Guide to Pregnancy and its related disorders and complications. Tips for caring of your baby properly while in pregnancy and after pregnancy.

A pregnant woman may become aware of uterine contractions by 24 weeks of pregnancy. These contractions are normal. They are called Braxton­Hicks contractions. On occasion, Braxton-Hicks contractions are rather severe. In addition, the cervix often shortens and occasionally dilates during the early part of the third trimester. If these two events combine in a single woman, deciding whether or not she is in early labor may be extraordinarily difficult. If in fact she is not, any treatment or none at all will appear equally successful. Evaluating the treatment thus is very difficult, as the measure of success is that nothing has happened. Often, we cannot be sure that there was ever a condition that required treatment.

Despite the inexact nature of diagnosis, certain steps usually are taken when a woman complains of any of the symptoms at any time between 23 and 37 weeks of pregnancy. (There is some disagreement regarding when to initiate treatment, although generally before 23 or 24 weeks, survival of the preterm infant is unlikely. Delivery at that time is considered a miscarriage, not a preterm birth. After 37 weeks, there is no worry about prematurity of the baby.)

If you have any of the symptoms noted in the box, call your physician or midwife or go to the hospital where you will have your baby(or your “back-up” hospital if you had planned a home or birth center birth). The physicians and midwives in the practice or clinic where you have your prenatal care will have given you instructions on how to contact somebody in case of an emergency or whether to go to the hospital’s labor unit or emergency room. Signs of preterm labor can be considered an emergency.

You will most likely be advised to meet your physician or midwife at the office or hospital. First, you will have an abdominal examination to determine if the examiner can feel any contractions and to estimate the size and position of the baby. You may be placed on a fetal monitor so that a recording of contractions can be made, although this is not always necessary. The straps placed around your abdomen may be irritating to the uterus and increase the contractions, if there are any. Usually, a recording of the fetal heart tones will be made.

An examination of the cervix with a speculum may be done next. If there is any question about whether or not the membranes have ruptured, this examination will be carried out under sterile conditions. The physician or midwife will look to see any signs of cervical opening and will check to see if the membranes are ruptured. There are a variety of ways to do that. Sometimes, there is an obvious pooling of fluid in the vagina. Other times, a sterile swab can be placed into the vagina. The secretions picked up by the swab are looked at under a microscope. When amniotic fluid dries on a slide, it forms a characteristic pattern that resembles a fern. This is called ferning, and indicates that the membranes have ruptured. A type of litmus paper, called nitrazine paper, may be placed on the discharge. If the yellow paper turns blue, this shows an alkaline pH. Since the vagina is acidic, the alkalinity often is due to amniotic fluid and means that the membranes have ruptured. A number of other secretions are alkaline, however, such as blood, the vaginal discharge of certain infections, and even cervical mucus. This test, then, is not completely reliable.

During this sterile speculum examination, vaginal or cervical cultures for organisms including group B strep, gonorrhea, and chlamydia may be taken. This feels no different from a Pap smear.

If the membranes are ruptured, the physician or midwife should refrain from doing a bimanual examination-an examination with his or her fingers. When the protective membranes are torn, vaginal examinations increase the risk of infection-a danger for both mother and baby. Usually, once an examination is done, the delivery needs to occur within 24 hours. Avoiding examinations minimizes the possibility of infection and allows for more flexibility in handling the situation. This is especially important if you have ruptured membranes without signs of labor.

If the membranes have not ruptured(said to be intact), then a bimanual or digital(finger) examination allows the physician or midwife to check with more accuracy whether the cervix is effaced(thinned) or dilated(opened). Ultrasound is an alternative way of checking, used in some medical centers. If the cervix is thick and closed or just a bit open or thinned, most likely you will be observed for several hours, lying in bed on your side, and reexamined. If there is cervical change, then the diagnosis of preterm labor is made. If there is no cervical change, then you will continue to be watched or sent home, depending on whether contractions are still present. Contractions consistent with preterm labor are 5 to 8 minutes apart, or occur at a rate of 4 in 20 minutes or 8 in 60 minutes.

If the cervix is open to at least 2 centimeters(a bit more than the width of the average finger), or 80 percent or more effaced, and contractions are occurring, then the diagnosis may be made without waiting to see if the cervix changes. Under these circumstances, if treatment is delayed, the opportunity to stop the labor may be missed.

If your physician or midwife determines that you are not in preterm labor, or you become aware that your contractions have stopped, you will most likely go home with instructions to rest, to refrain from heavy work, including housework and lifting of toddlers, and to avoid vaginal intercourse, nipple or breast stimulation, and orgasm until all signs of possible preterm labor are gone or you have reached 37 weeks gestation.

If your physician or midwife determines that you are in preterm labor, then an attempt usually will be made to stop the labor if you are less than 4 centimeters dilated and less than 34 weeks gestation. After 34 weeks gestation, most babies will survive and the risks of treatment usually render such treatment inadvisable. Other reasons for not treating preterm labor are:

*

Dilation of 5 centimeters or more.
*

Fetal death or an anomaly known to be incompatible with life(both of which may predispose to preterm labor).
*

Fetal distress or growth restriction(meaning that the baby may do better outside the uterus, despite being premature).
*

Maternal bleeding.
*

Maternal preeclampsia or eclampsia.
*

Abruptio placentae.
* Chorioamnionitis(infection of the membranes).

With Intact Membranes

There is no completely safe drug that will predictably and reliably turn off true preterm labor. Besides the uncertain value of the medications in stopping preterm labor, they all carry risks to the mother or the fetus or both. They must be used only with close observation. If a woman clearly has a vaginal or urinary tract infection, that condition is treated, although once labor has begun, antibiotic therapy will not stop it.

Without a known cause of preterm labor, treatment is aimed at stopping the contractions, rather than alleviating the cause. This is sometimes effective, although studies have shown that most treatments postpone birth for only 48 hours. This is enough time, however, to give the mother a medication that many experts believe speeds up maturation of the fetal lungs, helping to increase survival. It is also sufficient time to transfer the pregnant woman to a hospital that has a neonatal intensive care unit(NICU), called a tertiary care center or a Level III hospital. This is preferable to transferring a premature infant after birth, which poses more risks for the newborn and separates the mother and baby.

Promoting Fetal Lung Maturity: A corticosteroid drug called betamethasone or dexamethasone is given to the mother to promote fetal lung maturity. This drug is thought to cause the fetal lung to produce surfactant-a chemical that keeps the lungs expanded after each breath. In respiratory distress syndrome(previously called hyaline membrane disease), the lungs of the premature newborn collapse after each breath, making each breath as difficult as the first. This is a major cause of death in premature infants. Surfactant appears in the fetal lung in the second trimester, but may not be present in sufficient quantity to be effective before 34 weeks of pregnancy.

In 1995, the National Institutes of Health(NIH) hailed the use of corticosteroids as a major breakthrough in care for preterm newborns. Since this report, the therapy has been used widely in preterm labor. Recent studies, however, have not consistently supported its value.

For corticosteroids to be beneficial in causing lung maturity, there must be a delay of at least 24 hours between treatment and birth. If birth is delayed for 7 days, their effectiveness is unclear.

Standard regimens for administering the medication vary. One major obstetrical text reports the use of two doses of 12 mg betamethasone, injected into the muscle, 24 hours apart, or 12 hours apart if labor seems likely to occur before 48 hours have passed. Another major text reports use of 5 mg of dexamethasone every 12 hours for four doses. The therapy may be repeated every 7 days until 34 weeks gestation, although some controversy exists about whether repeated courses of steroid treatment might impair brain or immune system development in the fetus. More research is needed in this area.

Stopping Labor: Various drugs have been used to stop preterm labor, including beta-adrenergic receptor agonists, magnesium sulfate, prostaglandin inhibitors, calcium channel blocking agents, and oxytocin inhibitors. The act of stopping uterine contractions is called tocolysis(Greek: tocos = birth; lysis = dissolution). Women with medical diseases may not be able to use some or any of these drugs as they aggravate certain conditions.

Beta-Adrenergic Receptor Agonists. A group of cells called adrenergic receptors are found on the surface of smooth muscle cells. An agonist is a drug or other substance that can combine with the receptor cells. In the uterine muscle, stimulation of the beta-adrenergic receptors by an agonist causes the receptors to inhibit uterine contractions. Two beta-adrenergic agonists used to stop preterm contractions are ritodrine and terbutaline, although only ritodrine is approved for this use by the Food and Drug Administration.

Studies have found that these medications, given intravenously, stop labor for a day or two, at most. While this doesn’t give the fetus much time to grow, it may allow for the adminstration of corticosteroids or maternal transfer.

Since beta-adrenergic receptors are found in smooth muscle cells all over the body, these drugs affect many body systems. This limits their use. They can cause heart and lung problems, as serious as rapid or irregular heartbeat, decreased blood pressure, chest pain, and pulmonary edema(fluid in the lungs). They cause changes in body chemistry, including increased blood sugar, decreased blood potassium, and increased blood insulin levels. They cause less serious but quite unpleasant side effects such as vomiting, headaches, fever, and hallucinations. They may cause anxiety in the woman.

Women receiving ritodrine or terbutaline must be hospitalized and watched with extreme care. Women with poorly controlled diabetes or poorly controlled high blood pressure should not be given beta-adrenergic agonists.

Magnesium Sulfate. Another medication used in the effort to stop preterm labor is magnesium sulfate, usually given intravenously. Studies show its effects on labor to vary from none to stopping labor for the same duration as ritodrine. Magnesium can depress maternal respiration, although this effect is rare. A woman must be closely observed while the drug is being given. Magnesium therapy may also cause nausea and vomiting, decreased blood pressure, and headache. Magnesium eventually crosses the placenta and may affect newborn respirations as well.

Magnesium sulfate cannot be used in women with kidney failure, low blood calcium levels, or a disease called myasthenia gravis(characterized by severe muscle weakness).

Prostaglandin Inhibitors. Prostaglandins are a group of body chemicals involved in normal uterine contractions. Prostaglandins can be given to induce labor. Conversely, prostaglandin inhibitors can be used to stop labor. These inhibitors work by either reducing the formation of prostaglandins or blocking their action. Indomethacin is an example of a prostaglandin inhibitor that has been used to arrest labor.

Research studies have found prostaglandin inhibitors more effective than beta-agonists for delaying labor up to 48 hours, with fewer maternal side effects. Prostaglandin inhibitors, however, are associated with severe adverse effects on the fetus, including cardiac defects and brain hemorrhage. They can also cause bleeding in the mother. The use of these drugs for stopping labor is still under investigation.

Indomethacin cannot be used with maternal asthma, coronary artery disease, gastrointestinal bleeding, kidney failure, and oligohydramnios. Suspected heart or kidney abnormalities in the fetus also preclude its use.

Calcium Channel Blocking Agents. Reducing calcium levels in muscle cells reduces muscle contraction. Calcium channel blockers stop the entry of calcium into cells. (These drugs are used to treat high blood pressure because they relax the muscles in blood vessels.) An example of a calcium channel blocker that has been used to stop preterm labor is nifedipine.

Studies have shown that nifedipine can postpone delivery by 3 days­a greater delay than that seen with ritodrine. Maternal side effects are less than with ritodrine. The effect of this drug on the fetus, however, has not been studied extensively. Because it relaxes the muscles in blood vessels, it could lead to decreased blood pressure in the mother. This, in turn, could lead to decreased blood flow to the placenta. The extent to which this occurs warrants further study.

Nifedipine should not be used with magnesium sulfate as it enhances the effect of magnesium, leading to serious lung and heart problems. Women with liver disease cannot use nifedipine.

Oxytocin Inhibitors. Atosiban is a type of drug currently under development. It works by inhibiting oxytocin, a chemical responsible for uterine contractions. Its use has been limited but it may prove to be beneficial in the future.

The search for safer and more predictable drugs continues. It is difficult to slow down or speed up the uterus without affecting other body systems. The best drug would be one that limits its effects to the uterine muscle. Such a substance has not been identified.

Treatment of Premature Rupture of the Membranes

Premature rupture of the membranes(PROM) occurs as an uncontrollable gush or leakage of fluid. By definition, PROM is rupture of the membrane that occurs more than 12 hours before the onset of labor. If this occurs before 37 weeks gestation, it may be called preterm premature rupture o/the membranes(PPROM).

In the past, due to concern that prolonged rupture of membranes would lead to maternal and fetal infection, babies were all delivered shortly after rupture, regardless of gestational age. Research has not shown this to be beneficial to mother or baby.

Today, one of two care paths generally is followed when a woman has PPROM without labor:

1.

Nothing is done except to wait for labor with monitoring of maternal temperature and avoidance of all vaginal examinations.
2. Corticosteroid therapy is initiated, with or without medications to try to stop labor.

Delivery is only induced in the presence of maternal fever, indicating infection. Most women with PPROM will be in labor, either immediately or within 2 days.

Women with ruptured membranes before 37 weeks usually are admitted to the hospital for observation. The woman may be discharged home before the baby is born if the leakage of fluid stops and certain other conditions exist. The baby should be in the vertex or head down position; there must be no sign of infection; the woman must be able to rest and avoid vaginal intercourse at home; the woman or somebody in her family must be able to read a thermometer; the woman must be able to return for prenatal care visits at least weekly. This is a decision to be made individually for each woman.

Version is the term for the procedures used to turn a fetus from the transverse-or breech-presentation into a vertex-or head-down­ presentation. External version is done during the last weeks of pregnancy . Internal version is performed through the uterus after the membranes have ruptured. In obstetrics today, internal version is reserved for delivery of a second twin, and even then is performed infrequently.

Internal version is correctly termed internal podalic version(Greek: pous = foot) because the obstetrician inserts a hand into the uterus and grasps the fetus by one or both feet to turn the baby-usually from a transverse presentation into a footling breech. While the baby’s feet are grasped, the upper body is turned through the abdomen. The fetus is then delivered by breech extraction.

Internal version was used in antiquity, lost for intervening centuries, and reintroduced in 1550, prior to the development of forceps. At that time, if labor was obstructed, the only way to extract the baby without using hooks was pulling it out by its feet. Cesareans were not done because mothers were not expected to survive major surgery.

Internal version should be done only by those experienced in its performance. Nowadays, the indication for it is the extraction of a second twin, soon after the birth of the first child, when this twin is not in a breech or vertex presentation. If a second twin presents in a transverse lie, internal s version ordinarily is not difficult. The uterus is relaxed since the first twin has recently been delivered. Twins are usually smaller than other term babies and the foot or feet are readily grasped. The mother must be given appropriate anesthesia, but profound general anesthesia usually is not needed.

Jewelry is the irreplaceable part of your personality and thus, myjewelrybox has dedicated its web space to provide you with magnificent jewel designs. Apart from offering wonderful range of products, the website has also achieved fame in servicing its customers in a better way than any other online jewelry store.

Take a look at the variety of designs offered to you that will astonish you with their marvelous designs. These products include rings, earrings, pendants, bracelets, necklaces and many other products. You may also consider buying these products as gift items for your near and dear ones. The most special products are available in the form of engagements rings to add sparks to the occasion.

The various materials used to fabricate these designs include diamond, gemstones, rubies, pearls, gold, silver, murano glass amongst others. You may depend upon this website for the unbeatable price range offered by it on various products.

The website has made itself a convenient place for shopping by offering features like easy login, order tracking, fast shipping of products, return and replacement policies and also, the most powerful security tools. It is easy to search for your desired products, as the database of these products is well-organized.

The website offers exclusive offers and sale events from time to time to entertain its worthy customers. You may also find free packaging offers on different products. The website also helps you to choose right set of jewelry products like diamond earrings and necklaces by making suggestions.

In a nutshell, you can appreciate your decision of shopping from this website, as it is the most competent place to add jewels to your personality.

If you are on a weight loss spree, you must be using some diet pills, especially if your concern is reducing weight for purely physiological purposes more than cosmetic ones. Yes, it is a fact that diet pills help one reduce weight most effectively especially when combined with good diet and exercise. However, one has to take certain precautions and search for the best diet pills.

The people trust brands that have given consistent results and yielded optimal weight loss within stipulated time period. Such diet pills burn more calories and increase metabolism. Along with checking excessive appetite they also eliminate fat from your body and reduce cholesterol levels. Thus, you obtain better results than just with diet and exercise.

There are different types of diet pills and they all have different modus operandii. Some of them reduce appetite, some burn more fats. The Nueslim diet pills combine all the good characteristics together and offer you the safe diet pills that help you reduce substantial weight within short period of time. The natural ingredients of nueslim make it easier to maintain the reduced weight. No wonder people find Nueslim the best diet pills! And when these pills come with affordable price and money back guarantee, you have nothing to lose but everything to gain!

Who doesn’t like to have a sexy and sleek figure like Hollywood models? Well, though all of us desire that look, most of us just keep getting envious and do not do what we are supposed to do to get that figure. Procrastinating our fitness regime for unlimited duration after the New Year resolution weans into a corner, results in the excess bulge that we are loathing nowadays. Definitely we need to take definitive steps to clear away that flab, at least for health sake if not for walking the ramp! Weight loss thus should be our prime concern if we are exceeding normal waist hip ratio!

If you are thinking of starting with fitness regime that includes diet supplements, you are on right track. However you should utilize only those supplements that have good reputation in fitness markets. So, if you use supplements like Proactol, surely you will find consistent results soon. The proactol works for you by getting rid of excess body fat in first place. As proactol is made of pure herbs and veggies, you can safely embark on its fitness regime, without suffering from any unwanted side effects.

Why most people prefer Proactol is that they do not want their bodies saturated with artificial colors, aromas, and preservatives. Most weight loss supplements contain at least some of them. However Proactol is totally free of any such ingredients, thus ensuring natural way to lose weight. Along with burning excess energy, Proactol helps reduce appetite markedly, thus giving results in much shorter duration. Why not try becoming like those models physique-wise with Proactol regimen?

Everyone is boasting about utility of herbs and how they helped them get rid of a particular ailment. Now you can participate in this league of herb lovers to help yourself about the hoards of illnesses that are troubling you. And what if there is a powerful medium like vaporizer to transmit the power of herbs to your body? Nothing like that, isn’t it? Well, the vaporizers are much in demand for this sole reason of utilizing the power of herbs for the betterment of body.

Among all vaporizers, volcano vaporizers are one of the best bets when it comes to herbal treatment through vaporizers. The volcano vaporizer helps you to achieve better active ingredient concentration when you heat the herb at low temperature. This avails you greater benefits of not creating tar like stuff after burning. So, you are assured of your respiratory safety.

Regarding different herbs you can consult your doctor and finalize the ones suitable to you. This way, you can handle your bronchitis, asthma, allergic coughs and colds, reduced immunity etc. Moreover the heat chamber of volcano vaporizer does not require any maintenance. So, you can safely use it even daily to soothe your allergies or asthma. Even you can try it to quit smoking. When a single vaporizer is able to achieve you so many desired effects, why not buy one immediately?

Are you going to celebrate your parents’ marriage golden jubilee ceremony? Well, then this is the time when you can express your love to your dear parents because of whom you are at this stage of your life. You feel nostalgic when you recall the events of your past life when you were under a secured protection of your parents and how lovely it would e to avail that love again. Though the parameters have changed you know that they still love you immensely and you are the same apple of eye that you were some years ago. What can be better way than to gift pearls as a symbol of this crystal clear relationship?

You can go online today and register for your piece of perfect pearl jewelry made of cultured pearls that will look stunning on your still beautiful mother. You can also buy pearl cufflinks for your father, so that the pair will look matchless with the most apt match! Try to extract from your mother what kind of pearls she likes. Also try to evaluate what kind of jewelry piece she will like and she does not possess. This should be done with little trick and not openly, so that the surprise element prevails.

If your mother is interested in fresh water pearls that look stunning on middle aged women, you can go online and order for either fresh water pearls necklace, bracelet, earrings and a whole set, depending upon your budget. We know that you are not going to compromise on budget where the love for mother is concerned. Still with the online purchase, you will avail maximum discount on quality purchase and home shipping free. Yes, your parents’ love is unmatched. Show them how much you too care and love through pearl jewelry!

Most important in choosing a physician, midwife, or group practice for your maternity care is that you be comfortable with the thought of working with this person or group. You must have confidence in the individual or individuals, and this in itself is a good reason for looking into their qualifications and attitudes before making a commitment to them for example, you have strong feelings that you wish to breast-feed, it is not good for you to get your care from someone who is cool to the idea.The same goes for the conduct of labor. If you have attitudes about or experience with fetal monitoring, you should find out whether it is practice where you intend to deliver to require it or to individualize its use. If you have had a previous birth by cesarean and wish a vaginal birth, you should find out the attitudes toward such care on the part of those you choose to assist you in labor. What do you want your main source of pain relief to be? If you want to use relaxation, breathing, support. massage, and other nonpharmacologic remedies as much as possible, make sure your physician or midwife is comfortable with these options and won’t pressure you into medications or epidural anesthesia. If you want an episiotomy only on indication and not routinely, make sure that your obstetrician or midwife doesn’t believe in routine episitomy. If you want rooming-in with your baby 24 hours a day, but the hospital where your physician or midwife delivers does not provide for that you might think about switching providers. If you want an intravenous (IV) feeding tube only if you are dehydrated or need it for labor augmentation or medication, but the hospital at which your physician or midwife attends births insists on routine IVs, then you might want to find a provider at another facility, or consider a birthing center-or compromimise and have an IV

The fact that you have gone to a provider or facility does not mean that you are contracted to stay with it, if it turns out in the course of prenatal care that you are not at ease. If necessary, discuss this candidly with the people who have been providing your care so some resolution of the problem can be worked out amicably. Most of us who provide maternity care consider prenatal care as a commitment to follow through. We are often aware of the women who are uncomfortable in our care and are quite accepting when such women transfer themselves elsewhere. Of course, care will not be refused when you don’t exactly see eye-to-eye with your practitioners. Try to continue to raise your concerns and come to compromise solutions if you have no choice, as when you live in a small town and there are no alternative providers.

If you have trouble raising your concerns, something is a miss. You should never feel silly asking any question, you should not feel rushed, you should never feel that your concerns are made to seem trivial. It’s an old cliche, but the only silly question is the one you didn’t ask.

If you discover at the end of pregnancy that you are unhappy with what your practitioner is offering for labor and birth, you can certainly switch providers even at that late date, although some practitioners and birthing centers will not accept a woman late in pregnancy.

Most women at some point in their pregnancy, notice swelling in their feet and lower legs. Most times, the swelling is confined to the lower extremities. Swelling in your lower legs is made worse when you stand for long periods of time. If leg swelling is starting to become a problem, try to take several breaks during the day where you lie down with your feet raised. If you are working, try to move around frequently during the day. The action of your leg muscles helps return some of the excess fluid to other parts of your body. If you notice that one leg is much more swollen than the other, notify your care provider, since this can be a sign of a blood clot in your leg. However, remember that it is normal for the right leg to be slightly more swollen than the left, since the uterus tilts in such a way as to compress the drainage of blood from your right leg more than your left.

What do avoid

Diuretics are not safe in pregnancy.

Leg Cramps

Some women find that they wake up at night with sudden leg cramps. It’s not clear why these cramps become more common during pregnancy. Calcium supplementation may reduce symptoms and is safe during pregnancy. If leg cramps make you wake up at night, try to walk off the pain or place a warm compress on your calf. If you have persistent cramps try to pay special attention to your calves before going to bed. Stretch them out gently by stepping up on to a step and pressing your heels down one at a time. If you still have problems, talk to your doctor about magnesium supplements. Do not take magnesium supplements with out checking with your care provider first.

What’s safe to use

Calcium supplementation of 1 gm twice per day for 2 weeks.

Restless Legs Syndrome

About 10-20 percent of women will develop restless legs syndrome (RLS) during the second half of pregnancy. RLS usually occurs as you try to fall asleep. You might have tingling or other sensations in your lower legs, which give you the overwhelming urge to move your legs around. However, moving your legs or walking around does not relieve RLS. If your sleep is becoming disrupted, talk to your care provider. Sometimes this condition is associated with iron deficiency anemia, so iron supplementation may help. It’s best to avoid caffeinated drinks in the last half of the day because these may make symptoms worse.

Varicose Veins

The pressure of the growing uterus and consequent increased blood flow causes a notable increase in prominent veins in your upper and lower legs. As the pressure in your veins increases weakness in certain areas of the veins can cause the sides to balloon out. These are varicose veins. They may also occur in your vulva.

Varicose veins are more common with second and third pregnancies, but many women have them in their first pregnancy as well. Whether you get varicose veins or not is mostly genetic. You may be able to reduce the size of enlarged veins in your legs by wearing good support hose designed for pregnant women. However, many women find these hose hot and uncomfortable and of only slight benefit in reducing the appearance of varicose veins. Lying down with your feet up several times during the day may also help. If your veins remain enlarged after your pregnancy you can consider one of several cosmetic options, including laser treatments, sclerotherapy, and surgery. You should wait until after your have completed all your pregnancies to treat enlarged veins, since they are likely to return in subsequent pregnancies.

Stretch Marks

About half of all pregnant women will get stretch marks during pregnancy. Stretch marks often occur on the abdomen, but can also develop on your breasts and bottom. They are caused by microtears that occur in the connective tissue in your skin as the skin stretches more than it is able. Despite the claims made by manufacturers of various creams, no cream will prevent you from getting stretch marks. However, you can slightly reduce your chances of stretch marks by limiting your weight gain during pregnancy to 25-35 lb (11-16kg).

Stretch marks will fade over time, becoming faint and silvery. While you can’t prevent stretch marks, you can have them treated after pregnancy. Laser therapy is one option that is gaining in popularity. Plan on waiting to treat stretch marks until after all your pregnancies are completed since you are likely to develop more with each pregnancy. Treating stretch marks is considered cosmetic and is usually not covered by insurance.

Skin Changes

During pregnancy your skin undergoes enormous changes. Starting early on in pregnancy there is a big increase in the blood supply to your skin, which is euphemistically referred to as the glow of pregnancy.

Early in pregnancy, the most common skin change you may notice is an increase in acne as a result of hormone changes. It is safe to treat acne during pregnancy with creams and gels such as benzoyl peroxide or, after consultation with a dermatologist antibiotic creams. As you move in to the early second trimester, you may start to notice that your skin is darkening pregnancy stimulates production of the pigment melanin. You mal notice that pigmented areas of your body, including existing moles and your nipples, darken. New areas of pigment may also appear as your pregnancy progresses, including a dark line between your belly button and pubic hair called linea nigra. Some women also develop pigmentation across the nose and cheeks. Both these areas of pigmentation should fade after your pregnancy.

About two-thirds of women with lighter skin notice that the palms of their hands turn red. It results from the increased levels of the hormone estrogen in your body, and will disappear when you are no longer pregnant. Increased blood flow to your skin during pregnancy can also cause tiny red bumps surrounded by little red lines to form. These blemishes are called spider angioma and occur most often on the face, neck and upper chest but will fade after pregnancy. No treatment is needed unless he spider angioma are still present 3 months after pregnancy md you don’t like their appearance.

Sweating

Almost all pregnant women tend to feel warm during pregnancy. With this change in the way you perceive temperature and your increased metabolic rate, you are likely to notice that you are perspiring more. This is normal but can be irritating. Deodorant is safe during pregnancy so don’t worry if you find you need to use it more frequently.

Itching And Rashes

Many women have itchy skin during pregnancy, especially over their abdomen. Most of the itching seems to be associated with the physical skin stretching of pregnancy. Some women find that a cool sensation relieves some of the feeling of itching. Cool oatmeal baths or moisturizing lotion kept in the fridge may provide temporary relief. Itching may also be a sign of a condition called cholestasis of pregnancy, which sometimes develops in the third trimester. It is diagnosed with a blood test that examines the level of bile acids (produced by your liver) in your blood. If your doctor diagnoses this condition you will be given medication to reduce the excess bile acids. Thc usual treatment is a drug called ursodeoxycholic acid. High levels of bile acids can increase the chances of complications in your current pregnancy and may prompt your care provider to induce your labor prior to your due date. It is not know whether treatment with agents like ursodeoxycholic acid reduce the likelihood of pregnancy complications.

Warning Signs

If itching is accompanied by any of the following you should see your doctor.

• A significant bumpy rash on your abdomen this may be a condition called which is specific to pregnancy and needs more intensive treatment with prescription drugs.
• Persistent severe itching on your arms and legs with out a noticeable rash in the third trimester of pregnancy. This may be a symptom of a condition called cholestasis of pregnancy where bile acids from your liver build up in your skin, causing itching.

Safe Lifting

If at all possible, avoid lifting anything heavy, including your older toddler. If you do have to lift something, use the following technique.

• Stand with your feet hip-distance apart.
• Bend from your hips and knees, keeping your back straight.
• Keeping the object close to your body, use the strong muscles of your legs to lift.
• Keep your back straight for the whole lift.