Pregnancy related terminologies:
1) Weight gain
The amount of healthy weight gain during a pregnancy varies from woman to woman. Weight gain includes weight of the baby, growing placenta, extra fluid for circulation and the weight needed to provide nutrition for the growing fetus. Most needed weight gain occurs in later pregnancy.
Study suggests that ideally an overall pregnancy weight gain of normal weight (BMI of 18.5 – 24.9), of 11.3 – 15.9 kg (25–35 pounds) having a singleton pregnancy.
During pregnancy, insufficient or excessive weight gain can compromise the health of the mother and fetus. The most effective interventions for weight gain in underweight women is not clear. Being or becoming very overweight in pregnancy increases the risk of complications for mother and fetus, including cesarean section, gestational hypertension, pre-eclampsia, macrosomia and shoulder dystocia.
A systematic review found that diet is the most effective way to reduce weight gain and associated risks in pregnancy. The review did not find evidence of harm associated with diet control and exercise.
2) Exposure to environmental toxins
Intrauterine exposure to environmental toxins in pregnancy has the potential to cause adverse effects on the prenatal development of the embryo or fetus, as well as on pregnancy complications. Potential effects of toxic substances and pollution include congenital abnormalities. Also, neuroplastic effects of pollution can give rise to neuro developmental disorders in the child. Conditions of particular severity in pregnancy include mercury poisoning and lead poisoning.
3) Nutrition in pregnancy period:
A balanced, nutritious diet is an important aspect of a healthy pregnancy. Eating a healthy diet, balancing carbohydrates, fat, and proteins, and eating a variety of fruits and vegetables, usually ensures good nutrition.
Adequate periconceptional folic acid (also called folate or Vitamin B9) intake has been shown to decrease the risk of fetal neural tube defects such as spina bifida, a serious birth defect. The neural tube develops during the first 28 days of pregnancy, explaining the necessity to guarantee adequate periconceptional folate intake. Folate (from folia, leaf) is abundant in spinach (fresh, frozen, or canned), and is found in green leafy vegetables e.g. salads, beets, broccoli, asparagus, citrus fruits and melons, chickpeas (i.e. in the form of hummus or falafel), and eggs. Most wheat products (flour, noodles) are fortified with folic acid.
DHA omega-3 is a major structural fatty acid in the brain and retina, and is naturally found in breast milk. It is important for the woman to consume adequate amounts of DHA during pregnancy and while nursing to support her well-being and the health of her infant. Developing infants cannot produce DHA efficiently, and must receive this vital nutrient from the woman through the placenta during pregnancy and in breast milk after birth.
Several micronutrients are important for the health of the developing fetus. certain nutrients such as Vitamin D and calcium, required for bone development, may require supplementation.
Dangerous bacteria or parasites may contaminate foods. Careful washing of fruits and raw vegetables may remove these pathogens. Soft cheeses may contain Listeria; if milk is raw, the risk may increase. Cat feces pose a particular risk of toxoplasmosis. Pregnant women are also more prone to Salmonella infections from eggs and poultry, which should be thoroughly cooked. Practicing good hygiene in the kitchen can reduce these risks.
4) Sexual activity during pregnancy period :
Research suggests that during pregnancy both sexual desire and frequency of sexual relations decrease. In context of this overall decrease in desire, some studies indicate a second-trimester increase, preceding a decrease during the third trimester. Some individuals are sexually attracted to pregnant women.
Sex during pregnancy may not cause harm except when the healthcare professional advises that sexual intercourse should be avoided for particular medical reasons. Otherwise, for a healthy pregnant woman who is not ill or weak, there is no safe or right way to have sex during pregnancy. As a precaution, both partners avoid putting pressure on the uterus, or a partner's full weight on a pregnant belly.
5) Exercise during pregnancy period :
Under super viosion of a health care provider, doing regular aerobic exercise during pregnancy appears to improve or maintain the physical fitness. Physical exercise during pregnancy does appear to decrease the risk of C-section. All women without contraindications should be encouraged to participate in aerobic and strength-conditioning exercises as part of a healthy lifestyle during their pregnancy. Advice needed for the women who were not regular exercisers before pregnancy and who have complicated pregnancies earlier. They should avoid in engaging in high intensity exercise programs, such as jogging and aerobics for longer time.
Study suggests that earlier the main concerns of exercise in pregnancy were focused on the fetus and any potential maternal benefit was thought to be offset by potential risks to the fetus. However, they write that more recent information suggests that in the uncomplicated pregnancy, fetal injuries are highly unlikely. They do, however, list several circumstances when a woman should contact her health care provider before continuing with an exercise program. Contraindications include: Vaginal bleeding, dyspnea before exertion, dizziness, headache, chest pain, muscle weakness, preterm labor, decreased fetal movement, amniotic fluid leakage, and calf pain or swelling.
6) Discomforts of pregnancy:
Discomforts while pregnancy period are those conditions that do not pose any significant threat to the health of the mother or baby. Some examples are:
Nausea (morning sickness) - This occurs in majority of pregnant women, and typically improves after the first trimester. Women can experience this nausea during afternoon, evening, and throughout the entire day. Mild nausea may merely be a discomfort, but if severe and with vomiting causing water-electrolyte imbalance it can be classified as a pregnancy complication.
Back pain - It is common in pregnancy, can be very debilitating and can worsen in later pregnancy. This is usually beginning from the fifth month. It is believed to be caused by changing posture and can be worse in the evening time. It can be overcome by exercising in water, massage therapy, healthcare guidance etc. Support from pillows while sleeping might be able to help. Maternity support belts have not been shown to reduce low back pain in pregnancy. They may have some adverse effects, including pain and skin irritation for the mother, and potential effects on the fetus. So do consult & pick a right choice.
Pelvic girdle pain - It is complex and multi-factorial and likely to be represented by a series of sub-groups with different underlying pain drivers from peripheral or central nervous system, altered laxity/stiffness of muscles, laxity to injury of tendinous/ligamentous structures to 'mal-adaptive' body mechanics. There is pain, instability or dysfunction in the symphysis pubis and/or sacroiliac joints.
Other Common discomforts of pregnancy include:
- Braxton Hicks contractions - Occasional, irregular, and often painless contractions that occur several times per day.
- Edema (swelling) - It is Caused by compression of the inferior vena cava (IVC) and pelvic veins by the uterus leads to increased hydrostatic pressure in lower extremities.
- Increased urinary frequency - It is caused by increased intravascular volume, elevated GFR (glomerular filtration rate), and compression of the bladder by the expanding uterus.
- Urinary tract infection - It is caused by relaxation of the venous smooth muscle and increased intravascular pressure.
- Haemorrhoids (piles) are swollen veins at or inside the anal area, resulting from impaired venous return, straining associated with constipation, or increased intra-abdominal pressure in later pregnancy.
- Striae gravidarum, pregnancy-related stretch marks
Ill-health as a result of pregnancy is experienced by many women around the world.
The following are some examples of pregnancy complications:
- Pregnancy induced hypertension
- Postpartum depression
- Postpartum psychosis
- Thromboembolic disorders. The leading cause of death in pregnant women.
- PUPPP skin disease that develop around the 32nd week. Red plaques, papules, itchiness around the belly button that spread all over the body except for the inside of hands and face.
- Ectopic pregnancy, implantation of the embryo outside the uterus.
- Hyperemesis gravidarum, excessive nausea that is more severe than morning sickness.
There is also an increased susceptibility and severity of certain infections in pregnancy.
8) Inter current disease in pregnancy:
There may persist other diseases or conditions may not directly caused by the pregnancy that may become worse or be a potential risk to the pregnancy.
- Diabetes mellitus and pregnancy deals with the interactions of diabetes mellitus (not restricted to gestational diabetes) and pregnancy. Risks for the child include miscarriage, growth restriction, growth acceleration, fetal obesity (macrosomia), polyhydramnios and birth defects.
- Systemic lupus erythematosus and pregnancy confers an increased rate of fetal death in utero and spontaneous abortion (miscarriage), as well as of neonatal lupus.
- Thyroid disease in pregnancy can, if uncorrected, cause adverse effects on fetal and maternal well-being. The deleterious effects of thyroid dysfunction can also extend beyond pregnancy and delivery to affect neurointellectual development in the early life of the child. Demand for thyroid hormones is increased during pregnancy which may cause a previously unnoticed thyroid disorder to worsen.
- Hyper coagulability in pregnancy is the propensity of pregnant women to develop thrombosis (blood clots). Pregnancy itself is a factor of hyper coagulability (pregnancy-induced hyper coagulability), as a physiologically adaptive mechanism to prevent post partum bleeding. However, when combined with an additional underlying hyper coagulable states, the risk of thrombosis or embolism may become substantial.
Modern reproductive medicine offers many forms of assisted reproductive technology for couples who stay childless against their will, such as fertility medication, artificial insemination, in vitro fertilization and surrogacy.
An abortion is the termination of an embryo or fetus, either naturally or via medical methods. It is more often done within the first trimester than the second, and rarely in the third. Not using contraception, contraceptive failure, poor family planning or rape can lead to undesired pregnancies.
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