Saturday, October 14, 2017

简单说说耻骨联合分离 (附孕期疼痛及处理的有关资料)


一、什么是耻骨联合分离?

耻骨是位于骨盆前方的两片骨头,中间有空隙而非紧靠在一起。两片骨头间靠韧带及纤
维软骨组织联接起来,这个区域就叫耻骨联合。未怀孕的女性,其两片耻骨间的正常距
离为4—5mm;孕7-10周时分泌松弛素,可使骶髋关节和耻骨间纤维软骨及其韧带变得松
弛,耻骨间隙较未孕时增宽,两者间的距离至少会增加2-3mm,使得骨盆的伸缩性变大
以给予胎儿更多的成长空间。到了妊娠晚期,耻骨联合中间的缝隙甚至可增宽至0.3
~0.4厘米,以便为分娩时胎头能顺利娩出做好准备。因此耻骨联合分离几乎会发生在
所有妊娠的女性身上。

耻骨联合的上述变化,大多数孕妇都会安然无恙,只有当耻骨分离过大时,才会出现牵
拉痛,尤其在行走、上下楼时,由于身体重心偏向一侧,造成耻骨错缝,牵拉耻骨间的
纤维及韧带,故而更易引起疼痛。有些准妈妈可能由于对上述激素的敏感度太高,使得
耻骨联合区域非常松弛,两者之间的距离超过10mm;或因骨盆的大小、排列有问题,让
这个关节处承受了较多的压力,而导致了耻骨联合过度分离的发生,于是就感觉到了大
腿根部的疼痛。

产妇大都在分娩后黄体素分泌恢复正常,松弛的韧带及软骨也随之恢复正常。可在0.05
%-0.1%的产妇中,因内分泌(黄体素)分泌过多,致使韧带过度松弛,产时两侧骶
髂关节及耻骨联合易发生分离。产程过长,胎儿过大,产时用力不当或姿势不正,以及
腰骶部受寒等多种因素,造成产时或产后骨盆收缩力平衡失调,有可能使骶髂关节软骨
面发生错位。因骶髂关节的关节面粗糙,在形态上变化较多,易发生关节细微错位。由
于上述因素,造成产后骶髂关节错位,致使耻骨联合面不能恢复到正常位置,经过一段
时间未能自行回复,症状加剧者,就形成了产后耻骨联合分离症。

本病很少因单纯的外力所致,主要见于妊娠后期和产后妇女,尤其在分娩前,由于内分
泌因素影响,使耻骨联合韧带松弛是本病发生的内在因素。怀孕后期,由于胎儿重量压
迫骨盆造成耻骨联合分离,或在分娩时,如果产程过长,胎儿过大,接生粗暴,使松弛
的耻骨联合韧带发生损伤,产后耻骨联合不能恢复到正常位而发生分离。

二、有什么症状?

耻骨联合分离表现为耻骨联合局部突然发生的疼痛,常可听到撕裂声,疼痛可放射到腰
部、股部或腿部。活动时(散步或弯腰时)会产生一种蹒跚步态,在耻骨联合上方可触
及裂口,少数人可伴有局部软组织肿胀和血肿,阴道检查也可触及耻骨联合分离。骨盆
挤压分离试验可导致耻骨联合部位疼痛。诊断主要依靠临床症状和体征,X线对诊断意
义不大.

临床以耻骨联合处疼痛,且有明显压痛,单侧下肢不能负重,行走无力,双下肢抬举困
难,腰臀部酸痛为主要表现。如让患者仰卧,医者双手重叠置于耻骨联合处,垂直向下
压挤,可感觉疼痛。疼痛严重者,两下肢外展与起坐也发生困难,甚至不能行走。临床
症状主要有:

①大腿根部耻骨联合疼痛,在负重、登高、远行时加重;

②行走时重心移动缓慢,影响步行速度,步态呈鸭步;

③部分病人会出现腰背部、腹股沟区疼痛。

三、为什么会发生耻骨联合分离?

耻骨有左右两块,合抱构成骨盆前缘。耻骨间有纤维软骨相连并有韧带加固,平时不易
活动。孕后由于激素的影响,两耻骨稍有分离,使胎儿将来能顺利娩出。 但是,若耻
骨分离较大,便会在行走尤其是举步上楼时引起牵拉痛。因为上楼时后腿着地,身体重
心偏向一侧,左右耻骨错缝,牵拉纤维软骨和韧带,以致疼痛。若分离严重,韧带撕裂、
水肿,就不能行走。

当耻骨联合分离大于1cm时,相当于耻骨联合部分或全部分离,往往普遍出现症状,并
需要治疗。耻骨联合分离的发生率为0.2%~0.03%。胎头下降对骨盆包括柔软的耻骨韧
带的压迫;自然分娩中宫缩强度及分娩速度的影响,可能是耻骨联合分离的原因。与耻
骨联合分离有关的病因学因素包括:

1.难产或急产;

2.困难的产钳分娩;

3.头盆不称;

4.先露异常;

5.经产妇;

6.产时大腿受压或过分外展引起的大面积损伤;

7.既往有骨盆外伤史

8.先天性发育异常;

9.软骨病;

10.软骨软化;

11.佝偻病;

12.结核;

13.关节炎;

14.妊娠期激素水平升高所致的韧带柔弱

15.双胞胎、孕妇体重超标、巨大儿 


四、如何处理?如何防治?

发生耻骨联合分离而产生疼痛后,最重要的措施是卧床休息,减少活动,也可以用绷带
固定而减轻疼痛。耻骨联合分离常常同时合并耻骨联合关节软骨炎,所以也可抗炎治疗。
疼痛严重者还可以用麻药局部封闭治疗。总之,妊娠晚期耻骨疼痛是由于耻骨联合分
离而引起的,分娩后疼痛会逐渐好转。

通常采用保守治疗就可使功能完全恢复,很少需要手术治疗。产后绝对卧床休息,一般
取侧卧位。卧床时间依症状轻重、软组织受累情况及分离程度而定,并可用骨盆腹带绷
紧骨盆,或采用骨盆复位术等治疗。症状常在产后8周消失。临床上仅对复位不适当、
再次分离或症状持续存在的患者方考虑外科手术治疗。与耻骨联合分离有关的并发症有
骨不连、耻骨关节炎和耻骨骨炎、出血和感染,但极少见。耻骨联合分离一般不影响以
后的妊娠,但有些患者在以后的妊娠中尤其晚期妊娠时可感到耻骨联合部位疼痛。

1.妊娠期的防治与护
  
孕妇耻骨分离症的关键在于预防,应做到:

● 平时积极参加体育锻炼,以增强肌肉韧带张力

● 孕妇在妊娠期间可适当做些屈伸大腿的练习,但要避免作腰、臀部大幅度运动和其
他剧烈运动。

● 若骨盆某关节患有结核、风湿等病症时,应在治愈后再妊娠。

● 孕期营养要适中,防止胎儿因胎头过大而在分娩时加重耻骨分离。

耻骨联合分离的患者在妊娠期的防治与护理主要措施有:

● 用宽25~30cm弹力束带束缚骨盆,增加骨盆承重能力。束带上缘不要高于耻骨联合,
以免压迫腹部,影响胎儿生长发育。束带松紧度以骨盆能承受为标准,同时不严重影
响下肢静脉回流。白天站立或工作时应用,夜晚及卧床时放松,同时抬高下肢,利于静
脉回流。

● 减少下蹲、负重工作,减少站立、行走时间。

● 上、下午各增加1h休息时间,卧位休息时以侧卧为主。

● 饮食中添加高钙食品,增加日照时间,利于钙质吸收。

● 多与产妇沟通,解除其思想顾虑,做好心理护理。 

2.产后的治疗与护理

生产后的患者的治疗与护理方法主要有:

● 红外线灯照射耻骨联合,每日2次,每次30min;

● 弹力带束缚8周或骨盒牵引8周;

● 避免劳累、负重,增加卧床休息时间,以侧卧为主;

● 穿平底鞋,鞋底要柔软、舒适,避免穿带跟的硬底鞋,以免重心不稳增加疼痛;

● 使其保持愉悦的心情,告之产妇良好的心态能增加机体免疫力,有利于身体的快速
康复。

3.推拿治疗

本病推拿治疗的原则为整复错位,活血通络。基本手法如下:

● 患者俯卧,在腰臀部用攘法治疗,配合按揉八 、环跳、大肠俞、关元俞穴及下肢
后伸活动,手法宜轻柔
   
● 患者仰卧,单侧下肢和双侧下肢屈膝、屈髋,医者一手扶膝关节,一手扶踝关节处,
行髋关节摇法,然后牵引双侧下肢1~2分钟
   
● 让患者坐于床边,身体微向后仰,左手按在耻骨联合处,一助手在背后扶其背部,
另一助手站在患者前方,面向患者,两手握住患者双踝部,使双大腿外展外旋,双小腿
内收内旋,两足跟靠近臀部。医者坐患者左侧,以右髋部紧贴患者的左髋,右手紧按患
者对侧髋部,左手握住患者右手腕部,置于患者左手上部。医者令握踝部的助手迅速将
双腿向前拉直,与此同时,术者左手拿患者右手拍打和按压置于耻骨联合上的左手,医
者右手拉按患者右髋部,使之向内归合。以上手法重复2~3次,轻者1次可愈,重者隔3
日治疗1次。

4.妊娠耻骨联合分离从肾论治

● 补肾助阳强骨法 用治本病兼见腰脊疼痛,下肢痿弱,怕冷,肢凉无力,食少便溏,
尿清而长,舌体胖有齿痕、苔白者。可予巴戟天、狗脊、补骨脂、骨碎补;腰痛甚加
杜仲、续断、菟丝子;多尿加益智仁、覆盆子

● 滋阴补肾养骨法 用于治疗本病兼见手足心热,易汗出,头目眩晕,或口干,或耳
鸣,舌质红,脉虚数等症者。宜投生地黄、熟地黄、何首乌、沙苑子、女贞子、旱莲草、
枸杞子、山茱萸、龟板;若有潮热可酌加知母、地骨皮、牡丹皮。

● 益气生血活血法 妊娠耻骨联合分离多伴气血不足,或因命火不足以温煦中土致脾
运失健,可投黄芪、当归、茯苓、炒白术、党参或太子参、炮干姜、木香、山药、鸡内
金、紫河车;有气虚下陷之征加柴胡、升麻、甘草;寒重加肉桂 。若属耻骨联合分离
延至产后不愈者,经调治待气血旺,五脏充,肾气足,可再施以活血健骨之品,如丹参、
赤芍、苏木、鸡血藤、郁金、川芎、桃仁、红花;痛剧可酌加乳香、没药、蒲黄、五
灵脂。


五、如何预防与自我护理?

1.如何做好预防

耻骨分离是孕妇正常的生理现象,在正常情况下没有必要进行治疗。但为了防止耻骨分
离给孕妇带来较大的痛苦还是做到无病先防、患病早治。

● 重视孕期检查。要提高孕期检查的认识,定期了解耻骨分离的具体情况。

● 加强体育锻炼。多活动可增强肌肉与韧带的张力和耐受力,怀孕后经常进行适宜的
伸展大腿运动,碎步行走,以减轻耻骨分离引起的疼痛。

● 做好医学咨询。最好在怀孕前咨询一下丈夫,诸如罹患关节结核、相关关节曾经严
重损伤、严重的风湿性关节炎、骨软化症等,应在治愈后再生儿育女,不宜冒险生育。

● 注意适当休息。当妊娠月份较大时,耻骨分离较大时,应适当减少不适宜的活动。
产后避免过早起床,避免较大的活动幅度。诸如提拿重物、抬重物等均不适宜,以防止
扭伤骨盆,发生或加重耻骨分离。

● 照特殊孕妇。对于双胞胎、巨大儿或孕妇体重超重者,要给予特别关照。因这些孕
妇体重总量大,耻骨所担负的重量也自然增大。对于胎儿过在者,应合理饮食,以免营
养过剩,造成胎儿过大过重等发育异常,导致耻骨分离。

● 产后应避免过早起床或在床上扭动腰臀部,也不宜用布带紧裹腰身,以免起床或活
动不便而扭伤骨盆,加重耻骨分离。

2.如何自我护理?

● 不要强忍疼痛。如果某些动作让你感觉疼痛,可能的话,尽量避免这些动作。如果
你让这种疼痛恶化下去,可能需要很长时间才能恢复。 

● 经常做小幅度的动作。因为你在做一些动作的时候,可能不会马上感觉到它的后果,
但等到晚一点或睡觉的时候,你就会有感觉了。 

● 经常坐下来休息,坐下时,尽可能直立后背,并给后背一个很好的支撑。 

● 避免提举或推重物(超市的购物车可能会让你特别疼痛)。 

● 爬楼梯的时候,一次迈一个台阶。先将比较有力或方便的那条腿踏上台阶,然后再
迈另一条腿。上每级台阶时,都重复这个动作。 

● 避免使双腿持续分开的动作,比如上下汽车,或进出浴盆等。如果你必须分开双腿,
一定要小心地、慢慢地移动。 

● 尽量避免蛙泳,采用其他泳姿游泳时,也要小心。人们经常认为游泳能起到帮助作
用,因为人在水里时会比较舒服,可是当从水里出来后,疼痛就会加重。 

● 经常做骨盆底肌肉运动和小腹运动,能帮助缓解怀孕对骨盆造成的压力。你可以做
一些安全简单的小腹运动,首先将手和膝盖着地,趴在地上,使背部与地面保持水平。
吸气,然后,呼气时收紧骨盆底肌肉,同时,尽量向上收起肚脐。保持这种收缩姿势5
~10秒钟,不要憋气,背部保持不动。运动结束时,慢慢放松肌肉

● 睡觉时在两腿之间放一个小枕头。

● 在床上翻身,移动脚和臀部时,要尽量平行、缓慢地移动。

● 身体状况允许的话,可通过游泳来减轻关节的压力。

● 站立时两腿要对称性地站着。

● 穿内裤和长裤时坐下来。不要站着抬腿穿裤子或裙子。避免跨坐。

● 早晨起来,尽量坐着穿衣。

● 冷敷,放置冰袋在耻骨区。

● 穿平底鞋,孕妈妈的鞋底要柔软、舒适,避免穿带跟的硬底鞋,以免重心不稳增加
疼痛。

● 坐着时在背后放置腰枕

● 接受下背按摩。

● 束缚骨盆:用宽25—30cm的弹力束带束缚骨盆,增加骨盆的承重能力。束带上缘不
要高于耻骨联合,以免压迫腹部,影响胎儿的生长发育。束带松紧度以骨盆能承受为标
准,同时不严重影响下肢静脉回流。

六、分娩方式的选择

一般来讲,病情轻,胎儿不大,则不会影响分娩。若病情严重,胎体过大,则应剖腹产。
胎儿娩出,雌激素水平下降,耻骨联合处逐渐合拢,恢复原状,疼痛也就随之消失。
不过,产假期间还是应少走多卧,不作重体力劳动为妥。因此并不是发生耻骨联合分离
就一定要剖腹产,不过医生通常建议首选剖腹产,这是因为:

1.分娩过程中,产妇因耻骨联合疼痛而不敢用力,宫缩不佳,影响产程进展,增加分
娩时间,给母婴的健康带来危害。

2.产后病情加重,影响产妇的身体恢复,导致产后生活质量下降。

3.因产后生活不能完全自理,行动受影响,产妇情绪易焦燥、忧郁,增加产后忧郁症
的发生。

4.耻骨联合分离影响产妇对婴儿的哺育,影响母子之间情感交流。


七、注意事项

局部要保暖防寒,避免外伤和性生活,以利于康复。治疗期间腰及下肢不宜作大幅度的
活动。

★ 分娩时的注意事项:

在生产的方式上,除非孕妇有严重的耻骨联合过度分离,疼痛非常厉害或骨盆偏小,可
以考虑采取选择性的剖宫产,一般还是以自然生产为主,但是在生产的过程中,有几点
还需特别注意:

1.事先告知病情:生产前要告知医护人员耻骨联合分离的病情。

2.小心生产姿势:需要特别小心生产的姿势,产时避免两脚过度张开。

3.避免介入性分娩:避免平时常使用的一些介入性分娩方法,如产钳,因为它们常造
成耻骨联合处的伤害



★ ★ ★  孕 期 疼 痛 不 容 忽 视  ★ ★ ★


一、孕期各阶段的疼痛  

1.早期妊娠
  
早期妊娠时,准妈妈往往会出现早孕反应的头痛、胃脘部烧灼痛、胸骨后或上腹部疼痛、
乳房发胀有刺痛等症状

早期先兆流产以及宫外孕会引起腹部剧痛,先兆流产还会伴有阴道流血。准妈妈一旦出
现不明原因、且无法缓解的腹部剧痛,甚至出现阴道流血状况,必须立即前往医院就诊。
  
● 头痛
  
部分女性在怀孕早期可能发生头痛现象,这种症状属于常见的早孕反应。在头上敷热毛
巾,能有效缓解头痛。
  
● 胃脘部烧灼痛
  
随着子宫逐渐变大,准妈妈的肠胃增加了很大的压力,而且荷尔蒙使隔离食道和胃的肌
肉变得松弛,从而导致胃酸容易向上翻涌,并使胸部产生灼热感。为了缓解胃部疼痛,
医生通常会建议准妈妈每日少食多餐,少吃酸辣食物,饭后半小时内不要躺倒(吃饭时
尽量坐直,这样胃酸就不会向上走)。如果你晚上经常胃痛,可以请医生为你开一些抗
酸剂,在睡前服用。 
  
● 乳房发胀有刺痛
  
由于从妊娠早期乳房就开始增大,充血明显,因此,准妈妈会感觉乳房发胀有刺痛。所
以随着孕周的增加,选配适当的胸罩可减轻这种感觉。
  
2.中期妊娠
  
中期妊娠时,准妈妈往往会出现圆韧带牵拉痛、腿痛、子宫不规则无痛性收缩感觉。
  
如果准妈妈出现不明原因、且无法缓解的腹部剧痛,甚至出现阴道流血状况,可能是晚
期先兆流产所导致的,准妈妈须立即前往医院就诊。
  
● 圆韧带牵拉痛 
  
怀孕中期以后,随着子宫逐月迅速增大,子宫四周的韧带由原来松弛状态变为紧张状态,
尤其是位于子宫前侧的一对圆韧带,由于过度牵拉,可能造成牵引胀痛。但是疼痛不
会太重,仅是轻微抽痛。这种情况不须特别治疗,只要注意休息就可以了。
  
● 腿痛、抽筋
  
进入怀孕中期,准妈妈的小腿和大腿的后面,可能会发生疼痛,与坐骨神经痛相似,如
果准妈妈同时还患有下肢静脉曲张,则疼痛会更加剧烈。
  
从怀孕5个月开始,双腿还可能发生痉挛抽筋,尤其是在夜间易发作,往往把进入梦乡
的孕妇痛醒。适量补充钙片或维生素B可以减轻症状。如果症状较重,应当卧床休息,
或去医院检查。
  
● 子宫不规则无痛性收缩

自妊娠12周起,子宫会出现不规则无痛性收缩,这种收缩在腹部检查中可以感觉到,有
时准妈妈自己也能感觉到。准妈妈们会觉得腹部一阵阵发硬,但是无疼痛感觉。这种情
况不必紧张,只要注意适当休息即可。 

3.晚期妊娠

到了晚期妊娠后,准妈妈们觉得负担日益加重,诸如上肢疼痛麻木和无力、耻骨联合疼
痛、坐骨神经痛、外阴肿胀疼痛、痔疮痛、尿痛、牙龈肿胀疼痛出血……
  
●上肢疼痛麻木和无力

准妈妈妊娠晚期可能会感到单侧或双侧手部阵发性疼痛、麻木,有针刺或烧灼的感觉。
这是由于怀孕期间分泌的激素,尤其是松弛素会引起筋膜、肌腱、韧带及结缔组织变软、
松弛,同时累及神经所造成。手部有浮肿时或过度伸或屈腕时可触发症状。

准妈妈要减少使用电脑的时间,如果不行可以买一个腕托安在电脑键盘上(这样可以减
轻对腕神经的压迫)。

当感觉手指上有针扎般的疼痛时,轻轻按摩手指5分钟。上肢疼痛、麻木和无力多在夜
间发病,因此,睡觉时最好在手和手腕下垫一个枕头。

● 痔疮
  
准妈妈容易得痔疮,尤其是在进入妊娠晚期后,便秘、痔疮的程度可能会加重。为了防
止便秘,建议准妈妈们多喝水,多吃富含纤维质的食物(如水果、蔬菜和全麦面包)。
另外,经常做运动也能帮助你刺激消化系统。 
  
如果痔疮有灼热的疼痛感,而且发痒,准妈妈可以请医生开一些医用按摩乳,以擦拭疼
痛的部位。
  
● 耻骨联合疼痛
  
进入怀孕中晚期,有些准妈妈会感到耻骨莫名其妙的疼痛,有牵拉感觉,在上楼梯时,
痛感就更加明显。准妈妈的耻骨间隙较未孕时增宽,这是胎儿日益增大的生理需要。到
了孕妇分娩之后,耻骨间增宽的间隙也就逐渐恢复原来的位置。孕妇耻骨联合分离导致
的疼痛,一般人是可以忍受的。如果大幅度地耻骨错缝,在分离严重时导致韧带拉伤、
水肿,造成行走困难,准妈妈就必须卧床休息
  
为了预防或减轻耻骨联合疼痛,准妈妈需:

――重视孕期检查,定期了解耻骨分离的具体情况;

――加强体育锻炼,经常进行适宜的伸展大腿运动,增强肌肉与韧带的张力和耐受力;

――注意适当休息。 

――当妊娠晚期耻骨分离较大时,应适当减少不适宜的活动。

●静脉曲张

怀孕期间分泌的荷尔蒙导致肌肉松弛,而体内增加的血液容易又为你的血管增添了额外
的压力,结果很容易导致下肢形成静脉曲张。

是否会患下肢静脉曲张与遗传因素有很大关系。但是准妈妈也能通过减少站立时间 (即
不要用一种姿势站立很长时间)来预防下肢静脉曲张的发生。

坐下时最好不要搭腿,一有机会就把下肢抬高,有利于下肢静脉血液的回流,减轻对血
管造成的压力。孕期专用长筒袜对预防下肢静脉曲张也有一定帮助。但不要按摩静脉血
管,避免对静脉血管造成损伤。

● 外阴部疼痛
  
有些准妈妈在妊娠中晚期会感觉外阴部肿胀,同时局部皮肤发红,在行走时外阴出现剧
烈疼痛。这种现象临床上称为'外阴部静脉曲张'。预防外阴静脉曲张主要在于:避免妊
娠后期长时间的站立;避免穿过紧的裤子和鞋袜;不要接近热源或用过热的水洗浴。如
果已经发生外阴静脉曲张现象,准妈妈可以进行局部冷敷,或以冷开水坐浴,使外阴部
的曲张静脉血管收缩。局部涂抹氧化锌软膏,再撒一些爽身粉,同样有助于曲张静脉血
管收缩。
  
● 坐骨神经痛
随着胎儿的不断发育,胎儿的重量会给准妈妈的背部增加压力,并且挤压坐骨神经,从
而使准妈妈在腰部以下到腿的位置上产生强烈的刺痛。
  
改善坐骨神经痛的方法主要有:

――在日常生活中注意选择自己舒适的体位和睡眠姿势可以减轻这种疼痛;

――睡觉时左侧卧,并在两腿膝盖间夹放一个枕头,以增加流向子宫的血液;

――白天不要以同一种姿势站着或坐着超过半个小时;

――尽量不要举重物过头顶;

――游泳可以帮助减轻对坐骨神经的压力。 
  
● 腰痛
  
在妊娠晚期,随着子宫日渐增大,准妈妈的身体重心渐渐前移,在站立或走路时,为保
持重心平衡,准妈妈必须将肩部及头部向后仰,形成一种孕妇特有的挺胸突肚姿态。这
种姿态容易造成腰部脊柱的过度前凸弯曲,从而引起脊柱痛。

这种腰痛是正常的生理现象,没有危险性,只要适当注意休息,避免长时间站立或步行
即可。然而,有一种腰痛必须引起重视,它主要表现为右下腹部伴有疼痛感,并向右大
腿放射,同时伴有尿频、尿急等症状。这其实是一种名为“卵巢静脉综合征”的妊娠期
并发症。一旦发生此并发症,应及早去医院诊治。 
  
● 牙龈肿痛
  
随着孕周的增加,由于受大量雌激素影响,准妈妈的齿龈变得肥厚,易患齿龈炎,并且
出血疼痛。所以,准妈妈需注意口腔清洁卫生,刷牙时要选用柔软的牙刷。
  
● 临产时的宫缩痛
  
临产时,准妈妈的下腹部会产生轻微胀痛,这时,准妈妈不必紧张,要开始做好待产准
备了。当产生有规律并逐渐加强的宫缩痛时,准妈妈应到医院待产,迎接宝宝的安全降
临!
  

二、孕期病理性疼痛 
  
上文中提到的孕期疼痛,大多是生理性的。然而,有些病理性的疼痛必须引起准妈妈的
重视,比如先兆流产、先兆早产的宫缩痛、羊水过多时的腹部胀痛、羊水过少时的胎动
疼痛,子宫肌瘤变性疼痛,肾绞痛、胆石症胆绞痛……
  
有些甚至病症甚至是威胁准妈妈生命的,比如宫外孕,流产破裂的内出血急腹症疼痛,
胎盘早剥时的腹部剧痛,妊高征的头痛,子宫破裂时的腹部撕裂样疼痛,合并阑尾炎、
肠梗阻的外科急腹症疼痛……

无论是怎样的疼痛,只要伴有阴道流血流液、发热、呕吐、严重头痛、晕厥、胎动减少
或消失等症状,就须赶快就医!
  
● 确定宫内妊娠
  
月经超过一定时间没有来潮,就要到医院就诊,确定是否为宫内妊娠。如果是宫外孕,
可及早采取措施,使准妈妈免受痛苦。
  
● 遭遇突发性剧烈腹痛时
  
即使是确定了宫内妊娠的准妈妈,如果出现阵发性下腹疼痛,并伴有阴道流血流液,一
定要到医院就诊。出现这种状况,通常是流产或早产的先兆。必要时,要做B超以了解
胎儿胎盘等情况,以决定是否进一步保胎或作出其他处理方法。

● 头痛严重请就医 
  
准妈妈如果觉得头痛厉害,且出现日趋加重的趋势,并伴有呕吐、胸闷,甚至出现视物
模糊的现象,就该引起准妈妈重视了,这可能是妊娠高血压综合征的严重并发症。如果
不及时治疗,会危及母子安全。
  
● 及早发现胎盘早剥
  
如果腹部不慎受到外伤,或是患有合并妊高征的准妈妈,一旦出现腹部剧痛如硬板样,
不管是否有阴道流血,很可能是胎盘早剥,一定要急诊到医院。
  
● 子宫破裂

各种原因所致的胎儿下降,在临产后因子宫上段肌层强烈收缩而子宫下段被牵拉、伸展
、变薄易破。子宫破裂时,孕妇感到下腹持续剧痛、极度不安、面色潮红、呼吸急促;
子宫破裂瞬间剧痛,破裂后疼痛减轻,孕妇陷于休克状态。曾经有过子宫手术史出现下
腹部特别是原疤痕处的撕裂样疼痛,一定要争分夺秒立即到医院,很可能是先兆子宫破
裂或子宫破裂;
  
● 羊水过多或过少

在妊娠中晚期,羊水较少的准妈妈,由于胎儿皮肤与羊膜紧贴,每当胎动时孕妇会感到
疼痛;如果羊水过多,子宫高度膨胀时,准妈妈会产生压迫症状,感到腹部胀痛,消化
不良。急性羊水过多患者,还会有呼吸急促、心悸、脉速,不能平卧、外阴及下肢水肿、
静脉曲张等症状。发生上述状况的准妈妈,要及时去医院检查。平日里配合医生按时
做好产检,是应对可能出现的羊水过多或过少情况的最好措施。

● 还有哪些情况需引起重

――曾经有子宫肌瘤病史突觉下腹部特别是肌瘤部位疼痛明显并可能伴有发热,很有可
能是子宫肌瘤变性,应立即到医院就诊;
  
――如果在孕期特别是孕晚期出现右上腹疼痛向右肩部放射、腰部疼痛、腹部疼痛,并
同时可能有发热、恶心、呕吐、腹泻、排气排便异常等消化道症状,很可能是合并外科
疾患,如胆石症胆绞痛、肾绞痛、阑尾炎、肠梗阻等,也应立即到医院并且需要多科合
作治疗。
 

Friday, October 13, 2017

说说孕期血糖测试 (写给关心血糖问题的准妈妈们)


* 那么为何要做血糖测试?什么是一小时血糖测试和三小时血糖测试?

要回答以上问题,我们首先要了解一下什么是妊娠糖尿病。大约有2%~5%女性会在妊娠期间发生糖尿病,妊娠之后糖尿病自动消失,称为妊娠糖尿病。发生原因是由于妊娠时摄食量增加以及胎盘分泌的激素抵消胰岛素的作用,导致糖耐量异常甚至糖尿病;另外可能与胎盘产生的大量的胎盘生乳素、雌激素、孕激素有关。妊娠糖尿病更容易发生在肥胖和高龄产妇。

妊娠期糖尿病可以使新生儿成为巨大儿,新生儿出生后可出现低血糖和黄疸等;使孕妇流产率高、羊水过多、滞产及产后出血、围生(产)期死亡率增高等。而妊娠期间很少出现症状,
是孕期最常见的危害准妈妈健康的问题之一,而孕期血糖测试是发现这一问题的唯一途径。

一小时血糖测试称为Glucose Screening Test,或者Glucose Challenge Test (GCT),也就是血糖筛查试验,是孕24-28周之间进行的常规测试,用于初步筛查妊娠糖尿病,阳性只是说明可能会有问题,还要通过进一步的测试才能确定,其实阳性结果中只有约三分之一的准妈妈真正患有妊娠糖尿病。所以一小时血糖测试没过的JMs不必太担心。

这进一步的测试便是三小时血糖测试,即糖耐量测试,英文是Glucose Tolerance Test(GTT),也称为口服糖耐量试验(Oral Glucose Tolerance Test, OGTT),通过此测试可以确定是否患有妊娠糖尿病。

下面我们分别来看看一小时血糖测试和三小时血糖测试的具体要求。


*  一小时血糖测试(Glucose Screening Test)

不要求空腹,有的准妈妈喝糖水后可能会恶心呕吐,所以在喝糖水一小时之前最好吃点东西。喝糖水后如果呕吐,需要改日重新进行。抽血前一小时一口气喝下含50g葡萄糖的糖水。记得当时OB告诉我下次要做血糖测试,然后护士给了我一瓶糖水,让我提前一天晚上放进冰箱,第二天快去医院前喝下糖水。因为要求喝糖水之后一小时整抽血检测,所以建议我至少提前15分钟到医院。

一小时血糖水平通常在140mg/dL以上的要做三小时血糖测试,也有的OB可能将标准定在130mg/dL,这样就可能出现更多的假阳性。大概有15-23%的准妈妈的检测值会超过标准。如果你的一小时血糖水平高于200mg/dL,通常就认为患有糖尿病,不被要求做三小时血糖测试了,而介于140和200之间需要进一步做三小时血糖测试来确定是否患有妊娠糖尿病。


* 三小时血糖测试(Glucose Tolerance Test) 

要求空腹,糖水更甜或喝的量更多,所以更易引起恶心呕吐。测试前三天内,每天要求至少吃150g糖类。如果每餐你正常饮食再外加一片面包,那么你摄入的糖就差不多了。也有的说测试前一周内要正常饮食。测试前8-14小时开始,除了喝少量水,不能吃或喝任何东西(也不能抽烟或运动),所以三小时测试最好是上午一早就做。

首先空腹抽一次血,然后喝更高浓度或更多量的糖水,之后每一小时抽一次血,共三次。抽血结束之前你要一直在休息室等候,空腹加上三个小时下来可能会很饿,发生头晕虚脱之类,所以最好带点东西,抽完最后一次血后可以吃。

如果检测值有一个异常,你可能还要再做一次测试,或者被要求调整饮食和增加运动;如果有两个以上检测值异常,你会诊断为妊娠糖尿病,需要进行治疗。美国糖尿病联合会制定的标准如下,在此以上认为异常:

空腹   95 mg/dL
一小时  180 mg/dL
二小时  155 mg/dL
三小时  140 mg/dL


如果被诊断为妊娠糖尿病,OB可能会要求你找糖尿病专家或营养师来治疗,这种怀孕造成的糖尿病通常生完宝宝之后就没事了,不过也有少数人仍有,要在产后6周再次进行血糖测试。

如果常规尿样检测中就发现含糖量偏高,医生可能会让你在24周之前进行筛查测试,如果正常,可能会要求你24-28周再测一次。当然如果你孕前已经诊断有糖尿病就不必进行筛查试验了,而是和医生一起调治。

可见,没有糖尿病家庭史,各方面正常的JMs适当注意饮食和锻炼,不必太担心血糖测试的结果,一小时血糖测试只是初筛,没通过的准妈妈约占五分之一,而其中只有约三分之一可能是糖妈妈,所以大多数JMs一小时测试没过的,三小时测试是可以通过的。

另外还要注意,三小时测试前要正常饮食,或者摄入比平常稍多的糖分才有利于三小时测试通过。

至于一小时血糖测试,想再补充一下,有的OB似乎要求空腹,但其实按规定是不作要求的,从JMs的反应来看,吃东西之后好象比较容易通过,只是要注意在喝糖水一小时之前进食比较好。

最后祝所有的JMs好孕&好运!

孕妇不宜吃的20种食物(附孕妇饮食禁忌及Top Pregnancy Hazards)


一、容易流产食物:

1.螃蟹:它味道鲜美,但其性寒凉,有活血祛瘀之功,故对孕妇不利,尤其是蟹爪,
有明显的堕胎作用。
    
2.甲鱼:虽然它具有滋阴益肾的功效,但是甲鱼性味咸寒,有着较强的通血络、散瘀
块作用,因而有一定堕胎之弊,尤其是鳖甲的堕胎之力比鳖肉更强。
    
3.薏米:是一种药食同源之物,中医认为其质滑利。
    
药理实验证明,薏仁对子宫平滑肌有兴奋作用,可促使子宫收缩,因而有诱发流产的可
能;     

4.马齿苋:它既是草药又可作菜食用,其药性寒凉而滑利。实验证明,马齿苋汁对于
子宫有明显的兴奋作用,能使子宫收缩次数增多、强度增大,易造成流产。

二、对胎儿有害的食物
    
5.罐头食品
    
罐头食品在制作过程中都加入一定量的添加剂,如人工合成色素、香精、防腐剂等。尽
管这些添加剂对健康成人影响不大,但孕妇食入过多则对健康不利。另外,罐头食品营
养价值并不高,经高温处理后,食物中的维生素和其他营养成分都已受到一定程度的破
坏。
  
6.菠菜
    
人们一直认为菠菜含丰富的铁质,具有补血功能,所以被当做孕期预防贫血的佳蔬。其
实,菠菜中含铁不多,而是含有大量草酸。草酸可影响锌、钙的吸收。孕妇体内钙、锌
的含量减少,影响胎儿的生长发育。
  
7.巧克力和山楂
    
过多食用巧克力会使孕妇产生饱腹感,因而影响食欲,其结果是身体发胖,而必需的营
养却缺乏。孕妇较喜欢吃酸东西,山楂便成了首选果品。山楂对子宫有兴奋作用,孕妇
过食可使子宫收缩,导致流产的可能,故要少吃。
  
8.猪肝
    
芬兰和美国已向孕妇提出了应少吃猪肝的忠告。
    
因为在给牲畜迅速催肥的现代饲料中,添加了过多的催肥剂,其中维生素A含量很高,
致使它在动物肝脏中大量蓄积。孕妇过食猪肝,大量的维生素A便会很容易进入体内,
对胎儿发育危害很大,甚至会致畸。

9.久存的土豆
    
土豆中含有生物碱,存的越久的土豆生物碱含量越高。过多食用这种土豆,可影响胎儿
正常发育,导致胎儿畸形。当然,人的个体差异很大,并非每个人食用后都会出现异常,
但孕妇还是不吃为好,特别是不要吃长期贮存的土豆。
  
10.热性作料
    
孕妇吃热性作料小茴香、八角、花椒、胡椒、桂皮、五香粉等容易消耗肠道水分,
    
使胃肠分泌减少,造成肠道干燥、便秘。发生便秘后,孕妇必然用力屏气解便,使腹压
增加,压迫子宫内的胎儿,易造成胎动不安、早产等不良后果。
  
11.味精
    
味精的主要成分是谷氨酸钠,血液中的锌与其结合后便从尿中排出,味精摄入过多会消
耗大量的锌,导致孕妇体内缺锌。而锌是胎儿生长发育之必需品,故孕妇要少吃。
  
12.桂圆、荔枝:性温热易致胎热;
  
13.石榴:贫血者要少吃;
  
14.腌制酸菜:含有亚硝胺,可导致胎儿畸变。
  
15.西瓜:每天吃水果不宜超过250g,限量吃西瓜,因为西瓜是利尿剂,容易造成孕妇
脱水。

16.饮浓茶。
    
英国的一位医生发现茶叶中含有不少氟化物成分,一杯浓茶中氟化物含量可达1.25毫克。
如果用来喂养孕鼠,则发现所生小鼠有骨骼方面的畸形,氟对胎儿的危害虽然尚未肯
定,但还是不饮浓茶为好。孕期饮浓茶,不仅易患缺铁性贫血,影响胎儿的营养物质供
应,由于浓茶内含有咖啡因,还会增加孕妇的心跳和排尿次数,增加孕妇的心脏和肾脏
负担,有损母体和胎儿的健康。>>孕妇应少饮或不饮茶
  
17.饮咖啡和可乐型饮料。
    
咖啡和可乐的主要成分为咖啡因、可乐宁等生物碱。咖啡因和可乐宁是一种兴奋中枢神
经的药物。据测定,一瓶340克的可乐型饮料中含咖啡因50~80 毫克,如果一次饮用含
量达1克以上的咖啡因饮料,就会导致中枢神经系统兴奋,表现为躁动不安、呼吸加快、
肌肉震颤、心动过速、期外收缩及失眠、眼花、耳鸣等。即使服用1克以下,由于对
胃黏膜的刺激,也会出现恶心、呕吐、眩晕、心悸及心前区疼痛等中毒症状。胎儿对咖
啡因尤为敏感,咖啡因能迅速通过胎盘而作用于胎儿,使胎儿受到不良影响。有人对孕
鼠注射咖啡因实验证实,仔鼠易发生腭裂、脑膜膨出、脊柱裂、无下颌、无眼、骨骼异
常、矮小、四肢畸形等现象。为了下一代的健康,孕妇应当慎饮或禁饮咖啡及可乐型饮
料。
  
18.饮酒。
    
研究表明,孕妇饮酒是造成婴儿畸形和智力迟钝的重要原因。这是因为任何微量酒精都
可以毫无阻挡地通过胎盘而进入胎儿体内,使得胎儿体内的酒精浓度和母体内酒精浓度
一样。法国医学博士曾对127名有饮酒癖的妇女所生的孩子进行观察,发现他们都有共
向的缺陷:单眼皮,即使双眼皮也不明显,鼻子扁平,内侧眼角眼皮外翻,脸蛋扁平且
窄小,鼻沟模糊,上嘴唇薄且紧,下巴短。这种受酒精毒害、面部发育不健全的孩子约
占饮酒母亲所生孩子的1/3。更为严重的是酒精对大脑和心脏的危害,孕妇饮酒导致婴
儿患心脏病的约占30%。孕妇饮酒过多,生下的孩子不久就夭折的屡见不鲜。对死婴的
解剖结果表明,其大脑不仅小于正常儿,而且脑发育不全或呈明显畸形状态。不少国家
曾对胎儿期受酒精毒害的儿童进行智力测验,发现他们的智商都低于一般水平,大多数
表现为反应迟钝、智力低下或者白痴。

19.孕妇忌贪吃冷饮

20.孕妇谨慎食用土豆制成食品


★★ 孕妇饮食禁忌

1.想要孩子的夫妻忌饮“可乐”

美国哈佛大学医学院的科学家们,对目前出售的三种不同配方的可口可乐饮料,进
行了杀伤精子的试验,得出的结论是,新婚男子饮用可乐型饮料,会直接伤害精子,影
响男子的生育能力。

若受损伤的精子一旦与卵子结合,可能会导致胎儿畸形或先天不足。

医学家们将成活的精子加入到一定量的可乐饮料中,一分钟后测定精子的成活率。试
验表明,新型配方的可乐饮料能杀死58%的精子,而早期配方的可乐型饮料可全部杀死
精子。

他们对新婚女子饮用可乐型饮料也提出了忠告,奉劝她们少饮或不饮为佳。因为多数可
乐型饮料都含有咖啡因,它在体内很容易通过胎盘的吸收进入胎儿体内,危及胎儿的大
脑、心脏等重要器官,同样会使胎儿致畸或患先天性痴呆。

因此,专家门建议新婚夫妇以及想要孩子的夫妻,除应禁忌烟酒外,还不宜饮用可乐型
饮料。

2.孕妇不宜营养过剩

孕妇适当地改善饮食,增加营养,可以增强孕妇体质,促进胎儿发育。但若营养过剩,
危害非浅。

单纯地追求营养,使营养过剩,结果孕妇出现血压偏高,胎儿过大 (超过3500克,成为
巨大儿)。我国孕产妇死亡率为0.488‰,其主要原因是妊娠高血压引起的;另一原因是
“巨大儿”造成的难产,分娩期延长,引起产后大出血。因此,孕妇不宜营养过剩。

3.孕妇不宜只吃精制米面

人体中含有氢、碳、氮、氧、磷、钙等ll种多量元素(占人体总重量的99.95%), 还有
铁、锰、钴、铜、锌、碘、钒、氟等14种微量元素(只占体重的0.01%)。这些元素虽然
在体内的比重极小,但却是人体中必不可少的,一旦供应不足便可产生一系列疾病,甚
至出现死亡。

人体必需的微量元素,对孕妇、乳母和胎儿来说更需要,因为他们缺乏微量元素时会
引起更严重的后果。人们在生活中注意不偏食,尤其是孕妇,尽可能以“完整食品”(
指未经细加工过的食品,或经部分精制的食品)作为热量的主要来源。例如,少吃精制
大米和精制面等。因为“完整食品”中含有人体所必须的各种微量元素(铬、锰、锌等)
及维生素Bl、B6、E等,它们在精制加工过程中常常被损失掉,如果孕妇偏食精米、精
面,则易患营养缺乏症。

4.孕妇不要过多喝茶

孕妇如果喝茶太多、太浓,特别是饮用浓红茶,对胎儿会造成危害。

茶叶中含有2~5%的咖啡因, 每500毫升浓红茶水大约含咖啡因0.06毫克,如果每日喝
5杯浓茶, 就相当服用0.3~0.35毫克的咖啡因。咖啡因具有兴奋作用,服用过多会刺
激胎动增加,甚至危害胎儿的生长发育。日本专家的调查也证实,孕妇若每天饮5杯浓
红茶,就可能使新生儿体重减轻。

此外,茶叶中还含有多量的鞣酸,鞣酸可与孕妇食物中的铁元素,结合成一种不能被
机体吸收的复合物。孕妇如果过多地饮用浓茶,还有引起贫血的可能,也将给胎儿造成
先天性缺铁性贫血的隐患。科学家们进行过多次对照试验。用三氯化铁溶液作为铁质来
源给人服用,发现饮白开水者铁的吸收率为21.7%,而饮浓茶水者,铁的吸收率仅为6.
2%。 因此,孕期的妇女最好不要饮茶或饮少量淡茶为宜。

5.孕妇忌喝烈性酒

据美国的统计数字,因母亲怀孕期间饮酒而造成婴儿畸形,每年大约有5万人。医生将
这种因孕妇饮酒给胎儿造成的严重损害,称为胎儿酒精综合征。据调查,在美国所有的
智力迟钝者当中,胎儿酒精综合征就占了20%,因而成为威胁美国儿童智力发育的第一
位疾病。胎儿酒精综合征对婴儿的损害非常大。因为,酒精不像巴比妥类和鸦片类药物
那样,只影响中枢神经的发育,它对身体任何部位的组织细胞都能造成损害,从而引起
发育迟缓,颜面畸形,智能低下等严重后果。由于怀孕最初3个月,正是胎儿形成的重
要阶段,这时饮酒,对胎儿的损害特别严重。整个孕
期都贯穿了胎儿大脑的发育过程,胎儿生长的高峰是在妊娠的6个月以后,这时如继续
饮酒,将会给胎儿带来更严重的损害。

在妊娠初期的1~2个月,孕妇即使少量饮用一些含酒精饮料,也会影响胎儿发育及出生
后的智力。因此,孕妇不要喝烈性酒,最好是其它酒也不喝。

育龄妇女在孕前有饮酒习惯者,如在计划怀孕前就停止饮酒,其所生的子女可免遭酒精
的危害。

6.孕妇不宜多食酸性食物

—般来说,妇女在怀孕初期,常会出现恶心、呕吐等反应,而我国民间历来有用酸性食
物来缓解孕期呕吐的做法,甚至有用酸性药物止呕的做法。这些方法是不可取的。

近年来,国外研究指出,酸性食物和药物是导致畸胎的元凶之一。研究人员分别测定
了不同时期胎儿组织和母体血液的酸碱度,认为,在妊娠的最初半个月左右,不食或少
食酸性食物或含酸性的药物(如维生素C、阿司匹林等)为佳。因为,大量的酸性食品,
可使体内碱度下降,容易引起疲乏、无力。长时间的酸性体质,不仅容易使母体罹患某
些疾病,更重要的是会因此而影响胎儿正常、健康地生长发育,甚至可导致胎儿畸形。
因此,孕妇不宜过多食用酸性食物。

7.孕妇不宜多吃油条

在美国长岛地区,长期流行着一种震颤麻痹性神经系统疾病,后经过科学家试验,发现
当地土壤中含铝的成分高得惊人。又有人用含铝高的饲料喂养动物或直接把铝注入猫的
脑内,结果这些动物都变成了痴呆。也有科学家解剖了一些因痴呆而死亡的病人,同样
发现其大脑中含有高浓度的铝元素,最高者可达正常人的30倍以上。由此判断铝的超量
对人的大脑是极为不利的。

在油条的制作时,须加入一定量明矾,而明矾正是一种含铝的无机物。炸油条时,每
500克面粉就要用15克明矾,也就是说,如果孕妇每天吃两根油条,就等于吃了3克明
矾,这样天天积蓄起来,其摄入的铝相当惊人了。这些明矾中含的铝通过胎盘,侵入胎
儿的大脑,会使其形成大脑障碍,增加痴呆儿的机率。

8.孕妇不宜吃桂圆

桂圆中含有葡萄糖、维生素、蔗糖等物质,营养丰富,有补心安神、养血益脾之效。但
性温大热,一切阴虚内热体质及患热性病者均不宜食用。妇女怀孕后,阴血偏虚,阴虚
则滋生内热,因此孕妇往往有大便干燥、口干而胎热、肝经郁热的症侯。

我国医学一贯主张胎前宜清热凉血,桂圆性甘温,如孕妇食用桂圆,不仅不能保胎,反
而易出现漏红、腹痛等先兆流产症状。

因此,孕妇是不宜吃桂圆的。


9.孕妇不宜多吃菠菜

90年前,由于印刷上的错误,把菠菜含铁量的小数点右移了一位数,从此人们一直都认
为菠菜含有大量的铁,具有补血功能,把菠菜当做孕妇、儿童、病人理想的补血食品。
其实,菠菜中铁的含量并不多,其主要成分是草酸,而草酸对锌、钙有着不可低估的破
坏作用。

锌和钙是人体不可缺少的微量元素,如果人体缺锌,人就会感到食欲不振、味觉下降;
儿童一旦缺钙,有可能发生佝偻病,出现鸡胸、罗圈腿以及牙齿生长迟缓等现象。如果
孕妇过多食用菠菜,无疑对胎儿发育不利。

★★ What Are the Top Pregnancy Hazards?

You should be particularly mindful of a handful of things during your pregnancy, some of which are more harmful than others. Your doctor (or other health care provider) will likely talk to you about — or give you information on — which should be avoided altogether, dramatically reduced, and/or carefully considered during pregnancy.

Hazardous or Harmless?
● Alcohol
● Caffeine
● Certain Foods
● The Litter Box
● Medications
● Recreational Drugs
● Smoking
● Artificial Sweeteners
● Computer Monitors
● Flying
● Hair Dyes
● High-Impact Exercise
● Household Chemicals
● Bug Sprays
● Lead
● Microwaves
● Overheating
● Tanning
● Sex
● Drinking Water
● Teeth Whitening
● Vaccinations
● X-Rays

● Alcohol
Should I avoid it? Yes! Although it may seem harmless to have a glass of wine at dinner or a mug of beer out with friends, no one has determined what is a "safe amount" of alcohol to drink during pregnancy. Fetal alcohol syndrome (FAS) is caused by the consumption of a large amount of alcohol during pregnancy. What that amount is versus a safe amount is really not known. Because of the uncertainty, it's always wise to err on the side of caution and not drink any alcohol at all while you're pregnant.

What are the risks to my baby? One of the most common known causes of mental and physical birth defects, alcohol produces more severe abnormalities in a developing fetus than heroin, cocaine, or marijuana.

Alcohol is easily passed along to the baby, who is less able to eliminate alcohol than the mother. That means an unborn baby tends to develop a high concentration of alcohol, which stays in the baby's system for longer periods than it would in the mother's. And moderate alcohol intake, as well as periodic binge drinking, can possibly damage a baby's developing nervous system.

What can I do about it? If you had a drink or two before you even knew you were pregnant (as many women do), don't worry too much about it. But your best bet is to not drink any more alcohol for the rest of your pregnancy.

If you're an alcoholic or think you may have a drinking problem, be sure to talk to your doctor about it. He or she needs to know how much alcohol you've consumed and when during your pregnancy to get a better idea of how your unborn baby may have been affected. Your doctor may also be able to start you on a path to getting the help you need to stop drinking — for your sake and your baby's.

● Caffeine
Should I avoid and/or limit it? Yes. It's wise to cut down or eliminate caffeine intake. Studies indicate that caffeine consumption of more than 150 milligrams a day (about 1 1/2 cups of coffee) puts the pregnancy at higher risk. Less than that amount is probably safe.

What are the risks to my baby? High caffeine consumption has been linked to an increased risk of miscarriage.

What can I do about it? If you're having a hard time cutting out coffee cold turkey, here's how you can start:
――Cut your consumption down to one or two cups a day.
――Gradually reduce the amount by combining decaffeinated coffee with regular coffee.
――Eventually cut out the regular coffee altogether.

And remember that caffeine is not limited to coffee. Green and black tea, cola, and other soft drinks contain caffeine. Try switching to decaffeinated products (which may still have some caffeine, but in much smaller amounts) or caffeine-free alternatives.

If you're wondering whether chocolate, which also contains caffeine, is a concern, the good news is that you can have some of the scrumptious treat in moderation. Whereas a cup of brewed coffee has 95-135 milligrams of caffeine, the average chocolate bar has between 5-30 milligrams. So, small amounts of chocolate are fine.

● Certain Foods
Are there some I should avoid? Yes. Foods that are more likely to be contaminated with bacteria or heavy metals are ones to try to avoid or limit your exposure to. Those you should steer clear of altogether during pregnancy include:
――soft, unpasteurized cheeses (often advertised as "fresh") such as feta, goat, Brie, Camembert, blue-veined cheeses, and Mexican queso fresco
――unpasteurized milk, juices, and apple cider
――raw eggs or foods containing raw eggs, including mousse, tiramisu, raw cookie dough, eggnog, homemade ice cream, and Caesar dressing
――raw or undercooked fish (sushi), shellfish, or meats
――paté and meat spreads
――processed meats such as hot dogs and deli meats (these should be very well cooked before eating)

Also, although fish and shellfish can be an extremely healthy part of your pregnancy diet (they contain beneficial omega-3 fatty acids and are high in protein and low in saturated fat), you should avoid eating:
――shark
――swordfish
――king mackerel
――tilefish
――tuna steak (limited amounts of canned, preferably light, tuna is OK)

What are the risks to my baby? Although it's important to eat plenty of healthy foods during pregnancy, you also need to avoid food-borne illnesses, such as listeriosis, toxoplasmosis, and salmonella, which can be found in the foods listed in the first set of bullets. These infections can be life-threatening to an unborn baby and may cause birth defects or miscarriage.

And the types of fish mentioned above may contain high levels of mercury, which can cause damage to the developing brain of a fetus.

What can I do about it? Be sure to thoroughly wash all fruits and vegetables, which can carry food-borne illnesses or be coated with pesticide residue. And be mindful of what you're buying at the grocery store or when dining out.

When you choose seafood, eat a variety of fish and shellfish and limit the amount to about 12 ounces per week — that's about two meals. Common fish and shellfish that are low in mercury include: canned light tuna, catfish, pollock, salmon, and shrimp. But because albacore (or white) tuna has more mercury than canned light tuna, it's best to eat no more than 6 ounces (or one meal) of albacore tuna a week.

You may have to forego a few things during pregnancy that you normally enjoy. But just think how delicious they'll taste after waiting 9 months!

● Changing the Litter Box
Should I avoid it? Yes. Pregnancy is the prime time to get out of cleaning kitty's litter box. But that doesn't mean that you have to keep away from Fluffy!

What are the risks to my baby? An infection called toxoplasmosis can be spread through soiled cat litter boxes and can cause serious problems in a fetus, including prematurity, poor growth, and severe eye and brain damage. A pregnant woman who becomes infected often has no symptoms but can still pass the infection on to her developing baby.

What can I do about it? Have someone else change the litter box, making sure to clean it thoroughly and regularly, then wash his or her hands well afterward.

● Over-the-Counter and Prescription Medications
Should I avoid them? Some — yes; others — no. There are many medications you should steer clear of during pregnancy. Be sure to talk to your doctor about which prescription and over-the-counter (OTC) drugs you can and can't take, even if they seem like no big deal.

What are the risks to my baby? Even common OTC medications that are generally safe may be considered off-limits during pregnancy because of their potential effects on the baby. Certain prescription medications may also cause damage to the developing fetus. (The type of harm and extent of possible damage depends on the kind of medication.)
Also, although they may seem harmless, herbal remedies and supplements are not regulated by the U.S. Food and Drug Administration (FDA). That means that they don't have to follow any safety standards and, therefore, could be harmful to your baby.

What can I do about it? To make sure you don't take anything that could put your baby at risk talk to your doctor about:
――any medications you're taking — prescription and OTC — and ask which are safe to take during pregnancy
――any concerns you have about natural remedies, supplements, and vitamins

Also, be sure to let all of your health care providers know that you're pregnant so that they'll keep that in mind when recommending or prescribing any medications. If you were prescribed a medication before you became pregnant for an illness, disease, or condition you still have, your doctor can help you weigh the potential benefits and risks of continuing your prescription.

If you become sick (i.e., with a cold) or have symptoms that are causing you discomfort or pain (i.e., a headache or backache), talk to your doctor about medications you can take and alternative ways to help you feel better without medication.

● Recreational Drugs
Should I avoid them? Yes!

What are the risks to my baby? Pregnant women who use drugs may be placing their unborn babies at risk for:
――premature birth
――poor growth
――birth defects
――behavior and learning problems

And their babies could also be born addicted to those drugs.

What can I do about it? If you've used any drugs at any time during your pregnancy, it's important to inform your doctor. Even if you've quit, your unborn child could still be at risk for health problems. If you're still using drugs, talk to your doctor for help on how to quit. Health clinics such as Planned Parenthood also can recommend health care providers, at little or no cost, who can help you quit your habit and have a healthier pregnancy.

● Smoking
Should I avoid it? Yes! You wouldn't light a cigarette, put it in your baby's mouth, and encourage your little one to puff away. As ridiculous as this scenario seems, pregnant women who continue to smoke are allowing their fetus to smoke too. The smoking mother passes nicotine and carbon monoxide to her growing baby.

Likewise, you should steer clear of people who are smoking, whether they're coworkers, friends, family members, or other diners at a restaurant (if your state still allows smoking in public places).

What are the risks to my baby? If a pregnant woman smokes, it could cause:
――stillbirth
――prematurity
――low birth weight
――sudden infant death syndrome (SIDS)
――asthma and other respiratory problems

And the risks to a fetus from regular exposure to secondhand smoke include low birth weight and slowed growth.

What can I do about it? If you smoke, having a baby may be the motivation you need to quit. Talk to your doctor about options for kicking the habit.
If you spend time with people who smoke, ask them nicely to do it outside — and away from you if you're outside as well. And, of course, request the nonsmoking area whenever you dine out.

But What About...?
Whether you read it on an online pregnancy chat board, heard it from your best friend's coworker's cousin, or aren't sure where that nagging doubt came from, worries about what's OK during pregnancy abound. Here's the lowdown on some common ones that many expectant women wonder about.

● Artificial Sweeteners (Sugar Substitutes)
Should I avoid them? Although some are OK, one in particular isn't so clear-cut.
Aspartame, sucralose, and acesulfame-K have been found to be safe to use in moderation during pregnancy. However, you should avoid aspartame if you or your partner has a rare hereditary disease called phenylketonuria (PKU), in which the body can't break down the compound phenylalanine, which is found in aspartame. In that case, you should avoid aspartame altogether since your baby may also be born with the disease.

But the jury still seems to be out on whether saccharin, which is found in some foods and in the little pink packets, is safe to use during pregnancy or not — it can cross the placenta and could stay in the fetus' tissue. (Also, a sweetener called cyclamate was banned in the United States because of concern about cancer.)

What are the risks, if any, to my baby? Although some people have alleged that the artificial sweetener aspartame is linked with birth defects and illnesses ranging from multiple sclerosis to Parkinson's disease, government authorities and medical groups throughout the world have evaluated aspartame and approved it as safe for human consumption, including during pregnancy.

Research done during the 1970s suggested that saccharin caused bladder cancer in lab rats when given in large quantities. Since then, though, those studies have often been called into question. Also, a warning saying that it could cause cancer was removed from all saccharin-containing products' labels in 2000.

What can I do about it? With aspartame, sucralose, and acesulfame-K, moderation is the key. It's OK to have an occasional diet soda or sugar-free food with these sweeteners here and there. But if you're really craving something sweet, it's probably better to have the real thing, as long as it's in moderation.

If you've already consumed something with saccharin in it during your pregnancy, don't obsess about it. It's highly unlikely that small amounts could do any harm to your baby.
Still, it's wise to check product labels and try to avoid — or at least limit — anything with artificial sweeteners (especially saccharin), just to be safe. After all, this is one time in your life when you have a good reason to avoid diet foods! And the more naturally flavored whole foods you eat during pregnancy, the better.

● Computer Monitors (VDTs)
Should I avoid them? No. There is no evidence that computer monitors (also called video display terminals, or VDTs) cause any problems in unborn babies.

What are the risks, if any, to my baby? There's been speculation since the 1980s that VDTs are unsafe for pregnant women because of low levels of radiation (electromagnetic fields). But according to the National Institute for Occupational Safety and Health (NIOSH), part of the Centers for Disease Control and Prevention (CDC), computer monitors have not been found to cause low birth weight or preterm births.

What can I do about it? You don't need to do anything. Before you quit your office job or sit 10 feet away from the screen using a pool stick to type, rest assured that computer monitors are OK.

● Flying
Should I avoid it? No, not unless your due date is near or your doctor tells you that you or your baby has a medical condition that warrants keeping you near home. You can fly up to 4 weeks before your due date and that cut-off time is not because flying can cause problems, but because it's just best to stay close to home and your doctor in case you deliver.

However, pregnant women who shouldn't fly include those with:
――high blood pressure (or hypertension) during pregnancy
――sickle cell disease
――gestational diabetes that hasn't been well-controlled
――abnormalities of the placenta
――the risk of going into premature labor

What are the risks, if any, to my baby? For women with healthy pregnancies, there are no significant risks. However, women who have difficult pregnancies, especially involving their cardiovascular system, could be compromised by air flight and should discuss any flying plans with their doctor.

What can I do about it? Discuss any plans for lengthy or distant travel with your doctor during your last trimester, just in case. If he or she says it's OK, check with the airlines to find out what their policies are regarding flying during pregnancy. (Most airlines will allow pregnant women to fly up until week 36 for domestic flights and week 35 for international travel.)

To make sure your flight is as comfortable as possible, you may want to:
――Move your lower legs regularly and/or get out of your seat (especially during long flights) to promote blood circulation and help prevent blood cots.
――Wear support stockings to further prevent clotting in your legs.
――Keep your seatbelt on when you're seated to keep the jostling of turbulence to a minimum.

● Hair Dyes
Should I avoid them? No. According to the American College of Obstetricians and Gynecologists (ACOG), because very little dye is absorbed through the skin, dying your hair is "most likely safe" during pregnancy, despite what doctors in years past may have advised. That's good news for many expectant women — coloring your hair can be a great little confidence boost when everything else going on in your body feels so out of your control.

Having said that, though, very few studies have closely examined the many different kinds of hair treatments and their potential effects on a fetus. What we do know indicates that hair treatments are most likely safe.

What are the risks, if any, to my baby? None that are currently known.

What can I do about it? If you're still concerned, ask your doctor about natural, non-chemical dyes that could give you the little makeover you may need without the added worry. Also, having your hair highlighted (rather than dyed) uses far less chemicals.

● High-Impact Exercise
Should I avoid it? Yes. For most pregnant women, low-impact exercise is a great way to feel better, look better, and help prepare the body for labor. Unless your doctor tells you otherwise, stick to low-impact exercise. It's wise to avoid some exercises and activities such as:
――weight training and heavy lifting (after the first trimester)
――sit-ups (also after the first trimester)
――contact sports
――scuba diving
――bouncing
――jarring (anything that would cause a lot of up and down movement, such as horseback riding)
――leaping
――a sudden change of direction (such as downhill skiing)

What are the risks, if any, to my baby? High-impact exercise can cause increased pressure on the structures within the uterus that could lead to problems such as premature labor or bleeding.

What can I do about it? Some of the healthy ways pregnant women can stay fit include walking, swimming, water aerobics, yoga, and Pilates. But be sure to talk to your doctor before starting — or continuing — any exercise routine during pregnancy.

● Household Chemicals (Cleaners, Paint, etc.)
Should I avoid them? Some — yes; others — no. While chemicals like ammonia and chlorine may make you nauseated because of the smell, they're not toxic, says the March of Dimes. But others, such as some paints, paint thinners, oven cleaners, varnish removers, air fresheners, aerosols, carpet cleaners, etc., may be.

What are the risks, if any, to my baby? It depends on the product. Some household chemicals may have no effect, while others in high doses could potentially be harmful.

What can I do about it? Here a few tips to help keep household chemicals in perspective during your pregnancy:
――Talk to your doctor about any concerns you have with chemicals you use at home or at work.
――Look at product labels before using any product. If it's unsafe to use during pregnancy, the label should say that it's toxic. Find out not only if it's safe for you to use, but if it's safe for you to be around when being used by someone else. If the label doesn't specify, contact the manufacturer.
――Open windows and doors, and use rubber gloves and a mask when cleaning with or using any chemical.
――Wash your hands and arms, even if you wore gloves, after using any chemical.
――Opt for natural products like baking soda, borax, and vinegar for cleaning.
――Have someone else paint the baby's nursery, as much you'd probably like to do it yourself. And definitely don't help with the removal of paint if your home was built before 1978 as it may contain lead-based paint. Although many paints today are considered safer than those of the past, it's still a good idea to let someone else handle painting. You can always take over the decorating duties after the paint dries!

● Bug Sprays (Insecticides/Pesticides/Repellants)
Should I avoid them? Yes. They're considered poisons and pregnant women should stay away from them as much as possible.

What are the risks, if any, to my baby? Although there's no evidence that the typical occasional household use of insecticides does any damage to a baby, it's best to err on the side of caution. High levels of exposure may cause:
――miscarriage
――premature delivery
――birth defects

As for insect repellants (which may contain DEET, or diethyltoluamide), the risks aren't fully known. So, it's best to either not use them at all during pregnancy or to wear gloves to place a small amount on socks, shoes, and outer clothing instead of putting repellants directly on your skin.

What can I do about it? If you have a real problem with pesky bugs around your home, the March of Dimes suggests the following:
――Use safer methods of removal such as boric acid, which you should be able to find at your local hardware store.
――Make sure someone else applies the pesticides.
――When pesticides are sprayed outside, close all windows and turn off air-conditioning units and window fans to prevent the fumes from entering your home.
――Remove utensils, food, and dishes from areas where the chemicals will be used.
――Stay away from the treated area during the application and afterward for the amount of time specified on the product label.
――Have someone else wash any treated area where food is prepared or served.
――Wear rubber gloves when gardening outside where pesticides have been used.
――Have your water supply tested regularly if you have well water and use pesticides, fertilizers, and weed killers.

● Lead
Should I avoid it? Yes. However, exposure to high lead levels is rare for women in the United States.

What are the risks, if any, to my baby? Exposure to high levels of lead can cause:
――miscarriage
――premature delivery
――low birth weight
――developmental delays

But even low levels of lead can cause subtle problems with behavior and learning in children.

What can I do about it? If your home was built before 1978, it could have lead-based paint. But it only becomes a problem if the paint is chipping, peeling, or being removed. Some homes also may have lead pipes or copper piping with lead solder that can allow lead to enter the tap water.

If you have an older home or think that you may have lead piping or soldering and are concerned about lead exposure, you can have a professional come out to test your water, the dust in your home, the soil outside, and/or the paint around your home for lead.

Make sure that anyone who removes any potentially lead-based paint from your home:
――is a professional trained in removing lead paint (getting rid of lead-based paint isn't a project for a do-it-yourselfer!)
――removes it when you're not there
――doesn't scrape, sand, or use a heat gun to remove the paint (these methods may send lead dust into the air)
――thoroughly cleans the area immediately afterward

To help reduce potential lead levels in your tap water, you can run the water for 30 seconds before using it and/or buy a water filter that specifically says on the packaging that it removes lead.

● Microwaves
Should I avoid them? No. Nuke away! After all, for pregnant women on the go, especially those with other kids, microwaves are usually a must.

What are the risks, if any, to my baby? There are no medically proven risks. Microwaves don't leak radiation, and any that did would emit extremely small amounts that are virtually undetectable.

What can I do about it? If you're still concerned, you might want to make sure your microwave is working properly and isn't leaking or damaged. Researchers have determined that if a microwave does leak any radiation, it diminishes exponentially with distance from the microwave. In other words, if you have any concerns, stand a few feet away instead of immediately in front of the oven.

● Overheating (Hot Tubs, Saunas, Electric Blankets, etc.)
Should I avoid or limit it? Yes. You should limit activities that would raise your core temperature above 102 degrees Fahrenheit (38.9 degrees Celsius). They include:
――using saunas or hot tubs
――taking very hot, long baths and showers
――using electric blankets or heating pads
――getting a high fever
――becoming overheated when outside in hot weather or when exercising

What are the risks, if any, to my baby? If your body temperature goes above 102 degrees Fahrenheit (38.9 degrees Celsius) for more than 10 minutes, the elevated heat can cause problems with the fetus. Overheating in the first trimester can lead to neural tube defects. Later in the pregnancy, it can lead to dehydration.

What can I do about it? Instead of hot tubs or saunas, take a dip in a cool pool. And it's probably a good idea to stick to warm or slightly hot baths and showers. If you have a fever during your pregnancy, talk to your doctor about ways to lower it. And follow your body's cues that you're getting overheated when exercising or enjoying the great outdoors in the warmer months.

But if you've already become overheated during your pregnancy, don't worry too much about it. Chances are, you removed yourself from the uncomfortable situation before any damage was done.

● Self-Tanners/Sunless Tanners
Should I avoid them? Maybe. Although there's no proof that self-tanners are harmful to an unborn baby, there haven't been many studies done on their effects to a fetus.

What are the risks, if any, to my baby? No risks specific to tanning have been documented.

What can I do about it? For a summer glow, skip the self-tanner and apply some bronzer to your face, neck, shoulders, and chest. And if you do decide to try a self-tanner, that's far safer than lying out in the sun and becoming potentially overheated. Overheating in the first trimester, as discussed above, can lead to significant problems for the baby; later in the pregnancy, it could lead to dehydration in the mother. Still, ask your doctor before applying any"tan in a bottle."

● Sex
Should I avoid it? No. Most pregnant women having a "normal" pregnancy can continue having sex — it's perfectly safe for both mom and the baby, even up until the delivery. Of course, you'll probably need to modify positions for your own comfort as your belly gets bigger.

However, your doctor may advise against sexual intercourse if he or she anticipates or detects certain significant complications with your pregnancy, including:
――a history or threat of miscarriage
――a history of pre-term labor (you've previously delivered a baby before 37 weeks) or signs indicating the risk of pre-term labor (such as premature uterine contractions)
――unexplained vaginal bleeding, discharge, or cramping
――leakage of amniotic fluid (the fluid that surrounds the baby)
――placenta previa, a condition in which the placenta (the blood-rich structure that nourishes the baby) is situated down so low that it covers the cervix (the opening of the uterus)
――incompetent cervix, a condition in which the cervix is weakened and dilates (opens) prematurely, raising the risk for miscarriage or premature delivery
――multiple fetuses (you're having twins, triplets, etc.)

What are the risks, if any, to my baby? You should not have sex with a partner whose sexual history is unknown to you or who may have a sexually transmitted disease, such as herpes, genital warts, chlamydia, or HIV. If you become infected, the disease may be transmitted to your baby, with potentially dangerous consequences.

What can I do about it? Talk to your doctor about any discomfort you experience during or after sex or any other concerns.

● Tap/Drinking Water
Should I avoid it? Not necessarily. Before you go out and buy a 9-month supply of bottled water, tell your doctor where you live and whether you have public water or well water.

It's also important to note that just because water is bottled doesn't necessarily mean it's safer. Although bottled water (which is regulated by the FDA) may often taste better or just different, tap water meets the same Environmental Protection Agency (EPA) standards.

What are the risks, if any, to my baby? Different studies show different things, according to the March of Dimes. Some have found that the chlorine used to treat public water can turn into chloroform when it mixes with other materials in the water, which can increase the risk of miscarriage and poor fetal growth. But other studies have found no such links. Also of concern to some is the potential for the water to be contaminated by things like lead and pesticides. If you have well water you should probably have it checked regularly, such as once a year, whether you're pregnant or not.

What can I do about it? If you're concerned, contact your local water supplier to get a copy of the annual water quality report. If you're still concerned and/or have private well water, have your water tested by a state-certified laboratory. This can cost anywhere from $15 to hundreds, depending on the number of contaminants you want to have your water tested for.

To help ease your mind, you could also buy a water filtration system to help reduce the levels of lead, some bacteria and viruses, and chemicals such as chlorine. But be sure to read the product's label thoroughly, as some do more than others.
Countertop pitcher and faucet-mounted units are fairly inexpensive (some for under $50), whereas systems used to treat your entire home's water supply are much pricier (up to thousands of dollars). You can also have refillable water coolers delivered to your home, often through wholesale — or bulk items — stores.

● Teeth Whiteners/Teeth Bleaching
Should I avoid them? Maybe. As with self-tanners, no good studies have been done on teeth whiteners that definitively say whether they're safe to use if you're expecting. And some makers of whitening products do caution against using them during pregnancy. Some dentists encourage waiting until after pregnancy to get your teeth whitened and others say that the procedures are safe. The concern is primarily about the chemicals used in teeth whitening products that could be swallowed and the potential effect on a fetus.

What are the risks, if any, to my baby? There's currently no evidence that teeth whitening can harm a fetus.

What can I do about it? Talk to your doctor before plunking down the cash on whitening products. If you'd rather wait until after your pregnancy to try to make your teeth pearly white, simply brush regularly with whitening toothpaste, which may give a little extra kick to your smile.

● Vaccinations
Should I avoid them? Many — yes; others — no. It's best to wait until after your pregnancy for most vaccines, but a few are considered safe. Your doctor may say it's OK to get a vaccine if:
――there's a good chance that you could be exposed to a particular disease or infection and the benefits of vaccinating you outweigh the potential risks
――an infection would pose a risk to you or your baby
――the vaccine is unlikely to cause harm
However, the CDC recommends only these vaccines as safe during pregnancy if they're truly necessary:
――influenza (the flu) — but only the shot made with the inactivated virus
――hepatitis B
――meningitis
――rabies
――tetanus/diphtheria

What are the risks, if any, to my baby? Live-virus vaccines — those containing a live organism — aren't recommended for pregnant women because of the risk that the actual infection or disease the vaccine is meant to prevent may be passed along to the unborn baby. However, this depends on the circumstances and whether the vaccine would ultimately be safer to receive than being exposed to the actual disease. For example, the chickenpox vaccine may be safer to your unborn baby than getting the infection. So, it's important to speak to your doctor if you believe that you may have been exposed to a disease.

For the most part, though, researchers don't know what the risks of some vaccines may be to a fetus. So, it's wise to just wait to be vaccinated unless your doctor tells you otherwise.

What can I do about it? Be sure to talk to your doctor before getting any vaccination during pregnancy. It's also a good idea to inform your doctor if you became pregnant within 4 weeks of having a vaccine. And if your workplace requires certain vaccines, be sure to let them know you're pregnant before agreeing to be immunized.

● X-Rays
Should I avoid them? Yes and no. If your doctor thinks it's truly necessary — for your own well-being or your baby's — to get one during your pregnancy, then it's highly unlikely that low levels of X-ray radiation will be harmful. However, if you can safely wait to get an X-ray until after your baby is born, then that's probably the best way to go.
What are the risks, if any, to my baby? According to the American Academy of Family Physicians (AAFP), X-rays are most likely safe during pregnancy. Most diagnostic X-rays emit much less than 5 rads, which is the limit of what the FDA suggests a pregnant woman should be exposed to.

Different imaging studies emit different amounts of radiation and the direction of the X-ray beam also affects the possible exposure to the fetus. Dental X-rays, for example, aren't cause for much concern because the X-ray area is far from your uterus. However, researchers believe that a fetus is more susceptible to damage by radiation because of the rapid rate with which their cells are dividing.

What can I do about it? First, make sure that all of your health care providers (including your dentist and the X-ray technician) know about your pregnancy before you get an X-ray. Also make sure that your stomach is covered with a lead apron.
If you're concerned and would rather not get an X-ray at all during pregnancy, your doctor may be able to use an MRI (magnetic resonance imaging) test during the first trimester or an ultrasound anytime.


Although some things are certainly considered unsafe during pregnancy, try not to spend too much time wondering and worrying. When in doubt, just use common sense — if it seems like a bad idea, doesn't need to be done right now, or might be risky, hold off at least until you've had a conversation with your doctor about it. He or she can likely help ease your mind and may even give you license to do something you never expected to be able to do until after your special delivery.

Above all, make sure to follow the most important healthy pregnancy habits — eat right; get plenty of rest; steer clear of drugs, alcohol, and tobacco — and you'll be well on your way to keeping both you and your baby healthy.