2016年4月28日 星期四

孕婦均衡飲食 減嬰兒遺傳病

基因不一定決定命運,有外國研究發現,人的健康有八成在幼童期受環境因素影響,建議婦女把握懷孕前六個月關鍵期,忌吃太多或太少,減低嬰兒未來患有糖尿病等遺傳病風險。

外 國接連有大學如哈佛大學等發表研究,發現孩子健康有20%在受孕時由遺傳基因決定,其餘在幼童期受環境因素影響。根據「ENP」(早期營養編程科學),把 握兒童「前六後六」,即懷孕前六個月至幼兒六歲成長關鍵期,若孕婦攝取足夠營養素,可以減低孩子患上一些遺傳病風險如濕疹、糖尿病等。

把握懷孕前六個月關鍵期

註冊營養師張智良指,污染物如塑膠添加劑雙酚A,會啟動致肥基因,但老鼠研究發現進食維他命B12 等可抵銷效應。他指有研究發現荷蘭在1944年發生大饑荒時出生的嬰兒,到50歲時部分出現高血壓等徵狀;另有研究香港97年後出生的8,000個小童, 他們7歲時體重指標較高,而父母教育程度愈高,孩子愈重,反映孕婦懷孕時吃太多或太少均影響孩子健康。

張續說,葉酸在懷孕六至八星期時攝 取效果最佳,但婦女因多不知已懷孕而錯過,因此在計劃懷孕前應增攝取量;若本身超重,生育前亦宜應先減肥。他補充,孕婦應避免常吃燒烤食物,及少吃大魚, 減少攝取水銀等有害物質。 婦產科醫生則指,中國人有不少錯誤觀念,如孕婦要吃雙份食物,及不宜做運動等;此外亦不宜節食,否則孩子長大後回復正常進分量,亦會導致癡肥,孕婦 超重10至15公斤已足夠。







參考資料: 晴報
以上所提供的資訊僅作為教育及參考用途,如果你有任何醫療問題,
應向自己的婦產科專科醫生查詢,而不應單倚賴以上提供的資料

2016年4月27日 星期三

DHA Pregnanc


Adequate DHA intake is of utmost importance to expectant mothers. It has been shown that DHA plays a vital role in fetal brain and retinal development. According to international recommendations, the minimum daily requirement of DHA for pregnant or breast-feeding women is 200 milligrams, which is equivalent to a weekly intake of 1-2 portions of deep-sea fish that is rich in DHA.


However, pregnant ladies may find it difficult to eat fish because of alterations in taste and appetite. Furthermore, the concern of marine pollution is a real one, and expectant mothers may fear that inadvertent intake of heavy metal like mercury that comes with deep-sea fish may affect their babies.


Indeed there are other sources of DHA, among them are algae. Microalgae, from which algae oil DHA is extracted, are at the very start of the food chain. With a closely monitored production environment, algae oil is a safe source of DHA for expectant mothers.





Reference information:  http://womencare.com.hk/en/dha-pregnancy-benefit.html
The information aims to provide educational purpose only.  Anyone reading it should consult obstetrics and Gynecologist gynecologys before considering treatment and should not rely on the information above.  

2016年4月21日 星期四

不能輕視的婦科問題 (下)

亂經的治療

1.    輕鬆心情,充足睡眠
有些病人因考試或工作壓力大,睡眠不足引致月經失調。通常放鬆心情,減少壓力後,身體便會正常排卵,經期也變得有規律。

2.    藥物治療
如經期過多,醫生會建議服用止血藥及消炎藥減輕血量。如經期亂,可考慮服用荷爾蒙藥包括避孕藥或黃體素來調經。如病人因經期多而導致貧血,可多吃鐵質豐富的食物或服用鐵丸。

排卵異常而引致月經失調會影響生育,醫生會建議這些病人服用排卵藥,刺激排卵,增加懷孕機會。

3.    手術治療
但如果月經不能用藥物控制,肌瘤切除手術可改善月經情況。視乎肌瘤位置,可考慮在腹部微創割除,或做子宮內窺鏡切除或剖腹手術。

宮腔鏡手術是將小電刀從陰道引入切除小息肉或肌瘤,病人手術後只感受少許經痛感覺,沒有皮膚傷口,恢復快,即日可出院。

微創割肌瘤是指肚皮開三個一釐米(1cm)的小洞,然後放儀器將肌瘤攪碎,再從肚皮小洞口取出。但如醫生擔心肌瘤有機會是惡性,便會改為傳統剖腹手術,以免癌細胞擴散。如醫生發現病人患子宮內膜癌,便需進行子宮卵巢輸卵管及淋巴切除。

亂經原因眾多,建議女士們如有亂經問題最好先看醫生,以免影響生育或耽誤腫

婦產科專科醫生 黃凝












參考資料:Health Plus Magazine
以上所提供的資訊僅作為教育及參考用途,如果你有任何醫療問題,
應向自己婦產科專科醫生查詢,而不應單倚賴以上提供的資料。

2016年4月20日 星期三

不能輕視的婦科問題 (上)

亂經是指月經週期紊亂。正常的月經週期為21天至35天,來潮大約三至七天。來經過頻或太久才來經一次都屬於亂經,而經血量過多或過少也是不正常的警號。

門診中常遇到月經失調的病人,輕則可能是因為緊張而導致排卵問題,減低懷孕機會,嚴重則可能是子宮頸癌、子宮內膜癌,所以亂經問題不能忽視。

亂經的成因


1.    荷爾蒙分泌異常
緊張、睡眠不足、急劇減肥是常見的原因。另外,甲狀腺功能或乳激素水平異常也會引致亂經。

2.    婦科炎症及腫瘤
子宮頸發炎、子宮頸或子宮內膜的息肉或肌瘤、子宮內膜癌,都會引致陰道出血使月經週期不規則。

3.    多囊卵巢綜合症
患多囊卵巢的病人排卵出現異常,病人可能較多暗瘡、多體毛、肥胖,而且月經週期長,甚至出現「四季經」。這些病人不育機會也增加。

4.    排除懷孕的可能
在門診有病人因經期亂而求診,護士為她驗孕後發現原來她懷孕,因小產而有出血跡象。因此有性行為的女士,如有亂經情況可先自行驗孕。

亂經的檢查


1.    陰道檢查及婦科超聲波
如有性經驗的女性,婦科醫生一般會為病人作陰道檢查,和做陰道及腹部超聲波以排除婦科問題。

2.    抹片
如病人在一至兩年內沒有接受子宮頸抹片檢查,醫生會提醒病人同時做抹片檢查,確保子宮頸沒有細胞病變。

如沒有性經驗的年輕女性,婦科醫生並不會做婦科檢查或抹片。醫生會建議病人飲水直至急小便,然後做下腹超聲波檢查。

3.    子宮內膜化驗及子宮內窺鏡
如醫生擔心病人有機會患有子宮內膜癌,會提議病人在診所做子宮內膜抽取術,或在醫院做子宮內窺鏡檢查。

如病人經亂情況毒續而藥物又不能控制問題,或病人年齡超過45歲、肥胖,有多囊卵巢症或免疫系統疾病的病人,都是患子宮內膜癌的高危族群。
 .....續

婦產科專科醫生 黃凝


 









參考資料:Health Plus Magazine
以上所提供的資訊僅作為教育及參考用途,如果你有任何醫療問題,
應向自己婦產科專科醫生查詢,而不應單倚賴以上提供的資料。

2016年4月14日 星期四

Gene lab banned over test for sex (2)





'Although I told them I won't refer them to the laboratory, some of them found a way to get the test done and came back with a report. Some are reluctant to pay a deposit for a maternity package before they know the fetus is a boy or girl,' Wong said.
'The test's original purpose is for parents to check if the baby may suffer from severe sex-linked genetic diseases so they can have some prenatal counselling or an abortion, but doctors worry that the test is being used for gender selection including abortion,' she said.
Wong's earlier study, reported by the Post last year, found that the number of boys born in Hong Kong is soaring compared with girls, spurred by an influx of mainland mothers who prefer sons.
Wong said she would say it was unethical for doctors to refer patients for the test without knowing the real intentions behind it.
'Doctors won't know if the patient may use the result for the decision of abortion. Some parents may want to have better planning before the delivery, such as buying clothes for girls or boys,' she said.
Deputy medical director of the Union Hospital Dr Ares Leung Kwok-ling said the hospital's resident obstetricians 'have reached a consensus' not to use the test because the worry of it 'being abused for gender selection'.
'The test is different from ultrasound scans because it can tell the fetal sex in the first trimester [of pregnancy] while the ultrasound can only detect it in the second trimester. At the later stage of pregnancy, it is always easier for doctors to warn against an abortion because it would be more painful and risky to the mother,' said Leung, who is also senior vice-president of the college.
Dr Fung Tak-yuen, head of obstetrics at Baptist Hospital, said doctors in his department received requests from mainland mothers for fetal sexing, but the hospital denied them.
Head of obstetrics at the Hong Kong Sanatorium and Hospital Dr Joseph Chan Woon-tong said fetal sexing test was unnecessary. 'Why do we have to provide it?' he asked.
St Paul's Hospital administration discussed the test after requests from some mothers, but decided to ban it after DiagCor failed to provide scientific proof of its accuracy rate.
A sales and marketing manager at Diagcor, who gave her name only as Ms Ma, said the laboratory test was the first part of a paternity test. Ma said the test, which examines fetal genes contained in the mother's blood, can reveal whether the baby's Y-chromosome matches the father's.
If the baby is a girl, the doctor then takes a sample of amniotic fluid for testing for further matching with the father's genes. Fluid in the amniotic sac surrounding the fetus also contains fetal DNA.
Ma, who declined to provide the total number of requests for the test, would say only that demand is 'growing fast' among mainland mothers giving birth in Hong Kong.
She said how the test results were used was an issue of medical practice and a patient's choice.
'We have never promoted the test for fetal sexing, but some mothers need the paternity test results for immigration applications and other purposes ... other tests such as ultrasounds and samples of the amniotic fluid can also tell the sex of a fetus,' she said.
Two pregnant women from the mainland have appeared in Kowloon City Court accused of using false doctor's certificates to book obstetrics services in Hong Kong.
The women, who are both due to give birth in November, were arrested after they tried to make appointments at the Princess Margaret Hospital last month.
They were refused bail, and the case was adjourned until August 12.
130
The number of boys born for every 100 girls in China, from Henan in the north to Hainan in the south. Without selection it would be 105
Private obstetrician Dr Grace Wong Ying




Reference information:  Sunday Morning Post
The information aims to provide educational purpose only.  Anyone reading it should consult obstetrics and gynecologys before considering treatment and should not rely on the information above.

2016年4月13日 星期三

Gene lab banned over test for sex (1)

A Hong Kong biotechnology laboratory has been banned by private hospitals amid fears that mainland mums-to-be are using its services for unethical sex selection.
Doctors believe that some women are abusing a genetic test offered by DiagCor Bioscience which can identify the sex of a baby and its chances of developing a severe sex-linked genetic disorder. Parents who have a family history of a severe genetic disorder use this test to determine the chances of the fetus developing a severe genetic disease.
DiagCor in Kowloon Bay is the only laboratory to offer the test, which isolates fetal genes in the mother's blood.
The abortion of female fetuses is notorious in the mainland under the one-child policy. Hong Kong has become a destination for fetal sexing because mainland doctors may not disclose such information.
This issue has come to light days after Hong Kong set quotas for deliveries for mainland mothers next year - capped at 34,400, of which 31,000 will be at private hospitals and 3,400 at public hospitals. The government announced the quotas to ease pressure on services and allay fears among Hong Kong mothers-to-be that they will not get a bed.
DiagCor's test can be done as early as in the eighth week of pregnancy, compared with about 15 to 16 weeks for an ultrasound scan, doctors say.
If the test detects the presence of an XY chromosome pair, this confirms that the baby is a boy. An XX chromosome pair means it is a girl.
Although the test can determine the sex of a fetus, DiagCor says it has never been promoted as a tool for selection.
The College of Obstetricians and Gynaecologists has discussed the ethical issues related to the test but failed to reach a decision on what it should do. Expressing concerns on gender selection, the college held a special seminar for doctors last month on issues related to the test.
In Hong Kong, it is illegal to choose the sex of a child for non-medical reasons in assisted human reproduction treatment. But there is no law prohibiting fetal sexing.
At least four major private hospitals - Baptist Hospital, Union Hospital, St Paul's Hospital and the Hong Kong Sanatorium and Hospital - have banned the test, which is still available at a cost of a few thousand dollars through private practitioners.
Doctors said the laboratory reports had recently been made available in Chinese, making them more popular with mainland parents.
Private obstetrician Dr Grace Wong Ying said she encountered at least one to two mainland mothers each month who specifically requested the test.
 
 
 

 
 
 
Reference information:  Sunday Morning Post
The information aims to provide educational purpose only.  Anyone reading it should consult obstetrics and gynecologys before considering treatment and should not rely on the information above.

2016年4月8日 星期五

餵哺母乳時有甚麼技巧



  • 每次餵哺前,用暖濕毛巾清潔胸部,亦可用抗菌清潔乾棉作清潔
  • 擠少許奶於乳頭上,令寶寶意識到將進行餵哺母乳
  • 寶寶及媽媽的姿勢要舒適,可用枕頭式軟墊附助
  • 寶寶不要穿著太多衣服進食,體溫太暖,會減少寶寶的食欲
  • 留意寶寶要張大嘴巴至適合的吸吮範圍 (應含著整個或大部份乳暈)
  • 定時將寶寶的頭抑起,可令寶寶的口易於張開
  • 讓乳頭輕觸寶寶的上唇,他會本能地張開口,舌頭向下及向前伸
  • 寶寶睡著了,可用手指彈寶寶的腳板底或轉另一邊乳房餵哺,從而令寶寶起身繼續吸吮


怎樣知道寶寶吸吮得好?


  • 吸吮時,他的面頰會圓圓的鼓起來
  • 聽到他有節奏地「深而慢」吸吮,並發出如飲水的 “咕咕” 聲
  • 吃飽後會自行張嘴,放開乳房,並表現滿足
  • 於餵哺時,妳不會感到乳頭或乳房疼
  • 於餵哺後,乳房感覺柔軟,沒有乳漲




參考資料: womencare.com.hk/breastfeeding-technics.html
以上所提供的資訊僅作為教育及參考用途,如果你有任何醫療問題,
應向自己的婦產科專科醫生查詢,而不應單倚賴以上提供的資料。

2016年4月7日 星期四

餵哺母乳教學 -餵奶姿勢


1. 環抱式







 乃最常採用的餵哺方式
把寶寶平放於媽媽腹部上餵哺母乳
右手承托寶寶的頭、頸及身體。






 當寶寶張開口,媽媽用右手把寶寶的頭部移向乳房,從而開始吸吮
 成功吸吮,媽媽可把右手移放至寶寶的臀部,從而承托身體及頭部


2. 欖球式
適合剖腹生產或需要餵哺雙胞胎時用
寶寶如欖球一樣夾於腋下
用左手承托寶寶的頭、頸及身體
放置枕頭於寶寶下面,可作墊高用途



3. 側臥式

適合未能下床的媽媽時用
媽媽與寶寶同時側身睡在床上
媽媽頭部要有合適的承托
保持他的頭和身體成一直線

寶寶頭部對著媽媽的胸部
媽媽和寶寶腹部緊貼
媽媽單手托著寶寶頭和頸之間的位置






參考資料: womencare.com.hk/pumping-milk-tutorial.html
以上所提供的資訊僅作為教育及參考用途,如果你有任何醫療問題,
應向自己的婦產科專科醫生查詢,而不應單倚賴以上提供的資料。