Commonly Asked Questions in Pregnancy

Obsterics | Gynecology

Obstetrics

What can I do for headaches? Tylenol is safe to take for a headache, fever or any general discomfort. Follow the recommended dosage on the bottle.

What can I take for a cold? Sudafed or Actifed is safe to take for decongestant. Robitussin is safe to take for a cough. Tylenol is safe to take for a fever, aches, and pains. Sore throat lozenges are safe to take for a sore throat.

What do I do if I have been exposed to Chicken Pox? There is no danger to your baby if you have had the chicken pox. If you are not sure, a blood test can be done to determine if you are immune. If you are not immune, please call your physician.

What do I do if I have been exposed to Fifth's disease? It is likely that you have had the disease as a child and are, therefore, immune. If you are not sure, a blood test can be done to determine if you are immune. It is not likely that you will contract the disease with casual contact. Good hand washing and hygiene are important to prevent infection. Please call your physician if you have been exposed.

May I fly in an airplane? Please discuss with your doctor if you plan to travel during the third trimester. You should never fly in an airplane after your 35th week of pregnancy. When traveling, it is important to drink plenty of water and to get up and walk about the cabin of the plane every hour. Please check with your insurance company to make sure you are covered outside the Louisville area should an emergency arise.

Can I sleep on my back? You may sleep on your back until the third trimester as long as you are comfortable. At that time, if your uterus compresses your major blood vessels, you may become nauseated or dizzy. Placing a pillow under one hip should prevent these symptoms.

What can I do if I am constipated? Increase oral fluids, dietary fiber (fresh fruits and vegetables), and exercise (walking). You may try Citrucel, Metamucil, or Fibercon. Coffee and herbal teas can also have a laxative effect and alleviate constipation. In an emergency, Dulcolax suppositories or Fleet's enema may be used.

Is it normal to have aches and pains in the pelvis? Early in pregnancy, it is normal to feel cramping as the uterus grows and discomfort as the ligaments stretch. During the second trimester, it is normal to feel pains in the pelvis as the uterus grows, your skin stretches, and the baby moves around. During the third trimester, it is common to have a backache and sciatica. Sciatica causes shooting pains down the back of the leg and buttocks. Toward the end of the third trimester, ligaments in the hips and pelvis loosen, causing discomfort. The baby may kick nerves on the inside of the uterus causing shooting pains toward your upper abdomen or vagina. Areas of numbness may also occur on your abdomen. If you are concerned about preterm labor, please call your physician.

When can I expect to feel the baby move? You can expect to begin to feel the baby move at about 20 to 22 weeks of pregnancy. You may not feel daily regular movements until 28 weeks of pregnancy.

Is it normal to have vaginal spotting or bleeding after my vaginal exam (during the later part of the third trimester) or after intercourse? Yes, it is common to have spotting or bleeding in these situations as a result of cervical softening. The cervix must soften before dilation can occur. The spotting should resolve in about 24 hours. Call for heavy bleeding (like a period) or prolonged bleeding.

I have asthma (or allergies). Can I continue my regular medications? Yes. You need to be healthy for the baby to be healthy. Use of inhalers such as Ventolin, Asmacort, Proventil, or Flonase will help to keep the breathing passages open. If you are on an antihistamine, Claritin, Chlor-Trimeton, Benadryl, Dimetapp, Zyrtec and Tavist are the safest antihistamines.

You say I am 20 weeks pregnant. How many months is that? Obstetricians have standardized timing a pregnancy to 40 weeks so that it is easier to communicate and determine due dates as well as testing. The first day of your last menstrual period is used to calculate your due date. 20 weeks is exactly half way through your pregnancy or about 4 1/2 months along.

My dentist needs to take X-rays. Is this okay? You should continue to care for your teeth in the normal manner. If X-rays are necessary, your dentist will shield the baby. Filling cavities or taking antibiotics, if prescribed by your dentist, is safe and desirable as pregnancy can increase dental disease. Ampicillin is the most common antibiotic and is safe during pregnancy.

My feet are swollen, is this normal? Mild swelling of the ankles and legs is related to the normal and necessary increase in body fluids during pregnancy. To ease the discomfort, elevate your legs or lie down when you can, wear comfortable shoes, and avoid elastic-top socks or stockings. Drinking at least 8 to 10 eight ounce glasses of water a day will help to avoid excess water retention. Support hose may also help to ease the discomfort.

Is it okay to have my hair colored, highlighted, or permed? What about artificial nails? There is no information that any of these procedures will hurt your baby. Please weigh any benefits against any unknown potential risks.

Will it hurt the baby if I don't take my prenatal vitamins? Taking prenatal vitamins with folk acid or folic acid alone during the first trimester may decrease the incidence of neural tube defects like spina bifida. There is no data that after the first trimester prenatal vitamins are essential.

I would like to take a hot bath. Is this okay? Studies show that hot saunas during the first trimester may cause miscarriage. There is no evidence that hot baths cause any fetal harm.

I have a sinus infection. Can I take antibiotics? Yes. The only antibiotic that you should absolutely not take in pregnancy is tetracycline. Avoid sulfa and quinolone antibiotics in the third trimester.

Will higher elevations and altitude be harmful to the baby? No, but if you have any difficulty breathing, you should return to a lower elevation.

Is it okay to have sexual intercourse during pregnancy? There is no evidence that sex causes miscarriage or premature labor in low-risk pregnancies. You may be sexually active until labor starts unless your physician instructs you otherwise. If your pregnancy is complicated, discuss this with your doctor. Lubricants such as Astroglide or KY jelly are not harmful. A small amount of spotting during the 24 hours after intercourse is common.

Will stress hurt the baby? No.

I have pressure in my lower pelvis. Is this normal? Yes, hormones cause the ligaments and the cartilage in the joint to soften and move during the pregnancy.

It feels as if my heart is racing. Is this normal? Yes, it is common to have palpitations. Notify your physician if you have fainting spells.

I think I have a yeast infection. What medication can I use? It is safe to use any of the over-the-counter medications designed for treating a yeast infection.

What can I use to relieve the discomfort of hemorrhoids? Use Anusol HC cream or Tucks medicated pads to relieve hemorrhoidal discomfort. Increase the fluids and fiber in your diet to decrease constipation.

I don't drink milk and would like to know how much calcium I need to take. The recommended daily allowance during pregnancy is 1500 mg daily. TUMS antacid is the easiest sources of calcium to take.

I have varicose veins. Is there anything I can do to alleviate the discomfort and prevent them from getting worse? Avoid long periods of standing or sitting. When sitting, elevate your legs above the level of your hips. Try wearing support pantyhose throughout the day. Exercise, such as walking 20 to 30 minutes daily, is also helpful. If you are experiencing uncomfortable vulvar varicosities, wearing maternity exercise or bicycle shorts may help.

Is it safe to exercise? Yes. In an uncomplicated pregnancy, we recommend exercise as it makes labor easier, decreases the incidence of pre-term labor as well as cesarean section. If an exercise causes cramping, shortness of breath, or pain, then decrease the intensity or stop exercising and discuss with your doctor. You should be able to carry on a conversation while you exercise. Soccer, ice hockey, skiing, horseback riding, and water skiing are strongly discouraged. Scuba diving is not safe at any time during pregnancy.

The baby's heart rate is fast - does this mean that the baby is a girl or a boy? Heart rate does not determine whether the baby is a girl or boy.

I just had a second trimester ultrasound and the size of the baby does not correspond with the gestational age. Does this mean that my due date is different? If the dates are off by greater than 2 weeks, then the due date may be changed. If an ultrasound was performed earlier, your dates will not change.

Should I get the flu shot? It is highly recommended if you are pregnant or having your baby during the flu season that you get the flu shot.

How is the cord blood collected? After deciding to proceed with cord blood collection, the parents need to contact a collection company to obtain a collection kit. The kit is brought to the hospital and given to the labor nurse or obstetric tech for the delivery table. If a cesarean section is necessary, the kit must be placed on the sterile table. After the baby is delivered, your obstetrician collects the blood into the kit's collection system and then you send it back to be stored according to the directions included in the kit.

Does my insurance cover the cost of collection and storage? You should check with your carrier. Usually collection and storage are not a covered benefit. Your insurance may reimburse your physician for the professional charges encountered with the collection.

How do I find a cord blood collection company? Many companies are not providing this service. A list can be obtained at parentsguidecordblood.com. More information can be found at Cordbloodoptions.com, Viacord.com, or Cordbloodregistry.com. When choosing, look for a firm that has a good transplant history and that freezes the samples in their own facilities.

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Gynecology

1. Can birth control pills cause breast cancer?
This is an area of controversy and there is no definitive answer for this question. There have been studies that show no increase risk of breast cancer in birth control pill users and there have been studies that demonstrate the converse. From a review of all of these studies the conclusion that can be drawn is that birth control pills do not initiate breast cancer in women. However, in women who have an undetectable breast cancer, the pill may promote a faster growth of this cancer.

2. Does sex after hysterectomy change?
The effect of hysterectomy on sexual function is a controversial subject. It was thought in the past that women who had a complete hysterectomy (removing the uterus and cervix) experience more sexual dysfunction than women who don't. What seems more to be the case is that whatever a woman’s sexual functioning was like before surgery is what she can expect after surgery.

This may not be the case in a woman who has had a hysterectomy because of cancer or in a woman whose vagina may have been shortened as a result of their hysterectomy. In these cases, the shortened vagina may cause pain with intercourse which may then lead to other sexual problems. Women who have had their ovaries removed before they reach menopause may also experience decreased sexual desire and difficulty with arousal.

3. Is CA 125 a screening test for ovarian cancer?
There is no screening test that will tell you if you have ovarian cancer or not. Doctors use CA 125 to help in diagnosis and in monitoring the treatment of women with ovarian cancer. It helps in evaluating the likelihood that a suspicious ovarian cyst is cancer or not. Only when the cyst or ovary is removed and examined, you can be sure it is cancer or not. This test cannot be used to tell if you have ovarian cancer because the CA-125 marker may be elevated in conditions other than ovarian cancer. The test is not specific enough to use for this purpose. Other conditions that will cause the test to be elevated include endometriosis, fibroids, and diseases of the bowel. Even smoking has been showing to cause an elevation of CA125

4. What is Polycystic Ovarian Syndrome (PCOS)?
PCOS refers to a condition in which hormones (androgens/estrogen) are overproduced by the ovaries. In this condition, ovulation occurs sporadically. The excess and not well organized hormones can cause a lack of a menstrual cycle, excess hair growth, obesity, acne, and insulin resistance. As a result, women with PCOS are at a high risk of developing diabetes. As more and more research is being done on PCOS, more associations with other illnesses are being found. The treatment is to interrupt this persistently elevated level of estrogen either with use of birth control pills. Other medications are used to treat the symptoms of excess or abnormal hair growth and insulin resistance. Infertility can be treated with good response most of the time.

5. I often have a clear, non-odorous discharge from my vagina. Is this normal?
Your discharge is normal. Every woman is different; some have more discharge than others. You will notice that your discharge changes in appearance about 2 weeks after your cycle. As long as your discharge does not smell, is not irritating or itchy, you do not need to do anything about it. Younger women tend to have more discharge; this is related to the normal hormonal changes.

6. Is it okay to douche?
It is not necessary to douche at all. Douching can lead to changes in the environment of the vagina which can lead to infections such as Bacterial Vaginosis (BV) and yeast infections. The vagina is a self- cleaning organ. Also, if you already have an infection in the vagina, douching can spread this infection into your uterus and pelvic cavity. If you notice that your vagina has a foul odor, you may have an infection. This should be evaluated by a health care provider.

7. What if I become pregnant while taking birth control pills?
The most common reason women become pregnant on the Pill is improper usage. Pregnancies usually occur because initiation of the next cycle (the next pack of pills) is delayed or forgotten allowing for ovulation to take place. If you do become pregnant while taking the pill, immediately stop taking them. There have not been any reports that demonstrate the hormones in the pill adversely affect a developing fetus.

8. What are the side effects of birth control pills?
Side effects vary from person to person. Some women experience little, if any side effects, while others have significant side effects. Keep in mind that there are many hormonal combination of the Pill and if you did not tolerate one there might be a better one for you. The following is a list of some of the more common side effects and concerns:

Break-through bleeding: spotting or bleeding between periods, usually temporary
Amenorrhea: absence of menstrual cycle, can occur with prolonged use
Nausea/ Breast Tenderness: most intense in first few months of use, gradually resolves
Migraine: may either be better or worse on the Pill
Blood Clots: Very low risk; however, if a woman does develop a blood clot while using the Pill there can be an underlying clotting problem. Pill use is contraindicated in women with clotting disorders.

9. Who should not take the Pill?

Women with clotting disorders, heart disease, or strokes
Women with active liver disease
Women with known or suspected breast cancer
Women with undiagnosed abnormal vaginal bleeding
Pregnant women
Smokers over the age of 35

10. Is there any association between cancer and the Pill?
Women using the Pill decrease their risk of uterine cancer by 50%, ovarian cancer by 40% and benign breast disease by approximately 40%.

11. How long can I take the Pill?
The pill can be use for many years safely. Long term non-contraception benefits of the Pill include regulated menstrual cycle with less blood flow, reduced risk of iron deficiency anemia, and less painful periods.

12. How soon will I be able to get pregnant after discontinuing the Pill?
Infertility is not increased by use of the Pill. Women who have taken the pill have no higher rate of spontaneous miscarriages, and do not have higher rates of bearing children with abnormalities.

13. What is Emergency Contraception?
Emergency Contraception is the use of large doses of estrogen to prevent implantation. It is an important option for women and should be considered when condoms break or get misplaced, when sexual assault occurs, or when diaphragms or cervical caps dislodge. Treatment is initiated as soon after exposure but no later than 72 hours. Two doses are required 12 hours apart.

14. What is genital HPV infection?
Genital HPV infection is a sexually transmitted disease (STD) that is caused by human papillomavirus (HPV). Human papillomavirus is the name of a group of viruses that includes more than 100 different strains or types. More than 30 of these viruses are sexually transmitted, and they can infect the genital area of men and women including the skin of the penis, vulva (area outside the vagina), or anus, and the linings of the vagina, cervix, or rectum. Most people who become infected with HPV will not have any symptoms and will clear the infection on their own. Some of these viruses are called "high-risk" types, and may cause abnormal Pap tests. They may also lead to cancer of the cervix, vulva, vagina, anus, or penis. Others are called "low-risk" types, and they may cause mild Pap test abnormalities or genital warts. Genital warts are single or multiple growths or bumps that appear in the genital area, and sometimes are cauliflower shaped.

15. What is endometriosis?
Endometriosis is a common disorder that affects women of reproductive age. It occurs when normal endometrial tissue (the lining of the uterus) grows outside the uterus. This misplaced tissue may implant itself and grow anywhere within the abdominal cavity. The disease is highly unpredictable. Some women may have just a few isolated implants that never spread or grow, while in others the disease may spread throughout the pelvis. Endometriosis irritates surrounding tissue and may produce web like growths of scar tissue called adhesions. The scar tissue can bind the pelvic organs and even cover them entirely. Many women who have endometriosis experience few or no symptoms. However, in some women, endometriosis may cause severe menstrual cramps, pain during intercourse, and infertility.

16. What are the symptoms of endometriosis?
Progressively increasing menstrual cramping may be a symptom of endometriosis. These are caused by contractions of uterine muscle initiated by prostaglandins released from the endometrial tissue. A puzzling feature of endometriosis is that the degree of pain it causes is not related to the extent of the disease. Some women with extensive disease feel no pain at all. A woman with endometriosis may notice that as the disease progresses her periods become more painful or that the pain begins earlier or lasts longer.

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