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Vitamins and minerals are nutrients that are essential for the healthy development of the foetus. During pregnancy, the daily intake requirements for certain nutrients, such as folic acid, calcium, and iron will increase. Although a healthy and balanced diet is the best way to get these key nutrients, sometimes it may still fall short and supplements can help fill the nutritional gaps. Supplements are also useful if you are: · unable to prepare healthy meals regularly yourself. · vegetarians or vegans · have an eating disorder · having twins or multiple pregnancy But supplements should not be taken as a substitute for a healthy diet. They should be taken under the guidance of your obstetrician as overdose of certain vitamins may be harmful to the foetus. It is best to take prenatal supplements throughout your entire pregnancy. Your obstetrician may recommend you to continue taking them if you are breast-feeding.

Adenomyosis is a condition where the inner lining of the womb (endometrium) is abnormally embedded in the muscle layer of the womb ( myometrium). During menstruation, this misplaced tissue also bleeds causing surrounding muscle layers to become reactive and thickened. As a result, the whole womb gets enlarged giving rise to symptoms of heavy and painful menses. Adenomyoma is a localised form of adenomyosis where only some parts of the womb are swollen. This condition can mimic uterine fibroid on ultrasound examination which is just a simple growth in the myometrium. The differentiation between adenomyosis and uterine fibroid is further complicated by the fact that both can coexist in the same patient .and present similar symptoms.

I am married for 2 years, trying actively to conceive for the past 6 months without success. I went for a check-up recently and was told that I had uterine polyps. What are they and what are the causes? Must I have them removed? Uterine polyps also known as endometrial polyps are overgrowth of the cells in the inner lining of the womb (endometrium). They are attached to the wall of the womb by a stalk, the base of which can be thin or broad. They can be single or in a cluster and vary in size from a few millimetres to several centimetres. They usually extend into the cavity of the womb, but may slip down occasionally through the neck of the womb (cervix). They are usually noncancerous (benign), but may be pre-cancerous occasionally. They rarely turn cancerous. Hormonal imbalance resulting in an over-dominance of circulating female hormone, oestrogen appears to play a role in the formation of uterine polyps, the cells of which grow in response to oestrogen. Obesity and infertility are also associated with uterine polyps. Uterine polyps can occur in any age group but more commonly in older women around or completed menopause. They do not give rise to symptom usually but may cause the following occasionally Bleeding in between menstrual periods Excessively heavy menstrual flow Irregular vaginal bleeding Vaginal bleeding after menopause Infertility Uterine polyps may be detected by ultrasound examination, hysterosalpingogram (an X-ray examination for the uterine cavity) or by hysteroscopy using a thin telescope inserting into the cavity of the womb. Small polyps without symptoms might resolve on their own. No treatment is required unless other risk factors for uterine cancer are present. Since you have fertility issues, surgical removal using hysteroscope may be necessary. After the polyps have been examined under microscope, you may require medications such as progestogens to balance the oestrogen or GnRH agonist injection.

I am now in my 4th month of pregnancy. My friends advise me to take a lot of fish so that my child can have a better I. Q. I do not like to eat fish. Besides, I am afraid that fish may contain toxic substances, like mercury, which are toxic for my baby. Can I take other types of food? Should I take supplements? I presume you are referring to the omega-3 fatty acids found in fish. They belong to a class of fatty acids called essential fatty acids which the body cannot produce and must be obtained from food. Omega-3 fatty acids are the "good" fat that come in more than one form. The types found in fish, called DHA and EPA have the best health benefits. Another form known as ALA is found in vegetable oils, flaxseed, walnuts, and dark leafy vegetables. Omega 3 fatty acids are important for building healthy cells and maintaining brain and nerve function. They are important for the intellectual and visual development of the fetus. They have been found to reduce the risks of pregnant mother getting high blood pressure and premature birth. Studies have also suggested that they reduce the chances of babies having intrauterine growth restriction (IUGR)-a condition where the baby stops growing in the womb and remains small for the period of pregnancy. They also lower the incidence of maternal depression after birth. Rich sources of omega-3 fatty acids are found in fish, such as salmon, Pollock, tilapia, catfish, cod, anchovies, mackerel, sardines, sea bass and trout. World Health Organization recommends 1-2 servings of fish per week. As you rightly pointed out, there are increasing levels of mercury in fish from pollution in the environment. Large “predator” type of fish such as swordfish and shark are unsafe for pregnant women. Since you do not like fish, there are other sources of omega-3 such as egg yolks and meats, flaxseed, walnuts, canola and soybean. Vitamin supplements containing omega-3 fatty acids may be another option. The supplements are absorbed more efficiently with meals. But you may have the side effects of a fishy breath, a fishy taste in your mouth, occasional nausea and stomach upset. If these side effects are too much to bear, you may try algae supplements. Algae that is commercially grown is generally safe, though blue-green algae in the wild may contain toxins.