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What is a cryptic pregnancy? A cryptic pregnancy is when a woman is unaware that she is pregnant, often until the third trimester or even until she goes into labour. Unlike a concealed pregnancy where the woman knows she is pregnant but hides it, in a cryptic pregnancy the woman truly does not realise she is expecting a baby. The term "cryptic" means hidden or obscure. In a cryptic pregnancy, the usual physical signs of pregnancy like a growing belly, morning sickness, and missed periods may be absent, minimal, or misinterpreted. As a result, the pregnancy goes undetected for an extended period. Who is at risk for a cryptic pregnancy? While a cryptic pregnancy can happen to any woman, certain factors increase the likelihood: Young age, especially teenagers Irregular menstrual cycles or a history of missed periods Recent childbirth, breastfeeding, or perimenopause Polycystic ovary syndrome (PCOS) which causes hormonal imbalances Certain medications like contraceptives that may mask pregnancy symptoms Extreme stress or major life changes History of infertility or being told conception is unlikely Mental health conditions like depression, schizophrenia or bipolar disorder Women with risk factors should be alert for subtle signs of pregnancy and take a test if in doubt. Regular check-ups can also help detect a cryptic pregnancy early. How common is a cryptic pregnancy? Cryptic pregnancies are relatively rare but not as uncommon as one might think. Studies estimate that: About 1 in 475 women are unaware of their pregnancy until 20 weeks gestation Around 1 in 2,500 women do not realise they are pregnant until they go into labour Approximately 1 in 7,225 pregnancies are discovered during delivery itself So while it's not an everyday occurrence, a few thousand cases likely occur each year. Increased awareness can help women recognise a cryptic pregnancy sooner. Will a cryptic pregnancy show on a pregnancy test? Pregnancy tests work by detecting the hormone human chorionic gonadotropin (hCG) in urine. However, in some cases of cryptic pregnancy, at-home urine tests may show a false negative result due to: Taking the test too early before hCG levels rise Very low hCG levels that don't meet the test's threshold Doing the test incorrectly or misinterpreting the results Hormonal imbalances that affect hCG production If a woman suspects she may be pregnant despite a negative test, it's best to repeat the test after a week or consult a doctor for a blood test which can detect pregnancy earlier and more accurately. Ultrasounds can also confirm a cryptic pregnancy. Do you get your period in a cryptic pregnancy? Most women do not get real menstrual periods during any pregnancy, including a cryptic one. However, some pregnant women may experience light bleeding or spotting that can be mistaken for a period. This is not a true menstrual bleed but rather occurs due to hormonal changes or minor complications. In a cryptic pregnancy, this bleeding may be interpreted as a sign that the woman is not pregnant. What causes a cryptic pregnancy? The exact cryptic pregnancy causes are not fully understood, but contributing factors include: Lack of visible pregnancy symptoms like nausea, breast changes and weight gain Continued light bleeding that resembles menstrual periods Hormonal imbalances that suppress usual pregnancy signs A tilted uterus that doesn't show a prominent baby bump Misinterpreting pregnancy symptoms as being due to stress, weight changes or medical conditions Denial of the possibility of pregnancy due to using birth control or being told conception is unlikely What are the signs of cryptic pregnancy? The challenge with cryptic pregnancy is that the usual symptoms may be very mild, absent, or not recognized as related to pregnancy. Common cryptic pregnancy symptoms include: missed or unusually light periods, tender and swollen breasts, morning nausea, fatigue, bloating, mild weight gain, increased urination, mood swings, and mild cramps or back pain. Since these symptoms can also be linked to other conditions, it's important not to dismiss them. If you suspect cryptic pregnancy symptoms, taking a pregnancy test is a good first step. Trust your instincts—if something feels different or off, consider testing, especially if you have risk factors for a cryptic pregnancy. How long does a cryptic pregnancy last? A cryptic pregnancy lasts as long as a regular pregnancy, about 40 weeks from the last menstrual period. However, since the pregnancy is not detected in the first trimester as usual, it may seem shorter. In some cases, a cryptic pregnancy is only discovered when the woman goes into labour unexpectedly. The baby is often born smaller or earlier than average since prenatal care was absent during the pregnancy. How is a cryptic pregnancy diagnosed? Diagnosing a cryptic pregnancy can be tricky since symptoms are often subtle or explained away. Doctors may suspect it when a woman reports: A negative pregnancy test but no period for several months Unusual symptoms like nausea, breast changes, and fatigue Foetal movement sensations in the belly Sudden, unexplained weight gain and a growing abdomen To confirm a cryptic pregnancy, doctors use: Sensitive blood tests that detect pregnancy hormones Abdominal or transvaginal ultrasounds that show the baby A physical exam to feel the size of the uterus and check for a foetal heartbeat How is a cryptic pregnancy treated? Cryptic pregnancy treatment focuses on ensuring the health and safety of the mother and baby. It often involves: Comprehensive prenatal care including check-ups, tests and ultrasounds Monitoring foetal growth and development Maternal nutrition and vitamin supplementation Modifying any unhealthy lifestyle factors like smoking or drinking Preparing for labour and delivery, often with extra monitoring Addressing any psychological factors like denial or depression While it's not ideal to start prenatal care late, it's vital to begin as soon as a cryptic pregnancy is diagnosed. With proper management, many women with a cryptic pregnancy can still have a healthy baby. Can we prevent cryptic pregnancy? While not all cryptic pregnancies can be prevented, women can reduce their risk by: Tracking menstrual cycles and taking a pregnancy test if a period is late Being aware of early pregnancy signs and symptoms Maintaining a healthy weight and managing conditions like PCOS Addressing any psychological factors that may lead to denial Seeing a doctor regularly, especially if pregnancy is a possibility Women who have had a cryptic pregnancy before or have risk factors should be extra vigilant about monitoring for signs of pregnancy. What are the complications of a cryptic pregnancy? A cryptic pregnancy can have risks for both mother and baby due to the lack of prenatal care and monitoring. Potential complications include: Premature birth or low birth weight Undiagnosed maternal health conditions like high blood pressure or diabetes Nutrient deficiencies that affect fetal development Birth defects due to missed prenatal screening and prevention Psychological distress for the mother due to the surprise pregnancy Lack of preparation for childbirth and parenting Greater risk of labour complications due to insufficient prenatal guidance Difficulty accessing timely medical interventions during delivery While not all cryptic pregnancies have poor outcomes, early detection and treatment are vital for reducing complications. Regular prenatal care makes a big difference in ensuring a healthier pregnancy and birth experience. Conclusion Knowing the signs and symptoms of pregnancy, even subtle ones can help identify a cryptic pregnancy sooner. If you think you may have a cryptic pregnancy, don't hesitate to reach out for medical support. Metropolis Healthcare offers comprehensive prenatal testing and monitoring to help you have a healthy pregnancy and baby, even if detected late. Their at-home blood tests can confirm a pregnancy, and their expert team can guide you through the next steps. Remember, knowledge is power when it comes to your reproductive health. Recognising a cryptic pregnancy and seeking prompt care can make all the difference.

What is Pleurisy? Pleurisy, also known as pleuritis, is the inflammation of the pleura, the double-layered membrane surrounding the lungs and lining the chest cavity. The pleura usually has a smooth, slippery surface, which allows the lungs to move smoothly during breathing. When the pleura become inflamed, they lose their smoothness, causing the layers to rub together, resulting in sharp chest pain, especially when breathing deeply or coughing. Pleurisy causes can be attributed to infections (bacterial or viral), autoimmune diseases, or other underlying conditions like pulmonary embolism or rib fractures. Pleurisy treatment depends on the underlying cause. How do we know if we have pleurisy? The hallmark symptom of pleurisy is a sharp, stabbing pain in the chest that intensifies with deep breathing, coughing, or sneezing. The pain may be localised to one area of the chest or radiate to the shoulders and back. Shortness of breath, cough, and fever are other common pleurisy symptoms. How do we get pleurisy? Pleurisy can develop due to various underlying causes. Some common pleurisy causes include: Viral infections like the flu Bacterial infections such as pneumonia Autoimmune disorders like lupus or rheumatoid arthritis Lung cancer Pulmonary embolism (blood clot in the lungs) Tuberculosis Chest trauma or rib fractures Who does pleurisy affect? While pleurisy can affect people of all ages, some individuals are at higher risk, including: Older adults over 65, who are more prone to lung infections People with weakened immune systems Those with underlying health conditions like pneumonia, tuberculosis, lupus, or lung cancer Individuals who smoke or have a history of smoking How serious is pleurisy? The severity of pleurisy depends on the underlying cause. In some cases, such as those caused by viral infections, pleurisy may resolve on its own within a few days to weeks. However, pleurisy resulting from serious conditions like bacterial pneumonia, tuberculosis, or lung cancer requires prompt medical attention and treatment to prevent complications. What are the symptoms of pleurisy? The most common pleurisy symptoms include: Sharp chest pain that worsens with breathing, coughing, or sneezing Shortness of breath Cough (dry or productive) Fever and chills Rapid, shallow breathing Pain in one or both shoulders Headaches Joint pain (in some cases) What causes pleurisy? Various factors can lead to pleurisy. Let's explore some of the main pleurisy causes in more detail: Infections: Viral infections like influenza, mumps, or cytomegalovirus Bacterial infections, most commonly pneumonia Fungal infections, especially in immunocompromised individuals Parasitic infections like amebiasis Autoimmune disorders: Lupus Rheumatoid arthritis Sarcoidosis Wegener's granulomatosis Cancers: Lung cancer Lymphoma Mesothelioma (cancer of the pleura) Metastatic cancers that have spread to the lungs Other causes: Pulmonary embolism Tuberculosis Chest trauma or rib fractures Certain medications Complications from medical procedures like heart surgery Is pleurisy contagious? Pleurisy itself is not contagious. However, some of the underlying infections that cause pleurisy, such as flu or tuberculosis, can spread from person to person. Is pleurisy linked to COVID-19? Some studies suggest that COVID-19 can cause pleurisy as part of its wide range of respiratory symptoms. If you have pleurisy symptoms and suspect COVID-19 exposure, it's crucial to self-isolate and contact your healthcare provider. How is pleurisy diagnosed? Pleurisy diagnosis involves a combination of physical examination, imaging tests, and laboratory studies. Your doctor will listen to your lungs with a stethoscope to check for a rubbing sound (pleural friction rub) that indicates pleural inflammation. They will also assess your symptoms and risk factors. What tests will be done to diagnose pleurisy? To confirm a pleurisy diagnosis, your doctor may recommend the following tests: Chest X-ray: This imaging test can reveal pleural effusions (fluid buildup), lung infiltrates, or masses that may be causing pleurisy. CT scan: A CT scan provides more detailed images of the lungs and pleura, helping identify underlying conditions like pneumonia, pulmonary embolism, or tumours. Ultrasound: Pleural ultrasound can detect small amounts of pleural effusion and guide thoracentesis (fluid removal) if needed. Blood tests: Laboratory studies like complete blood count (CBC), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) can help identify infections or inflammation associated with pleurisy. Thoracentesis: In some cases, a sample of pleural fluid may be removed using a needle and sent for analysis to determine the cause of pleurisy, such as infection or cancer. Will a chest X-ray show pleurisy? A chest X-ray can often detect pleural effusions or lung abnormalities related to pleurisy. However, small amounts of pleural inflammation may not always be visible on an X-ray. in such cases, you may need a CT scan. How is pleurisy treated? Pleurisy treatment depends on the underlying cause. Some general treatment approaches include: Over-the-counter pain medications like ibuprofen can help manage chest pain and discomfort. If a bacterial infection is causing pleurisy, antibiotics will be prescribed to treat the infection. In cases of autoimmune-related pleurisy, corticosteroids may be used to reduce inflammation. If a large pleural effusion is present, fluid may need to be drained to relieve symptoms and prevent complications. Addressing the root cause of pleurisy, such as managing pneumonia, tuberculosis, or cancer, is crucial for effective treatment. How can we reduce our risk of pleurisy? While not all cases of pleurisy are preventable, you can take steps to lower your risk: Stay up to date with vaccinations Practice good hygiene, including frequent handwashing Manage underlying health conditions like autoimmune disorders or lung diseases Avoid smoking and secondhand smoke exposure Protect yourself from occupational hazards like asbestos What can we expect if we have pleurisy? The recovery time for pleurisy varies depending on the cause and severity. Most of the cases improve within a few days to weeks with appropriate treatment. However, some individuals may experience recurrent episodes of pleurisy, especially if an underlying chronic condition is present. Regular follow-up with your healthcare provider is essential to monitor your progress and prevent complications. Can pleurisy go away on its own? Mild cases of pleurisy, which are particularly those caused by viral infections, may resolve spontaneously without specific treatment. However, it's always best to consult a medical professional for an accurate diagnosis and appropriate management. Are there any complications of pleurisy? Untreated pleurisy can lead to pleural effusion, empyema (infection), or lung scarring, all of which can impair lung function. Can you get pleurisy more than once? Yes, recurrent episodes of pleurisy can occur, especially in individuals with underlying conditions like autoimmune disorders or chronic lung diseases. How do we take care of ourselves if we are at risk for pleurisy? If you have risk factors for pleurisy, it's crucial to: Manage underlying health conditions as directed by your doctor Avoid smoking and exposure to lung irritants Stay physically active and maintain a healthy weight Get recommended vaccinations Practice good self-care, including a balanced diet, adequate sleep, and stress management When to see a doctor? Seek medical attention if you experience: Chest pain that worsens with breathing Shortness of breath Persistent cough Fever and chills Unexplained weight loss Bloody or rust-coloured sputum Conclusion Pleurisy can be a concerning and painful condition, but understanding its causes, symptoms, and treatment options can empower you to take control of your lung health. If you suspect pleurisy, don't hesitate to consult a healthcare professional for an accurate diagnosis and personalized care plan. At Metropolis Healthcare, we offer comprehensive diagnostic services, including at-home sample collection, to help you get the answers and care you need. Our team of experienced phlebotomists and state-of-the-art laboratories ensure reliable results, while our user-friendly online portal and app make accessing your reports convenient.

What is premenstrual syndrome (PMS)? Premenstrual syndrome (PMS) is a common condition that affects millions of women worldwide. It refers to a set of physical and emotional symptoms that many women experience in the days leading up to their menstrual period. While the exact cause of PMS is not fully understood, hormonal fluctuations during the menstrual cycle are believed to play a significant role. Premenstrual syndrome symptoms typically start one to two weeks before the period and cease once menstruation begins or shortly thereafter. The severity of symptoms can vary from mild discomfort to significant disruption of daily activities. Understanding the signs and causes of PMS, as well as effective management strategies, can help women find relief and improve their overall well-being. What is the difference between PMS and PMDD? While premenstrual syndrome (PMS) can cause notable discomfort, premenstrual dysphoric disorder (PMDD) is a more severe form of the condition. Women with PMDD experience intense emotional symptoms, such as depression, irritability, and anxiety, that are severe enough to interfere with their daily life and relationships. In contrast, premenstrual syndrome symptoms, although bothersome, do not typically cause the same level of impairment. How common is PMS? Premenstrual syndrome affects a significant portion of women of reproductive age. According to research, the pooled prevalence of PMS among these women is approximately 47.8%. This means that nearly half of all women experience some degree of premenstrual symptoms. What are the symptoms of premenstrual syndrome? Premenstrual syndrome symptoms can be divided into physical and emotional categories. Here are some of the most common signs to look out for: Physical symptoms Breast swelling and tenderness Abdominal bloating and weight gain Headache and migraine Joint pain and backache Constipation or diarrhoea Gastrointestinal problems Skin issues such as acne Increased appetite with specific food cravings Fatigue and lethargy Emotional symptoms Irritability and mood swings Anxiety and restlessness Depression and sadness Crying spells and emotional outbursts Difficulty concentrating and remembering information Changes in sleep patterns, including insomnia or oversleeping Decreased sex drive Social withdrawal and hostility It's important to note that not all women experience the same premenstrual syndrome symptoms. Some may have predominantly physical discomfort, while others struggle more with emotional challenges. Keeping track of PMS symptoms in a journal can help you identify patterns and communicate more effectively with your healthcare provider. What is the relationship between PMS and premenstrual exacerbation (PME)? Premenstrual exacerbation (PME) refers to the worsening of existing medical or psychiatric conditions during the premenstrual phase. While PMS and PMDD are specific syndromes, PME can affect a wide range of health issues, such as migraines, asthma, or mental health disorders. The same hormonal and neurochemical changes that contribute to premenstrual syndrome can also exacerbate other pre-existing conditions. For example, a woman with anxiety may find that her symptoms intensify in the days leading up to her period due to PME. Recognising this connection can help women and their healthcare providers develop targeted management strategies. What causes premenstrual syndrome? Although the exact premenstrual syndrome causes are not fully understood, several factors are believed to contribute to its development: Hormonal fluctuations: Changes in estrogen and progesterone levels during the menstrual cycle are thought to play a significant role in PMS. Neurotransmitter imbalances: Hormonal shifts can impact neurotransmitters such as serotonin, gamma-aminobutyric acid (GABA), and catecholamines, which regulate mood and physical functions. Abnormal responses to progesterone: Some women may be more sensitive to the effects of progesterone, leading to premenstrual syndrome symptoms. Lifestyle factors: Diet, exercise, and sleep quality can influence the severity of premenstrual syndrome. Stress: High levels of stress and its effects on the hypothalamic-pituitary-adrenal (HPA) axis may contribute to PMS. How is premenstrual syndrome diagnosed? Premenstrual Syndrome (PMS) is diagnosed primarily through a detailed medical history, physical examination, and, in some cases, a pelvic exam. There is no definitive lab test for PMS, so diagnosis is often based on a pattern of recurring symptoms. Healthcare providers typically ask patients to keep a symptom journal to track the timing, severity, onset, and duration of symptoms over several menstrual cycles. This helps identify any consistent patterns related to the menstrual cycle. For a diagnosis of PMS, symptoms must meet specific criteria: they must occur in the five days before menstruation for at least three consecutive menstrual cycles, subside within four days after the period begins, and interfere with daily activities such as work, school, or relationships. Common premenstrual syndrome symptoms include irritability, mood swings, fatigue, bloating, and physical discomfort like breast tenderness or headaches. In some cases, a healthcare provider may conduct tests to rule out other conditions, such as thyroid disorders or depression, which can mimic premenstrual syndrome symptoms. By documenting the frequency and impact of symptoms, individuals can assist their healthcare provider in making a more accurate diagnosis and creating an appropriate premenstrual syndrome treatment plan. Is there a cure for premenstrual syndrome? Currently, there is no cure for PMS. However, various premenstrual syndrome treatment options can help manage its symptoms and improve quality of life. These treatments focus on alleviating physical and emotional discomfort rather than eliminating the condition entirely. The good news is that with the right combination of lifestyle changes, self-care strategies, and medical interventions when necessary, most women can find significant relief from PMS symptoms. How can we manage symptoms? Premenstrual Syndrome (PMS) refers to a set of physical, emotional, and behavioral symptoms that occur in the two weeks leading up to menstruation. While PMS affects many individuals, its severity can vary, and managing these symptoms often requires a combination of approaches, including medications, lifestyle changes, and vitamins or supplements. Medications One of the most common ways to manage PMS symptoms is through medication. Over-the-counter (OTC) pain relievers can help reduce cramps, headaches, and body aches. For mood-related symptoms like irritability or anxiety, a healthcare provider might recommend antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), which can also help improve sleep. In more severe cases, hormonal treatments like birth control pills or hormonal IUDs can regulate hormone fluctuations and provide relief from premenstrual syndrome symptoms. For extreme symptoms, doctors may also prescribe diuretics to reduce bloating and swelling, or non-steroidal anti-inflammatory drugs (NSAIDs) to alleviate pain. Lifestyle Changes Lifestyle adjustments can significantly reduce the severity of PMS symptoms. Regular physical activity, such as walking, swimming, or yoga, can help alleviate mood swings and reduce bloating. Exercise stimulates the release of endorphins, which act as natural mood enhancers. Additionally, practicing stress-reduction techniques like mindfulness, meditation, or deep breathing exercises can help manage irritability and anxiety that often accompany PMS. Dietary changes also play a crucial role in symptom management. Reducing intake of caffeine, sugar, and salty foods can help control mood swings, fatigue, and bloating. A balanced diet rich in fiber, fruits, vegetables, and whole grains supports hormonal balance. Staying hydrated and limiting alcohol consumption are also key strategies to reduce PMS-related fatigue and discomfort. Vitamins, Minerals, and Supplements Certain vitamins, minerals, and supplements have been shown to alleviate specific PMS symptoms. For example, vitamin B6 may help reduce irritability, fatigue, and mood swings. Magnesium supplements can decrease bloating, cramps, and headaches by helping muscles relax and supporting overall hormonal function. Calcium is another essential nutrient that can help manage PMS by reducing mood swings, fatigue, and physical discomfort. Omega-3 fatty acids, found in fish oil supplements, have anti-inflammatory properties that can reduce pain and cramping associated with PMS. By combining medications, lifestyle changes, and appropriate supplements, many people can find significant relief from the symptoms of PMS, improving their quality of life in the lead-up to menstruation. How can we prevent premenstrual syndrome? While PMS cannot be completely prevented, certain lifestyle changes can help reduce the severity of symptoms, like regular exercise, healthy diet, adequate sleep, and stress management. What can we expect if we have premenstrual syndrome? If you have PMS, you can expect symptoms to start 1-2 weeks before your period and resolve within a few days of menstruation beginning. Some women may experience only physical symptoms, while others have predominantly emotional ones. PMS symptoms can also change over time and may worsen during times of stress. How do you fix premenstrual syndrome? To manage PMS, try OTC pain relievers, vitamin supplements (calcium, B6), prescription meds (birth control, antidepressants), and lifestyle changes like exercise, diet, sleep, and stress reduction. However, consult a doctor first. How long does PMS last before you get your period? PMS symptoms typically begin 1-2 weeks before menstruation and peak in the final week of the luteal phase. They usually improve within a few days of the period starting. The exact duration can vary from woman to woman. What is PMDD and how does it relate to our period? Premenstrual dysphoric disorder (PMDD) is a more severe form of PMS. It involves intense mood-related symptoms that significantly interfere with daily functioning. PMDD symptoms occur in the week before the period, improve shortly after it starts, and cause substantial distress. When to see a doctor? See your doctor if PMS symptoms are severe, persist despite self-care measures, or interfere with your daily life and relationships. Your doctor can help determine if you have PMS or a more serious condition like PMDD. Conclusion Premenstrual syndrome (PMS) is a common condition that affects many women, causing a range of physical and emotional symptoms. Although there is no cure for PMS, various premenstrual syndrome treatment options, including medications, lifestyle changes, and supplements, can help manage symptoms and improve quality of life. If you're experiencing PMS symptoms and would like expert guidance, consider reaching out to Metropolis Healthcare. As a leading chain of diagnostic labs across India, Metropolis Healthcare offers accurate pathology testing and health check-up services. Remember, prioritising your well-being is within reach with the right knowledge, support, and medical care

What is orthostatic hypotension? Orthostatic hypotension is a sudden drop in blood pressure that occurs when you move from a seated or lying position to standing. Orthostatic hypotension symptoms could include dizziness, lightheadedness, blurred vision, and even fainting. The condition is also referred to as postural hypotension. What is blood pressure? Blood pressure is the force exerted by blood against the walls of your arteries. It's measured in millimetres of mercury (mmHg) and consists of two numbers: Systolic pressure: The top number, which measures the pressure when your heart beats Diastolic pressure: The bottom number, which measures the pressure between heartbeats Normal blood pressure is around 120/80 mmHg. Hypotension, or low blood pressure, is generally considered a reading of 90/60 mmHg or lower. What BP is orthostatic hypotension? Orthostatic hypotension is defined as a drop in systolic blood pressure of at least 20 mmHg or a drop in diastolic blood pressure of at least 10 mmHg within 3 minutes of standing up. This significant decrease in blood pressure reduces blood flow to the brain, causing the characteristic symptoms of orthostatic hypotension or postural hypotension. Who might get orthostatic hypotension? While orthostatic hypotension can affect anyone, certain groups are at higher risk: Older adults: The body's ability to regulate blood pressure declines with age. People who have been on prolonged bed rest: This can weaken the cardiovascular system. Pregnant women: Orthostatic hypotension causes could include hormonal changes and increased blood volume during pregnancy. Individuals with underlying health conditions: Parkinson's disease, heart problems, diabetes, and neurological disorders increase the likelihood of postural hypotension. How common is orthostatic hypotension? Orthostatic hypotension affects about 6% of the general population. However, it's more common in older adults, with 10-30% of people over 65 experiencing symptoms. The condition is also prevalent in long-term care facilities and among those who have recently given birth or undergone growth spurts. What are the symptoms of orthostatic hypotension? Orthostatic hypotension symptoms are the body’s response to a sudden drop in blood pressure when standing up. Here are the key symptoms: Dizziness or Lightheadedness: Feeling unsteady or faint upon standing Blurred Vision: Vision may temporarily become fuzzy or out of focus Fainting (Syncope): In severe cases, sudden loss of consciousness can occur Nausea: A sensation of queasiness or the urge to vomit Fatigue: Sudden weakness or tiredness may accompany other orthostatic hypotension symptoms Confusion: Some may experience disorientation or mental fog Muscle Tremors: Shaky or trembling muscles can occur These orthostatic hypotension symptoms usually improve once you sit or lie down. In more serious cases, symptoms may lead to falls or injuries, so prompt awareness and care are essential. What causes orthostatic hypotension? Orthostatic hypotension causes are generally grouped into two main categories: neurogenic and non-neurogenic. Neurogenic Causes: These are related to disorders that impair the autonomic nervous system’s ability to regulate blood pressure. Conditions such as Parkinson's disease, multiple system atrophy, and diabetic neuropathy fall under this category, as they can disrupt the body’s blood pressure adjustments upon standing, leading to orthostatic hypotension. Non-Neurogenic Causes: Non-neurogenic orthostatic hypotension causes include factors unrelated to the nervous system. Dehydration, blood loss, and certain medications (like diuretics and antidepressants) can reduce blood volume or pressure. Additionally, heart conditions that affect circulation, as well as environmental factors like prolonged standing or exposure to heat, can contribute to the sudden drop in blood pressure when standing up. How is orthostatic hypotension diagnosed? To diagnose orthostatic hypotension, your doctor will: Review your medical history and medications: Certain drugs or health conditions can contribute to blood pressure drops. Conduct a physical examination: This helps identify any underlying conditions affecting blood pressure regulation. Measure blood pressure in different positions: Blood pressure will be recorded while you are lying down, sitting, and standing to observe any significant drops. Order blood tests: Tests can reveal anaemia, low blood sugar, or other metabolic issues contributing to symptoms. Assess heart function: An echocardiogram may be used to evaluate your heart’s performance. Additional tests, such as a tilt table test, may be recommended based on your symptoms and health status. How do you fix orthostatic hypotension? Orthostatic hypotension treatment often involves addressing the underlying cause: Treating dehydration with fluids Adjusting medications that may contribute to the condition Managing heart conditions Making lifestyle changes, such as: Rising slowly from a seated or lying position Avoiding prolonged standing or hot environments Eating smaller, more frequent meals to prevent post-meal dizziness What medications/treatments are used in orthostatic hypotension? Depending on the severity and cause, an orthostatic hypotension treatment plan could include: Medications to increase blood volume Drugs that constrict blood vessels Compression stockings to improve blood flow in the legs Increased salt and fluid intake Physical therapy to improve muscle strength and circulation Side effects of the treatment While orthostatic hypotension treatment is generally well-tolerated, some medications may cause side effects like: Headaches Palpitations Fluid retention Supine hypertension (high blood pressure when lying down) Work closely with your doctor to find the right treatment plan that minimises side effects and effectively manages your symptoms. What are the complications of orthostatic hypotension? Orthostatic hypotension can lead to several complications, primarily due to reduced blood flow to the brain and other organs. Some potential complications include: Falls and injuries: Dizziness and fainting can increase the risk of falls, which may result in fractures, head injuries, or other trauma. Cardiovascular problems: Chronic low blood pressure can strain the heart and may increase the risk of heart failure or arrhythmias. Cognitive impairment: Repeated episodes of reduced blood flow to the brain may contribute to cognitive decline and dementia. How can we reduce our risk of orthostatic hypotension? Several strategies can help reduce your risk of developing orthostatic hypotension or manage your symptoms if you already have the condition: Stay hydrated: Drink plenty of water throughout the day to maintain adequate blood volume. Avoid sudden position changes: Take your time when standing up, and pause for a few moments before walking. Wear compression stockings: These garments help promote blood flow from your legs back to your heart. Adjust your diet: Eat smaller, more frequent meals and limit alcohol intake, as both can contribute to low blood pressure. Exercise regularly: Engaging in physical activity can improve your overall cardiovascular health and help regulate blood pressure. Reviewing your medications: Some medications, like diuretics or antidepressants, can contribute to low blood pressure. Your doctor may adjust your dosage or switch you to an alternative medication. What can we expect if we have orthostatic hypotension? If you have orthostatic hypotension, your healthcare provider will work with you to identify the underlying cause and develop an appropriate treatment plan. It's essential to follow your treatment plan consistently and communicate any concerns or changes in your symptoms to your healthcare provider. What is the outlook for orthostatic hypotension? The outlook for orthostatic hypotension depends on the underlying cause and the effectiveness of treatment. Many people can manage their symptoms and reduce their risk of complications by implementing lifestyle changes and following their prescribed treatment plan. However, some individuals may experience persistent symptoms or develop complications, particularly if the condition is caused by an underlying chronic illness. Are orthostatic hypotension and postural tachycardia syndrome (POTS) the same condition? While orthostatic hypotension and postural tachycardia syndrome (POTS) share some similarities, they are distinct conditions. Both involve changes in blood pressure and heart rate upon standing, but the specific patterns differ: Orthostatic hypotension: Characterised by a significant drop in blood pressure upon standing, often accompanied by dizziness or fainting. POTS: Characterised by a rapid increase in heart rate upon standing (at least 30 beats per minute), without a significant drop in blood pressure. Symptoms may include dizziness, fatigue, and palpitations. When to see a doctor? If you experience frequent episodes of dizziness, lightheadedness, or fainting upon standing, it's essential to consult your healthcare provider. They can help diagnose the underlying cause of your symptoms and recommend an appropriate treatment plan. Seeking medical attention is particularly important if your symptoms are severe, persistent, or interfere with your daily activities. Conclusion Orthostatic hypotension is a common condition that can impact your daily life. By understanding the causes, symptoms, and treatment options, you can take steps to manage your symptoms and reduce your risk of falls and injuries. At Metropolis Healthcare, our team of experts is dedicated to providing accurate diagnostic testing and personalised care to help you prioritise your health. With a network of advanced labs across India and convenient at-home sample collection services, we make managing conditions like orthostatic hypotension easier. Take control of your well-being today by booking a health check-up or exploring our comprehensive range of pathology tests.

What is oligomenorrhea? Oligomenorrhea is a menstrual disorder characterised by infrequent menstrual periods, with cycles occurring at intervals greater than 35 days. Women with oligomenorrhea typically have fewer than nine periods in a year. It is important to note that this condition is different from amenorrhea, which is the complete absence of menstrual periods. Oligomenorrhea is a common concern among women of reproductive age. While an occasional irregular cycle is usually not a cause for alarm, consistently having fewer than nine periods in a year can indicate an underlying health issue. What is the difference between oligomenorrhea and amenorrhea? Although oligomenorrhea and amenorrhea are both menstrual disorders, they differ in their presentation. Oligomenorrhea refers to infrequent periods, while amenorrhea is the complete absence of menstruation. Primary amenorrhea is when a girl has not started her periods by age 15, while secondary amenorrhea is when a woman who has previously had regular periods misses three or more cycles in a row. How common is oligomenorrhea? Oligomenorrhea affects a significant portion of women, particularly adolescents and those approaching menopause. Studies have shown that up to 11.7% of girls aged 15-18 experience infrequent periods. Additionally, certain medical conditions and lifestyle factors can increase the likelihood of developing oligomenorrhea. What are the symptoms of oligomenorrhea? The primary symptom of oligomenorrhea is having menstrual cycles that consistently last longer than 35 days or experiencing fewer than 9 periods in a year. Some other oligomenorrhea symptoms include: Light or short periods Symptoms of estrogen deficiency, such as: Loss of libido Breast atrophy Vaginal dryness Hot flashes If you notice any of these oligomenorrhea symptoms, it's important to consult with a healthcare provider to determine the underlying cause and appropriate treatment. What Causes Oligomenorrhea? Oligomenorrhea refers to infrequent or irregular menstrual cycles, typically with intervals longer than 35 days. Its causes are diverse, spanning hormonal imbalances, lifestyle factors, medical conditions, and genetic disorders. Hormonal Imbalances Polycystic Ovary Syndrome (PCOS): One of the leading oligomenorrhea causes, PCOS is associated with elevated androgen levels and insulin resistance, disrupting ovulation and menstrual regularity. Women with PCOS often experience other symptoms, such as acne, weight gain, and excessive hair growth. Hyperprolactinemia: Excess production of prolactin, often due to a pituitary tumor (prolactinoma) or certain medications, interferes with normal ovulation and can result in irregular or absent menstruation. Thyroid Disorders Hyperthyroidism: An overactive thyroid can accelerate metabolism, leading to hormonal imbalances that disrupt menstrual cycles. Hypothyroidism: Conversely, an underactive thyroid slows metabolism and can also impact the hypothalamic-pituitary-ovarian axis, causing infrequent periods. Physical Activity Intense Exercise: Excessive physical training, particularly in endurance sports or weight-sensitive activities like ballet or gymnastics, can suppress reproductive hormone production. This condition, known as hypothalamic amenorrhea, often results in oligomenorrhea. Eating Disorders Anorexia Nervosa and Bulimia Nervosa: Severe caloric restriction and nutrient deficiencies disrupt the hypothalamic-pituitary axis, reducing the production of gonadotropins and leading to irregular or absent menstrual cycles. Medications Certain drugs, such as antipsychotics, anti-epileptics, and glucocorticoids, may inhibit gonadotropin-releasing hormones, causing irregular menstrual cycles. Chronic Conditions Uncontrolled Diabetes and Chronic Illnesses: Chronic health problems can create metabolic and hormonal disruptions, contributing to oligomenorrhea. Perimenopause During the perimenopausal stage, fluctuating estrogen levels often result in irregular cycles before menstruation ceases entirely. Breastfeeding Elevated prolactin levels during breastfeeding can delay ovulation, leading to irregular menstrual cycles, including oligomenorrhea. Genetic and Congenital Conditions Turner Syndrome, Kallmann Syndrome, and Prader-Willi Syndrome are genetic disorders that impair normal reproductive function, resulting in infrequent or absent periods. Given the wide range of causes, diagnosing oligomenorrhea requires a detailed evaluation, including medical history, physical examination, and laboratory testing, to determine the underlying condition and guide appropriate treatment. How is oligomenorrhea diagnosed? Oligomenorrhea, characterised by infrequent or irregular menstrual cycles, requires a comprehensive diagnostic approach to determine its underlying cause. Healthcare professionals use a combination of medical history, physical examinations, and advanced imaging techniques to identify the root of the issue. Medical History The diagnostic process begins with a detailed medical history. This includes questions about the patient’s menstrual patterns, age of menarche, and any recent changes in cycle regularity. Physicians may ask about symptoms such as weight changes, acne, excessive hair growth, fatigue, or hot flashes, which could indicate hormonal imbalances or conditions like polycystic ovary syndrome (PCOS) or perimenopause. Lifestyle factors, including exercise habits, stress levels, and diet, are also reviewed. Additionally, a history of medication use, chronic illnesses, or family history of menstrual irregularities is crucial in narrowing down potential causes. Exams A thorough physical exam follows, focusing on signs that could point to specific conditions. For instance: BMI and Weight: To check for underweight or obesity, both of which can impact menstrual cycles Skin and Hair Examination: For signs of androgen excess, such as acne or hirsutism, often associated with PCOS Thyroid and Breast Exam: To assess for thyroid enlargement or galactorrhea (milky breast discharge), which may indicate hyperthyroidism or hyperprolactinemia. The pelvic exam evaluates the reproductive organs for any abnormalities such as masses or tenderness, which may suggest conditions like ovarian cysts or pelvic inflammatory disease. Imaging If necessary, imaging studies are performed to confirm the diagnosis: Ultrasound: A transvaginal or abdominal ultrasound evaluates the ovaries and uterus for structural abnormalities, such as ovarian cysts, fibroids, or uterine anomalies. MRI or CT Scans: In rare cases, advanced imaging helps detect pituitary tumors or other underlying structural issues. Laboratory tests often complement the diagnostic process, including hormone levels (FSH, LH, prolactin, and thyroid hormones), glucose, and insulin to identify underlying imbalances. Accurate diagnosis of oligomenorrhea is critical for effective treatment, ensuring the patient regains regular menstrual cycles and overall health. What tests will be done to diagnose oligomenorrhea? If you suspect you have oligomenorrhea, your doctor will perform a comprehensive evaluation to diagnose the condition and identify its underlying cause. This may include: Detailed questions about your menstrual cycle, including the interval between periods, duration of flow, and any recent changes in your cycle. A thorough physical exam to help identify signs of hormonal imbalances or other conditions Hormonal tests that measure levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, and testosterone An ultrasound or other imaging tests to examine your ovaries, uterus, and pituitary gland How is oligomenorrhea treated? Oligomenorrhea treatment depends on the underlying cause. Some common treatment options include: Hormonal therapy: Progestin or a combination of estrogen and progestin may be prescribed to regulate your menstrual cycle. Oral contraceptives can also help induce regular periods. Fertility treatment: If you're trying to conceive, certain medications can help stimulate ovulation and promote follicle maturation to support the process of ovulation. Addressing underlying conditions: If you have an underlying condition like polycystic ovary syndrome (PCOS) or a thyroid disorder, treating these issues can help regulate your menstrual cycle. Lifestyle changes: Adjusting your exercise routine, eating habits, and stress levels can help manage oligomenorrhea caused by factors like excessive exercise or eating disorders. How can we prevent oligomenorrhea? While not all cases of oligomenorrhea can be prevented, there are steps you can take to promote regular menstrual cycles. This includes maintaining a healthy lifestyle, managing stress, and scheduling regular check-ups. What can we expect if we have oligomenorrhea? Women with oligomenorrhea may experience: Irregular ovulation can make it harder to get pregnant. Low estrogen levels can cause symptoms like vaginal dryness, hot flashes, and reduced libido. Prolonged periods of infrequent menstruation can increase the risk of endometrial hyperplasia and cancer. Dealing with irregular periods can be stressful and may lead to anxiety or depression, especially if an underlying condition like an eating disorder is present. When to see a doctor? It's important to consult a healthcare provider if you experience: Menstrual cycles that are consistently more than 35 days apart Sudden changes in your menstrual cycle pattern Periods that are much lighter or heavier than usual Symptoms of underlying conditions like PCOS or thyroid disorders Difficulty getting pregnant Can oligomenorrhea cause infertility? Yes, oligomenorrhea can be associated with infertility. Infrequent or absent ovulation can make it more difficult to conceive. The underlying causes of oligomenorrhea, like PCOS or hormonal imbalances, can also impact fertility. If you're struggling to get pregnant and have irregular periods, it's important to discuss this with your doctor. Is PCOS the same as oligomenorrhea? No, polycystic ovary syndrome (PCOS) and oligomenorrhea are not the same, although irregular periods are a common symptom of PCOS. Women with PCOS may experience oligomenorrhea, but not all cases of infrequent periods are caused by PCOS. Other causes of oligomenorrhea include thyroid disorders, eating disorders, and excessive exercise. Conclusion If you're experiencing oligomenorrhea, it's essential to remember that you're not alone. Many women face menstrual irregularities at some point in their lives, and seeking medical guidance is a crucial step in understanding and managing your health. By working with a trusted healthcare provider, you can identify the underlying causes of your infrequent periods and explore oligomenorrhea treatment options that suit your individual needs. At Metropolis Healthcare, we understand the importance of accurate diagnostic testing in evaluating menstrual disorders like oligomenorrhea. Our team of skilled phlebotomists offers convenient at-home sample collection services, ensuring your comfort and privacy. With our state-of-the-art laboratories and commitment to delivering reliable results, you can trust Metropolis Healthcare to support you on your journey towards optimal menstrual health.

What is methemoglobinemia? Methemoglobinemia (metHb) is a blood disorder which is characterized by an elevated methemoglobin level. Methemoglobin is a form of haemoglobin in which the iron in the heme group is oxidised from the ferrous (Fe2+) to the ferric (Fe3+) state. This oxidation prevents the haemoglobin from effectively binding and releasing oxygen to the body's tissues. In normal circumstances, the body maintains methemoglobin levels below 1% of total haemoglobin. However, when these levels rise above 1%, it causes methemoglobinemia (metHb). The severity of the condition depends on the percentage of methemoglobin in the blood. How does this affect our body? Elevated methemoglobin levels in methemoglobinemia (metHb) significantly impact the body's ability to deliver oxygen to tissues. Here's how: Reduced oxygen-carrying capacity: Methemoglobin cannot bind and transport oxygen like normal haemoglobin, leading to a decrease in the blood's oxygen-carrying capacity. Impaired oxygen release: The presence of methemoglobin shifts the oxygen-dissociation curve is complex and can vary depending on the severity of the condition., making it harder for the remaining normal haemoglobin to release oxygen to the tissues. As a result, individuals with methemoglobinemia (metHb) may experience tissue hypoxia (oxygen deprivation) despite having normal or even high oxygen levels in their blood. Depending on the severity of the condition, this can lead to various symptoms and complications. What are methemoglobinemia symptoms? Methemoglobinemia symptoms can vary widely depending on the level of methemoglobin in the blood. Common signs and symptoms include: Cyanosis, a bluish discolouration of the skin, especially noticeable on the lips, fingernails, and toes Chocolate-brown coloured blood, which is an unusual finding Neurological symptoms such as headaches, dizziness, confusion, or disorientation Respiratory issues like shortness of breath and rapid heartbeat General fatigue and weakness that can worsen over time In severe cases, methemoglobinemia (metHb) can lead to seizures, loss of consciousness, or even death if left untreated. It’s also important to note that individuals with mild cases may not show any noticeable symptoms. If you notice any of these methemoglobinemia symptoms, seek medical attention promptly to ensure proper diagnosis and treatment. What are congenital methemoglobinemia symptoms? Congenital methemoglobinemia is an inherited form of the disorder that occurs due to genetic defects. Congenital methemoglobinemia symptoms can vary depending on the specific type: Type 1 (Erythrocyte Reductase Deficiency): Cyanosis (bluish discolouration of the skin) from birth or early infancy Generally asymptomatic, with individuals leading normal lives despite the persistent cyanosis Type 2 (Generalised Reductase Deficiency): Cyanosis Developmental delay Failure to thrive Intellectual disability Seizures Hemoglobin M Disease: Cyanosis Generally asymptomatic, despite elevated methemoglobin levels (15-30%) Individuals with congenital methemoglobinemia may require lifelong monitoring and management to prevent complications and ensure optimal health outcomes. What causes methemoglobinemia? Methemoglobinemia causes can be broadly classified into two categories: acquired and congenital (inherited). Acquired methemoglobinemia causes Acquired methemoglobinemia is more common and results from exposure to various substances that oxidise haemoglobin, such as: Medications: Topical anaesthetics Medications used for treating dermatological conditions and certain infections Antimalarial drugs Certain antibiotics Chemical exposures: Nitrites and nitrates (found in well water, meat preservatives, and some vegetables) Aniline dyes Naphthalene (found in mothballs) Ingestion of high-nitrate foods: Consuming large amounts of vegetables high in nitrates, such as spinach, beets, and carrots, can lead to acquired methemoglobinemia (metHb), particularly in infants. Congenital (inherited) methemoglobinemia causes Congenital methemoglobinemia is caused by genetic defects that affect the body's ability to reduce methemoglobin back to normal haemoglobin. The two main types of congenital methemoglobinemia are: Cytochrome b5 reductase (CYB5R) deficiency: Type 1: Affects only red blood cells, causing cyanosis without other significant symptoms Type 2: Affects all cells, leading to more severe symptoms, such as developmental delay and seizures Hemoglobin M disease: Caused by mutations in the globin genes, resulting in the formation of abnormal haemoglobin that is more prone to oxidation. Understanding the underlying methemoglobinemia causes is crucial for determining the appropriate treatment approach and preventing future episodes. How to diagnose methemoglobinemia? Diagnosing methemoglobinemia (metHB) requires a thorough clinical evaluation combined with laboratory investigations. The diagnostic process typically includes a detailed clinical assessment, blood tests to measure methemoglobin levels, as well as additional genetic or enzyme studies for suspected congenital methemoglobinemia cases. What tests are used to diagnose methemoglobinemia? The following tests are commonly used to diagnose methemoglobinemia (metHb): Arterial Blood Gas (ABG) Analysis: Measures the oxygen saturation and methemoglobin levels in the blood In methemoglobinemia, the oxygen saturation may appear normal or high, while the methemoglobin levels will be elevated ABG analysis may not provide accurate methemoglobin levels, as it relies on calculated values Co-oximetry: The gold standard for diagnosing methemoglobinemia (metHb) Directly measures the percentage of methemoglobin in the blood Provides accurate results, even in the presence of other abnormal haemoglobin variants Pulse Oximetry: A non-invasive test that measures oxygen saturation in the blood In methemoglobinemia (metHb), pulse oximetry may show a "saturation gap" between the oxygen saturation measured by pulse oximetry and the actual oxygen saturation measured by ABG or co-oximetry Pulse oximetry cannot directly measure methemoglobin levels and may not be reliable in detecting methemoglobinemia (metHb) Genetic Testing and Enzyme Activity Assays: Used to diagnose congenital forms of methemoglobinemia (metHb) Genetic testing can identify specific mutations in the genes responsible for the condition Enzyme activity assays measure the activity of the CYB5R enzyme, which is deficient in some forms of congenital methemoglobinemia (metHb) How to treat methemoglobinemia? Methemoglobinemia treatment depends on the severity and underlying cause of the condition. The primary treatment options include: Methylene blue: This is the first-line treatment for severe cases. It helps reduce methemoglobin levels, but it's contraindicated in people with G6PD deficiency. Oxygen therapy: While it may not be highly effective due to the impaired oxygen release, it's often used in combination with other treatments. Ascorbic acid: This can help reduce methemoglobin levels. Hyperbaric oxygen therapy: In severe cases, this may enhance oxygen delivery to tissues. Red blood cell transfusion or exchange transfusion: These may be necessary in severe cases to remove affected red blood cells. What are the treatment complications for methemoglobinemia? While methemoglobinemia treatment options are generally effective, there are some potential complications and considerations: Methylene blue side effects: It can be unsafe for patients with G6PD deficiency. Oxygen therapy limitations: It may not significantly improve oxygen levels due to the nature of the condition. Transfusion risks: As with any blood transfusion, there are risks of reactions and other complications. How can we reduce our risk of developing methemoglobinemia? To lower your risk of developing methemoglobinemia (metHb), consider the following: Avoid exposure to oxidizing agents: Be cautious with medications and chemicals known to cause the condition, such as benzocaine and dapsone. Monitor food intake: Limit consumption of foods high in nitrates or nitrites. Genetic counselling: For families with a history of congenital methemoglobinemia, genetic counselling can help identify and manage risks. What can we expect if I have methemoglobinemia? The prognosis for methemoglobinemia (metHb) depends on the type and severity of the condition: Congenital forms: Type 1 and Hemoglobin M disease often have a good prognosis with minimal symptoms. Type 2 is more severe and may cause developmental delays, intellectual disability, and seizures. Acquired forms: The prognosis is generally good with prompt treatment and removal of the causative agent. However, severe cases can lead to life-threatening complications if left untreated. How do we take care of ourselves? If you or a loved one has methemoglobinemia (metHb), it's crucial to: Follow your doctor's treatment plan and attend regular check-ups Avoid exposure to oxidizing agents and monitor your diet Learn to recognise the signs and symptoms of methemoglobinemia, such as cyanosis (bluish skin colour), chocolate-brown coloured blood, shortness of breath, fatigue, headache, and dizziness. Seek immediate medical attention if symptoms worsen or new symptoms develop. When to see a doctor? Consult a healthcare professional if you: Notice methemoglobinemia symptoms, especially after exposure to oxidizing agents Have a family history of the condition and plan to have children (genetic counselling) Experience side effects or complications from treatment Conclusion Methemoglobinemia (metHb) is an uncommon yet potentially serious blood disorder that impacts the body's ability to deliver oxygen. By understanding its causes, symptoms, and treatment options, you can take proactive steps to manage this condition effectively and minimize the risk of complications. If you suspect that you or someone close to you may have methemoglobinemia (metHb), it is crucial to seek advice from a healthcare professional for an accurate diagnosis and personalized methemoglobinemia treatment plan. At Metropolis Healthcare, we recognize the significance of early detection and effective management of blood disorders like methemoglobinemia. Our skilled phlebotomists offer convenient at-home sample collection, ensuring your blood samples are accurately processed in our advanced diagnostic labs. With a strong focus on delivering reliable results and personalized care, we enable you to prioritize your health and make informed decisions about your well-being.

What is Kernicterus? Kernicterus is a rare but serious neurological condition that occurs when dangerously high levels of bilirubin in the blood (hyperbilirubinemia) deposit in a baby's brain tissue. These deposits primarily affect areas like the basal ganglia and brainstem, leading to significant neurological damage. Also known as bilirubin encephalopathy (BE) or bilirubin-induced neurologic dysfunction (BIND), kernicterus causes could be attributed to severe, untreated cases of neonatal jaundice. Without prompt medical intervention, the condition can lead to permanent complications, including movement disorders, hearing loss, vision impairment, and developmental delays. Kernicterus is preventable through early recognition and treatment of jaundice in newborns, primarily using phototherapy or exchange transfusions to reduce bilirubin levels before they reach dangerous levels How Common is Kernicterus? Kernicterus is a rare condition, affecting approximately 1 in every 44,000 newborns in developed countries. This low incidence is due to the routine monitoring and treatment of newborn jaundice, which prevents it from progressing to kernicterus. What are the Symptoms of Kernicterus? Kernicterus symptoms in newborns often include extreme jaundice (yellowing of the skin and eyes), lethargy, and poor feeding. As the condition progresses, more severe signs can develop, such as high-pitched crying, unusual posturing (arching of the back), reduced muscle tone, and seizures. Long-term effects may include hearing loss, movement disorders, and intellectual disabilities. Recognising kernicterus symptoms early is crucial for prompt treatment to prevent permanent neurological damage. Kernicterus Stages Kernicterus symptoms develop in stages, starting with early signs like jaundice, lethargy, and feeding difficulties. Early Stage: Extreme jaundice, with yellowing of the skin, mucous membranes, and whites of the eyes Absent startle reflex (e.g., Moro reflex) Poor feeding or sucking Extreme sleepiness (lethargy) and low muscle tone (hypotonia) Middle Stage: High-pitched cry Irritability Arched back and heels (opisthotonus) Muscle spasms and reduced muscle tone Unusual eye movements Late Stage: Stupor or coma No appetite Seizures (epilepsy) Stiff, limp, or floppy muscles Strange eye movements Life-threatening complications such as respiratory distress and cardiac issues What Causes Kernicterus? Kernicterus causes include severe infant jaundice that is left untreated over time. Jaundice occurs due to high levels of bilirubin, a byproduct of red blood cell breakdown (hemolysis). In newborns, the liver may not be fully developed, making it less effective at removing bilirubin from the blood. If bilirubin levels become too high and are untreated, the bilirubin can cross the blood-brain barrier and deposit in brain tissue, leading to kernicterus. If jaundice is not managed promptly, the excess bilirubin can move out of the blood and collect in the brain, causing permanent damage. What are the Long-term Effects or Complications of Kernicterus? The long-term effects of kernicterus complications can be severe and include permanent brain damage, hearing loss, cerebral palsy, seizures and convulsions, and delayed or abnormal motor development. What are the Risk Factors for Kernicterus? Certain factors can increase a newborn's risk of developing kernicterus: Premature birth: Babies born prematurely are at higher risk due to less mature liver function. Rh hemolytic disease: Newborns with Rh hemolytic disease are at high risk for severe jaundice. Other hemolytic conditions that cause the breakdown of red blood cells (hemolysis) Family history of jaundice or kernicterus Inadequate breastfeeding leading to dehydration, which exacerbates jaundice. How is Kernicterus Diagnosed? Diagnosing kernicterus involves a combination of clinical evaluation and diagnostic tests to confirm elevated bilirubin levels. Kernicterus causes typically start with untreated severe jaundice, so healthcare providers closely assess symptoms such as extreme jaundice, abnormal posturing, high-pitched crying, and decreased reflexes. Transcutaneous Bilirubin (TcB) measurement is a non-invasive test often used as a preliminary screening tool. It detects bilirubin levels through the skin. If TcB levels are high, blood tests are conducted to measure serum bilirubin more accurately. Early diagnosis is critical because untreated kernicterus complications, such as permanent brain damage, hearing loss, and motor disabilities, can become irreversible. Imaging studies like MRI may also be recommended to assess bilirubin deposition in brain tissues. Kernicterus treatment relies heavily on early detection and intervention, such as phototherapy or exchange transfusions, to lower bilirubin levels and prevent progression to severe complications. What level of bilirubin causes kernicterus? Kernicterus develops when a newborn's bilirubin levels become extremely high, a condition called hyperbilirubinemia. Bilirubin is a yellow pigment that naturally forms during the breakdown of red blood cells. Normally, the liver filters bilirubin from the bloodstream. However, a newborn's still-developing liver may struggle to process excess bilirubin, leading to a buildup. Specifically, kernicterus becomes a risk when bilirubin reaches levels of: 25 mg/dL or higher: Considered very high, can lead to kernicterus 30 mg/dL or more: Associated with hazardous hyperbilirubinemia and higher kernicterus risk How is kernicterus treated? Prompt intervention is essential to manage kernicterus complications, reduce bilirubin levels, and prevent further brain damage. Kernicterus treatment typically includes: Phototherapy: Blue-light therapy is a common first-line treatment. It breaks down excess bilirubin in the skin, making it easier for the baby's body to process and eliminate. However, phototherapy alone may not suffice in severe cases. Exchange Transfusion: This emergency procedure rapidly reduces bilirubin levels by replacing some of the baby’s blood with donor blood. It is especially crucial in severe cases where bilirubin levels are dangerously high. Intravenous Fluids: Maintaining proper hydration supports the baby's liver and kidneys, enhancing bilirubin excretion. Feeding Support: Frequent feeding helps the baby excrete bilirubin through stool. If the baby is too weak to feed normally, tube feeding may be required. Early and aggressive treatment minimises the risk of permanent damage and improves outcomes for affected infants. How soon after treatment will our child feel better? The improvement in a child's condition after kernicterus treatment can vary depending on the severity of the hyperbilirubinemia and the stage at which treatment was initiated. If treatment is started early, before severe brain damage occurs, the baby may start to show improvement within a few days, such as reduced jaundice and improved alertness. However, if the condition has progressed to later stages, recovery may be slower and more complicated. In some cases, babies may start to show signs of improvement within 24 to 48 hours after the initiation of phototherapy or exchange transfusion, but the full extent of recovery and any long-term effects will depend on the severity of the brain damage incurred. Can kernicterus be prevented? Yes, kernicterus can be prevented by early detection and treatment of jaundice. Some key preventive measures include: Regular Monitoring: Healthcare providers should check babies for jaundice every 8-12 hours in the first 48 hours after birth, especially if there are risk factors for high bilirubin levels. Early Treatment: Initiating phototherapy or other treatments as soon as high bilirubin levels are detected can prevent kernicterus. Follow-Up Visits: Regular follow-up visits after discharge from the hospital are important to monitor bilirubin levels and ensure that jaundice is not worsening. What is the outlook for kernicterus? The outlook for kernicterus depends on the timing and effectiveness of the treatment. Early diagnosis and prompt treatment can lead to a full recovery without long-term complications for many babies. However, if kernicterus is not diagnosed and treated promptly, it can result in severe and permanent brain damage. Babies who receive treatment while the condition is in the early or middle stage may have a better prognosis, while those with late-stage kernicterus may face life-threatening complications, including hearing loss, cerebral palsy, and neuro-developmental retardation. Can a baby recover from kernicterus? Recovery from kernicterus is possible if the condition is diagnosed and treated early. Early intervention, such as phototherapy and exchange transfusions, can help reduce bilirubin levels and prevent further brain damage. However, if significant brain damage has occurred before treatment, the recovery may be incomplete, and the child may experience long-term complications such as cerebral palsy, hearing loss, and developmental delays. When to see a doctor? Parents should seek immediate medical attention if they notice any of the following kernicterus symptoms in their newborn: Yellowing of the skin and whites of the eyes Poor feeding Lethargy or extreme sleepiness High-pitched cry No startle reflex Brief pauses in breathing (apnoea) Muscles becoming unusually floppy Early detection and treatment are crucial in preventing kernicterus and minimising its impact. Conclusion While kernicterus is rare, parents must be aware of this serious complication of untreated newborn jaundice. By understanding the kernicterus symptoms, causes, and risk factors, you can take timely action to protect your baby's health. If you notice any signs of severe jaundice or kernicterus in your newborn, seek immediate medical attention. At Metropolis Healthcare, we understand the importance of early diagnosis in preventing complications like kernicterus. Our team of qualified blood collection technicians can make at-home visits for blood samples, which are processed at our advanced diagnostic labs. Test reports are conveniently shared online, empowering you to prioritise your baby's health.