Episode 35: Pregnancy Complications - Placenta Previa & Falls

Dr. Sophia:
Hello everyone. Welcome to the Dr. Sophia ObGyn podcast. I'm an obgyn practicing for over 15 years in my native New York City, and I love to help women learn about their bodies, empower them, and embrace themselves. On this podcast, we talk openly and with heart about all things affecting women from pregnancy, menopause, periods, sexual health, fertility, and so much more. Disclaimer: This is general medical information based on my professional opinion and experience. For specific medical advice, please refer to your physician.

Hello everyone, and welcome to the Dr. Sophia ObGyn podcast. Today, you're in for a special treat of part two of pregnancy complications, covering placenta previa and falls. You can listen to part one of our pregnancy complication series on episode 34, where we talked about preeclampsia. As always, I am joined by my good friend and co-host Touseef Mirza.

Touseef Mirza:
Hi everyone. So, yeah, so we wanted to continue from the previous episode of pregnancy complications. So this time we're gonna be talking about placenta previa, which, honestly, when we started to talk about doing this podcast, I didn't even know what that meant. I don't think I've ever heard that expression before. So we're gonna learn a lot today about that. And we're also gonna be talking about falls that are related to pregnancy and what are the effects of that as well. So first, let's start with placenta previa.

Dr. Sophia:
Placenta previa is a problem with the, as the term itself, placenta and previa, meaning before, and in this case, before the presenting part, it's when there is an aspect of the, of the placenta that covers what we call the internal os or the part of the cervix that would, that opens in order to allow for the baby to be delivered so that the placenta is basically covering the cervix. And we always check for placenta, where is the placenta? Throughout pregnancy, the most common time to look for it is between 18 and 20 weeks.

Touseef Mirza:
And so, just to back up placenta, when we mean that the placenta, that's-

Dr. Sophia:
The feeding organ.

Touseef Mirza:
And that is all inside the womb? Like a sack?

Dr. Sophia:
It's not the sack.

Touseef Mirza:
It's not the sack?

Dr. Sophia:
It's not the sack. The placenta is more so the very needy organ. It's its own organ that attaches to the wall of the uterus in order to allow communication between the mom and the baby. This is how the baby gets fed and gets all its nutrients, et cetera, through the placenta. So that's the connection, the connector between mom and baby.

Touseef Mirza:
I have so many more questions now.

Dr. Sophia:
I can imagine.

Touseef Mirza:
But we have to do a podcast on the placenta.

Dr. Sophia:
But that connection between mom and baby, and then the placenta attaches to the wall of the uterus. Now, if the placenta, or if we consider, or what we call the placental edge, is overlying, or part of the placenta is overlying the opening of the cervix. This is when we say you have a placenta previa.

Touseef Mirza:
So the cervix is?

Dr. Sophia:
The lowest part of the uterus. That is the part of the uterus. It's the cervix. It's also its own organ. It's a part of, it's the connector from the vaginal opening to the uterus or the womb. And that is what both flattens and opens at delivery in order to allow for your baby to be born. So the cervix, it is actually what holds the pregnancy in. It stays closed, it's tight. It develops this quote- unquote mucus plug that helps to make sure that no infection or bacteria goes up. Amazing. I know so many things are going through your mind right now. So amazing how the body figured it all out. So the cervix stays closed and eventually opens. Now the placenta should not be covering the cervix because the placenta is very vascular, meaning. It has a lot of blood and blood vessels because like I said, it is the connection between the mom's womb, the uterus and the baby, the umbilical cord that then feeds the baby.

Touseef Mirza:
Right. I have to ask this question. So, as a non-pregnant woman, yes, you have a placenta.

Dr. Sophia:
We do not have a placenta.

Touseef Mirza:
We do not have a placenta, no. The placenta, it develops-?

Dr. Sophia:
Literally is the only organ that we develop only during pregnancy, but it's its own organ and it develops when one becomes pregnant.

Touseef Mirza:
So it just starts to grow?

Dr. Sophia:
It just starts to grow. Amazing. It's amazing. No, you can never have a placenta.

Touseef Mirza:
Okay. All right.

Dr. Sophia:
What can I tell you?

Touseef Mirza:
So you're saying that the placenta, what is its usual position then? Where does it usually lodge itself?

Dr. Sophia:
It can be in the backside of the uterus. Remember the uterus is, it's like this muscle that is in a U shape. And the placenta can be on the backside, the front side, the top of the uterus. So

Touseef Mirza:
It's like the connector between all of the nutrients and everything delivered to the baby?

Dr. Sophia:
That is correct. It's a conduit. And at the time of fertilization and then what we call implantation, that’s where the burrowing kind of, of this new life that's forming, that burrows itself kind of into the uterus, is where that's also going to be the site of where the placenta then can grow.

Touseef Mirza:
So you're saying that if it actually covers the cervix, that's when there's an issue?

Dr. Sophia:
When the placenta covers the cervix, that's when there's an issue because the cervix, unlike the rest of the uterus that is of a muscle and it's very vascular, and the placenta wants to attach to the uterus because it's gonna get all of these nutrients, the cervix is not as vascular, the cervix. It does not have the same muscle tissue as the uterus in order to allow for feeding the baby that's growing. And moreover, the cervix has an opening, and that opening can open when it's supposed to for labor. But if the placenta is over the cervix, and let's say labor starts, the woman starts having contractions, well, that placenta that's covering the cervix can start to bleed. That bleeding that's occurring is maternal bleeding. That bleeding is coming from the mom, and that bleeding that occurs is typically bleeding. That is what we call painless bleeding.

Touseef Mirza:
And why is it bleeding?

Dr. Sophia:
It can bleed for so many different reasons. It's a disruption in the placental bed or the, you know, where the placental attachment is, because the-

Touseef Mirza:
The placenta is full of blood?

Dr. Sophia:
The placenta is full of blood because that is an organ that is full of blood. And the reason it's full of blood is because that's where it gains all of the nutrients that it's then transporting to the baby.

Touseef Mirza:
So if the blood is coming out from that perspective, it's really, like you said, the blood of the mom, because it's her organ?

Dr. Sophia:
It's her organ, it's the blood of the mom that's coming out. And it can come out for so many different reasons, it can come out for no reason at all. It's just a disruption in the placental bed. So you can have bleeding, and that is bleeding that typically occurs, like I said, it's usually painless. After 20 weeks, the placenta and the concept of a placenta previa can be diagnosed anywhere from 18 to 22 weeks. When we usually do something called an anatomy scan or a specific scan looking at the placenta as well as all of the baby's parts, 10 fingers, 10 toes, nose, lips, heart, everything. But one specific thing is definitely to look at the placenta, also to look at something called your cervix, and to look at the relationship between the placenta and your cervix.

Now, if your placenta happens to be covering your cervix at that time, because your uterus as well as the placenta are both dynamic. They have to grow. Your baby's growing, your uterus is growing, and the placenta is growing with it. About 90% of the time, someone who has a placenta previa at 20 weeks, that placenta previa actually can resolve, meaning if, even if it was covering the opening of the cervix, we call it the edge of the placenta covering the cervix. That placental edge moves up along with the baby, the growing uterus. And it moves away from the cervix.

Touseef Mirza:
It's not stuck at a certain spot?

Dr. Sophia:
No, it doesn't have to be stuck, especially if we, it's something that we recognize early. And not to say that we recognize it as if we can do something about it. But more so, your own body does something about it.

Touseef Mirza:
It knows something is off.

Dr. Sophia:
So while the development and the growth of the baby is happening and your uterus is also growing, and that placenta is also kind of moving up towards the area of the uterus, that's more, you know, juicy, more blood flow, more so instead of growing over the cervix, it grows the other way. You know, it's crazy how in tune the body can be. So most of it resolves, but in those cases where it doesn't. It's called placenta previa. These are the women who we say they should have full pelvic rest, meaning they should not be having sex during their pregnancy because of the fact that we don't wanna disrupt or cause bleeding. Again, understanding that that bleeding that's happening is maternal bleeding. And as the pregnancy progresses, anytime after 24 weeks, a woman can start to experience something called Braxton Hicks contractions, which is where the uterus is basically kind of doing this practice for when the real day of having labor is going to occur. But those practice contractions can still disrupt the placenta and cause it to have a bleeding episode.

Touseef Mirza:
When does this usually happen? In the second trimester,

Dr. Sophia:
In the late second trimester, early third trimester, you can start to have what we call Braxton Hicks contractions. Okay. And then other things that can cause contractions, dehydration, can lead to contractions, sex can lead to contractions.

Touseef Mirza:
Stress?

Dr. Sophia:
Probably stress. It can also happen even without contractions. Let's be clear, actually, that bleeding happening with placenta previa can occur regardless for no reason at all. It's painless. Women don't even know that they're having these contractions if they have them, and they don't even feel anything, they just wake up in a pool of blood.

Touseef Mirza:
When you say pool, you mean more than when we have our periods, like more blood?

Dr. Sophia:
It definitely can be more than what we expect when we have our period. It can be a little spotting, it can be filling up a pad, it can be filling up three pads. It can be almost anything. But the first sign of bleeding in placenta previa, what's called our, you know, like the sentinel bleed or the one that happens the first time, can sometimes be the time that you are diagnosed. So somewhere as early as maybe 18 weeks to 20 weeks, or you can be diagnosed at 20 weeks. And then the first time a woman has a bleeding episode tends to be after 26 weeks.

Touseef Mirza:
And because we don't have a period when we're pregnant?

Dr. Sophia:
No, there's no period during pregnancy.

Touseef Mirza:
Therefore, if there is blood, then something is abnormal?

Dr. Sophia:
Yes. Something is going on. If you have a diagnosis of a placenta previa, then the bleeding needs to be something that is addressed. You need to come in and be seen, because again, this is where we talk about the balancing act between mom and baby. Because placenta previa is maternal blood loss, then we can have severe maternal blood loss that will eventually affect the pregnancy and the baby. And what can happen is, is that because of this balancing act, we have to determine, well, when is the best optimal time to deliver? So, oftentimes women who have a placenta previa will be delivered before we expect labor to even come on. So they are usually delivered between, you know, 36 and 37 weeks.

Touseef Mirza:
Because pregnancy can provoke more bleeding,

Dr. Sophia:
Because when we get to the point of labor, we can provoke more bleeding. And when you have a placenta previa. Again, previa, being the placenta is the presenting part. It's not the baby's head that's coming out first, it's the placenta. And so that's not safe for delivery or a vaginal delivery. Let me be clear, that's not a safe condition for a vaginal delivery. And so those moms have to be delivered via C-section-

Touseef Mirza:
Because the placenta is right on the cervix?

Dr. Sophia:
Is on the cervix. So-

Touseef Mirza:
So it needs to come up first. And why isn't that safe?

Dr. Sophia:
Because of bleeding? Because of bleeding. We're talking about bleeding here. That can happen with the placenta previa.

Touseef Mirza:
So during the course of the pregnancy, if they're spotting here and there, or there's maybe some days like more bleeding, aside from I guess the woman potentially being anemic, are there other health concerns?

Dr. Sophia:
That she can hemorrhage? This bleeding can be very, very abundant and can cause not just anemia, but I mean, heavy bleeding can lead to other, other problems and controlling that bleeding. And also, the placenta is what's feeding the baby.

Touseef Mirza:
So you wanna keep the placenta because the baby needs it. Yes. But at the same time, because it's bleeding, it's affecting the mom. So what do you do to address the bleeding?

Dr. Sophia:
Mostly we can just observe actually, because it is usually well, we call self-remitting or you know, it can resolve on its own. Like the bleeding can happen, and then it just stops. So we usually hydrate those moms to make sure that it's not because of dehydration. We usually, if they're having any signs of contractions, we give them medications to stop any contractions that can be happening. Because in early pregnancy, you know, 26 weeks, 29 weeks, 32 weeks, a woman can have some contractions that she doesn't even feel to her it feels like, oh, the baby's moving, you know, but there's some uterine activity that's happening that would then incite that placenta to bleed. Granted again, you can do absolutely nothing. You could just be walking down the street and then you have a bleeding episode and this is bleeding that is happening. That doesn't hurt.

Touseef Mirza:
Like periods, for example.

Dr. Sophia:
My period hurts.

Touseef Mirza:
I mean, abdominally, yes, it hurts, you know?

Dr. Sophia:
Yeah. There's a sign that I'm gonna get, and like there's a little sign that I'm gonna get my periods. I'm not gonna liken it to a period. The concept of this bleeding, and it's a lot of bleeding, but it can start off as just small bleeding. And that can just be our first, even the first clue that that's a problem that you have.

Touseef Mirza:
So what would be, like when you said, that one of the worst complications could be hemorrhaging. That's correct. So at that point, if that happens, like, like during the delivery for example, how severe can that go up to?

Dr. Sophia:
It can lead to death. It can, but this is the problem. This is why it's something that I think we need to be more aware of, and that it can be a complication of pregnancy. And there are certain risk factors for placenta previa, for certain. If you've ever had a previous pregnancy with the placenta, previa puts you at an increased risk for having it. Again, if you've had any instrumentation of the uterus, whether that's because you've had a termination of pregnancy or you've needed some other surgical procedure on your uterus, that can put you at an increased risk. If you've had a previous C-section, that can put you at an increased risk. If you get pregnant due to reproductive technology such as IVF, you can put yourself at an increased risk. I mean, there are so many different things that can put you at an increased risk for developing a placenta previa. And so it is just kind of keeping that in the back of your mind, and if your doctor says that you have a placenta previa, understanding that the bleeding can become severe bleeding that can happen without you knowing it, just happens. You feel you're like, huh, did I pee on myself? And only to find that you're sitting in a pool of blood.

Touseef Mirza:
Wow.

Dr. Sophia:
Scary stuff.

Touseef Mirza:
It is scary stuff, but this is why we need to talk about it.

Dr. Sophia:
So in a woman with a placenta previa, she will typically be delivered early, not necessarily, if she's among that cohort of women who may have a placenta previa and doesn't ever have a bleeding episode, and so therefore she can get up to 37 weeks. Fantastic. But typically, the goal here is to deliver before the onset of labor, because we know for a fact that labor will cause bleeding of the placenta. We know that a mom who has a placenta previa will have to be delivered not only early, but also by C-section. So this is a case where a woman cannot have a vaginal delivery if she has a placenta previa.

Now, there are a couple of other terms, a low lying placenta. A low-lying placenta is one that gets close to the cervix but is not covering the cervix. And again, will typically resolve. And then, and is an, again, a non-issue, doesn't have the same potentials or the same bleeding issues, and those women can deliver and can have a vaginal birth. But when we talk about what's called a complete placenta previa, we are talking about women that cannot have a vaginal birth. We are talking about women who typically are delivered early. They are delivered via C-section. They are at times in the pregnancy, they are given the medication for fetal lung maturity, or to help the baby mature the lungs faster. They're given that medication at some point in the pregnancy because we know that the likelihood of delivering early is very high.

Touseef Mirza:
So one of the key takeaways for me is if you are bleeding when you're pregnant, you need to tell your obgyn asap.

Dr. Sophia:
Absolutely. Because we need to figure out what's going on. Oftentimes, we're going to have the diagnosis of a placenta previa early in the pregnancy, around 20 weeks. And the majority of those cases do resolve. So we really, if you have a placenta previa, we will typically repeat that ultrasound somewhere around 28 weeks in order to see if the growth of the uterus and the baby has your placenta moved in position, especially if you've not had any bleeding episodes in that time. If your placenta previa remains persistent, then we will continue to monitor it to see if it moves. But if it doesn't, then we have the conversation about the fact that it will require a cesarean delivery and delivery planning. In terms of timing.

Touseef Mirza:
Last question on that. When there is this situation considering the positioning of the placenta, does that affect the quality of nourishment to the baby or does it not really affect the baby?

Dr. Sophia:
The placenta is still being fed from the majority is from the uterus is still from the, from the uterus. There's a part of that placenta that is over the cervix. Typically, it's just a placental edge, but that's enough to cause a significant amount of bleeding. Whereas the majority of the placenta is still connected to the uterus. And by being connected to the uterus, it's still getting all of the nutrients and the things that it should get.

Touseef Mirza:
Alright. Let's move on to the last category we wanted to talk about, which is, if a woman who is pregnant unfortunately falls or has a big impact that affects herself and or her baby, what are the different types of falls that you've seen that women should be? Why does it happen more? I was actually researching this a little bit more, and it basically said that the falls are actually due, which makes sense when you think about it because your center of gravity is off totally off, like completely towards the front. And so the balancing can be a little bit challenging sometimes. But I did not know that. It can also, it's also, also it might be caused also because of the loosening of the joints.

Dr. Sophia:
So in pregnancy, yes, there's a laxity that happens due to the hormones of the joints. And part of this is to accommodate for delivery. Okay. So you feel like you're looser in your hips, for example. And that is a real thing aside from the center of gravity, that definitely changes because now you have this growing fetus that's to the front of your body. You know, your body now has to accommodate a new shift in terms of balancing. So between the laxity that happens at the level of the joints as well as the shift in your center of gravity. Yes, it does put women at an increased risk for falls. So, or I don't wanna say increased risk, but it certainly happens. Outside of that, women in pregnancy, their blood pressure tends to be lower. So they can sometimes have occasional dizzy spells that can happen, especially when they're not hydrated enough. Which is why in pregnancy, you're gonna hear your provider say, drink more water, drink more water, drink more water, drink more water. And part of that reasoning is because we want you to remain as hydrated as possible so that you don't experience some of those other shifts that happen naturally, physiologically in terms of, let's say a little bit of a lower blood pressure that can then kind of cause you to have maybe a little woozy spell when you first get up, for example.

Touseef Mirza:
And lose your balance.

Dr. Sophia:
And then lose your, and then cause you to lose your balance.

Touseef Mirza:
Yeah. So then if a woman in that situation does have a fall, what are the certain complications or effects of that happen?

Dr. Sophia:
The biggest problem with having a fall is direct trauma to the abdomen. Although even if you don't have direct trauma or injury to the belly.

Touseef Mirza:
So you're saying like, if I'm falling forward.

Dr. Sophia:
If you're falling forward and you fall on your face, you fall on your belly. And the concept of injuring or having an impact on your abdomen, and that can be from a fall, that can be from an accident. I mean, women who are pregnant, we are dynamic. We're living our lives. We're working, we're commuting, we're driving, we're doing everything.

Touseef Mirza:
People are at the gym.

Dr. Sophia:
We're at the gym. I mean, pregnancy is not a disease. Right. So pregnant women are living life. As such, we are experiencing everything else. And that includes, unfortunately, we can have things that happen to us, a car accident, for example, where, you know, the airbag may deploy your belly, may hit the steering wheel, and all of these things are totally possible.

Touseef Mirza:
So even if it's not a huge accident, but that, for example, a fender bender that can still have,

Dr. Sophia:
Have an impact. Exactly. And so when we talk about falls or we're talking about injury to the abdomen or accidents, what we're most afraid of is what we call premature separation of the placenta. Meaning that the placenta separates from the wall of the uterus when it's supposed to remain attached to the uterus. And the placenta are supposed to feel like one because that's the way that the baby is getting its nutrients. But moreover, that placenta is full of blood, and if it separates prematurely, then that area is just bleeding. And so a woman who has a fall should be observed and monitored to make sure that placental separation has not happened.

Touseef Mirza:
Let's say that a pregnant woman falls, but there's no, there's no bleeding. Yeah. You know, she slipped, she fell and she got back up. Do you still go see the doctor?

Dr. Sophia:
So the answer to that would be yes, especially if you have any kind of direct trauma to your abdomen, because you wanna make sure that all is okay with your placenta, with your baby. That you've not injured anything. Women fall and slip all the time. It's way better. And also for their own, like an anxiousness, you know, like just to stabilize even themselves on an emotional and mental level. To say, okay, I know I had this fall, but everything is okay with me and everything is okay with the baby.

Touseef Mirza:
To get it checked.

Dr. Sophia:
To get it checked.

Touseef Mirza:
So aside from the placenta, is there anything else that would?

Dr. Sophia:
The other thing that we worry about all the time is the fact that your water can break again, that water, that the baby is in the amniotic sac. Imagine that as a big water balloon that the baby's kind of swimming in and an impact like a fall can in fact cause that water bag to break. And if the water bag breaks too early, the mom is only 29 weeks. Well, 29 weeks is too early. And when the water bag breaks, it also increases the chances of the placenta separating too early,

Touseef Mirza:
Oh, the placenta.

Dr. Sophia:
That placenta.

Touseef Mirza:
Coming back into the conversation again.

Dr. Sophia:
So the water, and then when the water breaks, that also can lead, that's like a signal to the brain, oh, the water broke. Am I supposed to be in labor? Then labor can start. So, so many things it can, it can really like, cause some type of ripple effect basically, and a cascade of events that can lead to the outcome of a premature birth due to premature labor, due to the placenta separating prematurely. That's something called an abruption. All of those things are urgent, and are emergencies.

Touseef Mirza:
If the water breaks and it has not provoked the labor signals, can the baby still survive or not?

Dr. Sophia:
So it really does depend on where you are in the pregnancy, how quickly your water breaks. And I, I tell you, when your water breaks, it feels like the water just keeps coming. It, you know, it's like you're, you're peeing on yourself and it just doesn't stop. But if the water breaks and we are able to get you to the hospital before labor, we can start to give you some medications in order to help prevent labor. Okay. Certainly if you're premature, we can give you things again to help with a baby's maturity. The steroid shots that we talked about in terms of fetal lung maturity, depending on what gestational age you are, how pregnant you are. And then we keep you and observe you in the hospital with what we call continuous monitoring, where we're looking at that baby's heart rate and looking for signs of labor. We do our best to prevent labor. We do our best to keep the baby healthy and safe on the inside because the baby is constantly creating amniotic fluid. So as, although you're losing it, it's also still being created.

Touseef Mirza:
Okay. So it can, it can sort of replenish?

Dr. Sophia:
We can accumulate, but it may never accumulate to what it really should be or can be because you are constantly losing it. And what we call a leak, you know, they can have like a small break. Everything is dynamic and everything is alive, including that sack. And so it can almost do what we call reseal.

Touseef Mirza:
Another amazing thing,

Dr. Sophia:
Another amazing thing that can happen so it can reseal, which is why it's important to just be evaluated, make sure your water didn't break. Make sure that the placenta doesn't separate too early. Make sure that the baby is okay. Make sure that you are okay. Sometimes a woman has a fall and she's hurt her knees, she's hurt her elbows, she's hurt her wrists. All these things are still possible.

Touseef Mirza:
Or her ankle, you know.

Dr. Sophia:
Or her ankle. Because especially a woman, I mean, you know, you're pregnant obviously, and so when you fall, you're gonna do everything to prevent having a fall instinctively against falling on your belly, and you can hurt other parts of your body. True. And so, because of that, you need to be evaluated. You can hurt your shoulder, you can have a head injury. There are just so many other things that can happen. And even if you don't fall directly on your abdomen or on your belly, you can still have what we call shearing forces.

Touseef Mirza:
Yeah, that's what I was gonna ask. Let's say you just fell on your bum, you fell on your butt.

Dr. Sophia:
But you fall hard enough on your butt, that's still enough to jolt things and still can cause issues with the water breaking issues with your placenta. Now granted, the uterus, the amazing organ that it is, is like a huge cushion. It's like a big pillow. Your baby's in there sleeping on this soft, wonderful pillow, and this hot tub, that's how I like to consider it. The uterus is an amazing, amazing organ that really is there to protect your baby. But it's always better to know and to check.

Touseef Mirza:
So for falls and accidents, it's really about getting it checked.

Dr. Sophia:
Just get it checked.

Touseef Mirza:
Get it checked. We don't need that extra stress.

Dr. Sophia:
Yes, exactly.

Touseef Mirza:
So I didn't know, I didn't know that we were gonna talk about placenta so much. So this is interesting.

Dr. Sophia:
It's an amazing organ.

Touseef Mirza:
It is. It is an amazing organ.

Dr. Sophia:
It's an amazing organ. And I'm just glad we had this talk, only because these are basically kind of like three topics that people sometimes hear about. Oh yeah. Placenta previa or Oh yeah. Preeclampsia. But oh, I don't, you know, that didn't happen to me. I didn't have that in my pregnancy. But you may have a friend, you may have a family member, you may have someone at work who says it or mentions it and you're like, Hey, did you know, you know. Did you know? Or you may be the person who comes in contact with someone who's having an emergency due to any of these three conditions, and you are the one who can save them by just getting them help.

Touseef Mirza:
Right. So for example, if your friend who's pregnant falls, and you know, usually when we fall we say, everything's fine, it's fine, don't worry about it. But now we know. No, actually let's just go get you checked. Exactly. Then we'll come back to you, we'll confirm that you're fine. We'll come back to the coffee shop after. That's fine. Exactly. Right. Now we gotta go.

Dr. Sophia:
Exactly. Thank you as always for joining us on the Dr. Sophia ObGyn podcast. I hope you found this episode interesting and helpful. We are so excited to bring awareness to all of the potential complications that can happen during pregnancy. We want you to be mindful to always embrace your body, embrace yourself, be in tune with your body, and especially when we are pregnant.

Touseef Mirza:
And I just wanna say thank you, Dr. Sophia, and all the other physicians and ob-gyns that so meticulously look at the health of the baby and the health of the mom, and probably drive themselves crazy trying to figure out what's the best way to move forward. But you do that day in, day out. Thank you for that.

Dr. Sophia:
Bye everyone.

Touseef Mirza:
Bye.

Dr. Sophia:
This is general medical information based on my professional opinion and experience. For specific medical advice, please refer to your physician. Until next time, embrace your body. Embrace yourself.