Frequently Asked Questions
The inactivated vaccine during pregnancy is generally considered safe and can be given at any trimester. It is highly recommended to pregnant women who are at high risk of contracting the virus and developing the flu or pneumonia. Passive immunization of the new-born can be a secondary benefit.
A characteristic finding of normal childbirth, which is necessary throughout its duration for its completion, are the “odes”. The term is used to denote the increased contractility of the uterus at relatively regular intervals, which occurs clinically as “contractions”. The contractions are involuntary and occur suddenly. You should go to the maternity hospital if the contractions occur about every 5 minutes for at least an hour (or in a sudden or continuous outflow from the vagina – rupture of the membranes, significant vaginal bleeding or if you notice a significant reduction of fetal movements). When labour begins, labour pains become more regular.
Very low intensity, irregular and painless uterine contractions are generally present during pregnancy. Immediately after the fourth month of pregnancy and as the time of onset of labour approaches, these contractions become slightly more intense and are felt through the abdominal walls. These contractions are referred to as the Braxton-Hicks sign or as preparatory, as they appear before the actual onset of labour. Although Braxton-Hicks contractions are not painful, some women complain that they are annoying. After the 28th week these contractions stabilize and usually stop while walking or exercising. Braxton-Hicks contractions can be mistaken for true childbirth. However, they do not increase in intensity or frequency and do not cause cervical dilation. They are most often noticed during the first pregnancy, about one to two weeks prior to labour.
It takes about 6 weeks for the uterus, cervix, vagina and tissues to return to their normal pre-pregnancy state. Remember that ovulation will occur before you see your first postpartum period and this is why we strongly recommend to talk to a healthcare professional or your doctor about the method of contraception you will use. Breastfeeding provides birth control, but you need to take extra precautions.
Visiting the dentist during pregnancy is completely safe. What is important to avoid is x-rays. If you are asked to do so, contact your gynaecologist and make sure that during the examination all necessary measures will be taken for the safety of you and your baby. If your dentist requests a note from our office, we will be happy to provide it to you.
Although there are many reasons for abdominal pain during pregnancy, the most common cause is pain coming from the round ligaments of the uterus. The round ligament is a remnant of the gubernaculum extending from the uterine horns to the labia majora via the inguinal canal. As pregnancy progresses and the uterus grows, these ligaments enlarge and stretch, causing pain. This sensation is felt on both sides of the lower abdomen and sometimes on the back. The pain is sharp and probably more intense on the right side. Some movements can worsen the pain. This symptom has not been associated with adverse pregnancy outcomes. This is normal and the treatments include resting and applying warm compresses or heating the area where you feel pain. Medications often do not relieve symptoms.
The word sciatica refers to back pain caused by a sciatic nerve injury. This is a large nerve that extends from the lower back to the back of each limb. If for any reason the sciatic nerve is being hurt this causes pain in the lower back that extends to the hip, buttocks, and leg. In pregnancy, sciatica is a very common symptom that usually occurs late in pregnancy and disappears after childbirth. The most common symptom of sciatica is low back pain. Some women experience pain only at night. Usually, they are due to the weight of your abdomen pushing your waist muscles forward. Also, as your body prepares for childbirth, your ligaments soften more than usual. Several mechanical and hormonal changes during pregnancy contribute to this pain. Aggravating factors for feeling pain are a history of back pain, strenuous work and poor physical condition. Do not wear high heels, nor perfectly flat shoes, without proper support. Your posture is really important and can help you. When standing, try to keep your stomach and buttocks tight. Try not to stand for too long. If you have to, put one foot on a stool, with the knee bent, to avoid lower back pain. When standing on a hard floor, place a small non-slip mat under your feet to reduce pressure. Posture is important when you are sitting, but also when you are lying down. When sitting, try not to sink and use a pillow to support your waist. Learn to sit properly because the seat burdens your spine more than any other activity. Do not lift weights abruptly. Learn to relax. Many waist problems are aggravated by stress and it is advisable to try some relaxation exercises when the pain occurs. At night, lie down with a pillow between your knees to maintain proper posture. Also, use your hands to lift and support your abdomen or place a pillow under it as you sleep on your side. This will relieve your back and help avoid pain. Alternatively use a cold pad for 15 ‘and then a hot water bottle for another 15’ or take a warm (but not too hot) bath. Medicines should only be used in emergencies.
Many women have cramps during the onset of pregnancy. However, if you have persistent cramps and especially if they are accompanied by bleeding or bloodstains, it is important to see your doctor immediately. Magnesium helps prevent cramps in the legs often.
If you have had a miscarriage, the risk of a recurrent miscarriage is 20% to 25% after one miscarriage, 25% after two miscarriages, and 30% after three miscarriages. The problem needs to be investigated. In addition to the necessary haematological and hormonal testing, vaginal ultrasound, screening for antiphospholipid syndrome and thrombophilia, karyotypic screening for both parents and possibly hysteroscopy or laparoscopy are required.
A trip during pregnancy can be a very enjoyable and fun experience. Traveling during the first two trimesters is completely safe, provided that you do not suffer from any complication and you have consulted your doctor. You are not prohibited from traveling by plane, as long as you have not completed the 34th week of pregnancy.
The Apgar score is a test given to new-borns soon after birth. This test checks a baby’s heart rate, muscle tone, and other signs to see if extra medical care or emergency care is needed. The test is usually given twice: once at 1 minute after birth, and again at 5 minutes after birth. Sometimes, if there are concerns about the baby’s condition, the test may be given again. It is based on five points: pulse, respiratory rate, muscle tone, reflex irritability and the colour of the new-born described as pale, cyanotic or rosy. Assessments are made in the 1st and 5th minute after birth. Scores from 0 to 3 indicate severe difficulty, scores from 4 to 6 indicate moderate difficulty and scores from 7 to 10 indicate that the new-born is not having difficulty adjusting to extrauterine life and everything is normal. It is no longer so valuable in use as a diagnostic tool to initiate resuscitation and is not a prognosis for future neurological diseases of the infant.
There are other signs and symptoms of pregnancy. The ones you mentioned are the two most common and most obvious ones. Amenorrhea (when the period stops) is a reliable symptom in women of reproductive age. Nausea and vomiting occur during pregnancy reported in 70% of all pregnant women. These discomforts are very common in early pregnancy and usually last until the 12th week and probably a little longer. The name “morning sickness” is used because women report nausea that occurs only in the morning. However, this percentage is very small. Nausea and vomiting may persist throughout the day and may be exacerbated by emotional stress. Other signs or symptoms include frequent urination (usually up to the beginning of the second trimester), changes in the breast (such as increased tendency and deeper colour around the nipple area), swollen feet or hands, change in appetite and aversion to certain foods, constipation, fatigue and bloating in the abdomen (which are perceived from the 16th -18th week of pregnancy). Under the influence of progesterone there is also an increase in basal body temperature and due to melanin deposition is you are more likely to notice chloasma on the cheeks, forehead or nose and hyperpigmentation of the midline (these spots are the “maternal chloasma”). On the other hand, you should not forget that every pregnancy is unique and so it is different from one woman to another and from one pregnancy to the next. If you experience these symptoms but the pregnancy test is negative, come directly with our office.
Normally, it is not possible to continue to have a period while you are pregnant. It is possible, however, to be confused by the symptoms of implantation, that is, when the egg is fertilized and implanted in the lining wall of the uterus to begin the development of the fetus. These symptoms appear about 6 to 12 days after conception, so it is easy to think of it as an “early period”. This period lasts much less than the normal period of your menstrual cycle and you will notice a much smaller amount of blood. They may be just small spots of blood or more brown than “classic” bright red blood. Some women experience cramps during and a few days after implantation, which may look like menstrual cramps. If you feel unsure, take a pregnancy test or call the doctor to schedule an appointment.
Women who do not show clinical manifestations and have a negative culture can safely give birth vaginally. Mothers diagnosed with herpes infection should have a caesarean section before the follicle ruptures (“water break”) to prevent the infected fetus from passing through the infected genital tract. In an active genital herpes infection, if vaginal delivery is not avoided or a caesarean section is delayed for more than 4 hours after the rupture of the membranes, precautionary measures should be taken for the new-born.
There are several types of anaesthesia that can be used during childbirth. It is important to be informed of the options available to you in advance. After birth or the caesarean section, if you need an analgesic medicine, just ask it from the nursing staff.