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Author: Nisha Bunke, M.D. 1. How much weight should I expect to gain during pregnancy? Most women with a normal body mass index gain 25 to 35 pounds during pregnancy. Women who are obese are advised to gain less weight. On the other hand, women who are underweight may gain up to 40 pounds. Women who gain excessive weight during pregnancy should see a dietitian. (click here to determine your bmi). 2. When do I first need to see a doctor? A first prenatal visit should take place within the first trimester. If a woman is uncertain about the date of her last menstrual period, it is especially important to schedule an ultrasound appointment to accurately determine gestational dates. At the first doctor visit, a comprehensive medical history will be taken to assess any obstetrical risks and special medical needs of a patient. Simple blood work that is usually done at the first office visit includes ABO and Rh blood typing, screening for anemia, immunity to rubella, and testing for viral hepatitis and HIV. A pelvic exam, pap smear, chlamydia and gonorrhea test is also usually performed at the first visit. Urinalysis, blood pressure and weight checks, fundal height measurement and fetal heart auscultation are performed routinely at each office visit. 3. Should I seek care from a midwife or doctor? This is a personal decision. Typically, complicated pregnancies (i.e., women who have certain medical conditions, smoke, have a history of miscarriages, past c-section, or have other risk factors for a complicated pregnancy) require the care of a physician. Midwives are an option for normal, uncomplicated pregnancies that do not require advanced care. Either way, a woman should seek routine prenatal care by a qualified health care provider. 4. Can I consume caffeine during pregnancy? Caffeine in moderate amounts is probably safe in pregnancy. 5. Can I use artificial sweeteners? Saccharin containing products should be avoided during pregnancy. Saccharin can cross the placenta and enter the fetal tissue. 6. Why have I been told to avoid cats during pregnancy? Cats can carry bacteria called Toxoplasma, which can be harmful to the developing fetus. Women should avoid changing a cat's litter box since Toxoplasma can be found in the cat's feces. You should discuss with your health care provider specific precautions that you need to take to avoid infection caused by Toxoplasma. Poorly cooked meats, seafood and unpasteurized milk can also be contaminated with Toxoplasma. 7. What is gestational diabetes? Some women develop diabetes during pregnancy. Most of the time, it will resolve after pregnancy. However, these women are at a higher risk of developing diabetes in later life. 8. How do I know if I have gestational diabetes? Late in the second trimester, a one hour glucola test is performed. If this is number is elevated, a women will undergo another test called a three hour glucose tolerance test. A woman should discuss her risks of developing gestational diabetes and this test with her health care provider. 9. Are there any foods that I should avoid during pregnancy? Canned tuna fish and farmed salmon should be eaten in moderation. Tuna steaks, swordfish, shark and king mackerel should be avoided because they can contain high levels of mercury, which can harm the fetus. Raw fish and shellfish should be avoided because they can be infected with parasites and Norwalk-like viruses. 10. Is aspirin safe to use in pregnancy? Aspirin is not safe to use during pregnancy. Aspirin is a class D medication meaning that it may cause harm to the fetus. 11. Is air travel safe during pregnancy? Air travel is thought to be safe until about 8 months of gestation. Pregnancy is a hypercoaguable state, which means that women who are pregnant are at a greater risk of developing blood clots. For this reason, pregnant women should take stretch breaks each hour when driving on long trips or flights. 12. Are over the counter cold medications safe to take in pregnancy? Many over the counter medications are not safe to use in pregnancy. Pregnant women should consult their health care provider before trying any over the counter medication. 13. Can I use hair dye? It is generally recommended to avoid hair dye during the first trimester. 14. Can I work during pregnancy? Work limitations are unique to the individual and her job. Many healthy women choose to work throughout their entire pregnancy, until the moment they go into labor. A woman should discuss her specific work limitations and special medical needs with her health care provider. General work restrictions include avoidance of heavy lifting, exposure to chemicals, prolonged standing and extremes of temperatures. 15. What birth defects are screened for in prenatal care? An ultrasound can assess abnormalities of the spinal cord and organs like the heart and kidneys. There are blood tests available to screen for neural tube defects and chromosomal disorders (like Down Syndrome). Women who are at an increased risk for chromosomal disorders may be offered amniocentesis or chorionic villus sampling. Remember, that no test can guarantee that a baby will be born in perfect health. It is important that women who have a family history of congenital diseases disclose this information to their physician so that special care can be given to this matter. 16. Can I continue to have sex while I'm pregnant? Yes. However, if a woman has had vaginal bleeding, history of miscarriages, or other special situations, she may be advised to abstain from sex by her health care provider. A woman must take special care to protect her self from sexually transmitted diseases. Some sexually transmitted disease can cause birth defects in the developing fetus. 17. Can I have an occasional glass of wine during pregnancy? It is recommended to avoid all alcoholic containing beverages, tobacco use and drug use throughout pregnancy. 18. What if I get chicken pox during pregnancy? A woman who has not developed immunity to chicken pox infection (caused by the varicella virus) should consider becoming vaccinated before pregnancy. It is generally advised that she then wait one month before becoming pregnant after receiving the vaccine. If a woman develops chicken pox during the first trimester or early second trimester of her pregnancy, her fetus is at risk of developing the congenital varicella syndrome. The risk of developing this syndrome is estimated to be 0.4% for infection during the first 12 weeks of pregnancy and 2.0% for infection occurring 13-20 weeks of pregnancy. 19. How can I figure out my due date by using my last menstrual period? Go to www.askmd.org and click on the box on the left hand side named 'health calculators.' Browse the pregnancy calculators. 20. Can I exercise during pregnancy? Yes, pregnant women should strive for 30 minutes of moderate exercise each day. Many women may need to modify their exercise routines to avoid uncomfortable positions and overheating. It is necessary to drink sufficient amounts of water to avoid dehydration About the Author Dr. Bunke is a Resident Physician in Family Medicine. She is also the Health Content Editor at www.askmd.org, a comprehensive medical web site that offers free medical resources including health calculators, daily health news, medical term and abbreviation search, health information and more. AskMD.org is popular for its free 'ask a doctor' feature.
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