Thirty Questions and Thirty Answers on Pregnancy Health Care [Early Pregnancy + Second Pregnancy + Late Pregnancy]

When you first know that your baby has begun to be gestated, whether you are a first-time mother or an expectant mother of a second child, in addition to your longing and joy, you will more or less have some panic and worry. The Obstetrics Department of the Third Affiliated Hospital of Zhengzhou University has thoughtfully carried out a series of special activities on pregnancy health care to answer questions about some common pregnancy issues that pregnant mothers are concerned about. Download the 40-week pregnancy manual [PDF+TXT version] Early Pregnancy Chapter 01 How to tell if you are pregnant? For women with a history of sexual intercourse and regular menstruation, it is recommended that pregnancy should be suspected if the menstrual period is more than 10 days past due. It can be judged by early pregnancy reaction, early pregnancy test paper, or blood hCG test. B-ultrasound test can also be done after 6 weeks of menopause. 02 I didn’t know that I was pregnant. I had a chest X-ray for a physical examination. Will it affect the child? Within 2 weeks of fertilization, or 4 weeks of pregnancy, the impact of most drugs or medical examination methods on the embryo follows the \”all or nothing\” principle. If affected, it may cause death, miscarriage or stop development. If the fetus survives, there is no need to worry. Secondly, the radiation exposure dose caused by X-ray examination is far lower than the dose that would harm the fetus. Therefore, please do not sentence life to death easily. 03 What should I do if my early pregnancy reaction is too severe? Anorexia and vomiting are relatively normal symptoms of early pregnancy. Pregnant mothers should self-regulate their diet and try to choose foods that promote appetite, are nutritious and diverse, and are easy to digest. Eat small meals frequently. You can also supplement some vitamin B6 to reduce the symptoms of morning sickness. , Emotions are also very important. You can do something that interests you to divert your attention. If you still have severe morning sickness or even weight loss after self-adjustment, it is recommended to go to the hospital for liver function, blood electrolyte tests and urine ketone body tests. You may need hospitalization, intravenous water, electrolytes and caloric supplements, and let the gastrointestinal rest at the same time. . 04Can I eat seafood during pregnancy? Seafood itself will not affect the fetus, but seafood may contain parasites. Therefore, eat fresh, hygienic, and cooked seafood. 05B-ultrasound examination shows a triple pregnancy. Is it necessary to reduce the number of fetuses? Generally, for survivors of three or more pregnancies, it is recommended to reduce the number of fetuses. Because fetuses in multiple pregnancies are undernourished in a narrow space, they are at high risk of intrauterine growth restriction, premature birth, premature rupture of membranes, preeclampsia and other hypertensive diseases in late pregnancy, and postpartum hemorrhage during delivery. The risk of complications is high, endangering the lives of mother and baby. The main risks of fetal reduction are miscarriage and premature birth. Early fetal reduction is generally recommended to reduce complications in the second and third trimesters of pregnancy. 06What should older pregnant women pay attention to? Pregnant women of advanced age are defined as those aged ≥35 years at the time of delivery. Because after a woman reaches the age of 35, many aspects of her body begin to decline relatively. Pregnancy at this time will increase the incidence of fetal malformations; at the same time, the risk of intrauterine growth retardation, miscarriage and premature birth increases, and older pregnant women Susceptible to pregnancy complications such as heart disease, gestational hypertension and gestational diabetes. Therefore, special attention should be paid to health care during pregnancy and regular prenatal check-ups should be ensured. In addition to the routine NT ultrasound examination at 11-13+6 weeks and the major ultrasound examination at 20-24 weeks, it is recommended that pregnant women of advanced age should undergo ultrasound examination after 18 weeks of pregnancy.Afterwards, amniocentesis is performed directly to check the fetal chromosomes. If you are unwilling to undergo amniocentesis or have contraindications to amniocentesis, you can choose non-invasive DNA testing first, but you must understand the limitations of non-invasive DNA testing. 07Can I have a fetus with an increased NT value? It depends on the specific situation. The thickness of NT value is directly proportional to the incidence of chromosomal abnormalities, and can better evaluate the risk of trisomy 21, trisomy 18, trisomy 13, etc.; it is also related to fetal congenital cardiac structural malformations. Related, is the most common cause of non-chromosomal abnormality NT thickening. Secondly, NT thickening is also related to other structural malformations of the fetus: such as skeletal system malformations, diaphragmatic hernia, anterior abdominal wall defects (omphalocele), fetal dyskinesia syndrome, etc. In addition, thickening of NT value is also related to spontaneous abortion. A completely normal fetus may also have NT thickening. When you get the result of NT thickening, pregnant mothers should not be overly nervous and uneasy, and go to the hospital in time. We have professional experts to help you further investigate possible risks. 08The first child was delivered by cesarean section, and now I am pregnant with the second child. What should I pay attention to? Pregnancy after cesarean section should be at least 2 years and within 10 years. The shorter the interval, the greater the risk of uterine rupture in subsequent pregnancies. Pregnant mothers with scarred uterus can first undergo an ultrasound examination to understand the relationship between the implantation site of the embryo and the scar. If the embryo implants on the scar, it is a \”scar pregnancy\”. The risk of uterine rupture and massive bleeding is high, and it is recommended to terminate the pregnancy. If the implantation site is not at the scar, the pregnancy can continue, but there is still a risk of uterine rupture during pregnancy. It is recommended to strengthen perinatal care regularly. 09Can I play with mobile phones and computers during pregnancy? Can. The dose of radiation from daily electrical appliances is very small and will not cause harm to the mother and fetus. Normal use of mobile phones to make calls will have no impact on the fetus, but it is not recommended to play with mobile phones for a long time. Playing with mobile phones for a long time during pregnancy will affect your rest and vision. It is recommended that you should take more walks outdoors during pregnancy, relax your mind, take more rest, develop good living habits, do not stay up late, avoid fatigue, and have regular prenatal check-ups. . 10How to supplement folic acid during pregnancy? In order to prevent neural tube defects in the fetus, the demand for folic acid is high during pregnancy. In addition to the folic acid in food, pregnant mothers must also supplement synthetic folic acid. The country recommends taking 0.4 mg of folic acid orally three months before pregnancy. Women who have a history of childbearing with neural tube defects, suffer from diseases such as diabetes and epilepsy that affect folic acid metabolism, or are found to have genetic defects in folic acid metabolism, need to follow the doctor\’s advice to increase their folic acid intake according to their specific circumstances. Second trimester chapter 01 How to get a good night’s sleep? For pregnant mothers, adequate sleep is very important. As your uterus grows during the second trimester, how can you get a good night\’s sleep? First of all, avoid irritating foods such as coffee and tea before going to bed. Do not eat a large amount before going to bed, do not exercise strenuously, and do not be too emotional. Walking, reading, and drinking milk are all helpful for a good sleep; secondly, the left side is the most suitable sleeping position. This sleeping position can prevent the uterus from compressing the inferior vena cava, reduce the tension of the uterine blood vessels, and increase the placental blood flow. Provide a good environment for the fetus. between legsOr placing a small pillow behind your back to assist in proper adjustment can also help improve sleep quality. Finally, it is also very important to form your own fixed biological clock and develop a good habit of going to bed at the same time every day. 02How to count fetal movements? First-time mothers generally feel fetal movement around 20 weeks, while multiparous women notice it earlier. Due to differences in abdominal fat thickness and self-perception among pregnant mothers, the time when they first feel fetal movement varies from person to person. What is currently advocated is the 12-hour fetal movement count. Count fetal movement for one hour each day from 8 am to 9 am, 1 to 2 pm, and 8 to 9 pm. The three counts are added up and multiplied by 4 to get the 12-hour fetal movement count. The fetal movement counting time can be adjusted according to the fetal movement pattern. Fetal movement more than 3 times per hour or more than 30 times in 12 hours is normal fetal movement. If the fetal movement increases or decreases significantly, it is abnormal fetal movement and requires timely treatment. 03What to do about oral problems? Oral problems are more likely to occur during pregnancy than usual. How to avoid the damage caused by oral problems, a healthy diet and good living habits are crucial. The diet should be balanced and nutritious, and do not eat too much acidic, sugary, fatty and fried foods; good living habits, brush your teeth morning and evening, brush your teeth or rinse your mouth after each meal, and use soft bristles Toothbrush, brush your teeth for no less than three minutes each time. Tooth extraction in early pregnancy increases the risk of miscarriage, and tooth extraction in late pregnancy increases the risk of premature birth. Most dental treatments can be completed in the second trimester. The anesthetics used in dentistry are safe and generally will not harm the fetus. 04How can pregnant mothers prevent gestational diabetes? Regular diet: Eat small meals frequently, avoid high-sugar foods, and eat more high-quality protein foods such as chicken, shrimp, and fish. Appropriate exercise: Before exercising, you need to know whether you are suitable for exercise and what kind of exercise you are suitable for. Warm up before exercising and do some low-intensity aerobic exercise, such as walking. Do not exercise on an empty stomach and do not exercise on a full stomach. Exercise time can be arranged one hour after a meal. To prevent hypoglycemia, you can carry some snacks with you. If you feel uncomfortable, stop exercising. Weight control: The rate of weight gain during pregnancy needs to be strictly controlled. The weight gain is 1-2kg throughout the first trimester; the weight gain is 0.3-0.5kg per week in the second and third trimesters; a total weight gain of 10-12kg during pregnancy is reasonable. Do a good job of screening: Between 24 and 28 weeks of pregnancy, pregnant mothers also need to be screened for diabetes. They need to make an appointment with the doctor in advance to ask for precautions to avoid mistakes. 05How should pregnant mothers with gestational diabetes eat? The ideal goal of dietary control for gestational diabetes is to ensure and provide the calories and nutrients needed for pregnancy, avoid the occurrence of postprandial hyperglycemia or starvation ketosis, and ensure the normal growth and development of the fetus. Pregnant mothers with gestational diabetes should develop the habit of eating small and frequent meals. They can divide the food into five or six meals a day and allocate the energy of each meal. Avoid foods that cause blood sugar to rise rapidly, such as foods containing sucrose, fructose, glucose, maltose, etc.; avoid foods that are greasy, fatty, and high in cholesterol, consume less animal fat, and use vegetable oil instead. Within the acceptable portion size, consume more high-fiber foods. Brown rice or five-grain rice can be used instead of white rice. Multigrain steamed buns can be used instead of white steamed buns to increase the vegetable content. You can eatFresh fruits (such as apples, kiwis, strawberries and other fruits with low sugar content and low sweetness) and avoid drinking juice. 06Can I have sex during pregnancy? Yes, but sexual intercourse should be avoided during the first 3 months of pregnancy and the last month of pregnancy. You can have sexual intercourse during the rest of pregnancy, but you should be careful to do so gently and not too often. People with a history of miscarriage, premature birth, vaginal bleeding during pregnancy, low placenta, short cervical canal or cervical insufficiency, twin pregnancy, or expectant father suffering from sexually transmitted diseases should not have sexual intercourse during pregnancy. 07Can stretch marks be prevented? Can. Pregnant mothers with a high basic weight, excessive or rapid weight gain during pregnancy, heavy baby weight, young mother, or a family history of stretch marks are more likely to develop stretch marks during pregnancy. To prevent stretch marks, you need to eat regularly and control the weight of the pregnant mother and baby. In addition, using olive oil or massage cream from regular manufacturers can increase the elasticity of the skin to a certain extent and prevent stretch marks. 08Is prenatal education useful during pregnancy? it works. Timely and appropriate education and training of the fetus during pregnancy is beneficial to the child\’s later development and is the beginning of early education. In the second trimester of pregnancy, the fetus\’s internal, external and middle ears have formed, and the fetus can already hear some sounds at 24 weeks of pregnancy. At this time, pregnant women often listen to beautiful music or recite poetry and prose, etc., which helps to form a good stress response and maintain the physiology of mother and child. Mental health enables people\’s mental factors to be optimized during the fetal period. This is beneficial to the intellectual and physical development of the fetus, and lays a good foundation for cultivating talents with all-round development of morality, intelligence, body and beauty. 09 What are the contents of the mid-trimester examination? 1. Measure blood pressure, weight, uterine height, abdominal circumference, fetal heart rate, and pay attention to lower limb edema; 2. Review blood routine to detect anemia in time, and review urine routine to screen for pregnancy high blood pressure in time. Blood pressure diseases; 3. Serological screening for Down syndrome and neural tube defects is recommended at 15 to 20+6 weeks of pregnancy, and non-invasive DNA (12 to 22+6) or prenatal diagnosis is required for those over 35 years old; 4. Four-dimensional color ultrasound should be done at 20 to 24 weeks of pregnancy to screen for severe fetal malformations; 5. Diabetes screening (75g glucose screening test) should be done at 24 to 28 weeks of pregnancy. 10. Can I take medicine for cold during pregnancy? Colds with mild symptoms, such as runny nose and sneezing, generally have little impact on the fetus. You don\’t need to take medicine. Pay attention to getting enough rest, drinking more water, eating a light diet, and eating more fruits and vegetables rich in vitamin C. Colds with severe symptoms are accompanied by high fever, purulent nasal discharge, tonsillitis, etc. The cold itself will also have certain effects on the fetus, and in this case, medical treatment is required. Cold prevention is the most important: ventilating the room, staying out of crowded public places, not coming into contact with cold patients, exercising more, ensuring adequate sleep, and maintaining a good attitude can enhance resistance to the disease. Late Pregnancy Chapter 01 What are false contractions? As the fetal head gradually descends, it stimulates the lower segment of the uterus. This pulling stimulation will cause the uterus to contract. This kind of uterine contraction is what we often call \”false contractions.\” When false contractions occur, the pregnant mother will feel a falling sensation in the abdomen and cannot straighten her back. However, they are short-lived, irregular, non-cyclical, will not cause pain, cannot dilate the cervix, and are not indicative of labor. sign. The pain of true uterine contractions will last longer and longer, and the duration of labor pain will be longer and longer.The pain will gradually increase as labor progresses, and the time between labor pains will become shorter and shorter. However, for preterm pregnant mothers (less than 37 weeks), if false contractions occur frequently and are accompanied by abdominal pain and vaginal bleeding, they should seek medical treatment as soon as possible to prevent premature birth. Full-term pregnant mothers should not be too nervous about false contractions. Pay attention to relaxing the body, lying on the left side, and resting in bed for a while. Generally, the symptoms can be relieved. If they occur frequently or are accompanied by severe pain, they should seek medical treatment as soon as possible. Pregnant mothers should remember the difference between the two, which may save you a few trips to the hospital. 02What are the dietary precautions during the third trimester of pregnancy? As the expected date of delivery approaches, some pregnant mothers will eat and drink heavily and take supplements blindly in the third trimester of pregnancy in order to give birth to a \”fat baby\”. This approach is not advisable. Compared with the second trimester, the daily energy demand of pregnant mothers only increases by 200 kcal. 200 kcal corresponds to 100 grams of lean meat, 3 boiled eggs, or 400 ml of milk. Weekly weight gain during the third trimester should be controlled within 0.5 kilograms. Pregnant mothers can determine whether they are eating too much by measuring their weight gain. Overnutrition and excessive weight gain will increase the risk of giving birth to a \”macrosomia\”, which is not only detrimental to normal delivery, but will also affect your postpartum recovery. The daily protein intake in the third trimester of pregnancy increases by 30 grams compared with before pregnancy, and should reach about 85 grams per day; eggs, lean meat, and soy products can provide high-quality protein. For pregnant mothers who are obese and need to control their weight and avoid overnutrition, protein intake can be more through plant foods, and it is also possible to appropriately choose high-protein, low-fat fish or poultry. Pregnant mothers in the third trimester should also pay attention to continuing to supplement calcium and iron. The intake of calcium is 1,000 mg per day; foods such as milk and dairy products, dried shrimps, beans and soy products, and sesame are rich in calcium; the intake of iron is 1,000 mg per day. 29 mg; animal offal, animal blood, red meat, seaweed, fungus, etc. are rich in iron. Pregnant mothers in the third trimester of pregnancy should develop the eating habit of eating smaller meals more frequently, and eat less raw, cold, greasy, and indigestible foods. Impure eating should be avoided. 03What are the signs of premature birth? If you have regular abdominal pain between 28 weeks and less than 37 weeks of pregnancy, and the frequency gradually increases, up to 10 times a day or more, and cannot be relieved even if you change your posture or lie down to rest, it indicates that premature birth may occur; in addition, see Redness is also a reliable sign that labor is about to occur, and it often appears 24-48 hours before labor. For premature birth, pregnant mothers should have regular prenatal check-ups, and moderate sexual life in the third trimester to avoid premature rupture of membranes; early detection and early hospitalization for treatment should be achieved. 04 Is it dangerous for the umbilical cord to wrap around the neck? If the umbilical cord is too long, the baby is too small, the amount of amniotic fluid is too high, or the fetus moves frequently, it may cause the umbilical cord to wrap around the baby\’s neck, limbs or trunk. The impact of the umbilical cord wrapped around the neck on the baby is related to the tightness and number of weeks of the umbilical cord wrapping and the length of the umbilical cord. The most common situation is to wrap the umbilical cord around the neck for a week. The umbilical cord wrapping around the neck may prolong the delivery time. If it is wrapped too tightly or with too many turns, the baby\’s blood circulation may be blocked or even suffocated by lack of oxygen. In fact, if there is no evidence that the baby is hypoxic, the pregnant mother does not need to be too Count fetal movements, perform regular prenatal check-ups and monitor fetal heart rate, and let professional doctors assess whether the fetus has intrauterine hypoxia. The fact that the umbilical cord is wrapped around the neck does not mean that a cesarean section is necessary. If the baby is generally in good condition in the womb and the umbilical cord does not wrap around the neck 3 times or more before delivery, or the umbilical cord does not wrap around the neck and the umbilical cord wraps around the limbs, the pregnancy The mother can give birth to her baby with confidence. 05What should I do if I have premature rupture of membranes? Normally, the water will break when the cervix is ​​almost fully dilated, but in 10% of full-term pregnant mothers, the water will break before labor, which is premature rupture of membranes, and in 2%-3.5% of pregnant mothers, the water will break before term. Premature rupture of membranes. When the fetal membranes rupture prematurely, a light yellow clear liquid will suddenly flow out of the vagina, which may be mixed with meconium or vernix. Premature rupture of membranes may cause premature birth, increased perinatal mortality, intrauterine infection and puerperal infection. In severe cases, umbilical cord prolapse may occur. If the pregnant mother continues to sit or stand after the water breaks, the umbilical cord may slip in along with the amniotic fluid. In the vagina, if umbilical cord prolapse occurs, the compression of the umbilical cord will block the fetal blood circulation, causing acute fetal hypoxia, and intrauterine fetal death may occur in more than 7 minutes. Therefore, after the water breaks, pregnant mothers must pay attention to: first, lie down immediately and raise the buttocks; second, seek medical treatment immediately! 06What is labor analgesia? Labor analgesia refers to the use of various methods to relieve maternal pain during vaginal delivery. Current analgesic methods are roughly divided into non-drug analgesia, drug analgesia and narcotic analgesia. Non-drug analgesia mainly refers to psychiatric prevention methods, including prenatal education and intrapartum guidance; drug analgesia includes intramuscular or intravenous injection of analgesics, etc. Although the effect is obvious, the drugs easily pass through the placenta and may cause respiratory depression for the baby; currently Spinal anesthesia is the most commonly used clinical method of labor analgesia. Injecting anesthetic into the mother\’s spinal canal through the lumbar intervertebral space can significantly reduce pain while ensuring that the mother is awake and will not affect the baby. In our country, in order to avoid prolonged labor, labor analgesia usually starts anesthesia when the cervix is ​​dilated 3 cm, and stops anesthesia when the cervix is ​​fully dilated. 07What is doula delivery? Doula delivery refers to the provision of continuous psychological and physical support to pregnant mothers before, during and after birth by well-trained doulas and medical staff with birth experience. It is a kind of psychological therapy for labor analgesia. It can train mothers to divert their attention, relax muscles, reduce fear and tension, and reduce the brain\’s response to pain. It can eliminate labor pain to a certain extent and effectively avoid postpartum depression. happened. Generally speaking, doula delivery is suitable for women who are giving birth for the first time, have no complications and pregnancy complications, have no indication for cesarean section before delivery, and plan to give birth naturally. 08What is water birth? Water birth is when a mother gives birth to her baby in water. Qualified mothers can enter warm water to wait for delivery when the cervix is ​​dilated to 5-7 cm. During the entire process, the mother\’s body temperature, fetal heart rate and other data will be monitored. After the baby is delivered, the mother will be transferred to the delivery bed to check the birth canal. Deliver the placenta. Water delivery can significantly reduce pain, accelerate labor progress, protect the maternal perineum, increase perineal elasticity, and reduce the rate of episiotomy; however, it also has certain risks including infection, fetal tachycardia, umbilical cord rupture, etc. Not all pregnant women areSuitable for water birth, but not suitable for: premature birth, dystocia, multiple pregnancy, vaginal bleeding during delivery, infectious diseases, abnormal fetal position, placenta previa, etc. 09What are the signs of labor? Symptoms that indicate imminent labor are called \”threatened labor\” and mainly include 3 symptoms: ① Feeling of descent: As the fetal head descends, pregnant mothers will have a feeling of bloating in the lower abdomen, frequent urination, etc. Generally, the sensation of descent occurs later. Morning, just pay more attention and don\’t rush to the hospital. ②Redness: A small amount of vaginal bleeding before delivery, which is less than menstrual flow. Most of them occur 24-48 hours before delivery. There are certain individual differences. If you find redness, you should go to the hospital for further examination. ③ Uterine contractions: Pregnant mothers will feel that their belly becomes tight, hard, and bloated. Uterine contractions that threaten labor are generally irregular and short in duration. If the contractions become regular and gradually strengthen, the pregnant mother will begin to enter labor. At this time, you should go to the hospital as soon as possible. 10. What can expectant fathers do for childbirth? One week before the due date, the expectant father should adjust to the state of preparation for labor, keep his mobile phone open, and wait for the call at any time. In addition, you must prepare in advance: maternity bags, toiletries, clothes, food, ID cards, birth certificates, medical insurance cards, medical cards, various maternal examinations and test results during pregnancy, and plan the best route to the hospital in advance. In addition, expectant fathers should be more patient and considerate, and should take the initiative in serving tea, pouring water, chatting and massaging. After the newborn is born, you should first care for the great pregnant mother, and then pay attention to the baby.

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