DOCSLIB.ORG

Reporting on Prenatal Care April 2021

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Reporting on Prenatal Care April 2021 The Empire Plan APRIL 2021 REPORTING ON PRENATAL CARE Every baby deserves a healthy beginning and you can take steps before your baby is even born to help ensure a great start for your infant. That’s why The Empire Plan offers mother and baby the coverage you need. When your primary coverage is The Empire Plan, the Empire Plan Future Moms Program provides you with special services. For Empire Plan Enrollees and for their Enrolled Dependents, COBRA Enrollees with their Empire Plan benefits and Young Adult Option Enrollees TABLE OF CONTENTS Four Important Steps ........................................2 Feeding Your Baby ............................................11 Take Action to Be Healthy; Breastfeeding and Your Early Pregnancy .................................................4 Empire Plan Benefits ...................................... 12 Prenatal Testing .................................................5 Choosing Your Baby’s Doctor; New Parents ......................................................13 Future Moms Program ..................................... 7 Extended Care: Medical Case High Risk Pregnancy Program; Management; Questions & Answers ...........14 Exercise During Pregnancy.............................8 Postpartum Depression ..................................17 Your Healthy Diet During Pregnancy; Medications and Pregnancy ...........................9 Health Care Spending Account (HCSA) .... 19 Skincare Products to Avoid; Resources ......................................................... 20 Childbirth Education Classes ....................... 10 FOUR IMPORTANT STEPS TO HAVING A HEALTHY BABY 1. Call your doctor If you choose to participate in the As soon as you think you are pregnant, call your Future Moms Program, you will doctor. You can do the most for your baby during receive the following: the first three months of pregnancy, so try to start • A toll-free number you can call for answers to your doctor visits as soon as possible. your questions about important topics, such 2. Enroll in the Future Moms Program as pregnancy, labor, nursing and postpartum depression. This line is staffed by registered As soon as you know you are pregnant, call nurses, 24 hours a day, seven days a week. 1-877-7-NYSHIP (1-877-769-7447) and press or say 2 for the Hospital Program to learn about the Future • A helpful prenatal care book: Mayo Clinic Guide Moms Program. Call early – during the first month of to a Healthy Pregnancy. pregnancy, if possible – and tell the representative • Educational materials to help you handle any you’re calling about your pregnancy. The maternity unexpected events. specialist will ask you some questions to determine • Screening by a registered nurse for common if there are any potential concerns. pregnancy risks like premature delivery or depression. Questions may include: • Useful tools to help you, your doctor and • Is this your first pregnancy? your Future Moms nurse keep track of your • Have you had problems during pregnancy and spot possible risks. previous pregnancies? • Free online visits with a lactation consultant, • Do you have diabetes? counselor or registered dietitian. • Do you get urinary tract infections? 2 Reporting On | Prenatal Care | April 2021 • Free phone consultations with a dietitian, Participating Provider pharmacist, lactation consultant, exercise If you choose a participating provider (obstetrician, physiologist or licensed behavioral health family practice physician or certified nurse-midwife), clinician, if needed. there are no copayments for prenatal visits, delivery For more information on the services offered by or your six-week checkup after delivery. You pay only the Future Moms Program, see page 7. your copayment for routine obstetrical ultrasounds and covered services at participating laboratories. 3. Be informed Maternity services, including prenatal care, are also Ask your doctor or nurse-midwife, the doctor’s covered for you when acting as a surrogate. nurse and the maternity specialist questions. To locate an Empire Plan participating provider Community resources and websites listed on the or laboratory, call The Empire Plan toll free at back cover of this publication provide even more 1-877-7-NYSHIP (1-877-769-7447) and press or information. Make sure you know how you can say 1 for the Medical/Surgical Program. Or, visit have a healthy pregnancy and baby. the NYSHIP Online website at www.cs.ny.gov/ 4. Enroll your baby for coverage employee-benefits and click on Find a Provider. Always check with the provider before you Remember to change from Individual coverage receive services to make sure they participate to Family coverage or add your baby to your in The Empire Plan for New York State Family coverage. government employees. If you are an active employee, contact your Health Benefits Administrator within 30 days of your Non-participating Provider baby’s birth. If you choose a non-participating provider If you are a retiree, write to the Department of (obstetrician, family practice physician or certified Civil Service Employee Benefits Division, Albany, nurse-midwife), after the annual deductible is met, New York 12239, within 30 days of your baby’s birth.* The Empire Plan pays 80 percent of the reasonable and customary charges for maternity care up to * Retirees of Participating Agencies: Call the Health your coinsurance maximum. You pay the balance Benefits Administrator at your former agency. until the coinsurance is met. There are separate charges for services at non-participating laboratories. Your costs may be significantly higher if you choose a non-participating provider. Reporting On | Prenatal Care | April 2021 3 TAKE ACTION TO EARLY PREGNANCY BE HEALTHY The most common early signs and symptoms of pregnancy might include: If you become pregnant, or are planning on becoming pregnant, you will need to adjust your Fatigue lifestyle to ensure that you and your baby are as Supporting a pregnancy will take a lot of your healthy as possible. energy, especially in the first trimester. It is • Get early, regular care. Talk to your doctor about important to get plenty of rest. Fatigue is related prenatal care, your lifestyle and personal and to the high levels of the hormone progesterone. family medical history. These discussions can Eating foods rich in protein and iron may help. help your doctor identify possible risk factors Remember to take a prenatal vitamin for optimal and recommend treatment or lifestyle changes nutritional support. specific to your situation. • Take a prenatal multivitamin. A good prenatal Nausea vitamin will have higher levels of folic acid, which Although often called morning sickness, helps protect against congenital disabilities, nausea during pregnancy can happen at any premature birth, low birth weight, miscarriage time. Hormone levels are a contributing factor, and pregnancy complications. Folic acid is also including rising levels of the hormones human naturally found in orange juice, peanuts, green chorionic gonadotropin (hCG) and/or estrogen. leafy vegetables, beans, broccoli, asparagus, Not every woman experiences nausea, so do peas, lentils and enriched grain products. not be concerned if you are not experiencing this • Stop smoking. Smoking during pregnancy symptom. Try the following to relieve any sickness: can lead to low birth weight, preterm birth • Eat small, frequent meals. The stomach empties and stillbirth. Babies of mothers who smoked slowly during pregnancy and may not hold a during pregnancy are more likely to have large meal. Avoid spicy, fried and greasy foods. poor lung development, asthma, respiratory • Keep crackers at your bedside. Some women find infections or even Sudden Infant Death that eating crackers before getting out of bed or Syndrome (SIDS). Avoid secondhand smoke; moving around can help. it is just as dangerous. • Some women have aversions to certain smells. • Stop drinking alcohol, using illicit drugs and Identify the trigger situations and avoid them. taking prescription and over-the-counter drugs • Try fresh ginger. Make sure to look for items (including herbal supplements) that are not made with real ginger. You can also try grating prescribed by a doctor who knows you fresh ginger into a beverage. are pregnant. • Take your prenatal vitamins with your evening • Eat a balanced diet. Your baby is nourished by meal or before bed rather than on an what you eat, so be sure to include healthy food empty stomach. choices and avoid those with no nutritional value. • Gain enough weight, but not too much. Health Constipation care providers recommend that a woman of During pregnancy, your digestive system may slow normal weight gain 25 to 35 pounds during down. Although uncomfortable, it is not dangerous the course of pregnancy. Ask your doctor how and can be managed. Do not take any laxatives much weight you should gain, based on your unless instructed to do so. Also try these tips: weight before pregnancy. • Increase your fluid intake. • Increase your fiber; eat more fresh fruits and vegetables. 4 Reporting On | Prenatal Care | April 2021 • If you’re not already exercising, add mild exercise to your daily routine. • Check with your doctor to see if you can take a stool softener. This medication is usually safe during pregnancy. Breast Changes Breast changes are one of the very earliest symptoms in pregnancy. Rising hormone levels can cause breast tissue to become swollen, heavier and sore. While this may be uncomfortable, PRENATAL TESTING there is nothing to worry about. Prenatal tests are medical
Load more

Recommended publications
  • Initiating Maternal Milk Supply
    Initiating Maternal Milk Supply www.medelaeducation.com The Value of Human Milk Medela, Inc., 1101 Corporate Drive, McHenry, IL 60050 Phone: (800) 435-8316 or (815) 363-1166 Fax: (815) 363-1246 Email: [email protected] Medela is registered in the US Patent and Trademark Office and elsewhere. 1908576 A 0416 © 2016 Medela, Inc. Printed in the USA. Innovating Practice through Research and Evidence Technological Advances for Initiating Maternal Milk Supply: Implications for Successful Lactation Introduction This edition of Innovating Practice through Research and Evidence explores the use of pumping technology to enhance a woman’s ability to initiate and maintain breast milk production. For several years the American Academy of Pediatrics1 has recommended infants receive exclusive human milk feeding for the fi rst six months, and continue breastfeeding with additional foods up to a year and beyond. Yet data from the 2014 CDC Breastfeeding Report Card2 indicates fewer than 20% of mothers met this objective. There are multiple reasons women do not exclusively breastfeed or sustain lactation through and beyond the fi rst year. However, evidence indicates mothers who breastfeed immediately and frequently after birth have a greater likelihood of successful milk production. Unfortunately not all women are able to have this experience. The intent in this article is to highlight several studies related to a breast-pumping program specifi cally designed to enhance human milk production. Research suggests the secretory activation phase of lactation
    [Show full text]
  • Running Head: BREASTFEEDING SUPPORT 1 Virtual Lactation
    Running Head: BREASTFEEDING SUPPORT 1 Virtual Lactation Support for Breastfeeding Mothers During the Early Postpartum Period Shakeema S. Jordan College of Nursing, East Carolina University Doctor of Nursing Practice Program Dr. Tracey Bell April 30, 2021 Running Head: BREASTFEEDING SUPPORT 2 Notes from the Author I want to express a sincere thank you to Ivy Bagley, MSN, FNP-C, IBCLC for your expertise, support, and time. I also would like to send a special thank you to Dr. Tracey Bell for your support and mentorship. I dedicate my work to my family and friends. I want to send a special thank you to my husband, Barry Jordan, for your support and my two children, Keith and Bryce, for keeping me motivated and encouraged throughout the entire doctorate program. I also dedicate this project to many family members and friends who have supported me throughout the process. I will always appreciate all you have done. Through my personal story and the doctorate program journey, I have learned the importance of breastfeeding self-efficacy and advocacy. I understand the impact an adequate support system, education, and resources can have on your ability to reach your individualized breastfeeding goals. Running Head: BREASTFEEDING SUPPORT 3 Abstract Breastmilk is the clinical gold standard for infant feeding and nutrition. Although maternal and child health benefits are associated with breastfeeding, national, state, and local rates remain below target. In fact, 60% of mothers do not breastfeed for as long as intended. During the early postpartum period, mothers cease breastfeeding earlier than planned due to common barriers such as lack of suckling, nipple rejection, painful breast or nipples, latching or positioning difficulties, and nursing demands.
    [Show full text]
  • Breastfeeding Guide Lactation Services Department Breastfeeding: Off to a Great Start
    Breastfeeding Guide Lactation Services Department Breastfeeding: Off to a Great Start Offer to feed your baby: • when you see and hear behaviors that signal readiness to feed. Fussiness and hand to mouth motions may signal hunger. At other times, your baby is asking to be held or changed. He may be showing signs of being over-stimulated or tired. • until satisfied. In the early weeks and months, feeding lengths vary from 10 to 40 minutes per side. Offer both breasts at each feeding. Your baby may not always take the second side. Expect your baby to cluster feed to increase your milk supply, especially when going through growth spurts. • at least every 1 ½ to 3 hours during the day and a little less frequently at night. Time feedings from the start of one feeding to the start of the next. Most mothers are able to produce enough milk and do NOT need to supplement with formula. • using proper positioning. Turn your baby toward you while breastfeeding. With a wide open mouth, she takes in the areola along with the nipple. The cheeks and chin are touching the breast. Expect your baby to pause between suckle bursts. It is okay to gently stimulate her to suckle throughout the feeding. Your baby is getting enough breastmilk IF: • you hear audible swallows when your baby pauses between suckle bursts. You will hear them more often as your milk changes 24 Hours from colostrum to mature milk. st at least 6 feedings • there are 6 or more wet diapers by day 6. This number will 1 1 wet and 1 stool remain fairly constant after the first week.
    [Show full text]
  • Registration
    Location Registration REGISTRATION Please register early! San Diego County Midwives Our format includes the required three hours of 15644 Pomerado Road, S-302 lactation training to assist you in completing your Name Poway, CA 92064 DONA Certification. Address 858.278.2930 Complete this registration form and submit the Parking is available in front, come right in. We full amount or a $250 deposit to reserve a spot in City/State/Zip look forward to seeing you soon! Occasionally, a the workshop (balance due by the first meeting). change of venue is necessary. Please check Registration postmarked ONE week prior to Phone emails regularly course will be only $475. Late registration (on a Email Meals, snacks, beverages space available basis) is possible, for an additional fee of $40. Profession You may bring lunches and dinner for yourself Important Cancellation Information: If (refrigerator & microwave available) or there are cancellation is received in writing by one week Any birth experiences? many eating establishments nearby. prior to workshop, a full refund less a $50.00 Payment Methods: administrative fee will be refunded. After that • Stripe, CashApp or PayPal – if you would Please bring something to share on Saturday and time, no refunds will be given; however, you may like to use this option, let Lisa know and a Sunday with your fellow doula students. designate a substitute to use your registration or request for payment will be sent to you. transfer it to another training within 1 year of the • Check/money order payable to Gerri Ryan For further information: cancelled training. can be sent to Lisa’s address below: • Lisa – 619-988-3911 call/text or Lisa Simpkins [email protected] Workshop Preparation 825 W Beech Street, #104, San Diego, CA 92101 • Gerri – I.
    [Show full text]
  • Guidelines for Perinatal Care, 8Th Ed., Pp. 48-49, 198-205 ACOG Practice Bulletin, No 145, July 2014, Reaffirmed 2016 JOGNN, No
    Guidelines for Perinatal Care, 8th ed., pp. 48-49, 198-205 ACOG Practice Bulletin, No 145, July 2014, Reaffirmed 2016 JOGNN, No. 44, pp. 683-686, 2015 Terminology and interpretation of electronic fetal monitoring tracings as defined by National Institute of Child Health and Development (NICHD) Maternal Health Competencies - Fetal Assessment & Antenatal Fetal Surveillance Fetal Heart Tones (Beginning at 10 Weeks Gestation with hand-held Doppler) 1. Review provider or standing order 2. Explain procedure and obtains patient's verbal consent 3. Perform hand hygiene prior to engaging with patient 4. Assist patient into semi-recumbent position, expose abdomen 5. Locate the point of loudest fetal heart tones and a. Palpate maternal pulse b. Utilize pulse oximetry (placed on maternal index finger) 6. Monitor maternal pulse and count fetal heart rate for 1 full minute 7. Record findings 8. Demonstrate knowledge of fetal heart rate ranges: a. Normal = 110-160 bpm b. Bradycardia = < 110 bpm c. Tachycardia = > 160 bpm 9. Demonstrate knowledge of criteria for notifying provider of concerns/findings before, during, or after assessment (per clinical policies) Fundal Height (Beginning at 12 to 14 Weeks gestation) 1. Review provider or standing order 2. Explain procedure and obtain patient's verbal consent 3. Perform hand hygiene prior to engaging with patient 4. Assist patient to semi-recumbent position, expose abdomen 5. Ensure the abdomen is soft and palpates with 2 hands to locate the uterine fundus 6. Measure from top of fundus to top of symphysis pubis using a pliable, non-elastic tape measure, keeping the tape measure in contact with the skin, and measuring along the longitudinal axis without correcting to the abdominal midline 7.
    [Show full text]
  • The Empire Plan SEPTEMBER 2018 REPORTING ON
    The Empire Plan SEPTEMBER 2018 REPORTING ON PRENATAL CARE Every baby deserves a healthy beginning and you can take steps before your baby is even born to help ensure a great start for your infant. That’s why The Empire Plan offers mother and baby the coverage you need. When your primary coverage is The Empire Plan, the Empire Plan Future Moms Program provides you with special services. For Empire Plan enrollees and for their enrolled dependents, COBRA enrollees with their Empire Plan benefits and Young Adult Option enrollees TABLE OF CONTENTS Five Important Steps ........................................ 2 Feeding Your Baby ...........................................11 Take Action to Be Healthy; Breastfeeding and Your Early Pregnancy ................................................. 4 Empire Plan Benefits .......................................12 Prenatal Testing ................................................. 5 Choosing Your Baby’s Doctor; New Parents ......................................................13 Future Moms Program ......................................7 Extended Care: Medical Case High Risk Pregnancy Program; Management; Questions & Answers ...........14 Exercise During Pregnancy ............................ 8 Postpartum Depression .................................. 17 Your Healthy Diet During Pregnancy; Medications and Pregnancy ........................... 9 Health Care Spending Account ....................19 Skincare Products to Avoid; Resources ..........................................................20 Childbirth Education
    [Show full text]
  • Increasing Your Breastmilk Supply
    Information for breastfeeding families Increasing Your Breastmilk Supply During the first few days and weeks, frequent stimulation of the breasts by breastfeeding or by using a breast pump is essential to establish an abundant breastmilk supply. If Use a breast pump you find your milk supply is low, try the following recommendations. If you are • Use a hospital grade breast pump with a consistent, you will likely see an improvement double kit within a few days. Although it may take a • Pump after feedings or between feedings month or more to bring your supply up to • Rest 10-15 minutes prior to pumping. Eat meet your baby’s needs, you will see steady, and drink something gradual improvement. You will be glad that • Apply warmth to your breasts and you put the time and effort into massage before beginning to pump breastfeeding, and so will your baby!! • Try “power pumping.” Pump for 15 minutes every hour for a day; or try More breast stimulation pumping 10 minutes, resting 10 minutes, pumping 10 minutes and so on, for an hour • Breastfeed more often, at least 8 or more times per 24 hours Condition your let-down reflex • Discontinue the use of a pacifier • Try to get in “one more feeding” before you • Play relaxing music go to sleep, even if you have to wake the baby • Imagine your baby, look at pictures of • Offer both breasts at each feeding your baby, smell baby clothing or baby • “Burp & Switch”, using each breast twice or powder three times, and using different positions • Always pump in the same quiet, relaxed • “Top up feeds” Give a short feeding in 10- place; set up a routine 20 minutes if baby seems hungry • Do slow, deep, relaxed breathing; relax • Empty your breasts well by massaging your shoulders while the baby is feeding • Assure the baby is completely emptying Mother care your breasts at each feeding.
    [Show full text]
  • Prenatal Breastfeeding Education and Counseling Toolkit
    Acknowledgements The Knox County Health Department would like to thank the University of Tennessee Medical Center Regional Perinatal Program and the University of Tennessee Public Health Nutrition Program for their contributions to the development and distribution of this toolkit. This project is funded under a grant contract with the State of Tennessee. Table of Contents Introduction …………………………………………………………………………………………………….…3 Well Woman Care …………………………………………………………………………………………….. 5 First Trimester ………………………………………………………………………………………………….. 6 Second Trimester …………………………………………………………………………………….……….. 8 Third Trimester …………………………………………………………………………….…………………. 11 Six Weeks Postpartum ……………………………………………………………………….……………..15 Frequently Asked Questions ……………………………………………………………………………..19 Additional Resources ………………………………………………………………………………………..21 References ………………………………………………………………………………………..……………. 22 Appendix A: Breastfeeding Screening Tool..……………………………………………………….24 Appendix B: Prenatal Infographics …………………………………………………………………….26 1 Introduction It’s well-established that breastfeeding is the healthiest method of infant feeding. Breastfed infants are less likely to develop respiratory and ear infections, allergies, asthma, obesity, diabetes and childhood cancers. For mothers, breastfeeding reduces the risk of type 2 diabetes; breast, ovarian and cervical cancers; and postpartum depression. These are just a few of the numerous health benefits of breastfeeding. Many national health organizations including the American Congress of Obstetrics and Gynecologists
    [Show full text]
  • Pumping & Breastfeeding
    Parent Handout Pumping & Breastfeeding If you need to pump your milk, there are several options available. Types of Breast Pumps There are a variety of manual and electric breast pumps to choose from.The best pumps mimic a baby’s suck, pump efficiently, and do not cause discomfort. Many pumps come with discreet carrying bags so you can take the pump anywhere. The pumps range in price, and some can be rented. Since there are so many pumps on the market, a lactation consultant can help you choose the best one for you. If you choose to use a pump, it’s still a good idea to know how to express your milk by hand in case you are unable to pump. 1 2 3 Manual pumps Personal-use double Hospital-grade Manual pumps are the least electric pumps rental pumps expensive type of pump. Because If you’ll be using a pump daily, Hospital-grade pumps are available they require more time, they are consider purchasing a double electric to mothers who need to pump generally used for pumping every pump. This style is convenient if while they are in the hospital. They once in a while. To help with milk you are returning to work since you can also be rented for use after letdown, you may try massaging can pump both breasts at once and discharge through your hospital your breasts. Then, center the use it comfortably every day. Some or a pump rental station. These circular shield over the nipple and run on batteries, some must be electric double pumps are similar pump the handle.
    [Show full text]
  • Breastfeeding Your Baby: a Personalized
    Breastfeeding your baby General guidelines for breastfeeding a full-term, healthy baby This sheet goes over basic guidelines to The benefits of breast milk help you over the next weeks. Be sure to talk with your baby’s health care provider Breast milk is the ideal food for your baby. It has about feeding your baby. If you need help several advantages over formula: breastfeeding: . It is more easily digested than formula. In the hospital: . It contains a balance of nutrients that is ideal . Ask your nurse for help. for your baby. It contains antibodies and special cells that . Attend the breastfeeding class. help protect your baby from infections. The American Academy of Pediatrics Once you are at home recommends that full-term, healthy babies, . Call 617-667-5765 to leave a receive breast milk exclusively for at least the message for a BIDMC lactation first 6 months of life. Premature babies and consultant. those with medical problems should also receive breast milk as soon as possible after birth, with . Call your pediatric provider. or without supplements, according to each baby’s needs. Contact the resources listed on the back of this sheet. Remember: . Feed your baby at least 8-12 times every 24 Getting started hours. If your baby isn’t nursing well, call your health care provider. Rooming-in around the clock and . Keep a written feeding and diaper record. frequent skin-to-skin contact may (You will be given a form to use.) Notify your promote your baby’s readiness to baby’s health care provider if your baby is breastfeed.
    [Show full text]
  • Breast Pumps What Is a Breast Pump? — a Breast Pump Is a Device That Can Pump Milk out of a Woman's Breasts
    Breast pumps What is a breast pump? — A breast pump is a device that can pump milk out of a woman's breasts. If a woman is going to be away from her baby when it is time to breastfeed, she can instead pump milk from her breasts using a pump. The breast milk can be collected, stored, and fed to her baby later. A woman can use a breast pump to start her milk flow or keep her milk supply up when she wants to breastfeed but can't because: ●Her baby needs to stay in the hospital after birth because it was born too early or is sick ●She can't be with her baby all the time because of work, travel, or other reasons Are there different types of breast pumps? — Yes. The right breast pump for you will depend on why you need it and how often you plan to use it. The different types of breast pumps include: ●Electric pumps that are used in hospitals – These breast pumps are powerful and collect breast milk the fastest. They are often used by women whose babies need to stay in the hospital after birth. Women can also rent these types of pumps to use at home. ●Personal electric pumps – These breast pumps are smaller than hospital electric pumps. They can collect breast milk fast, but usually not as fast as hospital pumps. Personal pumps can come in a carrying case. They can be good for women who pump at work. ●Single-sided pumps – These breast pumps collect milk slower than hospital and personal electric pumps.
    [Show full text]
  • OBGYN-Study-Guide-1.Pdf
    OBSTETRICS PREGNANCY Physiology of Pregnancy: • CO input increases 30-50% (max 20-24 weeks) (mostly due to increase in stroke volume) • SVR anD arterial bp Decreases (likely due to increase in progesterone) o decrease in systolic blood pressure of 5 to 10 mm Hg and in diastolic blood pressure of 10 to 15 mm Hg that nadirs at week 24. • Increase tiDal volume 30-40% and total lung capacity decrease by 5% due to diaphragm • IncreaseD reD blooD cell mass • GI: nausea – due to elevations in estrogen, progesterone, hCG (resolve by 14-16 weeks) • Stomach – prolonged gastric emptying times and decreased GE sphincter tone à reflux • Kidneys increase in size anD ureters dilate during pregnancy à increaseD pyelonephritis • GFR increases by 50% in early pregnancy anD is maintaineD, RAAS increases = increase alDosterone, but no increaseD soDium bc GFR is also increaseD • RBC volume increases by 20-30%, plasma volume increases by 50% à decreased crit (dilutional anemia) • Labor can cause WBC to rise over 20 million • Pregnancy = hypercoagulable state (increase in fibrinogen anD factors VII-X); clotting and bleeding times do not change • Pregnancy = hyperestrogenic state • hCG double 48 hours during early pregnancy and reach peak at 10-12 weeks, decline to reach stead stage after week 15 • placenta produces hCG which maintains corpus luteum in early pregnancy • corpus luteum produces progesterone which maintains enDometrium • increaseD prolactin during pregnancy • elevation in T3 and T4, slight Decrease in TSH early on, but overall euthyroiD state • linea nigra, perineum, anD face skin (melasma) changes • increase carpal tunnel (median nerve compression) • increased caloric need 300cal/day during pregnancy and 500 during breastfeeding • shoulD gain 20-30 lb • increaseD caloric requirements: protein, iron, folate, calcium, other vitamins anD minerals Testing: In a patient with irregular menstrual cycles or unknown date of last menstruation, the last Date of intercourse shoulD be useD as the marker for repeating a urine pregnancy test.
    [Show full text]