Esrat - Followers Answers

1. Hormonal IUD side effects:
Hormonal IUDs (like Mirena, Kyleena, Liletta, and Skyla) can cause side effects. But for most people, that’s actually a good thing — the most common hormonal IUD side effects usually help make your periods better.
Hormonal IUDs can cut down on cramps and PMS, and they usually make your periods much lighter. Some people stop getting their periods at all while they have their IUD (don’t worry, this is totally normal and safe). In fact, many people get hormonal IUDs to help with heavy or painful periods, to treat symptoms of endometriosis or PCOS, or because they just don’t want to bleed every month.
Other hormonal IUD side effects can include:
Pain when the IUD is put in, and cramping or backaches for a few days after
spotting between periods
irregular periods
These usually go away within 3–6 months, once your body gets used to the new visitor in your uterus. And they don’t happen to everyone — many people use hormonal IUDs with no problems at all.
Over-the-counter pain medicine (like ibuprofen, naproxen, or aspirin) can usually help with IUD cramps. If you have cramping that doesn’t get better or is really painful, talk with your nurse or doctor. They may need to check to make sure that your IUD is in the right place.
The changes in your periods while you have your IUD can make some people worry about how they’ll know they’re not pregnant. But you don’t really need to worry about being pregnant even if you don’t get a period, because the IUD is really good at what it does — it’s more than 99% effective at preventing pregnancy.
If you do think you might be pregnant, take a pregnancy test and call your nurse or doctor right away if it’s positive. It’s very rare to get pregnant while you have an IUD, but if it does happen, it’s more likely to be an ectopic pregnancy, which can be dangerous and needs medical attention right away.
The hormones in these IUDs and other types of hormonal birth control (like the implant and shot) have been around for decades, and millions of people have used them safely. Hormonal IUD side effects aren’t dangerous, though there are some possible risks with using IUDs, like with any medicine.
2. Copper IUD side effects:
The copper IUD (aka Paragard IUD) has no hormones, so you don’t have to deal with any of the risks or side effects that can sometimes happen with hormonal birth control methods.
But copper IUDs often cause more bleeding and cramps during your period, especially in the first 3-6 months. For many people, this gets better over time.
Paragard side effects can include:
spotting between periods
irregular periods
heavier or longer periods
more or worse cramping during your periods
pain when your IUD is put in, and cramping or backaches for a few days after
Over-the-counter pain medicine can help with IUD cramps. And the cramping and bleeding usually get better after a few months, once your body gets used to your IUD. You can keep track of any side effects you may be having with our birth control app.
Birth control shouldn’t make you feel uncomfortable. If you have bleeding or pain that really bothers you, talk with your nurse or doctor. They may need to check and make sure your IUD is in the right place, or they might recommend a different method of birth control for you. Some people try a few different birth control methods before finding the right one for them.
The copper IUD has been around for decades, and millions of people have used it safely, though there are some possible risks, like with any medical device.
3. IUD removal side effects:
You may have some spotting for a little while after your nurse or doctor takes out your IUD, but otherwise, you should feel totally normal.
When you stop using an IUD, your body will eventually return to the way it was before you got it. So if your period got heavier on the copper IUD, it will go back to what was normal for you before you got the IUD. If you stopped getting your period on the hormonal IUD, your period will eventually come back after the IUD is out. It can take a few months for your period to go back to what’s normal for you.
An important thing to note: you can get pregnant right away once your IUD is out, even if your periods aren’t regular or haven’t come back yet. So if you have your IUD removed but you don’t want to get pregnant, make sure to use another birth control method.

Everyone’s body is different, and our bodies also change over time. So there’s no way to know exactly how your body will react to going off the IUD. But any side effects that you may have will go away within a few months as your body gets used to not having an IUD anymore.

If you’re really worried about the side effects of going off the IUD, talk with your nurse or doctor. They may be able to give you more specific information about what to expect based on your personal medical history.

The symptoms of HIV and AIDS vary, depending on the phase of infection.

Primary infection (Acute HIV)
Some people infected by HIV develop a flu-like illness within two to four weeks after the virus enters the body. This illness, known as primary (acute) HIV infection, may last for a few weeks. Possible signs and symptoms include:

Fever
Headache
Muscle aches and joint pain
Rash
Sore throat and painful mouth sores
Swollen lymph glands, mainly on the neck
Diarrhea
Weight loss
Cough
Night sweats
These symptoms can be so mild that you might not even notice them. However, the amount of virus in your bloodstream (viral load) is quite high at this time. As a result, the infection spreads more easily during primary infection than during the next stage.

Clinical latent infection (Chronic HIV)
In this stage of infection, HIV is still present in the body and in white blood cells. However, many people may not have any symptoms or infections during this time.

This stage can last for many years if you’re not receiving antiretroviral therapy (ART). Some people develop more severe disease much sooner.

Symptomatic HIV infection
As the virus continues to multiply and destroy your immune cells — the cells in your body that help fight off germs — you may develop mild infections or chronic signs and symptoms such as:

Fever
Fatigue
Swollen lymph nodes — often one of the first signs of HIV infection
Diarrhea
Weight loss
Oral yeast infection (thrush)
Shingles (herpes zoster)
Pneumonia
Progression to AIDS
Thanks to better antiviral treatments, most people with HIV in the U.S. today don’t develop AIDS. Untreated, HIV typically turns into AIDS in about 8 to 10 years.

When AIDS occurs, your immune system has been severely damaged. You’ll be more likely to develop opportunistic infections or opportunistic cancers — diseases that wouldn’t usually cause illness in a person with a healthy immune system.

The signs and symptoms of some of these infections may include:

Sweats
Chills
Recurring fever
Chronic diarrhea
Swollen lymph glands
Persistent white spots or unusual lesions on your tongue or in your mouth
Persistent, unexplained fatigue
Weakness
Weight loss
Skin rashes or bumps

Labour has three stages:

1. The first stage is when the neck of the womb (cervix) opens to 10cm dilated.
2. The second stage is when the baby moves down through the vagina and is born.
3. The third stage is when the placenta (afterbirth) is delivered.
The first stage of labor: dilation
Before labor starts, your cervix is long and firm. During the first hours of labor, the muscles of the uterus (womb) contract and help shorten and soften the cervix, so that it can dilate (open).
For first-time mothers, this stage can last from six to 36 hours. During this time you might experience:
Contractions – some can be quite mild, like a period pain; others can be sharp and strong. Initially, the contractions will be short (between 30 to 40 seconds) and irregular. Once contractions are five minutes apart and a minute or more in length, labor is said to be ‘established’.
A ‘show’ – the discharge of a plug of mucus that can be thick and stringy or blood-tinged. This may happen the day you go into labor, or up to a week before.
‘Breaking of your waters’ – this means the amniotic sac around your baby has ruptured.
Every labor is different. If you think you could be in labor, the first thing to do is relax and stay calm. The best place for early labor is at home.

When to ring your lead maternity carer (LMC) or our Labour & Birthing Suite (if you are giving birth at Auckland City Hospital):
Your contractions are coming every five minutes, lasting longer than 50 seconds, and have been getting stronger for at least two to three hours.
You have severe or constant abdominal pain with a tight abdomen.
Your water has broken and it is clear or has a tinge of pink. Put on a sanitary pad and check it after an hour. If it is wet, please ring us.
Your water has broken and it is green or brown. Call us immediately – you will be advised to come into the hospital.
If there is a change in the pattern of your baby’s movements.
You notice any vaginal bleeding – bright red vaginal bleeding is not normal.
Things to do and try at the hospital:
Try not to tense up during contractions. Your body is trying to release something, not tighten up.
Find positions that feel comfortable. Walk the corridors slowly, lean on the walls, use the Swiss ball and La-Z-boy chairs. Try to stay off the bed, unless for a short rest.
Water is great for relaxation and coping with contractions. If you don’t have use of a pool, try the shower.
Bring music and a player, if it relaxes or calms you.
Bring an electric oil burner and use your aromatherapy oil.
Continue to take refreshments and drink small amounts frequently.
Phone calls are a distraction from your tasks of giving birth and looking after your new baby. Encourage family and friends to phone one designated person for updates.

The second stage of labor: your baby
The second stage of labor begins when the cervix is fully dilated (open) and the baby’s head moves down out of the uterus and into the vagina (or birth canal). Your job at this stage is to push the baby through the birth canal, so you’ll need focused determination and energy.
The birth of your baby may take 30 minutes to an hour or longer. This second stage could be further extended if you have an epidural.
A small number of women will require assistance with their births, either by forceps or ventouse (vacuum extraction). The obstetrician will choose which is best for your situation.

The third stage of labor: the placenta
The final stage of labor is the delivery of the placenta. There can happen in one of two ways listed below.
Your LMC can help you to decide which approach would be best for you, taking into consideration your health, how your pregnancy has progressed and the type of labor and birth you experience.

1. Physiological management
The physiological third stage means waiting for your placenta to deliver spontaneously with your effort. This may take up to an hour following the birth; while you’re waiting, skin-to-skin with your baby and a first breastfeed will be encouraged.

2. Active management
Active management involves injecting an ecbolic (contracting drug) into your leg as your baby’s shoulders are born. The ecbolic speeds up placental separation and your uterus (womb) contracts down to reduce blood loss and ensure your womb remains contracted.

1. Postpartum hemorrhage (PPH)
When the third stage of labor is prolonged beyond 20-24 minutes (as opposed to the 30 minutes that was the earlier benchmark), it may be a risk factor for postpartum hemorrhage (PPH) which kills more than 1.25 million women a year.

Even when it doesn’t take maternal life, it causes excessive blood loss (over half a liter of blood) following childbirth in a staggering 14 million cases. Most of this bleeding comes from the placental site, which fails to contract properly.

Typically, natural figure-of-8 muscular fiber loops are present around the blood vessels, so that the torn vessels are quickly closed off after the placenta separates and the uterus contracts. PPH is particularly deadly because two out of every three women who develop PPH had no preceding risk factors before delivery.

PPH may also be associated with the following conditions which are also associated with an abnormal third stage. An anemic mother is at higher risk of PPH because clotting is more difficult and because even a relatively small blood loss may precipitate signs and symptoms of hypovolemia due to the initial lack of blood.

2. Retained placenta

Women need to be educated about the warning signs and symptoms of preeclampsia
New clinical practice guidelines on diagnosis, management of von Willebrand Disease
Women with COVID-19 more likely to suffer acute stress during childbirth
The retention of part or the whole of the placenta, including the membranes, for over 30 minutes after the delivery of the baby, is called the retained placenta. It has several causes:

Premature closure of the cervix so that the separated placenta is trapped inside the uterine cavity
A full urinary bladder prevents the placenta from passing through the birth canal by its pressure
Retention of a part of the membranes or placenta after placental expulsion
The last three conditions may also lead to uterine atony resulting in PPH because the uterus cannot contract well with the placenta inside it.

3. Atonic or flabby uterus:
In some women, the uterus doesn’t contract strongly enough to separate or expel the placenta completely. As mentioned above, a flabby uterus may be associated with a retained placenta, but also with conditions such as:

Placenta previa or implantation of the placenta in the lower part of the uterus, which means the muscle fibers are weakened by the infiltration of blood vessels and placental tissue between them. This leads to weak contractions after the delivery.
Placental abruption or premature separation of the placenta before the child is born
Multiparity: A woman who has already carried more than five pregnancies can have an atonic uterus and PPH.
Multiple pregnancies: If a woman is carrying twins or higher-order pregnancies, the abdomen and uterus are highly distended. The stretched uterine muscle fibers may be unable to contract properly immediately after delivery and this leads to atony.
Polyhydramnios: This refers to the presence of excessive (over 3L) amniotic fluid inside the uterus, which causes overstretching and subsequent atony of the uterine muscle in many cases
Large fetus: A woman carrying a large baby (weighing 4 kg or more) also has the potential for uterine atony because the muscles are weakened by the overstretching.
Prolonged labor and dehydration: If a woman is in labor for over 12 hours, it is more common to have uterine atony, perhaps because of muscular fatigue, dehydration, and acidosis.

4. Uterine inversion
This is a rare but very serious complication of the third stage, slightly more common with controlled cord traction, in which the uterus is turned inside out and comes out through the vulval orifice wholly or partly.

To avoid this, a non-separated placenta should never be pulled out using this technique. Fundal support is also taught as a method of preventing uterine inversion, but not enough evidence exists as to its usefulness. Risk factors for uterine inversion include:

Multiparity
Prolonged labor over 24 hours in duration
Short umbilical cord
Over-zealous cord traction
Use of magnesium sulfate which relaxes muscles, during labor
The placenta accrete when the placenta is firmly attached to the uterine muscle and cannot separate
Congenital uterine anomalies

T cells vs B Cells T cells and B cells are the two types of lymphocytes that are involved in triggering the immune response in the body. Both T cells and B cells are produced in the bone marrow. The T cells migrate to the thymus for maturation. Both T cells and B cells are involved in recognizing pathogens and other harmful, foreign materials inside the body such as bacteria, viruses, parasites, and dead cells. The two types of T cells are helper T cells and cytotoxic T cells. The major function of the helper T cells is to activate cytotoxic T cells and B cells. The cytotoxic T cells destroy pathogens by phagocytosis. B cells produce and secrete antibodies, activating the immune system to destroy the pathogens. The main difference between T cells and B cells is that T cells can only recognize viral antigens outside the infected cells whereas B cells can recognize the surface antigens of bacteria and viruses.