Pregnancy

Getting pregnant marks the beginning of a remarkable journey. Nurturing a new life inside the body subjects the pregnant mother to various changes, emotionally, mentally and physically. You may want to learn more about healthy pregnancy.

  1. Going through Pregnancy: How am I feeling?
    1. Having the baby growing and living inside the womb is an amazing process. Throughout the journey, mothers endure different changes both physically and emotionally, which make the experience of conceiving child a precious one. To better appreciate this, the duration of a 9-month pregnancy could be simplistically staged into three trimesters, of which each trimester is approximately three months.
  2. First Trimester
    1. The baby is conceived and it’s the beginning of pregnancy. The first 12 weeks of the fetal life shall marks a thousand and one events of utmost importance. During these weeks, cells multiply in a miraculous manner and major organs including the brain, heart, bones and skin are formed. Very soon, by the end of the third week, the fetus heart would have started beating.
    2. Upon pregnancy, the body works more than normal. The metabolic rate increases, the heart rate rises and the rate of breathing become more rapid. Therefore, mother who is newly adapting to these physiological changes usually feels ill and tired. Hormonal changes slowly induce change in physical appearance, they even may make you go off certain foods and crave on some others. Owing to the pregnancy hormones, pregnant mother often feel sick, stomach upset, nauseous, and vomiting often. These symptoms can happen at any time of the day and many find them worst in the mornings. Hence, it’s also known as the morning sickness. Taking high-carbohydrate food like wholemeal bread, potatoes, bananas, and pasta will help to counteract low blood sugar. Keep some dried fruit as snack while traveling out and always keep yourself well hydrated. Nevertheless, should you suffer badly from morning sickness and vomiting very frequently, do consult your physicians for further treatment.
    3. You might notice increase in frequency of urination due to pressure from the enlarging uterus on the urinary bladder. Urinary incontinence may occur especially when sneezing, coughing or laughing. Go urinate often whenever there is an urge of doing so, to minimize risk of urinary tract infection. Emotionally, you may be more volatile. Mood swing may be common as a result from excitement, stress and anxiety of being pregnant. To cope with these, take good care of yourself and always be positive minded. Support and understanding from your loved ones help.
  3. Second Trimester
    1. The baby grows at a greater rate at this stage. As the arms and legs of the fetus are more developed, the baby will begin to make her presence felt by moving in the womb. By then, mother should gain more energy and feeling much better as compared to previous trimester. You will also start noticing apparent weight gain and changes in body shape over the next three months. Skin changes such as dark patches and pigmentations may occur. Protect yourself from excessive sun exposure. Stretch marks may be common along the abdomen, arms, buttocks or thighs. Itchiness may be prominent due to the stretching of skin.
    2. Unfortunately, stretch marks are likely not preventable but may fade off gradually. Good moisturizers or emollients may help to reduce the discomfort. Nose congestion, nosebleeds and gum bleeds may be occurring. Leg cramps are common as pregnancy progresses. To prevent this, stay physically active and well-hydrated. Stretching the calf muscles before going to bed may be helpful too. Increase in vaginal discharge may be normal. However, do contact your health care provider if the discharge appears with unusual colour or foul smell.
    3. Last but not least, don’t forget to visit your antenatal clinic regularly through this trimester for follow up.
  4. Third Trimester
    1. The ultimate trimester of pregnancy would be more challenging physically and mentally. With the baby growing in size, his or her movements will become more noticeable. Fetal movement is an important parameter to the activity of the baby. By the end of pregnancy, weight gain of approximately 11 to 16 kilograms is expected. Backaches are common symptoms; good back support and massage may help to alleviate the discomfort. By now, sometimes even since the second trimester, the uterus might start to experience some small, warm-up contractions (Braxton Hicks contractions) which are weak and transient in nature. Seek for medical attention is these contractions become painful or augmented.
    2. Owing to the expanding of uterus and the pressure exerted onto the diaphragm, shortness of breath may occur especially while lying down. It’s thus useful to practice good body posture to alleviate too much pressure onto the lung. Similarly, the pressure posed by the growing womb onto the veins reduces the circulation of blood from the lower limbs. Fluid retention, swollen feet and ankles, puffy face and eyelids may occur. To reduce swelling, avoid prolonged standing, elevate feet while sleeping.
    3. At third trimester, check up with healthcare provider may be made more frequent. Screening on the gestational diabetes, anemia, high blood pressure, GBS infection may need to be carried out.
  5. Diabetes during pregnancy
    1. Diabetes during pregnancy (also known as gestational diabetes), is a disorder of blood sugar control that develops during pregnancy. Appropriate lifestyle modification and medical treatment are to be instituted promptly as it is important to manage the blood sugar level well to prevent unwanted complications to the pregnancy.
  6. Pregnancy-induced Hypertension
    1. Pregnancy-induced Hypertension or known as Gestational Hypertension can be described as the elevation of blood pressure developed after 20 weeks of pregnancy. Appropriate treatment and monitoring should be warranted to minimized risk of unwanted complications to the delivery process.
  7. Anemia
    1. Anemia is a condition characterized by the presence of an abnormally low level of red blood cells or hemoglobin. Severe anemia may affect the normal growth of fetus and possibly lead to delivery of preterm baby. Check with your doctors to manage the problem.
  8. Group B Streptococcus (GBS)
    1. Group B Streptococcus (GBS) is a kind of bacteria that may reside in the vagina or rectum. Under normal condition, it doesn’t confer sickness to the mother. However, it may impose risk of serious infection to the newborn upon birth. Hence, the healthcare provider would screen for the risk of GBS infection and treat it accordingly.
  9. Nutrition in Pregnancy
    1. Healthy diet during pregnancy is vital for both the mother and unborn baby. The mother’s nutrition would be the only source of all nourishment of which the developing baby needs. Pregnant mother would have an increased energy need. However, eating for two is essentially not eating twice as much. As a rule of thumb, the increment of calorie need during the first trimester (0 to 3 months) is marginal. Subsequently, an additional consumption of 300 calories per day should be accounted to support the growth of fetus. When carrying twins, the calorie need will be much higher. Throughout the different stages, monitor the pregnancy weight gain.
    2. On top of the additional calorie needs, eat a balanced diet to ensure adequate intake of protein, multiple vitamins, folic acid, minerals, fibres and fluid. Taking prenatal vitamin supplements could be a way to meet the recommended daily allowances of the essential nutrients. Recent studies have suggested the intake of Omega-3 during pregnancy has beneficial effects to the visual and cognitive development of the baby. Folic acid is essential to prevent neural tube defects (spinal bifida) in baby, every pregnancy woman need at least 400 mcg of folic acid daily starting from the planning of pregnancy. Good source of folic acid are mainly dark green leafy vegetables, beans or legums. Sufficient intake of calcium is important to meet the need of fetal bone growth. Calcium intake or supplementation of 1300 mg per day is recommended during pregnancy. Take also iron-rich foods (such as spinach, kale, apricots, prunes, raisins, beans, meat, liver etc) per day to combat anemia in pregnancy.
    3. A good dietary planning should provide sufficient calories for appropriate weight gain and avoid health complications (e.g. gestational diabetes, hypertension). In addition, eat only safe food. Select the source of your food prudently. Skip food that may harbor hazardous germs or parasites, such as unpasteurized milk, undercooked meat or eggs and raw seafood. Last but not least, say NO to alcohols and cigarettes. Find out more from your health care providers.
  10. Medication use in Pregnancy
    1. Not all medicines are safe to consume during pregnancy. Therefore, if you are using any medications for any health conditions, discuss with your healthcare provider or drug expert. Based on the availability of safety data, some medications are considered safe during pregnancy. On the other hand, some medications bear potential risks to birth defects.
    2. To name a few, blood pressure pills (such as ACE inhibitors), certain oral anti-diabetics, and cholesterol medications. Some vaccines may be harmful to the unborn child as well.
    3. Similarly, the use of medications sold over-the-counter, herbal or natural remedies during pregnancy may not be taken for granted. The safety data of medication use in pregnancy are used to direct the recommendation of medication therapy.
  11. Pharmaceutical Pregnancy Category
    1. The United States Food and Drug Administration (FDA) has established a classification of fetal risks due to use of medicines. Followings are the definitions for the pregnancy categories.
    2. Category A – Adequate and well-controlled studies have failed to demonstrate risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters)
    3. Category B – Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnancy women.
    4. Category C – Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
    5. Category D – There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
    6. Category X – Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits.
    7. In summary, Category A medicines are shown to be safe for pregnancy use, supported with adequate evidence. Examples of these medicines are folic acid, levothyroxine, pyridoxine. On the other hand, the use of medication from Category X should be avoided in pregnancy, Examples of Category X medications include isotretinoin, warfarin, methotrexate, finasteride etc. Do consult your pharmacists and physicians to learn more.

Know Your Medicine

  1. Things to know about the medicine you are taking
    1. Name of medicine (generic name and brand name)
    2. Reason for taking it
    3. How much to take and how often to take it
    4. Possible side effects and what to do if you have them
    5. How long is the prescribed duration
    6. Special instructions (taking it at bed time, with meals, on an empty stomach, etc.)
  2. Do's and Don'ts before taking your medicine
    1. Do read the label carefully.
    2. Do take your medicine exactly as your doctor/pharmacist tells you to.
    3. Prepare a schedule (if you are taking more than one type of medicine) so you know what medicine to take at what time of the day.
    4. Do consider using one pharmacy for all your prescriptions. The pharmacist can help you to keep track of what you're taking.
    5. Do make sure everyone you live with knows what medicine you're taking and when you're supposed to take it.
    6. Don't combine prescription medicine and over-the-counter medicine unless your doctor says it's all right.
    7. Don't stop taking your medicine or change how much you take or how often you take it without first talking to your doctor.
    8. Don't take someone else's medicine.
    9. Don't use medicine after its expiration date.
    10. Don't crush, break or chew tablets or capsules unless your doctor / pharmacist tells you it's all right. Some medicine won't work well unless they are taken whole.
  3. Generic versus Brand Name
  4. A brand-name drug product is originally discovered and developed by a pharmaceutical company. The innovator company can exclusively market and sell this 'brand-name' product for as long as the company has patent protection. When the patent expires, however, other companies may begin to sell the compound and market it as different name, shape or color. Therefore the major difference between a brand-name pharmaceutical and its generic counterpart is neither chemistry nor quality, but whether the drug is still under patent protection by the company that initially developed it.

  5. Drug versus Medicine
  6. A drug is a single chemical substance in a medicine that alters the structure or function of some of the body's biological processes. A medicine is a drug (or combination of drugs) that is intended to prevent illnesses, cure diseases and pain relievers. Not all drugs are medicine, for example alcohol and amphetamine.

  7. What time should you take your medicine?
  8. The medicine envelope will give clear instructions on and when you should take the medicine. Generally, all medicine should be taken after food, but there are exceptions. Therefore, you must follow the instructions stated carefully.
    1. Before Meals

      This means about one hour before a meal and NOT two minutes before. Some medicine need to be absorbed into your system quickly so that they can act at full strength. Some of the effects of the medicine could be lost or delayed with presence of food. If you forget to take it at this time, it is probably better to take it after meal than rather not at all.

    2. After Meals

      Some medicine can upset or irritate your stomach. To minimize this, the label may tell you to take your medicine within five to ten minutes after meals.

    3. Regular Intervals, Complete The Course

      When you are taking antibiotics for an infection, you often feel better after just a day or two. However, the germs can still be there, ready to multiply if you do not complete the course. Taking regular dosage as prescribed by your doctor/pharmacist and completing the course of medication, you maintain the antibiotic levels in your system to ensure the total elimination of all existing germs. Otherwise the germs can be resistant to the medicine and make you ill again.

  9. What is the best way to store medicine?
    1. Keep out of reach from children
    2. Store away from direct heat and sunlight
    3. Do not store capsules and tablets in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause chemical elements in the medicine to break down. In addition, do remove the cotton plug once the bottle is open to avoid moisture.
    4. Do not store medicine in the refrigerator unless directed to do so.
    5. Do not leave the medicine in an automobile for long period of time.
    6. Do not keep any medicine which has expired OR medicine you don't need any more.