Professional Documents
Culture Documents
and Pregnancy
PRE-PREGNANCY COMPLICATIONS
What is lung disease?
Lung disease refers to disorders that affect the lungs, the organs that allow us to breathe.
Breathing problems caused by lung disease may prevent the body from getting enough oxygen.
Examples of lung diseases are:
Asthma,
chronic
bronchitis,
and
emphysema
Lung cancer
Sarcoidosis
(sar-KOY-doh-sis)
and
pulmonary fibrosis
Lung disease is a major concern for women.
The number of U.S. women diagnosed with
lung disease is on the rise. More women are
also dying from lung disease.
Asthma
Asthma is a chronic (ongoing) disease of the airways in the lungs called bronchial tubes.
Bronchial tubes carry air into and out of the lungs. In people with asthma, the walls of these
airways become inflamed (swollen) and oversensitive. The airways overreact to things like
smoke,
air
pollution,
mold,
and
many
chemical
sprays.
They
also
can
be
irritated
by allergens (like pollen and dust mites) and by respiratory infections (like a cold). When the
airways overreact, they get narrower. This limits the flow of air into and out of the lungs and
causes trouble breathing. Asthma symptoms include wheezing, coughing, and tightness in the
chest.
Women are more likely than men to have asthma and are more likely to die from it. The
percentage of women, especially young women, with asthma is rising in the United States.
Researchers are not sure why. Many experts think that air pollution and allergens play a role in
this increase. Breathing tobacco smoke also is linked to an increased risk of asthma.
Lung cancer
Lung cancer is a disease in which abnormal (malignant) lung cells multiply and grow without
control. These cancerous cells can invade nearby tissues, spread to other parts of the body, or
both. The two major kinds of lung cancer are named for the way the cells look under a
microscope. They are:
Small cell lung cancer. This kind of lung cancer tends to spread quickly.
Non-small cell lung cancer. This is a term for several types of lung cancers that act in
a similar way. Most lung cancers are non-small cell. This kind of lung cancer tends to
spread more slowly than small cell lung cancer.
In the United States, more women now die from lung cancer than from any other type of cancer.
Tobacco use is the major cause of lung cancer.
Pulmonary emboli. These are blood clots that travel to the lungs from other parts of the
body and plug up blood vessels in the lungs. Some factors that increase your risk include
being pregnant, having recently given birth, and taking birth control pills or menopausal
hormone therapy. Pulmonary emboli can affect blood flow in the lungs and can reduce
oxygen flow into the blood. Very large emboli can cause sudden death.
Pulmonary hypertension. This is high blood pressure in the arteries that bring blood to
the lungs. It can affect blood flow in the lungs and can reduce oxygen flow into the blood.
Sarcoidosis and pulmonary fibrosis. These inflammatory diseases cause stiffening and
scarring in the lungs.
LAM
(lymphangioleiomyomatosis) (lim-FAN-jee-oh-LEE-oh-MEYE-oh-mah-TOH-sis).
This is a rare lung disease that mostly affects women in their mid-30s and 40s. Musclelike cells grow out of control in certain organs, including the lungs.
Influenza (the flu) and pneumonia. Flu is a respiratory infection that is caused by a
virus and can damage the lungs. Usually, people recover well from the flu, but it can be
dangerous and even deadly for some people. Those at greater risk include older people,
young children, pregnant women, and people with certain health conditions like asthma.
Pneumonia is a severe inflammation of the lungs that can be caused bybacteria, viruses,
and fungi. Fluid builds up in the lungs and may lower the amount of oxygen that the
blood can get from air that's breathed in. People most at risk are older than 65 or
younger than 2, or already have health problems. Vaccines are the best protection
against flu and pneumonia.
Smoking. Smoke from cigarettes, cigars, and pipes is the number one cause of lung
disease. Don't start smoking, or quit if you already smoke. If you live or work with a
smoker, avoid secondhand smoke. Ask smokers to smoke outdoors. Secondhand smoke is
especially bad for babies and young children.
Radon. This colorless, odorless gas is present in many homes and is a recognized cause
of lung cancer. You can check for radon with a kit bought at many hardware stores. Radon
can be reduced in your home if you find out there are high levels.
Asbestos. This is natural mineral fiber that is used in insulation, fireproofing materials,
car brakes, and other products. Asbestos can give off small fibers that are too small to be
seen and can be inhaled. Asbestos harms lung cells, causing lung scarring and lung
cancer. It can cause mesothelioma (MEZ-oh-THEE-lee-OH-muh), which is a cancer that
forms in the tissue covering the lungs and many other organs of the body.
Air pollution. Recent studies suggest that some air pollutants like car exhaust may
contribute to asthma, COPD, lung cancer, and other lung diseases.
Some diseases that affect the lungs, like the flu, are caused by germs (bacteria, viruses, and
fungi).
Trouble breathing
Shortness of breath
Make sure to call your doctor if you have any of these symptoms.
Symptoms of asthma?
Asthma
can
be
hard
to
diagnose.
The
signs
of
asthma
can
seem
like
the
signs
Coughing
Wheezing
Chest tightness
Shortness of breath
To diagnose asthma, the doctor asks about your symptoms and what seems to trigger them,
reviews your health history, and does a physical exam.
To confirm the diagnosis, the doctor may do other tests, such as:
Spirometry (speye-ROM-eh-tree).
The
doctor
uses
medical
machine
called
spirometer. This test measures how much air you can breathe in and out. It also
measures how fast you can blow air out. The doctor may also give you medicines and
then retest you to see if your results improve.
Chest x-ray or EKG (electrocardiogram). These tests can sometimes find out if
another disease or a foreign object may be causing your symptoms.
Other tests. The doctor may want to test for other problems that might be causing the
symptoms. These include stomach acid backing up into the throat, vocal cord problems,
or sleep apnea.
Treatment
Asthma is a chronic disease. Medicines can be used to treat asthma, but they cannot cure it. You
can help control your symptoms by working with your doctor to set up and then follow a personal
asthma action plan. The plan will include possible medications and ways to avoid things that
trigger your asthma.
Taking medicines
Asthma medicines work by opening the lung airways. The medicines used to treat asthma fall into
two groups: long-term control and quick relief.
Long-term control medicines are to be taken every day, usually over a long period of time.
They help prevent symptoms from starting. Once symptoms occur, they do not give quick relief.
These medicines include:
Inhaled corticosteroids. These are the preferred medicines for long-term asthma
control. They relieve airway inflammation and swelling.
Leukotriene
modifiers. These
pills
help
block
the
chain
reaction
that
causes
Cromolyn and nedocromil. These inhaled medicines can help keep airways from
reacting in response to an asthma trigger.
Quick-relief medicines are used only when needed. These include short-acting inhaled beta 2agonists and short-acting bronchodilators, like albuterol and pirbuteral. Quick-relief medicines
often relieve symptoms in minutes. They do this by quickly relaxing tightened muscles around
the airways. They are taken when symptoms worsen to prevent a full-blown asthma attack and to
stop attacks once they have started.
Avoid things that make your asthma worse. Common asthma triggers are tobacco smoke, animal
dander, dust mites, air pollution, mold, and pollens. You can try "fragrance-free" products if your
asthma is triggered by fragrances. Talk to your doctor about allergy shots if your asthma
symptoms are linked to allergens that you cannot avoid. The shots may lessen or prevent the
symptoms but will not cure the asthma. You can reduce your exposure to air pollution by limiting
your outdoor activities on days when the air quality in your neighborhood is poor.
Wheezing
Chest tightness
If you have some or all of these symptoms, make sure to talk to your doctor.
To find out if you have COPD, the doctor will:
Ask about your history of exposure to things that can cause COPD, such as tobacco
smoke, air pollution, or chemicals
The main test to check for COPD is spirometry. For this test, you will be asked to take a deep
breath and blow as hard as you can into a tube that is connected to a spirometer. This machine
measures how much air you breathe out and how fast.
Other tests can include:
Chest x-ray or chest computed tomography (CT) scan. These tests create pictures
of the heart and lungs. The pictures can show signs of COPD. They can also show
whether your symptoms are caused by another condition, such as heart failure.
Arterial blood gas test. This blood test measures the oxygen and carbon dioxide levels
in your blood. It can help determine how severe the COPD is and whether oxygen
therapy is needed.
TREATMENT OF COPD
Damage to the lungs cannot be repaired. The disease can be slowed by avoiding certain
exposures, though. For smokers, the best approach is to stop smoking. You should also limit your
exposure to smoke, dust, fumes, and irritating vapors at home and work. Also limit outdoor
activities during air pollution alerts. Treatment can relieve symptoms. Common medicines are:
Flu shots. Influenza (flu) can cause serious problems for people with COPD.
Pulmonary rehabilitation. This treatment helps people cope physically and mentally
with COPD. It can include exercise, training to manage the disease, diet advice, and
counseling.
Oxygen therapy. The patient receives extra oxygen, either through a tube or mask.
Surgery. Sometimes surgery can help people with severe COPD feel better. Lung
transplant surgery is becoming more common for people with severe emphysema.
Another procedure called lung volume reduction surgery is also used to treat some
patients with severe COPD of the emphysema type. In this surgery, the most damaged
part of each lung is removed.
LUNG CANCER
Coughing up blood
Chest pain
Hoarseness or wheezing
Pneumonia that doesn't go away or that goes away and comes back
In addition, you may feel very tired, have a loss of appetite, or unexplained weight loss. If you
have symptoms of lung cancer, it's important to talk to your doctor. The doctor will ask about
your health history, smoking history, and exposure to harmful substances. He or she will also do
a physical exam and may suggest some tests.
Common tests for diagnosis of lung cancer include:
Chest x-rays. Chest x-rays allow doctors to "see" abnormal growths in the lungs.
Computerized tomography scans (CT scans). CT scans are more powerful than
standard x-rays. The images can show subtle signs of cancer that don't show up on xrays. This can increase the chances of finding the cancer before it spreads further.
Sputum cytology. A sample of mucus that you cough up is studied to see if it has
cancer cells in it.
Bronchoscopy. Doctors pass a special tube called a bronchoscope through the nose or
mouth and down into the lungs. They can see into the lungs and remove small bits of
tissue to test.
Fine-needle aspiration. Doctors pass a needle through the chest wall into the lung to
remove a small amount of tissue or fluid.
Thoracotomy (thohr-uh-KOT-oh-mee). Doctors cut open the chest and remove tissue
from the lungs.
Where the cancer is and if it has spread to other parts of the body
Surgery is used to remove the lung tissue that has the cancerous tumor. Sometimes a large part
of a lung or all of it is removed. When the cancer has not spread, surgery can cure the patient.
Radiation therapy uses a machine to aim high-energy x-rays at the tumor. This energy kills
cancer cells. Radiation therapy can relieve pain and make a person feel better.
Chemotherapy uses medicine to kill cancer cells. Chemotherapy medicines can be given through
a vein or taken as a pill.
Targeted therapy uses medicine to block the growth and spread of cancer cells. It can be given
through a vein or taken as a pill.
Stop smoking. If you smoke, the most important thing you can do is stop. Talk to your
doctor about the best way to quit. All kinds of smoking (cigarettes, cigars, pipes, and
marijuana) can boost the chances of lung disease.
Avoid secondhand smoke. If you live or work with people who smoke cigarettes, pipes,
or cigars, ask them to smoke outside. Non-smokers have the right to a smoke-free
workplace.
Test for radon. Find out if there are high levels of the gas radon in your home or
workplace. You can buy a radon test kit at most hardware stores. The U.S. Environmental
Protection Agency offers information on how to deal with radon.
Avoid asbestos. Exposure to asbestos can cause scarring of the lungs, lung cancer, and
other serious lung disease. Asbestos can be a particular concern for those whose jobs put
them in contact with it. This includes people who maintain buildings that have insulation
or other materials that contain asbestos and people who repair car brakes or clutches.
Employers of those who work with asbestos should offer training about asbestos safety
and should regularly check levels of exposure. They also should provide ways to limit
exposure, such as special breathing masks that filter asbestos dust from the air.
Protect yourself from dust and chemical fumes. Working in dusty conditions and
with chemicals can increase your risk of lung disease. And the risk is not just from
industrial chemicals. Many products used at home, like paints and solvents, can cause or
aggravate lung disease. Read labels and carefully follow instructions for use. If possible,
avoid using products that cause eye, nose, or throat irritation. If you can't avoid them,
use them as little as possible and only in a well-ventilated area. Wear protective
equipment such as a special mask. Make sure you know which type of equipment you
need and how to wear it.
Eat a healthy diet. The National Cancer Institute notes that studies show that eating a
lot of fruits or vegetables may help lower the risk of lung cancer. Of course, diet can't
undo the damage caused by unhealthy behaviors like smoking.
Ask your doctor if you should have a spirometry test. Some groups recommend
routine spirometry testing of at-risk people, such as people who are over 45 and smoke
and those who are exposed to lung-damaging substances at work.
Ask your doctor about protecting yourself from flu and pneumonia with
vaccinations.
See your doctor if you have a cough that won't go away, trouble breathing, pain or
discomfort in your chest, or any of the other symptoms described here.
DEPRESSION
What is depression?
Life is full of ups and downs. But when the down times last for weeks or months at a time or keep
you from your regular activities, you may be suffering from depression. Depression is a medical
illness that involves the body, mood, and thoughts. It affects the way you eat and sleep, the way
you feel about yourself, and the way you think about things.
It is different from feeling "blue" or down for a few hours or a couple of days. It is not a condition
that can be willed or wished away.
Some kinds of depression show slightly different symptoms than those described above. Some
may start after a particular event. However, not all scientists agree on how to label and define
these forms of depression. They include:
Psychotic depression, which occurs when a severe depressive illness happens with
some form of psychosis, such as a break with reality, hallucinations, and delusions.
Seasonal affective disorder (SAD), which is a depression during the winter months,
when there is less natural sunlight.
Genetics (family history) If a woman has a family history of depression, she may be
more at risk of developing it herself. However, depression may also occur in women who
don't have a family history of depression.
Chemical imbalance The brains of people with depression look different than those
who don't have depression. Also, the parts of the brain that manage your mood,
thoughts, sleep, appetite, and behavior don't have the right balance of chemicals.
Stress Stressful life events such as trauma, loss of a loved one, a bad relationship,
work responsibilities, caring for children and aging parents, abuse, and poverty may
trigger depression in some people.
Medical illness Dealing with serious medical illnesses like stroke, heart attack, or
cancer can lead to depression.
Feeling hopeless
Decreased energy
No desire to eat and weight loss or eating to "feel better" and weight gain
Constant physical symptoms that do not get better with treatment, such as headaches,
upset stomach, and pain that doesn't go away
Family doctor
If you are unsure where to go for help, check the Yellow Pages under mental health, health,
social
services,
suicide
prevention,
crisis
intervention
services,
hotlines,
Punish yourself
Yet, hurting yourself does just that it hurts you. If you are thinking about hurting or even
killing yourself, please ask for help! Call 911, 800-273-TALK (8255) or 800-SUICIDE, or check
in your phone book for the number of a suicide crisis center. The centers offer experts who can
help callers talk through their problems and develop a plan of action. These hotlines can also tell
you where to go for more help in person. You also can talk with a family member you trust, a
clergy person, or a doctor. There is nothing wrong with asking for help everyone needs help
sometimes.
You might feel like your pain is too overwhelming to cope with, but those times don't last forever.
People do make it through suicidal thoughts. If you can't find someone to talk with, write down
your thoughts. Try to remember and write down the things you are grateful for. List the people
who are your friends and family, and care for you. Write about your hopes for the future. Read
what you have written when you need to remind yourself that your life is IMPORTANT!
Therapy
Some people with milder forms of depression do well with therapy alone. Others with moderate to
severe depression might benefit from antidepressants. It may take a few weeks or months before
you begin to feel a change in your mood. Some people do best with both treatments therapy
and antidepressants.
Ask your doctor to tell you about the effects and side effects of the drug.
Tell your doctor about any alternative therapies or over-the-counter medications you are
using.
Ask your doctor when and how the medication should be stopped. Some drugs can't be
stopped abruptly but must be tapered off slowly under a doctor's supervision.
Work with your doctor to determine which medication is right for you and what dosage is
best.
Be aware that some medications are effective only if they are taken regularly and that
symptoms may come back if the medication is stopped.
The warning says that patients of all ages taking antidepressants should be watched closely,
especially during the first weeks of treatment. Possible side effects to look for are worsening
depression, suicidal thinking or behavior, or any unusual changes in behavior such as
sleeplessness, agitation, or withdrawal from normal social situations. Families and caregivers
should pay close attention to the patient, and report any changes in behavior to the patient's
doctor. The latest information from the FDA on antidepressants can be found on their website.
Break up large tasks into small ones, set some priorities and do what you can as you can.
Try to spend time with other people and confide in a trusted friend or relative. Try not to
isolate yourself, and let others help you.
Expect your mood to improve gradually, not immediately. Do not expect to suddenly
"snap out of" your depression. Often during treatment for depression, sleep and appetite
will begin to improve before your depressed mood lifts.
Postpone important decisions, such as getting married or divorced or changing jobs, until
you feel better. Discuss decisions with others who know you well and have a more
objective view of your situation.
Be confident that positive thinking will replace negative thoughts as your depression
responds to treatment.
DIABETES MELLITUS
What is diabetes?
Diabetes means that your blood glucose (sugar) is too high. Your blood always has some glucose
in it because the body uses glucose for energy; it's the fuel that keeps you going. But too much
glucose in the blood is not good for your health.
Your body changes most of the food you eat into glucose. Your blood takes the glucose to the
cells throughout your body. The glucose needs insulin to get into the body's cells. Insulin is a
hormone made in the pancreas, an organ near the stomach. The pancreas releases insulin into
the blood. Insulin helps the glucose from food get into body cells. If your body does not make
enough insulin or the insulin does not work right, the glucose can't get into the cells, so it stays
in the blood. This makes your blood glucose level high, causing you to have diabetes.
If not controlled, diabetes can lead to blindness, heart disease, stroke, kidney failure,
amputations (having a toe or foot removed, for example), and nerve damage. In women,
diabetes can cause problems during pregnancy and make it more likely that your baby will be
born with birth defects.
What is pre-diabetes?
Pre-diabetes means your blood glucose is higher than normal but lower than the diabetes range.
It also means you are at risk of getting type 2 diabetes and heart disease. There is good news
though: You can reduce the risk of getting diabetes and even return to normal blood glucose
levels with modest weight loss and moderate physical activity. If you are told you have prediabetes, have your blood glucose checked again in 1 to 2 years.
Type 1 diabetes is commonly diagnosed in children and young adults, but it's a lifelong
condition. If you have this type of diabetes, your body does not make insulin, so you
must take insulin every day. Treatment for type 1 diabetes includes taking insulin shots or
using an insulin pump, making healthy food choices, getting regular physical activity,
taking aspirin daily (for many people), and controlling blood pressure and cholesterol
levels.
Type 2 diabetes is the most common type of diabetes about 9 out of 10 people with
diabetes have type 2 diabetes. You can get type 2 diabetes at any age, even during
childhood. In type 2 diabetes, your body makes insulin, but the insulin can't do its job, so
glucose is not getting into the cells. Treatment includes taking medicine, making healthy
food choices, getting regular physical activity, taking aspirin daily (for many people), and
controlling blood pressure and cholesterol levels. If you have type 2 diabetes, your body
generally produces less and less insulin over time. This means that you may need to
increase your medications or start using insulin in order to keep your diabetes in good
control.
Gestational diabetes Changing hormones and weight gain are part of a healthy pregnancy,
but these changes make it hard for your body to keep up with its need for insulin. When that
happens, your body doesn't get the energy it needs from the foods you eat.
Overweight or obesity
High blood pressure 140/90 mmHg or higher. Both numbers are important. If one or
both numbers are usually high, you have high blood pressure.
Having other health conditions that are linked to problems using insulin,
like polycystic ovarian syndrome (PCOS)
may want to get tested more often. If you're younger than 45, overweight, and have one or more
of the risk factors listed in "Am I at Risk for Diabetes?" you should get tested now. Ask your
doctor for a blood glucose or A1c test. Your doctor will tell you if you have normal blood glucose
(blood sugar), pre-diabetes, or diabetes.
Urinating a lot
Follow your meal plan Eat lots of whole grain foods, fruits, and vegetables.
Get moving Health benefits are gained by doing the following each week:
o
or
o
Test your blood glucose Keep track of your blood glucose levels and talk to your
doctor about ways to keep your levels on target. Many women report that their blood
glucose levels go up or down around their period. If you're going through menopause,
you might also notice your blood glucose levels going up and down.
Talk to your doctor about other things you can do to take good care of yourself. Taking care of
your diabetes can help prevent serious problems in your eyes, kidneys, nerves, gums and teeth,
and blood vessels.
Follow your meal plan You will meet with a dietitian or diabetes educator who will
help you design a meal plan full of healthy foods for you and your baby. You will be
advised to:
o
Limit sweets
Eat often three small meals and one to three snacks every day
Be careful about the carbohydrates you eat your meal plan will tell you
when to eat carbohydrates and how much to eat at each meal and snack
Get moving try to be active for at least 2 hours and 30 minutes each week. If you're
already active, your doctor can help you make an exercise plan for your pregnancy. If you
haven't been active in the past, talk to your doctor. Your doctor can suggest activities,
such as swimming or walking, to help keep your blood glucose on track.
Test your blood glucose Your doctor may ask you to use a small device called a
blood glucose meter to check your blood glucose levels. You will be shown how to use the
meter to check your blood glucose. Your diabetes team will tell you what your target
blood glucose range is, how often you need to check your blood glucose, and what to do
if it is not where it should be.
The following chart shows blood glucose targets for most women with gestational diabetes. Talk
with your health care team about whether these targets are right for you.
On awakening
Each time you check your blood glucose, write down the results in a record
book. Take the book with you when you visit your health care team. If your results are
often out of range, your health care team will suggest ways you can reach your targets.
Take your diabetes medicine exactly as your doctor tells you. You may need to
take insulin to keep your blood glucose at the right level. If so, your health care team will
show you how to give yourself insulin shots. Insulin will not harm your baby it cannot
move from your bloodstream to your baby's.
Maintain a healthy weight. Being overweight raises your risk for diabetes. Calculate
your Body Mass Index (BMI) to see if you're at a healthy weight. If you're overweight,
start making small changes to your eating habits by adding more whole grain foods,
fruits, and vegetables. Start exercising more, even if taking a short walk is all you can do
for now. If you're not sure where to start, talk to your doctor. Even a relatively small
amount of weight loss 10 to 15 pounds has been proven to delay or even prevent the
onset of type 2 diabetes.
Eat healthy
o
Eat lots of whole grains (such as whole wheat or rye bread, whole grain
cereal, or brown rice), fruits, and vegetables.
Choose foods low in fat and cholesterol. Read food labels. If you eat 2,000
calories per day, you should eat no more than 56 grams of fat each day.
If you drink alcohol, limit it to no more than one or two drinks (one 12ounce beer, one 5-ounce glass of wine, or one 1.5-ounce shot of hard liquor)
a day.
Get moving. Health benefits are gained by doing the following each week:
o
Get off the bus or subway a few stops early and walk the rest of the way
STI
Bacterial
Symptoms
vaginosis (BV)
Chlamydia
Vaginal itching
Infections that are not treated, even if there are no symptoms, can lead to:
Genital herpes
Nausea
Fever
Small red bumps, blisters, or open sores where the virus entered
the body, such as on the penis, vagina, or mouth
Vaginal discharge
Fever
Headache
Muscle aches
Symptoms may go away and then come back. Sores heal after 2 to 4
weeks.
Gonorrhea
Symptoms are often mild, but most women have no symptoms. If symptoms
are present, they most often appear within 10 days of becoming infected.
Symptoms are:
Infection that occurs in the throat, eye, or anus also might have symptoms in
these parts of the body.
Hepatitis B
HIV/AIDS
Low-grade fever
Tiredness
Loss of appetite
Diarrhea
Stomach pain
Some women may have no symptoms for 10 years or more. About half of
people with HIV get flu-like symptoms about 3 to 6 weeks after becoming
infected. Symptoms people can have for months or even years before the
onset of AIDS include:
Headache
Dry cough
Pelvic inflammatory disease (PID) that does not get better with
treatment
Human
papillomavirus
(HPV)
Visible warts in the genital area, including the thighs. Warts can
be raised or flat, alone or in groups, small or large, and sometimes
they are cauliflower-shaped.
Pubic lice
Symptoms include:
(sometimes called
"crabs")
Syphilis
If the infection is not treated, it moves to the secondary stage. This stage
starts 3 to 6 weeks after the sore appears. Symptoms of the secondary stage
are:
Fever
Weight loss
Tiredness
In the latent stage, symptoms go away, but can come back. Without
treatment, the infection may or may not move to the late stage. In the
late stage, symptoms are related to damage to internal organs, such as
the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints.
Some people may die.
Trichomoniasis
(sometimes called
"trich")
Pelvic and physical exam Your doctor can look for signs of infection, such as warts,
rashes, discharge.
Blood sample
Urine sample
Fluid or tissue sample A swab is used to collect a sample that can be looked at under
a microscope or sent to a lab for testing.
Dont have sex. The surest way to keep from getting any STI is to practice abstinence.
This means not having vaginal, oral, or anal sex. Keep in mind that some STIs, like
genital herpes, can be spread without having intercourse.
Be faithful. Having a sexual relationship with one partner who has been tested for STIs
and is not infected is another way to lower your risk of getting infected. Be faithful to
each other. This means you only have sex with each other and no one else.
Use condoms correctly and every time you have sex. Use condoms for all types of
sexual contact, even if intercourse does not take place. Use condoms from the very start
to the very end of each sex act, and with every sex partner. A male latex condom offers
the best protection. You can use a male polyurethane condom if you or your partner has
a latex allergy. For vaginal sex, use a male latex condom or a female condom if your
partner wont wear a condom. For anal sex, use a male latex condom. For oral sex, use a
male latex condom. A dental dam might also offer some protection from some STIs.
Know that some methods of birth control, like birth control pills, shots,
implants, or diaphragms, will not protect you from STIs. If you use one of these
methods, be sure to also use a condom correctly every timeyou have sex.
Talk with your sex partner(s) about STIs and using condoms before having
sex. Its up to you to set the ground rules and to make sure you are protected.
Dont assume youre at low risk for STIs if you have sex only with women. Some
common STIs are spread easily by skin-to-skin contact. Also, most women who have sex
with women have had sex with men, too. So a woman can get an STI from a male
partner and then pass it to a female partner.
Talk frankly with your doctor and your sex partner(s) about any STIs you or
your partner has or has had. Talk about symptoms, such as sores or discharge. Try not
to be embarrassed. Your doctor is there to help you with any and all health problems.
Also, being open with your doctor and partner will help you protect your health and the
health of others.
Have a yearly pelvic exam. Ask your doctor if you should be tested for STIs and how
often you should be retested. Testing for many STIs is simple and often can be done
during your checkup. The sooner an STI is found, the easier it is to treat.
Avoid using drugs or drinking too much alcohol. These activities may lead to risky
sexual behavior, such as not wearing a condom.
STIs can cause many of the same health problems in pregnant women as women who are not
pregnant. But having an STI also can threaten the pregnancy and unborn baby's health. Having
an STI during pregnancy can cause early labor, a woman's water to break early, and infection in
the uterus after the birth.
Some STIs can be passed from a pregnant woman to the baby before and during the babys
birth. Some STIs, like syphilis, cross the placenta and infect the baby while it is in the uterus.
Other STIs, like gonorrhea, chlamydia, hepatitis B, and genital herpes, can be passed from the
mother to the baby during delivery as the baby passes through the birth canal. HIV can cross the
placenta during pregnancy and infect the baby during the birth process.
The harmful effects to babies may include:
Eye infection
Pneumonia
Brain damage
Blindness
Deafness
Acute hepatitis
Meningitis
Cirrhosis
Stillbirth
Some of these problems can be prevented if the mother receives routine prenatal care, which
includes screening tests for STIs starting early in pregnancy and repeated close to delivery, if
needed. Other problems can be treated if the infection is found at birth.
Pregnant women should be screened at their first prenatal visit for STIs, including:
Chlamydia
Gonorrhea
Hepatitis B
HIV
Syphilis
In addition, some experts recommend that women who have had a premature delivery in the
past be screened and treated for bacterial vaginosis (BV) at the first prenatal visit. Even if a
woman has been tested for STIs in the past, she should be tested again when she becomes
pregnant.
Chlamydia, gonorrhea, syphilis, trichomoniasis, and BV can be treated and cured with antibiotics
during pregnancy. Viral STIs, such as genital herpes and HIV, have no cure. But antiviral
medication may be appropriate for some pregnant woman with herpes to reduce symptoms. For
women who have active genital herpes lesions at the onset of labor, a cesarean delivery (Csection) can lower the risk of passing the infection to the newborn. For women who are HIV
positive, taking antiviral medicines during pregnancy can lower the risk of giving HIV to the
newborn to less than 2 percent. C-section is also an option for some women with HIV. Women
who test negative for hepatitis B may receive the hepatitis B vaccine during pregnancy.
Pregnant women also can take steps to lower their risk of getting an STI during pregnancy.
for testing. They also are studying the reasons why many STIs have no symptoms, which can
delay diagnosis.
Research also is underway to develop new ways to treat STIs. For instance, more and more
people are becoming infected with types of gonorrhea that do not respond well to drugs. So
scientists are working to develop new antibiotics to treat these drug-resistant types. An example
of treatment research success is the life-prolonging effects of new drugs used to treat HIV.
COMPLICATIONS OF PREGNANCY
Complications of pregnancy are health problems that occur during pregnancy. They can involve
the mother's health, the baby's health, or both. Some women have health problems before they
become pregnant that could lead to complications. Other problems arise during the pregnancy.
Keep in mind that whether a complication is common or rare, there are ways to manage
problems that come up during pregnancy.
could be more harmful than the risks posed should you become pregnant. Be assured that you
are likely to have a normal, healthy baby when health problems are under control and you get
good prenatal care.
Condition
Asthma
Poorly controlled asthma may increase risk of preeclampsia, poor weight gain in
the fetus, preterm birth, cesarean birth, and other complications. If pregnant
women stop using asthma medicine, even mild asthma can become severe.
Depression
Depression that persists during pregnancy can make it hard for a woman to care
for herself and her unborn baby. Having depression before pregnancy also is a risk
factor for postpartum depression.
Diabetes
High blood glucose (sugar) levels during pregnancy can harm the fetus and
worsen a woman's long-termdiabetes complications. Doctors advise getting
diabetes under control at least three to six months before trying to conceive.
Eating disorders
Body image changes during pregnancy can cause eating disorders to worsen.
Eating disorders are linked to many pregnancy complications, including birth
defects andpremature birth. Women with eating disorders also have higher rates
of postpartum depression.
Epilepsy and
Seizures during pregnancy can harm the fetus, and increase the risk
other
seizure disorders
birth defects. For most pregnant women with epilepsy, using medicine poses less
risk to their own health and the health of their babies than stopping medicine.
High blood
Having chronic high blood pressure puts a pregnant woman and her baby at risk
pressure
for problems. Women with high blood pressure have a higher risk
of preeclampsiaand placental abruption (when the placenta separates from the
wall of the uterus). The likelihood of preterm birth and low birth weight also is
higher.
HIV
HIV can be passed from a woman to her baby during pregnancy or delivery. Yet
this risk is less than 2 percent if a woman takes certain HIV medicines during
pregnancy. Women who have HIV and want to become pregnant should talk to
their doctors before trying to conceive. Good prenatal care will help protect a
womans baby from HIV and keep her healthy.
Migraine
Overweight and
Recent studies suggest that the heavier a woman is before she becomes
Obesity
Sexually
Some STIs can cause early labor, a woman's water to break too early, and
transmitted
infection in the uterus after birth. Some STIs also can be passed from a woman to
infections (STIs)
her baby during pregnancy or delivery. Some ways STIs can harm the baby
include: low birth weight, dangerous infections, brain damage, blindness,
deafness, liver problems, or stillbirth.
Thyroid disease
Uterine fibroids
Uterine fibroids are not uncommon, but few cause symptoms that require
treatment. Uterine fibroids rarely cause miscarriage. Sometimes, fibroids can
cause preterm or breech birth. Cesarean delivery may be needed if a fibroid
blocks the birth canal.
Problem
Symptoms
Treatment
Feel tired
or weak
cells
Look pale
Feel faint
Shortness
of breath
Depression Extreme
sadness during pregnancy or
Intense
sadness
Helplessne
Therapy
Support groups
Medicines
ss and
irritability
Appetite
changes
Thoughts
of harming
self or baby
Ectopic (ek-TOP-ihk)
pregnancy When a
Abdominal
pain
Shoulder
pain
Vaginal ble
eding
Feeling
dizzy or faint
Baby
moving less
problems
than normal
(Learn how to
count your
baby's
movements o
n our Prenatal
early.
page.)
Baby is
smaller than
normal for
gestational
age
Some
problems have
no symptoms,
but are found
with prenatal
tests
pregnancy
Usually,
there are no
symptoms.
Sometimes,
extreme
thirst, hunger,
or fatigue
Screening
test shows
Preeclampsia
Early delivery
Cesearean birth
high blood
sugar levels
complicate delivery
High blood
pressure(pregnancy
High blood
pressure
without other
signs and
symptoms of
preeclampsia
Hyperemesis
gravidarum(HEYE-pur-EM-
Nausea
uh-suhss grav-uh-DAR-
go away
Vomiting
several times
sickness"
every day
Weight loss
Reduced
appetite
Dehydratio
n
Feeling
faint or
fainting
Signs of a
miscarriage can
include:
of pregnancies end in
miscarriage. Often,
Vaginal spo
tting or
bleeding*
pregnant
Cramping
or abdominal
pain
Fluid or
tissue passing
from the
vagina
* Spotting early in
pregnancy doesn't
mean miscarriage
is certain. Still,
contact your
doctor right away
if you have any
bleeding.
Painless va
ginal bleeding
during second
or third
trimester
For some,
no symptoms
Placental
abruption Placenta
Vaginal ble
eding
enough oxygen.
Cramping,
abdominal
pain, and
uterine
tenderness
High blood
Swelling of
hands and
face
Too much
protein in
urine
Stomach
pain
Blurred
vision
Dizziness
Headaches
pregnancy
Increased
vaginal
discharge
Pelvic
pressure and
cramping
Back pain
radiating to
the abdomen
Contractio
ns
symptoms and what you can do to keep healthy. Easy steps, such as hand washing, practicing
safe sex, and avoiding certain foods, can help protect you from some infections.
Infection
Symptoms
Grey or whitish
caused by an overgrowth
Burning when
passing urine or
itching
Some women
have no symptoms
ruhss) (CMV)
sore throat,
No treatment is currently
fatigue, and
swollen glands
Some women
have no symptoms
No symptoms
not hurt.
childbirth.
There may be no
symptoms. Or
B.
Nausea,
vomiting, and
chance of developing
diarrhea
pale bowel
movements
Whites of eyes
or skin looks
yellow
Second dose of
hepatitis B vaccine given
to baby at 1-2 months
before leaving.
old
Influenza (flu)
Fever
(sometimes) or
feeling
feverish/chills
Cough
Sore throat
Runny or stuffy
nose
Muscle or body
aches
Headaches
Feeling tired
Vomiting and
diarrhea
(sometimes)
Listeriosis (lih-steer-eeOH-suhss)
Fever, muscle
listeria.
aches, chills
An infection with the
harmful bacteria called
Sometimes
listeriosis.
diarrhea or nausea
If progresses,
severe headache
miscarriage.
KB).
Low-grade
fever
Tiredness
Rash on face,
trunk, and limbs
Painful and
swollen joints
Sexually transmitted
infection (STI)
Symptoms
depend on the
STI. Often, a
woman has no
early in pregnancy.
symptoms, which
is why screening
effects
pregnancy is so
important.
For more
information, see
our Sexually
transmitted
infections fact
sheet.
Toxoplasmosis (TOKsoh-plaz-MOH-suhss)
Mild flu-like
symptoms, or
possibly no
symptoms.
or raw meat
Washing produce
before eating
Cooking meat
completely
intellectual disabilities.
Washing cooking
utensils with hot, soapy
water
Urinary tract
infection(UTI)
Pain or burning
when urinating
Bacterial infection in
urinary tract. If untreated,
Frequent
urination
Pelvis, back,
stomach, or side
pain
Shaking, chills,
fever, sweats
Yeast infection
Extreme
An infection caused by an
itchiness in and
overgrowth of bacteria
Burning,
redness, and
swelling of the
vagina and
the vulva
Pain when
passing urine or
pregnancy.
during sex
A thick, white
vaginal discharge
that looks like
cottage cheese
and does not have
a bad smell
Feel dizzy
Suspect your baby is moving less than normal after 28 weeks of pregnancy (If you count
less than 10 movements within two hours. Learn how to count your baby's movements on
our Prenatal care and tests page.)