Pregnant Lifestyle
No 1 look after each other! share load, quarantine time each day for each other. fix a date night/activity. platonic and otherwise
old school but may still apply variably: one may be worried about nesting, the other financing the nesting, both focused on same thing just from different perspectives.
Preconception:
Immunisations
Folic acid 0.5mg daily for 3month prior to 3months gestation (bread also fortified)
(higher dose if FHx of NTD or mum has epilepsy)
?Dental check > fix prior to getting pregnant
Hx
PMHx
Make a family history tree (?genetic counselling )
Obstetric history
Check current medications are safe in pregnancy
No alcohol
No cigarettes
No drugs
No aspirin
Avoid lubricants, daily sexual activity more likely to conceive than second daily
Avoid environmental chemicals (cytotoxics/photography/paints/...)
Budget for the expense, inc life insurance, income protection, maternity/paternity leave
Will
Reduce stressors, and meditate to help cope with those that are not changable
Usually ovulate in middle of cycle ie D14 of 28, but as cycles range 23-37 not always predicatable
Basal Body Temp is temp first thing in the morning prior to sitting up. increases 1C in days post ovulation (helps predict future timing)
Cervix is low hard and closed early, rises, softens and opens slightly at ovulation
Mittelschmertz: lower abdomen pain on ovulation (can localise to side of pain) (v dysmenorrhea ie period pain which occurs with period)
Ovulation sticks measure LH (peaks just prior to ovulation)
Chloride ion surge measuring watch (surge before oestrogen ie ovulation ?4 days later)
Spit oestrogen increased making a fern pattern
(Rhythm method of contraception uses same tools to avoid conception)
Average is 6 months to conceive
Post conception:
No air travel after 28 weeks
No standing in trains
Folate as above
Iron
Immunise anticipated contacts
Avoid crash dieting, over exertion (overheating)
Avoid xrays
No
B6 10mg daily for morning sickness
Zinc 15mg daily for fertility
B12 for vegetarians/vegans
May feel flat, nauseous
Screening
Hb for anaemia
Gr and Rh antibodies (if mum neg, test dad if he is neg no need for anti D
thalassemia if medit or SEAsian
sickle if
CF if caucasian
Tay sachs if jewish
Genetic councellor if known inherited disease in family, >1 miscarriage, 1 stillbirth, 1 birth defect, consanguineous
Rubella (if non immune vaccinate and wait 1 month), varicella, HBV (sAg, cAb, sAb), Hep C, HIV
Syphilis, gonorrhoea, HSV, chlamydia, HPV (PAP)
CMV: if new wait 6m to conceive
toxoplasmosis titre if outdoor cat, eat raw meat, garden without gloves
Mantoux if high risk
TFTs
BP, urine protein (PIH), urine glucose (GDM)
Twins
Size, lie, HR
Depression symptoms
BSL (GDM)
Morphology at 18-20 weeks
HSV
GBS
Whooping cough vaccine at ?
Influenza at
For relatives/anticipated close contacts
Doctor:
1) as soon as pregnant
2) 4-6 weeks til 28/40
3) 2w 28-36
4) weekly until delivery
Classes
Post-natal
old school but may still apply variably: one may be worried about nesting, the other financing the nesting, both focused on same thing just from different perspectives.
Preconception:
Immunisations
Folic acid 0.5mg daily for 3month prior to 3months gestation (bread also fortified)
(higher dose if FHx of NTD or mum has epilepsy)
?Dental check > fix prior to getting pregnant
Hx
PMHx
Make a family history tree (?genetic counselling )
Obstetric history
Check current medications are safe in pregnancy
No alcohol
No cigarettes
No drugs
No aspirin
Avoid lubricants, daily sexual activity more likely to conceive than second daily
Avoid environmental chemicals (cytotoxics/photography/paints/...)
Budget for the expense, inc life insurance, income protection, maternity/paternity leave
Will
Reduce stressors, and meditate to help cope with those that are not changable
Usually ovulate in middle of cycle ie D14 of 28, but as cycles range 23-37 not always predicatable
Basal Body Temp is temp first thing in the morning prior to sitting up. increases 1C in days post ovulation (helps predict future timing)
Cervix is low hard and closed early, rises, softens and opens slightly at ovulation
Mittelschmertz: lower abdomen pain on ovulation (can localise to side of pain) (v dysmenorrhea ie period pain which occurs with period)
Ovulation sticks measure LH (peaks just prior to ovulation)
Chloride ion surge measuring watch (surge before oestrogen ie ovulation ?4 days later)
Spit oestrogen increased making a fern pattern
(Rhythm method of contraception uses same tools to avoid conception)
Average is 6 months to conceive
Post conception:
No air travel after 28 weeks
No standing in trains
Folate as above
Iron
Immunise anticipated contacts
Avoid crash dieting, over exertion (overheating)
Avoid xrays
No
- undercooked meat (toxoplasma, Listeria)
- cat litter/sand pits (toxoplasma)
- soft or unpasteurised cheeses: feta, brie, cam, blue (Listeria)
- assume <3yo have CMV in saliva and urine and wash hands after diaper (nappy) changes and handling anything that has touched their mouth or nose (including toys), or perineum (inc nappies, clothes, baths), and dont touch your mouth on any of these (ie kiss/share utensils/towel/beds)
- 2L water / day
- 4 serves of fruit and veg
- 4-6 serves of cereal/bread
- 3 cups of milk or Ca equivalent
- 1-2 serves of meat or protein alternative
- minimal sugar/fat
- limit caffeine to 2 cups / day
B6 10mg daily for morning sickness
Zinc 15mg daily for fertility
B12 for vegetarians/vegans
May feel flat, nauseous
Screening
Hb for anaemia
Gr and Rh antibodies (if mum neg, test dad if he is neg no need for anti D
thalassemia if medit or SEAsian
sickle if
CF if caucasian
Tay sachs if jewish
Genetic councellor if known inherited disease in family, >1 miscarriage, 1 stillbirth, 1 birth defect, consanguineous
Rubella (if non immune vaccinate and wait 1 month), varicella, HBV (sAg, cAb, sAb), Hep C, HIV
Syphilis, gonorrhoea, HSV, chlamydia, HPV (PAP)
CMV: if new wait 6m to conceive
toxoplasmosis titre if outdoor cat, eat raw meat, garden without gloves
Mantoux if high risk
TFTs
BP, urine protein (PIH), urine glucose (GDM)
Twins
Size, lie, HR
Depression symptoms
BSL (GDM)
Morphology at 18-20 weeks
HSV
GBS
Whooping cough vaccine at ?
Influenza at
For relatives/anticipated close contacts
Doctor:
1) as soon as pregnant
2) 4-6 weeks til 28/40
3) 2w 28-36
4) weekly until delivery
Classes
- antenatal exercises
- back care / posture
- relaxation
- analgesia ante/perinatal
- exercise (swimming)
- Cramps
- pain
- PV bleeding / fluid loss
- baby less active
- when contractions 5-10 mins apart
Post-natal
- no honey until >12mo (Botulism)
- Breast is best but not essential