test is
working. If HCG is present, this line is quickly
followed by a second, different coloured line,
which signifies pregnancy. A result can be
obtained within a few minutes.
P
625
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