Stretch Marks: Striae Gravidarum over abdomen, hips buttocks and sometimes breast. Seen in 90% of pregnancies. They partly regress after delivery, but most of tehm persist. Cause: Hormonal factores – (adrenocortical hormones, Estrogen, Relaxin), stretching of connective tissue and scratching. Stretchnil oint locally (Local creams with Vitamin E and also some herbal products to reduce elasticity and to reduce itching)Emollient creams and lotions to make stretched skin soft and comfortable. Physical exercises and well balanced diet, to avoid excessive weight gain which increase the striae. Pigmentation: Sites of pigmentation: Hidden areas: nipples, areaolae, external genitallia, axilla and medical portions of thighs. Exposed areas: Linea nigra over lower abdomen, chloasma or melasma over the face in more than 50% patients.Face washes 3 times a day – usemild cleaning products. Avoid going in direct sun as far as possible. Apply sunscreen t exposed areas, half hour before oing in Sun and use an umbrealla. Apply sunscreen with SPF (Sun Protection Factor) of >30 and UVA during daytime.At bedtime, use a cream or moisturizer containing antioxidants like vitamin A.C & E. Asthma and Pregnancy Use inhalers. All inhaled anti-asthmatic drugs, including steroids are completely safe. All oral bronchodilators – Salbutamol, Terbutaline, Deriphylin – are safe, but p[refer inhaled drugs. Avoid oral steroids, except for emergency. Use inhaled steroids, preferably inhaled Bechlomethasone. Use spacer minimize oral absorption of the drug. Stepwise approach:Inhaled Salbutamol, whenever bronchospas.If repeatd attaks, add inhaled Beclomethasone, to reduce bronchial inflammation. Add oral Bronchodilators.For severe persistent attacks, oral steroids may have to be considered. If mother or father asthmatic, after delivery, encourage breast feeding, as it definitely reduces the risk of developing atopic diseases in the child.
