Previously known as toxemia of pregnancy, pregnancy-induced hypertension is a potentially life-threatening disorder. It usually develops late in the second trimester or in the third trimester. Clinical manifestations of PIH include rapid weight gain, edema, high blood pressure, excretion of albumin in the urine, and convulsions.

PIH complicates about 5% of pregnancies and is among the leading causes of maternal deaths, prenatal deaths, and low birth-weight infants. It is categorized into two classifications:

1. Pre-eclampsia is the non-convulsive form of toxemia. It develops in about 7% of pregnancies and can either be mild or severe. It is characterized by hypertension with proteinuria (excretion of protein in the urine) and/or edema.
2. Eclampsia is the convulsive form of toxemia. About 5% of females with pre-eclampsia develop eclampsia. Of these, about 15% die from toxemia itself or its complications. This condition is characterized by convulsions or coma, both are usually associated with hypertension, proteinuria, and edema.

An unusually high incidence of pre-eclampsia seems to exist among socio-economically deprived groups. Epidemiologists interpret this as meaning that the high incidence is related more to the degree of nutritional deficiencies than to any other environmental factors. In fact, several studies have indicated that calcium and magnesium deficiency may play a role in the development of pre-eclampsia.

Therapy for pre-eclampsia is designed to halt the disorders progress, specifically the early effects of eclampsia such as convulsions, residual hypertension, and renal shutdown, and to ensure fetal survival. Some physicians advocate the prompt induction of labor, especially if the patient is near term; others follow a more conservative approach.

Therapy may include sedatives, such as Phenobarbital, along with complete bed rest, to relieve anxiety, reduce hypertension, and evaluate response to therapy. If renal function remains adequate, a high-protein, low-sodium, low-carbohydrate diet with increased fluid intake is recommended.

If the patient’s blood pressure fails to respond to bed rest and sedation and persistently rises above 160/110 mmHg, or if CNS (central nervous system) irritability increases, magnesium sulfate may produce general sedation, promote diuresis, reduce blood pressure, and prevent convulsions. If these measures fail to improve the patient’s condition, or if fetal life is endangered (as determined by stress or non-stress tests), cesarean section or oxytocin induction may be required to terminate the pregnancy.

Emergency treatment of eclamptic convulsions consists of immediate administration of Diazepam IV, followed by magnesium sulfate via IV drip, oxygen administration, and electronic fetal monitoring. After the patient’s condition stabilizes, a cesarean section may be performed.

Adequate nutrition, good prenatal care, and control of preexisting hypertension during pregnancy decrease the incidence and severity of pre-eclampsia.

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Pregnancy is unique in that at no other time in life does the well-being of an individual depend so much on the well-being of another. During pregnancy, the mother and child have an intimate and inseparable relationship. The health of the mother before and during pregnancy has profound effects on the status of her infant in the womb and at birth. Therefore, efforts are directed to the mother to ensure a safe and successful delivery and that her infant will be born well.

Pregnancy or gestation is the period from conception to birth and for human beings, it lasts from 38 to 42 weeks. It is often divided into thirds or trimesters, i.e., first, second, and third trimesters. Pregnancy has three stages namely implantation, organogenesis, and growth.

Implantation is the period in which the fertilized ovum implants itself in the uterus and begins to develop. This usually occurs during the first two weeks of conception. During organogenesis, the embryo undergoes differentiation or rapid cell division that occurs from two to eight weeks after conception. This is a critical period when organs are being formed and most vulnerable to adverse influences. If cell division and the final cell number achieved in an organ are limited during the critical period, it will have irreversible effects on later developmental stage.

For example, malnutrition that occurs at this stage may affect organ development that may not be reversed by subsequent refeeding. The remaining seven months is that last stage characterized primarily by growth in the number of cells and size of the organs until it can support extra- uterine life.

Anatomic and physiologic changes accompany normal pregnancy that affects most functions of the body. Most of these changes are seen in the very early weeks showing that they are not merely a response to physiologic stress but an integral part of the maternal- fetal system to create the most favorable environment possible for the developing fetus. The changes are necessary to regulate maternal metabolism, promote fetal growth, and prepare the mother for labor, birth, and lactation.

Lactation is the period of milk production by the mammary glands. The preparation for lactation starts during adolescence when hormonal changes bring about the development and increase in size of the breast, areola, and nipple. During pregnancy, these anatomical parts are markedly increased, especially in the latter stage of pregnancy, when the lobules of the alveolar system reach maximum size.

The two main hormones responsible for milk production are prolactin and oxytocin. The first milk is a thick, yellowish fluid that comes out on the second to the fifth day after delivery. This is called the colostrums and it is very important that the baby is fed this first milk because it contains antibodies and immune cells. It is richer in protein and lower in carbohydrate and fat, compared to the breast milk in later days, which is more watery and bluish. Colostrum is also a laxative, which initially cleans out the baby’s digestive organs.

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Having sexual intercourse a few days before the wife or female partner expects ovulation to take place will ensure that the longer-living female sperm is ready and waiting to fertilize the ovum just as it is released. The fast moving male sperm will have already perished after just a day or so. It is therefore important to be able to predict when ovulation will take place as ovulation kits will only show a positive result at the time of ovulation. Ovulation kits might be useful for, say, three months prior to when you wish to try conceiving as they will give you an accurate picture of your cycle.
The acidic environment favored by female sperm can be found near to the entrance of the vagina. Therefore it follows that having intercourse in positions which encourage shallower penetration will be favorable for the female sperm because it will thrive better than the male sperm and is more likely to be successful in fertilizing the ovum the instant that it is released.
Other natural ways to conceive a baby girl include watching your diet. It has been shown that women who eat a diet which uses up no more than the recommended calorie allowance each day are slightly more likely to conceive a girl. In addition, eating a diet rich in acidic foods, such as fruits, can help to make the body generally more acidic, which in turn favors the conception of a girl.

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Exercises during pregnancy

Exercise and nutrition are two most important aspects that should not be neglected during pregnancy. Proper nutrition will ensure that both mother and child will get the right kind and right amount of vitamins and minerals for proper development. Malnutrition during pregnancy often results in prematurity, low birth weight babies, abortion, stillbirth, and congenital defects. On the other hand, proper exercise will come in handy to strengthen the muscles used during labor and delivery.

The nutritional assessment is based on the diet history of the mother. Factors such as food preference, eating habits, religious or cultural influences, occupation and educational level are taken into consideration. Ideally, 2300 to 2700 calories a day should be taken during the entire course of pregnancy. Special attention and proper guidance must be given to pregnant adolescents, obese, or those with low pre-pregnancy weight and successive pregnancies. Even vegetarians need proper nutrition counseling because although they have high vitamin and mineral intake, vegetables have low protein content and may lack many essential amino acids that are only found in animal sources.

Food sources high in protein, Vitamin A, B, C, D, and E should be included in the diet of a pregnant woman. Eating folic acid-rich foods, such as asparagus, should also be encouraged because folic acid is essential to produce healthy red blood cells and prevent anemia. Calcium intake in the form of milk, cheese, and yoghurt should be increased because calcium is necessary for lactation and healthy bone formation for the fetus. Taking iron-rich foods is especially important during the last trimester to ensure that the fetus will have enough iron stores to last him during infancy when intake is mainly milk, a food that is deficient of iron.

Contrary to common belief, exercise during pregnancy is not contraindicated but should be done in moderation. Exercises should be individualized and designed according to age, physical condition, and stage of pregnancy. Swimming and tennis are not restricted unless done for the first time. Some of the recommended exercises during pregnancy are:

1. Pelvic rocking – Position yourself on your hand and knees. Contract your abdominal muscles to tilt your pelvis under. When this is done properly, it relieves low backaches and abdominal pressure, maintains good posture, and strengthens abdominal muscles after delivery.

2. Modified knee-chest position – Position yourself on all fours. Bring your knees closer to your chest then hold. This exercise relieves pelvic pressure and cramps in the thighs and buttocks. This may also relieve discomforts associated with hemorrhoids.

3. Shoulder circling – Sit on a chair with your backs straight. Rotate your shoulders inward for eight counts and then outwards for another eight counts. Frequency and repetition may be increased through time. This exercise strengthens the muscles of the chest.

4. Squatting and tailor sitting – Squatting is accomplished by keeping your legs apart when picking up objects to maintain balance. Tailor sitting, on the other hand is accomplished by doing an Indian sit and stretching your arms over the head. These exercises stretch and strengthen the muscles in the perineal area, increase circulation in the perineum, and make pelvic joints more pliable. When standing from a squatting position, always raise the buttocks first before raising the head to prevent postural hypotension.

5. Kegel exercise – This can be done by alternately contracting and relaxing the muscles of the pelvic floor to relieve congestion and discomfort in the pelvic region. Additionally, this exercise tones up the muscles of the pelvic floor.

6. Walking

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Emotional Changes during Pregnancy

A pregnant woman undergoes a variety of emotions during pregnancy, from the start of confirming pregnancy up to the period after child birth. It is believed that a baby in the mother’s womb can feel whatever emotion the mother is feeling. These emotions can negatively or positively affect the child’s development all throughout the period of pregnancy. This article aims to describe the normal emotional responses not only of the expecting mother but also the expectant father during pregnancy.

During the first trimester, the fetus is perceived to be an unidentA pregnant woman undergoes a variety of emotions during pregnancy, from the start of confirming pregnancy up to the period after child birth. It is believed that a baby in the mother’s womb can feel whatever emotion the mother is feeling. These emotions can negatively or positively affect the child’s development all throughout the period of pregnancy. This article aims to describe the normal emotional responses not only of the expecting mother but also the expectant father during pregnancy.A pregnant woman undergoes a variety of emotions during pregnancy, from the start of confirming pregnancy up to the period after child birth. It is believed that a baby in the mother’s womb can feel whatever emotion the mother is feeling. These emotions can negatively or positively affect the child’s development all throughout the period of pregnancy. This article aims to describe the normal emotional responses not only of the expecting mother but also the expectant father during pregnancy.

During the first trimester, the fetus is perceived to be an unidentified concept with great implications for the future but without a tangible evidence of reality. Some women may feel a degree of rejection, denial, and repression especially if the pregnancy is unplanned. At this time, the woman is faced with the psychological task of accepting the pregnancy. It is important that proper guidance be given regarding the importance of prenatal check-ups for both the baby’s and the mother’s well being. It is also advisable that appropriate education about the bodily changes occurring during pregnancy be emphasized at this stage for the mother to recognize the abnormal from the normal body adaptations during pregnancy.

In the second trimester, or the fourth to sixth month of pregnancy, the fetus is recognized as a separate entity. It is at this time that both mother and father fantasize about the appearance of the baby. Excitement over whose physical attributes, such as the color of the hair, color of the eyes, type of nose, etc. will be taken after by the baby. The mother’s psychological task at this stage is accepting the baby.

The mother begins to have a personal identification with the real baby about to be born during the third trimester. Preparing for the baby and the labor process is the psychological task during the seventh to ninth month of pregnancy. Both parents develop realistic plans for future child caring responsibilities. Couples discuss whether or not the mother will be allowed to go back to work or should stay at home full-time to watch over the baby. Some apprehension on whether or not the woman will be a good mother is common at this time, especially if it is the woman’s first pregnancy. This is the best time to teach the expectant parents about infant feeding methods and family planning. Fear of their baby’s death is also common at this time and may be allayed by letting the pregnant woman listen to the fetal heart sounds.

During the first trimester, the fetus is perceived to be an unidentified concept with great implications for the future but without a tangible evidence of reality. Some women may feel a degree of rejection, denial, and repression especially if the pregnancy is unplanned. At this time, the woman is faced with the psychological task of accepting the pregnancy. It is important that proper guidance be given regarding the importance of prenatal check-ups for both the baby’s and the mother’s well being. It is also advisable that appropriate education about the bodily changes occurring during pregnancy be emphasized at this stage for the mother to recognize the abnormal from the normal body adaptations during pregnancy.

In the second trimester, or the fourth to sixth month of pregnancy, the fetus is recognized as a separate entity. It is at this time that both mother and father fantasize about the appearance of the baby. Excitement over whose physical attributes, such as the color of the hair, color of the eyes, type of nose, etc. will be taken after by the baby. The mother’s psychological task at this stage is accepting the baby.

The mother begins to have a personal identification with the real baby about to be born during the third trimester. Preparing for the baby and the labor process is the psychological task during the seventh to ninth month of pregnancy. Both parents develop realistic plans for future child caring responsibilities. Couples discuss whether or not the mother will be allowed to go back to work or should stay at home full-time to watch over the baby. Some apprehension on whether or not the woman will be a good mother is common at this time, especially if it is the woman’s first pregnancy. This is the best time to teach the expectant parents about infant feeding methods and family planning. Fear of their baby’s death is also common at this time and may be allayed by letting the pregnant woman listen to the fetal heart sounds.ified concept with great implications for the future but without a tangible evidence of reality. Some women may feel a degree of rejection, denial, and repression especially if the pregnancy is unplanned. At this time, the woman is faced with the psychological task of accepting the pregnancy. It is important that proper guidance be given regarding the importance of prenatal check-ups for both the baby’s and the mother’s well being. It is also advisable that appropriate education about the bodily changes occurring during pregnancy be emphasized at this stage for the mother to recognize the abnormal from the normal body adaptations during pregnancy.

In the second trimester, or the fourth to sixth month of pregnancy, the fetus is recognized as a separate entity. It is at this time that both mother and father fantasize about the appearance of the baby. Excitement over whose physical attributes, such as the color of the hair, color of the eyes, type of nose, etc. will be taken after by the baby. The mother’s psychological task at this stage is accepting the baby.

The mother begins to have a personal identification with the real baby about to be born during the third trimester. Preparing for the baby and the labor process is the psychological task during the seventh to ninth month of pregnancy. Both parents develop realistic plans for future child caring responsibilities. Couples discuss whether or not the mother will be allowed to go back to work or should stay at home full-time to watch over the baby. Some apprehension on whether or not the woman will be a good mother is common at this time, especially if it is the woman’s first pregnancy. This is the best time to teach the expectant parents about infant feeding methods and family planning. Fear of their baby’s death is also common at this time and may be allayed by letting the pregnant woman listen to the fetal heart sounds.

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Changes in body during pregnancy.

The woman’s body was magnificently designed and bestowed with the powerful ability to adapt to any change occurring in times of stress or infirmity. One such period of stress is pregnancy. This article aims to explain the normal body adaptations during pregnancy and how to effectively manage and alleviate the discomforts associated with pregnancy.

During the end of the first trimester, there is a gradual increase of about 30 to 50% in the total workload of the heart. It reaches its peak during the sixth month of pregnancy. As a consequence, the expectant mother becomes easily exhausted and sometimes feels short of breath. Palpitations are common and may be due to the stimulation of the sympathetic nervous system on the first half of pregnancy, and an increased pressure of the uterus against the diaphragm during the second half of pregnancy.

Poor circulation results from the pressure of the gravid uterus on the blood vessels of the lower extremities. This can be prevented by raising the legs above the level of the hips during rest periods. Varicosities on the lower extremities are also common. Wearing elastic and support hose early in the morning upon waking up will promote blood flow; thus, prevent stasis of blood in the lower extremities. The application of elastic bandage from the foot to the trunk will help avoid congestion and impaired circulation in the distal part. Do not wrap the toes to determine if there is adequate circulation. Avoiding the use of constricting garters will also help address this problem.

Constipation and flatulence are common gastrointestinal discomforts during pregnancy. They may be due to the displacement of the stomach and intestines resulting to slower peristalsis and gastric emptying. Increase in fluid intake and roughage in the diet, establishing a regular time for bowel movement, and increasing exercise are some of the effective ways to manage constipation and flatulence. The use of stool softeners is also recommended. However, harsh laxatives should be avoided.

Hemorrhoids are another common complaint during pregnancy. These are due to the pressure exerted by the enlarged uterus on the intestines. Cold compress with witch hazel or Epsom salts or a hot sitz bath will help relieve the discomfort associated with hemorrhoids.

During the last trimester, heartburn is a common discomfort experienced by pregnant women. This is due to the increase in progesterone which is believed to decrease cardiac motility. As a result, the reversed peristaltic waves lead to the regurgitation of acidic stomach contents that cause the irritation. To manage this, it is recommended to take pats of butter before meals. Fried and fatty foods should also be avoided. Sips of milk at frequent intervals and small frequent meals are suggested. Antacids such as milk of magnesia may be taken, but never sodium bicarbonate, such as Alka Seltzer or baking soda, as these promote retention of fluids.

In attempts to change the center of gravity, pregnant women stand straighter and taller resulting in a lordotic position (often termed as the “pride of pregnancy”). The wobbly gait makes the pregnant women more prone to accidental falls. Thus, it is advisable to use low-heeled shoes and refrain from using the bath tub unless accompanied or non-skid materials are placed at the bottom of the tub or on the bathroom floor.

Leg cramps is another common complaint during pregnancy. This is caused by the pressure of the gravid uterus on the lower extremities, fatigue, and muscle tenseness. Frequent rest periods with feet elevated should be taken. The use of warm and comfortable clothing and an increase in calcium intake (through Calcium tabs and Calcium-rich foods in the diet) is highly recommended.

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How to deal with morning sickness.

Morning sickness is probably the most common gastrointestinal discomfort experienced during the first three months of pregnancy. The feeling of nausea and vomiting is associated with the increased levels of the pregnancy hormone called Human Chorionic Gonadotropin (HCG). Other associated causes of morning sickness are increased production of gastric acids during pregnancy, emotional factors, and increased sensitivity to odors.

There is a misconception of the term “morning sickness”. The episodes of nauseated feeling can actually happen any time of the day but is generally worst during the mornings. It may last through the day or may ease up a bit periodically. The onset of morning sickness may vary from person to person. For some it may start as early as the first four weeks of pregnancy. It may come and go during the entire course of pregnancy.

Mild morning sickness can be managed in a variety of ways. As a general rule, steer away from smells and foods that induce nausea. Another common practice is to eat crackers or dry toast 30 minutes before getting up from bed in the morning. Fatty and spicy foods should be avoided since they take longer to digest and tend to irritate the stomach. Eating small frequent meals throughout the day will ensure that your stomach is never empty; hence, reduce the probability of irritation. Sip fluid such as ginger ale to alleviate stomach queasiness. For working pregnant women, sucking on ginger or mint candies can be a good alternative to limit episodes of nausea and vomiting.

Though there is no scientific explanation, taking Vitamin B6 supplements seem to help ease morning sickness for some women. Wearing acupressure bands also helps provide relief from nausea for some women. This simple and inexpensive cotton wrist band works by pushing against the acupressure point associated with seasickness found under the wrist.

Before taking in any anti-nausea drugs, be sure to notify and check with your doctor or caregiver. Generally, self-medication is not encouraged because active ingredients of drugs can cross the placental barrier and may potentially harm the baby.

Excessive nausea and vomiting that persists beyond three months is called Hyperemesis gravidarum. This medical condition can result in dehydration and starvation. It is very detrimental to both mother and baby and requires immediate medical intervention. Replenishing fluids and electrolytes should be the priority for mothers with this condition. Complete bed rest with limited or no visitor is also an important aspect of treatment.

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Mother and Baby

Pregnancy and childbirth are considered to be an important, if not the most important, milestones in a woman’s life. Carrying human life in your womb for nine months and bringing that baby into this world are challenging feats that depict the true essence of womanhood.

Pregnancy begins with fertilization. Fertilization is defined as the union of a mature ovum and a sperm cell in the distal third of the fallopian tube. Immediately after this union, the resulting fertilized zygote stays in the fallopian tube for three to four days where it undergoes cell division. It then travels to the uterus where it implants itself and stays during the whole nine months of pregnancy.

The signs of pregnancy are characterized into three categories: the presumptive, the probable, and the positive. Presumptive signs are defined as the sensations and symptoms exhibited by a woman that possibly suggest pregnancy, but may also be due to some other underlying conditions. Presumptive signs during the first trimester of pregnancy include the cessation of menstruation, breast changes, morning sickness, increased frequency in urination, increasing fatigability, and an enlarging uterus. Increased skin pigmentation on the cheek and across the nose, more popularly known as the mask of pregnancy, is considered a presumptive sign commonly observed during the second trimester.

Contrary to popular knowledge, a positive pregnancy test result is only considered a probable sign of pregnancy. The hormone detected during the pregnancy test is called Human Chorionic Gonadotropin (HCG). However, this hormone is also secreted during a condition known as Hydatidiform mole or H-mole. By definition, probable signs indicate a definite or increased likelihood of pregnancy. Signs included under this category are: increase in the basal body temperature, purple discoloration of the vagina due to increased blood supply (known as Chadwick’s sign), softening of the lower segment of the uterus (called the Hegar’s sign), the increase in the vascularity and earlobe consistency of the cervix (also known as the Goodell’s sign), and the enlargement of the abdomen. These signs are usually observed during the first three months of pregnancy. Regular but painless contractions (known as Braxton-Hick’s contractions) commonly felt during the fourth to sixth month of pregnancy is also considered a probable sign.

Positive signs of pregnancy are absolute evidences of pregnancy that cannot be mistaken for any other health condition. Ultrasound evidence, fetal heart tones, fetal movement felt by the examiner and the fetal outline upon x-ray are categorized as positive signs of pregnancy.

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