Obstetrics Guide and Healthy Birth

Therefore, regular follow-up of mother and baby during pregnancy is indispensable for healthy pregnancy and delivery.

Pregnancy is examined in three periods and each of these periods is called trimester. The first trimester is the first 12 weeks, the second trimester is 13 – 27 weeks and third trimester 28 – 40 weeks. Each trimester has different characteristics and different points to consider.

Information during pregnancy:
Pregnancy follow-up and screening programs aim to inform the parents about the treatment and follow-up processes of abnormalities that may occur during pregnancy. Counseling before pregnancy and regular periodical checks during pregnancy allow early diagnosis of problems that may develop during pregnancy and treatment without causing serious consequences.

In spite of all efforts, there may be situations that endanger the life of the mother and the baby at any stage of pregnancy, which are unpredictable or that cannot be completely corrected with treatment.

Things to do before pregnancy:
If the mother’s work causes exposure to chemicals, radiation, lead or narcotic drugs, this may put the pregnancy at risk. In such cases, change of work or work at a different location in the same workplace should be planned.
Smoking or drinking alcohol should stoped.
If there is an inherited disease or an undiagnosed disease in the first children of the family or in the parent’s family, this should be questioned in detail.
Abnormalities, early losses, pregnancy diabetes or the development of high blood pressure during pregnancy should be questioned in previous pregnancies.
If rubella has not been vaccinated, the expectant mother should be vaccinated before pregnancy.
Whether toxoplasma infection has to be questioned.
If there is a known chronic disease (epilepsy, sugar, heart, hypertension, goiter, etc.), should be consulted to follow-up doctor and treatment changes should be done before pregnancy.
If there is vaginal or cervical infection, it should be treated and Papp smear (cervical cancer screening test) should be taken.
The ratio of weight to height (BMI = body mass index) should be reviewed, and if there is obesity, healthy weight loss should be provided under the control of physician and dietician. Nutritional characteristics should be reviewed and appropriate nutrition habits should be developed for the individual and pregnancy.
Evaluation of dental health should be made.
Whether folic acid intake is sufficient should be questioned and folic acid supplementation should be initiated.

Structure of Female Genital Organs:
Uterus (uterus) is the main organ of the female genital system. The lower part of the cervix called the vagina, the upper part of the tube with the name of the fallopian tubes are opened to the abdominal cavity. The main task of the uterus is to accept the egg that has been fertilized in the tubes and to hold it inside the inner wall of the uterus, which is called the endometrium. The fertilized egg, which reaches sufficient nutritional sources, becomes a fetus and grows here until birth. As the uterus grows during pregnancy, it expands to the abdomen; The approximate weight at birth is one kilogram.

Symptoms of pregnancy:
The first sign of pregnancy is delay of period.
Hormonal changes occur in the mammary glands, which causes fullness and tenderness in the breasts.
Approximately six weeks after pregnancy, hypersensitivity to odors and nausea and vomiting, which especially aggravate in the morning, can be seen. Although this condition usually regresses spontaneously after 3 months, it may rarely continue throughout the pregnancy.
Fatigue, headache, not feeling well and the desire to sleep continuously are the most prominent symptoms of early pregnancy.
Generally, the increase in body temperature makes it difficult to tolerate heat.
Metallic taste is felt in the mouth, saliva increases.
The number of daily urination increases due to changes in hormones in the first months of pregnancy and because of the pressure of the uterus which grows in the last three months.
Constipation is a common condition due to slowing of bowel movements.
Infant movements are felt after the fifth month in the first pregnancies and earlier in the subsequent pregnancies – from the fourth month onwards.

Risk Factors in Pregnancy:
– The mother is under 18 or older than 38.
– Starting pregnancy with excess weight (body mass index above 30).
– Previous gynecological diseases, surgeries, repeated cesarean sections.
– Drugs used by the expectant mother.
– More than 4 births.
– Another systemic disease of mother (hypertension, diabetes, heart and kidney diseases…).
– Premature birth in previous pregnancies, pregnancy poisoning (pre-eclampsia, eclampsia), infant growth retardation, stillbirth, 2 or more miscarriages.
– Blood mismatch: mother is Rh negative (-) and father is Rh positive (+).
– Relative marriages

Pregnancy Tracking:
The gestational age is calculated from the first day of the last menstrual period.

Pregnancy follow-up is carried out once a month until the 32nd week, every two weeks between 32-36 weeks and after the 36th week – as we approach birth – once a week. In addition, additional examinations are performed when there are abnormal symptoms. Weight and blood pressure are monitored at each examination. It is ideal for the expectant mother to gain between 10 and 12 kilograms during pregnancy: less than 8 kilos or more than 15 kilos will cause problems.

Ultrasonography in Pregnancy:
Ultrasonography is an important diagnostic tool that shows the condition, development and structure of the baby. Many of the major fetal abnormalities can be demonstrated by ultrasonography, but small fetal abnormalities that do not impair the baby’s structure may not be seen and can only be detected after birth. The best example of this is Down syndrome. In addition, many genetic and developmental disorders cannot be diagnosed with ultrasound. Some diseases may occur as a result of the fetus failing to function of the related organ in the later weeks of pregnancy, and therefore no problem can be detected in previous ultrasounds. The possibility of ultrasound to detect abnormalities in the baby varies depending on the thickness of the mother’s abdominal wall, the weight of the mother, the position of the baby and the amount of amniotic fluid, and the technical characteristics of the ultrasound.

First Examination in Pregnancy:
If pregnancy test (urine or blood) is positive in a patient with menstrual delay, the definitive diagnosis and whether it is normal should be evaluated by ultrasonography. Vaginal ultrasonography shows the gestational sac within the uterus from the 5th week and the fetus and heartbeat from the 6th to 7th weeks. It is also detected if there are abnormal conditions (empty pregnancy, ectopic pregnancy, grape pregnancy, multiple pregnancy, etc.). Vaginal ultrasonography is a painless procedure with no harm to the mother or the baby, and a clearer and more detailed image is obtained compared to pelvic ultrasonography.

The history of the pregnant woman about possible health problems is recorded. Information about previous pregnancies is obtained. Hereditary diseases, chronic diseases, smoking, alcohol and drug intake in the family are questioned.

Blood count, blood group, urine test, liver and kidney function tests, hepatitis B and C antigens, rubella and toxoplasma antigens and thyroid hormone are examined. Pregnancy risk situations are determined and possible measures are taken. If there is a blood mismatch, an indirect Coombs test is performed.

Recommended Examinations:
Measurement of nuchal translucency (NT) by ultrasound between 12-14 weeks of gestation provides information about Down syndrome, genetic diseases and some heart diseases. In addition to nuchal translucency measurement, Hcg and PAPP-A levels are measured in maternal blood and dual down syndrome screening test is performed. It is a highly reliable test.

16-18 haftalar arasında, eğer ikili test yapılamamış ise, güvenilirliği daha düşük olmakla birlikte yine de yeterli ve gerekli olan, üçlü veya dörtlü down sendromu tarama testleri yapılır. İkili tarama testi yapılmış ise üçlü veya dörtlü tarama testlerini yapmaya gerek yoktur; ancak üçlü –dörtlü testlerin bir parçası olan AFP MoM bakılır: fetüsün omurlarının açık kalma durumu olan, spina bifida (nöral tüp defekti) adı verilen ciddi bir hastalığın taramasıdır.

If there is a problem with the Down-Syndrome screening tests (which are screening tests), further examinations are needed and referred to a perinatologist (risky pregnancy specialist). There are several methods for definitive diagnosis: In the early period (up to 12-14 weeks), the baby’s partner can be sampled, called chorionic villus sampling. In the following weeks, the amniotic fluid in the baby is sampled with a thin needle, called amniocentesis. Another method is to detect fetal DNA in maternal blood, which is possible with the developing technology in recent years. The aim of all these methods is to learn and analyze the number of chromosomes of the fetus, which allows a definitive diagnosis.

In order to examine all the organs and limbs of the baby between 19-24 weeks and if there is a problem, a detailed screening ultrasound called Level 2 is applied to inform the child in the early time and take precautions if possible. If possible, this ultrasound should be performed by a perinatalogist or radiologist trained in this field.

Between 24 and 28 weeks, 50 grams or 75 grams of oral glucose screening test (OGTT) sugar loading test should be done. There is no harm to either the pregnant or the baby. If any of these test values ​​is high, the diagnosis of pregnancy diabetes is made.
After 24 weeks, if there is a blood mismatch, the indirect Coombs test is repeated. Again, tetanus vaccine is repeated this week.
After 28 weeks, monthly examinations are performed: the baby’s growth and development is monitored by ultrasound; the baby’s spouse and the amount of amniotic fluid the baby is in is evaluated. Every month, complete blood count and urinalysis are performed; weight and blood pressure are checked. If an examination is suspected, additional investigations may be requested.

NST (non-stress test) and contraction follow-up (follow-up of uterine contractions) are performed after 35 weeks of examination. This test is a test in which the baby’s heart movements are monitored and uterine contractions are monitored. At the same time, ultrasound evaluates the baby’s movements, breathing movements, posture and the amount of amniotic fluid, which is called the assessment of the baby’s well-being.

Changes in Baby and Maternal Candidate:
5-6. weeks: The baby is the size of an apple core at this stage. Floats in a liquid-filled pouch. Around the 6th week, heartbeats can be detected on ultrasound. In fact, the heart of the fetus starts beating from day 26; can be detected by color ultrasound in the early stages. The mother may consult a doctor with complaints such as nausea, fatigue, desire for constant sleep, frequent urination, emotional fluctuation.

Week 7: The baby is the size of a small grape seed and it is a period in which organs are formed and developed very quickly. The heart rate of the fetus should now be clearly seen on ultrasound this week.

Week 8: Baby reaches a small strawberry size, weighs about 2 grams. The bone canal (ie neural tube) where the baby’s spinal cord is located was completed approximately this week. The production function of the hormone responsible for the development and maintenance of the uterine lining where the baby is placed is transferred from the ovarian tissue to the so-called placenta: therefore the mother may have a small amount of vaginal bleeding.

9-12. weeks: During these weeks, the baby’s head, body, arms and legs begin to be distinguished very clearly. At 12 weeks, the fetus is about 6.5 cm tall and weighs about 18 grams.

12-14. weeks: Nuchal translucency (NT) of the baby is measured by ultrasound. This measurement gives us information about down syndrome, genetic diseases and some heart diseases.

Week 16: The expectant mother has entered the second trimester of pregnancy. He’s starting to feel better now. Darkening of the skin, especially around the nipple, begins. Your abdomen starts to become noticeable. During this quarter the expectant mother should gain 5 to 7 kilos. The baby is about 16 cm tall and weighs about 140 grams.

16-19. These weeks are the most critical period for the detection of anomalies. It is the interval of weeks in which a triple or quadruple test is performed.

19-24. weeks: The mother’s belly is now becoming more pronounced. The baby’s movements begin to be felt. As the baby grows, the mother’s appetite increases. Breasts are well grown and plump. Some milk may come from the nipples. Bleeding may occur in the gums. The baby is about 15 cm tall and weighs about 350 grams. In these weeks, when the organs of the baby are completed and reached certain sizes, the possibility of fetal abnormalities is increased by the second level detailed scanning ultrasound.

Week 24: Blood pressure and weight monitoring from this period is more important. Disruption of sugar metabolism is a common condition during pregnancy and usually occurs after this week. From this week, the sugar loading test is performed and measures are taken if there is pregnancy sugar. During this period the expectant mother becomes more sensitive to heat, loses more water than a normal person, so she should try to get more fluids.

24-28. weeks: The baby starts to see and close his / her eyes during these weeks. It can hear sounds, react to loud sounds. She can frown, open and close her mouth. He starts kicking. Irregular sleep periods are experienced. It absorbs the thumb, swallows the surrounding amniotic fluid. Starts breathing movements. The sense of taste develops during this period. It is thought that his personality improved after the 7th month.

28th week: The overweight of the expectant mother begins to increase in the hips and thighs. As the uterus grows, pressure starts to cause stomach burns, digestive difficulties and cramps. Pink-purple cracks start on the abdominal skin. There may be short-term and irregular contractions called pseudo-birth pains, but they usually do not cause pain. By the 28th week, the expectant mother should gain approximately 7-8 kilos, and then she can gain 3-4 kilos. The ideal weight range during pregnancy is 8 to 12 kg. The baby is about 25 cm tall and weighs about 900 grams.

Week 32: The baby has a fully proportioned body during this period. Although it is premature birth, babies can be kept alive by intensive care and necessary precautions. As the baby grows, it may put pressure on the internal organs of the expectant mother, causing respiratory distress or frequent urination. Your mother’s sleep may be disturbed, she may not be as comfortable as before. As the joints around the pelvis dilate to prepare for delivery, discomfort or pain may be felt in the abdomen and legs. This week, the baby is about 40 cm tall and weighs 1600 grams. The mother’s weight gain slowed down.

Week 36: Infant development is almost complete now, if born prematurely can live without medical support. The baby’s head begins to enter the pelvis, cannot move in the abdomen as much as before, but the kicks increase. The baby is about 46 cm tall and weighs 2500 grams. Swelling of the mother’s ankle and varicose varices become apparent. During this period, checks are carried out once a week until delivery.

Week 40: This is the expected delivery week, but delivery may take place 2 weeks before or 2 weeks after this date. There may be irregular and sparse pseudo-labor. The baby’s movements decreased compared to the previous period; however, the movement of the baby less than 10 to 12 times a day indicates that the baby may be in trouble, and the doctor should be consulted before checking.

Beginning of labor: Real birth pains are those that come at regular intervals, spread from the waist to the groin and the entire abdomen, causing abdominal stiffness. Prior to this, a bloody and slimy vaginal discharge, called engagement, may come. After the onset of pain, sometimes even before it starts, the amniotic fluid can be discharged: the arrival of the water is an indication that birth has begun. If the birth does not start spontaneously after the 41th week, it is initiated by the doctor.

When to apply for a doctor?
Intense vaginal discharge or burning sensation when urinating
Rise of fever
Severe abdominal or groin pain
Vaginal bleeding
Decrease or not feel baby movements
The arrival of water
Feeling rhythmic contractions (pain)
Diffuse body edema (swelling), visual disturbances, severe stomach pain or headache
Birth pain does not start despite the expected date

Common Problems in Pregnancy:
Strain sensation in the breast: Due to hormonal changes, blood flow to the breasts increases, milk channels grow and develop. The breast should be supported using appropriate bra. From 20 weeks onwards, a milk-like fluid may come from the breast. You shouldn’t squeeze the breast.

Weakness, feeling of tiredness and desire to sleep: During the first three months when the body tries to get used to pregnancy, the desire to sleep continuously, feeling of tiredness and weakness are considered normal. Sleep patterns return to normal after the first three months. In late pregnancy, insomnia may be experienced due to the baby’s movements and desire to urinate frequently. It may be useful to take a warm shower, drink a warm glass of milk or read a book before going to sleep. Tea, coffee, cola drinks should be avoided.

Weight gain: It is one of the most obvious changes in pregnancy. A pregnant woman who starts the pregnancy at normal weight, ideally 8 to 12 kg with balanced nutrition. pounds between. The normal weight gain in the first 3 months is only 1 kilogram.

Nausea and / or vomiting: It is generally thought to be caused by the hormone Hcg secreted during pregnancy; With the effect of pregnancy hormones may also increase with late emptying of the stomach and emotional stress and fatigue. After 12 weeks, it disappears by itself. It can rarely start after the 3rd month and continue throughout the pregnancy. In the first pregnancy, more nausea and vomiting are observed in young women and twin pregnancies.

It is recommended that the stomach does not remain empty, feeding slowly and frequently, consuming dry foods, and avoiding spicy, fatty, fried foods. Also drink plenty of water. Small meals should be made during the day and the stomach should be kept completely empty or completely full. In the morning, you need to get out of bed slowly and have some dry stuff like galeta-cracker-chickpeas at your bedside: snacks can help.

Nausea and vomiting is very severe and reduced intake of food is called hyperemesis gravidarum. In this case, the doctor should be consulted: anti-nausea drug, antacid and vitamin B6 should be started by the doctor. In very severe cases, hospitalization and treatment may be necessary.

Frequent urination: It is common in the first trimester and in the last trimester. The reason is the capacity of the growing uterus due to pressure on the neighboring bladder. With less urine than normal, the feeling of filling in the bladder occurs. In case of complaints such as burning and tingling while urinating, a doctor should be consulted considering the possibility of urinary tract infection.

Appetite changes: Increased appetite increases as pregnancy progresses due to increased nutritional requirements. The fact that this is especially against a certain food is called craving among the people. There is no medical explanation for this. The expectant mother may desire a food that she does not normally like or may be disgusted with a food that she loves very much.

Inguinal pain: In the very early stages of pregnancy, there may be pain in the groin, hip and lower back. There are several reasons for this: The fetus is buried in the uterine inner wall, and mild pains like menstrual pain may be felt when settling. In the later stages, as the uterus expands, the elastic tissues that hold it stretch to accommodate this development, which can be felt as pain. A warm bath, relaxation and relaxation exercises are helpful. However, if the pain is severe, accompanied by fever or bleeding, consult a doctor.

Palpitations and blood pressure problems: During pregnancy, the blood-forming fluid (serum) and blood cells increase significantly. The burden on the heart increases by 50% compared to the condition before pregnancy. All of these changes take place in order to deliver sufficient nutrients and oxygen to the fetus. This increases the heart rate slightly. A slight decrease in blood pressure during the first half of pregnancy may result in a fainting sensation. If palpitations are very severe and prolonged, the cause, particularly anemia and heart valve diseases, should be investigated.

Gastrointestinal complaints: During pregnancy, the effect of the hormone progesterone relaxes the smooth muscles of the stomach and intestines. The astringent muscle between the esophagus and stomach relaxes. Therefore, it is easier to get the acidic stomach contents into the esophagus. The time the food passes from the stomach to the intestine is prolonged. The uterus that grows during later pregnancy compresses the stomach upwards. Heartburn, souring and bloating are common complaints in pregnant women. Small amounts and frequent meals, fatty and acidic foods should be avoided. After eating, do not go to the supine position for at least 2 hours.

Another important problem is constipation. It occurs as a result of slowing of the gastrointestinal movements during pregnancy and compression of the uterus into the rectum. Plenty of liquid food (water, soup, juice, juicy food), pulp foods (vegetables, legumes, fruit, salads, whole wheat bread) should be eaten. If constipation is prolonged, it may cause hemorrhoids. Painful and bleeding swelling occurs in the breech area. In this case you should consult a doctor.

Gingival changes: Swelling and pain occur during pregnancy due to textural changes in the gums. Easy bleeding during brushing. Teeth should be brushed frequently, massaged and a toothbrush of appropriate softness should be selected.

Varicose veins: Increased pressure in the abdomen during pregnancy slows the rate of return of blood from the feet to the heart with veins. Varices, which become more prominent in the last months of pregnancy, can be seen in the legs and genital area. Avoid standing still for long periods of time. It is useful to sit with the legs raised. Small movements to exercise the legs, regular exercises can be done. Varicose veins are used for pregnant women.

Edema: Depending on the increase in the amount of fluid in the body, edema (swelling) of the legs, swelling of the feet and back may occur in recent months. Prolonged standing increases this situation. It is recommended not to stand up for a long time, to wear tight underwear and to wear elastic socks to ease the edema of the feet. Care should be taken for pre-eclampsia (pregnancy poisoning) if edema is apparent in the hands and face. Blood pressure measurement and urine protein should be consulted for a doctor.

Cramps: One of the complaints that occurs after the first half of pregnancy. It usually happens at night, and sometimes it is severe enough to wake you from sleep. Less physical activity, more overload, can cause inadequate intake of calcium and magnesium. Appropriate exercises, consuming plenty of milk and dairy products reduce cramps. It is made of calcium and magnesium supplements. Warm application to the legs can be relaxing.

Low back and back pain: Increasing weight with progressive gestation causes a change in position in the spine. The back and back vertebrae are formed by an inward slope, and the muscles around the spine remain muscular for a long time to maintain this condition. However, the joints between the bones in the hip region soften and relax: this is a preparation for the baby to pass through the region during delivery.
Supporting the waist with an appropriately sized pillow while sitting, wearing orthopedic shoes (should have light heels), and lying on an orthopedic bed that is not too soft can reduce these symptoms. Correct posture is important: posterior shoulders and upright posture reduce pains. It may be useful not to cross your legs while sitting, but to place your feet higher. It is important to lift the weight correctly: it is important to take the kneeling on the knees, lifting the hip up, not the back, so that the weight is upright. When lying on the knees and hips curved, the side lying position should be preferred; Taking a pillow under the knees and abdomen relieves pressure in the lower back area and relaxes the pregnant woman. Exercises to strengthen the abdominal muscles help reduce back pain.

Discharge: There may be a significant increase in vaginal discharge during pregnancy. This normal discharge is colorless and odorless. If the discharge is yellow-green and smelly, if there is burning in the vagina or if there is a discharge such as milk with itching, consult a doctor. If vaginal infections during pregnancy are not treated, they may cause unwanted conditions such as premature birth and early arrival of the baby’s water. General hygiene rules also apply during pregnancy: underwear should be changed daily, toilet cleaning should be done from the reservoir to the rectum, the vagina should not be washed inside, deodorant and perfumed products should not be used.

Skin changes: Due to the regional increase in melanin pigment, which gives the skin color with the effect of hormones during pregnancy, skin changes may occur, especially skin color darkening or skin blemishes. It is necessary to be protected from sunlight. These spots will disappear after birth. Skin moles may increase in size and darkness of color.
Cracks may occur due to rapid weight gain, especially in the abdomen. The depth and amount of these cracks are closely related to the skin’s ability to flex. Drinking water and using creams that moisturize the skin will reduce them.

Skin itching is usually caused by stretching the skin. It may be beneficial to take a warm shower and use moisturizing cream. In case of persistent itching, there may be other underlying problems.

Numbness and tingling in the hands and fingers: It is caused by compression of the nerve fibers in the wrist due to edema (carpal tunnel syndrome). Especially in the morning becomes apparent, the intensity decreases during the day. In some very severe cases, the splint provided by the physical therapy side may be required to reduce the pressure.

Psychological changes: Excessive susceptibility, sadness, irritability and sleep disorders may be thought to be caused by hormonal changes. The family’s support in this regard is considerably relaxing.

Drug use in pregnancy: This is the period in which the organ development of the fetus is the fastest and the most affected by external factors between the 30th and 60th days since the last menstrual date. During this period, the drug is not used unless it is very necessary and the doctor considers it necessary. In the first month, all or none of the laws apply to the medications used: that is, pregnancy results in a miscarriage or continues healthy without being affected at all.

Pregnancy and sexuality: During pregnancy, except for certain situations, there is no prohibition for sexual intercourse up to the last three weeks. Sexual intercourse is prohibited in cases such as vaginal bleeding, threat of miscarriage, threat of premature birth, opening of the amniotic sac, and the partner being a carrier of sexually transmitted diseases.

Pregnancy and travel: Pregnancy is not an obstacle to travel. Frequent breaks should be given during the trip, walk should be done during break and drink plenty of water. Air travel is OK; however, it is necessary to have a medical examination before: After the 28th week, in order to get on the plane, a report from the doctor bu no harm in getting this pregnant woman on board-is required.

Pregnancy and magnetic field: Devices used for security reasons at the entrance of buildings do not have any danger to pregnancy. If necessary, MRI can be performed for diagnosis in pregnant women.

Breast care during pregnancy: Breast milk is the most appropriate food for the baby. It is easy to digest due to its content. It makes a serious contribution to the baby’s immunity. It creates a strong emotional bond between mother and baby. It is necessary to realize the importance of breastfeeding during pregnancy. Preparations should be made for breastfeeding. Especially for the mothers who have problems at the nipple, moistening the nipple with suitable creams in the last month of pregnancy is ready for breastfeeding. In recent months, it is normal for a fluid similar to milk to come from the breast.

Down syndrome screening tests (double test, triple test, quadruple test) are not diagnostic tests; screening tests, that is, the baby can not say whether or not Down syndrome. These tests are risk analyzes that calculate the probability of down syndrome risk during pregnancy. If there is a problem with these tests, further tests – diagnostic tests (amniocentesis, CVS as well as chorionic villus sampling) are performed.

X-ray during pregnancy: Although it is known that high-dose radiation, such as cancer treatment, can harm the baby, low doses used for diagnostic purposes are unlikely to harm the baby. Nevertheless, it is best not to take any radiation during pregnancy, except in compulsory situations; In compulsory cases, it is more appropriate to perform after the first 3 months of pregnancy. It is not necessary to panic if the tooth or chest x-ray is taken for diagnostic purposes without knowing that she is pregnant, but the doctor should be notified and the radiation dose will be calculated according to the day of pregnancy.

Influenza and colds in pregnancy: Although the symptoms of flu and colds bothers the expectant mother, it does not harm the baby. Due to changes in the immune system, these symptoms may last longer in pregnant women. Regular feeding, frequent rest, avoiding contact with family members or persons with sore throat or fever, washing hands frequently can be done to avoid influenza. If the pregnant woman has the flu, the best way to cope is to take good care of yourself without taking medication. Abundant rest, plenty of fluids, moisturizing the room constantly, taking a warm bath, eating appetite, even if not the most important things to do. However: if the fever reaches 38.3 ° C, green and yellow mucus is removed, symptoms prevent sleep and eating, although the symptoms persist for more than a few days, it is necessary to consult a doctor.

Anemia in pregnancy (anemia): Increased needs of the baby during pregnancy increases the body’s iron needs. Iron is a very important element in the production of red blood cells. The need for iron doubles during pregnancy. During pregnancy, blood volume increases by approximately 45%. If there is not enough iron in the body, it cannot meet the need for increased red blood cell production and as a result anemia develops. Symptoms: fatigue, weakness, breathlessness, palpitations, dizziness and dizziness may be. Treatment is to take iron supplements.