Pregnancy

In the time it takes to count to 10, more than 60 women become pregnant around the world. Pregnancy is normally a 40-week journey, usually measured from the date of a woman's last menstrual period to the birth of her baby. It's a time of rapid development for the soon-to-be-baby, and sometime bewildering changes for the mother.

Pregnancy is divided into three periods, known as trimesters. Each lasts about 13 weeks. The trimesters are roughly equivalent to specific developmental stages.

First trimester: A baby's body and organ systems begin their initial development. This is the period during which most miscarriages and birth defects occur. It is also when women tend to experience morning sickness, fatigue, and other pregnancy-related symptoms. By the end of the first trimester, the average fetus is 3 inches long and weighs about an ounce.

Second trimester: During the second trimester, a baby grows skin and hair, and even develops fingerprints. A heartbeat can be heard with a stethoscope. For moms, morning sickness tends to fade, and sleep improves. But other problems, such as back pain, leg cramps, and heartburn, may appear. The baby's first movements are usually felt during the second trimester. By its end, the average baby is about 14 inches long and weighs more than 2 pounds. Babies delivered at the end of the second trimester may be able to survive with the help of medical technology.

Third trimester: The final stretch for baby and mother. It's a time of rapid growth and maturation for the baby. Toward the end of the third trimester, the baby usually moves into the "head down" position in preparation for birth. At 38 weeks, the baby is considered full term and can make its appearance at any time. Because the baby is getting so big, a mom can experience shortness of breath, hemorrhoids, and trouble sleeping. Toward the end of the third trimester, the average baby is 19 to 21 inches long and weighs between 6 and 10 pounds.

Pregnancy Articles

Chorionic Villus Sampling

Chorionic villi are small structures in the placenta that act like blood vessels. These structures contain cells from the developing fetus. A test that removes a sample of these cells through a needle is called chorionic villus sampling (CVS). CVS answers many of the same questions as amniocentesis about diseases that the baby might have. Diseases that can be diagnosed with CVS include Tay-Sachs, sickle cell anemia, cystic fibrosis, thalassemia, and Down syndrome. (Rh incompatibility and neural tube defects, however, can be diagnosed only through amniocentesis.) CVS can be done earlier in pregnancy than amniocentesis and can be done when there is not enough amniotic fluid to allow amniocentesis. However, it has some extra risks when compared with amniocentesis. (Locked) More »

Fetal Ultrasound

Ultrasound is a painless way to show a fetus in the uterus. The test uses sound waves and a type of sonar detection system to generate a black-and-white moving picture on a TV screen. Fetal ultrasound is useful for determining your pregnancy due date and evaluating the health of the baby and its position. It can show some but not all birth defects (for example, it can show some cases of spina bifida. Although some findings on ultrasound are used in screening tests for Down syndrome, it cannot by itself diagnose Down syndrome). It is also useful for diagnosing twins and can sometimes show the sex of your baby. (Locked) More »

Screening for Birth Defects in Early Pregnancy (Combined Test, Integrated Test, and Quadruple Test)

Blood tests and fetal ultrasound tests for pregnant women check the levels of protein and hormones being produced by the fetus and examine how the fetus is forming. The levels of four different substances as well as early findings on ultrasound can enable doctors to identify pregnancies that are at a higher risk for birth defects such as Down syndrome or neural tube defects (brain and spinal cord problems). If the screening tests suggest problems, your doctor might recommend additional tests, such as amniocentesis or chorionic villus sampling, to confirm the findings. (Locked) More »

Amniocentesis

Amniocentesis involves using a needle to take a sample of amniotic fluid, the fluid that surrounds a developing fetus during pregnancy. Tests of fetal cells found in this fluid can reveal the presence of Down syndrome or other chromosome problems in the baby. Amniocentesis can also show whether the lungs of the baby are mature enough to allow it to survive if it were delivered right away. Amniocentesis is often recommended for pregnant women over age 35, women who have an abnormal "triple screen" blood test during pregnancy, or women who have (or whose husbands have) a family history of certain diseases or birth defects. (Locked) More »

Making fertility-friendly lifestyle choices

If you are thinking about getting pregnant, you can do many simple, effective things right now to improve your chances of conception, because lifestyle can have profound effects on the reproductive functions of women and men. This means that increasing your fertility potential is something that you both can do without outside help. In addition to adopting a fertility-boosting diet and getting into the fertility zones for weight and exercise, there are a number of lifestyle choices you can make for improving fertility naturally. Tobacco smoking has been linked to reduced fertility in both women and men. In addition, a recent British study has found an association between smoking and stillbirths, low birthweight babies, and sudden infant death syndrome (SIDS). A woman who smokes is likely to have less chance of becoming pregnant and giving birth when treated with in vitro fertilization (IVF) than a woman who doesn't smoke. This is especially true if she smokes twenty or more cigarettes a day. A mechanism that may link cigarette smoking and reduced pregnancy rates following IVF is the observation that smoking appears to accelerate the rate of egg loss. Women who smoke have the elevated hormone levels that indicate a depleted supply of eggs and prematurely aged follicles. For men, anything that may lead to atherosclerosis, such as untreated diabetes or hypertension or even health habits such as smoking and a high-fat diet, may damage blood vessels and impair blood flow, leading to impotence. A good blood supply to the penis is necessary to achieve an erection. More »

Emergencies and First Aid - Birth of the Placenta

The placenta, which has provided the fetus with nourishment, is attached to the umbilical cord and is delivered about 20 minutes after the baby. Do not pull on the cord; delivery of the placenta occurs on its own. You can help by gently massaging the woman’s lower abdomen. The uterus will feel like a hard round mass. Massaging the abdomen helps the uterus contract, which also helps stop bleeding. After the placenta is delivered, place it in a plastic bag to take with the woman and baby to the hospital. It is normal for more bleeding to occur after delivery of the placenta. Continue gently massaging the woman’s lower abdomen. More »

When You Visit Your Doctor - Pregnancy: 1st Trimester

Your age and how it will affect your pregnancy. Have you been pregnant before? If so, what was the outcome of each pregnancy. Did you have a full-term pregnancy (your baby was born close to your due date)? Did you give birth via a vaginal delivery or a cesarean section ("C-section") surgery? If you had a C-section, what type of C-section was it? Did any of your pregnancies end in miscarriage, voluntary abortion, or an ectopic (tubal) pregnancy? Does this pregnancy come at a good time for you? When was the first day of your last menstrual period? What is the usual length of your menstrual cycle? Do you have any medical problems such as diabetes, high blood pressure, thyroid problems, asthma, tuberculosis, epilepsy, or heart disease? Have you ever had any sexually transmitted infections such as gonorrhea, herpes, syphilis, or human papilloma virus (HPV)? Do any medical problems tend to run in your family such as sickle cell anemia, cystic fibrosis, Down syndrome, or hemophilia? Are you taking any medications (including over-the-counter medications)? If so, what are they? Do you smoke? If so, how many packs per day? In an average week, how many alcoholic beverages do you consume? Do you use any recreational drugs? Did you have any problems getting pregnant? Do you eat a well-balanced diet? Are you taking any vitamins, including folic acid (folate)? Do you exercise regularly? What is your home situation like? Who do you live with? Is your partner supportive of this pregnancy? If not, has your partner hit or threatened you? Are you having any problems with morning sickness (that is, nausea and vomiting)? Are you having any bleeding from your vagina? Temperature, blood pressure, pulse, weight Chest exam Heart exam Abdominal exam Pelvic exam with Pap smear and cervical cultures Leg exam Confirm pregnancy with blood or urine test Complete blood count and blood type Blood tests for syphilis, rubella antibodies, hepatitis B, HIV Urinalysis Portable Doppler instrument or stethoscope to measure fetal heart sounds Urine culture "Triple screen" (also known as "AFP-3" or "Enhanced AFP" Genetic testing   More »

When You Visit Your Doctor - Pregnancy: 2nd Trimester

How do you feel? Have you had any problems since your last visit? Have you had any vaginal bleeding or spotting? Have you had persistent vomiting? Have you had any pain or uterine cramping? Have you noticed swelling of your face or fingers? Have you had any problems with your vision? Are you getting frequent headaches? Have you had any vaginal discharge? Have you noticed fetal movement? Are you planning to breast-feed or bottle-feed? Blood pressure, weight Abdominal exam including measurement of the height of your fundus (top of the uterus) and using a portable Doppler instrument or stethoscope to measure fetal heart sounds Consider repeat complete blood count Fetal ultrasound Glucose tolerance test Rhogam (Rh-Immunoglobulin), if your blood type is Rh negative (see p. 920)   More »

When You Visit Your Doctor - Pregnancy: 3rd Trimester

Do you have adequate support at home from family or friends? How do you feel? Have you had any problems since your last visit? Have you had any vaginal bleeding or spotting? Have you had any pain or uterine cramping? Have you had any discharge or leakage of fluid from your vagina? Have you noticed swelling of your face or ankles? Have you had any problems with your vision? Are you getting frequent headaches? Have you noticed a change in the frequency or intensity of fetal movement? Are you planning to breast-feed or bottle-feed? Have you selected a pediatrician for your baby? Are you taking classes on labor and delivery? Have you added health insurance coverage for your new baby? Have you purchased a special car seat to hold your baby when riding in your car? Have you decided on whether the baby will have a circumcision, if a boy? Have you talked with your doctor about the length of your stay in the hospital? Do you know the signs of going into labor so that you can call your doctor when labor begins? (These include uterine contractions and rupture of the membranes). Breasts (to see if your nipples are inverted) Abdominal exam, including measurement of the height of your fundus (top of the uterus) Culture of the vagina and rectum for Group B streptococcus bacteria Fetal ultrasound   More »