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Speaking about health before pregnancy, we mean way of life, nutrition, physical activity, habits, and also possible chronic diseases, such as heightened blood pressure or diabetes. If you have such diseases, then you just have to visit a doctor beforehand. You know, this may complicate pregnancy, bring harm to an unborn baby. Tell your doctor which medicinal preparations and in which doses you take. Doctor will recommend you tests and observations you should pass, for example, X-ray photography. Try to discuss all questions you have for the moment.

 

It is much simpler to think over a strategy of treatment before pregnancy and then worrying about complications.

 

Diabetes
Diabetes – it is a disease, appearing as a result of lack of insulin in organism, this hormone is produced by pancreas. If you have diabetes, it will be more difficult for you to become pregnant. Moreover, diabetes can influence passing of pregnancy seriously. First of all, it can become a reason of miscarriage or giving birth to a dead baby. Secondly, women suffering from diabetes can give birth to babies with inborn defects.
You can reduce risk of such complications due to constant control of sugar content in blood during pregnancy. If you don’t care of your state, then diabetes while pregnancy may turn out to be dangerous both for you and your future baby. Majority of complications, connected with diabetes, are displayed during first trimester, i.e. during first 13 weeks of pregnancy.

 

Pregnancy may cause complications of state while diabetes, what will require increase of insulin doses. This can be easily determined with help of test on sugar content in blood. Majority of doctors recommend taking a special care of this disease development during at least 2-3 months before conception. This will help to reduce probability of risk of miscarriage or other problems. Probably, you will have to pass tests on sugar content in blood several times per day, to control disease completely and avoid possible complications. Past experience shows that women, suffering from diabetes, had serious problems with conception and passing of pregnancy. But die to complete and constant control even women-diabetics can count on successful result of pregnancy and delivery.

 

If in your family there were cases of diabetes or you have slightest suspicions as for your own health, pass tests before pregnancy surely.

 

Asthma
About 1% of pregnant women suffer from asthma. It is impossible to predict influence of pregnancy on asthma. Half of women, suffering from this disease, notice no changes during pregnancy, about 25% feel even slight improvement, and the rest (25%) observe worsening of state.

 

Majority of anti-asthma remedies are safe for pregnant, but it is still better to consult a doctor as for preparation to take. Almost all who suffer from asthma know what may become a reason of fit, so avoid contact with allergens before getting pregnant and during whole pregnancy. Try to control your state yet before pregnancy.

 

Hypertension
Hypertension, or high blood pressure, can cause complication both of mother’s and unborn baby’s health. For women it is connected with risk of refusal of kidneys work, probability of hypertensic crisis or headache. Increase of a future mother’s blood pressure may become a reason for decrease of blood inflow to placenta, what will lead to delays of fetus development, i.e. a baby will weigh less, than normal while birth.

 

If you had high blood pressure before pregnancy, then you just have to take care of it during all 9 months. Probably, gynaecologist will send you to therapeutist’s or family doctor’s observation with this purpose.
Before making a decision to become pregnant, women, suffering from hypertension, should consult a doctor. Some remedies against high blood pressure are safe for pregnant, some are not. On no account quit taking pills and reduce dose without a doctor’s prescription! This can be dangerous. If you plan giving birth to a baby, ask you doctor about remedies you are taking against high blood pressure, and about safety of taking these medicines during pregnancy.

 

Heart diseases
During pregnancy load on heart increases about 50%. If you have sick heart, it is necessary for your doctor to know about it before you become pregnant.

 

Some heart diseases, such as mitral valve prolapse, can seriously complicate passing of pregnancy. Probably, you will even have to take antibiotics before delivery. Other heart diseases, such as inborn heart disease, may seriously influence state of health. In this case pregnancy and delivery are sometimes contra-indicated.

 

Consult your doctor as for heart diseases before you become pregnant.

 

Kidneys and urinary bladder diseases
Infections of urinary system, in particular urinary bladder, often appear during pregnancy. If you don’t cure disease in time, infection may pass to kidneys, causing pyelonephritis.

 

Infections of urinary bladder and pyelonephritis may lead to premature birth. If you ever suffered from pyelonephritis or repeating infections of urinary system, this should be determined before pregnancy.

 

Stones in kidneys also may complicate passing pf pregnancy. This disease is accompanied by severe pains in lower part of belly, so it is quite difficult to diagnose it during pregnancy. Moreover, stones in kidneys may become a reason of appearance of infections of urinary system and pyelonephritis.

 

If you ever had some only infection of urinary bladder, you should not worry a lot. But you still should inform your doctor about it. He will decide whether you need to pass more careful observation before pregnancy.

 

Thyroid gland diseases
Thyroid gland diseases may appear both because of excess or lack of thyroid hormone. Excess of hormone is called thyrotoxicosis. In this case metabolism in human organism is speeded up. This may be caused by Graves’ disease. Thyrotoxicosis is usually cured with help of operation of medicinal remedies, reducing content of thyroid hormone in organism. If you don’t cure this disease, there’s rather high level of risk premature birth and giving birth to a baby with low weight.

 

You can carry our treatment during pregnancy too: there’re quite safe preparations, which pregnant women may take.

 

Lack of thyroid hormone – hypothyroidism – is usually caused by disease of autoimmune origin. In this case thyroid gland is damaged by anti-bodies, which are produced by your organism. While hypothyroidism taking of thyroid hormones is prescribed. Not cured hypothyroidism threatens with sterility or habitual noncarrying of pregnancy.

 

If you have thyrotoxicosis or hypothyroidism, you need to pass through observation before pregnancy, to determine doses of medicinal remedies, necessary for treatment. In the process of pregnancy your necessity in preparations may change, and then you will have to pass another observation.

 

Anemia
Anemia means that there’s lack of haemoglobin in your organism. There’re several reasons and in connection with this several kinds of anemia. Symptoms of anemia are weakness, giddiness, lack of air and pale skin.
During pregnancy necessity of organism in iron and iron-containing substances increases. If in the beginning of pregnancy you suffer from lack of iron in blood, anemia increases this lack. So you need to take vitamins and preparations, containing full choice of microelements, necessary for organism.

 

One of specific types of anemia – sicle-cell disease, which is passed genetically: it is mainly spread among black population. If you suffer from sicle-cell disease, your organism is deprived of oxygen. Passing of this kind of anemia can be very painful, and it also may serve as a reason for other diseases and complications during pregnancy. Sicle-cell disease cannot be cured and may be passed to your baby. Women, suffering from sicle-cell disease, have very high percent of miscarriages and infections of urinary system. They also may suffer from high blood pressure and painful hypertension strokes.

 

Another kind of anemia – thalassanemia is also passed genetically. If some of your relatives suffers from thalassanemia or you suppose you can have it, check it before pregnancy.

 

Lupus
Lupus is a vascular disease of autoimmune origin. This means your organism produces anti-bodies that may destroy your organs or influence functions of these organs negatively. Lupus can affect different organs, including joints, kidneys, lungs and heart.

 

This disease is hard to diagnose. One woman of 700 in the age from 15 to 64 years suffers from lupus. Among black women it is met more often, in one case of 254. As a rule, lupus more often strikes women, than men, especially women of genital age, i.e. from 20 to 40 years.

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Lupus treatment is highly individual and usually means taking if steroids. It is better not to become pregnant during fit of this disease, as miscarriages are extremely often among women suffering from lupus. Risk of giving birth to a dead baby also increases.

 

Babies, born from mothers, suffering from lupus, can have rash. They also can have different heart diseases. Premature birth and delay of pre-natal development of fetus are also quite possible.
If you suffer from lupus, consult your doctor before pregnancy definitely.

 

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Epilepsy and epileptic seizures
Epilepsy – is a chronic disease, characterized by different kinds of seizures (fits). Most often epilepsy is displayed by big and small epileptic seizures. Chance of giving birth to a baby with epileptic disease can be 1 of 30 for women, suffering from epilepsy. Such babies have risk of in-born diseases, probably, connected with medicines, which a future mother took during pregnancy.

 

If you take medicines against epilepsy, it is very important to consult your doctor before pregnancy. Discuss doses and type of medicines, which you take, as many preparations, relieving seizures of epilepsy, cause in-born diseases in babies. However, there are safe remedies for fetus, for example, Phenobarbital.

 

Seizures can be dangerous both for mother and fetus. So it is especially important to take remedies precisely according to a doctor’s prescription during pregnancy. On no account reduce dose or quit taking medicine yourself, without a doctor!

 

Migraine
About 15-20% of all pregnant women suffer from migraine. Many women notice improvement of health during pregnancy. If you are going to take pills against headache during pregnancy, check with your doctor how much they are safe for you and future baby.

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Cancerous growths
A question of probability of cancer’s influence on pregnancy depends on the fact which organ it stroke and how wide is growth. Breast cancer is most often form of cancer, met among women. If you had breast cancer, this will not influence pregnancy anyway, and pregnancy, in its turn, will not cause breast cancer.
Many doctors advice to wait 2-3 years with childbirth after breast cancer treatment. It is very important to discuss case history and method of treatment with your doctor yet before pregnancy. Situation may become quite complicated, if you are pregnant and pass treatment at the same time. Many medicines and remedies against cancer are not safe for future mother and baby.

 

Other diseases
We examined only some chronic diseases. However, any disease can be dangerous for future baby. So if you suffer from some chronic disease or have to take medicines constantly, discuss it with your doctor.
General rule is following: it is better not to take medicines or pass any medical treatment at the moment of conception and on early stages of pregnancy. Laying of all organs and tissues of a baby takes place during 1st trimester of pregnancy, and during this period you need to protect a future baby from harmful influences of medicines or observations. You will feel better and calmer, if you solve all these problems before pregnancy.

 

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PREGNANCY DIAGNOSIS IN ruminants

 

1 Introduction

 

Rectal palptation in small ruminants is of little value due to the size of the pelvis. (Wani, 1981). The caudal artery monitoring, bloatment, non-return to oestrus, udder development and other tests tried have had little success, (Wani & Sahni,1980). The more recent interest in early pregnancy 3. diagnosis of small ruminants is of academic and economic importance (Mellado,2003). A highly valued zygote or embryo when transferred to a less valued surrogate mother (recipient) needs to be closely monitored and the early detection of conception helps in repeated use of baren females. Proper management of pregnant animals also prevents embryonic losses. The method applied should be safe to both offspring and dam and needs to be cheap and easily applied. A review of various methods and techniques used for early pregnancy diagnosis in small ruminants. (sheep and goats) is presented.

 

.2 Early Signs of Pregnancy

 

2.1. Maintenance of a functional corpus luteum

 

It was evident that conception prolongs the life of the CL and prolongation and maintenance of a functional CL is triggered by the developing conceptus. These signals ensure the maintenance of the structural integrity of the CL. Corpus luteum produces progesterone, which maintains the uterine endometrium in a state permitting embryonic development, implantation and foetal-placental development (wani,1984b) . The formation and regression of the corpus luteum (CL) in Muzzaffarinagri ewes and Jamunapari goats was monitored at 3 days intervals for an entire oestruous cycle. Laparotomy and laparoscopic methods were used in these experiments.

 

The Endometrium undergoes tissue remodeling. This change in Extra cellular Matrix (ECM ) components is needed for successful implantation. Cytokinens 8,18 and 19 have been detected in the caprine endometrium during early pregnancy using immunofluorescence. Thus the presence of these cytokinen at approximately day 15 post conception is indicative of pregnancy in goats.

 

The implantation process in goats starts around day 18 post mating. During this phase intense type I collagen staining was detected throughout the uterine caruncular and intracaruncular stroma. For embryonic trophoblastic adhesions with endometrium, local control of protease activity is suggested. (Guillomot, 1999).

 

The earliest signs of pregnancy is the non-regression of the cyclic CL, which can be observed by the following methods:

 

i. Laparoscopy and Laparotomy approximately day 18-25 post mating. (Wani, 1982, 1988, 1984b,Wani & Buchoo, 1990, Wani & Buchoo, 1993, Cuellar et al, 1990, Wani et al, 2003).

 

ii. Serum Progesterone values higher than 1 ng/ml e.g 2 to 3 ng/ml. (Wani, 1989; Shreif, 1997, Boscas et al, 2003, Al-Merestani et al, 1999, Zarkawiet et al, 1999). Diagnosis of Pregnancy accurately (100%) predicted on the basis of serum progesterone P4 values around 17-19 days post mating .

 

iii. Pregnancy associated ovine glycoproteins recorded approximately post mating indicate pregnancy in sheep. (Karen et al, 2003; Verberckmoes, et al, 2004) or secretion of 17 & 22-24 K Da proteins on day 17 post mating in the caprine conceptus. (Guillomot et al, 1998).

 

iv. Non-return to oestrus (Mellado, 2003)

 

Some of the other early pregnancy signs detected by various methods are set out in Table 1.

 

3 Non-rejection of early conceptus

 

Progesterone maintains the uterine endometrium in a state which allows for embryonic development, implantation and foetal placental development. Details of foetomaternal relationships have been described (Mufti, 1997, Mufti et al, 2000)and are shown illustrated in Fig 1to 5. The presence of an early conceptus prolongs the life of corpus- luteum. These pregnancy signals are secreted as proteins. (Heap et al, 1990). Some of these proteins have been identified as ovine Trophablast protein I (OTP-1) in sheep which prevents the release of PGF2 alpha and thus helps in the maintenance of the corpus luteum. In cyclic ewes (non-pregnant) PGF2 alpha pulses are released in response to oxytocin with receptors being in the endometrium. The earliest signal of pregnancy is detected by a marked reduction in the endometrial oxytocin receptor numbers. The OTP-1 may inhibit synthesis of endometrial receptors for oestrogen and oxytocin. This possibly prevents luteolysis and maintains the dominance of theuterus by progesterone which is pre-requisite for the establishment and maintenance of pregnancy. (Bretzlaft and Romano, 2001; Wani, 1996; Ala cam et al, 1988).

 

The expression of progesterone receptors (PR) in the caprine uterus markedly increases during the peri-implantation period and estrogen –(ER) receptors do not increase in relation to PR, thus signaling the non-rejection of the early conceptus. (Flores et al, 2001). Progesterone in milk too can be found during early fertilization and conception (Cough et al, 1989).

 

Caprine H-type I antigen expression is unregulated during peri-implantation and progesterone P4 level stimulate it. It may be a useful marker to signal uterine preparations for receiving and retaining pregnancy in goats. (Powell et al, 2000). The caprine pregnancy related glycoprotein (Ca PAG) may help the conceptus to develop and is found around 18-19 day post mating . (Garbayo et al 2000). Endometrial tissue the undergoes remodeling to retain the conceptus in gravid small ruminant females. (Guillomot, 1999)

 

The dephosphorylated state of caprine uterine myocin in early pregnancy may help the conceptus to grow. Changes in the expression of native myocin, myosin heavy chains (MHCS) and myosin light chains (MLCS) were observed. (Kumar and Katoch, 1997).

 

For the development of the blastocyst, a proper uterine environment is essential. Besides the maintenance of the corpus luteum, production and availability of progesterone, the non-rejection of conceptus (blastocyst) is another critical feature of this period. The embryo produces interferons (embryo-IFN). This embryo IFN is homologous with – interfersons ( ? –IFN) and Ovine Trophoblast Interferons (OTI) of early pregnancy.

 

Purified OTP and recombinant OTP (r-oTP) produced in yeast exhibit antiviral activity and these r-OTP and OTP inhibit the release of endometrial PGF2 ? . This helps in the non-regression of the CL and indirectly maintains the early conceptus. Intra uterine r-OTP administered at a dose of 340 µg/ day for a week maintained the C.L in cyclic ewes for a month or so of . The inter- oestruos interval in 80% of the ewes was about a month or more. This dose r-OTP was as a effective as 14-16 day old conceptus. OTP was found to be immunosuppressive in several in-vitro and in-vivo assays. An assay on phytohaemagglutinin A revealed both OTP and r-OTP to be immunosuppressive. This was further verified by the inhibitory activity of r-OTP in Graft Versus Host Reaction. (GVH assays). Trophoblast interferons play a strategic role in the prevention of early pregnancy loss as it inhibits CD + blastogenesis. The role of CD + cells and as helper T lymphocytes and delayed+ Type hyper sensitivity mediators (DTHS) would explain this immuno- suppressive rate of OTP. (ILeri et al, 1996; Karen et al, 2003; Wani, 1996).

 

3.4 Oestrogen: – Pregesterone ratio (E:P ratio)

 

The role of oxytocin in inducing uterine PGF2 alpha was discussed earlier. However, the release of PGF2 under the action of oxytocin depends on or is controlled by progesterone and oestradiol. It was further indicated that ewes with a high E:P ratio may generate stronger luteolytic signals. It was demonstrated that low progesterone and high oestradiol combination record the largest and sustained increase in PGF2 alpha following oxytocin injection. Trophoblast interferons act locally to suppress the uterine oxytocin receptors in sheep.(Karen et al, 2003 ).

 

5 Maternal recognition of pregnancy

 

The maternal recognition of pregnancy in sheep and cattle is centered around the production by the trophoblast of type I x interferon (tINF). This tIFN then suppresses uterine oxytocin receptor concentrations (OTr). The oxytocin receptor (OTr) occupancy is associated with oxytocin induced PGF2 alpha release. OTr inhibition may represent the principal antiluteolytic mechanism of tIFN and secretion of the conceptus secretory proteins or bovine recombinant IFN to the uterus reduces OTr. Concentrations in intact and ovarectionized steroid treated ewes . A relationship between the conceptus secretory proteins and the metabolic products and those in the peripheral blood of the dam exists. ( Mufti; 1996; Mufti et al, 2000). There are conflicting reports making the action of oestradiol on oxytocin receptor concentration. (Powell et al, 2000). Trophoblastic cells contain interferon on day 14-17 after mating. During maternal recognition of pregnancy goat interferon was detected on day 18 post mating, its absence signifies pregnancy maintenance has been taken over by the corpus luteum. Thus a very thin line exists between maternal recognition of pregnancy and its maintenance or sustenance by the CL. (Gillomot et al, 1998).

 

6 The Reliability Pregnancy tests

 

Various methods used for correctly predicting pregnancy in sheep and goats during gestation have been summarized in Table 2. The accuracy varies from 70 to100% with different ultrasonic equipment. Different models as well as principles involved have been extensively reviewed (Wani, 1991; Wani et al,1998) and other methods of pregnancy detection during this stage e.g serum progesterone determination, vaginal cytology, laparotomy, estrone sulphate are summarized (Table-2). Various techniques were also evaluated in assessing mid-gestation. The various pregnancy signs as quoted by

 

various researchers using ultrasonography are summarized in Table 3. Of late certain anatomical features in the live, developing conceptus in vivo have been reported. This is reviewed and a summary is presented (Table 4). Various live foetal measurements like Biparietal diameter, Amniotic vesicle diameter, foetal radius and Tibia lengths are reviewed and shown (Table 5). Various pregnancy related images, histological sections and morphology of endometeruim have recently be published (Wani et al 2007, 2006 abc) where images are presented 6-15

 

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