Pregnancy

The Center for Women’s Health is pleased to offer you some information on pregnancy. Please contact the staff at the Center for Women’s Health if you wish to discuss any of these topics in more detail

Diabetes and Pregnancy

Diabetes is a condition that causes high levels of glucose in the blood. Glucose is a sugar that is the body’s main source of fuel. Health problems can arise when the glucose levels are too high or not well controlled.

Causes:
Diabetes occurs when there is a problem with the way the body makes or uses insulin. Insulin is a hormone that converts the glucose in food into energy. During pregnancy, the hormones produced by the placenta can change the way insulin works. As a result, gestational diabetes may occur. Gestational diabetes can occur even when no risk factors or symptoms are present.

Effects During Pregnancy:
The risk of problems during pregnancy is greatest when diabetes is not well controlled. If you have diabetes or if you are at risk of developing gestational diabetes, you should be aware of the problems that may arise:

Birth defects

Macrosomia (very large baby)

Preeclampsia is high blood pressure during pregnancy

Hydramnios occurs when there is too much amniotic fluid

Urinary tract infections

Respiratory distress syndrome can make it harder for the baby to breathe after birth.

Preparing for Pregnancy:
If you have diabetes, preparing for pregnancy can improve your health and that of your future child. Plan to see your doctor before you get pregnant to discuss your care.

Diabetes Control:
There are a number of ways that you can measure your glucose level. All are safe and simple to use on a daily basis. You may need to check your glucose often each day to keep it at a normal level. To be most effective, the results should be kept accurately and reported to your doctor.

Home Monitoring:
Glucose meters or strips can be used to measure glucose levels.

Exercise During Pregnancy

Benefits of Exercise: Regular exercise builds bones and muscles, gives you energy, and keeps you healthy. It is just as important when you are pregnant. Becoming active and exercising at least 20 minutes on most days of the week can benefit your health in the following ways:

Helps reduce backaches, constipation, bloating and swelling
May help prevent or treat gestational diabetes
Increases your energy
Improves your mood
Improves your posture
Promotes muscle tone, strength and endurance
Helps you sleep better
Pregnancy causes many changes in your body, some of which will affect your ability to exercise. The hormones produced during pregnancy cause your ligaments and joints to become relaxed. Remember that during pregnancy you are carrying extra pounds — as much as 25 to 40 pounds at the end of pregnancy. The extra weight in the front of your body shifts your center of gravity and places stress on joints and muscles, especially those in the pelvis and lower back. The extra weight you are carrying will make your body work harder than before you were pregnant. Exercise increases the flow of oxygen and blood to the muscles being worked and away from other parts of your body. So, it’s important not to overdo it.

Before beginning your exercise program, talk with your doctor to make sure you do not have any health condition that would limit your activity. Most forms of exercise are safe during pregnancy. However, some types of exercise involve positions and movements that may be uncomfortable, tiring or harmful for pregnant women. For instance, after the first trimester of pregnancy, women should not do exercises that require them to lie flat on their backs.

Certain sports are safe during pregnancy, even for beginners: Walking or swimming is good exercise for anyone. Cycling provides a good aerobic workout. Aerobics is a good way to keep your heart and lungs strong. Other exercises, if done in moderation, are safe for women who have done them for a while before pregnancy:

Running/Jogging/Walking
Racquet sports
Strength training
Low impact aerobics
Yoga
The following activities should be avoided during pregnancy:

Water, or snow skiing
Contact sports
Scuba diving

Infertility Evaluation

The testing begins with a physical exam and health history. The health history will focus on key points:

Menstrual Cycle Analysis – Review of the menstrual patterns, irregular bleeding or painful periods.
Pregnancy History
Disease History – A history of past diseases to determine if this has contributed to difficulties in getting pregnant. Sexually transmitted diseases (STDs), cancer, and other factors might cause for fertility problems.
Birth Control – Reviewing previously used methods of birth control to determine if this is preventing you from getting pregnant.
Social History – Any environmental exposures or social habits (such as smoking, drug or alcohol abuse) which could contribute to the infertility.
Physical Exam – Evaluation of the uterus, tubes, ovaries, for physical problems preventing pregnancy.

Infertility Testing

There are many ways to see if ovulation occurs. Some tests are done by the woman, and others are done by the doctor.

Urine Test. A way to predict ovulation is by using a urine test kit at home. This test measures luteinizing hormone (LH), a hormone that causes ovulation to occur. If the test is positive, it means ovulation is about to occur. Sometimes these kits are used with basal body temperature charts.
Basal Body Temperature. After a woman ovulates, there is a small increase in body temperature. To measure basal body temperature, a woman takes her temperature by mouth every morning before she gets out of bed and records it on a chart. This record should be kept for 2–3 menstrual cycles to see if ovulation occurs.
Blood Test. After a woman ovulates, the ovaries produce the hormone progesterone. A blood test taken in the second half of the menstrual cycle can measure progesterone to show if ovulation has occurred.
Endometrial Biopsy. The lining of the uterus (endometrium) changes at ovulation. Sometimes a biopsy (a sample of the tissue) is done in this area to find out whether and when ovulation has occurred. A small plastic tube is inserted into the vagina and through the cervix. A sample of the lining is taken to check for ovulation and tissue response. Luteal phase dysfunction is diagnosed if the histological findings lag behind the expected cycle duration by more than two days. It should be noted that endometrial biopsy is used less frequently with the advent of modern ultrasonography and other noninvasive tests.
Other tests, such as a Pap test and blood tests, may also be performed.

For more assistance with your infertility issues contact the Center for Women’s Health.

What Are Obstetric Ultrasounds Or Sonograms?

Obstetric Ultrasound is the use of ultrasound scans in pregnancy. Since its introduction in the late 1950’s ultrasonography has become a very useful diagnostic tool in Obstetrics.

A pregnancy ultrasound is a method of seeing the fetus and female pelvic organs during pregnancy. The ultrasound machine sends out high-frequency sound waves. These waves bounce off body structures to create a picture.

Why Is Ultrasound Used During A Pregnancy?

Ultrasound scans are considered to be a safe, non-invasive, accurate and cost-effective investigation in the fetus. It has progressively become an indispensable obstetric tool and plays an important role in the care of every pregnant woman. Some physicians order an ultrasound when an abnormality is suspected, while others advocate screening ultrasounds. You should consult your health care provider to determine the most appropriate scanning schedule for you.

Scans may be performed in the first trimester to:

Confirm a normal pregnancy
Assess the baby’s age and size
Rule out abnormalities, such as ectopic pregnancies or potential for miscarriage
Assess the baby’s heart
Determine if there are multiple pregnancies
Identify abnormalities of the placenta, uterus, and other pelvic structures
Scans may also be obtained in the second and third trimesters to:

Assess the baby’s age, growth, position, and sometimes gender
Identify any developmental problems
Rule out multiple pregnancies
Evaluate the placenta, amniotic fluid, and remaining structures of the pelvis

How Is An Ultrasound Or Sonogram Performed?

You will lie down for the procedure. A clear, water-based conducting gel will be applied to your skin over your abdomen and pelvis. The gel helps transmit sound waves. A hand-held probe is then moved over the area.

Another method is performed with a specially designed probe placed in the vagina of the patient (transvaginal ultrasound scanning). This technique often complements conventional ultrasound techniques by providing better detail. Consult your health care provider to determine which technique is most appropriate for you.

Are Ultrasounds And Sonograms Safe?

There is no documented effect on patients and their fetuses with the use of current ultrasound techniques. Unlike X-rays, ionizing radiation is not present.