FETAL CIRCULATION

Primitive heart, starts beating at about 4 weeks.
Circulatory system of fetus, established between 8-12 weeks.
Fetus develops its own blood, no mixing with mother´s. Lugs only receive a tiny proportion of fetal blood.

Placenta carries out respiration, normal function of lugs is not required.

FETAL HEART CIRCULATION

Breast-feeding while pregnant

Generally, it's safe to continue breast-feeding while pregnant — as long as you're careful about eating a healthy diet and diligently drinking plenty of fluids. There's an important caveat, however. Breast-feeding can trigger mild uterine contractions. Although these contractions aren't a concern during an uncomplicated pregnancy, your health care provider might discourage breast-feeding while pregnant if you have a history of preterm labor or you're experiencing uterine pain or bleeding.
If you're considering breast-feeding while pregnant, be prepared for changes your nursing child might notice. Although breast milk continues to be nutritionally sound throughout pregnancy, the content of your breast milk will change — which might change the way your milk tastes. In addition, your milk production is quite likely to decrease as your pregnancy progresses. These factors could lead your nursing child to wean on his or her own before the baby is born.
Your comfort might also be a concern. During pregnancy, nipple tenderness and breast soreness are common. The discomfort might intensify while breast-feeding. Pregnancy-related fatigue might pose challenges as well. If you want to continue breast-feeding while pregnant — or breast-feed both the baby and the older child after delivery — you might need additional support from loved ones or other close contacts. Also check with your health care provider about taking supplemental prenatal vitamins.

 

Headaches during pregnancy

There's much you can do to prevent or relieve headaches during pregnancy without taking medication. Start with simple prevention tips:

• Avoid headache triggers. Keep track of your meals, activities and headaches for several days to help pinpoint your headache triggers — then do your best to avoid your triggers.
• Include physical activity in your daily routine. Try a daily walk or other moderate aerobic exercise.
• Manage stress. Find healthy ways to cope with the stressors in your life, such as delegating tasks on your to-do list and spending time with people who lift your spirits.
• Practice relaxation techniques. Try calming activities such as deep breathing, yoga and visualization.
• Eat smaller, more-frequent meals throughout the day. Regular meals will keep your blood sugar on an even keel, which can help prevent headaches.
• Drink plenty of fluids. Staying hydrated can keep you feeling your best.
• Follow a regular sleep schedule. Fatigue and lack of sleep can contribute to headaches during pregnancy. Go to bed and wake up at about the same time every day, even on weekends.
• Consider biofeedback. With this mind-body technique, you learn to control certain bodily functions — such as muscle tension, heart rate and blood pressure — to prevent headaches or reduce headache pain. If you'd like to try biofeedback to treat headaches during pregnancy, ask your health care provider for a referral to a biofeedback therapist.

When a headache strikes:

• Rest. Lie down in a dark, quiet room with your eyes closed.
• Use a compress. Apply a warm compress (such as a hot towel) to your face, eyes and temples — or try a cold compress on the back of your neck.
• Try massage. Ask someone to massage your shoulders and neck to relieve tension. You might rub your temples, too.

If these steps don't help, check with your health care provider about other treatment options for headaches during pregnancy.
Most pregnant women can safely take acetaminophen (Tylenol, others) to treat occasional headaches. Your health care provider might recommend other medications as well. As with any medication, though, make sure you have the OK from your health care provider first.
Herbal headache remedies, such as feverfew and butterbur, aren't generally recommended during pregnancy.

 

Aspirin during pregnancy

Generally, aspirin and ibuprofen (Advil, Motrin IB, others) aren't recommended as pain relievers during pregnancy.
Aspirin interferes with your blood's clotting action. As a result, taking aspirin during pregnancy — especially after 32 weeks — can contribute to maternal and fetal bleeding. Aspirin and ibuprofen can also cause the premature closure of a vessel in a baby's heart, which can lead to high blood pressure in the baby's lungs (pulmonary hypertension), and prolong labor.
However, low-dose aspirin therapy is sometimes prescribed during pregnancy to help treat medical conditions. If you need to take aspirin during your third trimester of pregnancy, your health care provider will likely closely monitor you and your baby.
If you need to take a pain reliever during pregnancy, ask your health care provider about the options. He or she might approve occasional use of acetaminophen (Tylenol, others).

 

PREGNANCY AND OBESITY

Concerned about pregnancy and obesity? Understand the risks of obesity during pregnancy — plus steps to promote a healthy pregnancy.

Being obese during pregnancy can have a major impact on your health and your baby's health. Find out about the possible complications, recommendations for weight gain and what you can do to promote a healthy pregnancy.
What's considered obese?

Obesity is defined as having an excessive amount of body fat. A formula based on height and weight — called the body mass index (BMI) — is often used to determine if a person is obese.

BMI Weight status

Below 18.5 Underweight
18.5-24.9 Normal
25-29.9 Overweight
30 and higher Obese
40 and higher Extreme obesity

Could obesity affect my ability to get pregnant?

Being obese can harm your fertility by inhibiting normal ovulation. Obesity can also affect the outcome of in vitro fertilization (IVF). As a woman's BMI increases, so does the risk of unsuccessful IVF.

How might obesity affect my pregnancy?

Being obese during pregnancy increases the risk of various pregnancy complications, including:

Gestational diabetes. Women who are obese are more likely to have diabetes that develops during pregnancy (gestational diabetes) than are women who have a normal weight.

Preeclampsia. Women who are obese are at increased risk of developing high blood pressure and protein in the urine after 20 weeks of pregnancy (preeclampsia).

Infection. Women who are obese during pregnancy are at increased risk of urinary tract infections. Obesity also increases the risk of postpartum infection, whether the baby is delivered vaginally or by C-section.

Thrombosis. Women who are obese during pregnancy are at increased risk of a serious condition in which a blood clot forms inside a blood vessel (thrombosis).

Obstructive sleep apnea. Women who are obese during pregnancy might be at increased risk of a potentially serious sleep disorder in which breathing repeatedly stops and starts (obstructive sleep apnea). Pregnancy might also worsen existing obstructive sleep apnea.

Overdue pregnancy. Obesity increases the risk that pregnancy will continue beyond the expected due date.

Labor problems. Labor induction is more common in women who are obese. Obesity can also interfere with the use of certain types of pain medication, such as an epidural block.

C-section. Obesity during pregnancy increases the likelihood of elective and emergency C-sections. Obesity also increases the risk of C-section complications, such as delayed healing and wound infections. Women who are obese are also less likely to have a successful vaginal delivery after a C-section (VBAC).

Pregnancy loss. Obesity increases the risk of miscarriage and stillbirth.