Is My Pregnancy Going Well?

Am I Pregnant?

While a missed period is one of the biggest clues that a woman is pregnant, it’s usually not the first sign. Some women suspect they are pregnant before their menstrual cycle is late.

Symptoms that might indicate you are pregnant include:

  • Tenderness of the breasts and nipples
  • Fatigue (1-6 weeks after conception)
  • Frequent urination (6-8 weeks after conception)
  • Nausea, queasiness, vomiting (first half of pregnancy)
  • Food cravings (entire pregnancy)

When a woman suspects that she is pregnant, she should visit a doctor to confirm her condition as soon as possible.

  • Laboratory blood tests can verify pregnancy as soon as 6 or 7 days after conception.
  • A urine test may detect pregnancy as early as 10 days after conception.

The blood and urine test both measure the level human chorionic gonadotropin (HCG), a hormone that is only produced in a woman’s body when she has placental tissue growing there. The placenta is the tissue within the uterus (womb) through which the mother provides nourishment to the fetus.

The Importance Of Prenatal Care

One of the most important things you can do for yourself and your baby is to seek proper prenatal care. Prenatal care consists of:

  • Regular appointments starting early and continuing throughout the pregnancy
  • Laboratory testing for potential problems with the developing baby or yourself
  • Monitoring for problems such as abnormal changes in blood pressure, blood chemistry, urine chemistry, and weight
  • Getting plenty of exercise and eating properly
  • Giving up bad habits such as smoking, drinking alcohol, or using street drugs.

It is also important for a woman to alert her doctor immediately if anything unusual occurs during pregnancy, such as:

  • The baby’s movement is greatly reduced or stops.
  • She experiences vaginal bleeding or cramping.
  • She develops swelling of her hands and face, or persistent headaches.
  • She leaks amniotic fluid from her vagina.
  • She develops pain in her abdomen.

Improved technologies and more accurate prenatal tests now make it possible to spot complications earlier and take appropriate action in time to save the fetus and/or the mother.

Things To Avoid During Pregnancy

A woman’s habits greatly influence the health of her unborn child. When pregnant, a woman should avoid the following:

  • Alcohol. Consuming alcohol while pregnant can cause birth defects and other problems. Consistent alcohol use during pregnancy can cause fetal alcohol syndrome, a permanent and lifelong condition.
  • Cigarettes. Smoking is linked to low birth weight, premature birth, miscarriage and other complications. Nicotine causes blood vessels to constrict. That means the baby won’t get the proper oxygen and nourishment it needs to grow.
  • Medications. Many over-the-counter (OTC) and prescribed medications can harm an unborn child. Your physician can give you a list of which medications you can take safely during pregnancy.
  • Narcotics. Illegal drugs, such as cocaine, can deprive developing babies of vital oxygen and nourishment. This can lead to birth defects, or cause addictions in newborns.
  • Caffeine. Discuss with your doctor how much caffeine, if any, you can have during your pregnancy. Caffeine is found in coffee, tea, colas, and other products
  • Contact with cat feces. A serious disease that can be contracted from cleaning cat litter boxes is toxoplasmosis), which is spread by a microbe that causes lymph-node and nervous-system problems. In pregnant women, this parasite can cause birth defects, stillbirths and miscarriages.

Facts About Pregnancy

  • Four in 10 young women become pregnant at least once before they reach the age of 20 — nearly 1 million a year.
  • Improved technology has made home pregnancy tests about as accurate as blood tests-nearly 99 percent under perfect conditions.
  • Recent research shows that some exercise is healthy during pregnancy.
  • To calculate the due date, one can follow a guide called Nägele’s rule. This calculates the estimated date by subtracting 3 months from the first day of the last menstrual period and adding 7 days. increased
  • Older women have an increased chance of bearing twins.
  • 10 to 20 percent of pregnant women do not have morning sickness.
  • The risk of miscarriage in all pregnancies is around 15 to 30 percent. If the baby is developing normally the risk of miscarriage falls to less than 3 percent.
  • The overall risk of delivering a baby with a birth defect is approximately 3 percent.
  • The chances of a child dying in the later stages of pregnancy or soon after delivery are less than 1 percent.

Weeks of Pregnancy: What to Expect

The entire process of pregnancy-from conception to birth-takes about nine months, or 40 weeks of pregnancy. The pregnancy is divided into three-month periods known as trimesters.

The First Trimester (Weeks 1 to 13)

The first three months of fetal development are, perhaps, the most important. During the first 60 days, most of the baby’s organs form. It is at this stage that the unborn child is most sensitive to environmental chemicals, drugs and viruses that can cause birth defects.

The average fetus is about 3 inches long and weighs about 1 ounce by the end of the first trimester. It is normal for the fetus’ head to be disproportionately larger than the rest of its body. Some other important developments during the first trimester include:

  • By week 7, it is usually possible to see the developing baby within the womb and detect its heartbeat by ultrasound examinations.
  • By week 8, the baby’s face and features begin forming.
  • The first bone cells form.
  • Fingers and toes are growing, along with the beginnings of nails.
  • The liver begins making bile (a liquid that helps break down fats in food so they can be absorbed), and the kidneys begin secreting urine into the bladder.
  • The circulatory and respiratory systems begin functioning.
  • The fetus also begins to move during the first trimester, although the mother won’t feel movement until around the fourth month.

The Second Trimester (Weeks 14 to 26)

During this time, the fetus begins to grow and its organs mature. The increasing size of the uterus becomes obvious in the second trimester of pregnancy, as the woman’s belly begins to swell. Many women need to start wearing looser or maternity clothes at this time.

In the womb, a protective layer of amniotic fluid begins to surround the growing baby. Other developments in the second trimester include:

  • By the end of the second trimester, the baby is about 1 foot long and weighs about 1 pound. If birth occurs at this time, the fetus will attempt to breathe, but survival is unlikely before week 24.
  • The baby’s genitals are fully formed by week 14. The sex of the child can be determined using ultrasound.
  • By weeks 12 to 14, the fetal heartbeat can be heard with a stethoscope.
  • Hearing is well established by 24 weeks, when the baby begins to respond to outside sounds. The baby can now hear the mother’s voice and is likely to recognize it after birth.
  • Beginning at 16 weeks, the baby is sensitive to light, and by 28 weeks a baby can open his or her eyes and turn the head.

Need To Know:

By the fourth month, many women feel the first signs of life in their abdomen. The baby starts to kick and move. The amount of movement varies as the pregnancy continues. Babies move more at night and after the mother eats. As long as the mother feels the baby moving vigorously, it is likely in good health. If the movements decrease day by day, the mother should tell her physician.

The Third Trimester (Weeks 27 to 40)

The third trimester begins at the 27th week of pregnancy and lasts until birth. The baby continues to grow and put on weight throughout the last trimester of pregnancy. During the last month, the fetus grows about one-half pound per week.

By the ninth month, the baby usually settles into a position delivery, with the head down and arms and legs pulled up tightly against the chest.

Other developments during the third trimester include:

  • By week 28, the baby’s eyes are open and a child born at this time can move its limbs and cry weakly. However, the infant will weigh only about two pounds. But because of recent advances in caring for premature babies, 90 percent of babies born at this stage will survive.
  • The baby’s movements become more frequent and vigorous.
  • The baby is considered full-term after 37 weeks from the beginning of the mother’s last period.

What Can I Expect At The Doctor’s Office?

Women should plan a doctor’s visit early in pregnancy. A woman’s health during those first weeks is crucial to normal fetal development.

Many doctors schedule prenatal visits monthly for the first 28 weeks of pregnancy, every two weeks from 28 to 36 weeks, and weekly during the last month. Prenatal visits usually include routine blood and urine tests.

The First Doctor’s Visit

An initial pregnancy visit usually includes a medical history, a physical exam, and a number of prenatal tests. These tests include:

  • Urinalysis. A urine test screens for protein and glucose (sugar), which could indicate diabetes, [hyperlink to Diabetes in Pregnancy article] infection, or kidney disease. Technicians also check the urine for an elevated white blood cell count, which could signal disease or infection of the kidney or bladder.

    For more detailed information about diabetes that develops during pregnancy, go to Diabetes In Pregnancy.

  • Pap smear. A Pap smear test is a procedure for detecting and diagnosing malignant (cancerous) and premalignant (precancerous) conditions of the female genital tract. The site of the test is the cervix, which is the opening that leads to the uterus. The test is an important part of preventive care.

    For more detailed information about PAP smear, go to PAP Smear.

  • Blood tests. Physicians test blood in pregnant women for the following conditions:
    1. Anemia – Anemia is a deficiency in hemoglobin (a protein found in red blood cells). The most common symptoms of anemia are paleness and fatigue.

      For more detailed information about Anemia, go to Anemia.

    2. Infection – An elevated white-blood cell count indicates that a woman has an infection in her body.
    3. Rhesus (RH) factor – Usually first performed early in the pregnancy, and may be performed again as the pregnancy progresses. Women who lack the Rh factor (a substance found in red blood cells) are considered Rh-negative. Rh status, whether positive or negative, does not affect health before pregnancy. But during pregnancy, if an expectant mother is Rh-negative and her fetus is Rh-positive, problems can arise.
    4. Sexually transmitted diseases – Diseases such as syphilis and AIDS may be transmitted from mother to baby and can also cause birth defects and other health problems for the child.
    5. Hepatitis B – The hepatitis virus, which causes liver disease, can be transmitted to the fetus, resulting in a severe-and potentially fatal-infection of the liver.
  • Cultures. A culture is an examination of tissue to look for infection.
    1. Urine culture – A urine sample is cultured to determine if bacteria are present.
    2. Genital tract culture – The cervix is cultured for gonorrhea and chlamydia The lower vagina and rectum is cultured at 35 to 37 weeks of gestation for Group B streptococcus. If this is positive, the woman needs to be treated with antibiotics such as penicillin during labor to prevent a serious infection in the newborn.

Need To Know:

If an Rh-negative woman is carrying an Rh-positive fetus, her immune system may produce antibodies against the Rh factor in the fetus’s blood. The result can be mild or severe damage or death in the fetus from Rh disease (also called hemolytic disease or erythroblastosis).

Physicians use a blood test to determine whether an Rh-negative mother is producing antibodies against red blood cells. If the test indicates that the mother had not produced these harmful antibodies, a physician can give a woman an injection of a blood product called Rh immunoglobin during and after pregnancy, and this prevents antibodies from forming.

Regular Visits During Pregnancy

During the prenatal visits, the doctor will check:

  • Blood pressure. A physician will carefully monitor a pregnant woman’s blood pressure, because hypertension (high blood pressure) can be harmful to both mother and baby. Hypertension may result in preeclampsiaa potentially serious elevation of blood pressure that may occur late in pregnancy.
  • Mother’s weight. Most women gain about 1 pound a week after the first trimester. Women within 20 percent of their ideal body weight should gain 25 to 35 pounds during the pregnancy. A slowing or stopping of weight gain in the mother can be an indication of poor nutrition. A rapid gain in weight could indicate excessive fluid retention (edema), which can be a sign of preeclampsia.
  • Uterine size. The growth of the uterus is checked each visit. It is determined by checking the fundal height-the distance between the top (fundus) of the uterus and the pubic bone. If the uterus is too small, it could indicate an error in the due date or that the fetus or volume of amniotic fluid is too small or the fetus is not growing normally. If uterine size is too large, it could indicate twins, excess amniotic fluid, or a large fetus.
  • Fetal heart rate. Listening to the sounds or movement of the fetal heart is the most certain method of assuring that the fetus is alive. This heart rate can be determined by two methods:
    1. Obstetricians can directly listen for the heart sounds of the fetus using a special stethoscope that is more sensitive than ones used on adults. The normal fetal heart rate is 120 to 160 beats per minute.
    2. Frequently, an ultrasonic device known as a doppler is used to detect the fetal heart rate. This device allows measurement of the fetal heart rate much earlier in pregnancy than the stethoscope and allows the mother to hear the fetal heart as well.

Nice To Know:

The doctor finds the top of a woman’s uterus by gently tapping and pressing on her abdomen and measures from that point down along the front of the abdomen to her pubic bone. During the middle of pregnancy from about 18 to 34 weeks the fundal height, in centimeters, often equals the number of weeks of pregnancy.

Glucose Tolerance Test

A doctor may perform a glucose screening and testing to determine whether a pregnant woman has gestational diabetes. Diabetes involves an abnormality in the hormone insulin, which regulates levels ofblood sugar (glucose). In a person with diabetes, the body does not produce enough insulin, or it does not properly use the insulin it does produce. The result is an excess amount of glucose in the blood, which can give rise to numerous health problems.

Gestational diabetes is a form of diabetes that develops during pregnancy. It is caused by changes in a pregnant woman’s metabolism and hormone production. Gestational diabetes poses many potential problems for the baby. For example, the baby may put on excess weight before birth, a condition called macrosomia.

To screen for gestational diabetes, the mother drinks a glucose solution containing 50 grams of glucose, and a blood test is done one hour later. If the glucose value in this blood test is high, a three-hour oral glucose tolerance test will need to be done. For three days prior to this test, the mother’s diet should contain ample amounts of carbohydrates. On the day of the test, she must fast. Before drinking the glucose solution, and every hour for three hours afterward, the mother’s blood glucose level is measured.

For more detailed information about diabetes that develops during pregnancy, go to Diabetes In Pregnancy.


Prenatal Testing

Some tests, called indicated tests, are usually reserved for women who are considered at increased risk due to something her medical or genetic history or an abnormal result in a screening test. However, some indicated tests, such as ultrasound, are being used more often during pregnancy, regardless of whether the mother or fetus is at risk of health problems.

Prenatal tests include:

  • Ultrasound
  • Alpha-fetoprotein
  • Contraction stress testing
  • Non-stress testing
  • Fetal motion count
  • Amniocentesis
  • Other screening tests

Ultrasound

Ultrasound, or sonogram, uses high frequency sound waves to form an image of the uterus, placenta, and fetus. This view into the uterus allows doctors to measure many details about the fetus, including:

  • Growth of the fetus
  • Abnormalities of the fetal structures such as heart, brain, limbs, kidneys, and stomach
  • Birth defects
  • Amount of amniotic fluid
  • Location and development of the placenta
  • Gestational age or duration of the pregnancy

The test can be performed almost any time during pregnancy. In the earliest months, it can be performed with a probe placed in the vagina. However, most are performed with a wand placed on the abdomen over the uterus.

Alpha-Fetoprotein (AFP)

Between 15 and 18 weeks, the doctor may perform a test to determine the level of alpha-fetoprotein (AFP) in a pregnant woman’s blood. AFP is a substance normally produced by a growing fetus. In AFP testing, a blood sample taken from a vein in the arm is analyzed. If the test shows that the AFP level is higher or lower than normal, further tests will be done to confirm or rule out fetal problems.

High AFP levels will occur with twin pregnancies. Also, measuring AFP can help determine the presence of a type of birth defect called aneural tube defect. Neural tube defects are an abnormality in which the spinal cord or brain does not form properly. An increased level of AFP may be found in the blood of a woman whose fetus has a neural tube defect or an abdominal wall defect in formation. An AFP level that is lower than normal may be linked to an increased risk of Down syndrome.

Contraction Stress Testing

This test uses a fetal monitor to continuously record the baby’s heart rate and uterine contraction on special paper. A decrease in the fetal heart rate in response to contractions of the uterus is a positive test result. This may involve the use of oxytocin or other means to cause uterine contraction. The test is performed when the fetus is believed to be at increased risk for stillbirth. A negative test suggests that the fetus is at low risk for stillbirth, whereas a positive test indicates that the fetus may be in danger.

Non-Stress Testing

In this procedure, the fetal monitor is attached to the mother’s abdomen and records the fetal heart rate. The doctor listens for increases, or accelerations, in the fetal heart rate. If the baby is believed to be asleep, a buzzer is sounded to awaken the fetus. Like contraction stress testing, this test is also performed when the fetus is believed to be at increased risk for stillbirth, but it does not require uterine contractions. A flat fetal heart rate can indicate an increased risk of stillbirth.

Fetal Motion Count

There are a variety of ways in which this test is performed but all rely upon a sudden change in the number of fetal movements in a specified period of time. In most cases, the mother keeps track of the number of times she feels the baby move. Further tests will be performed if the mother notes a sudden decrease or absence of movements. Although some physicians use this procedure because it is easy to use and inexpensive, the appropriate role of fetal motion counting in prenatal care is controversial.

Amniocentesis

The amniotic fluid that surrounds the growing fetus can yield important information. Amniocentesis allows a small sample of this fluid to be collected for analysis. Using sonogram as a guide, doctors insert a long, thin needle through the abdominal wall and the wall of the uterus into the fluid cavity surrounding the fetus.

Nice To Know:

Amniocentesis is usually offered to women who are at an increased risk for having a baby with a birth defect. These women include those who will be age 35 or older on their due date and those who have a history of birth defects in their immediate family.

Amniocentesis may be done for many reasons:

  • To identify genetic defects
  • To test for fetal lung maturity
  • To detect isoimmunization to Rh factor

Genetic amniocentesis. One of the most common reasons for amniocentesis is to identify genetic defects. Genes carry the master plan of a person’s physical makeup. Because the amniotic fluid and the developing fetus are formed from the same cells, they share the same genetic makeup. Amniotic fluid can therefore be studied to see whether the fetus’s chromosomes are normal. Amniocentesis may also be done as a follow-up procedure in the event of a positive AFP test. Since the results of genetic amniocentesis may influence parental decisions about whether or not to carry a pregnancy to term, it is performed early, usually during the fourth month.

Amniocentesis for fetal lung maturity. This test is performed if there is concern that the infant may be at risk for lung development problems. In order to remain open, the lungs require a substance known as surfactant, lack of which is amajor cause of lung problems in premature infants. Amniocentesis for fetal lung maturity testing is usually reserved for situations in which early delivery is desirable, but the lung maturity of the fetus is in question.

Amniocentesis for isoimmunization. Isoimmunization occurs when Rh or other antibodies from the mother cross the placenta and destroy red blood cells in the fetus, causing anemia. This destruction can be measured by testing the amniotic fluid for bilirubin, a reddish-yellow pigment formed mainly by the decomposition of hemoglobin in worn-out red blood cells. Amniocentesis for isoimmunization is usually performed at various intervals during the second half of pregnancy.

For more detailed information about Anemia, go to Anemia.

Other Screening Tests

A number of other screening tests provide further assurance that a baby is progressing normally.These tests include:

  • Human chorionic gonadotropin (HCG). This substance can be measured in blood or urine samples taken from the mother. The most common reason to measure HCG is to diagnose pregnancy. However, physicians also use HCG testing to detect Down syndrome in a fetus.
  • Estriol. Earlier in pregnancy, this measurement can be used in conjunction with maternal age, AFP, and HCG to help in the prediction of Down syndrome.

What Can Go Wrong During Pregnancy?

Most pregnancies are uncomplicated and end with the birth of a normal, healthy baby. Early diagnosis and treatment of any complications will often prevent serious problems.

Regular check-ups can help you learn to recognize the difference between the normal changes and those that can indicate a problem. Problems during pregnancy include:

  • Birth defects
  • Ectopic pregnancy
  • Preeclampsia
  • Bleeding
  • Miscarriage
  • Loss of amniotic fluid
  • Diseases in pregnancy

Need To Know:

If you experience any of the following symptoms, notify your doctor immediately. Do not wait until your next scheduled checkup.

  • Vaginal bleeding or spotting
  • Sudden pronounced weight gain
  • Sharp or prolonged pain in your abdomen
  • Severe vomiting
  • Visual problems such as dimness, blurring, flashing light, or seeing dots
  • Sudden and serious swelling of the face, hands, and feet
  • Severe and ongoing headache
  • Painful, burning urination
  • Decreased urination
  • Chills and/or fever
  • Sudden escape of fluid from the vagina

Birth Defects

The overall risk of delivering a child with a birth defect is only 3 percent. The most common defects are those associated with the brain and spinal column, heart, and limbs.

The other main defect involves chromosomes in the cells of the fetus. The most common occurrence is Down syndrome. The risk of Down syndrome ranges from less than 1 in 1,000 in young women to 1 in 100 for women who conceive at age 40.

Ectopic Pregnancy

In an ectopic pregnancy, the fertilized egg attaches itself in a place other than inside the uterus. More than 95 percent of ectopic pregnancies occur in a fallopian tube. The narrow fallopian tubes are not designed to hold a growing embryo, so the fertilized egg in a tubal pregnancy cannot develop normally. Eventually, the thin walls of the fallopian tube stretch to the point of bursting. If this happens, a woman experiences severe pain and bleeding, and her life may be in danger.

 

Ectopic pregnancy occurs in 2 percent of reported pregnancies in the United States. Even so, death from ectopic pregnancy is rare, occurring in less than 1 of every 2,500 cases. This low rate is largely a result of new techniques to detect ectopic pregnancy at an early stage, when it can be treated successfully.

Need To Know:

An ectopic pregnancy can cause a rupture of the fallopian tube. If you are pregnant and experience sudden, sharp, severe abdominal pain seek treatment immediately.

Preeclampsia (Toxemia)

Preeclampsia is characterized by high blood pressure, swelling of the face and hands, and protein in the urine after the 20th week of pregnancy. It is a potentially serious condition that, if left untreated, can lead to complications or death in the mother or the baby.

There is no specific treatment for preeclampsia, nor is it known how to prevent it. The only sure way to end the preeclampsia is to deliver the baby, sometimes despite the fact that the baby may be premature.

Bleeding

Up to 25 percent of all pregnant women have bleeding at some point in pregnancy, and of these women, about half will have a miscarriage. Vaginal bleeding is the chief sign of miscarriagein mid-pregnancy. Bleeding in later pregnancy can result from serious problems with the placenta. These could be that the placenta is too low and covering the cervix (placenta previa) or that it has prematurely separated from the uterine wall (abruption). These conditions often need to be treated by doing a cesarean delivery.

Need To Know:

If bleeding is slight or spotty, there may be no cause for concern. But report moderate to heavy bleeding in pregnancy as soon as possible, because it may be a sign of one of the following problems:

  • Miscarriage (if it occurs before 20 weeks)
  • Preterm labor (if it occurs between 20 and 37 weeks)
  • Problems with the placenta (the organ that nourishes the developing fetus) conditions in which it lies too low in the uterus or begins to separate from the inner wall of the uterus before birth

If you have any bleeding along with pain or cramping during pregnancy, immediately call your doctor or go to an emergency room.

Miscarriage

Miscarriage, technically called spontaneous abortion, is defined as the loss of a pregnancy before 20 weeks of gestation. It has been estimated to occur in 15 to 30 percent of all pregnancies.

More than 50 percent of miscarriages in the first trimester are caused by chromosomal abnormalities. Infections, uncontrolled diabetes, uterine abnormalities, or a woman’s production of certain antibodies during pregnancy can also cause an early miscarriage. The warning sign of vaginal bleeding and uterine cramps precedes nearly all miscarriages.

Loss of Amniotic Fluid

The developing fetus floats in amniotic fluid, which is contained in the amniotic sac. During pregnancy the amniotic fluid increases in volume as the fetus grows. Amniotic fluid volume is greatest at approximately 37 weeks of gestation, when it averages 1,000 ml.  Approximately 800 ml of amniotic fluid surrounds the baby at full term (40 weeks). This fluid is constantly circulated by the baby swallowing and “inhaling” existing fluid and replacing it through “exhalation” and urination.

Amniotic fluid accomplishes numerous functions for the fetus, including:

  • Protects from outside injury by cushioning sudden blows or movements
  • Allows for freedom of fetal movement and permits symmetrical musculoskeletal development
  • Maintains a relatively constant temperature for the environment surrounding the fetus, thus protecting the fetus from heat loss
  • Permits proper lung development because the fetual breathes the fluid into the lungs

When a woman goes into labor her “water breaks” and amniotic fluid leaks from the uterus and through the vagina. Normally, a woman’s water does not break until labor is underway, however, sometimes amniotic fluid is lost too early. This can make it difficult for the fetus to grow and develop fully before birth, cause premature delivery, jeopardize the baby’s lung development, and put the fetus at risk for infection. About 35 percent of preterm deliveries occur because of early rupture of the amniotic sac.

If a pregnant woman notices any fluid leaking from her vagina, she should go to the hospital emergency room at once. She may go into pre-term labor, although many mothers’ whose waters break early do not deliver for a number of weeks, this allowing the baby to grow bigger and the lungs to mature before birth.

Diseases In Pregnancy

Many of the potential problems in pregnancy are best managed when they are detected early. The exams and tests done as part of routine prenatal care are intended to detect the early signs of these and other complications.

  • Gestational DiabetesA small percentage (one to four percent) of pregnant women develop diabetes mellitus, usually in the second or third trimester, referred to as gestational diabetes. The disease poses a serious threat for both the woman and her unborn child. Gestational diabetes has been linked to neonatal hypoglycemia and having a large newborn. The disease often resolves immediately after delivery.

    For more detailed information about diabetes that develops during pregnancy, go to Diabetes In Pregnancy.

  • Hypertension. Hypertension (high blood pressure) during pregnancy can be life threatening to both the woman and the fetus. Hypertension can cause seizures, organ disturbances, edema (swelling of body tissues) and protein in the urine. Together these symptoms cause a condition called preeclampsia, which can result in premature delivery and fetal death.
  • Rubella. Also known as German measles, the disease is usually not serious in children and adults. But if a woman is infected just before or during pregnancy, the disease can cause heart problems, deafness, and other serious problems for the fetus. A rubella vaccine should not be given to a woman who is pregnant or a woman planning to become pregnant within three months. Most women are immune and, therefore, the baby is not at risk.

Pregnancy: Preparing for Birth

No two births are alike. Labor is a series of changing conditions, and no amount of examination can predict how a woman or her baby will respond.

What Type Of Delivery Is Best?

The mother’s health and/or baby’s condition will largely determine the type of delivery.

  • Vaginal birth is the traditional style of delivery in which the mother is an active participant.
  • Cesarean birth is a surgical delivery through an abdominal incision.

Often the position of your baby or the placenta affects the course of labor. Cesarean delivery may be needed if the baby’s position cannot be changed or if the placenta’s position makes vaginal delivery a risk. A Cesarean also is needed if the fetus is unable to tolerate labor and is becoming low on oxygen, or if the labor fails to progress.

Is This Labor?

Labor is a series of uterine contractions that open the cervix for birth.

Your due date is a good guide in determining if you are indeed in labor. But it’s important to remember that babies are often born days or weeks before or after due dates.

Signs the baby will soon be born include:

  • Irregular tightening or contractions of the uterus
  • Increased and thickened vaginal secretions
  • Pink or brown-tinged discharge indicating breakdown of the mucus plug sealing the uterus

Labor often starts slowly. Regular, uncomfortable contractions that come more often than one every 10 minutes may mean the woman is in labor.

Many women are told to leave for the hospital when contractions are 5 to 10 minutes apart or if there is bleeding or leaking of amniotic fluid.

If your physician believes continuing the pregnancy might harm you or your baby, he or she may induce labor. Induction of labor often involves chemical or physical stimulation. Techniques include:

  • Physical stimulation to loosen the amniotic sac from the uterine wall
  • Rupturing the membranes with a special tool
  • Administering a drug to start labor, either by giving it intravenously (oxytocin) or into the vagina (prostaglandins)

Pregnancy: Frequently Asked Questions

Here are some frequently asked questions related to pregnancy:

Q: Is spotting a reason for concern?

A: One in five women experience light spotting early in pregnancy. However, heavy bleeding can indicate a serious problem. Call your doctor right away at any sign of blood.

Q: How much do I need to eat when I’m pregnant?

A: To help your baby grow properly, you need to eat about 300 more calories each day However, skip junk foods that are high in calories, fat, and sugar. Instead choose wholesome foods from each of the four food groups to ensure that you get enough of the proper nutrients.

Q: Is it safe to have sex?

A: Intercourse does not cause miscarriage or harm the unborn baby. But it can make the uterus contract, causing light cramping. If cramping continues or spotting occurs, contact your healthcare provider immediately. Pregnant women may be more comfortable having intercourse in the top position or on their side.

Q: How can I relieve morning sickness?

A: The American Dietetic Association suggests switching to smaller, more frequent meals. Women may also try taking their prenatal vitamins later in the day. Keeping some plain crackers on a bedside table and eating them before getting out of bed might also help.


Pregnancy: Putting It All Together

Here is a summary of the important facts and information related to pregnancy:

  • Having a baby is one of the most important events in a woman’s life. Most women worry about whether the baby they are carrying is healthy.
  • Early and regular prenatal care is the best insurance against problems in pregnancy.
  • Prenatal tests usually assure the parents that the pregnancy is progressing normally and allow doctors and parents to spot problems early.
  • If a woman is concerned about the health of her baby, she should immediately discuss it with her physician. Tests can often alleviate any concern.

Pregnancy – Glossary

Here are definitions of medical terms related to pregnancy:

Alpha-fetoprotein: A fetal protein normally present in the blood and amniotic fluid of pregnant women. High or low levels can be associated with certain birth defects. The protein is also abnormally present in adults with liver cancer.

Amniotic fluid: The fluid in which the fetus develops.

Amniotic sac: A thin, tough, membranous sac that encloses the fetus. It is filled with fluid in which the fetus is suspended.

Antibodies: A protein produced by the body in response to an infection.

Bilirubin: Orange or yellow pigment found in bile, the fluid produced by the liver. It is a result of the breakdown of hemoglobin. An excess of this produces jaundice.

Chromosomes: A threadlike linear strand of DNA and associated proteins in the nucleus of cells that carries the genes and functions in the transmission of hereditary information.

Ectopic pregnancy: Implantation and subsequent development of a fertilized egg outside the uterus, as in a fallopian tube.

Estriol: An estrogenic hormone found in the blood and urine during pregnancy.

Fallopian tube: A pair of slender ducts through which ova (eggs) pass from the ovaries to the uterus in the female reproductive system.

Gestational diabetes: Diabetes that occurs during pregnancy. Diabetes is a condition in which the pancreas does not produce enough insulin or the body cannot use the insulin produced. As a result, glucose (blood sugar) increases in the blood and is passed out of the body through the urine.

Glucose: Blood sugar, also known as dextrose. Converted into energy for the body’s cells.

Human chorionic gonadotrophin (HCG): A hormone produced by the placenta during pregnancy. It is the indicator that shows up on both home and physician-administered pregnancy tests.

Hemoglobin: A red pigmented protein containing iron. Found in red blood cells. It carries oxygen to body tissues.

Karyotype: The chromosomal characteristics of a cell.

Macrosomia: A fetus with macrosomia has significant overgrowth and weighs more than 10 pounds.

Miscarriage: The expulsion of a nonviable fetus from the uterus in the first 20 weeks of pregnancy. Also called spontaneous abortion.

Neural tube defect: Any of various congenital defects of the brain and spinal cord, such as spina bifida, resulting from incomplete closing or development of the neural tube in an embryo.

Oxytocin: Pituitary hormone that stimulates breast milk production.

Placenta: Spongy uterine material through which the mother provides nourishment to the fetus. The placenta is discarded after delivery and referred to as the afterbirth.

Preeclampsia: A condition of hypertension occurring in pregnancy, typically indicated by fluid retention and high blood pressure.

Rh-isoimmunization: When Rh -factor antibodies cross the placenta and affect the red blood cells of the fetus, causing anemia and other problems.

Surfactant: A wetting agent secreted by the cells lining the alveoli of the lungs to prevent the lung walls from sticking together.

Toxoplasmosis: A disease caused by the sporozoan Toxoplasma gondii, found in cat feces. It can be fatal to a fetus.

Ultrasound: The use of ultrasonic to monitor a developing fetus.

Uterine contraction: A rhythmic tightening in labor of the upper uterine musculature that contracts the size of the uterus and pushes the fetus toward the birth canal.


Pregnancy: Additional Sources Of Information

Here are some reliable sources that can provide more information on pregnancy:

American College of Obstetricians and Gynecologists 
http://www.acog.org

March of Dimes 
http://www.modimes.org

Childbirth.org 
http://www.childbirth.org

National Institutes of Health 
http://www.nih.gov

National Institute of Child Health and Human Development 
http://www.nichd.nih.gov/

American Pregnancy Association 
Pregnancy Symptoms – Early Signs of Pregnancy

Cord Blood Banking Information

Provides information on public and private umbilical cord blood collection and storage.

Online: http://www.cordbankings.com/


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