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Chapter 2 Now That You’re Pregnant By: Trevella Lawson What you may be concerned about • Your gynecological history & your family history o • Previous Abortions o • You need to make sure that any aspect of your obstetrical and gynecological history is passed on to your practitioner. It is also important to share the history of past generations to help protect todays generation. If you had multiple second trimester abortions, it can increase the chance of premature delivery. Let your practitioner know about your abortion(s), because the more they know the better care you will receive. Pregnancies too close together o Conceiving before you’ve fully recovered from a recent pregnancy and delivery puts strain on the body. Studies indicate that 2 - 2½ years is the medically ideal space between pregnancies. It is essential to be aware of the toll of a closely spaced pregnancies can take. What you may be concerned about • • • The second time around o May ‘feel’ and ‘look’ pregnant sooner, and will be able to feel movement sooner. Repeat cesareans & vaginal birth after cesarean o Having cesareans are considered a much safer option than it once was. It is possible to give birth vaginally after having a cesareans, but must be under the right circumstances. Obesity o It is important to be aware of possible complications that extra weight could lead to and what you can do about them. There is an increased risk of gestational diabetes and high blood pressure. Also accurately dating the pregnancy may be tricky. What you may be concerned about • • Having a baby at an older age o Pregnancy becomes more risky as you grow older. When trying to become pregnant at an older age you may not be able to become pregnant at all because of decreased fertility. Also fathers who are older, their sperm may contribute to birth defects such as Down syndrome. Herpes & STD’s o Having herpes during pregnancy is a cause for concern, but chances are excellent that your baby will arrive safe especially if you and your practitioner take protective steps during pregnancy. STD’s present a hazard to the fetus, but most STD’s are easily diagnosed and treated safely. What you may be concerned about • An Uncomfortable pregnancy o General Health - Once you become pregnant continue taking good care of yourself as well as your pregnancy o Diet - Follow the Pregnancy Diet it improves a pregnant womans chance of having a comfortable pregnancy o Weight Gain - Gaining weight at a steady rate within recommended boundaries can help minimize the chances of hemorrhoids, varicose veins, stretch marks, backache, fatigue, indigestion, and shortness of breath. o Fitness - Getting enough, and the right kind of exercise can improve your general well being. o Lifestyle Pace - Living a hectic life can trigger some of the most uncomfortable pregnancy symptoms, can prevent this by slowing your lifestyle pace down. o Other Children - Having one or more children tends to aggravate pregnancy symptoms. What it’s important to know about prenatal diagnosis • Through prenatal diagnosis, it can help determine to some extent if your baby is going to be okay. Because of inherent risks, prenatal diagnosis isn’t for everyone. Woman who are good candidates for prenatal diagnosis are… Woman over the age of 35, have a family history of genetic disease, have a genetic disorder, have been exposed to infection that could cause a birth defect, have been exposed to substances that could be harmful to their developing baby, previous unsuccessful pregnancies, or have tested positive on a prenatal screening test. Screening Tests • • Woman go through screening tests before deciding to undergo prenatal diagnosis. First trimester screening o • Second trimester screening o • First trimester screening for down syndrome involves and ultrasound and blood tests, and if results are abnormal woman would be offered amniocentesis. The triple screen is a simple blood test that measures three hormones produced by the fetus and passed into the mother’s bloodstream. The triple screen cannot diagnose a birth defect, it can only indicate the risk of having a birth defect. Ultra Sound o Ultrasounds allow visualization and “examination” of the fetus without the use Diagnostic Tests • Chorionic villus sampling o • CVS can give results earlier in the pregnancy than amniocentesis, it is helpful for those who consider a therapeutic pregnancy termination is something is seriously wrong. CVS is useful for detecting disorders such as Tay-Sachs, sickle-cell anemia, cystic fibrosis, and down syndrome. Amniocentesis o Is recommended for women over the age of 35, previously had a child with chromosomal abnormality, couple has another child or close relative with a neural tube defect, mother is a carrier of an X-linked genetic disorder, both parents are carriers of an autosomal recessive inherited disorder, parent is known to have a condition such as Huntington’s chorea, or results of a screening test turn out to be abnormal. Diagnostic Tests • Other types of prenatal diagnoses o o o o o Percutaneous umbilical blood sampling: Useful for diagnosing several blood and skin diseases that amniocentesis can’t detect. Maternal blood test to determine fetal gender. Fetal skin sampling: Helps detect certain skin disorders. Magnetic resonance imaging (MRI) Echocardiography: Detects defects in the fetal heart.