Pregnancy-7

Management


See also: Prenatal care

Prenatal medical care is of recognized value throughout the developed world. Periconceptional folic acid supplementation is the only type of supplementation of proven efficacy.[citation needed]

Nutrition

Main article: Nutrition and pregnancy

A balanced, nutritious diet is an important aspect of a healthy pregnancy. Eating a healthy diet, balancing carbohydrates, fat, and proteins, and eating a variety of fruits and vegetables, usually ensures good nutrition. Those whose diets are affected by health issues, religious requirements, or ethical beliefs may choose to consult a health professional for specific advice.

Adequate periconceptional folic acid (also called folate or Vitamin B9) intake has been proven to limit fetal neural tube defects, preventing spina bifida, a very serious birth defect. The neural tube develops during the first 28 days of pregnancy, explaining the necessity to guarantee adequate periconceptional folate intake. Folates (from folia, leaf) are abundant in spinach (fresh, frozen, or canned), and are also found in green vegetables, salads, citrus fruit and melon, chickpeas (i.e. in the form of hummus or falafel), and eggs. In the United States and Canada, most wheat products (flour, noodles) are fortified with folic acid.

DHA omega-3 is a major structural fatty acid in the brain and retina, and is naturally found in breast milk. It is important for a mother to consume adequate amounts of DHA during pregnancy and while nursing to support her well-being and the health of her infant. Developing infants cannot produce DHA efficiently, and must receive this vital nutrient from the mother through the placenta during pregnancy and in breast milk after birth.

Several micronutrients are important for the health of the developing fetus, especially in areas of the world where insufficient nutrition is prevalent.[46] In developed areas, such as Western Europe and the United States, certain nutrients such as Vitamin D and calcium, required for bone development, may require supplementation.

Dangerous bacteria or parasites may contaminate foods, particularly listeria and toxoplasma, toxoplasmosis agent. Careful washing of fruits and raw vegetables may remove these pathogens, as may thoroughly cooking leftovers, meat, or processed meat. Soft cheeses may contain listeria; if milk is raw the risk may increase. Cat feces pose a particular risk of toxoplasmosis. Pregnant women are also more prone to catching salmonella infections from eggs and poultry, which should be thoroughly cooked. Practicing good hygiene in the kitchen can reduce these risks.
Weight gain

Caloric intake must be increased to ensure proper development of the fetus. The amount of weight gained during pregnancy varies among women. The National Health Service recommends that overall weight gain during the 9 month period for women who start pregnancy with normal weight be 10 to 12 kilograms (22–26 lb). During pregnancy, insufficient weight gain can compromise the health of the fetus. Likewise, excessive weight gain can pose risks to the woman and the fetus. Women who are prone to being overweight may choose to plan a healthy diet and exercise to help moderate the amount of weight gained.

Immune tolerance

Main article: Immune tolerance in pregnancy

The fetus inside a mother may be viewed as an unusually successful allograft, since it genetically differs from the mother. In the same way, many cases of spontaneous abortion may be described in the same way as maternal transplant rejection.

Drugs in pregnancy

Main article: Drugs in pregnancy

Drugs used during pregnancy can have temporary or permanent effects on the fetus. Therefore many physicians would prefer not to prescribe for pregnant women, the major concern being over teratogenicity of the drugs. This results in inappropriate treatment of pregnant women. Use of drugs in pregnancy is not always wrong. For example, high fever is harmful for the fetus in the early months. Use of paracetamol is better than no treatment at all. Also, diabetes mellitus during pregnancy may need intensive therapy with insulin. Drugs have been classified into categories A,B,C,D and X based on the Food and Drug Administration (FDA) rating system to provide therapeutic guidance based on potential benefits and fetal risks. Drugs like multivitamins that have demonstrated no fetal risks after controlled studies in humans are classified as Category A. On the other hand drugs like thalidomide with proven fetal risks that outweigh all benefits are classified as Category X.

Exposure to toxins

Various toxins pose a significant hazard to fetuses during development:

Alcohol ingestion during pregnancy may cause fetal alcohol syndrome, a permanent and often devastating birth-defect syndrome. A number of studies have shown that light to moderate drinking during pregnancy might not pose a risk to the fetus, although no amount of alcohol during pregnancy can be guaranteed to be absolutely safe.

Women who have suffered mercury poisoning in pregnancy have sometimes given birth to children with serious birth defects, termed Minamata disease.

Sexual activity during pregnancy

Most pregnant women can enjoy sexual activity during pregnancy throughout gravidity. Most research suggests that, during pregnancy, both sexual desire and frequency of sexual relations decrease.[57][58] In context of this overall decrease in desire, some studies indicate a second-trimester increase, preceding a decrease. However, these decreases are not universal: a significant number of women report greater sexual satisfaction throughout their pregnancies.

Abortion

Main article: Abortion

An abortion is the removal or expulsion of an embryo or fetus from the uterus, resulting in or caused by its death. This can occur spontaneously or accidentally as with a miscarriage, or be artificially induced by medical, surgical or other means