Some Basic
Pointers (Week 15)
Alpha-fetoprotein Testing
(AFP)
As your baby grows, it produces AFP.
This protein is found in increasing
amounts in the amniotic fluid. The
level of AFP can be meaningful during
pregnancy. An AFP test is usually
done between 16 and 18 weeks of gestation.
The timing of this test is important
and should be done in correlation
to the gestational age of pregnancy
and to the mother's weight. An elevated
level of AFP can indicate problems
with the fetus such as spina bifida
(spinal cord problem) or conversely
anencephaly (central nervous system
defects) found in association between
low levels of AFP. Low levels of AFP
have also been linked with Down syndrome.
In the past amniocentesis was the
only way to test for Down syndrome.
If the level of AFP is not normal,
a detailed ultrasound examination
is done to look for spina bifida,
Down syndrome and anencephaly. This
ultrasound may help determine how
far you are into your pregnancy. AFP
test is not done on all women. There
risk involved is low and it basically
informs your doctor on fetal growth
and development.
Pap Smears during Pregnancy
One is usually done at the beginning
of pregnancy. By now the results are
back and your doctor will address
the results with you if the results
were found abnormal. Pap smears are
done during the pelvic exam and it
is to identify cancerous or precancerous
cells from the cervix, which is located
at the top of the vagina. Pap smears
are screening tests. If your result
is abnormal, your doctor must decide
on treatment. Continue to get checked
as your doctor advises. If the cells
are found to be premalignant or not
too serious, it may be possible to
monitor during pregnancy with colposcopy
or pap smears; biopsies are usually
not done during this time as it can
cause the sensitive cervix to bleed
easily. This situation must be handled
very sensitively. Women who delivery
vaginally may find a change in abnormal
pap smears in that after giving birth,
the Pap smear became normal. The next
step can be a colposcopy, a procedure
that uses an instrument similar to
a microscope to look at the cervix.
Your doctor will be able to see the
abnormal areas so that biopsies can
be taken after pregnancy. A biopsy
will give a better picture of the
problem. If there is a possibility
of the abnormal cells spreading to
other parts of the body, a cone biopsy
may need to be done. This determines
the extent of more severe disease
and removes the abnormal tissue. This
surgery is done with an anesthesia
but not during pregnancy. There are
several ways to treat abnormal cells
but none of these can be conducted
on the pregnant woman. These treatments
include surgically removing the abnormal
spot, electric cautery to burn the
affected spots, crycautery to freeze
small lesions, laser treatment to
destroy abnormal cells and cone biopsy
for more severe lesions.
Change Sleeping Positions
Now
As you grow larger, finding comfortable
positions can become a problem. Don't
lie on your back when you sleep. This
position can place the uterus on top
of important blood vessels (the aorta
and inferior vena cava) that run down
the back of your abdomen. This can
decrease circulation to your baby
and parts of your body. Some pregnant
women also face breathing problems
when lying on their backs. Lying on
your stomach puts additional pressure
on your growing uterus. This is the
reason to learn to sleep on your side.
So, start now to learn to sleep on
your side; it will pay off later as
you become bigger. Sometimes it helps
to put extra pillows. Put one behind
you so you won't roll onto your back
and lie sleeping on your back; another
between your legs or rest your top
leg on a pillow. There are special
pregnancy pillows that support your
entire body in the market as well.
Getting a good night's sleep
Sleeping soundly may be difficult
for you now or later in pregnancy.
Some suggestions below might help:
• Go to bed and wake up at the
same time each day
• Don't drink too much fluid
at night. Slow down after 6 pm so
you don't have to visit the bathroom
all night long
• Avoid caffeine after late
afternoon
• Get regular exercise
• Sleep in a cool bedroom; 21.1
C is ideal
• If you have heartburn problems,
sleep propped up
You may experience shortness of breath
due to enlarged abdomen and this will
interfere with your sleep. Try lying
on your left side. Prop up your head
and shoulders on extra pillows. Light
exercise and warm showers or soaks
may also help. A glass of warm milk
may do the trick or if none of these
work, try sleeping partially sitting
up in a recliner.
