Category Archives: Parenting & Families

Group B Streptococcal

Group B Streptococcal (GBS) infection is found in the genital area of up to 30 percent of healthy women. Most infected pregnant women show no signs of illness, but are at increased risk for kidney infections, premature rupture of the membranes, preterm labor, and stillbirth. The biggest danger is to infants who become infected during birth. While not all infants become ill, if you or someone else in the family is ill, it is best that you do not make contact with the baby; otherwise serious replications could take place. The factors that increase the risk of complications are prematurity, fever during labor, high level bacteria, and prolonged rupture of the membranes mix to delivery.

According to the Centers for Disease Control (CDC), culture of the vaginal and rectal area to check for group B strep should be performed on all pregnant women at 35 to 37 weeks of pregnancy. Women who tested positive during pregnancy with either the genital culture or urine culture, who previously had an infant with GBS, or who deliver before 37 weeks gestation should be treated during labor with antibiotics. Women who did not have a culture done or whose culture result is not known should be given antibiotics if they are less than 37 weeks pregnant, have had ruptured membranes for longer than 18 hours, or have a temperature of over 100.4°F (Fahrenheit).

Treatment with antibiotics during labor has been shown to be highly effective in preventing complications in newborns if the antibiotics are administered 4 or more hours prior to delivery. If the infant is delivered less than 4 hours following the administration of antibiotics or shows signs of infection, a partial or full septic workup may be required. This may include blood tests, a spinal tap, chest X-rays, and/or intravenous administration of antibiotics. The CDC also recommends that all infants of treated mothers be observed for 48 hours after delivery.

Emotional Symptoms During Third Trimester Pregnancy

During the third trimester, most women focus more and more on the baby, and on labor and delivery. Most parents consider the search for a name to be an important past time. They also spend time preparing an area in the house for the baby. Almost all women by now have accepted that they are pregnant and are able to differentiate their babies as real people, separate from themselves.

Time during the third trimester seems endless. Many women count on their doctors to bring the end of their discomfort and may be very discouraged if go a week or more beyond.

Because of their large size, some women experience a drop in self-esteem during the first trimester. They need the people around them, especially their husband to reassure them that they are still attractive.

You can use your preoccupation with labor and delivery to your advantage this time. Gather as much information about the birth experience as possible. Read books, take classes, and talk to new mothers. However, avoid people who repeatedly attempt to discourage you from taking prepared childbirth classes or who dwell on negative birth experiences. You need to keep a confident, relaxed attitude toward the upcoming event. Do not avoid your fears.

Do not avoid your fears but at the same time, do not allow negative thinking to dominate you. Most chances for a positive birth experience are to a great extent determined based on your attitude. Fear and anxiety create negative experiences.

Nonstress Tests

Nonstress test can be a very reliable noninvasive test for fetal well-being. It is measuring the fetal heart rate in response to fetal activity on a fetal monitor.

In a nonstress test, the woman is placed on an electronic fetal monitor and when the heart rate is noted. The woman is given a control to push when she feels the baby move. The control places a mark on the readout. Sometimes, a transducer is used to make a buzzing sound over the baby’s head. When this is done, the test is called a vibroacoustic stimulation test (VST). An increase in the fetal heart rate indicates fetal well-being. If the result is negative, additional testing, such as an oxytocin challenge test, is usually required.

Nonstress test results can be affected by low blood sugar, so you should eat before taking the test. The results can also be affected by illness of the fetus.

Pregnancy Nutritional Needs

When a woman is pregnant, she is growing not only a baby, but also a placenta. This placenta, like the baby, needs to be adequately nourished to ensure proper implantation and development for efficient functioning, the placenta carries out many essential life functions for the baby. Along with umbilical cord, amniotic sac, and uterus, the placenta is a life support system for this tiny person.

The placenta, in providing nourishment for the baby, works very much a fuel pump. If the fuel is of poor quality or the wrong octane for the part large engine, the pump will work ineffectively or may even stop completely. Also, if the pressure or the volume of the fuel coming through the pump affected, the pump’s efficiency will be altered. If you think of the nutrients the bloodstream as fuel, you can see that a poor diet results in a poor quality of nutrients moving through the “placenta-pump.” If the volume of fluid in bloodstream is inadequate, then the pressure of the blood coming through “placenta-pump” will be low and the nutrients will not be able to get through in sufficient quantity to adequately nourish the fetus.

The body’s blood volume needs to increase by more than 50 percent during the last half of pregnancy to enable the placenta to be efficient. This increase requires an adequate intake of sodium (salt), along with a sufficient intake of fluids. Many women experience an increased desire for during pregnancy. This is the body’s way of ensuring the supply that is needed to help increase its blood volume. Thus, restricting salt may hinder body’s performance of this vital function and can result in intrauterine growth retardation.

Sufficient fluid intake is also needed for the production of amniotic fluid. By the last weeks of pregnancy, the amniotic sac contains about 1 quart amniotic fluid to cushion and protect the baby. This fluid is replaced every hour. In addition, tissue fluid increases by an estimated 2 to 3 quarts during pregnancy. You need to drink at least 2 quarts of liquid a day to maintain the levels and to ensure a healthy pregnancy. The best fluids to drink are water, milk, and fruit juices. Stay away from alcohol and drinks that contain caffeine.

Many women and doctors are overly concerned about edema (swelling during pregnancy). Some degree of swelling is normal. The enlarging uterus pressing on the veins of the legs causes dependent edema in women who stand or sit for long periods. In addition, estrogen, which is manufactured by the placenta during pregnancy, causes the tissues to retain extra fluid. Before you were pregnant, you may have noticed water retention just before your menstrual period. Women who took birth control pills may also have experienced it. This was caused by the increased estrogen in the body.

In years past, doctors often treated this normal swelling with diuretics (water pills), as well as with a diet restricted in salt. Fortunately, they no longer follow these practices because of the potential side effects. In addition almost all obstetrical authors now warn that diuretics can actually increase the symptoms and may even cause more serious side effects, including a rise it the blood pH (the relative acidity or alkalinity of substances), exchange of nutrients and waste products, decreased tolerance of carmines, generalized edema, severe loss of calcium through the urine, and amino depletion. If the swelling is a result of hypovolemia (low blood volume diuretics may drive salt and water from the circulation and lower the time volume even further). This could actually cause or accentuate the PIH that a low-dose diuretic was supposed to prevent. Sometimes, however, diuretics are used in pregnancy, such as when the woman has abnormal swelling due heart disease or kidney disease.

Rather than resort to diuretics or salt restriction, the normal pregnant lady should make certain that her protein consumption is ample and that her salt intake is adequate. Salt is contained naturally in many foods. During pregnancy, “salt to taste” is a good rule to follow.

Your liver also helps to maintain an increased blood volume during pregnancy. It does this by providing albumin, a protein that keeps water in circulation. An inadequate intake of protein prevents the liver from producing enough albumins to hold water in the bloodstream. The water therefore leaks in around the woman’s tissues, creating abnormal puffiness.

The liver also filters the pregnancy-induced hormones in amounts equal to what is supplied by 100 birth control pills taken and get rids the body of toxins normally produced in the lower bowel. Altogether, the liver performs approximately 500 functions. Since the liver is rather increasing stress as the baby grows, you need to increase your intake of calories, protein, vitamins, and sodium during the last half of your pregnancy counteract this stress.

The baby’s brain grows the most during the last 2 months, and an adequate amount of protein is essential at this time for building brain cells. So even if your diet has been unstructured up to your seventh month, a change now can directly benefit your baby. Conversely, if your diet has been adequate up to the seventh month, but you now begin restricting calories in an effort to control your weight gain, your baby may suffer.

Weight gain is often the focus of too much concern during pregnancy. Gaining weight is expected and necessary for the well-being of the mother-to-be baby. The amount of weight gain varies from woman to woman, as does concern of weight gain. Total weight gain is determined by pre-pregnant weights, eating habits, daily activities, and metabolism. Since every woman is unique, there is no specific weight gain that is correct for all pregnant women. However, if a woman was underweight before becoming pregnant, she will tend to gain more weight than what is expected in the average woman.

Even for overweight women, dieting during pregnancy is risky for both mother-to-be and child. Change the woman’s diet to eliminate high-calories. A diet that provides less than 2,300 calories provides the nutrients necessary for the baby to grow or for the woman to gain an adequate amount of weight.

During the last weeks of pregnancy, the baby lays down stores of vital and insulating body fat essential for his survival. He builds his stores his diet for the first 6 months of extra uterine life will be low tie iron supplement in infant formula is poorly absorbed by babies. Nevertheless, during the last months of pregnancy, you must eat foods that will provide you and your baby with a sufficient supply of iron. After birth, breast feeding will help. Breast milk contains just a small amount of iron, but iron is efficiently absorbed and utilized by the baby, which allows the infant iron supply to last longer.

If you are experiencing a multiple pregnancy, your increased nutrition needs are greater than those of a woman carrying a single baby. Each day, need to consume an additional 20 to 25 grams of protein per baby and take at least 300 more calories per baby. Physiologic swelling is even more regenerated, as you may have additional placentas or one larger placenta providing a greater quantity of estrogen. The larger and heavier uterus restricts blood flow from the veins of your legs more than normal, increasing the dent from edema. The weight gain in a woman carrying twins can be as much as to 50 pounds if she is eating correctly. Women who eat a healthy diet and not restrict their salt intake often give birth to babies who are of no weight (not less than 5 1/2 pounds) and who arrive at term, not premature as is usually expected.

Multiple Pregnancy

If you are pregnant with more than one baby—with twins, triplets, or more your pregnancy is called a multiple pregnancy. Fraternal twins are more common than identical twins and are the result of two sperm fertilizing two egg Fraternal twins may or may not be the same sex and are no more alike appearance than any other siblings. Identical twins occur less frequently are the result of one sperm fertilizing one egg, which then separates. Since identical twins carry the same genetic material, they are always the same and always look alike, and always have the same blood type. They may be mini images of each other.

During pregnancy, an increased demand is placed on the body of a woman carrying more than one baby as well as additional placentas or one larger percents. The discomforts of pregnancy are accentuated; since there is increased demand on the circulatory system and the uterus is larger in size. The chances of PIH and preterm labor are greater. For these reasons, many physicians place these women on bed rest at around 28 weeks gestation.

Women experiencing a multiple pregnancy have higher protein and calcium requirements. Additional protein is necessary to provide for adequate growth of the babies and ensure good muscle tone of the over distended uterus. Women who eat well during pregnancy decrease their chances for complications and increase the chances for delivering at term.

First Trimester During Pregnancy

Pregnancy is generally divided into three trimesters, or three periods of 3 months each, for purposes of discussion. This is done because most women experience the same general changes during each trimester.

During pregnancy, two kinds of development go on at once—the physical changes in the mother-to-be and the physical changes in the fetus. Along with the physical changes the woman experiences, some emotional changes take place. You and your partner can use these changes as opportunities to grow, to expand your awareness of yourselves and of each other, to deepen your sense of responsibility, and to become aware of what millions of other parents-to-be have experienced.

The first trimester of pregnancy is the first 3 calendar months, or through the fourteenth week of gestation. You will experience many physical and emotional changes during this time, although most of the physical changes will be more noticeable to you than to anyone else.

Physical Changes

The major physical changes that women experience during the first trimester include the following:

Uterus

For many women, a missed menstrual period is the first sign of pregnancy. Other women continue to have very light periods for the first 2 to 3 months. This lack of a regular period is due to the high levels of estrogen that the body produces to maintain the uterine lining that maintain the developing embryo.

By the time the fetus is 12 weeks old, the placenta, or afterbirth, has developed. The uterus has grown to the size of a grapefruit, with its top reaching above the pubic bone. The cervix has already begun softening.

Vagina

The vagina has begun thickening and softening. It has also turned blue to violet in color as a result of the increased blood supply to the area. Vaginal secretions have become more noticeable and will increase in amount as the pregnancy progresses.

Breasts

A tingling or prickling sensation is often felt in the breasts during the first of pregnancy. This is because the blood supply is increasing and the milk secreting glands are growing. After a few weeks or months, the prickling will disappear, but the breasts will usually continue to tingle until the third trimester.

During the eighth week, veins may become visible under the skin, and seated areas appear on the areola, the dark area surrounding. These elevated areas are the Montgomery glands, which secrete oil in preparation for breastfeeding.

Urination

Many women experience an increased need to urinate during the first trimester because the enlarging uterus is pressing on the bladder. This can usually eases during the second trimester, as the uterus rises out of the pelvis. Even though it means more trips to the bathroom, you should drink plenty of fluids to maintain good kidney function and to provide the water to metabolize the protein you eat.

Digestion

About half of all pregnant women feel nauseated and may vomit during early pregnancy, and sometimes also in later pregnancy. This condition is called morning sickness, although it can occur at any time during the day. Morning sickness is attributed to an increase in hormone levels, a lack of vitamin B5 and/or low blood sugar. Eating foods high in B vitamins and consumption of small high-protein meals throughout the day usually help this condition.

In addition to nausea, some women also have trouble with indigestion and heartburn. The hormones relaxin and progesterone relax the smooth muscles in the body, including the sphincter at the top of the stomach, which keeps food in the stomach. Progesterone is also responsible for relaxing the intestines somewhat, thereby slowing digestion and making constipation easier. Eating a diet high in fiber (fresh fruits and vegetables, and whole tarts), drinking plenty of fluids, and exercising regularly help to minimize constipation.

Skin

The hormones of pregnancy can affect your skin either positively or negatively. Many women experience the glow of pregnancy, and their skin radiance. Others are not so fortunate and develop acne. Continue to eat a good diet and drink plenty of water. Wash your face two or three times a day with a gentle cleanser and apply moisturizer to dry areas. Avoid the temptation to pick at or squeeze the blemishes. This will only increase the likelihood of infection and scarring. Choose makeup that does not clog the pores or try limiting the time you wear it. Wash the applicators or purchase new blush brushes or powder “puffs.” If the acne is severe, you may need to see a dermatologist. Make sure that he knows you are pregnant. Two common medications used for acne, Accutane and Retin A, should not be used during pregnancy.

Fatigue

Pregnancy brings changes to every system in the body, and the changes require a great deal of physical and emotional energy. Properly resting is extremely important for an expectant mother. You should not feel guilty about resting during the day or about going to bed early. You need rest to adjust to pregnancy.

Amniocentesis

Amniocentesis is a test to detect abnormalities in the baby. It may also be done to assess fetal lung maturity if induction of labor or cesarean delivery is indicated. The test is performed by administering a local anesthetic, then drawing a sample of amniotic fluid using a long needle inserted through the abdominal and uterine walls. It should be done in conjunction with ultrasound, which will show the location of the fetus, the placenta, and the umbilical cord.

The amniotic fluid is sent to a lab for culturing and testing. Certain tests such as those for Tay-Sachs disease, Hunter’s syndrome, neural tube defects, and fetal lung maturity can be performed immediately. These tests measure chemicals produced by the baby that are present in the amniotic fluid. To determine fetal lung maturity, the amniotic fluid is examined for the specific phospholipids that are present when a baby’s lungs are mature.

Most tests require that the fetal cells be isolated and given sufficient time to multiply, usually 2 to 4 weeks. Then a complete chromosomal analysis is done to detect the presence of Down syndrome or other genetic abnormalities. The sex of the baby is also established. When amniocentesis is used for detecting abnormalities, it is generally performed between 16 and 18 weeks gestation. Before 14 weeks, there usually is insufficient amniotic fluid. Some caregivers are performing amniocentesis between 11 and 13 weeks. But one study found that when amniocentesis is performed before 86 days, an increase in foot deformities (turned-in and clubfeet) was observed. When testing for gestational maturity, the procedure is done in the last trimester.

Amniocentesis is a very valuable procedure, but according to many experts, it can be misused. The risks include some chance of blood exchange between the woman and baby, creating a greater Rh incompatibility when testing for the condition; infection of the amniotic fluid; peritonitis; blood clots; placental hemorrhage; injury to the baby; and even premature labor Amniocentesis should definitely not be done just to satisfy curiosity about the baby’s sex. And, unless you plan to terminate your pregnancy if an abnormality is found, or unless your doctor plans to alter your care, it is questionably whether you should have this test done just for the genetic information.

Hypertension in Pregnancy

Hypertension (high blood pressure) that occurs during pregnancy is called Pregnancy-Induced Hypertension (PIH). Most women who develop PIH did not have hypertension before pregnancy and will not have it after. PIH was formerly known as toxemia. While the cause of PIH is unknown, some studies suggest that the blame lies with an imbalance of the substances that regulate the constriction and dilation of the blood vessels. The risk factors include a diet low in protein or calcium, a history of preeclampsia prior to 32 weeks gestation, chronic high blood pressure, kidney disease, lupus, diabetes, multiple pregnancy, age (under 20 or over 35), and being overweight. A new theory states that PIH may be an immune response to a new sex partner since 85 percent of cases occur in first-time pregnancies. Several studies have shown that a good diet can reduce the risk of developing PIH. A diet containing 75 to 100 grams of protein and 1,500 to 2,000 milligrams of calcium recommended.

PIH affects both the woman and the fetus. High blood pressure constricts mood flow to the uterus. This can result in the baby receiving less oxygen and nutrients, which will affect his growth. In addition, the placenta may separate from the wall of the uterus before delivery and result in bleeding and shock. If untreated, PIH can become preeclampsia, which is characterized by vim blood pressure, protein in the urine, sudden weight gain, and swelling of the face and hands. It may be necessary to induce labor if the blood pressure do not controlled. This may lead to a premature infant. Rarely, preeclampsia increases to eclampsia, which is marked by convulsions and coma.

Treatment of PIH consists of bed rest for mild conditions. Occasionally, a caiman must be hospitalized. If the blood pressure is not controlled, delivery by induction of labor or cesarean section may be necessary to save the lives of the woman and baby. The medication magnesium sulfate is administered intravenously to prevent convulsions. The risk of seizures diminishes 48 hours after delivery of the baby.

Traveling During Pregnancy

  • If you are like most women, traveling during pregnancy is no problem, as long as you follow a few guidelines. These guidelines are:
  • Check with your caregiver to make sure there are no special healthcare contacts that would prevent you from traveling.
  • Try to plan any trips for your second trimester, when comfort is the greatest.
  • While traveling, walk around often to improve circulation.
  • Wear comfortable shoes and clothing.
  • Take along light snacks and juice to prevent hunger and decrease nausea.
  • Do not take motion sickness pills or any other medications before checking walk your caregiver.
  • Take time to eat regular, nutritious meals.
  • Eat plenty of high fiber foods to ease constipation.
  • Get your usual amount of sleep and rest often. Elevate your feet.
  • If you are traveling far from home, take a copy of your medical record and get the name of a doctor or facility where you could go for treatment if nectarine.
  • If traveling by car, do not ride for more than 6 hours a day. Stop every 1 to 2 hours to walk around. Always wear a seat belt.
  • If traveling by air, sit in an aisle seat for the greatest comfort. Wear layers of clothing so that you can adjust as the cabin temperature changes. Drink plenty of fluids.
  • If traveling overseas, drink only bottled beverages. Do not use ice in your drinks and do not eat raw, unpeeled fruits or vegetables. Also, avoid raw meat, and make sure that any milk you drink has been pasteurized.

The best guideline you can follow is to keep your plans flexible and to change them according to your body’s signals. If you use common sense, traveling during pregnancy can be a pleasure, not an inconvenience.

Oxytocin Challenge Test

Oxytocin Challenge Test (OCT) is done in the hospital to help determine how well the baby will undergo the stress of labor. The OCT is also known as the Contraction Stress Test.

Oxytocin is a medication that causes uterine contractions. While reclining on a 45-degree angle, the woman is given oxytocin intravenously until she has contractions 3 to 4 minutes apart for a full half-hour. At the same time, the heart rate is electronically monitored to check the effect of the contractions on the baby. If the results are positive—that is, the fetal heart rate appears normal during the stress of the contractions—the doctor may recommend a wean birth, since the baby may not be able to tolerate the stress of labor. If the results are negative—that is, the heart rate remains normal during the contractions—the baby will most likely do well during labor.

When taking the OCT, avoid lying flat on your back. This can cause your blood pressure to drop, decreasing oxygen to the baby and possibly causing the appearance of fetal distress on the monitor.