Pregnancy is an individual and personal process that each woman lives in a different way according to the education, habits, values, customs and culture. Although manifestations share with other women, in the end, each one lives it in a certain way depending on the different situations of life. 1. Having a chronic illness, 2. Work activity risk, 3 twin and multiple pregnancy, pregnant 4. Travel. 1. Having a chronic illness In order that the woman suffering from a chronic health problem can enjoy the pregnancy, it is recommended to plan pregnancy so that occurs at a time when the disease is stabilized. The pregnant woman with a chronic disease may require specific controls, but can benefit, like any other woman, the advice of the health team or groups for birth preparation, childbirth and parenting. Women need to report the health team specialized in their desire gestational disease as it will be responsible for its advice on lifestyle changes (diet, physical activity, rest, postural hygiene, etc. ) that They help you achieve and maintain pregnancy. In most cases, pregnant women suffering from a chronic disease is considered a high obstetric risk pregnant, so the preconception visit is especially important.
Monitoring of pregnancy is used to perform in the hospital as high-risk pregnancy requires special monitoring specific controls, depending on the disease or chronic illness. Health Tips: Diet and pregnancy in chronic diseases 1. 1 endocrinological problems thyroid disease The thyroid gland is overloaded during pregnancy, so it is necessary that the woman suffering thyroid problems visit to an endocrinologist for you to adjust medication before pregnancy. Currently, drugs to treat thyroid disorders are compatible with pregnancy. Hypothyroidism is especially important, because it can cause subfertility and infertility and increased risk of abortion during the first trimester. One of the causes of hypothyroidism is iodine deficiency in the diet, essential for the production of thyroid hormone. It should be noted that, from the 10th week of pregnancy, the fetus no longer dependent on maternal thyroid hormones, but from its own thyroid, so it needs a sufficient supply of iodine comes from maternal intake . This is especially important in women suffering from hypothyroidism and in populations where this health problem is endemic and there is a very high rate of neonatal hypothyroidism. Therefore, it is recommended that the entire population use iodized salt and that all pregnant women, with or without thyroid problems, take an iodine supplement. Mellitus diabetes
Diabetes can be pre-pregnancy or gestational, if detected during pregnancy. It can also be insulin-dependent or not. In all cases it is considered a high risk pregnancy. It is desirable that women with diabetes plan the time of gestation in order that levels of blood sugar are as balanced as possible. It should be noted that pregnancy and is a diabetogenic process itself (increases the level of blood sugar), with some insulin resistance. High levels of sugar during pregnancy can adversely affect the fetus and pregnancy, as they involve risks of abortion, fetal malformation and death. Chronic severe diabetes complications (nephropathy, retinopathy and heart disease) are considered an absolute or relative contraindication of pregnancy, depending on the type and severity of the complication, since pregnancy can aggravate symptoms and even endanger the life of women. The endocrinologist or nurse who helps women to adjust the diet, insulin and physical activity to the new state, in order to avoid sudden changes in blood sugar (hypoglycemia or hyperglycemia) and get a good metabolic control. Thus, the woman keeps track of pregnancy obstetrician, but also needs the near endocrine control equipment. Health Tips: Diabetes 1. 2. liver and digestive problems
Gestation is characterized by a slowdown of intestinal transit due to relaxation of the muscles of the digestive system and displacement suffering abdominal organs by uterine growth. That means they can worsen or decompensation problems existing health, such as constipation, gastroesophageal reflux (the passage of gastric contents into the esophagus), heartburn (burning sensation in the esophagus), gastritis (inflammation of the mucosa stomach), gastric ulcer or liver colic. Uterine growth also causes increased pressure on the rectum and can cause or aggravate hemorrhoids, so that may actually cause blood clots. In these cases, changes and hygienic-drug treatment (gastroprotective or antacids) or surgical (in the case of thrombosed hemorrhoids), are recommended if necessary. Health advice: food before own pregnancy disorders 1. 3 Cardiovascular problems Another feature of pregnancy is overloading the cardiovascular system, because of increased blood volume (volume of circulating blood) and fluid retention in the tissues. heart Disease Heart disease makes the heart work harder. So pregnant women suffering from heart disease should be stabilized as possible. In cases of severe (grade IV) heart disease, pregnancy is contraindicated. If the disease is congenital, it is recommended that a study of early prenatal diagnosis.
Varicose veins in the legs Women with varicose veins in the legs can see aggravated his health problem. During pregnancy, the venous return from the lower extremities is directly affected by the increase in abdominal pressure because of increased uterine volume, which hinders the return of blood from the lower extremities to the heart. vulvar varicose veins, which can be asymptomatic (without discomfort) or painful they may also appear. We must assess in each case the need for physical and postural hygiene measures. Hypertension Hypertension in a pregnant woman can have serious consequences for both the fetus (eg, prematurity and fetal growth retardation) and for the mother. The pregnant woman suffering from hypertension may experience a worsening of their condition that may result during the first and second trimester abortion and get even eclampsia (convulsions due to hypertension that may occur in the second and the third quarter). TA must be maintained below 140/90 mmHg, but without lowering it to the point that compromises the circulation between the uterus and the placenta (uteroplacental circulation). Both in the case of women with chronic hypertension as in the case of those who suffer during pregnancy for the first time, pregnancy is considered high risk and preconception advice goes through changes in medication and dietary habits. 1. 4 Hematologic Problems Women suffering hematological problems are more likely to suffer abortion and thromboembolism (blockage of an artery and commitment of circulation, temporary or not).
Therefore, it is advisable to inform the health team hematology desire to become pregnant and carry a specific analytical monitoring (blood count, platelet count and coagulation tests). Anemia, coagulation disorder or thrombocytopenia (decreased number of platelets in the blood) influence childbirth (may make it vaginal or caesarean) and type of analgesia to be used (for example, coagulopathy is a contraindication for epidural analgesia). 1. 5 Breathing problems The woman with breathing problems can see their condition worsened, especially after the 24th week, because of the lung compression caused by the displacement of the abdominal viscera. Dyspnea (breathing difficulty) and feeling tired may increase significantly and be aggravated by anemia and edema (swelling) of the nasal mucosa own pregnancy. Asthmatic women can usually continue their usual treatment during the preconception period and during pregnancy. 1. 6. musculoskeletal problems Pregnancy causes a number of changes in the static of women. These changes can aggravate chronic injuries such as lordosis (excessive curvature of the lumbar portion of the spine) or scoliosis (lateral deviation of the normal curvature of the spine) and cause pain and sciatica. 1.
7 Urinary problems Asymptomatic bacteriuria is a urinary tract infection that may go unnoticed in pregnant women. If you have kidney problems or previous urinary, you may develop acute pyelonephritis (inflammation of the kidneys and ureters because of a urinary tract infection or a ureteral or renal obstruction) with serious consequences, such as the threat of premature birth ( APP). 1. 8 Neurological problems The approach of pregnancy in women with neurological problems depends on the type of disorder, the degree of involvement and stage of disease. Not all neurological diseases affect pregnancy, but some increase the risk of fetal and maternal complications. Epilepsy Anticonvulsants treatments interfere with the absorption of folic acid, so preconceptional 0. 4 mg / day, given in normal pregnancies, 5 mg / day should be increased. It should be changed as usual for epilepsy or suspend medication, as anticonvulsants are teratogenic (may cause fetal malformations). Also keep in mind that partial seizures and absences do not affect the fetus, but it will affect seizures, which can also lead to serious consequences for the mother. Headache (migraine)
Headaches tend to improve during the second and third quarter, excluding tensional origin. It should be noted that the pregnant woman suffering headache can make a medical treatment with paracetamol or stronger painkillers without prejudice to pregnancy or the fetus. It is also important that women know nonpharmacological alternatives, such as complemetarias therapies: yoga, body techniques, etc. 1. 9 Psychological problems Pregnancy is a period in which substantially worsen the symptoms of mental disorders, as often women should forgo the usual medication; also own physiological changes of pregnancy and childbirth can also lead to a worsening of symptoms. The period of maximum risk is the postpartum period: during pregnancy, the symptoms of illnesses such as schizophrenia or bipolar disorder, but are worse in the postpartum period, so that increases the risk of postpartum depression. 1. 10 Cancer Gestation not aggravate or minimizes cancerous processes, except for breast cancer and melanoma. If the diagnosis and treatment have been made during the peri- or during the first trimester of pregnancy period, it should be noted that radiotherapy is highly teratogenic (may cause birth defects). We must assess the risk involved for women delayed until postpartum cancer therapy, and for the fetus, the risks involved treatments such as hormone therapy, chemotherapy or surgery. Health Tips: Cancer
1. 11 Infections Infections can be caused by viruses, bacteria, protozoa, fungi and plasmodia. There is a group of infectious diseases, called TORCH (toxoplasmosis, rubella, cytomegalovirus and herpes), with different causal agents, but with similar characteristics with respect to the effects on the fetus. The TORCH have the following characteristics: They are asymptomatic or mild to women; affect the fetus variably; delays cause uterine growth; cause irreversible chronic sequelae; You can be diagnosed with an analytical. The involvement of fetal infection depends on the stage of gestation at which it and the type of microorganism occurs. Transmission occurs through the placenta during pregnancy, or through the birth canal. It should be considered, especially sexually transmitted diseases and to care for women with immune problems base, to advise them and be able to influence, more specifically, in the prevention of infectious diseases.
AIDS When, in a couple, one member has AIDS antibodies, you should be aware that can transmit the virus to both the HIV-positive partner and the unborn child. However, with good control of the disease and current treatments, the chances of transmission of the disease to the fetus are very low. Currently, we recommend using assisted reproductive techniques to achieve pregnancy and out from the second trimester of pregnancy, take a treatment with antiretroviral drugs to reduce the chances of infection from mother to fetus. For the same reason, it is also recommended to carry out the delivery by Caesarean section and not feeding a baby with breast milk. 1. 12 Myopia The pujos of second stage of labor increased intracranial pressure and the risk of retinal detachment. Therefore, a woman with high myopia may be advisable cesarean delivery. 1. 13 Dermatological problems During pregnancy, skin changes, which may be temporary, such as increasing the amount of facial hair or acne, or definitive, as striae are also produced. There are some skin diseases or skin diseases own pregnancy that cause the appearance of spots or dermatitis, usually with pruritus (itching), which disappear after childbirth.
2. Work Activity Risk The risk in working life is one aspect that is valued during the preconception visit or the first follow-up visit pregnancy. A specific rules governing the exposure of pregnant women to risk agents in work activity and establishes the criteria for evaluating these risks. teratogens. Some drugs, radiation, anesthetic gases, CO2, pesticides, chemicals, smoke and dust may have teratogenic effects. Postures and loads pesos. Bipedalism for three hours or more increases the risk of prematurity. In addition, it may aggravate the presence of varicose veins. 3kg load more increases the risk of lower back pain, especially antiergonómicas and repetitively conditions. extreme from the 5th month (competitive sports, dance, etc. ) are discouraged activities. Night work.
working hours that develops between 22 pm and 7 am is considered night work. Although the negative effects of night work on pregnancy are unclear, it is recommended that pregnant women working at this time. infectious agents. It is not advisable exposed to infectious agents such as rubella, cytomegalovirus, hepatitis B, toxoplasma, herpes or syphilis. Extreme temperatures. The labor law stipulates that the optimum temperature for work is between 17 ° C and 27 ° C, although it may vary depending on the type of activity and the environment where it takes place; also establishes the degree of humidity and air velocity. The extreme heat (over 36 ° C) significantly increases the risk of spontaneous abortion. Furthermore, continued exposure to cold can have general local negative consequences (numbness, numbness, pain and freezing) or (loss of concentration, confusion, incoordination and hypothermia); So working environments with temperatures below 0 ° C adversely affect the pregnancy. Noise. A work environment with more than 100 dB is considered noisy. Exposed to an environment like this can cause hearing loss and effects on the nervous and cardiovascular system. Pregnant women should not be exposed to environments of more than 80 dB from the 20th or 22nd week. Vibrations.
Vibration exposure during pregnancy increases the risk of placental abruption, premature birth and spontaneous abortion. The magnitude of the effects of vibration depends on the frequency and amplitude: the more amplitude, more negative effects on the body and pregnancy. 3. twin and multiple pregnancy Pregnancy of twins and multiple pregnancy, whether they are spontaneous and achieved with assisted reproduction techniques are considered, respectively, high risk and very high risk. It is recommended to monitor in specialized hospitals because ultrasound check of the most intense fetuses necessary. In this type of gestations, it is normal to increase the typical physical manifestations of pregnancy such as vomiting and nausea because of the high levels of the pregnancy hormone, and appear, early, constipation, hemorrhoids, low back pain, varicose veins, breathlessness (related to increased abdominal volume), tachycardia (related to cardiac overload) and anemia. The twin and multiple pregnancies have a higher incidence of maternal and fetal complications, such as: I abortion, preterm delivery, hypertensive disease of pregnancy, intrauterine growth retardation, postpartum hemorrhage,
abruption. The recommendations in the delivery of twins depend mainly on the state of maternal and fetal health and placement of fetuses. In a multiple pregnancy it is recommended Caesarean section, but, today, is a measure that is in controversy and begins to value vaginal delivery depending on the characteristics of each pregnancy. 4. Traveling pregnant Travel, leisure or personal or professional issues is a normal activity in the lives of women, pregnant and traveling is becoming more frequent. Precautions to be taken into account depend on the means of transport, distance and destination. It is not contraindicated in healthy pregnant women with a healthy pregnancy traveling by motorcycle or bicycle, though not the most recommended means of transport.