MY HEART DOCTOR
misconceptions
Ryan and Di'ah went to a hamlet that was close to the subdistrict.
Ryan uses a service car and Ryan is not only alone but he also goes with doctor Maya as a pediatrician.
"Yank, sometimes you can pack a car at home" said Di'ah.
"Why so!'' answer Ryan.
"Well, brother Syahril who bought, so you can also pack occasionally" said Di'ah, Ryan saw Di'ah nyalang.
Ryan did not want to fuss because at this time they are not only two but four.
Luckily Di'ah said that when the doctor Maya and husband had not yet boarded the car.
"Badn't brother Syahril's cousin so brother also entitled dong makek car that" said Di'ah, Ryan closed his eyes and took a breath in control of his emotions.
"If her cousin's sister whatever belongs to her sister doesn't have the right to wear it because it's her's" Ryan said withholding her emotions.
"But brother, at least not." said Di'ah.
"Enough." replied Ryan with his voice high.
"Sister is always so, sister always relented. brother also entitled brother,." said Di'ah who helped raise his voice.
"Heh" said Ryan, who could not reply because Maya and her husband had gotten into the car.
Ryan repeatedly took a breath, Ryan refocused himself on carrying his car.
In 'ah as long as only silent, he still wants if the husband can also enjoy the style that Syahril had, Di'ah thought if the car in their house was owned by Syahril.
Mimi and Syahril have arrived in the hamlet like jaya, they also began to provide the best service to the residents.
Syahril and Mimi work hand in hand to provide services to the citizens. Even Mimi found residents who have a history of heart and are pregnant.
Mimi also advised the pregnant woman not to give breast milk to her child later.
At first the mother refused but Mimi also gave a long explanation to this mother.
"This is how my mother knows that pregnancy and childbirth are fun and long-awaited events by prospective mothers. However, during pregnancy, there are some things that change in the heart and blood vessels of the mother, and this is actually a natural adaptation process that occurs to ensure the supply for the needs of the future mother and fetus in the womb during pregnancy.
Pregnancy causes a number of physiological changes of the cardiovascular system that will be well tolerated by healthy women, but will be a dangerous threat to pregnant women who have previous heart defects. Without accurate diagnosis and good treatment, heart disease in pregnancy can be a significant cause of maternal mortality and morbidity.
Heart disease is the leading cause of death in women in the United States and is the third leading cause of death in women aged 25 – 44 years. Heart disease affects about 1% of pregnancies, with the maternal mortality rate according to Sachs at 0.3 out of 100,000 in Massachusetts. But according to Tillery maternal mortality rate reached 10 – 25 % despite the development of diagnosis and treatment of maternal cardiovascular disease in this day and age.
Although the incidence of heart disease in pregnancy is about 1%, symptoms such as shortness of breath or noisy signs of systolic ejection that are symptoms of heart disease, can appear at about 90% of the pregnancy population as a consequence of physiological changes in the body induced by the pregnancy itself.
Among several cardiovascular diseases, hypertension is the most common cardiovascular disease in pregnancy, as much as 6-8% of all pregnancies. In western countries, congenital heart disease is the most common heart disease found during pregnancy (75 – 82% ).
Outside Europe and northern America only range 9 – 19 %. Rheumatic heart disease dominates in countries other than western countries, ranging from 56 – 89 % of all heart disease in pregnancy. Cardiomyopathy is rare, but it is a severe cause of complications of heart disease in pregnancy.
Pregnancy with heart disease is included in the category of high risk because it endangers the life safety of pregnant women. Based on the severity of heart disease is classified into several levels.
There are even mothers who should not get pregnant in a state where the heart has severe failure of function such as in the case of Acute Myocard Infarction, Pulmonary Hypertension, Marfan Syndrome, Eisenmenger Syndrome .
In the case of pregnancy with heart disease should be under the supervision of an obstetrician and a specialist in heart disease. Mothers who have a history of heart disease and experience pregnancy, resulting in a heavy workload of the heart. Therefore, it is necessary to have an antenatal examination (examination and monitoring of the health of pregnant women on a regular basis. In addition to the pregnancy examination also carried out several supporting examinations including ECG (Electro Cardio Grafi), Echocardiography in the mother and obstetric ultrasound (Ultra Sono Grafi) and NST (Non Stress Test).
Well I'd better advise mom to go to the city hospital for further examination.
The purpose of the examination is to monitor the condition of the mother's heart health and the state of the baby . During pregnancy blood tests are also done periodically.
For pregnant women with heart disease, some diseases such as anemia, respiratory tract infections, urinary tract infections that result in kidney function failure and blood pressure increases wherever possible are avoided. This aims to not aggravate the condition of pregnancy with heart disease and avoid complications that may occur.
I only brought a makeshift tool so I couldn't check the whole thing. So I suggest mom to check the whole yes it was in the city hospital.
I'll be recommending a cardiologist at a city hospital" Mimi said
"What happens when we get pregnant with heart disease?" ask the mother who accompanied him
"As I said before. In pregnancy with a normal heart, pregnant women can tolerate these physiological changes. But in women with heart disease, these changes actually cause risks for himself and his fetus.
During pregnancy, there will be a 30-50% increase in maternal blood volume starting from the first trimester, and reaching a peak at the 24th week of pregnancy.
This increase in volume will cause the heart to work “laster” to pump more blood. Heart rate will also increase by 10-15 beats above the value before pregnancy.
Under normal conditions, blood pressure will decrease slightly in the first and second trimesters of pregnancy and usually returns to its initial values in the 3rd trimester.
These changes that sometimes make normal mothers without any heart defects sometimes become tired and palpitations.
With the occurrence of the above changes, pregnancy can be a “stressor” for the heart and make heart complaints become heavier and worse.
"What is the effect of heart disease in pregnant women on the fetus in the dock?" ask the mother who listened.
"As a result of heart disease in pregnancy, there is an increase in heart rate in pregnant women and the longer the heart will experience fatigue.
Finally, the delivery of oxygen and food substances from mother to fetus through – ari becomes disrupted and the amount of oxygen received by the fetus will decrease.
The fetus has impaired growth and lack of oxygen. As a result, pregnant women have the potential to experience miscarriage and premature birth (birth before enough months). Especially if during pregnancy the mother does not get the handling of pregnancy checks and treatment properly." replied Mimi, it looks the pregnant woman who has a bowed heart.
"What should I do when I'm pregnant with this heart condition doc? this is our first child." he said grudgingly.
"If a pregnant woman suffers from heart disease, in addition to pregnant women should be under the supervision of a doctor, you should pay attention to some of my advice below
2) Enough rest, eight hours at night one or two hours during the day.
Sleeping position should be tilted to one side of the body so that blood circulation from the mother to the fetus smoothly.
3) Avoid exhausting activities so that the heart does not gain weight workload.
Learn to practice breathing properly. This is important as the body's adaptation process to the increasingly urgent enlargement of the abdominal cavity (diaphragm).
In normal circumstances without heart abnormalities, sometimes some pregnant women also complain of a bit shortness of breath due to the growing uterus.
Pay attention to any changes or complaints that feel heavier than usual, such as shortness of breath, chest pain or chest pounding faster, dizziness and easily fainting. Under these circumstances, immediately see a doctor" said Mimi
"And regularly take heart medications prescribed by a doctor and balanced with a special diet of heart patients.
Keep from having respiratory infections. Take iron supplements regularly as recommended by midwives or doctors to prevent anemia during pregnancy.
Consuming foods especially those containing iron and folic acid. It is a dark green vegetable. Avoid caffeinated beverages (coffee ) and alcoholic beverages
Avoiding nicotine (cigarettes). Maintain personal hygiene during pregnancy, especially the cleanliness of the genitals so that urinary tract infections do not occur.
"Most importantly, pregnancy control according to a predetermined schedule obstetricians, midwives and heart disease specialists who handle pregnancy.
"My advice later after the mother checked the whole doctor at the city hospital, later the mother can also check with Idan or an obstetrician in this hamlet" said Mimi
"So doc, what about the drugs I've been taking?" ask her.
"Stop the consumption of jbunyang drugs during this mother consumption. Because at the time of pregnancy, the blood circulation of the mother and baby is only separated by the placenta.
Some heart medicines may cross the placental blood barrier so that they are present in the fetal blood circulation, and may cause risks to the baby. Some medications should be discontinued during pregnancy.
Later I will give new drugs that are safe for the mother and fetus." replied Mimi.
"Dok, can I Emmm." she asked softly and shed her tears.
"I understand mom's worries. Women with heart disease can get pregnant safely with no or few complications. Through preparation and heart health care before, during, and after pregnancy, a woman can get pregnant safely and comfortably.
"My advice is that communication, education and information (KIE) for pregnant women with heart disease is very important, for that, KIE programs related to the health of pregnant women suffering from heart disease are given before pregnancy, during pregnancy and post pregnancy. This is an effort to prevent maternal and fetal death.
"Have you consulted your doctor before?" Mimi asked the pregnant woman and the mother shook her head. Mimi breathed out.
Mimi feels sorry for the pregnant woman, for a woman the main thing that makes her happy after marriage is giving offspring to her beloved husband.
"Is mom here with her husband?" mimi asked and she shook her head again.
"I'm here with my brother-in-law Doc" he replied.
"Emm, is mother brother or sister of your husband yes this mother?' asked Mimi Alda the woman who accompanied the mother.
"I'm her brother Doc" she replied.
"Emm I hope you can convey this to your husband, please tell her husband's pepper to bring the mother more overall control in the city hospital. To see the development of the fetus and the condition of the mother's heart" said Mimi.
"Okay doc, I'll be up to my sister's pepper" he replied.
"Emm doc, can pregnant women with heart disease give birth normally?" ask the pregnant woman.
"Will my baby also have similar problems if I have a heart defect?" ask her to worry.
Before answering smiling at the pregnant woman. The fear felt by the mother.
"Most patients can give birth normally, and it is safer than C-section. If the heart is able to tolerate the pressure of pregnancy, it should also be able to tolerate childbirth. If the woman cannot push during childbirth, the doctor can help remove the baby with forceps or vacuum. Most women with heart disease can receive a local anesthetic injection in the spine if the mother wants one."
"Disorders of the heart are the most common birth defects, and women born with heart defects are at high risk of giving birth to babies with heart defects"
"If you have congenital heart disease, your baby's heart should be assessed in utero with a fetal echocardiogram, a noninvasive type ultrasound by a specialist."
"Prenatal diagnosis will help you understand how to fix the problem and avoid any complications during pregnancy or childbirth. The good news is, most conditions are reversible after birth" Mimi said.
"Does it suckle doc?" ask again.
"Feeding is recommended for most women with heart defects, even those who are taking medication. Therefore discuss the adjustment of care that you will need with a health care provider. Sometimes alternative medicines will be recommended.
If you have a congenital heart problem that increases your risk of endocarditis drastically, your doctor may discuss your risk of mastitis while breastfeeding. These common infections can carry risks in this situation. Pumping and delivering ASI may be recommended in some circumstances.'
"Therefore, I advise you to check more fully at the city hospital because the equipment there is certainly more complete"
"But what I see from the current condition of the mother, I recommend that later mothers do not breastfeed directly.''
"Mothers can give breast milk to babies through the breast pump.'' said Mimi.
"Is there anything you want to ask me again?'' ask Mimi. The mother fell silent and finally she shook her head.
"No doc, thank you in advance" he replied.
"Together mother, do not forget my message yes mother. For the next mother can always routinely check with Syahril's doctor" said Mimi.
"Good Mom, thank you again" he said, and they retreated by shaking hands first.
tbc
