Starting Out Right in
Early Pregnancy

Vitamin C, commonly found in citrus products such as oranges, helps with the absorption of iron. Taking an iron supplement with orange juice or squeezing lemon on a salad is a good way to boost your absorption.

Fiber: You should increase the fiber or “roughage” in your diet (whole grains, fresh fruits and vegetables), and try to drink at least eight 8oz glasses of fluids per day. Prenatal

 vitamins, the weight of the growing uterus and the increased hormone production of pregnancy can slow your digestion and lead to constipation.

Caffeine: Limit your caffeine consumption (coffee, tea, sodas) and high-calorie fluid intake (sodas.) One to two caffeinated drinks per day are safe.

Limit Exposure to Potential Pathogen Sources:

• Do not eat sushi or unpasteurized cheeses.
• All meat that you eat should be fully cooked. Deli meat should be heated before consuming.
• Always wash your produce prior to eating it. This will decrease your exposure to pesticides and surface bacteria.

Don’t Restrict Calories: Although this is not the time to diet, eat wisely, and avoid empty calories. If you are overweight, ask your physician about a referral to meet with a dietitian to develop a healthy eating plan.

Managing Nausea and Vomiting in Pregnancy

• If you are experiencing nausea with pregnancy, try eating small, frequent meals. Nausea is often worse on an empty stomach.
• Sip on liquids, but don't try to drink a full glass in one go.
• Many women find lemon drops or crystallized ginger candy help ease feelings of nausea.
• If odors are bothering you, try consuming cold foods, which tend to be less aromatic. Some good options include: watermelon, popsicles, Jell-O, applesauce, or fruit juice mixed with ice to make a light slushy drink.
• As long as you are urinating several times a day, and the color is light yellow, you are not dehydrated.
• If you are vomiting more than once a day, or losing weight, let your doctor know immediately.

If these suggestions do not improve your symptoms, call your doctor to discuss the use of prescription medications that help minimize nausea and vomiting.

Heartburn and Indigestion

• Eat many small meals.
• Avoid acidic foods such as lemons and tomatoes.
• Avoid spicy foods.
• It is safe to take Tums, Mylanta and over-the-counter Zantac.

Constipation

• Drink plenty of liquids; fruit juices such as papaya, mango and prune are very good options.
• You may use Colace pills, which are available over the counter. You can take up to 150 mg per day.

Diarrhea

• Eat a bland diet, such as the BRAT diet (bananas, rice, apples, toast) until the diarrhea stops
• Make sure to drink plenty of fluids
• Kaopectate is safe
• Do not take Immodium or any other medications without consulting your doctor

Cough/Nasal Congestion

• Spend some time in a steamy shower.
• Robitussin (plain) is safe to take.
• Saline nose drops are safe.

Insomnia

• Benadryl (diphenhydramine) on occasion is safe
• If the Benadryl is not helping, please contact your doctor to discuss other options

Sex During Pregnancy

• You should abstain from sex until an ultrasound confirms that you have a pregnancy with a normal heartbeat within the uterus.
• Once a healthy pregnancy is established, you can resume normal sexual activity.
• If you experience pain, cramping or bleeding during sex, call your doctor prior to initiating any further sexual activity.

Exercise During Pregnancy

Staying healthy during pregnancy is important. However, if you did not exercise regularly prior to pregnancy, now is not the time to start an intense new program. Below are some helpful hints for exercising. It is recommended that you not resume exercise until a pregnancy ultrasound reveals a fetus with a heartbeat. If you have any questions, consult with your physician.

At the start of your pregnancy, you will notice that you become short of breath faster than you are used to. This is a normal change in pregnancy. Try to exercise so that you don't tire out too quickly. A good rule of thumb is to make sure that you are able to carry on a conversation while exercising. If you become too short of breath to talk normally, you're probably overdoing it.

Many forms of exercise are safe during pregnancy. Things to avoid include lying flat on your back after the first trimester. Any sport that risks falls or injury to your abdomen should be avoided.

• Walking is great exercise, even if you were not active prior to becoming pregnant.
• Swimming is generally safe. Avoid hot tubs.
• Running and stationary cycling are good for aerobic exercise. Be careful as your belly grows, as your sense of balance will change. You need to avoid exercises if you feel unstable, as you are at risk of falling and injuring your abdomen.
• Many pregnancy classes are offered at local gyms, health clubs and pools. These include swimming, aerobics and yoga for pregnancy. You may want to take advantage of these offerings.
• Exercises to avoid during pregnancy include downhill skiing, rollerblading, racket sports, contact sports and scuba diving.
• Be sure to drink plenty of fluids before, during and after you exercise. Be extra careful in hot weather.
• Your center of balance changes as your belly grows, increasing your risk of falling. When walking up and down stairs, hold onto the railing. Decrease the height of the heels on shoes that you wear.

If you are traveling in a car, train or airplane for an extended period of time, you should get up and stretch your legs at least every 2 hours. This will decrease the risk of blood clots, which are more common during pregnancy.

Prenatal Testing

The following is an introduction to some of the more common prenatal tests that may be offered to you by your obstetrician. You should discuss the pros and cons of these tests with your obstetrician at your first prenatal visit.

First Trimester Screening (the "BUN" test)

The BUN exam includes blood tests and an ultrasound exam. It is performed between 11 and 14 weeks of pregnancy to detect the risk of Down syndrome and some other chromosome abnormalities, such as Trisomy 18.

An ultrasound exam, called a nuchal translucency screening, is used to measure the skin thickness at the back of the neck of the fetus. This helps determine the risk of a chromosomal abnormality.

The results of the nuchal translucency screening are then combined with those of the blood tests and the mother's age to assess the risk for the fetus. In the first trimester this combined test detects Down syndrome in about 85% of cases. When the nuchal translucency thickness is increased, the fetus may have a heart defect or a genetic condition. In this case, your doctor may suggest further testing such as a level II ultrasound, amniocentesis, or chorionic villus sampling.

This test may be somewhat less accurate if you are pregnant with multiples.

If you are pregnant with the assistance of a donor egg, you should let your physician know the age of the egg donor for the BUN test result to be accurate.

This test poses no risk to the fetus.

Second Trimester Screening (The "triple" or "quad" screen)

In the second trimester, a test called a "multiple marker screening" is offered to screen for Down syndrome, trisomy-18, and neural tube defects. This test measures the level of three or four substances in your blood. It is usually performed between 15 and 20 weeks of pregnancy. The stage of pregnancy at the time of the test is important, because levels of the substances measured change during pregnancy. These tests can pick up 70-80% of fetuses affected by Down syndrome, and 80% of fetuses with neural tube defects.

Diagnostic Testing

These tests are used to actually diagnose a pregnancy with an abnormality, whereas screening tests can only provide a percentage chance that an abnormality exists.

Diagnostic tests include:

• Amniocentesis: For this test, a small amount of amniotic fluid and cells are taken from the sac surrounding the fetus and tested. This test is generally performed between 15 and19 weeks of pregnancy.
• Chorionic Villus Sampling (CVS): For this test, a small sample of cells is taken from the placenta and tested. This test is done in the first trimester of pregnancy, generally between weeks 10 and 12 of pregnancy.
• Level II Ultrasound: This type of ultrasound exam gives a detailed view of the baby's organs. It is a good test for diagnosing neural tube and heart defects.

Both amniocentesis and CVS carry a small risk of miscarriage. This risk will be discussed with by your physician prior to performing either of these tests.

For more information regarding early pregnancy, please see:

• Fish Facts for Pregnant Women
• Pregnancy Food Don'ts
• Pregnancy Do's and Don'ts