Medical Attention during Pregnancy

Medical Attention during Pregnancy

Medical Attention during Pregnancy There may be times during pregnancy when using medicine is a choice. Some of the medicine choices you and your doctor make while you are pregnant may differ from the choices you make when you are not pregnant. For example, if you get a cold, you may decide to “live with” your stuffy nose instead of using the “stuffy nose” medicine you use when you are not pregnant. Other times, using medicine is not a choice—it is needed. Other women need to use medicine every day to control long-term health problems like asthma, diabetes, depression, or seizures. Also, some women have a pregnancy problem that needs medicine treatment which includes severe nausea and vomiting, earlier pregnancy losses, or preterm labor.  

All women who can get pregnant should take a multivitamin or prenatal vitamin that contains at least 400 micrograms (µg) of folic acid (a B vitamin) to prevent birth defects of the brain and spinal cord. You should begin taking these vitamins before you become pregnant or if you could become pregnant. It is also a good idea to discuss to avoid caffeine, alcohol, and smoking with your doctor at this time. Women who are pregnant or trying to get pregnant should take a daily.

It is best to start taking these vitamins before you become pregnant or if you could become pregnant. Folic acid reduces the chance of a baby having a neural tube defect, like spinal bifida, where the spine or brain does not form the right way. 


What is Group B Strep (GBS)? 


GBS is a bacteria normally found in the vagina and lower intestine of 30-40 % of all healthy adult women. 


If a woman has this bacterium in her vagina and rectum without any symptoms, she is said to be colonized (positive).  It is estimated that 15-40 % of all pregnant women are colonized.  


Being identified as positive does not mean that the mother has Group B Strep disease or that her baby will become ill.  It means that the woman and her physician or midwife must plan the birth with this information in mind.   


Based on the current recommendation the physicians and midwives have elected to test all the women at 35 – 36 weeks of pregnancy and offer IV antibiotics in active labor to all GBS colonized positive women. 

If you have tested positive for Group B Strep, it is important that you and your partner talk to your physician, midwife and the baby’s doctor about the plan of care for you and your baby.  


If you are GBS positive, what will happen?  


You will be asked to come to the hospital as soon as your water breaks or active labor begins.  Shortly after birth, your baby’s blood may be obtained to look for infection.  A blood culture may be done to see if there is an actual infection in the blood.  Depending upon the result of the blood culture and /or your baby’s health, treatment may be started after you have had a discussion with your baby’s doctor or midwife.   


Treatment of your baby may be necessary if: 

·             your baby’s blood test is abnormal

·             your baby has signs of illness 


Treatment of your baby is a decision that is made by the baby’s doctor, you and your family in a collaborative fashion based fashion based upon the baby’s health at the time of birth and in the hours following birth. 


If the baby appears ill (lethargy, pale, irritable, unstable temperature), the baby will have tests to look for evidence of infection. 


In this case, because GBS can overwhelm a newborn so quickly, it is better to start intravenous antibiotics immediately.   

Babies infected with GBS may have mild to severe symptom.  Some baby deaths have occurred from GBS infection. 




After discharge, if you are concerned, it is always best to err on the side of caution in seeking medical attention for a baby regardless of the baby’s age.   


Breastfeeding and GBS 


As for any baby, breastfeeding is the optimal feeding method.  If you have screened positive for GBS, you can still breastfeed.  There are antibodies present in the breast milk, which helps the baby’s immune response.  As a part of your normal routine, always keep your hands and nipple area clean.  


Routine Newborn Blood Testing  

Newborns are routinely screened for phenylketonuria (PKU) and hypothyroidism using a small blood sample taken from the baby’s heel.  This blood test must be done after 24 hours of age but before five days of age.  Babies with PKU cannot process a part o the protein called phenylalanine, which is found in certain foods.  Without treatment, phenylalanine builds up in the bloodstream and causes brain damage and mental delays.   


Early detection of this disorder allows the baby to be treated with a special formula that is low in phenylalnine if they are bottle-fed.  If they are breastfeeding, no special diet is needed until other foods are introduced.  PKU affects one baby in 10,000 to 25,000. Hypothyroidism can retard growth and slow brain development. 


Early detection allows the baby to be treated with thyroid hormone to ensure normal development.  Hypothyridism affects one baby within 2 weeks after the birth. 

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