Here are the most common types of ultrasounds for pregnancy:

Standard Ultrasound

A standard ultrasound is the most common type performed during pregnancy. The technician holds a wand shaped transducer and rubs it over the stomach to produce two-dimensional pictures of the baby. If the doctor has any reason to suspect problems with the fetus, he may ask the technician to perform an advanced ultrasound. In an advanced ultrasound, the doctor points out areas of concern and the technician pays particular attention to those area.

Transvaginal Scan

In the case of a high risk pregnancy or if the mother is experiencing health issues, the obstetrician may want to perform an ultrasound earlier than a standard ultrasound. In these cases, a transvaginal ultrasound is used. The technician inserts the transducer into the vagina to perform the scan. Once the pregnancy reaches ten weeks, the obstetrician will typically choose a standard ultrasound.

Fetal Echocardiography

This ultrasound assesses potential problems with the development and anatomy of the baby’s heart and diagnoses any suspected heart defects. The obstetrician may recommend a fetal echocardiograph if he sees something suspicious on the standard ultrasound. He may also recommend a fetal echocardiograph if the patient or her partner has a history of cardiac abnormalities or the doctor notices irregularity in the fetal heartbeat. The technician can perform fetal echocardiographs either vaginally or through the abdomen.

3-D Ultrasound

A 3-D ultrasound uses computer software along with a specially designed transducer to generate a more complete picture of the baby. The transducer takes images in a series of slices which, when transmitted to the computer, form a three dimensional picture.

Dynamic 3-D Ultrasound

Often called a 4-D ultrasound, this ultrasound uses specially designed transducers to give a more realistic view of the baby. Parents enjoy seeing the dynamic 3-D ultrasounds because they can see their baby in action. The doctor and parents can watch the baby move in the uterus. While 3-D and dynamic 3-D ultrasounds are fun for the parent, they offer no diagnostic advantage over standard ultrasounds.

Info from LiveStrong

Image from UNC Healthcare

The usual schedule of prenatal visits to your practitioner is:

• Monthly for the first 28 weeks
• Every two weeks from 28 to 36 weeks
• Weekly thereafter until delivery.

The frequency and complexity of these visits may vary, according to your practitioner’s philosophy, your previous obstetrical history, and any special needs you and your baby may have.

If you are like me, and lucky enough to be experiencing a normal, healthy pregnancy, you may think these visits are a little too frequent, bordering on obsessive. Things are going fine! What exactly is your doctor checking out and looking for?

Dr. Sears explains what’s going on at each doctors visit, tests and examinations, things to watch for, and what to discuss with your doctor throughout each exciting stage of pregnancy.

FIRST MONTH VISIT TO YOUR HEALTHCARE PROVIDER

0-4 WEEKS
On your first visit to your healthcare provider plan to have:

• Confirmation of pregnancy
• A general medical history and previous obstetrical history if you have one
• A general physical exam, including an internal exam
• Blood tests: hemoglobin and hematocrit, blood typing, rubella titer, hepatitis B screen (HIV screen, venereal disease screen, and sickle cell screen are optional)
• Examination and possible cultures for vaginal infections
• Pap smear
• Possible blood test for genetic diseases if your history warrants
• Urinalysis to test for infection, sugar, and protein
• Weight and blood pressure check
• Counseling on proper nutrition and avoiding environmental hazards
• An opportunity to discuss your concerns

5-9 WEEKS
During this month’s visit you may have:

• An examination of your abdomen
• An examination of the size and height of uterus
• A hemoglobin and hematocrit check for anemia
• Nutritional counseling
• Weight and blood pressure check
• Urinalysis to test for infection, sugar, and protein
• An opportunity to discuss your concerns

10-14 WEEKS
During this month’s visit you may have:

• Examination of your abdomen to feel the top of the uterus
• Examination of the size and height of uterus
• Hemoglobin and hematocrit
• Urinalysis to test for infection, sugar, and protein
• Weight and blood pressure check
• Possibly hearing baby’s heartbeat with a doppler device
• Discussion of tests if needed: ultrasound, chorionic villus sampling, amniocentesis, and prenatal screening for genetic problems
• Exam for swelling of hands and legs or fluid retention
• An opportunity to discuss your concerns

FOURTH MONTH VISIT TO YOUR HEALTHCARE PROVIDER

15-19 WEEKS
During this month’s visit you may have:

• Examination of the size and height of uterus
• Examination for swelling varicose veins, and rashes
• An opportunity to hear baby’s heartbeat
• Opportunity to possibly see baby move and all the organs that are now developed on ultrasound, if indicated
• A triple screen test for possible prenatal genetic defects
• Weight and blood pressure check (expect a more rapid weight gain over the next three months)
• Urinalysis to test for infection, sugar, and protein
• Ultrasound in many practices is now a routine around 15-19 weeks to screen for possible birth defects, number of babies, placental location, and dating of baby’s age.
• An opportunity to discuss feeling baby move, which you may have already
• An opportunity to discuss your concerns

FIFTH MONTH VISIT TO YOUR HEALTHCARE PROVIDER

20-24 WEEKS
During this month’s visit you may have:

• Examination for the size and height of uterus
• An abdominal exam
• Examination of your breasts and skin
• Examination for swelling of hands, legs, and enlargement of veins
• Weight and blood pressure
• Urinalysis to test for infection, sugar, and protein
• An opportunity to hear baby’s heartbeat
• An opportunity to see baby on ultrasound, if indicated
• An assessment of fetal activity — how often your baby moves and what it feels like
• An opportunity to discuss your concerns

24-28 WEEKS
During this month’s visit you may have:

• Examination of the size and height of uterus
• Weight and blood pressure check
• Urinalysis to test for infection, sugar, and protein
• Oral glucose tolerance test, screening for gestational glucose intolerance, if indicated
• Vaginal culture, screening test for beta strep infection, if indicated
• An opportunity to hear your baby’s heart beat
• An opportunity to see your baby growing on ultrasound, if indicated
• An opportunity to discuss your concerns

28-32 WEEKS
During this month’s visit you may have:

• Examination of the size and height of uterus
• Examination of your skin for rashes, enlarging veins, and swelling
• Weight and blood pressure check
• Urinalysis to test for infection, sugar, and protein
• Hemoglobin and hematocrit, if indicated
• Review of your diet, an opportunity to discuss your weight, if necessary.
• An opportunity to hear baby’s heartbeat
• An opportunity to see on ultrasound how baby has grown (if indicated)
• An opportunity to discuss your concerns

During month seven and eight your healthcare provider may want to check you twice a month.

32-36 WEEKS
During this month’s visit you may have:

• Examination of the size and height of uterus
• Examination of your skin for rashes, enlarging veins, and swelling
• Weight and blood pressure check
• Urinalysis to test for infection, sugar, and protein
• Hemoglobin and hematocrit, if indicated
• Review of your diet, an opportunity to discuss your weight, if necessary.
• An opportunity to hear baby’s heartbeat
• An opportunity to see how baby has grown on ultrasound, if indicated
• An opportunity to discuss your concerns

During month seven and eight your healthcare provider may want to check you twice a month.

36-40 WEEKS
During this month your healthcare provider may check you weekly. During this month’s visit you may have:

• Examination of the size and height of uterus
• Palpation of your uterus to determine position of baby
• An internal exam, if indicated
• Weight and blood pressure check
• An ultrasound exam if needed to determine the size and position of your baby
• Urinalysis to test for infection, sugar, and protein,
• An opportunity to discuss when to call your practitioner if labor begins
• An opportunity to discuss the difference between Braxton-Hicks contractions and the “real” ones
• An opportunity to discuss signs that labor has begun
• An opportunity to discuss when to go to the hospital or birth center
• An opportunity to discuss your birth plan, including labor assistants, avoiding episiotomy, or special birth requests
• An opportunity to discuss other concerns

If your weekly or twice weekly visits drag on, your healthcare provider may discuss what to do when you’re “overdue”. You may have weekly ultrasound examinations to assess the volume of the amniotic fluid, a biophysical profile, or discussion of possible induction of labor at some point. If you are overdue your healthcare provider will counsel you on worrisome signs to watch for. Frequency and content of healthcare provider visits during the final month depends greatly on your particular obstetrical situation.

For more information on pregnancy, healthcare, and medical testing, visit Ask Dr. Sears!

This comes a little late for the holidays (sorry!), but here’s a good book to know about in case you have a party coming up (or just feel like mixing a fun drink to enjoy with your husband or a friend)! Haute Mama published the following two recipes from a new book called “Preggatinis: Mixology for the Mom-To-Be,” by Natalie Bovis-Nelsen (the Liquid Muse).

Here are two sample drinks to try out…

Chanukah Bubbly Bubbala
Celebrate the Festival of Lights while sipping Bubbly Bubbala and impress your Mommy-to-be guests with a perfectly palette pleasing combination to tantalize those taste sensitive tongues.

• Champagne flute
• Sparkling concord grape juice
• ½ ounce lemon juice
• 1 teaspoon granulated sugar
• 1 lemon wheel
• Pour sugar and lemon juice into a champagne flute. Fill with sparkling concord grape juice.
Garnish with lemon wheel.

Christmas Spice of the Season Mulled Wine
Simmering spiced wine on the stove makes the whole house smell like Christmas. With this alcohol-removed version, you don’t have to miss out on that special sense-memory.

• Wine goblet, or other heat resistant glass
• 1 bottle Fre® merlot alcohol-removed wine
• 1 teaspoon almond extract
• 2 cinnamon sticks (If desired, buy additional cinnamon sticks and garnish each cup with one).
• 3 whole cloves
• ½ teaspoon ground nutmeg
• 1 tablespoon of honey
• Pour wine into a double boiler pot, over medium heat. Add other ingredients, and stir until honey has dissolved. Reduce heat, cover and gently simmer, stirring occasionally. Serve…

…serve what? Serve warm? Not sure, it was cut off But in any case, if you are expecting a little one but don’t want to miss out on any of the fun, this is a good book for you!

If you decide to try out any of the recipes, let us know how they turned out! Happy celebrating!

A hernia is simply a hole in the muscular layer of the abdominal wall, which causes intestinal or fatty tissue within the abdomen to stick out. This can cause pain and, occasionally, intestinal obstruction.

Hernias can occur as a result of any increase in abdominal pressure. While straining and lifting are most commonly associated with hernias, the pressure in your abdomen will undoubtedly increase from a growing fetus.

Hernias do not go away. Once a hernia has formed, it will remain until it has been repaired. However, not all hernias need to be repaired, particularly hernias that are not causing any symptoms. This is particularly true during pregnancy.

Most hernias diagnosed during pregnancy can be treated without surgery and if surgery is necessary in most cases it can be delayed until several months after the baby is born. In many cases, the hernia becomes less painful later in pregnancy due to the uterus blocking the hole in the muscles.

Surgeons should consider the risks of surgery in considering repair. During the first trimester, the likelihood of a miscarriage is increased with an elective operation. During the third trimester, the likelihood of pre-term labor is increased. Elective surgery should only be considered during the second trimester (months 4-6). However, the growing baby and uterus will place increased stretch and strain on the repair and could result in an early recurrence of the hernia. In general, when hernias return, they are larger than they were originally.

In general, hernias are repaired with a soft and pliable material called mesh. Mesh is sewn around the hernia to reinforce the defect in the musculature. While mesh is very strong and is designed to prevent hernias from returning, it will not stretch. If a mesh is placed during pregnancy, it may tear away from the muscles as a result of the growing uterus, resulting in a return of the hernia. This can cause significant discomfort during the remainder of pregnancy.

Minimally invasive surgical techniques can be used to repair most hernias. Three tiny incisions are made, and a small camera is placed inside of the abdomen. Patients undergoing a minimally invasive, or laparoscopic, hernia repair will have less postoperative discomfort and a quicker return to normal activities while avoiding the larger incision associated with a traditional open operation. The long-term outcomes following hernia repair are comparable between traditional open surgery and minimally invasive surgery.

Even with a hernia, a Cesarean section is not usually necessary. Almost all women can safely deliver a baby vaginally. Your obstetrician or midwife can help you throughout the delivery process to ensure that the hernia does not become a problem during delivery.

The development of a hernia during pregnancy is not uncommon. The joy of future motherhood need not be interrupted by the development of this new bulge. By working closely with your obstetrician and hernia surgeon, most hernias will not endanger your well being or your baby’s.

Japanese Weekend Sublimation dress from Blossom Maternity. The rosy foliage and square neck make this a stunning choice for any party! Or how about this sleek Olian dress, also from Blossom Maternity, in a rich cocoa:

Old Navy is always a good stop for stylish, affordable maternity clothes. This season’s dresses are simply gorgeous! My two favorites are this red knit front-tie dress and this luxurious satin paisley dress. You’ll be the belle of the ball!

If you want to mix ‘n’ match, Due Maternity has some fabulous dressy tops, like the Cobalt Floral Strapless top, silver, sequined silk cami, or pink Twig top.

Another pretty option, also from Old Navy, is this elegant voile tank with cut-out bodice that can be paired with your favorite skirt or pants. You might also like the satin puff sleeve top. Best part: They are only $12.50 each!

But what to wear with these fabulous tops? The Over Bump Skirt is a fabulous option, with kick pleats and belt. If you prefer pants, try these comfy velveteen pants or shiny straight leg trousers.

If you want something super sassy to show off your blooming figure, the Boob Shiny Maternity dress is a real attention-stealer. (Just don’t ask me why the designer is named Boob… must be a British thing. They do ship to the US, though!). For something more conservative and elegant, the Satin Bow Dress is stylish and and classy.

Of course, when in doubt, there’s always a little black dress. Strapless and V-neck wrap dress from Due Maternity. The Japanese Weekend wrap dress is lovely for something more modest. Also check out Liz Lange for Target, which has over 30 styles of black dresses at affordable prices!

If you need something for a black-tie event, you can’t go wrong with a floor-length, black stretch-lace dress. I also think this green lace gown with scalloped lace detail is beautiful… and LOVE the white ribbon gown!  I reccomend that you check out Maternity Clothing Fashion for lots more super gorgeous, glamorous dresses.

It’s chilly outside, so you’ll need something pretty and cozy to keep out the cold! This cardigan from Mimi Maternity ties in the front with a gorgeous satin bow. For full coverage, try their wool front button maternity coat.

And… just for fun (since not many of us can afford a$1,540 Amethyst maternity gown or $1,340 Gold fish gown):

Ooh la la!! Now THAT would make a statement at your office holiday party!

Did you find the perfect party dress online? Let us know where to find it!

The first ultrasound is exciting, and each one, where the baby is a little more identifiably human, is anticipated more and more with each visit. By eight weeks the image resembles a lima bean with a pulse; by fifteen weeks the ultrasound image can show baby’s major organs; by the 20th week, the ultrasound pictures can often confirm the sex of your baby.

Twenty-year follow-up studies of thousands of mothers and babies who received diagnostic ultrasound have shown no apparent harmful effects. It is certainly safer than x-rays. There is a theoretical concern about whether the sound waves striking growing fetal tissues can cause any damage the cell. The National Institutes of Health Task Force on Diagnostic Ultrasound concludes: “We could find no evidence to justify the recommendation that every pregnancy be screened by ultrasound. In the face of even theoretical risks, where there is no benefit, then the theoretical risks cannot be justified.”

This means that, as fun as it is to see your growing baby on screen, the use of ultrasounds is really to check the baby’s progress and make sure he is developing properly. Dr. Sears lists 12 benefits of ultrasound:

1. Verify whether or not the mother is pregnant, when pregnancy tests and the usual signs of pregnancy are unclear.

2. Detect a possible ectopic pregnancy .

3. Obtain a more precise determination of baby’s gestational age when there is a discrepancy between uterine size and estimated due date. In the first half of pregnancy ultrasound can accurately date baby’s gestation within 7 to 10 days. In later months it is not as accurate and is useless for dating the pregnancy.

4. Evaluate baby’s growth if other signs, such as uterine size, suggest a problem.

5. Determine the cause of unexplained bleeding.

6. Confirm how baby lies in the uterus (breech, transverse, vertex) if the clinical signs are unclear late in pregnancy.

7. Detect suspected multiple pregnancies if mother’s uterus is growing faster than expected.

8. Detect problems with the placenta, such as placenta previa (the placenta being positioned too low or over the cervix) and abruptio placentae (the placenta is separating prematurely, causing bleeding).

9. Measure the amount of amniotic fluid if mother is losing amniotic fluid or not replenishing it at a normal rate.

10. Detect abnormalities of the uterus, especially in women with a history of previous miscarriages or problem pregnancies.

11. Detect developmental abnormalities in the growing baby that would influence where baby should be delivered and what preparations need to be made beforehand. Abnormalities of heart, lung, and intestinal development can, if detected early, alert parents and healthcare providers to deliver the baby in facilities equipped to begin management immediately after birth. Oftentimes, early recognition and early treatment can be lifesaving.

12. Assist in medical or surgical procedures: amniocentesis, chorionic villus sampling, trying to turn a breech baby, fetoscopy, or intrauterine transfusion.

Throwing a baby shower? Shop for baby shower favors here!

Q: Now that I am pregnant I have noted severe foot and other joint pains whenever I have to stand or walk for an extended period of time. What is the reason … and besides taking medications, can anything be done to help?

A: As many as 80 to 85 percent of women experience increased pain in their feet, legs, neck and back during pregnancy. Most doctors will tell you that wearing good shoes and massage is all that can be done to relieve the pain of this very common affliction. The reason for this pain is often the release of a hormone (relaxin) that allows stretching of ligaments in the pelvis to facilitate the birthing process. Since we live in a society that stands and walks on hard concrete surfaces, this hormone allows the feet to spread, flatten out and fatigue easily during the pregnancy. What is sometimes helpful is the purchase of over-the-counter orthotics, available at many sporting goods and drug stores. If not effective, then a custom-made foot orthotic, made by a podiatrist, is required to offer the greatest relief. Orthotics are custom-made supports that cradle the feet inside the shoes and hold them in a corrected position. They are a safe, effective, noninvasive treatment for the foot and posture. Orthotics also are effective in treating many other problems as well.

The connection between heavy drinking and “poor behavioural and cognitive outcomes in children is well established.” But what about light drinking?

Researchers found that:

• Children born to mothers who drank a little alcohol (1 to 2 units a week) while pregnant were not more likely to have behavioral difficulties or cognitive issues, compared to children born to mothers who abstained during pregnancy.

• Indeed, for some behavioral and cognitive outcomes, children born to light drinkers were less likely to have problems compared to children of mothers who abstained.

• Boys born to mothers who drank lightly were 40 per cent less likely to have “conduct” problems and 30 per cent less likely to show hyperactive behavior. (Even after adjusting for family and socioeconomic factors.)

• Boys whose mothers drank lightly while pregnant were also more likely to score higher in vocabulary tests and exercises where they had to identify colors, shapes, letters and numbers.

• Girls born to mothers who only drank a little alcohol were 30 per cent less likely to have emotional and peer problems compared to girls born to mothers who abstained, but this tendency appeared to depend partly on family and social background.

Lead author Dr Yvonne Kelly speculates on why this might be so. “Light drinkers tend to be more socially advantaged than abstainers… However, it may also be that light-drinking mothers tend to be more relaxed themselves and this contributes to better behavioral and cognitive outcomes in their children,” she added.

Until now, policy in the US and England has pushed toward total abstinence in order to be on the safe side. However, Kelly questions this:  “Our study’s findings do raise questions as to whether the current push for policy to recommend complete abstinence during pregnancy is merited and suggest that further research needs to be done.”

Either way, it seems safe to say that an occasional glass of wine will not hurt your baby. As my grandfather would say, “I’ll drink to that!”

L’Chaim!

Source: Medical News Today

Pregnant women will be warned this week to limit their caffeine consumption to 200mg, the equivalent of two average-sized mugs of coffee a day, or risk giving birth to underweight babies. The amount has been lowered from the previous recommended caffeine limit of 300mg.

Remember that caffeine comes in other forms too! The 200mg limit is equivalent to four cups of tea, five cans of cola, three energy drinks or five bars of chocolate.

The advice from the Food Standards Agency (FSA) comes a week after scientists found that a weekly glass of wine during pregnancy could help boost a baby’s behavior and vocabulary. Caffeine, however, is linked to low birth weight and miscarriages. The research, to be published in the British Medical Journal on Wednesday, found that women with a caffeine intake of more than 200mg a day were more likely to give birth to smaller babies.

“If you’re small for gestational age, you’re more likely to have intellectual impairment and hyperactivity in later life.” Other research has found that drinking more than 200mg of coffee a day also doubled the risk of miscarriage.

The first 12 weeks of pregnancy is the most crucial time for the baby, when most miscarriages occur. Therefor Pat O’Brien, consultant obstetrician and spokesman for the Royal College of Obstetricians and Gynecologists, recommends that women abstain from caffeine during the first trimester.

Source: The Times Online

Reuters reports: “Smoking during pregnancy increases the risk of stillbirth,” the researchers write in the British Journal of Obstetrics and Gynecology. “The use of NRT (nicotine replacement therapy) in pregnancy is a possible harm reduction strategy,” they add.

As part of the study, information was gathered for 87,032 singleton pregnancies. Two percent of women reported using nicotine replacement during pregnancy. Of these women, 14 percent did not smoke during pregnancy, 30 percent quit smoking during pregnancy, and 56 percent continued to smoke.

There were 495 stillbirths, 8 of them among the NRT users.

Those who used NRT had a 43 percent lower risk of stillbirth after accounting for other risk factors. Even those women who continued to smoke while using NRT, reduced the risk of stillbirth by 17 percent. Smokers who did not use NRT during pregnancy had a 46 percent higher risk of having a stillbirth.

Bottom line: Researchers believe the use of these products may be safe for some women, particularly if they would continue smoking without them. Don’t use any nicotine replacement therapy or other smoking cessation product without checking with your health care provider. They can help determine what methods of smoking cessation are safe and effective for you.

See also:

Quitting Smoking During Pregnancy

Smoking and Infertility

One More Reason to Quit Smoking

Quit Smoking for a Calmer Baby