当初怀大宝时真是一无所知，不知要找OB，也不知要做什么检查，更不知会碰到什么问
题。后来怀小宝时情况就不同了，至少在医院做完pregnancy test之后，我就自己选择了OB
，离我上班相当近。我曾担心从我家到医院开车要一个小时左右会不会太远，OB告诉我
即便是第二胎，从有反应到宝宝出生也要好几个小时，不会那么快的。
生个健康快乐的宝宝比什么都重要。怀孕期间准妈妈容易感到疲劳，情绪波动比较大，如果有早孕反应，饮食也是个问题。我的原则是尽量远离对宝宝可能有害的因素，心情放松。现将我可以想到的准妈妈可能比较关心的一些问题结合我的OB提供的一些材料写出来，仅供大家参考。具体还是要以各OB说的为准，不全的地方恳请大家补充。
1、孕期及产后检查
＊ 第一次见OB，付了co-pay，以后的常规检查没有付。第一次见OB，要做pap smear. 宝
宝心跳大概可在怀孕10周后听见，我是11周的时候第一次听到宝宝心跳的。
＊ B超通常在18周左右做一次，临检查前被要求去上厕所。主要是为了检查宝宝各组织器官的生长发育状况，也可能确定宝宝的性别。如果有什么concern或者问题，也可以做多次。
＊ 讨论AFP，可以选做，但不是必需的
＊ 28周左右做Glucose Screen and blood count，To look for diabetes and
anemia in pregnancy. 血糖一小时测试前要吃饭，在喝糖水一小时前进食即可；如果一小
时没过，三小时测试要求空腹。
＊ Rh Negative women will get a RhoGam injection at 28 weeks
＊ 每次见OB要检查体重、血压以及尿样。护士好象每次还问我有无疼痛之类，特别是
到了后期。平常OB就听听心跳，回答我提出的问题。见OB的频率：28周内每4周一次；28-36周每2-3周一次；36周到生，每周一次。
＊ 产后6周检查 pap smear以及讨论避孕问题
＊ 一年后复查 pap smear
2. 孕期反应
＊ 不适及身体的变化：
backache
Nausea and Vomitting
Constipation/Hemorrhoids
Minor abdominal cramping
Braxton-Hicks cotractions starting around 16 sweeks-irregular and feel like
menstrual cramps. They do not make changes in your cervix.
Swelling of the feet and ankles
Fatigure/dizziness
Frequent urination
Round ligament pain
Increased vaginal discharge(may use OTC Monistat for yeast infections)
Spotting, especially at expected time of menstruation, after intercourse, or
with yeast infection
Varicose veins
Breast fullness, tenderness, and leakage of colostrum
Weight gain of 25-35 pounds IF pre-pregnancy weight is within normal limits
for height. This is NOT all fat.
Mood swings
Nasal congestion
Excess Salivation
我当时比较明显的是早孕反应，一直持续到宝宝出生，见什么都没有胃口，瞌睡，体重
大概增了30磅。所幸没有任何浮肿的问题。
减轻早孕反应：起床之前吃几片饼干，早上起来先在床上坐一会儿再站起来，避免突然
动作；少食多餐；避免油腻食物；尽量吃一些含蛋白的食物。为了保证宝宝有足够的维生素摄入，我一直坚持吃prenatal vitamins，从知道怀孕直到宝宝断奶。
＊ 出现以下危险信号 需要联系OB
Abdominal pain/Severe cramping
Decreased or absent baby movement
Leaking of amniotic fluid (clear and watery-doesn\'t smell like urine)
Vaginal bleeding
Vision changes (blurry vision or seeing spots)
Severe headache
如果是临产，出现破水、宫缩达到一定频率或者见红(出血比较多)时要及时给医院打电
话，然后去医院。
3. 孕期禁忌
我当时是戒了咖啡及药物，虽然医生认为有些是安全的。前12周是宝宝生长发育的关键
期，还是尽量注意为好。除了吸烟喝酒对宝宝不好外，Hot tubs/saunas也不好，另外要注意别摔跤，开车也要特别注意安全。
＊ Alcohol, tobacco, & non-prescribed medications or drugs not safe during
pregnancy
＊ Saccharin (Sweet-n-Low)
＊ Limit NutraSweet to 1 drink per day
＊ Excessive caffeine(1 cup per day is okay)
＊ Douching
＊ Hot tubs/saunas
＊ Activities that may cause a fall, such as snow or water skiing or
horseback riding
＊ If you do fall, you may call the clinic nurse line for phone assessment
during during clinic hours. You may need to be seen quickly for monitoring.
If so, you should go to the Emergency Department. If you are less than 20
weeks, you may stay in the ED for evaluation. Pregnancies beyond 20 weeks
are typically sent from the ED TO OB Triage. You should not go to the clinic.
4. 孕期可以安全使用的药物
＊ Pain: Tylenol
＊ Cold Symptoms: Chlortrimeton
Sudafed: Only after 12 weeks and if you don\'t have high
blood pressure problems
Robitussin (plain only)
Cough drops (Sugar-free if diabetic)
Benadryl
Chloraseptic Spray or throat lozenges (use sugar free
lozengers if you are diabetic)
＊ Nasal congestion: Saline nasal spray
＊ Allergies: Over-the-Counter Claritin
＊ Heartburn: Tums/Mylanta/Maalox/Rolaids/Zantac
＊ Constipation: Metamucil/Colace/Milk of Magnesia/Fiabercon/Pericolace
＊ Diarrhea: Immodium/Kaopectate
＊ Hemorrhoids: Preparation H/Annusol/Tucks/Sitz baths
＊ Yeast Infection: Monistat 3 or 7 day
＊ Rashes/Itching: Hydrocortisone 1% Benadryl cream
＊ Asthma: Prescription inhalers may be used
＊ Prenatal vitamins: (with 1000 micrograms Folic Acid) 我吃的prenatal vitamins含叶酸是800mg
5. 孕期饮食问题
＊ Do not eat hot dogs, deli and luncheon meats unless they are reheated
until steaming hot and eaten while still hot.
＊ Do not eat soft chesses such as Feta, Brie, goat, Camembert, blue-veined
cheeses, and Mexican-style chesses such as queso fresco or queso blanco. You
may eat hard chesses like cheddar, semi soft chesses like mozzarella, or
any pasteurized cheeses like slices, spreads, cream chesse and cottage
cheese.
＊ Do not eat refrigerated pates or meat spreads. Canned or shelf-stable are
okay to eat.
＊ Do not eat refrigerated smoked seafood, unless it is cooked in a dish
like a casserole. Canned shelf-stable smoked seafood is ok.
＊ Stay away from eating alfalfa sprouts. They are too difficult to clean
well and may harbor bacteria.
＊ Sushi is ok if it is either cooked or vegetarian. NO RAW FISH.
＊ Pay close attention to the expiration dates on your foods.
＊ Avoid cross-contaminating other foods, utensils, cutting boards and
preparation surfaces
＊Wash your hands with hot soapy water for at least 20 seconds after
handling any of these foods or raw foods. Also wash cutting boards, dishes,
and utensils to prevent cross contamination
＊ Eat foods that are high in long acting proteins such as milk, yogurt,
cheese, peanut butter and nuts. Avoid greasy, highly seasoned and fried
foods. Drink fluids, including soups, between, rather than with, meals.
6. 其他常见问题
对怀孕期间烫发、染发、看牙医、涂料气味、养猫、旅行、清洁剂、sex等有疑问的JMs可以从下面找到答案。
＊ Perming Hair, Hair Coloring, Hair Highlights
Generally considered sage after the first trimester （12－14 weeks）.
Processing may be different due to hormonal changes.
＊ Chemical Extermination
Vacate home for 48 hours after extermination.
＊ Dental Care
Regular dental check-ups are expecially important during pregnancy.
Novocain is allowed as long as it contains no epinephrine. No X-Rays should
be done unless absolutely necessary and your mid-section is shielded with
lead, from and back. If you need antibiotics prior to dental work, most are
safe.
＊ Cats and Cat Litter
Exposure to cates is not a problesm during pregnancy. Pregnant women
should not change litter boxes or be exposed to cat feces.
＊ Household Cleaner Exposure
These are not harmful to pregnant women if gloves are worn to prevent
exposure to skin and cleaners are used in well ventilated areas.
＊ Sunscreen Use
Use sunscreen with at least SPF 15 or greater when exposed to sun. Reapply
sunscreen every 30 minutes during prolonged exposure.
＊ Painting Inside the Home
Not dangerous if done in a well ventilated area.
＊ Gardening
Safe as long as gloves are worn.
＊ Travel
Unless you are on bed rest or have been instructed otherwise, car or air
travel is safe until 34 weeks. It is important to walk every hour. If flying
, drink large amounts of water, as air travel dehydrates the body quickly.
＊ Sexual Intercourse
Safe until you deliver unless have been advised otherwise by your doctor
or you have any of the following problems:
Water has broken
Incompetent cervix
Placenta previa
Preterm labor
最后提一下孕期的锻炼问题，原则上怀孕期间锻炼还是很安全的，并且可以减轻早孕反应、增加体力、降低压力、加快生产以及产后恢复，但要注意以下几点：
＊ Increase water intake before, during and after exercise.
＊ Wear a supportive bra.
＊ Do a 5 minute warm-up and a 5-10 minute cool down.
＊ Low impact, such as walking and swimming, is best.
＊ Avoid brisk exercise in hot/humid weather.
＊ Intensive exercise should last no longer than 15 minutes.
＊ Keep your heart rate at 140 or below.
＊ AVOID:
deep knee bends
full sit ups
double leg raises
Straight leg toe touches
After 20 weeks (5 months), no exercises that require you to lie on your back for more than 5 minutes.
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