Pregnancy

Pregnancy is a unique experience for every woman and it is important for her to enjoy it and remember this as such.

General advice

As part of her antenatal care, it is important to focus on the following issues:

• healthy eating and exercising
• taking folic acid
• stopping smoking
• cutting out, or down on, alcohol
• getting advice and tests for sexually transmitted infections
• adopting a healthy stress-free life style

Teratogens

There is a general belief that any exposure to medication or other factors, during pregnancy poses a potential risk to the developing baby. However, the vast majority of drugs are actually considered to be safe.

Teratogens are environmental agents used during pregnancy that interfere with fetal development, potentially resulting in congenital malformation or birth defect. Although most known teratogens are drugs, they can also be infections, such as rubella and toxoplasma, chemicals or radiation. In many cases, the potential teratogenic effect is dose dependant. Finally, it is important to know that not every exposure would necessarily result in fetal damage.

The most important issue to clarify is timing of the exposure during pregnancy. Depending on when exposure took place, the following scenarios can occur:

1. The two week period from conception to the time of the first missed period, is often called the “all-or-none” period. It is generally accepted that exposures during this time do not cause malformations to the fetus. In the rare case of exposure to extremely high doses of an agent, for example radiation, chances are that a full miscarriage may be caused, rather than a fetal abnormality.
2. The embryonic period, from 4 – 10 weeks after last menstrual period (LMP) is the most critical period of development, because all organs are being formed during this period of time. Defects such as spina bifida or cardiac defects, may occur
3. The fetal period (from 11 weeks until term) is not a high-risk period of time for birth defects. However, exposures during this time may affect normally formed organs. For example, regular alcohol consumption, may result in the brain and nervous system damage.

Scans in pregnancy

Ultrasound scans use sound waves to build a picture of the baby in the uterus. Scans are completely painless, are safe for mothers as well as babies, and can be carried out at any stage of pregnancy, either transvaginally (in the early weeks) or transabdominally.

Two are the most important scans performed during pregnancy:

1. The nuchal translucency scan (NT scan) can assess the baby's risk of having Down syndrome and some other chromosomal abnormalities, as well as major congenital heart problems.
   
   The NT scan measures the clear (translucent) space at the back of the baby's neck. Babies with abnormalities tend to accumulate more fluid at the back of their neck, causing this space to be larger than average. The NT scan is performed between 11 and 14 weeks of pregnancy, and is usually combined with a blood test, measuring b-HCG and PAPP-A levels in the mother’s blood stream. NT scan is a screening test and therefore does not give a diagnosis. The scan can only assess each baby's risk for certain problems and help us decide whether to perform chorionic villus sampling (CVS) or amniocentesis to find out whether the baby is actually affected.
2. The second scan offered to all pregnant women is called the anomaly scan, or mid-pregnancy scan, and usually takes place between 18 and 21 weeks of pregnancy. This scan checks for structural abnormalities (anomalies) in the baby.

Aromatherapy & massage in labour

Aromatherapy is both a science and an art in which highly concentrated essential oils extracted from various parts of the different plants are used for their therapeutic properties.

Aromatherapy and massage offers relaxation and acts as an adjunct to enhance normal labour.

It can be offered to:

• Women who are at term with a normal pregnancy
• Women in the latent phase of labour
• Women in established labour

It is not suitable for:

• Antenatal women < 37 weeks gestation
• Known allergy to any of the essential oils or carrier oils

Oils available for use while in labour are as follows:

• Bergamot – to help with analgesia, relief of fear and spasms, uplifting
• Clary Sage – said to enhance uterine action, induction and acceleration, antibacterial
• Grapefruit – said to be calming and help relieve fear and anxiety
• Lavender – said to relieve backache, sciatica, symphisis pubis pain, antibacterial

The carrier oil of choice will usually be Grapeseed Oil.

The maximum numbers of oils allowed in one mix is 3, all diluted into the carrier oil.

Areas to massage include:

• Back, shoulders
• Hands
• Feet

Prenatal Yoga

Prenatal yoga is a modern approach of exercise in pregnancy, that encourages stretching, mental centering and focused breathing. Research suggests that prenatal yoga is safe and may benefit pregnant women as well as their babies.

Yoga in pregnancy can improve sleep, decrease stress, increase strength of pelvic floor muscles needed for childbirth and decrease lower back pain, nausea and headaches.

Important considerations, when you attend Yoga classes:

• “Hot" yoga (working out in an overheated room) is to be avoided in pregnancy.
• Inform the tutor about your pregnancy and how advanced your pregnancy is
• Avoid exercises that make you lie on your back because the uterus can apply pressure on a big vessel next to your spine, thus reducing blood flow to the uterus.
• Avoid lying on your tummy (prone), upside-down postures (inversions), as awell as stretching your abdominal muscles too much.
• In advanced pregnancy use a chair for support in order to avoid losing your balance and risking injury to yourself or your baby.
• Keep your pelvis in a neutral position during poses.
• When practicing twisting poses, twist more from the shoulders and back than from the waist, to avoid putting any pressure on your abdomen.
• If you feel any discomfort, stop.

After pregnancy, Yoga can also help new mothers handle the stress of looking after the newborn as well as postnatal depression that quite often affects new mothers.

In any case, Dr Bazeos works with Yoga trainers who are particularly interested in pregnant women, so do not hesitate to ask for their advice.