Care during pregnancy

Nutrition

Nutrition in general is very important aspect of good health for each one of us. So, imagine the increase in demand for essential nutrients during pregnancy for the Mother is not just consuming food and nutrients for herself but also the baby which is growing in her womb. And not to forget she is also undergoing various changes within.

Many women lack the required scale of nutrients like iron, folate, calcium, vitamin D or protein which are highly essential during Pregnancy. Hence, it is very important that a pregnant woman consumes nutrition rich foods along with the supplements prescribed by her Obstetricians and Gynaecologists.

According to ACOG, American College of Obstetricians and Gynaecologists, you should try to eat a variety of foods from these basic food groups. If you do so, you are more likely to get all the nutrients you need for a healthy pregnancy.

But just in case you are allergic to any of these, it is always suggested to consult your doctor before consuming.

Grains

Bread, pasta, oatmeal, cereal, and tortillas are all grains.

Fruits

Fruits can be fresh, canned, frozen, or dried. Juice that is 100% fruit juice also counts.

Vegetables

Vegetables can be raw or cooked, frozen, canned, dried, or 100% vegetable juice.

Protein

Protein foods include meat, poultry, seafood, beans and peas, eggs, processed soy products, nuts, and seeds.

Dairy

Milk and products made from milk, such as cheese, yogurt, and ice cream, make up the dairy group

Some common foods to avoid during Pregnancy are as follows.

Raw/undercooked meat (includes fish, beef, chicken etc)
Avoid Tuna, Mackerel altogether
Limit Caffeine intake to less than 200mg/day
Unpasteurized milk/cheese/fruit juice
Alcohol should not be consumed at any cost
Avoid processed junk food altogether
High sodium food
Avoid the fruit Papaya altogether

SOME HARMFUL DRUGS TO AVOID DURING PREGNANCY

Well, falling sick seems completely a NO during Pregnancy. Common cold or even a headache may seem completely normal and self-medicated otherwise but during pregnancy self-medication or OTC, Over the Counter medicine is strictly not allowed irrespective of the problem.

An obstetrician/gynaecologist (OB/GYN) will be the best guide to determine which drugs to consume and which to terminate as it can cross the placenta and cause defects in the baby. You and the baby growing within shall be in good care provided you listen and follow the rules your Gynaecologist prescribe.

This also means as and when you face any problem during pregnancy, you should be consulting your Gynaecologist immediately.

Some common drugs to avoid are,

ACE Inhibitors- Captopril, Enalapril, lisinopril, benazepril
Acne mediation- Accutane, Retin-A
Androgens (male hormones)
Anticoagulants with warfarin
Anticonvulsants- Phenytoin, valproic acid, trimethadione, carbamazepine
Bipolar medication- Lithium
Anticancer drugs- methotrexate and aminopterin
Antirheumatic drugs with penicillamine
Any alcohol-containing substances
Nicotine patches
Antithyroid drugs- thiouracil, carbimazole
Cocaine
Hormone- diethylstilboestrol
Thalidomide

PREGNANCY TERM TESTS

Test 1: The Pregnancy test

Available in drugstores
The pregnancy test checks for the levels of the pregnancy hormone- HCG, Human Chorionic Gonadotropin in the urine of the mother.
This test is usually effective to detect pregnancy after a missed period, on the next month. It is only by this time that the levels of the hormone HCG substantially rise in the urine to be detected by the test.

How to perform the test?

Buy a pregnancy test kit, which is available in almost all pharmacies and drug stores near you.
Upon opening of the pack, you will find a Pregnancy tester stick.
On one end of the stick, there will be an indicated region where the stick must touch urine.
The contact with urine can be done by holding the stick against the urine stream, urinating in a cup, and dipping the stick in it or using a dropper to bring the stick in contact with few drops of urine.
Wait for about a minute for the test results to show up.

How to interpret the results of a pregnancy test?

The result interpretation depends on the standards used by the pregnancy kits. Read the instructions on the cover or on any paper attached to the pregnancy kit. The instructions to conducting and interpreting the results are usually written there. However, depending on the type of pregnancy kit, the possible interpretations are:

In case of single window tests, two lines indicate a positive result (pregnancy confirmed) and one line indicates a negative result (not pregnant).
Some tests come with a test line and two windows. In these tests, the display of a plus sign indicates a positive result and the display of just the test line indicates a negative result.
Digital pregnancy tests plainly display “yes” or “you are pregnant” on the window.

Accuracy of the home pregnancy test is about 99 percent
In case of a positive result, it is important to schedule an appointment with a doctor as soon as possible.

Test 2: Confirming Pregnancy by doctor

Visits to the doctor to perform screenings and tests and discuss the future course of the pregnancy are termed as prenatal visits.
During her first prenatal visit, the woman consults the doctor reporting a positive result in a home pregnancy test.

The doctor performs tests to confirm the pregnancy:

1. Qualitative blood test: The pregnant woman’s blood sample collected and the levels of the HCG hormone is detected in the blood. The accuracy of this test is the same as the home pregnancy urine test and the results are displayed as plain “positive” or “negative”.

2. Quantitative test: The quantity of the hormone HCG is measured by this test, in the blood of the pregnant woman. This is more accurate than the qualitative test as the results of the level of HCG are displayed accurately.

Upon confirming a positive result, the doctor will present the results to the mother and will ask the mother if she would be willing to continue with the pregnancy. If the mother says yes, the schedule of the future visits to the doctor’s clinics is prepared.

How often is it recommended to visit the doctor’s clinic?

The schedule for the visit to the doctor’s clinic differs according to trimesters, with the number of visits increasing in number per week as the woman approaches labour during her final trimester. The recommended visiting schedule, in case of confirmed normal pregnancy is:

Week 4 to 28: 1 prenatal visit a month.
Week 28 to 36: 1 prenatal visit every 2 weeks.
Week 36 to 40: 1 prenatal visit every week.

Test 3: Blood pressure, weight, and blood sugar assessment

Next during the first prenatal visit, the doctor performs a routine blood pressure and blood sugar assessment.
High pressure can be extremely dangerous for the life of the mother as well as the child during pregnancy. In extreme conditions, it can result in a fatal condition known as eclampsia which results in the death in the mother. Therefore, it is important for the clinician to routinely check the blood pressure of the pregnant woman during every prenatal visit.
Gestational Diabetes is another condition which is a cause of severe diabetic complications in the mother. Routine blood sugar tests help the clinician to track the blood sugar of the mother, to prevent any complications.
The weight of the mother during every prenatal visit is recorded and assessed by the doctor. The weight gain occurs due to the increase of the weight of the child, the growth of pregnancy tissue, the retention of some fluids in some regions etc.
The normal weight gain during pregnancy is calculated by taking the BMI of the woman during pregnancy. In case of women who fall within the “normal” BMI range of 18.5 to 24.9, the normal weight gain is considered to be of 11.5 to 16kgs.
The BP test, sugar test and recording of weight is assessed by the clinician during every prenatal visit, without any exception.

Test 4: PAP smear

Any HPV infection can cause major complications during pregnancy. To detect for the presence of the Human Papilloma Virus in the cervix of the pregnant woman, a PAP smear test is performed by the clinician.
Since HPV infections mostly result in cervical cancer, the PAP smear detects for cases of any undetected cervical cancer in pregnant women.

How is it performed?

The woman is directed to an additional room where the feet of the woman are placed on stirrups.
A speculum is used to open the vagina to make the cervix accessible.
A swab is collected by the doctor and is preserved in a jar/kit.
The sample is sent to the laboratory to check for cervical cancer

The lab results are assessed by the doctor and in case of a positive result, it does not directly indicate that the woman has cervical cancer. I might also indicate minor cell growth or changes in the cervix. This will depend on the grading and it will be assessed by the clinician.

Test 5: Tests for Sexually transmitted infections and other infections

During the woman’s first pre-natal visit, the doctor also performs tests to check for any sexually transmitted infections which can cause issues in the child.

The STDs screened for are:

Mumps
Poliomyelitis
Toxoplasmosis
Syphilis
Malaria
Smallpox (eradicated from the world)
Cytomegalovirus
HIV
Chlamydia
Zika virus
Hepatitis C, D and E
Herpes simplex

Test 6: Ultrasounds

Ultrasound exams are not performed on every visit.
Women can have a standard ultrasound exam between 18 and 20 weeks to look for signs of problems with the child’s organs and to ensure that the foetus is growing properly.
The age of the foetus is also assessed in every ultrasound.

How is it performed?

The doctor will ask you to lie down on the bed and to lift your shirt up to expose the lower abdomen.
A gel will be spread on your lower abdomen to the pelvis and a monitor will be placed beside you where the ultrasound results are displayed.
The doctor takes a tool to navigate around your pelvis to reach up to the area where the embryo/foetus is implanted.
The monitor displays the results of the ultrasound and the doctor can print it out for the mother to take home, if she wishes!

Test 7: Amniocentesis

This is usually performed in the beginning of the second trimester of pregnancy.
This test can diagnosis certain birth defects, including Downs syndrome, Cystic fibrosis, Spina bifida

How is it performed?

The nurse or the doctor uses a cotton to apply some alcohol over the area to incise,
A needle is taken and inserted to reach the fluid in the amniotic sac.
The fluid is collected and sent for testing in the laboratory.

The doctor will assess the results and will leave the decision of continuing the pregnancy up to the parent/s of the foetus.

Test 8: Biophysical profile

This is performed before delivery in the third trimester of pregnancy.
This test involves an ultrasound and a Non stress test to assess the heart rate, movement, breathing, muscle tone and amniotic fluid around the child.
The non-stress test is performed after placing a small belt sound the mother’s belly to check the status of the foetus.

Test 9: Group B streptococcus screening

A vaginal swab is performed to check for any streptococcal infection before delivery in the pregnant woman.
Any infection can cause serious complications in the child after delivery. So, it is important to check for any streptococcal infection by the clinician before delivery.