Pregnancy Week By Week (Week 22)

Week 22 Fetus

Must-ask Questions this Week (Week 22)

What are the risks involved if I were involved in a car accident?

Your baby is well protected in the event of all but the most serious of car accidents. Generally there is only cause for concern if the steering wheel or airbag hits our belly; if the impact is serious then the there is a risk of placental abruption or if you yourself are badly injured. While mothers and babies survive minor accidents with no incident, it is safer to get your doctor's assurance that everything is OK with you and your baby.

How much of protection does my uterus provide in the event of a fall?

Your pelvic bones provide some protection, the muscles that line the wall of your uterus help to keep your baby safe and the amniotic sac and water acts as cushion. There is reason to worry only if you face severe abdominal pain, contractions, bleeding, or a leakage of the amniotic fluid or if you notice a decrease in fetal movements after a fall. In such a situation you would want to see your doctor to get a thorough assessment.

I have been craving for brownies? Why is this and how do I deal with it?

There is considerable debate as to whether cravings are biological or psychological in nature, but regardless as to what causes them, it is important to know how to manage them. If you treat yourself to brownies everyday, you will have to deal with excess weight for some time to come. An occasional treat here and there is fine but overindulgence is not advisable. Here are some tips on how to manage your cravings:

• Ask yourself if it is food what you are really craving for. Sometimes we may crave for something else like sleep of fluids but reach out for the most accessible item, in this case food to replace the actual thing. Food is often used as a substitute for sleep and thirst is confused for hunger. Dehydration sends confusing signals to our system causing us to think of food when all we need is water

• Ask yourself if something healthier will do the trick. If glucose biscuits and a glass of milk will do it for you, then have that instead. But if brownie is all that you can think of, then treat yourself to it and then think calories, and swear off it for the next couple of days (as long as you can)

• Ask yourself why are your cabinets, refrigerators laden with goodies like ice cream, chocolates and brownies. Temptation is not easy to fight off. Imagine if you didn't keep such stuffs at home, imagine having to drive to the supermarket to fulfill the urge. Half the time you will not want to make that effort or trip to get your fix

Some Basic Pointers (Week 22)

Just the Facts

• Try not to worry too much if you are told by your doctor that you are measuring too big or too small for your dates. Not every baby's growth falls on the fetal growth curve to the dot

• Untreated vaginosis and untreated UTI may cause you to go into labor prematurely

• Look for childbirth classes that are high on content and material

• Check with your doctor before making any travel arrangements; not all women are fortunate enough to be able to travel while pregnant

• Don't panic if you fall; your baby is well protected against minor mishaps


Anemia

Anemia in pregnancy is common. Treatment is important for you and your baby. Being anemic makes you feel tired easily and even may experience dizziness as well. There is a fine balance between the production of blood cells and the destruction of these cells. Blood cells carry oxygen to the various parts of the body; anemia is a situation where there is a low count of blood cells. During pregnancy both the blood cells and plasma (the liquid part of the blood) increases but the latter increases more. Your doctor keeps a tab on such readings with a hematocrit reading which measures the percentage of blood. With that your hemoglobin level is tested as well; hemoglobin is the protein component of red blood cells. If you are anemic your hematocrit is lower than 37 and hemoglobin lower than 12. Blood loss is inevitable during delivery; being anemic means you are at higher risk of needing a blood transfusion after birth of baby. Your doctor will advise you on diet and supplements if you found anemic. Iron-deficiency anemia is the most common type in pregnancy. Your baby depends on your iron store for iron supply. If you have this condition, your red blood cells will deplete faster as baby will require the cells for its own build up and your body does not enough iron to produce red blood cells. Most prenatal vitamins have iron in them but there are supplements too. If for some reason you are not able to digest vitamins, the alternative will be to rely on ferrous sulphate. Iron is very vital in all pregnancies. Unfortunately despite supplements and vitamins some women still face iron deficiency. The reasons include:

• Bleeding during pregnancy

• Multiple fetuses

• Poor diet

• Overuse of antacid which causes a fall in iron absorption

• Previous surgery in the stomach or part of the small bowel (making sufficient iron absorption difficult before pregnancy)

The goal is to increase iron consumption so it must be taken on a daily basis. Side effects of iron supplements include nausea and vomiting with upset stomach. If this occurs you may to switch to a lower dose. These supplements are also constipating. If you cannot take the supplements orally, your diet has to change to include iron-rich foods such as liver or spinach; check with your doctor on dietary issues. Sickle-cell anemia is common in dark skinned and women of Mediterranean or African descent. This version of anemia happens because the bone marrow is not able to replenish blood cells fast enough when they are destroyed; furthermore the cells produced are abnormal, causing severe pain as they get blocked in the blood vessels and cannot flow. You may possess the trait without having the disease itself and you could pass the trait or the disease to your child. Inform your doctor of any family history of the disease. Sickle-cell anemia is detectable through a blood test; it can be diagnosed in the fetus through amniocentesis or CVS. Women with this type of anemia are more likely to have pyelonephritis and bacteria in their urine.

A woman with this disorder may suffer bouts of pain (sickle crisis) throughout her life; pain in the abdomen or limbs caused by the blockage of cells happens repeatedly. These episodes can be severe enough to require hospitalization. Risks a pregnant woman with this disease are painful sickle crisis, infections and congestive heart failure; risks to the fetus include a high incidence of miscarriage and stillbirth. On a more positive note, even though the risks are high, many sickle-cell anemia patients have successful pregnancies. Thalassemia is again not a very common version of anemia. It afflicts people of Mediterranean origin. It is characterized by underproduction of protein that makes up the red blood cells. If you have a family history or you yourself have thalassemia, discuss it with your doctor.

Feeling under the weather?

Viral infections, diarrhea and cold will knock on your door during your pregnancy. Not only will you feel more inadequate, these problems may raise concerns for you. How to feel better, what medications are safe, should you continue with your vitamins, how to deal with loss of appetite are but some queries that will cross your mind. If you are sick and not sure how to handle it, call your doctor. Your doctor will advise you on medications. There are things you can do to bring relief to yourself. If you have diarrhea or viral attack, drink lots of fluids like water, juice and chicken broth. Going off the regular diet with no solids is not going to harm you or your baby, but liquids is a MUST. Solids and milk only serves to upset your situation further. If diarrhea is a stubborn one (still there after 24 hours) contact your doctor for advice on medications safe during pregnancy. Prenatal vitamins can be skipped when you are ill; once you are able to keep your food down, resume vitamins. Usually viral and diarrhea don't stay for long and you should be feeling well in no time. Remember to consult your doctor on medicines, take ample rest and pay heed to your fluid intake.

Stress and Pregnancy

Stress during this time is common; new body image, feeling unwell, hormonal changes, the prospect of becoming a parent are all new feelings. To compound matters, job stress or family issues may weigh you down too. But you have to remind yourself to relax as stress isn't good, especially not good for your pregnancy. There are things you can do to remove stress:

• Get enough sleep / rest everyday. Lack of sleep makes you restless and more prone to feeling stress

• Relax during the day by listening to music, reading or going for walks. Have some quiet time by yourself

• Exercise is a good stress reliever - walking or going to the gym helps

• Eat healthy. Sufficient calories prevents you from feeling low

• Do stuffs that you enjoy, just for you

• Stay positive and wear a smile. Changing the way you think about something can have an effect. Thinking positively about an unpleasant situation eases the stress about. It is all about attitude!

• If smells soothes you, burn scented candles, buy flowers, burn aromatherapy oils or add some to your tub

• Share your thoughts with your partner or close friends or family instead of bottling up

Your Nutrition (Week 22)

Fluids, especially water is very, very important during pregnancy - its importance cannot be emphasized enough. We tend to forget or ignore our thirst but the fact is fluids help your body process nutrients, develop new cells, keep up blood volume and regulate body temperature. Studies indicate that for every 15 calories your body burns you need 1 tablespoon of water; for 2000 calories you will need about 2 quarts of water. Since your caloric needs increase during this time so will your need for water. Six to eight glasses per day is good and this excludes beverages. Milk, vegetable juice, fruit juice and herbal teas are choices you can take beside water. Do not count tea, coffee or cola as fluids - in fact avoid them. The sodium and caffeine in them function as diuretics. Common problems like headaches, constipation, bladder infections and uterine cramping become less of a problem if you are good in your fluid intake. Your urine is a good barometer to check on your intake. If it is light yellow to clear, you are doing fine; dark yellow on the other hand suggests that you have to up your intake. Don't wait till you get thirsty to drink something; by that time you would have already lost 1% of your body's fluids. A good tip is to sip on fluids - water and juices - throughout the day and not only when you are thirsty.