Parenting - Prenatal to preschool/Parenting_PrenatalToPreschool.bin/dp/0041/00418.txt

Text File | 1993-06-14 | 6KB | 125 lines

$Unique_ID{PAR00418}
$Pretitle{}
$Title{Pregnancy:  The Fourth Month:  Ask the Doctor}
$Subtitle{}
$Author{
Editors of Consumer Guide
Ellis, Jeffrey W
Ellis, Maria}
$Subject{Fourth Month: Ask Doctor Special Tests? obstetrics Ultrasound sound
waves baby placenta Alpha-fetoprotein AFP Screening neural tube defect
spina bifida anencephaly Amniocentesis amniotic fluid sac Tay-Sachs surfactant
chromosome abnormalities Down's syndrome Monthly doctor Visit weight blood
pressure urine sugar protein backache uterus heartbeat doppler}
$Log{
Ultrasound Study*0041801.tif}

Miracle of Birth


The Fourth Month:  Ask the Doctor


Do I Need Special Tests?


     The tremendous advances made in obstetrics over the last two decades have
greatly increased the safety of both mother and baby during pregnancy.  Among
these advances are three common tests that can help determine the health of
your baby while he is still in your uterus.

     Ultrasound

     This is one of the most commonly used tests in obstetrics today.  An
ultrasound test involves the use of a machine that sends sound waves through
your abdominal wall and uterus.  These sound waves rebound off the baby's
tissue and the placenta and are transmitted back to a screen to form a
"picture" of the baby and placenta.  Using ultrasound, your doctor can "see"
inside your uterus and gain valuable information about the development of the
baby and the placenta.
     An ultrasound test is most commonly performed during pregnancy for one
or more of the following reasons.

  -  To determine the age of the baby if there is a question about the dates
     of your last menstrual period
  -  To check the size of the baby to make sure he is growing normally
  -  To determine the location of the placenta if you experience vaginal
     bleeding
  -  To determine if you are carrying more than one baby
  -  To detect physical abnormalities in the baby or placenta
  -  To determine the location of the baby and placenta before amniocentesis
  -  To locate the site of the pregnancy if it is suspected to be outside the
     uterus (ectopic pregnancy)

     The entire ultrasound procedure takes about 15 to 20 minutes and causes
no discomfort.  To date, no harmful effects of ultrasound have been found for
either mother or baby.

     Alpha-fetoprotein (AFP) Screening

     Alpha-fetoprotein is a substance, produced by the developing baby, that
passes into the mother's bloodstream through the umbilical cord.  Normally,
only a small amount of alpha-fetoprotein enters the mother's blood.  However,
in cases where the baby suffers from a neural tube defect, such as spina
bifida (failure of the spinal column to close completely) or anencephaly
(failure of the brain to develop), alpha-fetoprotein levels in the mother's
blood are abnormally high.
     Neural tube defects occur approximately once in every thousand births.
Since these defects are so common, testing for alpha-fetoprotein is now
recommended for all pregnant women.
     The test is best performed about 16 to 18 weeks after the first day of
your last menstrual period and involves taking a small sample of your blood.
Results are usually available in less than one week.

     Amniocentesis

     This procedure involves the removal of a small amount of amniotic fluid
from the amniotic sac that surrounds the baby.  The fluid is obtained by
inserting a needle through the walls of your abdomen and uterus.
     Before an amniocentesis is performed, an ultrasound test is done to
determine the exact location of the baby and the placenta.  Next, the skin
over your abdomen is cleansed and a small amount of local anesthetic is
injected to numb the skin.  Using the ultrasound picture as a guide, the
doctor inserts a hollow needle through the skin and into the uterus.  About
two tablespoons of amniotic fluid are then extracted with a syringe.
     A laboratory analysis of the amniotic fluid can provide your doctor with
information about the baby's health.  For example, the fluid itself can be
analyzed to determine if the baby has Tay-Sachs disease or other serious
inherited conditions.  The fluid can also be analyzed for the presence of
surfactant, a substance that develops in the baby's lungs during the third
trimester to prevent his lungs from collapsing at birth.  This analysis can
help your doctor to determine if the baby will be able to breathe normally
outside your body.
     Cells that have been shed from the baby's skin are also present in the
amniotic fluid and can be cultured and analyzed to determine if the baby has
any chromosome abnormalities such as Down's syndrome.
     The discomforts of amniocentesis are minor, but the test does involve
some risk of infection and other complications.  Therefore, an amniocentesis
should be performed only after you and your doctor have determined that the
possible benefits of the test outweigh the possible risks.  If the test is
necessary, it will be performed between the sixteenth and eighteenth week
after the first day of your last menstrual period.


This Month's Visit

     During this month's office visit, the doctor will probably:

  -  Check your weight.  By now, you will have gained about six to eight
     pounds.
  -  Check your blood pressure.  Your blood pressure may now be slightly below
     what it was before pregnancy.
  -  Check your urine for sugar and protein.  You should normally have neither
     sugar nor protein in your urine.
  -  Ask about symptoms of pregnancy.  You may now be experiencing backache.
  -  Ask how you are feeling.
  -  Ask if you can feel the baby moving.  You may begin to feel movement
     toward the end of this month.
  -  Check the growth of the uterus by feeling your lower abdomen.  By the end
     of this month, the top of the uterus will be about halfway between your
     pubic bone and your navel.
  -  Listen for the baby's heartbeat.  You and your doctor will easily hear
     the heartbeat by using an instrument called a doppler.
  -  Perform a blood test for alpha-fetoprotein (see this month's Ask the
     Doctor).