Resources
ACOG American Congress of Obstetricians and Gynecologists www.acog.org/for_patients patient information in the form of frequently asked questions is available according to categories: pregnancy, gynecology, labor/delivery, postpartum www.marchofdimes.com select category- pregnancy Cary Obstetrics and Gynecology
Pregnancy Guide
919-389-3447 Trianglebreastfeeding.com
28
PHYSICIANSPHYSICIANS Pediatricians There are a number of outstanding pediatricians in the area. We are happy to give you suggestions for offices in the geographic area. Your best reference source is friends and colleagues with newborns and toddlers.
Apex Pediatrics 919-290-1090 Care Pediatrics 919-858-0600 Cary Children’s Clinic 919-852-3456 Cary Pediatric Center 919-467-3211 Cornerstone Pediatric and Adolescent Medicine Dr.Dr. Michael Michael Anthony Anthony Dr.Dr. Anne Anne Bond Bond Bonpain Bonpain 919-460-0993 Excel Pediatrics 910-891-5437 Holly Springs Pediatrics 919-249-4700 Internal Medicine/Pediatric Associates 919-380-7531 Jeffers, Mann and Artman Pediatrics 919-786-5001 R and R Pediatrics 919-367-9833 Rex Pediatrics of Cary 919-387-3160 Shifa Pediatric Clinic 919-300-7726 Tots N Teens Pediatrics 919-362-7155 Triangle Pediatric Center 919-467-5543 Dr. Noemi Maydew Dr. Gilberto Rodrigo Dr. Noemi Maydew Dr. Gilberto Rodrigo Village Pediatrics 919-469-1989 Western Wake Pediatrics 919-859-9991
27 Dr.Dr. Elita Elita Wyckoff Wyckoff AshleyDr. Jennifer Head, Fraley NP Is vaginal bleeding in pregnancy normal? C n ra la i ns n y r re nancy han y r e er a inal leedin can e ca sed r n r al r s in r rac ice r ide care r y d rin y r e en s si a i ns lan a i n y r er ili ed e re nancy r al is r ide y and y r a y can ca se a inal s in i e ise s in can cc r i h he es care e ill d all e can ens re y r a er e ercise and in erc rse d e he increased re nancy is ha y heal hy and sa e his is ne he l d l he cer i s e ra le and i r an e eriences a woman’s life. We are overjoyed that you chose us. Am I in labor? ay n n hen la r e ins e rec end y call he ice hen c n rac i ns are e ery in es r ne h r d ra i n y Office Information de ini i n la r is hen he c n rac i ns are ca sin r ice is en nday hr h h rsday a y r cer i hin and dila e en lease n e ha and riday a n n r sched led ice isi s e l sin y r c s l is n an indica i n la r is are c n enien ly l ca ed i hin a l c r he e innin s here is n need c n ac he d c r i h s i al a e ed Cary r address is e his ha ens a erly lace i e Cary C ll a in en s are ade in ad ance r ain ice h ne n er is 919-467-5941. If we don’t answer or y need c n ac s n he ee ends r a er ice h rs lease call he ans erin ser ice a 1-888-828- 7182 e ha e e erienced s a a le r ide ad ice d rin re lar ice h rs re ardin y r re nancy ice ails le r he ria e n rse are addressed i hin a h r i e d ra i n e er r r en c ncerns la r r lea in l id in r he rece i nis d rin he call
e ass red ne r hysicians is n call e ery ni h and ill e a le res nd any r en iss es he ans erin ser ice ill a e y r in r a i n and reas n r call he n call hysician ill call y r ly ai in es r a re rn call e re callin he ans erin ser ice a ain hr h he ni h e are deli erin a ies er r in e er ency s r eries ans erin h ne calls and ryin e s e res in
etween. If your uestion is not of an ur ent nature Frequently asked questions: lease wait until re ular office hours. he office staff What should I do if I get in a car accident? all the will have etter access to your medical record doctor immediately. he accident may re uire fetal electronic rescri in system and resources to research monitorin in the hos ital. your concern. Do I have to sleep on the left side? No. It’s not Office Visits recommended that you slee on your ac after ffice visits are recommended every wee s until wee s. he lar e lood vessels e tendin u the ac wee s then more fre uently as determined y your can e com ressed y the enlar in uterus thus doctor enerally every wee s until wee s then decreasin the amount of lood oin to the fetus. wee ly until delivery. n anatomic survey of the a y owever, it doesn’t matter which side you sleep on. is done etween wee s. he se of the a y may e identified at that time. o other ultrasounds are How many people are allowed in the delivery room? scheduled if the re nancy ro resses without he num er of eo le in the delivery room de ends on com lications. the ty e of delivery and if it is a routine delivery. his is enerally dictated y hos ital olicy. Billing aternity enefits can e confusin . ur illin staff Can I travel? es. It is safe to travel u until wee s. and office mana er are availa le to review insurance However, see not on ZIKA virus. covera e and answer illin uestions. Insurance When do I have to be induced? Induction ty ically claims for the lo al fee will e su mitted after delivery occurs if the due date has assed or there is a ro lem for the ill. owever services outside the lo al fee are with the maternal health or fetal health. uidelines illed at the time of service ultrasounds injections and recommend delivery efore wee s. he ris to the nonstress tests. If you leave our care efore delivery a y increases su stantially after that oint. you will e char ed only for your office visits la oratory tests and other services erformed. Can I have a dental exam? es. outine teeth cleanin is recommended ecause oor oral hy iene can cause ro lems in the re nancy.
If I had a previous csection, do I have to schedule another csection? ou have two choices a trial of la or after csection or a re eat csection
Postpartum Postpartum blues occur within the irst wee s N I N ollowin deli ery. omen may eel depressed, an ious and tear ul. ryin or no reason, di iculty sleepin and eelin s o inade uacy are also commonly e perienced. e deli er all o stetrical patients at ymptoms should dissipate completely within a couple wee s. a e ed ary ospital owe er, postpartum depression is much more se ere. he intense eelin s o sadness and an iety tend to ildaire arm d impair the woman rom completin daily tas s. ostpartum depression can occur up to year a ter ary, N ha in a a y ut typically starts within the irst wee s o child irth. I you or your amily has concerns a out postpartum ll patients must prere ister with the hospital prior to depression, we recommend that you consult your deli ery. he prere istration orm can e ound in the doctor. edication is o ten used to control postpartum hospital older. depression.
In re erence to breast feeding, drin in ample amounts o luids is essential to replace what is used or ma in mil . emem er ati ue and dehydration may decrease the mil supply. astitis is the in ection o the reast tissue resultin in reast pain, e er, ody aches and red warm reast. his is a common in ection in reast eedin women. n e aluation y your doctor is needed i the si ns o mastitis appear.
Circumcision is remo al o the outer s in o the penis ores in that co ers the head o the penis. It is typically done on the irst or second day a ter irth. hou h this procedure has minimal ris s, the decision to ha e it done is personal. e respect your decision re ardless.
Childbirth Classes two common techni ues. he doctor will ultimately a e ed ary ospital o ers child irth and reast decide the best route. We don’t endorse inductions for eedin classes in addition to hospital tours. lasses con enience. tend to ill up uic ly so we encoura e you to enroll early in your pre nancy. Cesarean sections sections are ma or a dominal sur eries. ometimes Ultrasounds they are scheduled due to the outcome o a pre ious enerally ultrasounds are done to evaluate the fetus deli ery and other times, they are unplanned at the end and its development. Initially an ultrasound confirms o a di icult la or. I you are plannin a csection, that a pregnancy is in the uterus. During this same visit, e pect deli ery in the th wee . e arran e the date a due date is established. The fetal si e is measured and time o csection around the nd wee o ice isit. and if it coincides with your last menstrual period, your lanned cesarean sections are scheduled onday due date is confirmed. The ultrasound done at - throu h riday. owe er, i you o into la or prior to weeks looks at the baby s organ development, si e, the planned csection date, you will li ely ha e your placenta and fluid. Remember the earlier the csection the day you start la or. ultrasound, the more accurate the ultrasound for dating your pregnancy. ikely your due date will not change Vaginal birth after Cesarean (VBAC) after the initial ultrasound. As an aside, our practice ome women that deli ered ia csection with their irst offers D ultrasounds for an additional fee. pre nancy are interested in attemptin a a inal deli ery. his is called a trial o la or a ter csection. andidates are limited to only one pre ious csection. n ortunately we cannot uarantee a success ul . here are se eral actors that can a ect the potential Laboratory Tests success reason or pre ious csection, maternal wei ht o esity, ailure to dilate cer i and need or First trimester induction. e support your desire or ut we will e eral lood tests are o tained within the irst isits. e orthcomin in counselin you re ardin potential he tests are done to ensure a healthy start to the success and ris s associated. pre nancy. ome o the tests are North arolina state law. estin includes I , epatitis, hlamydia, e ad ised that a serious ris o is uterine rupture, onorrhea and yphilis in addition to pap smear and althou h this occurs in re uently. i ewise, uterine ultrasound. rine samples are retrie ed e ery isit to rupture can cause etal compromise and in ury resultin test or idney unction. in permanent neurolo ical dama e and death.
s ont neous bor t the ro ri te est tion e Second trimester nd durin th t bor e i be tchfu for n o e of the s e tests done in the first tri ester re de i tions fro nor . f there is de i tion fro re e ted in round ee s. ddition test nor or if circu st nces rise re entin the onset for di betes in re n nc is done. We discour e of bor t the ro ri te ti e e ro ise to discuss tients fro e tin or drin in n thin cont inin h t this de i tion is nd h t ctions if n re the su r hours rior to the test. f tient f i s the s fest for ou nd our b b . hese reco end tions initi test nother ore s ecific nd confir tor test i be uided b st tistic ro en s fe r ctices is schedu ed. f bnor ues re resent on th t fro eric n on ress of bstetrici n nd test est tion di betes is di nosed. i b ood neco o ist nd other i e inded or ni tions. su r ssess ent nd n tern te diet o in in ctions or not t in ro ri te ctions s the c rboh dr tes nd su r re then re uired. c se be counter to these reco end tions cou d f note est tion di betes ffects of ut ou nd or our b b t incre sed ris s for re n ncies. f untre ted it c n ffect both other nd co ic tions. b b . otenti co ic tions inc ude er r e b b croso i o b ood su r nd bre thin Overdue difficu ties in the b b . e e ber th t our due d te is ust n esti te. We ddition b ood tests indic te if ou re ositi e for h re un b e to redict hen ou i de i er. t is nor f ctor. Wo en ho do not h e it re described s h for b bies to de i er bet een nd ee s. ne ti e nd re uire edic tion c ed rho i en ese rch indic tes subst nti incre se in sti births t ee s . his edic tion ensures th t our bod fter ee s. s resu t our o is to de i er our does not de e o n i une res onse to h ositi e he th b b in the st ee t the test . ur ho e b b . is ou i o into bor on ou o n. Third trimester Inductions rou tre tococcus is b cteri co on o eti es bor does not occur t the ro ri te ti e found in nd round the in nd rectu . t is not to h e our b b . or so e o en the due d te h s sexually transmitted disease. Women typically don’t ssed. or other o en edic conditions for the h e s to s but the b cteri c n c use se ere o or e en the b b necessit te de i er . o n i ness in ne born. neu oni se sis nd enin itis induction is done hich e ns bor is rtifici c n de e o in ne born e osed to . n order to st rted. here re se er ethods used to st rt n re ent infection s b test t the in nd rectu induction. he ethod is de endent on se er f ctors is done bet een ee s. f is found on the inc udin cer ic di tion nd eff ce ent. ech nic s b cu ture or in the urine ou i be i en di tion ith c theter nd itocin u ent tion re ntibiotics in bor.
Options for chromosomal abnormality screening Nonstress tests and biophysical profiles or patients who desire screening for chromosomal W en additional assessment is necessary eyond abnormalities, there are both invasive and noninvasive listenin to t e eart rate it a oppler a nonstress test options. ne test is the measurement of nuchal test is done. t is a prolon ed monitorin o t e etal translucency (fluid collection at the back of the fetal eart rate or a minimum duration o minutes. n neck). This ultrasound evaluation is performed e en more ad anced test or etal ell ein is a between - weeks in con unction with blood tests iop ysical pro ile. t is a scored etal test or from the mother. The anatomy ultrasound completed mo ement muscle tone reat in and amniotic luid. at - weeks is another noninvasive test looking for is test is done usin an ultrasound. ese tests are structural defects or signs of fetal abnormality. i ly predicti e o etal ealt . These tests have a small risk of false positive results. or this reason, some women opt for more specific Birth plans t esting. We are committed to i in you and your a y t e est care. ur primary oal is to deli er a ealt y a y to a ealt y mom. i e ise most omen a e ost o t e tests t at minimi e dou t and con irm expectations or t eir irt experience. We ant to dia nosis are in asi e and include c orionic illus ma e it onder ul and a oyous occasion. ome omen samplin and amniocentesis. orionic illus samplin c oose to document t eir la or desires in t e orm o a consists o retrie in pieces o t e placenta it irt plan. is is not a re uirement. ut i you a e an ultrasound and needle et een ee s. pre erences e ould li e to no . lease e ad ised i e ise amniocentesis collects amniotic luid rom t at Wa e ed ary ospital as some policies t at are around t e a y usin an ultrasound uided needle re uired or sa e patient care. t rou t e a dominal and uterine all. ot o t e pre ious tests carry some ris to t e pre nancy and t e OUR BIRTH PLAN etus. e onin asi e renatal test is an n recent years it as ecome popular or many patients exception. onin asi e prenatal testin is t e ne est to create a “birth plan” in which they detail t eir opes a aila le testin or some c romosomal a normalities for pregnancy and labor. We’d like to point out that ia lood. is test detects c romosomal material sometimes o e er en t ese plans are ery deri ed rom t e etus circulatin in t e maternal lood. detailed patients can ecome disappointed en t can identi y a etus a ected it trisomy and things don’t go exactly according to their plan. o n yndrome . ere are se eral rand names Occasionally patient’s plans may include re uests or or t is test armony aterni eri y and demands or a course o action t at could increase ris s anorama. or you and or your a y or e en e dan erous. o in our “birth plan”, we would prefer to await the onset of
WE’D LIKE TO KNOW… For additional questions regarding screening tests, don’t hesitate to ask your doctor. or patients that choose eaking fluid from the agina in asi e tests or amniocentesis , we refer to aginal bleeding like a period Obstetrical specialists for those procedures. welling of the face ision changes e ere and continuous headache hest pain ersistent omiting e er o er . ainful urination ecreased or no fetal mo ement terine contraction more than in one hour if less than weeks ersistent abdominal pain nable to tolerate food li uids for hours
Kick Counts etal acti ity is a good indicator of fetal well being. s a result, you can monitor your own baby’s movement starting at 28 weeks. We recommend ‘kick counts’. irst identify a time of day when the baby is most active. Count the baby’s movements for a one hour We recommend you discuss all prescription medicines at your first isit. erbal remedies are not recommended in duration. f the baby mo es times, the baby is doing pregnancy so discontinue them immediately. well. emember to remo e all distractions phone, tele ision during the fetal assessment. f you do not edications afe for regnancy reach mo ements in the allotted time, eat a snack or a oid during first trimester drink a be erage before repeating the assessment. all Remember, no medications have been approved by the FDA the doctor if still unable to reach mo ements. as safe for use in pregnancy.
T N Shortness of breath is common during regnancy. t llergies seasonal antihistamine loratidine Claritin causes a sensation of erceived inability to take a dee and acute nasal fe ofenadine llegra dri breath. his is caused by elevation of the dia hragm cetiri ine yrtec di henhydramine enadryl due to the enlarging uterus. owever, ersistent Cold sores antiviral ocosanol breva shortness of breath without relief should be evaluated lysine Consti ation stool softener docusate Colace, urfak by your doctor.
bulking agent bran any ran Cereals syllium husk etamucil Swelling of the legs and feet is relatively normal in methylcellulose Citrucel regnancy. t is ty ically caused by changes in fluid
osmotic la ative olyethylene glycol ira distribution in the body. he swelling may be uncomfortable but is not concerning unless it is severe stimulant la ative bisacodyl oral su . ulcola and or changes in a short eriod of time. Consult your
Cough e ectorant guaifenesin ucine , obitussin doctor if this is resent in con unction with headache, cough su ressant de tromethor han n many cold vision changes, hand or face swelling and nausea. re arations cough dro s iarrhea anti diarrheal o ermide modium ylicon, as , as loating anti foaming imethicone ha yme astric eflu antihistamine ranitidine antac famotidine e cid cimetidine agamet
roton um ome ra ole rilosec inhibitor lanso ra ole revacid esome ra ole e ium rabe ra ole ci e analgesic eadache Fever cetamino hen ylenol anti yretic calcium carbonate ums, olaids, aluminum aalo tabs aalo eartburn antacid magnesium liquid, ylanta simethicone
anesthetic re aration emorrhoids ointment s ray ucks erma last ylenol analgesic do ulamine nsomnia nisom antihistamine di henhydramine enadryl cean ist asal Congestion saline saline s ray n many cold decongestant henyle hrine re arations vasoconstrictor seudoe hedrine udafed aginal east antifungal icona ole onistat
tissue or clots from the vagina. ee in mind, some women don’t have any signs of the pregnancy ending. iscarriages cannot be revented. I early flu shots are an effective and safe method to Headaches in regnancy es ecially in the first and early rotect you and your baby from the flu and other second trimester are common. ncreased water intake, serious com lication from the flu. regnant women get restful slee and ylenol can hel . he frequency of much sicker from the flu than non regnant women. headaches will decrease usually before 2 weeks. ewborn babies younger than months are at risk for emember to avoid ibu rofen. infection as well. he vaccination rovides immune rotection via antibodies for mom and baby. he inactivated influen a vaccine is recommended for all ome women e erience a shar , stabbing sensation regnant women and can be given in any trimester. along the lower abdomen and groin. his is called regnant women should not receive the vaccine via round ligament pain. t is usually resent on one side. nasal s ray. owever, a small number of immuni ed t occurs with standing, rolling over in bed, changing women will acquire influen a. o, if you develo flu like osition and any maneuver that alters stress on sym toms fever, body aches and res iratory changes , abdominal wall connective tissue. contact the office immediately. f confirmed, an antiviral medication called amiflu may be given to Dizziness in regnancy is caused by a sudden dro in abate the infection. blood ressure. ehydration, low blood sugar and standing for long eriods of time are factors that T D increase and worsen the di iness. Feeling faint and T clammy are accom anying sym toms. ncrease your water intake immediately to feel better and avoid Pertussis whoo ing cough is a contagious res iratory recurrence. tract infection. ym toms include severe cough, runny nose and fever. s the cough rogresses, a whoo ing T sound develo s when breathing between coughs. n a Vaginal discharge tends to increase substantially during newborn, this infection can be life threatening. regnancy. his is due to the increased estrogen levels. ince this is normal, antici ate this change. owever, if Tetanus is an infection transmitted through a break in your discharge changes to a green color or has a foul skin. t causes ainful muscle s asms and can even odor, an e am is warranted. revent swallowing.
8
Diphtheria s a y starts ith a sore throat and o grade fever. e ing in the throat can ead to diffic ty reathing. Nausea and vomiting is often referred to as orning e to a significant ree ergence of hooping co gh in sic ness. o ever it is not i ited to the orning the nited tates inc ding orth aro ina the dap ho rs. his s a y pea s in the th ee of pregnancy vaccination is reco ended d ring every pregnancy. and typica y reso ves co p ete y y the th ee . t is or the a y and o to receive opti a enefits it he pf to eat s a er ea s snac s and avoid foods sho d e ad inistered et een ee s. i e high in fat and foods ith strong odors. eart rn and ith other vaccinations the anti odies deve oped in gastric ref can orsen the na sea and vo iting so o are passed to the fet s. avoid foods that sti ate heart rn i.e. spicy foods. ver the co nter s ggestions to re ieve na sea inc de N sea ands vita in nat ra inger prod cts tea o en ith nor a eight efore pregnancy che s and hard candy i e preggie pops. rescription on y need e tra ca ories in pregnancy and the edications are very he pf hen na sea and vo iting eight gain sho dshould not e ceedexceed 30lbs s for the entire is severe and persists. a p es inc de henergan pregnancy. a anced diet has vegeta es fr its ofran and ic egis. eep in ind that na sea ay ho e grains dairy and ean proteins. or those starting contin e despite edications. the pregnancy ith an e evated eight gain sho d not e ceed s. rin at east o nces of Vaginal bleeding is ite co on. t is not an ater dai y. rtificia s eeteners are fine in i ediate indication of the pregnancy ending. oderation. e reco end dai y prenata nfort nate y there is itt e that can e done hen tivita ins. ost prenata vita ins are very si i ar eeding occ rs. ypica y traso nd eva ation is done so we don’t prefer a particular brand. o e inc de to confir the hea th of the pregnancy aby’s heart o ega fatty acids hich ay e eneficia for feta rate and ocation of the a y if yo are at east ee s rain deve op ent. tra iron and fo ic acid are a so pregnant. essentia d ring pregnancy and postpart period. n ade ate a o nt of fo ic acid is cg dai y. a ci f there is a pro e in pregnancy iscarriage can g sho d e incorporated in yo r diet as e . occ r. iscarriage can happen at any point in the pregnancy t is ost co on in the first ee s Fish first tri ester . ifteen to t enty percent of a regnant o en are a o ed p to ea s a ee pregnancies end in this fashion. he fo o ing are so e o nces of fish and or she fish o in erc ry. or co on signs of iscarriage vagina eeding i e a period persistent cra ping in the pe vis and passage of
T ore infor ation on arious types of fish you can eat urin pre nancy tra el is allowed e en o erseas. e see the food safety website or the website. ha e se eral reco endations in the e ent you tra el while pre nant o not eat rin plenty of water har arry your own snac s wordfish al around e ery hours in ac erel Don’t miss prenatal visits ilefish hec to see if there are any i uni ations o on fish hi h in ercury necessary rappie a e a copy of edical records atfish now your blood type and other i portant rouper edical history o on fish low in ercury e stron ly discoura e tra el after wee s. hri p About the ZIKA Virus rab About the ZIKA Virus obster Recently there has been quite a bit of publicity surrounding the Zika virus and its effects on pregnancy. Infection with Zika can cause callops serious birth defects including microcephaly (small head) and other al on brain defects. These defects can lead to lifelong problems including lounder seizures, learning disabilities, problems feeding, hearing and vision anned li ht tuna loss. There is no vaccine available at this time. The Zika virus is spread in three ways, an infected mosquito bites oods hi h in ron you, engaging in sex with an infected individual and, finally, the eats e yol s dried beans or peas reen leafy mother transfers it to your unborn child in pregnancy. Travel to high- e etables dried fruits nuts peanut butter rains risk areas is not recommended. This includes South America and Mexico as well as parts of Africa, India and in the Caribbean. The oods hi h in alciu CDC is frequently updating geographic regions that are at high risk. il yo urt cotta e cheese broccoli This information is found on their website at www.cdc.gov.
The symptoms of Zika virus are generally mild and can easily be con- fused with the flu or a number of other viral infections. An infected person may have fatigue, low-grade fever, rash, joint pain or red affeine consu ption is safe in oderation. e and itchy eyes. It is important to remember that all the symptoms reco end less than ounces of coffee per day. or none of the symptoms may be present. Consult the CDC website obacco use is not reco ended. t can si nificantly before you travel as these high-risk areas are updated on a daily affect fetal rowth and de elop ent specifically lun basis. Please contact us to discuss testing for Zika virus if either you de elop ent and fetal birth wei ht. o a ount of or your partner I have traveled to such areas or if either you or your partner had symptoms of the infection. al o ol ons mption is sa e or t e et s n al o ol E r n t e pre nant patient oes ire tl to t e a er ise in pre nan is reat an en o ra e o an an a se serio s ealt pro lems etal al o ol impa t e er ise li e al in an s immin are t e est spe tr m isor ers in l in etal al o ol s n rome o ever i o i not e er ise re larl prior to preterm irt lo irt ei t an learnin isa ilities pre nan al in is an a tivit e re ommen t is are st a e possi le o t omes ver important to sta rate an avoi over eatin
I er ises to avoi oo orne illness is more ommon it ertain oo s onta t sports emem er an in e tion o taine rin t e pre nan orse a ri in s iin an lin an e passe to t e et s amples o t ese oo s a ivin in l e ra meats npaste ri e mil eese an in lat on a en reater t an ee s i es a an n er oo e meats an animal pro ts s as ee i en is po ltr an e s Unsafe activities during pregnancy s o l e avoi e rin pre nan aser air removal Listeriosis loo onation is is an in e tion a se a a teria no n ettin a tattoo as isteria t an a se mis arria e premat re eliver sin a ne me i ine ontainin retinoi a i an in e tion o t e ne orn t an e present in a ivin ertain oo s spe i i all so t npaste ri e eeses se o irearms an mil lso e re ommen avoi eatin ot o s sin a tannin e an l n eon eli meats nless eate to steamin e s atin roller la in s iin orse a ri in lle al r s an al o ol se Toxoplasmosis ot t s sa na an steam room is is an in e tion a se a parasite o n in soil an ra meat in a ition to at e es t an Safe activities during pregnancy a se etal in e tion t at ltimatel en s in etal eat n or er to prote t o rsel an o r n orn il oo ani re pe i re meats t oro l an as o r an s a ter an lin Dental or ra meat voi an in at litter an manip latin air perme rela e or olore in a ventilate room t e litter o a in a at immin ravelin t ro airport se rit