Fetal Monitors

tlsos asked:


1 Introduction

Multiple pregnancy poses particular problems for women, their infants, and for their caregivers. Women are likely to experience the common, unpleasant symptoms of pregnancy, such as heartburn, backache, hemorrhoids, difficulty walking, and tiredness to a greater degree than women with a singleton pregnancy. They are more likely to suffer from anemia, hypertension, pre-eclampsia, preterm labor, and operative delivery. The increased risks to the babies include congenital malformations, monochorionicity (both babies sharing one placenta), poor fetal growth, preterm birth, and perinatal death. For the survivors, in the long term there is a greater risk of cerebral palsy.

2 Prenatal care

A wide range of options for regular antenatal attendance are practised, ranging from modified shared care between obstetrician and general practitioner to weekly visits from the 20th week of gestation onwards. There is no evidence to suggest that one pattern of prenatal care is better than another, because this important research question has never been properly addressed. Regular prenatal visits permit screening for hypertension and pre-eclampsia by careful determination of blood pressure, and, if elevated, checking for proteinuria. Care for women with a multiple pregnancy who develop hypertension may be particularly important, and should follow current treatment recommendations.

2.1 Advice and support

Women with a multiple pregnancy need advice and support from caregivers to help them deal with the particular problems of multiple pregnancy and with the common, unpleasant symptoms of pregnancy, such as hemorrhoids, heartburn, and backache (see Chapter 13). They may be especially anxious about the pregnancy, the birth, and their ability to cope with the practical and financial demands of more than one new baby. Assisting women to find support, such as a special antenatal class for women with a multiple pregnancy or referring them to a multiple-birth support group, may help.

2.2 Nutrition

Fetal demands for iron and folate are increased in multiple pregnancy and anemia is reported more frequently than in singleton pregnancies. Routine iron and folate supplementation is often advised from the beginning of the second trimester, although this has not been shown to improve the clinical outcome of the pregnancy.

 

2.3 Ultrasound

If routine ultrasonography is not carried out, an ultrasound examination is indicated when multiple pregnancy is suspected. Routine early ultrasonography results in earlier detection of multiple pregnancies, the detection of mono-amniotic pregnancies (with greater risk), and the detection of some unsuspected congenital abnormalities. Earlier detection of multiple pregnancy has not been shown to improve fetal outcome.

The risk of neural tube defects, cardiac anomalies, and bowel atresias, have all been reported to be increased in twin pregnancies. Conjoined twins and twin reversed arterial perfusion sequence are rare anomalies that are found exclusively in multiple pregnancies. Early diagnosis of fetal anomaly enables appropriate counseling as to the care options available.

The prediction of amnionicity (number of amniotic sacs) and chorionicity (separate or joined placentas) by first-trimester ultrasound is possible, though its accuracy and the relevance to pregnancy outcome remains to be determined. In theory at least, knowledge of amnionicity and chorionicity may be helpful in a number of ways, such as in the differentiation of twin-to-twin transfusion syndrome from a twin pregnancy complicated by intra-uterine growth restriction, in management after a single fetal death, or where one of the twins has a major congenital malformation and selective termination is considered.

If twin-to-twin transfusion syndrome develops, several therapeutic options have been advocated. These include: non-steroidal anti-inflammatory drugs, repeated therapeutic amniocenteses, and techniques that interrupt the pathological placental circulation. The results of controlled trials of these therapies are awaited, although there has been minimal evidence to date that any of these improve infant outcome.

Poor fetal growth of one or more babies is a risk in a multiple pregnancy. No adequately controlled data are available on the value of regular ultrasound or umbilical artery Doppler for assessing fetal growth and well-being in multiple pregnancy.

3 Preterm birth

Preterm birth presents the greatest threat to infant survival. Counseling as to the signs and symptoms of preterm labor with advice to present to the hospital if they occur, together with a written information sheet, may be of value, although this approach has not been subjected to a controlled evaluation.

Prediction of preterm birth is difficult. Cervical assessment by digital examination or by ultrasonography has been reported to provide useful prediction of the risk of preterm birth.

 How frequent these assessments should be made is uncertain, and whether they are more beneficial than harmful is unknown.

Cervical fibronectin may prove to be useful in predicting which women will give birth preterm, although the main strength lies in its negative predictive value. Whether the measurement of fibronectin will be useful clinically to improve pregnancy outcome remains to be established by controlled trials.

Several prenatal treatments have been used in attempts to reduce the risk of preterm birth and its sequelae in women with multiple pregnancy. These include cervical cerclage, beta-mimetic agents, home uterine-activity monitoring, and hospitalization for bed rest. All have been evaluated by controlled trials but, to date, none have proven to be of value in reducing the risk of preterm birth.

3.1 Cervical cerclage

In normal pregnancy, the uterine cervix is thought to assume a sphincter-like function to retain the contents of the uterus. A congenital or traumatically-acquired weakness of the cervix, or the unusual physiological circumstance of multiple pregnancy, are factors that may render the cervix incapable of performing this function as efficiently as usual.

The data available from controlled trials of cervical cerclage in twin pregnancy are too few to be clinically useful. They are compatible with both a large beneficial effect and with a large adverse effect of the operation. Cervical cerclage does affect other aspects of clinical care and carries some specific risks. It should not be adopted specifically for twin pregnancy outside the context of further controlled trials of sufficient size and quality.

3.2 Prophylactic betamimetic agents

Trials have been conducted with a number of oral betamimetic agents, including isoxuprine, ritodrine, salbutamol, and terbutaline, in various doses, for the prevention of preterm labor in women with multiple pregnancy. In spite of the diversity of agents and the varying doses used, the results are consistent. No beneficial effect of prophylactic betamimetic administration has been detected on preterm birth, low birthweight, or perinatal mortality. Although prophylactic betamimetic agents have not succeeded in postponing delivery or in improving fetal growth, the four trials that provide information on the incidence of respiratory distress syndrome suggest that the frequency of this adverse outcome may be significantly reduced. No such effect has been found with prophylactic betamimetics in singleton pregnancies, and it might be a chance finding.

In the light of the theoretical dangers of chronic fetal exposure to betamimetic agents, prophylactic administration of these drugs should only be considered in the context of well-controlled clinical trials.

3.3 Home uterine-activity monitoring

Trials of home uterine-activity monitoring in multiple pregnancy have been small, and not enough detail is available to evaluate the potential sources of bias. There are suggestions that babies born to mothers using home uterine-activity monitoring for twin pregnancy may be less likely to weigh less than 1500 g, or to be admitted to a special care nursery. Because of the high potential for bias, these data must be viewed with caution. Home uterine-activity monitoring, if adopted at all, should not be adopted outside the context of adequately controlled trials.

3.4 Hospitalization in multiple pregnancy

Prolonged bed rest in multiple pregnancy, with the aim of increasing the duration of gestation, improving fetal growth, and decreasing perinatal mortality, has been advocated for many years. The general considerations about the use of bed rest (see Chapter 14), apply equally strongly to its use in multiple pregnancy, as the practice is not innocuous.

Hospitalization and bed-rest in multiple pregnancy was introduced into clinical practice without adequate evaluation and the policy has still not been fully evaluated. Only recently have a few trials been conducted and further controlled evaluations are necessary to clarify the effects of this intervention. More information is available from twin than from higher multiple pregnancies.

There is some suggestion from these trials that routine hospitalization of women with twin pregnancies may result in a decreased risk of maternal hypertension, but a positive impact on more relevant outcomes has been negligible. Indeed the data suggest that routine hospitalization may have adverse effects. The risk of very preterm birth (less than 34 weeks gestation) and very low-birthweight babies was increased by routine hospitalization in these trials. No differences have been detected in the incidence of depressed Apgar score, admission to special care nurseries, or perinatal mortality.

Some obstetricians have suggested that hospitalization for bed rest in twin pregnancies should be applied only for women deemed to be at higher than average risk of preterm birth. Although this more conservative advice is possibly justified, there is remarkably little good evidence to support it. Only one such selective policy has been evaluated in a randomized trial. Comparison between the hospitalized and control groups of women with early cervical dilatation failed to show any benefits on the risk of preterm birth, perinatal mortality, fetal growth, or other neonatal outcomes. There is no basis for widespread adoption of the policy.

Only one trial of bed-rest in triplet pregnancies has been published. The results of this trial suggest that a number of adverse outcomes, including preterm birth, perinatal death, and low birthweight, can be reduced by routine hospitalization of women with a triplet pregnancy. The trial was small; the findings were compatible with chance; and further research is required.

4 Delivery

Virtually no data from controlled trials are available to help determine the choice between vaginal birth and cesarean section for women with multiple pregnancy. A single trial has assessed the effect of cesarean section for delivery when the second twin was in a non-vertex presentation. As would be expected, maternal febrile morbidity and need for general anesthesia was increased with cesarean section. No offsetting advantages in terms of decreased fetal or neonatal morbidity or mortality were found.

5 Conclusions

Additional support may be needed to help women with the emotional, practical, and financial demands of pregnancy and planning for more than one baby.

Routine early ultrasonography results in early diagnosis, detection of fetal abnormalities, and can determine amnionicity and chorionicity. Whether this improves the outcome for the mother or infant is unknown. Regular antenatal attendance permits screening for hypertension. Iron or folate supplementation may help to prevent anemia.

Prediction of preterm birth is difficult and the role of cervical assessment and clinical use of fibronectin remains to be evaluated by controlled trials. Therapies that aim to reduce the risk of preterm birth have not been shown to be effective.

There is currently no sound evidence to support the practice of routine bed-rest in hospital for women with a twin pregnancy; indeed the evidence suggests that this may be harmful. Whether or not such a policy would be justified in women at higher risk of preterm labor, such as those with triplet pregnancy or with early cervical dilatation, remains to be established.

The use of cervical cerclage, oral betamimetics, or home uterine-monitoring, for women with multiple pregnancy cannot be justified outside the context of adequately controlled trials. The indications for cesarean delivery with multiple pregnancy have not been established.



Theodore

Myhealthidea.com asked:


Pregnancy is the carrying of one or more embryos or fetuses by female mammals, including humans, inside their bodies. In a pregnancy, there can be multiple gestations (for example, in the case of twins, or triplets). Human pregnancy is the most studied of all mammalian pregnancies.

Human pregnancy lasts approximately 9 months between the time of the last menstrual cycle and childbirth (38 weeks from fertilisation). The medical term for a pregnant woman is genetalian, just as the medical term for the potential baby is embryo (early weeks) and then fetus (until birth). A woman who is pregnant for the first time is known as a primigravida or gravida 1: a woman who has never been pregnant is known as a gravida 0; similarly, the terms para 0, para 1 and so on are used for the number of times a woman has given birth.

Medical and legal definitions

In many societies’ medical and legal definitions, human pregnancy is somewhat arbitrarily divided into three trimester periods, as a means to simplify reference to the different stages of fetal development The first trimester period carries the highest risk of miscarriage (natural death of embryo or fetus). During the second trimester the development of the fetus can start to be monitored and diagnosed. The third trimester marks the beginning of viability, which means the fetus might survive if an early birth occurs.

Everyone expects pregnancy to bring an expanding waistline. But many women are surprised by the other body changes that pop-up. Get the low-down on stretch marks, weight gain, heartburn and other “joys” of pregnancy.

Pregnancy Planning Step by Step Guide

Pregnancy is the carrying of one or more embryos or fetuses by female mammals, including humans, inside their bodies. In a pregnancy, there can be multiple gestations (for example, in the case of twins, or triplets). Human pregnancy is the most studied of all mammalian pregnancies.

Human pregnancy lasts approximately 9 months between the time of the last menstrual cycle and childbirth (38 weeks from fertilisation). The medical term for a pregnant woman is genetalian, just as the medical term for the potential baby is embryo (early weeks) and then fetus (until birth). A woman who is pregnant for the first time is known as a primigravida or gravida 1: a woman who has never been pregnant is known as a gravida 0; similarly, the terms para 0, para 1 and so on are used for the number of times a woman has given birth.

In many societies’ medical and legal definitions, human pregnancy is somewhat arbitrarily divided into three trimester periods, as a means to simplify reference to the different stages of fetal development. The first trimester period carries the highest risk of miscarriage (natural death of embryo or fetus). During the second trimester the development of the fetus can start to be monitored and diagnosed. The third trimester marks the beginning of viability, which means the fetus might survive if an early birth occurs.

Pregnancy planning

If you are planning to become pregnant, taking certain steps can help reduce risks to both you and your baby. Proper health before deciding to become pregnant is almost as important as maintaining a healthy body during pregnancy.

The first few weeks in utero are crucial in fetus development. However, many women do not realize they are pregnant until several weeks after conception. Planning ahead, and taking care of yourself before becoming pregnant, is the best thing you can do for you and your baby.

One of the most important steps in helping you prepare for a healthy pregnancy is a pre-pregnancy examination (often called preconception care) performed by your physician before you become pregnant.

A preconception visit includes assessments of a woman’s overall health and identification of potential risk factors that may complicate pregnancy. Women can receive advice and treatment for medical conditions suh as diabetes or heart disease that may be changed by pregnancy. By preparing in advance, you can be your healthiest before becoming pregnant.

A preconception examination may include any/all of the following:

Family medical history

an assessment of the maternal and paternal medical history, to determine if any family member has had any medical conditions such as high blood pressure, diabetes, and/or mental retardation.

Genetic testing

an assessment of any possible genetic disorders, as several genetic disorders may be inherited, such as sickle cell anemia (a serious blood disorder that primarily occurs in African-Americans) or Tay-Sachs disease (a nerve breakdown disorder marked by progressive mental and physical retardation that primarily occurs in individuals of Eastern European Jewish origin). Some genetic disorders can be detected by blood tests before pregnancy.

Personal medical history

an assessment of the woman’s personal medical history to determine if there are any medical conditions that may require special care during pregnancy, such as epilepsy, diabetes, high blood pressure, anemia, and/or allergies; previous surgeries; past pregnancies, including the number, length of pregnancy (gestation), previous pregnancy complications, and pregnancy losses. http://www.myhealthidea.com

Vaccination status

an assessment of current vaccinations/inoculations to assess a woman’s immunity to rubella (German measles), in particular, since contracting this disease during pregnancy can cause miscarriage or birth defects. If a woman is not immune, a vaccine may be given at least three months before conception to provide immunity.

Infection screening

To determine if a woman has a sexually transmitted infection, urinary tract infection, or other infection that could be harmful to the fetus and to the mother. http://www.myhealthidea.com



Sandra

Dylan Morris asked:


Since genital herpes is a life-long, incurable condition, it is an issue that definitely needs to be discussed when a woman is considering giving birth. While genital herpes is not typically harmful to adults, when a woman is thinking about becoming pregnant or if she is already pregnant, she and her partner must discuss the possible implications a genital herpes diagnosis may have on an infant.

 

It is common for genital herpes-infected mothers to give birth without passing the virus on to their infant, even with normal vaginal delivery. In fact, according to the American Social Health Association, less than 0.1% of infants born in America each year contract genital herpes during delivery.

 

A woman who contracts herpes before pregnancy passes herpes antibodies that her body has produced on to her fetus, which protects it from contracting the virus.

 

Infants are more at risk of contracting the virus during later stages of pregnancy, particularly the last trimester, because the mother’s body does not have time to produce antibodies to pass to the fetus.

 

If genital herpes is contracted during the latter part of pregnancy, or if the mother has long-standing genital herpes or symptoms during the time of labor, it is a good idea to opt for a cesarean section delivery versus a vaginal one.

 

There are only two situations where the fetus is at risk of contracting genital herpes:

 

* During the first trimester, a severe initial outbreak occurs that can result in a miscarriage. This is very rare and can also occur as a result other virus infections.

* During the last trimester, a severe initial outbreak occurs. This is risky because a large amount of virus is present with little time for the mother to develop protective antibodies. Neonatal herpes can be fatal but is rare in developed countries. Careful monitoring and use of treatment and/or choosing to get a C-section can decrease likelihood of neonatal herpes.

 

If an expectant mother or her sexual partner has genital herpes, it’s important to tell the doctor so that s/he will take the proper precautions.

 

If the mother is not infected, but the partner is, take these precautions during pregnancy:

 

* Use latex condoms if you engage in sexual intercourse throughout pregnancy

* To reduce genital herpes recurrences, the male should take oral antiviral drugs throughout the pregnancy

* Avoid oral sex during pregnancy if the male has facial herpes.

* Get regular checkups and discuss the prospect of a C-section.

 

If the expectant mother HAS genital herpes, the chances of passing the virus to the unborn child are again, slim, due to the presence of antibodies in the body that will be passed to the child. However, here are some tips to reduce the risk even more:

 

 

* Be certain that your physician, obstetrician or midwife is aware of your genital herpes diagnosis.

* During labor, examine yourself for any genital symptoms - sores, itching, tingling or tenderness.

* Early in the pregnancy discuss the options for controlling an active herpes outbreak at the time of delivery. The choices are to carry on with a vaginal delivery or to have a Cesarean section.

* Request that your physician does not manually break the water around the infant unless necessary. The bag may help prevent any virus in the birth canal from being contracted.

* Request that your physician does not use a fetal scalp monitor during labor to monitor the baby’s heart rate unless medically required. This instrument makes tiny punctures in the baby’s scalp, which may allow the virus to enter. Often, an external monitor can be substituted.

* Request that doctors do not use forceps during delivery. They may cause breaks in the baby’s scalp, which may allow the virus to enter.

* After delivery, closely monitor the infant for about 4 weeks for symptoms of neonatal herpes: blisters, fever, fatigue, irritability, or lack of appetite. If any of these are noticed, take the infant to a doctor immediately.

 

If these and other pregnancy guidelines are followed, the infant is likely to contract the virus. To decrease chances of outbreaks during pregnancy, it is advisable to take some form of treatment. Many people opt for natural treatments that have been proven to decrease duration, frequency and severity of herpes outbreaks. Some natural compounds have even been found to significantly reduce the chance of passing herpes to infants.



Christopher

Cookie asked:


I’m pregnant and would like to purchase one. Is it safe to get a fetal heart monitor and use it at home? I saw one and I wanted to buy it but the nurse at the clinic said they might not be safe for the baby? Anyone has one and used it? what do you think?

Francisco

Gagan asked:


There is a government body called Delhi Pollution control committee existing in Delhi called DPCC basically established for controlling pollution in this national capital region (DELHI). I being an environment friendly citizen applied for a unit in prime industrial area of New Delhi only after installing and successfully running the required systems for controlling pollution and treatment of Water.

Inspite of giving all possible proofs to the department they made our consent application a big issue and keep on demanding huge amount of money from us which due to no other option we keet on giving them the amount whenever demanded from them. Since I had refused them bribe when they had their first visit after the application, they were exploiting us all the time. In the mean time they were providing consents to the people which were not having systems for controlling pollution installed at their polluting units at a nominal bribe of 12000 This procedure of providing consent to operate polluting manufacturing units after getting bribe and not installing pollution control measures is till today\’s date ie.27-06-2008 is kept on followed. I complained this matter to CVC (Central Vigilance Commission ) and CBI but of no use.

The member secretary Mrs. Naini Jayaseelan whose office is in secretariat building was continuously abusing me with words I have never heard. She even was torturing me of what kind of science graduation I have attained in front of excise commissioner and then deputy commissioner of DPCC Mrs. Debashree Mukherjee. She was agreeing sometimes and abusing me and my family other time.

1)I had applied for a consent only when I had successfully treated water continuously for two years in Gagan Enterprises.

2)At the time of installation of the treatment plant , DPCC was not playing any active role in Delhi.

3)When I submitted my application form they tried to grammatically figure out mistakes in that because at that time also they were receiving bribes from polluting units.

4)Even now there is no need to give you any media briefs for the kind and level of pollution in River Yamuna.

5)There are unlimited number of manufacturing units draining immense amount of UNTREATED water in Yamuna existing in Delhi.

6)Delhi face the threat of becoming a desert in the near future.

7)Ground water is being contaminated by toxic elements released by industrial untreated discharge. The disposal of industrial effluents into the Yamuna flood plain and water channels around Delhi, seepage through sewage dumps, agricultural waste, percolation of liquid wastes and general bad hygiene habits and poor sanitation provisions has led to this pollution.

8)Two decades ago Yamuna was a river, but what remains of it now is a sluggish flow laden with plastic, solid waste, untreated industrial water and corpses.

9)Japan Bank for International Co-operation extended a soft loan of Rs.700 crore for treating Yamuna. But due to collection of bribes by the DPCC officials proprietors of industrial units are allowed to flush untreated water into sewer.

10)The biochemical oxygen demand(BOD),dissolved oxygen(DO) and colon bacillus colonies-three main parameters to gauge water quality-have worsened due to increasing corruption.

11)The courts are only concerned about removing encroachments and unauthorized colonies who discharge organic wastes.

The untreated inorganic industrial effluents obviously make way into the river even if discharged by automatic machines or labours working in factories because industries are sources of huge bribe collection which fill pockets of Naini Jayaseelan also. This criteria is not dependent on the place of residence of workers.

12)There is widespread pollution of Delhi\’s underground water system due to excessive seepage of toxic chemicals like arsenic, mercury and fluorides. This is not surprising when 19 industrial drains empty into the Yamuna flood plain alone.

13)The pollutants that have affected the environment due to this uncontrolled seepage are nitrates, potassium, phosphates and heavy metals like cadmium, chromium, copper, iron, nickel, lead and zinc.

14)People can be exposed to chromium through breathing, eating or drinking and through skin contact with chromium or chromium compounds. The level of chromium in air and water is generally low. In drinking water the level of chromium is usually low as well, but contaminated well water may contain the dangerous chromium(IV); hexavalent chromium.

For most people eating food that contains chromium(III) is the main route of chromium uptake, as chromium(III) occurs naturally in many vegetables, fruits, meats, yeasts and grains. Various ways of food preparation and storage may alter the chromium contents of food. When food in stores in steel tanks or cans chromium concentrations may rise. Chromium(III) is an essential nutrient for humans and shortages may cause heart conditions, disruptions of metabolisms and diabetes. But the uptake of too much chromium(III) can cause health effects as well, for instance skin rashes. Chromium(VI) is a danger to human health, mainly for people who work in the steel and textile industry. People who smoke tobacco also have a higher chance of exposure to chromium. Chromium(VI) is known to cause various health effects. When it is a compound in leather products, it can cause allergic reactions, such as skin rash. After breathing it in chromium(VI) can cause nose irritations and nosebleeds.

Other health problems that are caused by chromium(VI) are: Skin rashes Upset stomachs and ulcers Respiratory problems Weakened immune systems Kidney and liver damage Alteration of genetic material Lung cancer Death The health hazards associated with exposure to chromium are dependent on its oxidation state. The metal form (chromium as it exists in this product) is of low toxicity. The hexavalent form is toxic. Adverse effects of the hexavalent form on the skin may include ulcerations, dermatitis, and allergic skin reactions. Inhalation of hexavalent chromium compounds can result in ulceration and perforation of the mucous membranes of the nasal septum, irritation of the pharynx and larynx, asthmatic bronchitis, bronchospasms and Respiratory symptoms may include coughing and wheezing, shortness of breath, and nasal itch.

15)Nickel is not known to cause any health problems when people are exposed to it at levels above the MCL for relatively short periods of time. Nickel has the potential to cause the following effects from a lifetime exposure at levels above the MCL: decreased body weight; heart and liver damage; skin irritation.

16)Exposure occurs from lead\’s presence in air, food, water, soil, dustfall, paint, and other materials. Lead is readily absorbed by the body via the primary routes of entry, inhalation and ingestion. Studies indicate that 10% to 20% of inhaled lead enters the blood stream. In children, approximately 50% of ingested lead is absorbed as compared to 8% to 10% for adults. This is especially significant since much of children\’s lead exposure is caused by their normal habits of mouthing dirty hands, objects and materials.

(A growing body of research suggests there may be no safe level of lead ingestion.) Within the body, lead is found in circulating red blood cells, soft tissues(liver and kidney), and bone (where lead is accumulated). Blood lead concentrations are the most reliable indicator of recent lead exposure. Known health effects of lead poisoning include: Anemia. Brain and nervous system damage, which can include permanent mental and motor retardation and in extreme cases, death. Severe kidney injury or failure. Injury to the gastrointestinal system and the heart.

Damage to the reproductive system, including: Ovarian and testicular dysfunction. Impaired fetal blood synthesis, premature births, and other delivery complications. Long-term, low level lead exposure causes learning deficits and behavioral problems in children. The major source to children is through contact with the dust or chips from old lead-containing paint. However, significant airborne exposure may occur near manufacturing facilities emitting large amounts of lead. At present, a child with blood lead levels over 10 micrograms per deciliter (µg/dl) is considered lead-poisoned. Exposure to air containing 1 µg/m3 of lead is associated with a 5 µg/dl increase in blood lead; thus, long-term exposure to air containing over 2 µg/m3 could cause a child to become lead-poisoned. Recent studies suggest that lead may be a factor in high blood pressure and subsequent heart disease in middle-aged white males. Effects on Plants and Animals At common low ambient concentrations lead does not usually pose a threat to plants and animals. However, exposure to high concentrations has adversely affected domestic animals, wildlife, and aquatic life. Areas near major emission sources are most susceptible. In past years, small animals trapped near highways showed high lead levels.

Water is polluted with zinc, due to the presence of large quantities of zinc in the wastewater of industrial plants. This wastewater is not purified satisfactory. One of the consequences is that rivers are depositing zinc-polluted sludge on their banks. Zinc may also increase the acidity of waters. Some fish can accumulate zinc in their bodies, when they live in zinc-contaminated waterways. When zinc enters the bodies of these fish it is able to bio magnify up the food chain. Large quantities of zinc can be found in soils. When the soils of farmland are polluted with zinc, animals will absorb concentrations that are damaging to their health. Water-soluble zinc that is located in soils can contaminate groundwater. Zinc cannot only be a threat to cattle, but also to plant species. Plants often have a zinc uptake that their systems cannot handle, due to the accumulation of zinc in soils. On zinc-rich soils only a limited number of plants has a chance of survival. That is why there is not much plant diversity near zinc-disposing factories. Due to the effects upon plants zinc is a serious threat to the productions of farmlands. Despite of this zinc-containing manures are still applied. Finally, zinc can interrupt the activity in soils, as it negatively influences the activity of microorganisms and earthworms. The breakdown of organic matter may seriously slow down because of this.

17) Around 1393 mld of sewerage finds its way into river Yamuna through 19 major drains. Out falling into the river carrying 218 mls which includes 48 mgd of industrial effluent.

BOD content of this water is 587 mld in all the 5 sewerage zones of Delhi. 64% of total BOD is from domestic sources. 10-15% of nutrients added to the soils through fertilizers eventually find their surface water system. The highest load occurs from the NCT Delhi (about 152 MT/day of BOD load) as compared to the loads of other cities which vary from 1 mt/day) as per Yamuna Action Plan. Everyday about 1880 mld of waste water is discharge into the river from Delhi through 18 drains. More than 95% waster water in Delhi is drained by 5 drains viz. Nazafgarh, Sen Nursing home, and power house drain.

18)The 48 km stretch of the Yamuna River in Delhi is heavily polluted by domestic and industrial wastewater.

19)Chemical contamination will lead to the spread of many lethal diseases like cancer in the near future.

20)There are 28 industrial areas in Delhi. Most of the small and tiny industries do not have individual facilities to treat liquid waste.

21)The alarming rise in chemical pollution last year too and consumption by humans is likely to cause a number of diseases. This process is never checked due to money and favour collection by Delhi Pollution Control Committe all the time they visit polluted industries. It is well-known that cadmium contamination causes anaemia, high blood pressure, liver trouble and hepatic and renal disorders. Nickel causes pneumonia, lung and nose cancer, headache nausea and vomiting. Lead may cause gastric problems, kidney diseases and nervous disorders. Zinc is toxic to plants.

22)The air pollution has increased in these years also.

23)Children have narrower airways than do adults. Thus, irritation or inflammation caused by air pollution that would produce only a slight response in an adult can result in a potentially significant obstruction of the airways in a young child. During exercise, children, like adults, breathe with both their nose and mouth rather than just their noses. When the nose is bypassed during the breathing process, the filtering effects of the nose are lost, therefore allowing more air pollution to be inhaled.

24)Sulfur dioxide not only has a bad odor, it can irritate the respiratory system. Exposure to high concentrations for short periods of time can constrict the bronchi and increase mucous flow, making breathing difficult. Children, the elderly, those with chronic lung disease, and asthmatics are especially susceptible to these effects. Sulfur dioxide can also: Immediately irritate the lung and throat at concentrations greater than 6 parts per million (ppm) in many people.

Impair the respiratory system\’s defenses against foreign particles and bacteria, when exposed to concentrations less than 6 ppm for longer time periods. Apparently enhance the harmful effects of ozone. (Combinations of the two gases at concentrations occasionally found in the ambient air appear to increase airway resistance to breathing.) Sulfur dioxide tends to have more toxic effects when acidic pollutants, liquid or solid aerosols, and particulates are also present. (In the 1950s and 1960s, thousands of excess deaths occurred in areas where SO2 concentrations exceeded 1 ppm for a few days and other pollutants were also high.) Effects are more pronounced among mouth breathers, e.g., people who are exercising or who have head colds. These effects include: Health problems, such as episodes of bronchitis requiring hospitalization associated with lower-level acid concentrations. Self-reported respiratory conditions, such as chronic cough and difficult breathing, associated with acid aerosol concentrations. (Asthmatic individuals are especially susceptible to these effects. The elderly and those with chronic respiratory conditions may also be affected at lower concentrations than the general population.) Increased respiratory tract infections, associated with longer term, lower-level exposures to SO2 and acid aerosols.

Subjective symptoms, such as headaches and nausea, in the absence of pathological abnormalities, due to long-term exposure. Effects on Plants Sulfur dioxide easily injures many plant species and varieties, both native and cultivated. Some of the most sensitive plants include various commercially valuable pines, legumes, red and black oaks, white ash, alfalfa and blackberry. The effects include: Visible injury to the most sensitive plants at exposures as low as 0.12 ppm for 8 hours.

Visible injury to many other plant types of intermediate sensitivity at exposures of 0.30 ppm for 8 hours. Positive benefits from low levels, in a very few species growing on sulfur deficient soils. Other Effects Increases in sulfur dioxide concentrations accelerate the corrosion of metals, probably through the formation of acids. (SO2 is a major precursor to acidic deposition.) Sulfur oxides may also damage stone and masonry, paint, various fibers, paper, leather, and electrical components. Increased SO2 also contributes to impaired visibility. Particulate sulfate, much of which is derived from sulfur dioxide emissions, is a major component of the complex total suspended particulate mixture.

25)Diesel cars in 2006 represent nearly 20% of new car registrations in Delhi, up from 4% in 1999. While gasoline cars have increased at 8.5% annually, diesel cars have maintained a growth rate of 16.6%. It is shocking to note that diesel cars during the same period have increased by 425 per cent.

The share of diesel cars, a mere 4 per cent of the total new car registration in 1999, has climbed to nearly 20 per cent in 2006. While petrol cars have increased at 8.5 per cent annually, diesel cars have maintained a growth rate of 16.6 per annum,\” the release added The cumulative effect is overwhelming the emissions benefits gained by the city\’s earlier phase-out of its 12,000 diesel buses. It is calculated that the 118,631 diesel cars on the city\’s roads are equivalent to adding particulate emissions from nearly 30,000 diesel buses. NOx levels are steadily rising.

26)Nine of every twenty residents suffer from lung, liver or genetic disorders due to highly-polluted air in the capital city of 16 million. It has been found that polluted air has also altered immunity and caused blood-related abnormalities among many of the victims. Permissible limits suitable for drinking water is as follows: (mg/l) Cu 0.05 Fe 0.1 NO3 45 F 1.0 Zn 0.05 SO4 200 Ca 75 Mg 30 Mn 200 Hg 0.01 Cd 0.005 As 0.05 Pb 0.01 Cr 0.05 Ni 0.02 Hardness 2mg/l pH 7-8.5 Delhi’s drinking water has the levels of manganese, copper, nickel, chromium, iron selenium, lead, arsenic, mercury and cadmium highly above the Indian Standards (IS) specification regulated for drinking water thereby more increasing pollution in Delhi.

27)There is serious problems with the extremely poor monitoring capacities of government agencies because they collect bribe and so give wrong data which is broadly indicative.

28)The way the government, the courts and Mrs. Naini Jayaseelan are proceeding, it is clear that the intention is not to fight pollution.

29) I had closed Gagan Enterprises in April 2004 itself.

30)DPCC and any environment groups in India only want media attention and no more devoted towards controlling pollution and not forcibly closing polluting units even today.

31)If I was right in controlling pollution then the reasons for my application were also righteous, this means I was tortured. If I was wrong in the decision for application, this means DPCC is not acting even today, because consents are being provided to polluting units in New Delhi after getting bribes, Then also Human Right Commission should pay at least some attention to my complaint and do whatever is suitable to the greatest authority in this earth, to become true to your lord.

32)There is a difference between long term remedies and short temporary measures for controlling pollution.

33)DPCC is not following any of the above procedures because they are able to gather bribe from polluting units which thereby flourish more and thus polluting more, I being surviving in the same system along with maintain huge expenses for pollution control devices also giving bribes.

34)The products manufactured in delhi are consumed in other states also.

35)The eligibility or intention of owner of any unit is the only criteria which is responsible for the methods that company employ in controlling pollution.

36)This factor is not dependent on geographic location of the polluting unit. Simply relocating industries means relocating pollution from the backyard of Delhi\’s elite to wherever human life can be found to be cheaper

37) My first claim is that inspite of relocating the polluting units, there should be ban on individuals to open any manufacturing unit whether polluting or not; in any area. If ohchr is ready to send me details of proofs required to show and prove my complaints i can send that through any medium and also through courier.

38)As I had already mentioned due to the torture faced by me when I was operating an industry in which all the pollution control measures were installed and successfully being used continuously for treatment and purification of water and air; for not giving bribe too often, I had to face more hassles and torture, I closed that unit in march 2004

39)Now i have opened an Electronic Goods showroom in September 2004

40)For no reason DDA officials visited this premises and told me that we are there to encourage youngsters and we don’t require small amount of bribe.

41)Since they don’t use the exact words to demand money and talk like demanding gifts which is much a common way of harassing and collecting bribe in Delhi, and also I was in no mood to give bribe because of fewer resources and also less daily expenditure money I can utilize at any moment of time.

42)They(A government organization) are again ready to exploit me and my family by demanding more and more money.

43)IF GOVERNMENT AGENCIES DON\’T HAVE ENOUGH LAWS TO PUNISH AND FINE ANYONE WORKING IN THIS CITY,THEY CANT DISCOURAGE AND HARASS THEM BY SENDING INAPPROPRIATE AND INCOMPLETE NOTICES THAT CANNOT BE IMPONDED ON THEM, JUST BECAUSE THEY NEED MORE BRIBE.

44)I am explaining below three more(3 i had already explained) of domestic remedies i have tried to exploit as advised by you. 1)Government of Delhi Grievance Cell Complaint No. CMO/PGC/2006/515174 2)Supreme Court Of India Reference No. 1056(Civil Appeal) dt.12-03-2006 3)Hard Copy submitted To Political secretary Of Mrs.Sonia Gandhi Mr.Motilal Vohra (Home Ministry Of India Office) 10 Race Course New Delhi-01 35)

45)I am sending you more proof to place my complaint but my demand is another reply in the form of e mail. I have just given one of the examples of domestic remedies which I had already exhausted before complaining to human rights commission Thus I am in no intention to repeat this kind of procedures of domestic remedies because they are of no use in the kind of society, system we are surviving in India.

The level of ethics and commitment is almost nil in all government employees of India. I am no longer able to continue to survive remembering that torture and humiliation. Gagan Deep Maggo Reference G/SO 215/1 human rights commission.



Alfred

☆Lindsey & Jackson☆ asked:


I saw a Fetal Dopler Monitor at Wal-Mart by Bebe Sounds for $19.95. I want to buy it, so I can hear the baby as often as I’d like. But, the problem is I’m only 18 weeks. (4 1/2 months). I was wondering if I’d be able to hear the baby with that monitor at this point or if I should wait. I want to buy it tomorrow, ha ha.

Luis

momie_2bee asked:


I am 13 weeks pregnant and want to reant a baby doppler to monitor the babys heartbeat. I have lost several babies and didn’t know until i went in with no heartbeat. My last baby at 20 weeks due to umbilical cord accident. To ease the worry of not having a heartbeat between doc visits he suggested a baby doppler, has anyone reanted on from the net before? What is the best one to use and did you have success with it. Thanks

David

sara asked:


Has any one ever used one and if so, how soon will I be able to hear the heart beat? I am 10 weeks preg. and havent heard anything yet but a bunch of growls… I go to the Dr on the 19th and he says I will hear the heartbeat then..

Norman