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    PREGNANCY & BABY'S FIRST YEAR

    The First Trimester
    Common Concerns in the First Trimester

    Some Common Questions
    Q: I always get a bad cold in winter, and this year is no exception. But this time I'm pregnant. Is there any safe way I can treat the symptoms? Can my illness harm the baby?

    A: The symptoms of even a bad cold or flu, though they can make you miserable, are usually not harmful to your baby. Being run down, however, is a strain on your body. And unfortunately, colds tend to last longer during pregnancy, because of changes in your immune system.

    Eating well, getting plenty of rest, exercising and avoiding close contact with anyone who has the sniffles or a sore throat are the best ways to keep from catching a cold or flu. If you're around family or co-workers with colds, wash your hands often. Cold germs are easily passed hand to hand, especially if you touch your eyes, nose or mouth after contact with the sick person.

    The best way to deal with colds and flu during pregnancy is to take care of yourself without taking medications. Treat the symptoms first with plenty of rest and extra fluids. In addition to helping your body fight the cold, drinking plenty of fluids may help keep your stuffy nose clearer. Nasal congestion can also be helped by using a humidifier in your bedroom at night, sleeping propped up with your head elevated or breathing the steam from a pan of simmering water with a towel over your head. A sore throat may be soothed by sucking on ice chips, drinking warm liquids or gargling with very warm salt water. Cool baths can help lower a fever.

    Although your appetite may be affected by a cold, take care to continue eating well. Eat smaller amounts more frequently throughout the day if you can't tolerate large meals.

    Call your doctor if:

    * Your fever reaches 102 degrees Fahrenheit (38.8 Celsius)
    * You are coughing up greenish or yellow mucus
    * Your symptoms are bad enough to keep you from eating or sleeping
    * The symptoms persist for more than a few days with no signs of improvement

    It may be possible to treat your symptoms with a cold remedy -- or a secondary infection (such as bronchitis or sinus infection) with an antibiotic -- but this decision must be made by your doctor.

    Q: Are X-rays harmful during pregnancy? Should I avoid getting them during a dental checkup? What about other types of X-rays?

    A: Although exposure to high doses of X-rays, such as radiation treatments for cancer, can harm the fetus, the low doses used for diagnostic purposes are unlikely to cause damage. If you had a diagnostic X-ray before you knew you were pregnant, don't become alarmed; talk with your doctor.

    At doses of less than 10 roentgens (a unit of radiation exposure), there is no significant increase in the risk of birth defects. Dental X-rays and other common diagnostic procedures deliver far less than this amount. Even a direct X-ray of a pregnant woman's abdomen delivers a very tiny exposure (only about 0.05 roentgen). A chest X-ray of the mother exposes the uterus to an even smaller fraction (0.001 roentgen).

    As with any medical procedure or medication during pregnancy, however, it's best not to have an X-ray unless it becomes necessary. Routine dental X-rays are usually put off until after delivery, or at least until the third trimester. But if a complication or injury makes an X-ray necessary, let your care provider know that you are pregnant before undergoing the procedure. Usually, the abdomen can be shielded with a lead apron.

    Q: My 2-year-old child wants to be carried all the time. Is it true that lifting her, or any heavy weight, can cause a miscarriage?

    A: Picking up your toddler or lifting heavy objects is more likely to harm your back than your fetus. It is not true that this can cause a miscarriage. As long as you don't exhaust yourself or strain your back, you should have no fears about lifting.

    This will become more of a concern in later pregnancy, as your center of gravity changes and your enlarging abdomen starts to affect the way you normally move, lift, stand and carry. It's a good idea to get in the habit now of lifting by bending at the knees, not the waist, and pushing up with your legs, keeping your back as straight as possible. This is the best way to lift anything heavy, even if you're not pregnant. Certain conditions in pregnancy require a woman to avoid heavy lifting after the first trimester. These include cervical incompetence and the risk of preterm labor.

    Q: I'm pregnant with my second baby. Do I need to be concerned about diseases such as chickenpox that my small son may be exposed to?

    A: Although it's possible for childhood diseases to affect pregnant women, fortunately, they're rare in adults. The most common, such as chickenpox, rubella and mumps, are viral diseases that usually infect children younger than 15 years. And once you've had these diseases, you're immune to them for life. Even if you haven't had them, you were probably vaccinated against rubella and mumps as a child.

    If you are unsure whether you had these diseases or the vaccines for them, there is still little reason to worry. It is true that these viruses can potentially harm a fetus in early pregnancy, but they cannot be transmitted directly to the fetus from infected people. The only way your fetus can be affected by them is if you yourself become ill. So unless you know you're immune, avoid contact with anyone who has chickenpox, measles, mumps or rubella, especially during the first trimester.

    Of course, your own child should be vaccinated at 12-15 months of age for measles, mumps and rubella if he or she hasn't been already. The same goes for you, too, but not during pregnancy because the vaccines for rubella and mumps can potentially harm the fetus. If you have never had chickenpox but become exposed during pregnancy, contact your doctor to find out whether tests or medications would be helpful.

    Q: Should I be concerned about having sex while I'm pregnant? Can vigorous sex or orgasm trigger a miscarriage?

    A: There is usually no need to refrain from making love or having an orgasm at any stage of pregnancy. However, doctors sometimes advise women to refrain from lovemaking in the last few weeks before delivery. But it is not true that intercourse or orgasm will cause a miscarriage in early pregnancy.

    Your doctor may advise you against having intercourse if you have had a previous miscarriage or preterm labor. Infection, bleeding and pain are also reasons to refrain from having sex (and to call your doctor).

    The way that women feel about sex during the first trimester varies. You and your partner may enjoy the freedom from birth control. Or fatigue and nausea may dampen your interest. The important thing is for you and your partner to follow your feelings. There's no need to restrict lovemaking in early pregnancy unless you want to, or your doctor advises it.

    Q: My sleep patterns are totally different now that I'm pregnant; I often have insomnia, and my dreams are very vivid. Is this difference normal?

    A: Yes. Considering all the changes you're going through, both physically and emotionally , it's not surprising that your sleep is affected. Although many women sleep more during the first trimester than before they were pregnant, some have trouble sleeping through the night. Insomnia won't harm your baby, and it won't hurt you, either, unless you become exhausted from it. Here are a few suggestions if you can't sleep through the night:

    * Don't lie awake worrying about not sleeping; get up and read, write a letter, listen to a book on tape, do needlework or knitting or involve yourself in some other activity.
    * If you get sleepy during the day but can't sleep at night, try taking short naps in the afternoon or early evening.
    * If anxiety is keeping you awake, ask your doctor about relaxation exercises that may help.

    Vivid dreaming or nightmares are also common during pregnancy. Dreams may be the mind's way of processing unconscious information, such as emotional or physical changes. You may find that you are dreaming more now than before or that you are remembering your dreams more clearly once you awaken. If disturbing dreams or nightmares are a cause of great concern or distress, it may be helpful to talk with a therapist or counselor to help sort out what's troubling you.

    Q: I've been nauseated quite a bit during these first months of my pregnancy. On top of that, I seem to have an unusual problem: I'm salivating a lot. It gets to be almost embarrassing at times. Am I imagining this?

    A: No, you're not. Excessive salivation, called ptyalism (TIE-a-lism), is a somewhat unusual side effect of pregnancy, but it is nonetheless real and can be an annoyance. It is not an indication that anything is wrong. Ptyalism seems to occur with nausea in some women. In fact, it may be that women are not producing any more saliva than usual, but rather, because of their nausea, they are not swallowing as much as they normally would.

    Excessive salivation in pregnancy may be linked to eating starchy foods, so cutting down on these may help. When your nausea begins to decrease in the next trimester, this problem is likely to ease off as well.



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