Brief Answer:
Get Thyroid Function Test done

Detailed Answer:
Dear xxxxxxxxxx,

There are many factors which are responsible for dizziness and fatigue during pregnancy. However, your haemoglobin, blood pressure and diabetes are within normal range. Would you please upload the reports for my review?

Minor drop in the iron levels will not be reflected in haemoglobin levels; however cytochrome enzymes drop leading to fatigue and dizziness. Please get your blood iron levels done

Pregnancy is an additional load on the woman's body. She has to nourish an additional body on her own nutrition. Hence, minor metabolic variations also may reflect in dizziness and fatigue. Thyroid deficiency (Hypothyroidism) is very commonly noticed during pregnancy. Hypothyroidism does cause dizziness, fatigue and lethargy. So please get your Thyroid function test (T3, T4, TSH) done.

Please upload all these reports for my review to enable me to advise you further.

Meanwhile, have high protein and high carbohydrate diet. Eat short but frequent feeds (6 times a day), since the capacity of stomach to distend has gone low. This will give you some freshness.

Awaiting all your reports of the suggested tests and others also.

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Brief Answer:
Please furnish the reports in details.

Detailed Answer:
Dear xxxxxxxxxxxx

Thyroid reports are never negative or positive. They are in figures - levels of T3, T4 and TSH. Please inform me those figures in details.

You had mentioned in your original query that your blood sugar levels are normal. Please upload the reports. I would like to know the exact levels. They are different from non-pregnant state.

Haemoglobin 11.1 gms% is not bad, still not very good in pregnancy. Please try to bring it above 12.5 gms%. I would advise you to take iron tablets to increase your haemoglobin levels. Along with iron, you have to take proteins also, otherwise haemoglobin will not increase.

Please get the other suggested reports also performed.


xxxxxxxx please, the reports are required for proper assessment of your health. I would urge you to cooperate with me. If you want any more information, I am always available for you, xxxxxxxxxxx.

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Brief Answer:
Supine Hypotension or Postural Hypotension seem to be the cause

Detailed Answer:
Dear xxxxxxxxx,

Thank you very much for uploading all your reports. I have gone through them and all seem to be within normal limits for the pregnancy.

During pregnancy, uterus is growing in size. So when you lye flat on your back, the great vessel called as Inferior vena cava which takes large amount of blood to the heart gets compressed by uterus. This causes low blood pressure leading to dizziness. This phenomenon is called as Supine hypotension syndrome. This vessel is located on the right side of the vertebral column in the abdomen. Hence it is advised that during pregnancy, you should lie on left side position only.

The other possibility is when you suddenly change your position like lying down to sitting or standing, sitting to standing, there is sudden drop in blood pressure. This phenomenon is called as Postural Hypotension syndrome. This sudden drop in blood pressure causes giddiness.

I would advise you to get your blood pressure checked as follows:

1. Get your blood pressure recorded in sitting position. Then Lye down on your back and get the blood pressure recorded. If there is remarkable drop in blood pressure, it is suggesting Supine hypotension syndrome. The turn on your left side and again record the blood pressure after 10 minutes. If the blood pressure improves, this confirms the diagnosis of Supine Hypotension Syndrome.

2. Record your blood pressure in left side position. Then sit down and record the blood pressure and then stand up to record the blood pressure. If you notice remarkable drop in sitting and standing position, it confirms the diagnosis of Postural Hypotension.

In these condition, nothing need be done drastically as these are physiological variations. Please be slow in changing the position and take rest only in left sided position. Drinking of plenty of water may help you increase blood pressure; however, doubtful. Also improve your haemoglobin percentage by intake of good iron and proteins.

I would appreciate if you inform me your blood pressure recording. I feel you should get some relief form giddiness with this care.

Also please check for another condition. If you had common cold, it may cause blocking of the Eustachian tube which connects middle ear to the throat. This may lead to swelling of the inner ear where the organ for maintaining the balance is situated. Such condition is called as Vestibulitis. There it leads to dizziness. This dizziness is typically after moving the position of the head. Please press behind your ears. If you get pain, it may suggest this condition. Better get confirmed and/or diagnosed from ENT surgeon. If so, some steroid or some anti-inflammatory medicine with antibiotics may give you relief. Hot gargles and steam inhalation also is helpful in such conditions.

You are on iron treatment. Iron does increase acidity in the stomach which can cause giddiness. If you are getting heartburn due to acidity, you may switch iron to time released spansule format which will not increase the acidity. To get relief from the current acidity, you may take some antacids for short course. However, you should not continue antacids for long otherwise it will affect the iron absorption and will lead to anaemia - both in you and your baby.

I hope these instructions should help you to get rid of or minimize your dizziness.

If you find this information useful, you may post a review with 5 stars rating for me. If you want any more information, I am always available for you, xxxxxxxxxxx.

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Brief Answer:
Postural Hypotension

Detailed Answer:
Dear xxxxxxxxxxx,

It is good that you are not having vestibulitis.

You are having Postural Hypotension. There is considerable fall in the standing position than sitting position. Even in lying down position also, there is drop in blood pressure. This could be due to supine hypotension also.

Please rise slowly. Turn on your left side and gradually sit down. Wait in sitting position for some time. Then gradually stand up with some support. After standing also wait for some time before you start walking. This is a variation in pregnancy and will get OK after you deliver. You should take care in the toilet specifically. Do not latch the door from inside and tell some one to be at the door.

Try improve your haemoglobin level also. Though you are not anaemic, your haemoglobin for pregnancy is on the lower side. That also causes postural hypotension. Also take care of the acidity. Try to change the iron preparation to the suggested type.

I feel with some care in life-style, you should go through the pregnancy uneventfully.

Please let me know if you would like to have any more information.

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Brief Answer:
You have to take your own informed decision

Detailed Answer:
Dear xxxxxxxxxxxxx,

MRI is not exposure to X-rays. It is Magnetic Resonance Imaging. Theoretically, there should not be any risk to the baby by MRI; however, there is no sufficient data to support either for or against MRI safety in Pregnancy.

There have been a number of laboratory and clinical investigations conducted to determine the effects of using MRI during pregnancy. Most of the laboratory studies showed no evidence of injury or harm to the foetus, though few studies have reported adverse outcomes for laboratory animals. However, whether or not these findings can be extrapolated to human subjects is debatable.

There is one view that noise associated with MRI may impact the foetus.

It has been stated in the Policies, Guidelines, and Recommendations for MRI Safety and Patient Management issued by the Safety Committee of the Society for Magnetic Resonance Imaging in 1991 that MR procedures may be used in pregnant patients to address important clinical problems or to manage potential complications for the patient or foetus. The overall decision to utilize an MRI procedure in a pregnant patient involves answering a series of important questions including, the following:
-Is ultrasonography satisfactory for diagnosis?
-Is the MRI procedure appropriate to address the clinical question?
-Is obstetrical intervention prior to the MR procedure a possibility? That is, is termination of pregnancy a consideration? Is early delivery a consideration?

With regard to the use of MR procedures in pregnant patients, this diagnostic technique should not be withheld for the following cases:
-Patients with active brain or spine signs and symptoms requiring imaging.
-Patients with cancer requiring imaging.
-Patients with chest, abdomen, and pelvic signs and symptoms of active disease when ultrasonography is non-diagnostic.
-In specific cases of suspected foetal anomaly or complex foetal disorder.

These questions can be answered only after thorough clinical examination and routine investigations by an Obstetrician only.

Considering all this information, I feel performing MRI decision should be taken with the consultation of managing Consultant Obstetrician. It should not be considered as casual investigation during pregnancy.

I have provided you all the information available in the medical literature. Now you have to take informed decision (with the help of your Obstetrician). I hope this information is quite sufficient for you. However, if you want to have any more information, I am always available for you, xxxxxxxxxx.

If you feel you are satisfied with the information I have provided you so far, you may please post a detailed review with 5 star rating for me.

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