Pregnancy, Fertility and Childbirth

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• QWhat is twin-to-twin transfusion syndrome?

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  A Sigma Nursing answered

  Twin to twin transfusion syndrome (TTTS) is an abnormality of the placental vasculature during pregnancy which affects identical twins. Identical twins share a common monochorionic placenta. If the placenta contains abnormal blood vessels the umbilical cord blood flow and the circulations of the fetuses becomes connected. As a result one fetus, known as the donor, receives less blood flow and the nutrients it contains which the other fetus, known as the recipient, receives more blood flow and the nutrients it contains.

  At birth, both infants may have problems depending on the severity of the transfusion syndrome. The donor twin may have too little blood and need a blood transfusion, while the recipient twin may have too much blood and may need to have the amount of blood in his or her body reduced. While the infants are identical twins, they may have significantly different birth weight as the donor is frequently small from gestational age due to the lack of nutrients during intrauterine life which the recipient is bigger as a result of the increased volume of blood in the circulatory system.

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• QHow safe is it to clean out a litter box while pregnant?

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  A Laura DeSmeth , Administration, answered on behalf of Medical City Dallas

  Whether you have an indoor-only or outdoor cat will affect how safe it is to clean its litter box when pregnant. There is a risk for toxoplasmosis.

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• QWhat is an ectopic pregnancy?

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  A Dr. Deborah Raines, MSN , Nursing, answered on behalf of Sigma Nursing

  An ectopic pregnancy is an abnormal pregnancy which implants outside of the uterus. The most common place for an ectopic pregnancy is in the fallopian tube, but it also can occur in the abdomen or pelvic.

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• QHow soon after giving birth can I exercise?

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  A Brigham and Women's Hospital answered

  Although you may be eager to shed any weight gained during pregnancy, be prepared to allow your body time to recover from giving birth. Check first with your medical provider about beginning exercise. In general, if you had a vaginal delivery, you may begin mild exercise right away. If you had a cesarean, wait until after your six-week postpartum exam or until all abdominal tenderness has vanished; although you may climb stairs, avoid lifting anything heavier than your baby. Until your exam, exercise by standing up straight wearing sensible shoes, walking and holding in your abdominal muscles.

• QHow long does a normal pregnancy last?

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  A StoneSprings Hospital Center answered

  A normal low-risk pregnancy can last anywhere from 38 to 41 or 42 weeks

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• QHow should I care for my breasts after giving birth?

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  A StoneSprings Hospital Center answered

  How you care for your breasts after childbirth depends on whether or not you will breastfeed your baby.

  If you are planning to breastfeed, take a breastfeeding class or talk to a lactation specialist before your baby is born. You will want to create a care plan based on your specific breast anatomy and any special needs you might have.

  Here are some other things to think about:

  • Consider if you will want a nipple shield, gel pads or lanolin cream. 
  • Bring a nursing pillow with you to the hospital for support while feeding your baby.
  • Purchase nursing pads before you go, too.
  • Buy milk storage bottles or bags.
  • Obtain milk warmers and a breast pump. Most insurance plans will provide you with a breast pump. Call your insurance provider for details.
  • Buy properly fitted nursing bras and nursing shirts. 

  If you are not breastfeeding, talk to you baby's pediatrician about formula choices.  Prepare to wear a supportive bra that reduces nipple stimulation.

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• QHow is an ectopic pregnancy treated?

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  A Intermountain Healthcare answered

  An ectopic pregnancy is extremely dangerous for the pregnant woman. As the fertilized egg grows, it will eventually burst (rupture) the organ that contains it. This can cause severe, life-threatening bleeding inside the abdomen.

  An ectopic pregnancy must be ended as soon as possible. It can be ended with a medication called methotrexate or through surgery. When an ectopic pregnancy is discovered early (during the first six weeks) in the pregnancy and specific hormone levels are low, the doctor will probably recommend methotrexate.

• QWhich vaccinations should I have during pregnancy?

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  A Johnston-Willis Hospital - HCA Virginia answered

  Among all the health questions that arise during pregnancy, one of the biggest is: what medicines and vaccines are safe during this time?

  The most important vaccine during pregnancy is for influenza. The “flu shot” is given annually to combat the anticipated strains of flu circulating in that given year, and it is of paramount importance for pregnant women to receive the inactivated flu vaccine. Contracting the flu during pregnancy puts you at serious risk for complications and hospitalization, and symptoms can be detrimental to the pregnancy.

  You should also get the Tdap vaccine for tetanus, diphtheria and acellular pertussis during each pregnancy. Ideally, this will be administered between weeks 27 and 36 of your pregnancy during your third trimester.

  Some of a woman’s immunity to disease is passed along to their baby during pregnancy, protecting them from some diseases during the first few months of life, before the baby’s 2-month checkup when initial vaccines are routinely administered.

  In addition to boosting your immunity during pregnancy, you should be cautious about travel to areas known to be common locations for vaccine-preventable diseases. Talk to your doctor about any planned international travel and work together on a care plan if the trip is unavoidable.

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• QHow can I ease heartburn during pregnancy?

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  A Brigham and Women's Hospital answered

  Actually, this is common indigestion, but it can be bothersome. You can use over-the-counter antacid remedies, but do not use baking soda or sodium bicarbonate. For severe heartburn, try elevating the head of your bed to encourage your stomach fluids to stay down. Adding four inches of books beneath the head posts is a good way to boost the head of the bed temporarily.

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