The Pregnancy Page

Am I Pregnant?

Congratulations. You think you might be pregnant. How can you be sure? Most women will miss a period, but not always. Some women have irregular cycles and don’t notice while others may spot the first month or two and confuse it with a period. Nausea, vomiting,tiredness, mood swings, food cravings and frequent urination are symptoms of pregnancy. Other signs are increase in vaginal discharge, darkening of the skin around the nipple and breast tenderness. Many women know their body, and if you think you’re pregnant, you usually are.

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Pregnancy Test

Over-the-counter pregnancy tests are helpful and measure the amount of hCG (hormone secreted during pregnancy by the placenta) in your urine. They detect a pregnancy 10-12 days after conceiving or 2-3 days before the next expected menstrual period.So waiting until you miss a period is a good time to check for pregnancy. This test should detect at least 25-50 mIUs of hCG hormone in your urine, the amount produced in a pregnancy at about 4- 5 weeks. Always check your urine first thing in the morning or when you have not urinated for at least four hours. These test are easy to perform, just take several minutes for the results and most cost $10.00-$25.00.

However, all positive tests do not result in a normal pregnancy. Some women may have an ectopic pregnancy (pregnancy in tube), hydatidiform mole (placental tissue overgrows usually without a fetus or one that can not survive) or other abnormal conditions that produce pregnancy hormone. It is important to see a doctor to confirm all expected pregnancies.Also the test can come up negative if the test is not properly performed or done too early.Blood test ordered by your health provider called a serum beta–human chorionic gonadotropin (hCG) is more sensitive and can usually detect a pregnancy within 7 days.

Confusing Definitions:

Trimesters?

  • 1st Trimester: conception until 12 weeks
  • 2nd trimester: 13-28 weeks
  • 3rd trimester: 28 weeks until term
  • -These may vary in some literature-

  • Pre-term: before 37 weeks
  • Post-term: after 41 weeks
  • Post-dates: after due date
  • Most weeks refer to completed weeks Ex: 41 weeks means 41 completed weeks or 41 weeks and 6 days)

    When We I Feel My Baby Move?

    This is probably one of the most exciting moments in pregnancy. Most women feel movement between 16- 20 weeks gestation and the medical term for this is “quickening”. At 20 weeks the fetus weighs about 11 0z, is 61/2 inches long and the foot size is 32 mm or 1.3 inches (not much longer than the standard paper margin). So don’t expect a real kick.

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    The initial movements are described as feathery or a light “flutters”. The first time many women are not sure they felt anything. Over time those flutters get much stronger. Towards the end of pregnancy, it feels like a real kick and gets you good up under the ribs. Towards the end of pregnancy your doctor may ask you to count your baby’s movements. Most should move 10 times in a 2-hour period within a 24-hour day. Anything less you should call your doctor.

    Important Prenatal Visits

    It is important to keep up with all your prenatal visits, but some are more important than others. That’s because your doctor may need to do specific testing within a certain time period, and missing that visit may cause you not to be eligible for thetest. These visit you want to make sure not to miss.

    1st Visit:

    First visit should be arranged as soon as you know you are pregnant. A complete physical exam is done including a pelvic exam and recording of your weight and blood pressure. Initial pre-natal labs include:

    CBC:Check hemoglobin levels to see if you are anemic, platelets to check your ability to clot your blood and WBC level to look for any possible infections.

    Blood Type and RH factor: Identify your blood type. See if you have produced any abnormal antibodies (what your body produces to protect it from any foreign substances) in your blood that could harm the pregnancy. Also identify if you are Rh positive (have a certain factor on your red blood cells) or Rh negative (do not have a certain factor on your red blood cells). This can also produce potential problems in pregnancy if the mother is Rh positive and the fetus is Rh negative, where the mother’s antibodies begins to attack the fetus’ red blood cells.

    Hepatitis B:Viral infection that can be passed from an infected person through blood, semen or vaginal fluids. Can give flu-like symptoms, jaundice (yellow color to the skin) cause liver disease and increase your risk for liver cancer. Untreated this infection can be passed to the newborn causing significant liver complications and death.

    Rubella Titer: Check to see if you have developed an immunity (have produced antibodies) against the Rubella virus that can cause German measles. In the newborn this virus can cause a significant number of symptoms including deafness, blindness, seizures and mental retardation.

    Syphilis Test (RPR): Looks to see if you have any present or past exposure to syphilis. This infection in the newborn can cause irritability, failure to gain weight, rash, saddle nose (no bridge to nose). Later in life they can develop Hutchinson teeth (abnormal, notched peg shaped teeth), blindness, deafness and bone problems.

    HIV Test (Human Immunodeficiency Virus): This virus can be passed to the newborn, especially if the mother’s viral titers are high and she is not taking appropriate anti-viral medication. Infected newborns may have failure to gain weight, seizures or death. Children who survive are slower in development and at risk for deadly infections.

    Pap test: test that evaluated cells taken from the lower part of your womb or cervix. Looks for abnormal cells that can be pre-cancerous or cancer. Most check for HPV (human papilloma virus), especially if the Pap test is abnormal. Certain types of this virus can increase your chances of developing cervical cancer.

    Screen for sexual infections: taking a culture of the cervix or checking the urine can do this. Most look for Gonorrhea or Chlamydia infections. Gonorrhea can cause an increased risk of preterm labor, miscarriages or premature rupture of the membranes. (Bag of water). Infected newborns can have eye infections that may lead to blindness, joint infections or life-threatening blood infections.Chlymadia can cause pneumonia or eye infections in the newborn.

    2)1st Trimester Screening:This is best offered between 11-13 weeks. It usually combines a blood test with an ultrasound. This screens pregnant women for the risk of genetic problems, especially Down’s syndrome. The blood test checks the levels of two pregnancy related substances, hCG and PAPP-A.The ultrasound measures the nuchal translucency or fat pad on the back of the baby’s neck, and abnormal results may also indicate a potential heart problem

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    The test does not look for neural tube defects (openings in the spinal cord or brain), so women who have this testing done will need an additional blood test in the second trimester called a MSAFP.

    2nd trimester screening: Penta Screen, Quad Screen, or Triple Screen is performed between 15-20 weeks and measures substances in the blood called multiple markers.Looks for genetic problems, especially Downs syndrome, Trisomy 18 and Trisomy 13. Also looks for neural tube defects.

    These are screening test only. They do not give a diagnosis only suggest further testing.

    3)Targeted Ultrasound:Detailed ultrasound that looks at the gestational age, fluid around the fetus, placenta and fetal anatomy. Best done 18-20 weeks.

    4)Screen for Diabetes:Pregnancy hormones cause pregnant women to be at risk for developing diabetes. This screening test is performed at 24-28 weeks. It is done earlier if the patient has risk factors like obesity, previous history of gestational diabetes or a stillbirth. Fasting is not required but should be done at least several hours after a large meal. A blood glucose level of 140mg/dL or greater will identify 80% of women with gestational diabetes. This may require further testing with a longer blood test for diabetes called the 3-hr OGTT. If two or more of the four values are abnormal, a diagnosis of gestational diabetes can be made.

    5)GBS Culture:This is a vaginal/peri-rectal culture done between 35-37 weeks. It looks for normal bacteria called GBSfound in the vagina of 30% of women. However, a baby who passes through the birth canal when a woman carries this infection is at risk for pneumonia (lung infection), septicemia (blood infection), or meningitis (infection of the lining of the brain and spinal cord).

    My Diet

    In a single word, healthy. Hopefully these eating habits you will maintain after the pregnancy. There are many additional demands on the body at this time, and most pregnant women should consume an extra 300 more calories each day. These extra calories can be made up in healthy foods like carton low fat yogurt/apple/peanut butter cracker or slice whole-wheat bread/4 oz. chicken breast baked. Look up the calories in healthy foods and get creative.

    Make sure you are getting a variety from the major food groups including breads and grains, fruits, vegetables, dairy products and protein. Stay well hydrated with 6-8 8-oz.glasses of water. Smaller multiple meals are better tolerated. Fried and spicy foods are hard on the digestion and make the nausea worse. Fats especially saturated ones and sweets should be limited. Nausea can be treated with wristbands, ginger, coke syrup, vitamin B6 and later anti-nausea medications.

    Prenatal vitamins sometimes worsen nausea. Take at night or every other day until nausea improves. You can also ask for prenatal vitamins that are smaller, scored, and chewable or contain B6 to help with nausea. Many vitamins and minerals are important, especially calcium, iron, vitamin A, vitamin C and folic acid. Limit caffeine to no more than 300 mg per day; avoid alcohol and drugs not prescribed by your doctor.

    FDA-approved sweeteners can be used in moderation are aspartame (Equal or NutraSweet), acesulfame-K (Sunett), and sucralose (Splenda). Avoid saccharin. High levels of mercury have been found in shark, swordfish, king mackerel, or white snapper, so avoid them as well as raw fish. Unpasteurized cheeses like Brie, Camembert feta, blue-veined, and Mexican-style cheeses may cause Listeria infection. This infection can also be found in deli meats, pâté and hot dogs not thoroughly cooked.

    Can I Exercise?

    For most exercises, yes. Actually most exercises done prior to becoming pregnant can be continued. This is a great way to stay healthy, strengthen muscles and sleep better. Always start slow and work-up to a comfortable routine. Remember as the pregnancy progresses, can use support devices you may do less because of the increased fatigue and additional weight. Walking, yoga swimming, stationary recumbent bicycling, pelvic strengthening and stretching are good exercises. Refrain from those that cause bouncing or jarring.

    Also do not engage in activities where you can fall like skiing, gymnastics, racquet sports and horseback riding. Snowboarding, contact sports, scuba diving, or exercises that require prolonged standing or lying flat on your back are probably not good either. Limit your exercise time to 30 minutes because the more you exercise, blood is drawn away from the baby to your extremities. Also limit time in the sauna, whirlpool or hot tub to 5-10 minutes. Always talk to your doctor before beginning any exercise program.

    Symptoms of Concern

  • Complete loss of pregnancy symptoms once established in the first trimester. The hormones produced in pregnancy give you symptoms, this may signal a potential problem.
  • Abdominal cramps that become severe especially with vaginal bleeding can be a sign of a threatened or missed abortion or ectopic pregnancy.
  • Tightening of the womb or contractions before 37 weeks that become stronger or more regular may be a sign of early labor.
  • Leaking of fluid may signal your water has broken. If last more than 24 hours can increase the risk of infection to you and your baby.
  • Severe headaches especially with blurred vision and pain in the right upper abdomen may signal a blood pressure problem called pre-eclampsia.
  • Complete lack of fetal movement for greater than 24 hours once movement is established, you may want to notify your health provider.
  • What To Take To The Hospital

    For Mom:

  • Start with a few personal items; trial sizes are better. Include toothbrush, toothpaste, lip balm, deodorant, a brush and comb, makeup, light fragrance spray and a twisty for longer hair, shampoo, conditioner
  • Loose fitting nightgown, preferably two that are inexpensive. Those with short sleeves make it easier to take blood pressure.
  • Bathrobe, slippers and/or socks, shower shoes
  • Comfy Stuff: relaxing music, good book, puzzle/games, pictures of loved ones
  • Phone call list with names and numbers, your cell phone and charger or a prepaid phone card for long distance
  • Comfortable nursing bras or regular bras, breast pads, nipple cream Your breasts are likely to be tender and swollen, tucks pads. Several pairsloose fitting, comfy, comfortable maternity underwear.
  • Healthy snacks like crackers, veggies, fruit, nuts and granola bars but check with your doctor before eating them
  • Gifts for older siblings, notepad with pen (for taking notes and writing down questions),
  • Comfy maternity (still look 6 months pregnant) outfit to wear home,
  • Most hospital will provide basic toiletries, sanitary pads and mesh underwear, but its nice to have a few of your own things.
  • Small amount of money less than $20.00, change for vending machine.
  • For the drive to the hospital, you may want to bring an old towel and plastic garbage sack in case your water breaks.
  • For Baby:

  • Infant car seat having previously reviewed instructions and installed
  • A loose fitting outfit so not to rub against umbilical cord. Cover head, hands and feet. (Weather specific) Also make sure the car seat strap can buckle properly with the baby’s outfit on.
  • A receiving blanket to tuck the baby comfortably in the car seat
  • Wipes and extra diapers(sometimes hospital provides)
  • What Not To Bring

  • Jewelry
  • Valuables
  • Medications
  • Lots of money
  • Breast pump