Nausea and vomiting in pregnancy are quite common, with 50-90 percent of pregnant women experiencing it to some degree. Often it is just “morning sickness,” and many women often experience relief from their symptoms by the 14th week of pregnancy. Click the link below for more information.
Congratulations! This is a guide to your pregnancy to help you understand expectations and plan for your prenatal care and delivery.
Congratulations to you and your family! Discovering a twin pregnancy is often a surprising and particularly exciting event in one’s life. The physicians and staff at Bedford Commons OB-GYN are committed to working with you to make your special pregnancy a healthy and rewarding experience. In general, twin pregnancies are high-risk pregnancies because the potential for pregnancy complications in twin gestations is higher than in single pregnancies. These potential complications include anemia, altered position of the twins, gestational diabetes, altered growth of one or both twins, infant pre-maturity, pregnancy induced hypertension, and fetal distress. Keeping in mind that most patients expecting twins experience a normal pregnancy, your physicians will meet with you regularly and monitor carefully for the development of any of these problems.
Because you are supporting the development and growth of two infants, we strongly advise you to monitor your nutrition. In addition to your daily prenatal vitamin, we recommend additional daily iron (ferrous sulfate 325 mg tablet twice daily) and calcium (500 mg or more). You can expect to gain 35 to 45 pounds during your twin pregnancy experience. You may meet with our nutritionist to discuss diet during the pregnancy. Also, each patient should discuss her due date with one of the physicians if any uncertainty exists.
Your physicians will arrange for an 18-20 week ultrasound in our office to monitor the growth of both twins. Subsequent ultrasound exams will be scheduled to evaluate the growth pattern of each fetus, assess the amount of amniotic fluid, review the status of the placenta(s) and record the position of each twin fetus. Because of the risk of pre-term labor, it is important to investigate potential arrangements for childcare, housekeeping tasks and meal preparation as hospitalization and/or bedrest may be needed. Your physicians will also review with you the signs of premature labor including rhythmic abdominal or pelvic cramping, backaches, increased vaginal discharge or leakage of vaginal fluid.
During the last trimester, more frequent office visits are scheduled with the physicians so that both maternal and fetal wellbeing are carefully monitored. Ultrasound exams may be done at more frequent intervals to continue to assess growth and position of twins. During the last few weeks of pregnancy, the overall status and position of both infants will be reviewed with each patient. Theses parameters will become very important as you and your physicians review the best mode of delivery for you and your twin infants. Please feel free to discuss questions or concerns that you may have at this special time with your providers at Bedford Commons OB-GYN.
If a Three-Hour Glucose Tolerance Test has been scheduled, it is to determine if you have Gestational Diabetes. Please use the following dietary instructions to ensure that your test results are as accurate as possible:
- Eat at least three meals a day starting three days before the test.
- The meals should contain many carbohydrates (“starchy” foods such as breads, cereal, pasta, rice, potatoes, corn, bananas, yogurt, cookies. . .)
- In addition, eat one of the following extra carbohydrate servings each day to challenge your body’s ability to process sugar:
- 2 slices of bread
- 1 piece of cake
- 1 candy bar
- 1 can non-diet soda
- Do not “diet” before the test as dieting may cause inaccurate results.
The Night Before the Test
- Do not eat or drink anything except water after midnight.
- Do not smoke, chew gum, or eat cough drops or hard candy.
- Report to the laboratory at your scheduled appointment time.
- A lab technician will draw a fasting blood glucose sample and then will ask you to drink a bottle of Glucola, a high sugar drink.
- Blood samples will be drawn at one, two, and three-hour intervals.
- You may drink water during the three-hour test but must delay eating until after completion of the test. Consider bringing a snack with you to the lab to eat immediately following the test.
- You may wish to bring reading material with you to the laboratory to pass the time.
View our approved list of safe medications for pregnant women below, please note this list changes frequently so please reach out to us with any additional questions.
The term anemia refers to a lack of satisfactory red blood cells. Red blood cells are important in the transportation of oxygen throughout the body. Anemia during pregnancy is diagnosed when the concentration of red blood cells per 100 milliliters of blood (hematocrit) falls below 33. Anemia is a common problem during pregnancy, occurring in up to 50% of all women.
Anemia may occur as the pregnant woman’s amount of blood increases during the second trimester. In addition, diets low in iron or folic acid, closely spaced pregnancies or twin pregnancies may contribute to anemia.
Mild anemia does not pose a significant risk to the developing baby. Treatment is indicated, however, to prevent anemia from becoming severe, which could harm the fetus. In addition, treatment of mild anemia will protect the mother from side effects related to blood loss during childbirth.
Most anemias are caused by iron deficiency. The treatment is increased dietary intake of iron and iron supplementation by pill.
Although dietary sources of iron alone will not correct anemia, iron is best absorbed from food. Iron from animal foods is better absorbed than iron from plant or enriched foods. Eating foods high in Vitamin C (e.g., citrus fruits and juices) along with a meal high in iron will help iron absorption from the intestine. Coffee and tea decrease the amount of iron absorbed, as do foods high in fiber. Refer to the list on the bottom of this card for sources of iron-rich foods.
We recommend the following treatment for anemia:
Ferrous Sulfate 325 mg
It is recommended to take Ferrous Sulfate 325mg every other day, in addition to the prenatal vitamin. “Generic” preparations of iron will be the least expensive. “Brand-name” iron preparations may have appealing features but are not necessary unless you are having side effects; for instance, Ferro-sequels include an ingredient to prevent constipation, Ferancee-HP contains Vitamin C to enhance absorption, and Slow-Fe is time-released to help prevent stomach upset. Most iron pills are available without a prescription.
Increased dietary intake of iron-rich foods:
Iron from animal foods is better absorbed than iron from plant sources or enriched foods.
Eating foods high in Vitamin C (e.g., citrus fruits and juices) along with a meal high in iron will help iron absorption from the intestine.
Some good sources of iron are: steak, hamburger, dried beans & peas, baked potato, broccoli, prune juice, spinach, shrimp, and ready-to-eat cereals (such as Cream of Wheat)
Constipation is the most common side effect of iron supplementation. Docusate (brand name Colace) is a stool softener that can safely be taken in pregnancy to help with constipation. It is available over the counter. In addition, it is not unusual to have green or dark-colored stool while taking an iron supplement.
The use of folic acid reduces the risk of neural tube birth defects (spina bifida) when taken for at least one month before conceiving and in the early weeks of pregnancy.
For this reason, we encourage women who are planning a pregnancy or who can become pregnant to supplement their diet with 0.4 milligrams (400 mcgs) of folic acid per day. This is the amount contained in most multivitamins. Consuming a diet high in folic acid is also important.
Good natural sources of folic acid include orange juice, green leafy vegetables, beans, peas and liver. Some breakfast cereals are fortified with folic acid, and all “enriched” grain products include folic acid.
The surest way to get the recommended amount of folic acid is to eat a healthy diet and take a multivitamin supplement every day.
If you have any personal history of neural tube defect, or if you have an intestinal disease that interferes with nutrient absorption, consult with a health care provider for special folic acid dosing.