Showing posts with label pregnancy. Show all posts
Showing posts with label pregnancy. Show all posts
Tuesday, October 07, 2008
Estimated Date of Delivery (EDD)
You can calculate the estimated date of delivery (EDD) by counting 40 weeks from the first day of your last period. But should remember that since you don't know the exact date of ovulation this EDD is approximate. Click on image below for the EDD chart.
Wednesday, April 30, 2008
Stages of labour
The process of labour and birth is divided into three stages.
The first stage begins with the onset of contractions that cause progressive changes in your cervix and ends when your cervix is fully dilated. This stage is divided into two phases: early (or latent) and active labor.
During early labor, your cervix gradually effaces (thins out) and dilates (opens). That's followed by active labor, when your cervix begins to dilate more rapidly and contractions are longer, stronger, and closer together. People often refer to the last part of active labor as transition.
The second stage of labor begins once you're fully dilated and ends with the birth of your baby. This is sometimes referred to as the pushing stage.
The third and final stage begins right after the birth of your baby and ends with the separation and subsequent delivery of the placenta.
Every pregnancy is different, and there's wide variation in the length of labor. For first-time moms who are at least 37 weeks along, labor often takes between ten and 20 hours. For some women, though, it lasts much longer, while for others it's over much sooner. Labor generally progresses more quickly for women who've already given birth vaginally.
First stage: Early labor
Once your contractions are coming at relatively regular intervals and your cervix begins to progressively dilate and efface, you're officially in early labor. But unless your labor starts suddenly and you go from no contractions to fairly regular contractions right away, it can be tricky to determine exactly when true labor starts. That's because early labor contractions are sometimes hard to distinguish from the inefficient Braxton Hicks contractions that may immediately precede them and contribute to so-called false labor.
If you're not yet at 37 weeks and you're noticing contractions or other signs of labor, call your caregiver immediately so she can determine whether you're in preterm labor.
During early labor, your contractions will gradually become longer, stronger, and closer together. While the experience of labor varies widely, it might start with contractions coming every ten minutes and lasting 30 seconds each.
Eventually they'll be coming every five minutes and lasting 40 to 60 seconds each as you reach the end of early labor. Some women have much more frequent contractions during this phase, but the contractions will still tend to be mild and last less than a minute.
Sometimes early labor contractions are quite painful, even though they may be dilating your cervix much more slowly than you'd like. If your labor is typical, however, your early contractions won't require the same attention that later ones will.
You'll probably be able to talk through them and putter around the house. You may even feel like taking a short walk. If you feel like relaxing instead, take a warm bath, watch a video, or doze off between contractions if you can.
You may notice an increase in mucusy vaginal discharge, which may be tinged with blood — the so-called bloody show. This is perfectly normal, but if you see more than a tinge of blood, be sure to call your caregiver. Also call if your water breaks, even if you're not having contractions yet.
Otherwise, if you're at least 37 weeks along and your caregiver hasn't advised you differently, expect to sit out early labor at home. (When to call your midwife or doctor and when she's likely to have you go to the hospital or birth center are things to discuss ahead of time at your prenatal visits.)
Early labor ends when your cervix is about 4 centimeters dilated and your progress starts to accelerate.
First stage: Active labor
Active labor is when things really get rolling. Your contractions become more frequent, longer, and stronger, and your cervix begins dilating more quickly, going from about 4 to 10 centimeters. (The last part of active labor, when the cervix dilates from 8 to 10 centimeters, is called transition, which is described separately in the next section.)
In contrast to early labor, you'll no longer be able to talk through the contractions. Toward the end of active labor your baby may begin to descend, although he might have started to descend earlier or he might not start until the next stage.
As a general rule, once you've had regular, painful contractions (each lasting about 60 seconds) every five minutes for an hour, it's time to call your midwife or doctor and head to the hospital or birth center. Some prefer a call sooner, so clarify this with your caregiver ahead of time.
In most cases, the frequency of contractions eventually increases to every two and a half to three minutes, although some women never have them more often than every five minutes, even during transition.
Transition
The last part of active labor — when your cervix dilates from 8 to a full 10 centimeters — is called the transition period because it marks the shift to the second stage of labor. This is the most intense part of labor. Contractions are usually very strong, coming every two and a half to three minutes or so and lasting a minute or more, and you may start shaking and shivering.
By the time your cervix is fully dilated and transition is over, your baby has usually descended somewhat into your pelvis. This is when you might begin to feel rectal pressure, as if you have to move your bowels. Some women begin to bear down spontaneously — to "push" — and may even start making deep grunting sounds at this point.
There's often a lot of bloody discharge. You may also feel nauseated or even vomit now.
Some babies, however, descend earlier and the mom feels the urge to push before she's fully dilated. And others don't descend significantly until later, in which case the mom may reach full dilation without feeling any rectal pressure. It's different for every woman and with every birth.
If you've had an epidural, the pressure you'll feel will depend on the type and amount of medication you're getting and how low the baby is in your pelvis. If you'd like to be a more active participant in the pushing stage, ask to have your epidural dose lowered at the end of transition.
Second stage: Pushing
Once your cervix is fully dilated, the work of the second stage of labor begins: the final descent and birth of your baby. At the beginning of the second stage, your contractions may be a little further apart, giving you the chance for a much-needed rest between them.
Many women find their contractions in the second stage easier to handle than the contractions in active labor because bearing down offers some relief. Others don't like the sensation of pushing.
If your baby's very low in your pelvis, you may feel an involuntary urge to push early in the second stage (and sometimes even before). But if your baby's still relatively high, you probably won't have this sensation right away.
As your uterus contracts, it exerts pressure on your baby, moving him down the birth canal. So if everything's going well, you might want to take it slowly and let your uterus do the work until you feel the urge to push. Waiting a while may leave you less exhausted and frustrated in the end.
However, in many hospitals it's still routine practice to coach women to push with each contraction in an effort to speed up the baby's descent — so let your caregiver know if you'd prefer to wait until you feel a spontaneous urge to bear down.
If you have an epidural, the loss of sensation can blunt the urge to push, so you may not feel it until your baby's head has descended quite a bit. Patience often works wonders. In some cases, though, you'll eventually need explicit directions to help you push effectively.
Your baby's descent may be rapid or, especially if this is your first, gradual. With each contraction, the force of your uterus — combined with the force of your abdominal muscles if you're actively pushing — exerts pressure on your baby to continue to move down through the birth canal. When a contraction is over and your uterus is relaxed, your baby's head will recede slightly in a "two steps forward, one step back" kind of progression.
Try different positions for pushing until you find one that feels right and is effective for you. It's not unusual to use a variety of positions during the second stage.
After a time, your perineum (the tissue between your vagina and rectum) will begin to bulge with each push, and before long your baby's scalp will become visible — a very exciting moment and a sign that the end is in sight. You can ask for a mirror to get that first glimpse of your baby, or you may simply want to reach down and touch the top of his head.
Now the urge to push becomes even more compelling. With each contraction, more and more of your baby's head becomes visible. The pressure of his head on your perineum feels very intense, and you may notice a strong burning or stinging sensation as your tissue begins to stretch.
At some point, your caregiver may ask you to push more gently or to stop pushing altogether so your baby's head has a chance to gradually stretch out your vaginal opening and perineum. A slow, controlled delivery can help keep your perineum from tearing. By now, the urge to push may be so overwhelming that you'll be coached to blow or pant during contractions to help counter it.
Your baby's head continues to advance with each push until it "crowns" — the time when the widest part of his head is finally visible. The excitement in the room will grow as your baby's face begins to appear: his forehead, his nose, his mouth, and, finally, his chin.
After your baby's head emerges, your doctor or midwife will suction his mouth and nose and feel around his neck for the umbilical cord. (No need to worry. If the cord is around his neck, your caregiver will either slip it over his head or, if need be, clamp and cut it.)
His head then turns to the side as his shoulders rotate inside your pelvis to get into position for their exit. With the next contraction, you'll be coached to push as his shoulders emerge, one at a time, followed by his body.
Once your baby hits the atmosphere, he needs to be kept warm and will be dried off with a towel. Your doctor or midwife may quickly suction your baby's mouth and nasal passages again if he seems to have a lot of mucus.
If there are no complications, he'll be lifted onto your bare belly so you can touch, kiss, and simply marvel at him. The skin-to-skin contact will keep your baby nice and toasty, and he'll be covered with a warm blanket — and perhaps given his first hat — to prevent heat loss.
Your caregiver will clamp the umbilical cord in two places and then cut between the two clamps — or your partner can do the honors.
You may feel a wide range of emotions now: euphoria, awe, pride, disbelief, excitement (to name but a few), and, of course, intense relief that it's all over. Exhausted as you may be, you'll also probably feel a burst of energy, and any thoughts of sleep will vanish for the time being.
Third stage: Delivering the placenta
Minutes after giving birth, your uterus begins to contract again. The first few contractions usually separate the placenta from your uterine wall. When your caregiver sees signs of separation, she may ask you to gently push to help expel the placenta. This is usually one short push that's not at all difficult or painful.
How long the third stage lasts
On average, the third stage of labor takes about five to ten minutes.
And then what?
After you deliver the placenta, your uterus should contract and get very firm. You'll be able to feel the top of it in your belly, around the level of your navel.
Your caregiver, and later your nurse, will periodically check to see that your uterus remains firm, and massage it if it isn't. This is important because the contraction of the uterus helps cut off and collapse the open blood vessels at the site where the placenta was attached. If your uterus doesn't contract properly, you'll continue to bleed profusely from those vessels.
If you're planning to breastfeed, you can do so now if you and your baby are both willing. Not all babies are eager to nurse in the minutes after birth, but try holding your baby's lips close to your breast for a little while. Most babies will eventually begin to nurse in the first hour or so after birth if given the chance.
Early nursing is good for your baby and can be deeply satisfying for you. What's more, nursing triggers the release of oxytocin, the same hormone that causes contractions, which helps your uterus stay firm and well contracted.
If you're not going to nurse or your uterus isn't firm, you'll be given oxytocin to help it contract. (Some providers routinely give it to all women at this point). If you're bleeding excessively, you'll be treated for that as well.
Your contractions at this point are relatively mild. By now your focus has shifted to your baby, and you may be oblivious to everything else going on around you. If this is your first baby, you may feel only a few contractions after you've delivered the placenta. If you've had a baby before, you may continue to feel occasional contractions for the next day or two.
These so-called afterbirth pains can feel like strong menstrual cramps. If they bother you, ask for pain medication. You may also have the chills or feel very shaky. This is perfectly normal and won't last long. Don't hesitate to ask for a warm blanket if you need one.
Your caregiver will examine the placenta to make sure it's all there. Then she'll check you thoroughly to spot any tears that need to be stitched.
If you tore or had an episiotomy, you'll get an injection of a local anesthetic before being sutured. You may want to hold your newborn while you're getting stitches — it can be a great distraction. If you're feeling too shaky, ask your partner to sit by your side and hold your new arrival while you look at him.
If you had an epidural, an anesthesiologist or nurse anesthetist will come by and remove the catheter from your back. This takes just a second and doesn't hurt.
Extracted from babycentre website
The first stage begins with the onset of contractions that cause progressive changes in your cervix and ends when your cervix is fully dilated. This stage is divided into two phases: early (or latent) and active labor.
During early labor, your cervix gradually effaces (thins out) and dilates (opens). That's followed by active labor, when your cervix begins to dilate more rapidly and contractions are longer, stronger, and closer together. People often refer to the last part of active labor as transition.
The second stage of labor begins once you're fully dilated and ends with the birth of your baby. This is sometimes referred to as the pushing stage.
The third and final stage begins right after the birth of your baby and ends with the separation and subsequent delivery of the placenta.
Every pregnancy is different, and there's wide variation in the length of labor. For first-time moms who are at least 37 weeks along, labor often takes between ten and 20 hours. For some women, though, it lasts much longer, while for others it's over much sooner. Labor generally progresses more quickly for women who've already given birth vaginally.
First stage: Early labor
Once your contractions are coming at relatively regular intervals and your cervix begins to progressively dilate and efface, you're officially in early labor. But unless your labor starts suddenly and you go from no contractions to fairly regular contractions right away, it can be tricky to determine exactly when true labor starts. That's because early labor contractions are sometimes hard to distinguish from the inefficient Braxton Hicks contractions that may immediately precede them and contribute to so-called false labor.
If you're not yet at 37 weeks and you're noticing contractions or other signs of labor, call your caregiver immediately so she can determine whether you're in preterm labor.
During early labor, your contractions will gradually become longer, stronger, and closer together. While the experience of labor varies widely, it might start with contractions coming every ten minutes and lasting 30 seconds each.
Eventually they'll be coming every five minutes and lasting 40 to 60 seconds each as you reach the end of early labor. Some women have much more frequent contractions during this phase, but the contractions will still tend to be mild and last less than a minute.
Sometimes early labor contractions are quite painful, even though they may be dilating your cervix much more slowly than you'd like. If your labor is typical, however, your early contractions won't require the same attention that later ones will.
You'll probably be able to talk through them and putter around the house. You may even feel like taking a short walk. If you feel like relaxing instead, take a warm bath, watch a video, or doze off between contractions if you can.
You may notice an increase in mucusy vaginal discharge, which may be tinged with blood — the so-called bloody show. This is perfectly normal, but if you see more than a tinge of blood, be sure to call your caregiver. Also call if your water breaks, even if you're not having contractions yet.
Otherwise, if you're at least 37 weeks along and your caregiver hasn't advised you differently, expect to sit out early labor at home. (When to call your midwife or doctor and when she's likely to have you go to the hospital or birth center are things to discuss ahead of time at your prenatal visits.)
Early labor ends when your cervix is about 4 centimeters dilated and your progress starts to accelerate.
First stage: Active labor
Active labor is when things really get rolling. Your contractions become more frequent, longer, and stronger, and your cervix begins dilating more quickly, going from about 4 to 10 centimeters. (The last part of active labor, when the cervix dilates from 8 to 10 centimeters, is called transition, which is described separately in the next section.)
In contrast to early labor, you'll no longer be able to talk through the contractions. Toward the end of active labor your baby may begin to descend, although he might have started to descend earlier or he might not start until the next stage.
As a general rule, once you've had regular, painful contractions (each lasting about 60 seconds) every five minutes for an hour, it's time to call your midwife or doctor and head to the hospital or birth center. Some prefer a call sooner, so clarify this with your caregiver ahead of time.
In most cases, the frequency of contractions eventually increases to every two and a half to three minutes, although some women never have them more often than every five minutes, even during transition.
Transition
The last part of active labor — when your cervix dilates from 8 to a full 10 centimeters — is called the transition period because it marks the shift to the second stage of labor. This is the most intense part of labor. Contractions are usually very strong, coming every two and a half to three minutes or so and lasting a minute or more, and you may start shaking and shivering.
By the time your cervix is fully dilated and transition is over, your baby has usually descended somewhat into your pelvis. This is when you might begin to feel rectal pressure, as if you have to move your bowels. Some women begin to bear down spontaneously — to "push" — and may even start making deep grunting sounds at this point.
There's often a lot of bloody discharge. You may also feel nauseated or even vomit now.
Some babies, however, descend earlier and the mom feels the urge to push before she's fully dilated. And others don't descend significantly until later, in which case the mom may reach full dilation without feeling any rectal pressure. It's different for every woman and with every birth.
If you've had an epidural, the pressure you'll feel will depend on the type and amount of medication you're getting and how low the baby is in your pelvis. If you'd like to be a more active participant in the pushing stage, ask to have your epidural dose lowered at the end of transition.
Second stage: Pushing
Once your cervix is fully dilated, the work of the second stage of labor begins: the final descent and birth of your baby. At the beginning of the second stage, your contractions may be a little further apart, giving you the chance for a much-needed rest between them.
Many women find their contractions in the second stage easier to handle than the contractions in active labor because bearing down offers some relief. Others don't like the sensation of pushing.
If your baby's very low in your pelvis, you may feel an involuntary urge to push early in the second stage (and sometimes even before). But if your baby's still relatively high, you probably won't have this sensation right away.
As your uterus contracts, it exerts pressure on your baby, moving him down the birth canal. So if everything's going well, you might want to take it slowly and let your uterus do the work until you feel the urge to push. Waiting a while may leave you less exhausted and frustrated in the end.
However, in many hospitals it's still routine practice to coach women to push with each contraction in an effort to speed up the baby's descent — so let your caregiver know if you'd prefer to wait until you feel a spontaneous urge to bear down.
If you have an epidural, the loss of sensation can blunt the urge to push, so you may not feel it until your baby's head has descended quite a bit. Patience often works wonders. In some cases, though, you'll eventually need explicit directions to help you push effectively.
Your baby's descent may be rapid or, especially if this is your first, gradual. With each contraction, the force of your uterus — combined with the force of your abdominal muscles if you're actively pushing — exerts pressure on your baby to continue to move down through the birth canal. When a contraction is over and your uterus is relaxed, your baby's head will recede slightly in a "two steps forward, one step back" kind of progression.
Try different positions for pushing until you find one that feels right and is effective for you. It's not unusual to use a variety of positions during the second stage.
After a time, your perineum (the tissue between your vagina and rectum) will begin to bulge with each push, and before long your baby's scalp will become visible — a very exciting moment and a sign that the end is in sight. You can ask for a mirror to get that first glimpse of your baby, or you may simply want to reach down and touch the top of his head.
Now the urge to push becomes even more compelling. With each contraction, more and more of your baby's head becomes visible. The pressure of his head on your perineum feels very intense, and you may notice a strong burning or stinging sensation as your tissue begins to stretch.
At some point, your caregiver may ask you to push more gently or to stop pushing altogether so your baby's head has a chance to gradually stretch out your vaginal opening and perineum. A slow, controlled delivery can help keep your perineum from tearing. By now, the urge to push may be so overwhelming that you'll be coached to blow or pant during contractions to help counter it.
Your baby's head continues to advance with each push until it "crowns" — the time when the widest part of his head is finally visible. The excitement in the room will grow as your baby's face begins to appear: his forehead, his nose, his mouth, and, finally, his chin.
After your baby's head emerges, your doctor or midwife will suction his mouth and nose and feel around his neck for the umbilical cord. (No need to worry. If the cord is around his neck, your caregiver will either slip it over his head or, if need be, clamp and cut it.)
His head then turns to the side as his shoulders rotate inside your pelvis to get into position for their exit. With the next contraction, you'll be coached to push as his shoulders emerge, one at a time, followed by his body.
Once your baby hits the atmosphere, he needs to be kept warm and will be dried off with a towel. Your doctor or midwife may quickly suction your baby's mouth and nasal passages again if he seems to have a lot of mucus.
If there are no complications, he'll be lifted onto your bare belly so you can touch, kiss, and simply marvel at him. The skin-to-skin contact will keep your baby nice and toasty, and he'll be covered with a warm blanket — and perhaps given his first hat — to prevent heat loss.
Your caregiver will clamp the umbilical cord in two places and then cut between the two clamps — or your partner can do the honors.
You may feel a wide range of emotions now: euphoria, awe, pride, disbelief, excitement (to name but a few), and, of course, intense relief that it's all over. Exhausted as you may be, you'll also probably feel a burst of energy, and any thoughts of sleep will vanish for the time being.
Third stage: Delivering the placenta
Minutes after giving birth, your uterus begins to contract again. The first few contractions usually separate the placenta from your uterine wall. When your caregiver sees signs of separation, she may ask you to gently push to help expel the placenta. This is usually one short push that's not at all difficult or painful.
How long the third stage lasts
On average, the third stage of labor takes about five to ten minutes.
And then what?
After you deliver the placenta, your uterus should contract and get very firm. You'll be able to feel the top of it in your belly, around the level of your navel.
Your caregiver, and later your nurse, will periodically check to see that your uterus remains firm, and massage it if it isn't. This is important because the contraction of the uterus helps cut off and collapse the open blood vessels at the site where the placenta was attached. If your uterus doesn't contract properly, you'll continue to bleed profusely from those vessels.
If you're planning to breastfeed, you can do so now if you and your baby are both willing. Not all babies are eager to nurse in the minutes after birth, but try holding your baby's lips close to your breast for a little while. Most babies will eventually begin to nurse in the first hour or so after birth if given the chance.
Early nursing is good for your baby and can be deeply satisfying for you. What's more, nursing triggers the release of oxytocin, the same hormone that causes contractions, which helps your uterus stay firm and well contracted.
If you're not going to nurse or your uterus isn't firm, you'll be given oxytocin to help it contract. (Some providers routinely give it to all women at this point). If you're bleeding excessively, you'll be treated for that as well.
Your contractions at this point are relatively mild. By now your focus has shifted to your baby, and you may be oblivious to everything else going on around you. If this is your first baby, you may feel only a few contractions after you've delivered the placenta. If you've had a baby before, you may continue to feel occasional contractions for the next day or two.
These so-called afterbirth pains can feel like strong menstrual cramps. If they bother you, ask for pain medication. You may also have the chills or feel very shaky. This is perfectly normal and won't last long. Don't hesitate to ask for a warm blanket if you need one.
Your caregiver will examine the placenta to make sure it's all there. Then she'll check you thoroughly to spot any tears that need to be stitched.
If you tore or had an episiotomy, you'll get an injection of a local anesthetic before being sutured. You may want to hold your newborn while you're getting stitches — it can be a great distraction. If you're feeling too shaky, ask your partner to sit by your side and hold your new arrival while you look at him.
If you had an epidural, an anesthesiologist or nurse anesthetist will come by and remove the catheter from your back. This takes just a second and doesn't hurt.
Extracted from babycentre website
Friday, January 25, 2008
Skin and pregnancy
Skin changes are well-accepted and expected effects of pregnancy Before, you jump the gun and start calling it a disease, you should know that most of these new observations are directly related to the physiological changes that are taking place in your new body
When these skin disorders occur, the first thought that enters the mind of most pregnant mothers is whether any of these skin problems will be transferred to the developing fetus in any adverse way. Fortunately, most of the common skin diseases seen in pregnancy are of no risk to the mother or baby and are simply the marks of motherhood and a tolerable inconvenience.
The common aggravating condition chloasma (the mask of pregnancy) or bad acne, does send some women to the dermatologist. However, depending on your hormones and skin condition, you may not suffer from these problems. Some women develop rashes and some are completely unaffected. If you have had a long-term acne condition, you may be surprised to find that it clears up during pregnancy. Also, having a rash during your first pregnancy does not automatically mean that the rash will return for subsequent pregnancies.
Acne, eczema and psoriasis
Many skin conditions such as psoriasis, eczema and acne are modified by pregnancy In some cases, the rashes do not show up in a genetically predisposed individual until a pregnancy occurs. Even in these cases, the impact of the pregnancy on the skin condition is unpredictable, basically, the glands beneath the skin work overtime in a pregnant body, causing oil-producing glands to become more productive and sweat glands to overwork, causing the mother to perspire more.
According to the American Academy of Dermatology, psoriasis is a chronic genetic skin disorder characterised by raised thickened patch of red skin covered with silvery-white scales that can affect any part of the body. While psoriasis tends to improve during pregnancy, it can flare out of control after delivery.
Rosacea, the red acne-like rash on the face, tends to worsen during pregnancy. This is because the increase in blood volume that peaks during the second trimester and tends to bring more blood to the skin, giving the highly vascular areas like the face a rosier appearance.
Pruritus gravidarurn
Pruritus or itching, is by far the most common dermatosis seen, it usually begins in the later stages of pregnancy. It is widely accepted that the sluggish flow and retention of bile salts that occurs in pregnancy, is the cause of the itch.
Usually centred around the abdomen, the itch may spread to the limbs in severe cases. 'Me condition occurs from the first trimester and may persist right up to delivery. According to Doctor Herbert Goodheart, MD, in the Journal of Women's Health, this condition is often thought to possibly be a variation of PUPPP without lesions.
Treatment involves use of itch-reduction measures such as cooling the skin, applying anti-itch lotions and oral antihistamines, if the itch is severe. Pruritus gravidarum does not have any adverse effect on the baby or on the progress of the pregnancy, however, it may recur with subsequent pregnancies or if the woman takes certain oral contraceptives.
Polymorphic Eruption Of Pregnancy (PEP)
According to the National Skin Centre, one in 300 pregnant women develop this itchy skin disease. The onset of the rash is usually in the third trimester, especially from the 35th week onwards. On the average, the rash will last for up to six weeks, usually clearing within two to three weeks after delivery. However, in some women, the onset of the rash may be delayed till a few days after delivery.
The term polymorphic means 'many forms' and this aptly describes the appearance of the rash. It usually occurs over the abdominal stretch marks as itchy, red spots or lumps, much like hives. It then progresses to the legs and arms. As a rule, the face and upper trunk are not involved. It may take the form of red patches, papules (spots), vesicles (small water blisters) or dry, red, scaly patches (eczema?like). The itch is usually quite intense.
Treatment is with the use of cold compresses, steroid creams and oral antihistamines. More severe cases may require short courses of oral steroids. PEP itself does not harm the mother or baby
Pruritic Urticarial Papules
Pruritic urticarial papules and plaques of pregnancy (PUPPP) is a common dermatosis of late pregnancy. This common rash is characterised by small red bumps and hives that can cause slight to severe itching. It typically shows up during a woman's third trimester and usually disappears after delivery. While it is not dangerous to mum or baby, the itching can be very annoying, it usually starts on the abdomen and can extend to upper thighs, buttocks and chest.
PUPs is usually treated topically with soothing ointrments, oatmeal baths and calamine lotion. When itching makes a woman too uncomfortable, she can ask her doctor about antihistamines safe for use during pregnancy
Chloasma
If you wake up one morning and find yellow or brown patches on your face, you are most probably suffering from chloasma. These skin pigmentation changes on the face especially the forehead, nose, and cheeks are termed chloasma, or the "mask of pregnancy." According to co-author of "Dermatoses of Pregnancy", dermatologist, George Kroumpouzo, MD, PhD "Chloasma has been reported in up to 70 percent of pregnant women and causes an increase in pigmentation that occurs almost exclusively in sun?exposed areas." This can sometimes include the forearms as well.
These skin splotches will gradually fade after delivery, and darker women tend to experience chloasma more because of the increased levels of estrogen and progesterone that stimulate pigment?producing cells.
Dermatologists encourage the use of proper sunscreen as well as treatment with lightening agents, chemical peels and tretinoin. Some women opt for laser treatments after delivery.
Should I feel threatened?
Common pregnancy-related skin changes pose no health problems. But other conditions, such as skin cancer, could bring about skin discoloration in anyone, pregnant or not. Consult your caregiver if you notice any changes in the colour or size of a mole, or if changes in skin pigmentation are accompanied by pain, tenderness, or redness.
Most skin changes during pregnancy are benign but in rare cases, severe itchiness in your third trimester -- known as cholestasis of pregnancy- could be a sign of a serious liver problem. The itchiness may be accompanied by nausea, vomiting, loss of appetite, fatigue, and jaundice. Call your doctor or immediately if you have any of these symptoms.
Source: Motherhood Magazine
When these skin disorders occur, the first thought that enters the mind of most pregnant mothers is whether any of these skin problems will be transferred to the developing fetus in any adverse way. Fortunately, most of the common skin diseases seen in pregnancy are of no risk to the mother or baby and are simply the marks of motherhood and a tolerable inconvenience.
The common aggravating condition chloasma (the mask of pregnancy) or bad acne, does send some women to the dermatologist. However, depending on your hormones and skin condition, you may not suffer from these problems. Some women develop rashes and some are completely unaffected. If you have had a long-term acne condition, you may be surprised to find that it clears up during pregnancy. Also, having a rash during your first pregnancy does not automatically mean that the rash will return for subsequent pregnancies.
Acne, eczema and psoriasis
Many skin conditions such as psoriasis, eczema and acne are modified by pregnancy In some cases, the rashes do not show up in a genetically predisposed individual until a pregnancy occurs. Even in these cases, the impact of the pregnancy on the skin condition is unpredictable, basically, the glands beneath the skin work overtime in a pregnant body, causing oil-producing glands to become more productive and sweat glands to overwork, causing the mother to perspire more.
According to the American Academy of Dermatology, psoriasis is a chronic genetic skin disorder characterised by raised thickened patch of red skin covered with silvery-white scales that can affect any part of the body. While psoriasis tends to improve during pregnancy, it can flare out of control after delivery.
Rosacea, the red acne-like rash on the face, tends to worsen during pregnancy. This is because the increase in blood volume that peaks during the second trimester and tends to bring more blood to the skin, giving the highly vascular areas like the face a rosier appearance.
Pruritus gravidarurn
Pruritus or itching, is by far the most common dermatosis seen, it usually begins in the later stages of pregnancy. It is widely accepted that the sluggish flow and retention of bile salts that occurs in pregnancy, is the cause of the itch.
Usually centred around the abdomen, the itch may spread to the limbs in severe cases. 'Me condition occurs from the first trimester and may persist right up to delivery. According to Doctor Herbert Goodheart, MD, in the Journal of Women's Health, this condition is often thought to possibly be a variation of PUPPP without lesions.
Treatment involves use of itch-reduction measures such as cooling the skin, applying anti-itch lotions and oral antihistamines, if the itch is severe. Pruritus gravidarum does not have any adverse effect on the baby or on the progress of the pregnancy, however, it may recur with subsequent pregnancies or if the woman takes certain oral contraceptives.
Polymorphic Eruption Of Pregnancy (PEP)
According to the National Skin Centre, one in 300 pregnant women develop this itchy skin disease. The onset of the rash is usually in the third trimester, especially from the 35th week onwards. On the average, the rash will last for up to six weeks, usually clearing within two to three weeks after delivery. However, in some women, the onset of the rash may be delayed till a few days after delivery.
The term polymorphic means 'many forms' and this aptly describes the appearance of the rash. It usually occurs over the abdominal stretch marks as itchy, red spots or lumps, much like hives. It then progresses to the legs and arms. As a rule, the face and upper trunk are not involved. It may take the form of red patches, papules (spots), vesicles (small water blisters) or dry, red, scaly patches (eczema?like). The itch is usually quite intense.
Treatment is with the use of cold compresses, steroid creams and oral antihistamines. More severe cases may require short courses of oral steroids. PEP itself does not harm the mother or baby
Pruritic Urticarial Papules
Pruritic urticarial papules and plaques of pregnancy (PUPPP) is a common dermatosis of late pregnancy. This common rash is characterised by small red bumps and hives that can cause slight to severe itching. It typically shows up during a woman's third trimester and usually disappears after delivery. While it is not dangerous to mum or baby, the itching can be very annoying, it usually starts on the abdomen and can extend to upper thighs, buttocks and chest.
PUPs is usually treated topically with soothing ointrments, oatmeal baths and calamine lotion. When itching makes a woman too uncomfortable, she can ask her doctor about antihistamines safe for use during pregnancy
Chloasma
If you wake up one morning and find yellow or brown patches on your face, you are most probably suffering from chloasma. These skin pigmentation changes on the face especially the forehead, nose, and cheeks are termed chloasma, or the "mask of pregnancy." According to co-author of "Dermatoses of Pregnancy", dermatologist, George Kroumpouzo, MD, PhD "Chloasma has been reported in up to 70 percent of pregnant women and causes an increase in pigmentation that occurs almost exclusively in sun?exposed areas." This can sometimes include the forearms as well.
These skin splotches will gradually fade after delivery, and darker women tend to experience chloasma more because of the increased levels of estrogen and progesterone that stimulate pigment?producing cells.
Dermatologists encourage the use of proper sunscreen as well as treatment with lightening agents, chemical peels and tretinoin. Some women opt for laser treatments after delivery.
Should I feel threatened?
Common pregnancy-related skin changes pose no health problems. But other conditions, such as skin cancer, could bring about skin discoloration in anyone, pregnant or not. Consult your caregiver if you notice any changes in the colour or size of a mole, or if changes in skin pigmentation are accompanied by pain, tenderness, or redness.
Most skin changes during pregnancy are benign but in rare cases, severe itchiness in your third trimester -- known as cholestasis of pregnancy- could be a sign of a serious liver problem. The itchiness may be accompanied by nausea, vomiting, loss of appetite, fatigue, and jaundice. Call your doctor or immediately if you have any of these symptoms.
Source: Motherhood Magazine
Braxton Hicks contractions
Braxton-Hicks contractions are painless contractions that occur at irregular intervals -- although they do not hurt, they can be felt nonetheless. They were first described in 1872 by J. Braxton Hicks. Braxton-Hicks actually begin very, very early in pregnancy; contractions have been seen with ultrasound in the first trimester! They may be stimulated by massaging the uterus. These irregular contractions do not cause the cervix to soften or to dilate, nor do they increase the risk of preterm delivery. As pregnancy progresses, Braxton-Hicks contractions may become more frequent and stronger, although they are still irregular and rarely painful.
Contractions that lead to labor, defined as regular contractions that produce thinning or dilating of the cervix, generally produce more discomfort -- or outright pain -- and occur at regular intervals. Usually, as labor begins, contractions will be fairly far apart; gradually the interval between contractions will lessen until they are three to five minutes apart. If regular 10-15 minute contractions occur before 37 weeks of pregnancy, you should notify your doctor immediately, as these may be a sign of preterm labor. At term, many obstetricians recommend staying at home until the contractions have been five minutes or less apart for one hour -- always follow your own doctor's directions, however.
At any point in the pregnancy, if you are worried about these Braxton-Hicks contractions, see your doctor. A quick exam to check your cervix can reassure you that the contractions you are feeling are not the real thing.
Source: by Kelly Shanahan, M.D, iVillage.com
Contractions that lead to labor, defined as regular contractions that produce thinning or dilating of the cervix, generally produce more discomfort -- or outright pain -- and occur at regular intervals. Usually, as labor begins, contractions will be fairly far apart; gradually the interval between contractions will lessen until they are three to five minutes apart. If regular 10-15 minute contractions occur before 37 weeks of pregnancy, you should notify your doctor immediately, as these may be a sign of preterm labor. At term, many obstetricians recommend staying at home until the contractions have been five minutes or less apart for one hour -- always follow your own doctor's directions, however.
At any point in the pregnancy, if you are worried about these Braxton-Hicks contractions, see your doctor. A quick exam to check your cervix can reassure you that the contractions you are feeling are not the real thing.
Source: by Kelly Shanahan, M.D, iVillage.com
8 golden rules to eating well
CGH's dietitian, Dietetic & Catering, Patsy Soh, has eight rules to eating out well - they will make choosing healthy hawker centre meals a cinch
Rule 1 Have a variety of foods A balanced meal should have carbohydrates (rice and alternatives), fruits, vegetables, meat, and milk and milk items.
Rule 2 Eat more fruits and veggies Dark green leafy vegetables supply foiate, vitamins and minerals. Folate is needed to prevent spina bifida, a condition where baby's spine develops poorly. The vitamins in greens fortify both mother and child's immunity systems against illnesses. Orange or red fruits as well as broccoli, have lots of vitamin C that aids iron absorption.
Rule 3 Eat more high-calcium foods Some musts.. Fish with edible bones like sardines and ikan bilis, tofu (read label to see that calcium has been added), and milk and dairy foods, or calcium-fortified soy bean drink.
Rule 4 Ensure good iron intake Red meats like beef, lamb, pork and offal supply iron that's needed for your increased blood supply to baby. Liver is good, but take it once a week as it's a high-cholesterol food. Avoid tea as the tannin in it inhibits iron absorption. Have a fruit juice instead.
Rule 5 Choose foods that are low in sugar, salt and fats Too much sugary and oily foods will add to excess weight. They can also lead to diabetes and high blood pressure. Avoid oily and spicy foods too - these worsen morning sickness and may give heartburn (when stomach juices go back up the gullet giving that sour, burning sensation).
Rule 6 Eat small, frequent meals Usually breakfast, lunch and dinner, and two snacks in between. You will manage the nausea better this way.
Rule 7 Drink plenty of fluids You need eight to 10 glasses a day. Plain water, low-fat milk, or milk fortified with iron like Marigold 1Cal Milk, fruit or vegetable juices are good. The Health Ministry warns that too much alcohol in the first three months is bad. Alcohol crosses into baby's blood stream and studies show that it leads to mental and physical retardation.
Rule 8 Avoid uncooked food Be careful with raw egg and seafood as they can cause food poisoning. Pre-cooked and chilled meats like bacon, ham and salmon are also not a good idea unless warmed up to piping hot, says Patsy. "Shop-bought" salad is risky too, she says. These veggies have been exposed for a long time and may contain listeria. In non-pregnant women, this can give a bad tummy upset. The risk for pregnant women is miscarriage and still birth.
Fish to avoid in pregnancy
An advisory panel to the US Food and Drug Administration (FDA) recommended in late July (2002) that pregnant women and women of childbearing age limit their intake of tuna while further tests are done. The problem was the presence of mercury in the fish. This includes tinned tuna. The FDA was already advising pregnant women to avoid shark, swordfish, tilefish and king mackerel , because of mercury levels, and to eat a variety of fish ensure against high mercury intake.
Source of omega-3
What makes fish so good? The most highly-publicised benefit is its omega-3 fatty acid or oil, thought to help blood clot less easily. This cuts the risk of heart disease, heart attack and stroke. Fish in the diet is also thought to help protect against diseases such as joint inflammation, prostate cancer and tumours. For example, while Greenland Eskimos and Danes eat almost the same amount of total fat, the former eat a lot of omega-3 fatty acids, and have a much lower incidence of breast cancer - it's thought that it is the n-3 acids that inhibit tumour growth.
So how much fish should you eat? At least two servings per week, say experts.
Sources:
1) The Singapore Women's Weekly (May 2002). Pg 75
2) Today's Parents, Jul 2001.
3) Today's Parents, Sep 2002.
Rule 1 Have a variety of foods A balanced meal should have carbohydrates (rice and alternatives), fruits, vegetables, meat, and milk and milk items.
Rule 2 Eat more fruits and veggies Dark green leafy vegetables supply foiate, vitamins and minerals. Folate is needed to prevent spina bifida, a condition where baby's spine develops poorly. The vitamins in greens fortify both mother and child's immunity systems against illnesses. Orange or red fruits as well as broccoli, have lots of vitamin C that aids iron absorption.
Rule 3 Eat more high-calcium foods Some musts.. Fish with edible bones like sardines and ikan bilis, tofu (read label to see that calcium has been added), and milk and dairy foods, or calcium-fortified soy bean drink.
Rule 4 Ensure good iron intake Red meats like beef, lamb, pork and offal supply iron that's needed for your increased blood supply to baby. Liver is good, but take it once a week as it's a high-cholesterol food. Avoid tea as the tannin in it inhibits iron absorption. Have a fruit juice instead.
Rule 5 Choose foods that are low in sugar, salt and fats Too much sugary and oily foods will add to excess weight. They can also lead to diabetes and high blood pressure. Avoid oily and spicy foods too - these worsen morning sickness and may give heartburn (when stomach juices go back up the gullet giving that sour, burning sensation).
Rule 6 Eat small, frequent meals Usually breakfast, lunch and dinner, and two snacks in between. You will manage the nausea better this way.
Rule 7 Drink plenty of fluids You need eight to 10 glasses a day. Plain water, low-fat milk, or milk fortified with iron like Marigold 1Cal Milk, fruit or vegetable juices are good. The Health Ministry warns that too much alcohol in the first three months is bad. Alcohol crosses into baby's blood stream and studies show that it leads to mental and physical retardation.
Rule 8 Avoid uncooked food Be careful with raw egg and seafood as they can cause food poisoning. Pre-cooked and chilled meats like bacon, ham and salmon are also not a good idea unless warmed up to piping hot, says Patsy. "Shop-bought" salad is risky too, she says. These veggies have been exposed for a long time and may contain listeria. In non-pregnant women, this can give a bad tummy upset. The risk for pregnant women is miscarriage and still birth.
Fish to avoid in pregnancy
An advisory panel to the US Food and Drug Administration (FDA) recommended in late July (2002) that pregnant women and women of childbearing age limit their intake of tuna while further tests are done. The problem was the presence of mercury in the fish. This includes tinned tuna. The FDA was already advising pregnant women to avoid shark, swordfish, tilefish and king mackerel , because of mercury levels, and to eat a variety of fish ensure against high mercury intake.
Source of omega-3
What makes fish so good? The most highly-publicised benefit is its omega-3 fatty acid or oil, thought to help blood clot less easily. This cuts the risk of heart disease, heart attack and stroke. Fish in the diet is also thought to help protect against diseases such as joint inflammation, prostate cancer and tumours. For example, while Greenland Eskimos and Danes eat almost the same amount of total fat, the former eat a lot of omega-3 fatty acids, and have a much lower incidence of breast cancer - it's thought that it is the n-3 acids that inhibit tumour growth.
So how much fish should you eat? At least two servings per week, say experts.
Sources:
1) The Singapore Women's Weekly (May 2002). Pg 75
2) Today's Parents, Jul 2001.
3) Today's Parents, Sep 2002.
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