Enjoying Your Pregnancy Guide to Understanding - Brigham and ...

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30 Your Prenatal Guide HEPATITIS C Hepatitis C is a viral hepatitis that is spread through blood contact, including organ transplantation, intravenous drug use and blood transfusion. It can also be spread through sexual relations and from an infected mother to her child during birth. Most cases of hepatitis C are mild, and many go undiagnosed. However, a large percentage of people who have been exposed to hepatitis C can develop chronic infection that can cause symptoms many years later. It may also be transmitted to other people. If you have ever had unexplained hepatitis or jaundice, received blood transfusions or underwent organ transplant prior to 1993, used intravenous drugs, or had a sexual partner with these issues, please inform your obstetric care provider. You and your baby may benefit from testing for hepatitis C. CHICKENPOX (VARICELLA) Many women have already had chickenpox during their childhood. That’s why the disease is so uncommon during adulthood. It is however likely to be more severe in adults and pregnant women who do get it. If you are exposed to chickenpox and are not sure you have had it, contact us immediately. A simple blood test can establish your immunity. If you are non-immune and the exposure occurred less than 96 hours ago, an injection of varicella-zoster immune globulin (VZIG) can be given that can prevent or modify the disease. If you become infected at or near the time of delivery, your baby will get a special immune globulin injection to prevent him/her from getting a serious infection. INFLUENZA (FLU) If a pregnant woman gets the flu, she is more likely to become very sick. We will consider giving you a vaccination if certain medical conditions or seasonal considerations put you at increased risk for infection. HIV/HUMAN IMMUNODEFICIENCY VIRUS HIV is a sexually transmitted infection which causes AIDS. HIV (the AIDS virus) is transmitted by having any type of sex without a condom, and by sharing needles, for example when using intravenous drugs. Also, a pregnant woman can transmit HIV to her baby during pregnancy or by breastfeeding. There are now medicines available to an HIV-infected pregnant woman to decrease the chances that the infection will be passed on to her baby during pregnancy or at the time of birth. The sooner HIV is diagnosed and treatment is started, the better chance both mother and baby will have of staying healthy. Studies have shown that many women with HIV do not even know they could be infected. A simple blood test is available to see if you have been exposed to HIV. Since people may have the virus for many years and not know it, it is important that all pregnant women be tested. This test is recommended whether or not you think you have been exposed. Knowing if you have HIV is very important to your health and that of your unborn baby. The test is confidential and requires your consent. It can be performed along with other routine tests obtained during your pregnancy. Please discuss this test with your health care provider. CYTOMEGALOVIRUS (CMV) This is the most common viral infection that affects the newborn infant. If you become infected you’ll experience a nonspecific illness characterized by sore throat, fever, and swollen glands or you may have no symptoms at all. Because of its trivial nature it’s rarely recognized. This virus can remain in healthy adults for a lifetime and periodically become active. When active, the virus can cross the placenta to your unborn baby and cause physical impairments at birth. It appears that a baby is at greatest risk if the mother becomes infected for the first time during her pregnancy. Risk to the baby is not nearly so great if the mother experiences a flare up during pregnancy from a previously acquired infection. Fortunately, those infants born to mothers who have the most severe form of infection only rarely develop the serious consequences of the disease in the newborn period. Currently there is no effective treatment available for either the pregnant mother or her newborn baby and the majority of maternal infections are not easily diagnosed. Pregnant women may reduce exposure by careful handwashing and hygiene practices. MUMPS Mumps is uncommon during pregnancy because of the childhood vaccine and low infection rate in susceptible adults. However, it does appear to increase the rate of miscarriages and premature labor. Newborns rarely have abnormalities just because their mothers had the mumps during pregnancy.
Your Prenatal Guide 31 PROBLEMS DURING PREGNANCY There are many problems that can arise during pregnancy. Some are trivial, but others can be serious. EARLY PREGNANCY BLEEDING There are many causes of bleeding during pregnancy. Possible causes depend upon when it occurs. If you experience bleeding early in your pregnancy, we’ll perform a pelvic exam and an ultrasound to determine the cause. Two serious causes of early pregnancy bleeding are miscarriage and ectopic pregnancy. Miscarriage is the most common serious cause of early bleeding and occurs in 15-20 percent of all pregnancies, usually within the first three months. Most miscarriages cannot be prevented. They are nature’s way of dealing with pregnancies that are not developing properly. It is characterized by bleeding more than you would during a heavy period and is usually associated with cramping. An ectopic pregnancy, or the implantation of a fertilized egg outside the womb (usually in a fallopian tube), is another serious cause of early bleeding. Ectopic pregnancies occur in less than one percent of all pregnancies and are almost always associated with severe pain. Most of the bleeding is internal, which can be life-threatening because of its hidden nature. Call your obstetric care provider immediately if you experience severe abdominal pain early in your pregnancy. LATE PREGNANCY BLEEDING Bleeding late in pregnancy can be serious, but the most common cause is “bloody show,” one of the first signs of labor. This is caused by the thinning of the cervix and is usually associated with thick mucous. Cervical irritation and pelvic exams can also cause bleeding. The most serious late pregnancy bleeding is caused by either placenta previa or placental abruption. When these conditions occur, they are most often in the final three months of the pregnancy. Placenta previa results when the placenta partially or completely covers the cervix. As your cervix thins in preparation for labor, bleeding may occur. The other serious cause of late bleeding, placenta abruption, occurs when the placenta prematurely detaches from the inner lining of the womb. This is usually accompanied by abdominal pain. Either condition can lead to the death of the unborn baby. If you experience significant bleeding in your pregnancy, you may be hospitalized for observation and evaluation. If the bleeding is serious or if the fetal monitor shows a persistent, non-reassuring fetal heart rate pattern, a cesarean birth may be required. Most bleeding is the result of minor causes that require no treatment. It is important however, for you to know that bleeding can indicate serious problems. You should report all bleeding to us immediately. HIGH BLOOD PRESSURE IN PREGNANCY Fewer than 10 percent of pregnant women develop a syndrome associated with high blood pressure, also known as toxemia, preeclampsia or Pregnancy Induced Hypertension (PIH). The cause of this potentially serious condition is unknown. When changes of blood pressure are detected early, the mother and the baby can avoid serious problems. If undetected, however, preeclampsia can cause damage to the eyes, kidneys, brain and liver of the mother. The fetus can suffer from a lack of oxygen and nutrients which can lead to growth problems or even death. Teenage mothers are more likely to develop the disorder, usually during the last three months of their first pregnancy. Women who are overweight, diabetic or older than 35 years are also at risk. Mothers with kidney disease, twins or a history of high blood pressure are also likely candidates. High blood pressure is caused when the blood vessels in the body contract, increasing the pressure and lessening the amount of blood flowing to the uterus, placenta and the fetus. Mild changes in blood pressure for a brief period are unlikely to cause problems. However, prolonged and severe spasm of the vessels can be potentially harmful to mother and baby. A sudden weight gain or acute swelling of the face and hands can indirectly signal high blood pressure. Some women experience no distinct symptoms at all. Headaches, visual disturbances, or pain in the upper abdomen may indicate a more serious problem. By monitoring your blood pressure, weight and urine at each prenatal checkup, we are able, for the most part, to make an early diagnosis of the problem and avoid serious complications. We treat each case of preeclampsia differently depending upon a variety of factors usually determined through special testing and how close you are to your due date. Bed rest at home or hospitalization may become necessary, but the eventual birth of your baby will cure the disorder.
Page 1 and 2: Specializing in care for a lifetime
Page 3 and 4: Congratulations! You're Pregnant! Y
Page 5 and 6: Table of Contents 3 CARING FOR YOUR
Page 7 and 8: INITIAL PRENATAL CARE INITIAL OFFIC
Page 9 and 10: Your Prenatal Guide 7 • GENETIC A
Page 11 and 12: Your Prenatal Guide 9 Conversely, a
Page 13 and 14: First Month During your first month
Page 15 and 16: Your Prenatal Guide 13 MORNING SICK
Page 17 and 18: Your Prenatal Guide 15 movements li
Page 19 and 20: Fats, Oils, and Sweets Use sparingl
Page 21 and 22: Things You Should Know Before Havin
Page 23 and 24: Prior to admission: Please ask your
Page 25 and 26: Your Prenatal Guide 23 APPROPRIATE
Page 27 and 28: Your Prenatal Guide 25 INFANT FEEDI
Page 29 and 30: Your Prenatal Guide 27 EXERCISES FO
Page 31: Your Prenatal Guide 29 disorders ma
Page 35 and 36: Your Prenatal Guide 33 RH DISEASE A
Page 37 and 38: IS THIS REALLY LABOR? Your Prenatal
Page 39 and 40: UTERINE INCISIONS Transverse Incisi
Page 41 and 42: Your Prenatal Guide 39 YOUR OWN CHA
Page 43: 75 Francis Street Boston, MA 02115

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