What are the exercise routines recommended and safe during pregnancy?

What are the exercise routines recommended and safe during pregnancy?

Obstetricians suggest that expecting mothers get at least 30 minutes or more of moderate exercise per day, most days of the week.

What counts in that 30 minutes?

·     Three 10-minute walks throughout the day are just as important as 30 minutes on the treadmill or bike at the gym. 

·  

    Swimming is a particularly good exercise in pregnancy, as the water helps to support your extra weight. This can be a huge relief, especially in the third trimester. And unlike other forms of exercise, swimming helps you to feel cool.

·     

     Moderate jogging starting early in pregnancy can help you avoid excess weight gain and keep you in shape for labor in a few short months.

          

   

    Elliptical use while pregnant provides a low-impact cardiovascular workout while toning muscles. 

    Indoor Cycling - The best thing about this is that the bike supports your weight, so there is less stress on your body. A stationary bike is a great exercise because there is a low risk of falling.

    Yoga has a long-standing reputation for relieving stress and pressure on your body. Most forms of yoga will be safe for you and your baby. There are special classes for pregnant women. Avoid lying flat on your back for extended periods of time and try not to overstretch.

    Low impact Aerobics is great for your heart and lungs and improves muscle strength. It is safe to do and can help you to have a healthier pregnancy. 

    Pilates strengthens your tummy, back and pelvic floor muscles, which are the areas that can cause problems during pregnancy and after the birth. So, it's a great exercise to do when you're pregnant, although some of the exercises will need to be modified as you get nearer your due date. 

      Light Weightlifting is a great way to stay fit during pregnancy—as long as you stay within certain limits.  Exercising during pregnancy, including weight training, comes with many benefits, such as help with labor and delivery, with improving your stamina.

Most exercises are safe to perform during pregnancy, as long as you exercise with caution and do not overdo it.  Make sure to consult your obstetrician prior to starting your exercise routines.  It should be noted that each pregnancy differs from one another.

Feto Maternal & Genetyx Center is highly reputed fetal medicine specialist center offering expert prenatal care. Our German Board-certified doctors are always available to support you with professional care.

Please contact us on +9714 3604040/ Whatsapp:  +97155 9025744/www.fetalmedicine.ae

Fever During Pregnancy

Developing a fever during pregnancy is a concern for most mothers. Since a fever means that the mother is fighting a developing infection, it is best to get to the root cause.

Though the infection might be a cause for concern for the developing fetus, there are ongoing studies on the effect of the fever itself. Recent research suggests that very high fever (higher than 100.4⁰F) in the first trimester could possibly lead to birth defects. Although this is yet to be confirmed, it is best to get treatment as soon as possible.

Common causes for fever in pregnancy are:

•  Common cold/ flu
•  Food poisoning
•  Urinary tract infection
• Other viral/ bacterial infections

The best way to avoid falling ill, is to wash your hands often, and stay away from people who are sick. Stay hydrated and eat healthy. Most importantly, consult with your doctor, even if your fever has passed on its own.

Feto Maternal & Genetyx Center is a highly reputed fetal medicine specialist center offering expert prenatal care. Our German & French Board certified doctors are always available to support you with professional care.

Please contact us on +9714 3604040/ Whatsapp:+971559025744/www.fetalmedicine.ae 

Should You Exercise in Pregnancy?

The answer is yes. While you may not have the stamina to do a marathon, exercise during pregnancy is important for mom and baby alike. Most women highly benefit from exercising throughout their pregnancy.

Your doctor or healthcare provider can give you recommendations on safe pregnancy exercises depending on your pregnancy case.

Why Exercise During Pregnancy?

Exercising during pregnancy carries with it many benefits. Below are some of the reported benefits :

• It is a common that pregnant ladies experience fatigue. However, exercising can help increase your energy level and lessen fatigue during pregnancy. 
  

• Exercising during pregnancy can help relieve backaches associated with pregnancy and help strengthen and tone the muscles in the body. One very important benefit is, it strengthens your cardiovascular system.

• Exercise in pregnant women helps stimulate the bowels and reduces constipation during pregnancy.

• Pregnancy exercises can help promote adequate circulation and decrease complications associated with varicose veins. Walking is one of the best exercises to improve your circulation when pregnant.

• It promotes better sleep. 

• Tensions and anxiety during pregnancy is normal. Exercising provides an ideal outlet for reducing these unwanted feelings.

• You will feel better about your body during pregnancy and can help maintain a healthy weight gain during pregnancy.

• Exercising will help increase your endurance and prepare your body for the rigors of labor.

• Women who exercise during pregnancy will typically regain their pre-pregnancy shape more quickly. 

Please contact us on +9714 3604040

Whatsapp:  +97155 9025744

www.fetalmedicine.ae  

ONCOGENETICS - Aim of Oncogenetic Consultation

Multidisciplinary approach for patients predisposed to or suffering from cancer, is essential for a better outcome. It is conducted by oncologists, radiologists, geneticists, histopathologists, psychologists and social workers.

Oncogenetics is the use of genetic information for better screening and management of cancer according to the genetic profile. Despite the remarkable progress in molecular genetics, family history, pedigree analysis, clinical data analysis, choice of the most adapted genetic test plays a major role in patient care and choice of management plan. All these data are gathered during oncogenetic consultation which is provided by clinical geneticist. Moreover, announcement of genetic results should be conducted by a geneticist, since it has to be accompanied by explanation of the results and their impacts.

Cancer is caused by genetic alteration which induces deregulation of cellular division, cellular function and apoptosis. Genetic mutations causing cancer can be divided into two distinct entities which are germline (inherited form) and somatic mutations (sporadic form) inducing cancers.

Aim of Oncogenetic Consultation
Inherited cancer	Sporadic cancer
1.     Accurate assessment of cancer risk 2.     Focus monitoring / prevention measures for carriers 3.     Reassure non carrier 4.     Precise calculation of risk of transmission to offspring 5.     The right to know	1.     Genetic profiling of tumor through genetic biomarkers 2.     Differentiate between hereditary and sporadic cancers 3.     Guide patient’s management plan with other specialists 4.     Monitor treatment

In g

In germline mutation, an inherited alteration of tumor suppressor gene or oncogene is 

inherited from one of the parents resulting in early or multiple development of cancer(s) in the same family (inherited cancer). However, this represents 5-10% of all cancer cases. Moreover, development of cancer in such genetically predisposed individuals depends on penetrance of the mutated gene. On the other hand, in somatic mutation, alteration of oncogenes or other cell regulators is induced mainly by environmental factors (sporadic cancer).

Written and edited by Dr Azza Attia

European Board Certified Consultant of Medical Genetics

Tips on Sun Exposure with Feto Maternal & GenetYX Center

Summer is in full swing! While the beach might be calling you with neon signs, it is important to keep in mind some important points to take care of yourself and your baby -

Though we need the sun to get Vitamin D, it is a good idea to optimize the exposure to the sun. It is best to avoid going out in the sun between 10am to 4pm.

Increase in your body temperature could lead to dehydration, and also affect the fetus.

Prolonged exposure to the sun can lead to sunburn, and increase your chances of developing cancer.

While tanning beds might be a great alternative to get a gorgeous tan, they still carry some of the risks of sun related exposure. Restricted use of tanning lotions is advised.

Important points to remember –

   Keep drinking fluids !

   Wear comfortable clothes which cover the body

   Avoid mid day activities

   Use sunscreens that are approved, and regularly through the day

   Visit your Gynaecologist for more specific advice and about Vitamin D supplements

Feto Maternal & GenetYX Center is highly reputed fetal medicine specialist center offering expert prenatal care. Our German Board certified doctors are always available to support you with professional care.

Please contact us on +9714 3604040 
Whatsapp: +97155 9025744
www.fetalmedicine.ae

Truffle Hunting: It’s all about the right chemistry! Or – metaphorically speaking, “love is in the air.”

Although I don’t believe in bottled aphrodisiacs – except maybe Veuve Cliquot – I have to admit something seems to be quite real about the “right chemistry”. Whether it is the first flicker of attraction only, or sparks flying between two people, I bet that when you are in that moment, you are not worrying about the chemistry of desire. And that makes perfect sense!

Nearly 150 years ago, Charles Darwin postulated the existence of chemical signals involved in the control of sexual behaviors. These signals fulfill fundamental roles in enabling identification of the perfect mating partner of the opposite sex, the appropriate species and of maximum satisfaction.

Pheromones are subconsciously released odor signals, micro particles to attract and encourage the opposite sex to mate with us. These odors function as a primer, leading to attraction and promoting the desire for copulation. In the last decade pheromones and their receptors were closer investigated and identified, allowing visualization and manipulation of the neural circuits that link these sensory signals with particular human behaviors. Mapping of the neural circuitry responsible for converting the detection of a single chemical cue into a specific sexual behavior seems to be an ongoing exciting, challenging scientific goal.

Our immune system genes imbue each of us with a very unique “odor-print” like a fingerprint. We experience smell through a series of specialized proteins known as chemo-sensoric odor receptors. Although we normally associate these receptors with the nose, we actually rather “sense” pheromones. A healthy body presents these smell detecting receptors in many areas of the body. In fact, the female and male pelvic organs are equipped with thousands of such receptors. How much these are alerted or vigilant varies on the pheromone signals they receive and how responsive the sensors are developed and imprinted.

Interestingly, there is enormous diversity in the chemical nature of our pheromones and their impact. Women are more selective when deciding to mate and delicately distinguish if chemo-sensory meta-communication ensures that they find a high-quality mate that satisfies their reproductive and erotic needs. Female pheromones typically comprise a divine blend of chemicals rather than just a single pheromone. A unique identity is conferred by varying minor components of the blend or by varying the ratio between the components. There are pheromones that are secreted into the vagina at optimum ratios during lubrication with the aim of encouraging men to desire to copulate and climax. This group of pheromones can remarkably increase testosterone levels in men, causing feelings of arousal in men if a woman with this “pheromone-cocktail” is present.

Androstenol hormone

Androstenol-containing pheromones increase chattiness and friendliness from both sexes and can increase sexual attractiveness as well. Therefore it has been referred to as an “ice-breaker” pheromone. Pheromones with a higher ratio of androstenol or its isomers are more masculine. Those pheromones are more dominant and create an aura of safety, protection, and reliability associated with more charismatic alpha males.

Funny enough, androstanol, and its derivatives are found in truffles. This was discussed as an explanation for how pigs locate them deep in the ground.

Men instinctively coordinate their release of sperms using pheromones. And coordination is very important because sperms are diluted easily and are short-lived. An effective pheromone push therefore provides a selective advantage in terms of reproductive performance. Some studies provide evidence that human steroids meta-communication differs in effectiveness, depending on the sender-recipient resonance, demonstrating that our visual gender perception draws on subconscious chemo-sensory biological cues, an effect that has huge impact on our subconscious sexual behaviour and readyness.Pheromones are catalysts and primers. As we secrete these chemicals through perspiration, they are subconsciously “sensed“ by the nose, brain, and nervous system. They are powerful signals of attraction or what we call “sex appeal”.

Most important pheromone receptors seem to

exist in sperm cells. Certain chemo-sensory receptors found in sperm cells respond to a floral compound, a smell we associate with flowers. The presence of floral scent detectors in sperms seem to help them navigate towards an egg. Sperms are motile cells that move via the presence of a ‘tail’. Sperm cell movement is directed towards areas of high concentrations of certain floral scents. Therefore eggs do not wait passively for the sperm to arrive but in fact produce floral chemicals that in turn attract the sperm to them, meaning that female reproductive cells have the capacity to produce chemical attractants, which increase the probability of successful fertilization. Interestingly, the ability for sperm cells to “smell“ also physically spurts their swimming/progressive forward motility rather than going in loops.

Evidently, the complex cloud of aromas we emit needs a lot more parsing before science closes the book on pheromones since pheromones don’t evoke innate stereotyped sexual behaviors. There is substantial plasticity in pheromone blends and the responses they evoke to provide greater nuance. Fascinatingly, this close relationship has led to pheromones being co-opted for several other non-sexual functions as well, such as guiding humans to suitable food sources, promoting recovering sleep, a strong immune system, and mental well being.

Conclusions:

It’s all about the right chemistry. Or – metaphorically spoken –“love is in the air“.

Life is Darwinism – Survival of the fittest! Some of us just seem to have “magic bullets“ in their body odor. Sometimes it just clicks. Next time you have a nose-jerk reaction because you just walked past someone smelling “Oh so good”, it could be the perfume this person is wearing – or it might just be your perfect pheromone-cocktail match!

Let’s sniff it out! Are you equipped for the great truffle hunt?

Dr. Amelie Hofmann-Werther

Specialist in Obstetrics & Gynaecology

(Facharzt Germany)

Cervical Dysplasia & Coloscopy

Master Class in Fetal Medicine        

Intellectual Disability

What is the difference between mental retardation and intellectual DISABILITY? 

Intellectual disability is the new term that replaced mental retardation in the recent years.

What is intellectual disability?

It means marked impairment in intellectual functions (understanding, and proper response) and adaptive behavior. 

What is developmental DISABILITY?

It can be considered as an early sign of intellectual disability in infant and early childhood. It is manifested by marked delay in more than two developmental milestones such as holding head, grasping, sitting up, crawling, walking, speaking, and so on, in the absence of any apparent cause. It should not be confused with simple lagging. You have to consult your pediatrician if you have any doubt.

What are the different causes of intellectual disability?

Prenatal Causes

Fetal alcohol syndrome, exposure to toxins during pregnancy, and some maternal infections.
Some genetic diseases such as Down syndrome, Fragile X, metabolic diseases.

Perinatal causes

Fetal hypoxia during delivery, brain trauma and extreme preterm.

Postnatal causes

Brain trauma, brain hemorrhage, meningitis and encephalitis, uncontrolled severe convulsions, some metabolic diseases and toxins.

How to manage intellectual disability

• Diagnose
• Search for the cause
• Proper and adapted care for the affected child according to the cause
• Prevent recurrence through genetic counselling

Dr. Azza Abd El Moneim Attia Mohamed
French Board
Consultant Clinical Genetics

  

Genetic effects of consanguineous marriages

Consanguineous marriages - It is a marriage of biologically (blood) related persons, they can be 1^st degree, 2^nd degree or 3 degree cousins. 
Advantages:

• Early marriage
• More stable marriage
• More children
• More convenient for parents
• More or less equivalent socioeconomic and cultural background in the couple

Genetic effects - As both parents share more or less similar genetic information, there is increased risk for transmission of autosomal recessive diseases. Of course 1^st degree cousins have more empirical risks than 2^nd or 3^rd degree cousins.

What is an autosomal recessive (AR) disease?

It is a genetic inherited disease transmitted from two completely healthy parents, each of them carrier of a defect in one copy of his gene. When both abnormal gene copies are transmitted to the offspring, the disease starts to appear.
The risk of this couple to have an affected child is 25% or ¼ and it is the same risk for each pregnancy.
Examples of these diseases are thalassemia, sickle cell anemia, most of metabolic diseases, some mental retardation, some neurological or neuromuscular diseases, familial Mediterranean fever, and cystic fibrosis.

How to avoid appearance of autosomal recessive DISEASES in my family?

Genetic screening whether premarital or preconception to detect the carrier status of the parents and to avoid conception of an affected offspring by genetic analysis.

However, if pregnancy occurs, we can also do early prenatal diagnosis as early as 12 weeks of gestation but the genetic status of the parents should be determined early before 12 weeks of gestation to allow prenatal or pre-conception diagnosis. 

How to know that we have an autosomal recessive disease in my family?

By recurrence of the same clinical manifestations in more than one offspring derived from consanguineous parents. However, you should not wait for that to do genetic screening for your couple if you are consanguineous parents.
To be noted that consanguineous marriage is common in North Africa, East Asia, and middle east.

Dr. Azza Abd El Moneim Attia Mohamed
French Board
Consultant Clinical Genetics

 

NIPT – Non Invasive Prenatal Test

NIPT – Non Invasive Prenatal Test

NIPT is a Non-Invasive Prenatal Test (NIPT) performed on maternal blood to screen pregnancies for the most common fetal chromosome anomalies: trisomy 21 (Down syndrome), trisomy 18 (Edwards syndrome), trisomy 13 (Patau syndrome) and sex chromosome abnormalities. It can also screen for some common microdeletions syndromes and triploidy.

Who should consider having NIPT?

1.    NIPT can be performed in all pregnancies without specific indication as it has a higher sensitivity than combined screening done by fetal NT scan and biochemical double marker test.

2.    Early gender detection for medical reasons or according to the request of the parents.

3.    Intermediate risk detected by first trimester combined screening.

4.    High risk detected by first trimester combined screening if the couple decline invasive test. However, invasive test is the most appropriate test to be done in such condition.

5.    Advanced maternal age above 35 years old as we require more sensitive test with increased risk for chromosomal anomalies caused by advanced maternal age

6.    Some soft tissue marker anomalies detected in the morphology scan.

7.    In case of high risk screening detected by triple or quadruple marker test in the second trimester.

8.    Anxious mother or parents.

9.    Twin pregnancy to detect the zygosity and risk for major common chromosomal anomalies or common microdeletions syndromes concerning this pregnancy as well as fetal gender(s).

1. History of previous pregnancy with accidental (de novo) chromosomal anomaly.

What is the detection rate for NIPT?

Most NIPT tests have a >99% detection rate for Down syndrome and a false positive rate below 1%. Its sensitivity for other common chromosomal anomalies or common microdeletions range from 95-99%

How early in my pregnancy can I have NIPT?

Most NIPT companies provide the test from 9-10 weeks gestation. An ultrasound scan must confirm the gestation prior to the test.

How long until I get a result?

NIPT takes around 10 working days from sample collection to receiving the report.

Does NIPT replace the need for my nuchal translucency (NT) scan at 12 weeks or morphology scan at 21 weeks?

Definitely not. The NT scan is important for assessing physical anomalies as well as providing a screening assessment for trisomy 13, 18 & 21. The morphology scan is a detailed organ scan which is mandatory at 21 weeks.

What does NIPT involve?

A blood sample from the mother and a brief consultation with our genetic counselor who can answer all your questions.

Can I have NIPT with an IVF or twin pregnancy?

At least one of the NIPT companies can offer this test for twins and IVF pregnancies.

When is NIPT not advised?

When there are fetal major anomalies on the ultrasound or when there are known genetic conditions that cannot be diagnosed by NIPT. Invasive prenatal test is the recommended test in this condition.

In case of vanishing twin or empty gestational sac as NIPT will have a higher rate of false positive results.

Will I find out the sex of my baby with NIPT?

NIPT will report on the gender of your baby if you request this service. There is no extra cost.

Follow up procedure after NIPT

1.    Normal NIPT result – no specific follow up is necessary however if an ultrasound examination of the fetus reveals anomalies then further testing might be recommended.

2.    In case of a test failure – in a small number of pregnancies (<4%) not enough fetal DNA can be extracted from the maternal blood, and NIPT cannot be performed. A repeat sample may be requested at no extra cost.

3.    Abnormal NIPT result – A consultation with our genetic counselor is recommended to discuss the implications of the chromosomal abnormality with the patient. Due to the possibility of a false positive result we recommend confirming a positive result with invasive testing (CVS or amniocentesis).

Dr. Azza Abd El Moneim Attia Mohamed

French Board

Consultant Clinical Genetics