Please refer to your handbook that was given to you at your new ob interview. This advice is not a substitute for any instructions your doctor has previously given you in the office. This is routine pregnancy advice, in normal low risk pregnancies. MEDICATIONS
Abstinence from all medications is preferred during pregnancy, except prenatal vitamins. However, the following medications may be taken:
1. Headache- Tylenol (regular or extra-strength) 2. Colds- Sudafed, Tylenol Cold 3. Cough- Robitussin DM 4. Diarrhea- Imodium 5. Constipation- Citrucel, Senokot, Metamucil, Colace, Milk of Magnesia 6. Indigestion- Antacids, such as Mylanta, Gaviscon, Tums, or Maalox; after
the first trimester- Zantac or Pepcid over the counter.
7. Nausea- Vitamin B6- 100mg twice daily, Seabands, or candied ginger 8. Sleep- Benadryl 25mg at bedtime NUTRITION AND PREGNANCY
It is recommended that during pregnancy, each woman should intake a well-balanced healthful diet.
1. Eat at least 3 servings of fruits and 4 servings vegetables a day. Which
includes all dark green, orange, and yellow leafy vegetables and all fruits. Kool-aid or fruit drinks do not count as your daily fruit and vegetable intake. An 8oz. glass of 100% fruit juice without corn syrup counts.
2. Eat 4 servings of whole grains, such as whole wheat, oats, and brown rice.
3. Eat 2 eggs daily. Eggs are rich in omega3 fatty acids, protein, and iron. 4. Eat 4-5 servings of dairy products, such as milk, cheese, or yogurt. 5. Eat 3-4 lean meats such as chicken, beef, or pork. Or meat substitutes, such as 6. Drink at least 8-10 glasses of water daily. Avoid excess salt, sugar, and caffeine. IMPORTANT FOOD SOURCES Beef, Pork, Veal, Chicken, Fish, Shellfish, Grains, Cereals, Fruits, Beans,
Legumes, Dairy Products, Carrots, Corn, Lettuce, Molasses, Tofu, Peanut Butter POTASSIUM Bananas, Tomatoes, Potatoes, Oranges, Cantaloupe, Melons, Peaches, Prunes,
Apricots, Raisins, Watermelon, Beets, Green Vegetables, Soybeans, Squash, Mushrooms, Nuts, Salt Substitute, Buttermilk or Low fat Milk, Citrus/Prune/or Tomato Juice
MAGNESIUM
Enriched grains, such as cereal, bread, rice and pasta. Orange juice, green leafy vegetables, broccoli, asparagus, peas, lentils, beans and peanuts. FLUIDS
Water, Milk, Juice, Sports Drinks (such as Gatorade, Powerade)
It is very important that you drink at least 8-10 glasses of water daily. Avoid caffeine- caffeine dehydrates you. Do not count sodas, teas, juice, or milk as part of your daily water intake.
FOODS AND CHEMICALS TO AVOID Avoid fish with high levels of mercury, such as shark, tile fish, swordfish, and king mackerel. Albacore tuna is higher in mercury than regular light tuna. Eat albacore tuna only 12 ounces monthly. It is better to eat light tuna packed in spring water 12 ounces weekly. Avoid exposure to toxic chemicals and substances. Take special care with cleaning products and always read the label. Clean in a well ventilated area. Avoid lead based paints, indoor shooting ranges, and using dishes that contain lead. TOXOPLASMOSIS Toxoplasmosis is an infection caused by a parasite that can harm an unborn baby.
1. Avoid handling cat litter, it’s ok to pet your cat and hold him. 2. Wear gloves when gardening. 3. Do not eat undercooked meats.
Lymphocytic choriomeningitis virus is carried by rodents, including pet hamsters and guinea pigs. LCMV can cause abnormalities in pregnancy.
1. Avoid all rodents. 2. Do not handle rodent urine, droppings, or nesting materials. 3. Wash your hands if you must handle rodents, and avoid touching your mouth LISTERIOSIS Listeriosis is an infection caused by bacteria in unpasteurized or undercooked foods. It can be treated with antibiotics, but it is best to prevent the infection first.
1. Cook raw foods thoroughly, such as beef, pork, poultry, and fish. 2. Wash all vegetables/fruits before eating. 3. Avoid unpasteurized milk. 4. Avoid soft cheeses, such as brie, camembert, and blue veined cheeses. 5. Cook hot dogs before eating.
The risk of deli meats being contaminated with listeriosis is extremely low, as long as the deli is clean.
URINARY TRACT INFECTIONS
A Urinary Tract Infection, or UTI is an infection in either the kidneys or the bladder. Symptoms include but are not limited to pain or burning with urination, frequency and urgency, blood in the urine, or foul smelling urine. Pregnant women are more susceptible to urinary tract infections. Fortunately, there are some preventions.
1. Drink plenty of water, at least 8-10 glasses of water daily. Drink cranberry juice, that is 100% juice without added sugar or corn syrup, at least 2-3 glasses daily.
2. Avoid sodas, tea, coffee, and alcohol intake. Bacteria love sugar and caffeine.
3. Urinate immediately after intercourse to flush out any bacteria.
4. Empty your bladder every 4 hours or as needed to prevent bladder distention.
5. Do not take frequent bubble baths. Wipe the perineum from front to back after urinating. Keep the perineal area clean and dry. Wear cotton underwear and no douching. 6. If your doctor has prescribed antibiotics for you, take the complete course even if you are feeling better. All of the medicine should be taken to prevent a recurrent UTI.
EXERCISE
Physical activity during pregnancy can benefit both you and your baby by lessening discomfort and fatigue, making labor easier and increasing the likelihood of early recovery after delivery. Light to moderate exercise strengthens the abdominal and back muscles, which help improve posture and decrease aches and pains. Practicing yoga, Pilates, walking, swimming and cycling on a stationary bike are safe for pregnant women. It is best to exercise at least 30 minutes each day, drink plenty of water when exercising and rest after. PREGNANCY DISCOMFORTS Causes: hormone changes with increased stomach acid in the pregnant woman. Treatments: 1. Avoid empty or overloaded stomach.
2. Eat small, frequent meals. 3. Avoid greasy, fried, rich or spicy foods. 4. Keep crackers, popcorn, or dry cereal at the bedside. Eat something when you first wake, but before you get out of bed. This starts the digestive process that will remove excess stomach acid and relieve nausea. 5. Have your breakfast after the nausea subsides. 6. Get up slowly- sudden movements can aggravate nausea. 7. Eat a high protein snack before bedtime. 8. Limit coffee. Coffee stimulates stomach acid secretion. 9. Stop smoking. Smoking increases the secretion of stomach acids.
Usually 50-75% of pregnant women experience nausea anytime during the day, but usually the symptoms resolve after 12 weeks. HEARTBURN
Causes: increased stomach acid and pressure of the uterus on the stomach. Treatments: 1. Bland diet
CONSTIPATION AND GAS
Causes: pressure from the uterus on the bowel and less room for proper digestion. Treatments: 1. Exercise, such as walking- 30 minutes daily.
2. Increase fiber in the diet, such as fruits, vegetables, and whole grains.
5. Use Citrucel, Senokot, Metamucil, or Colace.
HEMORRHOIDS
Causes: constipation, pressure from uterus, lack of exercise, or familial tendency. Treatments: 1. Avoid constipation or straining. BACKACHE
Causes: poor posture, poor body mechanics, breast enlargement, or strain on
muscles as the uterus enlarged. Treatments: 1. Correct posture. SHORTNESS OF BREATH
Causes: pressure on the diaphragm in the last few months of pregnancy. Treatments: 1. Use complete breath.
FREQUENT URINATION
Causes: pressure of uterus on bladder in the first 3 months and when baby drops. Treatments: 1.Cut down fluid one hour before bedtime.
ROUND LIGAMENT CRAMPS(Felt on either side of the abdomen, where the groin meets the leg. Worse upon getting out of bed or chair and upon walking.)
Causes: increased pressure from growing uterus, pressure on nerves from uterus
or fetal position, or pressure from softening and movement of pelvic bones. Treatments: 1. Exercise regularly.
2. Apply heat to area, but not directly on the abdomen.
5. May soak in bathtub if able to get out on own.
SWOLLEN ANKLES AND LEGS
Causes: increase in blood volume, heat, gravity, pressure on blood vessels and
supply from uterus. Treatments: 1. Elevate feet above heart level frequently.
2. Wear support hose to waist, not thigh high.
3. Lie on left side when resting/sleeping.
4. Soak in the bathtub; water pressure decreases swelling.
This advice is not a substitute for any instructions your doctor has previously given you in the office. This is routine pregnancy advice, in normal low risk pregnancies.
LABOR PRECAUTIONS
If you have bright red vaginal bleeding, that is more than spotting, proceed to
labor and delivery. If you have mild spotting or dark brown old blood, this is not a concern; especially if your cervix has been checked within the past 24 hours, or you have had intercourse within the past 24 hours.
If you are more than 36 weeks gestation and this is your first baby and you are
having contractions lasting 60 seconds each, and they are 3-5 minutes apart for 1-2 hours and painful, proceed to labor and delivery. If this is your second or greater baby, proceed to labor and delivery when your contractions are 5 minutes apart, and strong.
If you are less then 37 weeks gestation, and are having contractions or cramping
that are more than 6 in an hour, drink at least 3-4 large glasses of water and rest on your left side. If the contractions still continue more than 6 in an hour than proceed to labor and delivery.
If you have broken your water or had a large gush of fluid, proceed to labor and
delivery. If you are not sure if your water has broken, apply a sanitary pad to your underwear and walk around for an hour. If the pad is soaked after walking, then proceed to labor and delivery. If not, it is probably cervical mucus which is normal.
If you have decreased fetal movement, drink at least 3-4 large glasses of water
and a large sugary drink, like orange or grape juice. Lay on your left side and rest. If you still have decreased fetal movement after an hour of drinking, proceed to labor and delivery.
If you have any questions please feel free to call the office, during business hours
@ 481-7222. An on-call doctor is available 24 hours/7 days a week for emergency calls. If your question can wait until office hours, please call back. Thank you.
Basic Requirements: Provisions of Section 15010, BASIC MECHANICALREQUIREMENTS are a part of this Section. General: Provide those piping specialties which are required for the pipingsystems specified in other sections of these specifications. Related Sections: Other Sections of Division 15 which relate to therequirements of this Section may include but are not limited to thefollowing:1. 15050, B
Essentials MS can affect your emotions as well as your body. Although this has been recognised since MS was firstdescribed in the 19th century, it is only more recently thatwe have begun to understand more about how MS candepression cause changes in mood and feelings. 1 There are now many treatments available to help manage these often upsettingand difficult aspects of MS. Medication, talk