Archive for May, 2009
Pregnancy occurring metabolic adjustments aimed at correcting the imbalance that occurs when a greater nutritional need for the fetus. One of these imbalances is that the body needs more insulin to bring a more precise use of glucose. Clear evidence of this change is experienced by all pregnant women, usually in the morning noticed the unpleasant symptoms of hypoglycemia: nausea, sleepiness, fatigue, weakness, and so on.
Pregnancy progresses, the metabolic adaptation intensifies, reaching great importance during the last 20 weeks of pregnancy. All these metabolic changes lead to a number of considerations when they occur in a diabetic woman:
* In some patients, Diabetes first appears during pregnancy.
* The conventional criteria for diagnosis of diabetes are not applicable during pregnancy
* As the pregnancy progresses there is an increase in insulin needs.
* The usual criteria of strict metabolic control are not applicable during pregnancy
Detection of Diabetes Mellitus (DMG)
The data suggest a DMG are:
* Glycosuria (glucose in urine) in a second fasting urine sample (see below).
* A history of:
* Abortions unexplained.
* Newborns large for gestational age.
* Malformations in the newborn.
* Significant maternal obesity (90 kg or more).
Some minor data are multiparity, toxemia of pregnancy and recurrent preterm birth repeated. The presence of more than one data increases the likelihood that a disorder in glucose metabolism.
Glycosuria (glucose in urine) is a frequent finding, as 15% of pregnant women have, so the search for cases based on this information alone is ineffective. The validity of this test may increase when using a second fasting urine sample, the urine is released into the wake despises and collected a second sample 15 minutes later when the patient is still fasting.
Suspected cases of DMG should be seen every 15 days by the endocrinologist, is working together and the obstetrician. Measures should be taken prenatal routine. There should be special emphasis on weight control. Each visit must be a blood sugar after eating. If this test does not exceed 120 mg / dl), evidence of oral glucose tolerance should be deferred until the 37 th -38 th weeks of gestation, at which time it is more likely to give positive. If at any visit after eating glucose exceeds 120 mg / dl, it should be a test of glucose tolerance without delay. If the test is negative in early pregnancy, however, diagnosis, and the test should be repeated at 37-38 weeks, before making a final decision. Patients who have a negative tolerance test at 37-38 weeks is considered normal.
If the test is positive you can make the diagnosis of gestational diabetes and the patient is given a controlled diet and you are in the same way that a diabetic clinic. If the criteria for ideal glycemic control are not achieved soon, we start treatment with insulin. The existence of a high need for insulin during pregnancy does not necessarily indicate that diabetes persists after birth.
MONITORING OF DMG
After the test should be repeated postpartum glucose tolerance. If the test is still positive, the patient has a diabetes clinic (which was revealed for the first time during pregnancy). If not, the correct diagnosis is gestational diabetes mellitus. As some patients with DM develop clinical DMG then they should be advised to maintain a normal body weight and requested to attend an annual review, or immediately if you become pregnant again.
Whenever there is a release of a mature egg from the ovary it is pushed down to the fallopian tubes and the tiny hairs on the inside of the fallopian tubes wave in slow motion as to push the egg towards the womb where the occurrence of conception takes place. If in case conception does not occur then the lining of uterine wall and blood is shed with the unfertilized egg. This process is known as menstruation.
Often only one egg is released from the ovary during ovulation and the egg released can stay alive up to 1 day. The time of ovulation is very crucial for a woman to conceive, as it is the period when maximum fertility is observed. The time of ovulation can determine the pregnancy as fertility is at its peak 5 days before ovulation and it continues even after 2 days of occurrence of ovulation. Some times ovulation can occur even if the menstrual period have not occurred and vice versa. There are countless eggs in a woman for ovulation, but stress is the main cause for disruption of ovulation. When the egg is not fertilized, it is re-absorbed by the uterus. Women may feel pain around the ovaries and there can be little blood spotting during ovulation.
When the menstrual cycle in a woman is normal then it is easy to determine the fertility days, although there are number of cases where women have irregular periods or abnormal menstrual cycles due to various reasons. Many women have ovulation between the 11th to the 21st day of their menstrual cycle; this is counted from the first day of the Last menstrual period. Sexual intercourse is these days increases the chance of pregnancy as these days are known as the fertile days.
The two parts of the ovulation cycle are the follicular phase and luteal phase. The follicular phase begins on the first day of the last menstrual period and it continues till the ovulation occurs. Every woman have a different menstrual cycle and it can last anywhere between a week to forty days. The luteal phase begins from the day of the ovulation and continues till the beginning of the next period. This phase is shorter when compared to the follicular phase as it lasts anywhere between 12-16 days.
A basal thermometer is usually used to determine the rise in body temperature, which indicates the occurrence of ovulation. The tracking of ovulation gives an idea whether a woman stands a chance to get pregnant or not during her cycle.
Women can improve their chances of getting pregnant during ovulation and also they can try for a certain gender of the baby. There are x (female) and y (male) sperm cells which are produced by men and they are responsible for the gender of the baby. When the intercourse takes place closer to the ovulation the chances are bright to have a baby boy, as the y sperm cells are quicker than the x sperm cells. They reach the egg first, so if you have intercourse one day before ovulation a baby boy can be expected. To increase the chances of having a baby girl you should have intercourse 3-4 day prior to ovulation as the y sperm cells are slower than the x sperms cells and they take much time to reach the egg, but they are larger and stronger than x sperm cells. The process can be a bit confusing at times but it is necessary to know the period of ovulation as it helps a woman to decide whether she wants a pregnancy or to prevent pregnancy.
You don’t have to visit an expensive salon to enjoy a manicure. You can pamper yourself at home when you are sitting down relaxing one evening. All you need are some nail scissors or clippers, cotton wool balls, a bowl of warm soapy water, emery boards, polish remover, cuticle cream and orange sticks, and some
pretty nail polish. You can also use-a nail strengthener and a clear varnish for a top coat if wished. A manicure need not take long — under 30 minutes even
if you are polishing your nails and waiting for them to dry before applying the top protective coat of clear varnish.
1. Remove any old nail polish with a special oil- based remover using cotton wool pads.
2. File the nails to an oval shape with an emery board, filing from each side upwards towards the centre. Don’t file back and forth.
3. Gently massage in some cuticle cream and then soak for a few minutes in warm soapy water. Remove any dirt with a soft nail brush.
4. Use an orange stick tipped with cotton wool to gently push back the cuticles and remove any dead skin. Dip it in cuticle cream to do this. Dry your
5. Now you can apply polish if wished. If your nails are inclined to be brittle, start off by applying a base coat of nail strengthener. When it is dry,
apply a colored polish. Dark polish tends to make nails look longer; pale pearly polishes diminish them.
6. When the polish is thoroughly dry, you may wish to apply another coat. Dry and then apply a protective, hardening, clear top coat to prevent any unsightly
chipping which may occur.
Now you should start taking special care of your nails. Just as pregnancy affects the skin in different ways, some women find that their nails become
stronger than ever while a minority complains of brittle, split ones. As a general rule, nails tend to grow faster and stronger during pregnancy, especially
if you are eating a healthy diet that supplies plenty of calcium and iron. Taking an iron supplement also tends to make nails healthier. Often, nails are
brittle and tend to break easily in the first three months of pregnancy while your body is adjusting to the new stresses imposed on it and then improve in
the last two trimesters. If you want to have beautiful hands and nails throughout your pregnancy you should follow these guidelines:
1. Always wear rubber gloves when washing-up and doing household chores such as cleaning, washing and dusting.
2. Wear strong gloves when gardening to protect the hands from dirt, thorns and chemicals.
3. Apply moisturizing hand cream every day, especially after washing your hands which can be drying, and in winter when they may become dry and chafed.
Nails should be pink, smooth, strong and flexible – not brittle, ridged and mottled with white spots. They are made of keratin, a form of protein, and their
health is directly related to your diet. A doctor can tell a lot about your general state of inner health by examining your nails. The nutrients you need
are: 1 Vitamin A to help prevent nails splitting and breaking. Liver, cod liver oil, carrots, yellow fruit and vegetables, dried apricots and dark green
leafy vegetables will all help promote healthy nails.
2. Vitamin B deficiency can cause nails to look ridged and to split easily. A daily helping of brewer’s yeast and yoghurt will help right matters.
3. Iron helps make nails look pink and healthy – pale; weak nails may be a result of a lack of this important mineral in your diet. Eat a weekly helping of
liver together with eggs, whole-grain cereals and leafy green vegetables. They are best taken with a source of vitamin C for better absorption – oranges,
baked potato, tomatoes and peppers, for instance.
4. Zinc is rather an overlooked mineral in our food and is often deficient in women who tend to eat an over-refined and processed diet. A tell-tale sign of
zinc deficiency is white spots on the nails. A zinc supplement taken with plenty of fresh dark green vegetables, whole-grain cereals, meat and seafood often clears up nail problems.
5. Calcium in milk, cheese, eggs, yoghurt and sardines helps keep nails strong and healthy-looking.
6. Protein is the main constituent of nails and therefore it is an essential element in your diet, either from animal or vegetable sources.
During the first month of your pregnancy you are probably not even aware of the fact that you have conceived. Most exercise that you do in the first two or three months is unlikely to harm your baby. And the fitter and healthier you are at the time of conception and throughout the duration of your pregnancy, the greater your chances of a healthy baby and a shorter, easier delivery. Many women have run, jogged, cycled, swum and danced their way through pregnancy and they have had the advantages of a greater sense of fitness and physical well-being, less weight gained, a faster recovery after the birth of their babies and a shorter time regaining their figures.
The days have gone where doctors advised pregnant women to stop working and put their feet up for nine months of physical inactivity. Women now know that this led to poor muscle tone, reduced body awareness and, in fact, a body that was ill-prepared for the rigorous demands of labor. Of course, you will need regular periods of rest and relaxation when you are pregnant, but you require exercise, too. So there is no need to stop your sports or active exercise in the first few months unless your doctor advises strongly against it on medical grounds.
As the months pass, you will need to moderate your usual exercise programme as your ‘bump’ gets larger.
You can either exercise at home or attend the special classes that are now held for pregnant women at many gyms, leisure centers and exercise studios. These usually cater for women from their third month onwards. Work-outs and exercise programmers are devised to build strength and stamina for labor, to maintain muscle tone and flexibility and to teach body awareness. It is surprising how little many women know about their own bodies and how they function. During pregnancy you will want to understand more about the internal workings of your body and how they affect the baby growing inside you. An increased awareness of your body acquired through physical exercise can heighten your physical responses and help you to understand your pregnancy better and to be more conscious of your unborn child.
Regular exercise can help teach you to listen to your body, to get to know its limitations and also to realize its potential for endurance and flexibility — two qualities that will be needed in labor. The stronger and suppler your body is, the easier and faster you should be able to give birth to your baby and recover afterwards.
The best time to start exercising is before you get pregnant so that you can build up a level of fitness and strength in advance. This sort of fitness is easier to maintain throughout your pregnancy than if you have to start from scratch in the second or third month. Also, it is important to establish the fitness habit and to make exercise an integral part of your lifestyle and daily routine. If you are used to exercising regularly, it will be less difficult and tiresome to continue doing so throughout your pregnancy.
Someone who is reasonably fit and active before conception can usually continue to swim, cycle, dance, work-out or jog well into their pregnancy as long as she does not feel any discomfort or pain. Inevitably as the months pass and you get heavier, you will find yourself slowing down and you will not be able to achieve what was once possible and normal. Be sure to check with your doctor or midwife if you are worried about exercising during pregnancy.
1. You will feel fitter, happier and more energetic if you exercise throughout your pregnancy. You will get to know and like your body. This is very important as your body assumes new, unfamiliar curves, your waistline thickens, and some fat may build up on upper arms, thighs and hips. Although these may be the inevitable result of hormonal changes within you, they can be controlled with regular exercise.
2. Exercise will strengthen your muscles. This is not only important during labor but also in the months leading up to it. During pregnancy your poor muscles have to take a lot of extra strain – for example, if your abdominal muscles are slightly flabby, your lower back muscles will have to bear all the hard work of supporting your spine and this may lead to lower backache – a common enough problem in later pregnancy.
3. Regular exercise can help keep all muscles in good working order – keep them well-toned and strong. Gentle exercise repeated every day can firm up abdominal, hip and leg muscles and sagging upper arms, and strengthen shoulders, back and chest muscles.
4 As you exercise and tone up these muscles, you will control any extra weight gain in these areas. Although you are not exercising to lose weight, you are toning up the muscles underneath the rounded, fleshy pads that may appear. These trouble-spots will gradually disappear after the baby is born, especially if you breastfeed your child and practice your postnatal exercises.
5. Scientific research has shown that well-toned, strong muscles will help in delivery, too. You can increase your chances of having a shorter, easier labor. Women who are physically fit and exercise regularly throughout their pregnancies suffer fewer complications in labor and 50 per cent less Caesarean births. They have more strength and stamina, are more physically aware of their bodies and how muscle groups work. Thus they are better able to control the contractions and the pace of the birth itself.
6. Aerobic exercise such as walking, cycling, jogging, swimming and dancing promotes cardiovascular fitness – a stronger heart and circulatory system. Thus you can pump oxygen more efficiently to meet the requirements of your baby. Better circulation has beauty spin-offs, too. You are less likely to develop ugly varicose veins in your legs.
7. Cardiovascular fitness can also reduce your chances of suffering many common pregnancy aches and pains – good circulation leads to better bowel action and can prevent constipation and piles.
8. Exercise can help develop stronger back muscles and better posture. You will discover that your weight load shifts forwards as the baby grows and your balance will change as your centre of gravity is situated in your abdomen. You may develop a tendency to throw yourself forwards, or lean backwards to counteract this. Neither is right and will only lead to unnecessary backache. Exercise will strengthen your back and abdominal muscles and help you to walk tall and straight.
9. If you are unused to exercise you may fad that it brings a whole new dimension to your life – you will feel more energetic and more confident about your changing body and the whole experiment of being pregnant. You will also have the reassurance of knowing that the more you do to keep yourself in good shape, fit and healthy, the more likely it is that your baby will be healthy, too
10. Last but not least, keeping fit in pregnancy not only speeds up the process of regaining your natural body shape after birth, but it also builds strength and endurance for the task of coping with a small baby and being permanently on call for the first few weeks. This is an emotional time for many women – they feel tired or weak and yet they need to summon up all their reserves of strength to face up to the challenge of caring for a new life. Strong arm and back muscles will help you carry the growing baby in your arms and lift her up from her cot or pram.
If you have not exercised regularly in the past, pregnancy is not the time to embark on a strenuous exercise programme. However, this does not mean that you should continue to be totally inactive. Even if you are very unfit indeed, there is still a wide range of exercises that you can do to improve flexibility, suppleness and muscle tone and strengthen your heart. Do not leave it until the fourth month or even later in your pregnancy. Start now as soon as you discover that you are pregnant.
How do you start? Well, if you are overweight or anxious about your level of fitness you should seek your doctor’s advice. Whatever form of exercise you choose, it is important to start off slowly and build up your fitness gradually. The old maxim is: train don’t strain. This means not trying to run before you can walk and only increasing the number of repetitions of certain exercises, or the distance you swim, walk or cycle as you feel stronger.
Walking is one of the best ways to start exercising. It can be gentle or brisk; you can control the pace and rest whenever you feel tired or breathless. Try to walk for at least 30 minutes every day and make it part of your routine. Although it may not feel particularly demanding or strenuous, walking has cardiovascular benefits and it will help improve your general circulation and increase the oxygen flow to your developing baby. For short shopping expeditions or visiting friends who live locally, walk instead of taking the car. Be sure to wear flat, comfortable shoes with well-cushioned soles as high heels may distort your natural posture and encourage backache.
If you are tempted to join an exercise class, be sure to tell the instructor that you are pregnant and ask her if there are any exercises that you should not attempt. Concentrate only on gentle exercises with fewer repetitions if you are unfit and out of condition or, better still, join a specially devised antenatal class. Some cater only for women who are more than three months pregnant so you may have to be content with walking, swimming or cycling for a couple of months while you wait.
There is no reason why you should not continue running, walking, cycling, swimming, dancing or working-out throughout your pregnancy if you have achieved a reasonable level of fitness and are used to doing it for at least 20-30 minutes per session three or more times per week. However, if you feel any pain or discomfort you should stop immediately. If pain persists, consult a doctor.
Some fit women continue to jog right through their pregnancies, even on the day that labor starts! Invariably they enjoy easy deliveries, regain their figures quickly and resume running within weeks of the birth. If you are one of them, pay particular attention to your clothing and make sure that it is loose and not restricting in any way. Your shoes should have well-conditioned soles for extra shock absorption as you pound the ground more heavily than usual. Run only on grass. Roads and hard surfaces tend to jar your spine, joints and muscles and may lead to injury. If you have never run before and are reading this, please do not take up jogging for the first time in pregnancy. Although it is an excellent preparation for pregnancy it may be harmful rather than beneficial if you start training after conception and are unused to the strains it places on your body.