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  • Care during Pregnancy

Care during Pregnancy

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Eating Healthy Food
Nutritious dietNutritious diet
An expecting mother should eat healthy and nutritious food during and after pregnancy. She should follow a well–balanced diet that has sufficient requirements of proteins, minerals, calcium, iron and vitamins and is easily digestible. While doing this one should take care of excessive calories which can lead to permanent obesity.

Generally, most of the mothers–to–be in India are given high calorie food like wheat flour with lots of dry fruits and desi–ghee. There is a concept and belief that the mother must eat food for two, which is all wrong. Ideally she should increase her daily calorie intake by another 300 calories. (The calorie intake should be about 2200–2500 calories) She should also increase milk intake to about 600 ml a day along with dal, fish, meat, eggs and plenty of fresh fruits and green vegetables in her diet.

Food. Food You Need Extra. Calories (kcal).
Milk. 100 gram. 83
Pulses. 15 gram. 52
Cereals. 35 gram. 118
Sugar. 10 gram. 40
Fat. - -
Total. - 293

Weight should be watched closely during pregnancy. The normal weight gained by a woman during her pregnancy is accepted as being about 10 kg or about 22 pounds. This may differ from women to women and the maturity of the baby. It may be roughly as 10 per cent at the tenth week, 20 per cent at the twentieth week, 30 per cent at the thirtieth week and 40 per cent at term. If the mother’s weight fails to increase there is risk that the baby will be small in size or there is the risk of intrauterine death. If she gains excessive weight there is a risk of developing toxemia in pregnancy and also obesity with its complications after pregnancy.

Dietetic iron is not sufficient to meet the daily requirement especially in the second half of pregnancy hence supplementary iron is given to all pregnant mothers from 20 weeks onwards. Your physician will prescribe whatever is required. (The requirement increases by about 20 mg/day). If any essential vitamins are lacking in the food, they are given daily from the 20th week onwards.

Vaccinations
Tetanus Toxoid
This vaccine is very vital not only to the mother but also to the fetus. Incase the the woman has been immunized in the past, she has to take a booster dose of 0.5 ml which is given in the last trimester.
If the woman has not immunized in the past, then she has to be given two shots of the Tetanus Toxoid, first at 16–20weeks and the second at 20–25 weeks.
Other vaccines like Cholera and Typhoid should be taken if there is an epidemic.
Vaccination against Yellow Fever is needed only if the mother is traveling overseas to certain countries.

Visits To Your Obstetrician
Antenatal care
The main purpose to have your regular checkup is to ensure a normal pregnancy with the delivery of a healthy baby from a healthy mother. The to–be–mothers can have these check–ups at an antenatal clinic or at her family physician's clinic. By doing this you make sure that nothing goes wrong during the pregnancy and labor. These check–ups also answer your questions to certain conditions that appear at every stage of pregnancy.

The woman should visit her physician preferably within the first 8 weeks of pregnancy. The check up is done at intervals of 4 weeks from the first visit. The first hospital visit should also occur between 12 and 16 weeks.
Calculation of the EDD (Expected Date of Delivery)
The EDD is calculated by adding 9 months (+) or (–) 7 days (by the English calendar) after the 1st day of the last menstrual cycle before conception.
For Example. A woman had her first day of the last menstrual period on 1st June. By adding 9 calendar months it comes to 1st of March and then add 7 days i.e. 8th of March, which becomes the expected date of delivery.

Details required will be
  • Place of residence.
  • Emergency contact number.
  • Age, marital status, duration of marriage and gravidity (history of previous pregnancies).
  • A full menstrual history.
Past History
Medical and surgical, family details, smoking, alcohol and drug ingestion, inoculation risk

Clinical Examination
Weight, height, blood pressure, urinalysis for protein, blood and glucose

General
Chest, Heart, Breasts, etc.

Abdominal
Masses, Tenderness, Fundal height

Pelvic
Routine vaginal examination is usually not required

Routine investigations to be done are
Examination of the blood. for Hemoglobin, determination of blood group and Rh factor. Also test for VDRL (Venereal disease).
Urine Examination. for sugar, protein and pus cells.
Cervical cytology (to study the structure and function of the cervix).
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