A) Prenatal Visits:

These visits should begin early.

Women who are planning to conceive should also visit the pre-pregnancy (Pre- Conception) clinic.

Prenatal visits should be regular:

0-28 Weeks: Every 4 weeks

28-36 Weeks: Every 2 weeks.

after 36 weeks: weekly ,till delivery

B Medications:

Do not take any medications unless prescribed by your doctor/health care provider.

C Diet:

i) Eat a balanced diet with proteins , carbohydrates and vegetables.

ii) Take prenatal vitamins with iron and folic acid . Vitamin A should be avoided as retinol/ retinoic acid can cause human birth defects (Teratogen).

iii) Pregnant women should not diet to loose weight. They should expect to gain about 20-40 lb.

iv) Eat fresh foods and vegetables.

v) Avoid eating raw meat or fish. Fish suspected of having high levels of mercury should also be avoided.

vi) Reduction in caffeine intake (reduce to 1 cup of coffee, 1 cup of tea or 1 cup of caffeinated cola daily).

D) Birth Classes:

Pregnant women and their partners should be encouraged to join birth classes.

E) Rest and Activity:

Adequate rest must be taken every day.

Sternous physical activities/exercise should be avoided by pregnant women.

However mild to moderate exercises are recommended.

Heart rate should be kept to below 140 beats/ minute during exercise.

F) X-Rays and other Noxious Exposures:

Avoid all X-rays unless approved by your physician.

Always inform your physician, dentist and other health care provider that you are pregnant or you are planning to conceive.

Chemical and radiation hazards should be avoided (especially  for industrial workers)

Avoid excessive heat, like spending long time in hot water tubs.

Handling of cat feces shoud be avoided.

Gloves should be worn during gardening.

G) Alcohol:

Alcohol should be avoided in pregnancy as there is no safe limit for the level of alcohol intake. The baby can suffer from fetal alcohol syndrome which can result in permanent damage to the central nervous system of the baby.

Fetal alcohol syndrome is probably due to the direct toxic effect of ethanol and its metabolites such as acetaldehyde.

On examination of the baby ,the characteristic findings are low set ears, shortened palpebral fissures, hypoplasia of the mid face, a smooth philtrum ,thin upper lip, microcephaly, mental retardation and attention deficit disorder. Other abnormalities include skeletal and cardiac abnormalities.

Fetal alcohol syndrome will be covered extensively in another post.

H) Cigarette Smoking:

This topic will be covered extensively in a subsequent post. However a summary will be presented here.

Cigarette smoking results in fetal exposure to carbon monoxide and nicotine.

Premature delivery occurs more commonly among cigarette smokers (20% more frequently among smokers).

The birth weight of the fetuses of smoking mothers are on average 200g less than the fetal birth weight among non-smokers.

There is also a much higher risk of abruptio placentae, premature rupture of membranes and placenta previa (low lying placenta) among smoking mothers.

Passive smoking is equally dangerous to pregnant women and their fetuses as it is to any other human beings (and perhaps animals and pets).

Cigarette Smoking and pregnancy will be covered extensively in another post.

I) Illict Drugs and Pregnancy

Cocaine and amphetamines are common drugs that are taken by many women of child bearing age. It is difficult to manage and even anticipate due to the fact that most of them even deny the use of illict drugs.

Amphetamines and cocaine have powerful vasoconstrictive effects that can lead to numerous complications in pregnancy such as preterm delivery, placental abruption, sudden infant death syndrome (SIDS) ,intrauterine growth restriction, premature rupture of membranes and neurobehavoural deficits.

Opoids (eg Opium) can cause prematurity ,fetal death and intrauterine growth retardation.

Illict Drugs and pregnancy will be covered extensively in another post.

References:

Page 764 to 765 Chapter 18 Obstetrics CMDT 2006 -Current Medical Diagnosis and Treatment. Edited by Lawrence M. Tierney, Jr. ,Stephen J. McPhee, Maxine A. Papadakis 45th edition Lange Publications.Mc Graw Hill

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