Redefine Meaning of "Term Pregnancy" ✿

"The nation’s ob-gyns have redefined ‘term pregnancy’ to improve newborn outcomes and expand efforts to prevent nonmedically indicated deliveries before 39 weeks of gestation. In a joint Committee Opinion, The American College of Obstetricians and Gynecologists (The College) and the Society for Maternal-Fetal Medicine (SMFM) are discouraging use of the general label ‘term pregnancy’ and replacing it with a series of more specific labels: ‘early term,’ ‘full term,’ ‘late term,’ and ‘postterm.’  

 

The following represent the four new definitions of ‘term’ deliveries:

• Early Term: Between 37 weeks 0 days and 38 weeks 6 days
• Full Term: Between 39 weeks 0 days and 40 weeks 6 days
• Late Term: Between 41 weeks 0 days and 41 weeks 6 days
• Postterm: Between 42 weeks 0 days and beyond

“This terminology change makes it clear to both patients and doctors that newborn outcomes are not uniform even after 37 weeks,” said Jeffrey L. Ecker, MD, chair of The College’s Committee on Obstetric Practice. “Each week of gestation up to 39 weeks is important for a fetus to fully develop before delivery and have a healthy start.”

On average, a pregnancy with a single fetus lasts 40 weeks from the first day of the last menstrual period. This calculation determines a pregnant woman’s estimated date of delivery (EDD). Previously, babies were considered ‘term’ if they were born anytime between three weeks before and two weeks after the EDD (37–42 weeks of gestation). “Until recently, doctors believed that babies delivered in this five-week window had essentially the same good health outcomes,” said Dr. Ecker.

Research over the past several years, however, shows that every week of gestation matters for the health of newborns. The last few weeks of pregnancy within these 40 weeks allow a baby’s brain and lungs to fully mature. Babies born between 39 weeks 0 days and 40 weeks 6 days gestation have the best health outcomes, compared with babies born before or after this period. This distinct time period is now referred to as “Full Term.”

Planned deliveries before 39 weeks 0 days should occur only when there are significant health risks to a woman and/or the fetus in continuing the pregnancy, according to Dr. Ecker. Sometimes delivery before 39 weeks 0 days is unavoidable, such as when a woman’s water breaks or contractions come early. 

The College and SMFM encourage physicians, researchers, and public health officials to adopt these new precisely-defined terms in order to improve data collection and reporting, clinical research, and provide the highest quality pregnancy care." 

http://www.acog.org/About_ACOG/ACOG_Departments/~/media/Committee%20Opinions/Committee%20on%20Obstetric%20Practice/co579.pdf

http://www.acog.org/Resources_And_Publications/Committee_Opinions/Committee_on_Obstetric_Practice/Nonmedically_Indicated_Early-Term_Deliveries

Group B streptococcus ✿

Group B streptococcus (Group B strep or GBS): 

"Is a common type of bacteria (tiny organisms that live in and around your body) that can cause infection. Usually GBS is not serious for adults, but it can hurt newborns. 

Many people carry Group B strep bacteria and don’t know it. It may never make you sick. GBS in adults usually doesn’t have any symptoms, but it can cause some minor infections, like a bladder or urinary tract infection (UTI). While GBS may not be harmful to you, it can be very harmful to your baby. If you’re pregnant, you can pass it to your baby during labor and childbirth. About 1 out of 4 pregnant women (25 percent) carry GBS bacteria. The best way to know if you have GBS is to get tested. If you do have GBS, though, there’s good news: your health care provider can give you treatment during labor and birth that protects your baby from GBS
.

How do you know if you have GBS?

Your provider tests you for GBS at 35 to 37 weeks of pregnancy. Testing for GBS is simple and painless. Your provider takes a swab of your vagina and rectum and sends the sample to a laboratory. Your test results are usually available in 1 to 2 days.

Your provider also can use some quick screening tests during labor to test you for GBS. But these should not replace the regular GBS test that you get at 35 to 37 weeks of pregnancy.

How can you protect your baby from GBS?

If your GBS test at 35 to 37 weeks shows you have the infection, your provider gives you medicine called an antibiotic during labor and birth through an IV (through a needle into a vein). You also may be treated if you have any risk factors for GBS and you don’t know your GBS test results or you haven’t been tested yet. Treatment with antibiotics helps prevent your baby from getting the infection.

Penicillin is the best antibiotic for most women. Another antibiotic called ampicillin also can be used. These medicines usually are safe for you and your baby. But some women (up to 1 in 25 women, or 4 percent) treated with penicillin have a mild allergic reaction, like a rash. About 1 in 10,000 women have a serious allergic reaction that needs to be treated right away. If you’re allergic to penicillin, your provider can treat you with a different medicine. If your test shows you have GBS, remind your health care providers at the hospital when you go to have your baby. This way, you can be treated quickly. Treatment works best when it begins at least 4 hours before childbirth. If you have GBS and you’re having a scheduled cesarean birth (c-section) before labor starts and before your water breaks, you probably don’t need antibiotics. It’s not helpful to take oral antibiotics before labor to treat GBS. The bacteria can return quickly, so you could have it again by the time you have your baby. 

If you have GBS, what are the chances that you can pass it to your baby?

If you have GBS during childbirth and it’s not treated, there is a 1 to 2 in 100 chance (1 to 2 percent) that your baby will get the infection. The chances are higher if you have any of these risk factors:

• Your baby is premature. This means your baby is born before 37 weeks of pregnancy.
• Your water breaks (also called ruptured membranes) 18 hours or more before you have your baby.
• You have a fever (100.4 F or higher) during labor.
• You’ve already had a baby with a GBS infection.
• You had a UTI during your pregnancy that was caused by GBS.

If you have GBS and you’re treated during labor and birth, your treatment helps protect your baby from the infection. 

What problems can GBS cause in newborns?

Babies with a GBS infection can have one or more of these illnesses:

• Meningitis, an infection of the fluid and lining around the brain
• Pneumonia, a lung infection
• Sepsis, a blood infection

Pneumonia and sepsis in newborns can be life-threatening. 

Most babies who are treated for GBS do fine. But even with treatment, about 1 in 20 babies (5 percent) who have GBS die. Premature babies are more likely to die from GBS than full-term babies (born at 39 to 41 weeks of pregnancy). 

GBS infection may lead to health problems later in life. For example, about 1 in 4 babies (25 percent) who have meningitis caused by GBS develop:

• Cerebral palsy
• Hearing problems
• Seizures
• Learning problems

If your baby has GBS infection, how is he treated?

It’s important to try and prevent a newborn from getting GBS. But if a baby does get infected with early-onset GBS or late-onset GBS, he is treated with antibiotics through an IV. 

If you’re treated for GBS during labor, does your baby need special treatment? 

Probably not. But if you have a uterine infection (an infection in your uterus) during labor and birth, your baby should be tested for GBS. Your baby’s provider can treat your baby with antibiotics while you wait for the test results. "

Pregnancy and Sleep ✿

Pregnancy and Sleep:

"Several sleep disorders can be caused or made worse by pregnancy. In a study of over 600 pregnant women, 26% reported symptoms of restless legs syndrome (RLS), a condition characterized by unpleasant feelings in the legs that worsen at night and that are relieved by movement. Another common problem during pregnancy is heartburn, also known as gastroesophageal reflux disease (GERD). One recent study found that 30-50% of pregnant women experience GERD almost constantly during pregnancy. Pregnant women are also at risk for developing sleep apnea, a disorder in which breathing is repeatedly interrupted during sleep. This is particularly true of women who are overweight when they become pregnant. Sleep apnea may also be associated with complications during pregnancy such as gestational hypertension, preeclampsia, or low birth weight. It is also associated with more daytime sleepiness compared to women who do not have sleep apnea during pregnancy. If you are pregnant and feel you may suffer from sleep apnea, it is very important that you talk to your doctor. Poor sleep can also have an effect on labor and delivery. Researchers from the University of California at San Francisco recently found that women who slept fewer than 6 hours per night had longer labors and were 4.5 times more likely to have cesarean deliveries. Based on these findings, the researchers recommend that doctors discuss both sleep quantity and sleep quality with their pregnant patients as part of basic prenatal care and stress the importance of "sleeping for 2".

Here are the common sleep problems and their symptoms that may occur during pregnancy:

• Insomnia – symptoms of insomnia include difficulty falling asleep, staying asleep, or waking up too early or feeling unrefreshed. Insomnia related to stress or anxiety about labor, delivery and/or balancing work and motherhood may result in significant sleep loss. The discomforts of pregnancy such as nausea, back pain and fetal movements may also disturb sleep.
• Restless legs syndrome (RLS) - symptoms of RLS include unpleasant feelings in the legs, sometimes described as creepy, tingly or achy. These feelings are worse at night or in the hours before bed and they are temporarily relieved by movement or stretching.
• Sleep apnea – sleep apnea is a sleep disorder in which breathing is repeatedly interrupted during sleep. A noticeable feature of sleep apnea is heavy snoring accompanied by long pauses, and then gasping or choking during sleep.
• Nocturnal gastroesophageal reflux (nighttime GERD) – GERD, also known as heartburn, is considered a normal part of pregnancy. However, nighttime symptoms of GERD can damage the esophagus and disrupt sleep during pregnancy.
• Frequent nighttime urination – the frequent need to urinate at night is a common feature of pregnancy and can result in loss of sleep." sleepfoundation.org

Vaginal Birth and Water Birth ✿

Vaginal birth:

• Most babies are born through vaginal birth.
• Labor feels different for every woman.
• You may decide to have medicine to help with labor pain.

Most women have their baby through vaginal birth. Vaginal birth means your uterus contracts (tightens up and then relaxes) to help push your baby out through the vagina. 

In this topic, find out about labor and childbirth. You may feel excited about having your baby but nervous about labor. Labor feels different for every woman. Learn about ways to cope with labor pain, including medicines and other methods, like breathing and relaxation. 

If your pregnancy is healthy, wait for labor to begin on its own. For some women, labor is slow to begin. Your provider may give you medicine to help induce (start) labor. If you’re thinking about inducing labor, find out why waiting until at least 39 weeks is so important for your baby. 

If you had a cesarean birth in a previous pregnancy, you may be able to have a vaginal birth in your next pregnancy. This is called vaginal birth after cesarean (also called VBAC). Find out more about VBAC to see if it’s an option for you.

Water Birth:

Water birth is when a woman gives birth in water. While water birth is gaining popularity with some women, there isn't enough research to know if it's safe. In fact, it may be harmful to some women and their babies. The trouble is that, like home birth, you don't know that water birth is safe for you and baby until after the baby is born and there have been no complications. Some women use warm water to help them deal with labor pain, but then come out of the birthing tub for a more traditional bed delivery. Others choose to experience all three stages of labor in water.  Whatever you decide, it's important you are cared for by someone who is medically trained in pregnancy and childbirth. This professional can be an obstetrician/gynecologist (OB/GYN), a family physician or a certified nurse-midwife. Not all health providers will perform a water birth. If you're considering a water birth, it's important to talk with your health provider. 

Water birth pros:

• Some women find a water birth to be soothing and relaxing.
• Floating in water may help a woman feel lighter and lessen body weight.
• Warm water may help relax the perineum (area between the vagina and the rectum) and make the delivery easier.

Water birth cons:

• Research is limited. We don't know if water births are safe for mom and baby.
• If the tub is not properly cleaned, it can lead to infection.
• The baby may gasp for his first breath while still underwater, causing him to inhale water.
• The umbilical cord may snap during water birth. This could lead to serious blood loss for the baby.

Swollen ankles, feet and hands ✿

Os Edemas são muito comuns durante a gravidez visto que existe um aumento do fluxo sanguineo, e as Mulheres com retenção de liquidos têm ainda mais tendência para os inchaços. Quando os inchaços aparecem repentinamente (mãos;pés;cara) juntamente com outros sintomas nomeadamente Tensões Altas;Dor de cabeça;proteínas na urina (entre outros) pode ser um sinal de Pré-eclâmpsia nesses casos uma visita ao Obstetra é aconselhada. Os inchaços já apareceram por aqui a algum tempo, quando olho para os meus pés penso logo 'Parecem mesmo batatas'. Mesmo quando estou parada acabam por inchar, mas se andar/estiver de pés começam a inchar ainda mais. As mãos o que me incomoda para além de andarem inchadas é o facto de as sentir várias vezes 'dormentes'. 
Aqui em baixo vou deixar algumas informações sobre pré-eclâmpsia.

About pre-eclampsia:

• "Preeclampsia is a condition that occurs only during pregnancy. Diagnoses is made by the combination of high blood pressure and protein in the urine, occurring after week 20 of pregnancy. Preeclampsia may also be called toxemia and is often precluded by gestational hypertension. Preeclampsia affects about 2-6% of healthy, first time moms." americanpregnancy.org

• "What is pre-eclampsia?

Pre-eclampsia is a condition that typically occurs after 20 weeks of pregnancy. It is a 

combination of:

• raised blood pressure (hypertension)

• protein in your urine (proteinuria).

The exact cause of pre-eclampsia is not understood.

Often there are no symptoms and it may be picked up at your routine antenatal 

appointments when you have your blood pressure checked and urine tested. This is why 

you are asked to bring a urine sample to your appointments.

• Why do I need to know if I have pre-eclampsia?

Pre-eclampsia is common, affecting between two and eight in 100 women during 

pregnancy. It is usually mild and normally has very little effect on pregnancy. However, it 

is important to know if you have the condition because, in a small number of cases, it can 

develop into a more serious illness. Severe pre-eclampsia can be life-threatening for both 

mother and baby.

Around one in 200 women (0.5%) develop severe pre-eclampsia during pregnancy. The 

symptoms tend to occur later on in pregnancy but can also occur for the first time only 

after birth.

The symptoms of severe pre-eclampsia include:

• severe headache that doesn’t go away with simple painkillers

• problems with vision, such as blurring or flashing before the eyes

• severe pain just below the ribs

• heartburn that doesn’t go away with antacids

• rapidly increasing swelling of the face, hands or feet

• feeling very unwell.

These symptoms are serious and you should seek medical help immediately. If in doubt, 

contact the maternity unit at your local hospital.

In severe pre-eclampsia, other organs, such as the liver or kidneys, can sometimes become 

affected and there can be problems with blood clotting.

• How may pre-eclampsia affect my baby?

Pre-eclampsia affects the development of the placenta (afterbirth), which may prevent your 

baby growing as it should. There may also be less fluid around your baby in the womb.

If the placenta is severely affected, your baby may become very unwell. In some cases, the 

baby may even die in the womb. Monitoring aims to pick up those babies who 

are most at risk." http://www.rcog.org.uk/files/rcog-corp/Pre-eclampsia.pdf

I know what you mean ✿

"Feeling like a turtle stuck on its back every time you try to sit up"

37 Days Remaining, 87% ❤

Bem, só faltam 5 semanas e 2 dias (37 dias) para conhecermos a nossa Princesinha mais linda, que ansiedade, falta tão pouquinho     

Maternity Shoot - 32 Weeks 5 Days (22/12/13) ❤

Ainda não tinha publicado aqui algumas fotos que tiramos com 32 semaninhas e 5 dias, vou deixar aqui algumas: