Birth of the child a part the second

At presence at the woman of complications of pregnancy or any diseases in the offered schemes corrections are brought. As a rule, it is done by the doctor the accoucheur-gynecologist observing the woman in female consultation, or the therapist of female consultation.

Clothes for pregnant women. The woman always remains the woman. Therefore and during pregnancy she wishes to be elegantly dressed. At the same time the clothes during this period should correspond to a physiological condition of an organism. Frequently women believe, that in pregnancy the clothes question is minor, especially in house conditions. It is not absolutely true. With taste the dressed woman transfers pregnancy is easier.

To clothes of the pregnant woman a number of requirements is shown: the dress should not constrain movement, it should be a lung, soft, correspond to a season of year; the bra should not squeeze a breast, shoulders, its size during pregnancy varies; the underwear should be always pure.

In connection with increase in weight of a body of the woman during pregnancy loading considerably increases by feet. For stability, reduction of loading by bends of feet, their forward parts the footwear should be carried on the low or expanded heel. The footwear on a high heel except instability of gait promotes development плоскостопия.

Stockings are better for fastening to elastic bands of a belt or a special bandage. Cowards and body stockings also should not have hard elastic bands and squeeze a body.

The outer clothing needs to be picked up so that it was free and did not press in a belt. Such clothes hide increasing stomach and do the woman tidy and elegant.

With increase in term of pregnancy muscles of a forward belly wall that can promote stomach omission are stretched, thereby to change position of a fruit in a uterus. For the prevention of these complications it is recommended to carry a special belt-bandage which serves as an additional support for a stomach and a uterus. A bandage put on laying, string together according to trunk volume. Bandage carrying helps to keep correctness of a bearing and symmetry.

Work and rest mode. In our country the big attention to a labour safety of the woman during pregnancy is paid. In considerable number of industries work kinds on which it is forbidden to use pregnant women are defined. From 4th month of pregnancy the legislation provides clearing of the woman of overtime works, night shifts, business trips, In case of need on the conclusion of the accoucheur-gynecologist it can be translated on more safe for it and the future child work. At some enterprises for such women special places for work and even цехи are allocated. Many industrial enterprises have possibility to give to pregnant women a free dietary food, and also places in sanatoria-dispensaries.

At normally proceeding pregnancy the woman receives дородовый holiday for 56 days, in the presence of complications it can be increased by longer term.

It is better to take the next labour holiday during the period from 4th pregnancy till 7th week. It allows the woman in adaptation to pregnancy more to happen on air.

The pregnant woman should remember and that house work should be moderated. Moderate work is useful and obligatory, he trains muscles, improves activity of internal bodies and by that raises the general tone of an organism. At heavy physical work when the oxygen most part arrives not to a fruit, and to working muscles, supply of a fruit by oxygen worsens. Therefore for pregnancy it is necessary to refuse sewing on the foot machine, drivings on a bicycle, from выбивания carpets, carrying over of heavy subjects on the big distances. From first months of pregnancy it is necessary to alternate work to rest every 40-50 minute It is undesirable to carry out homework in inclined position.

All told should remember not only the woman, but also its relatives and whenever possible create favorable conditions for rest of the pregnant woman.

At pregnancy the requirement for oxygen raises on 25—30 %. Fruit breath is carried out by carrying over of oxygen from parent blood in fruit blood through walls of vessels in ворсинах (хориона) placentae. Oxygen transition is carried out at the expense of a difference of its pressure on either side of a placentary membrane (from mother — above, from a fruit — more low),

As parent blood is sated with oxygen through lungs, there is clear a necessity of regular walks. It is expedient to pregnant women to walk some times in day on 1—1,5 ч. Before a dream walk is obligatory.

Essential value for a normal current of pregnancy has a dream. During a dream bodies receive the fullest rest, working capacity of nervous cages is restored. Duration of a dream of the pregnant woman should be not less than 9-10 ч a day, usually from 22-23 ч evenings to 7—8 ч mornings, in well aired premise.

It is rather important to create also emotionally favorable conditions for the pregnant woman, Now it is established, that the fruit is capable to perceive mood of mother, to hear its voice, music. In this connection for the pregnant woman in a family the favorable psychological climate should be created. Especially it is necessary to remember it to the husband.

Personal hygiene. From the moment of pregnancy approach as it was already spoken, in an organism of the woman the numerous original changes shown by functional reorganisation of all bodies and systems start to occur. In this connection observance of some hygienic requirements during pregnancy gets special value.

During pregnancy the requirement for calcium salts in this connection available caries of a teeth becomes aggravated, and frequently increases and more intensively develops again. Therefore the system of medical supervision over the pregnant woman necessarily joins survey of the doctor-stomatologist and oral cavity sanitation. The pregnant woman along with the standard hygienic measures (cleaning of a teeth in the morning and in the evening, rinsing of a mouth after food) should watch closely a condition of an oral cavity and a teeth more. At occurrence of caries of a teeth, гингивит and other signs of an inflammation it is necessary to address without fail to the doctor-stomatologist.

It is known, that the pure skin well "breathes", absorbs oxygen, allocates carbonic acid and substances harmful to an organism, facilitating thereby work of lungs and kidneys. In pregnancy exchange reactions in an organism of the woman become more active, as this process joins also a fruit. All it demands more careful hygienic care of a body. With that end in view the pregnant woman is followed by 2 times a day, in the morning and in the evening to take a warm shower, more frequent change нательного and bed-clothes is necessary also.

Demand periodic hygienic processing (shaving of hair and daily обмывание their warm water) axillary hollows as a various sort microbes here accumulate.

During pregnancy the woman should give special attention to observance of some hygienic rules concerning mammary glands and genitals. Mammary glands and dummies should be washed daily room temperature water, with their subsequent grinding by a rigid pure towel. Thanks to such processing эпителий nipples grows coarse a little and becomes steadier against mechanical irritation at feeding. If dummies flat or involved it is necessary to make massage. The technique of massage of mammary glands accustoms the woman during visiting of "motherhood school».

The pregnant woman is recommended to carry conveniently sewed brassiere from a cotton fabric. Its size should be changed in process of increase in volume of mammary glands that cups corresponded to their form and size.

Abundance of sebaceous glands in the field of genitals and the strengthened inflow of blood to them promote formation of a considerable quantity of a secret, in which as in a nutrient medium, pathogenic microbes quickly breed.

For the purpose of preventive maintenance of inflammatory diseases it is recommended to wash 2—3 times a day external genitals warm water. At occurrence plentiful is more white, sexual ways testifying to inflammatory disease, it is necessary to address immediately to the doctor of female consultation as available inflammatory process can amaze околоплодные fruit covers, reduce their protective function and cause pre-natal инфицирование околоплодных waters and the fruit.

The come pregnancy dictates necessity of change of a rhythm of the sexual intercourses. In the first 2 months of pregnancy when there is an implantation плодного eggs and placenta formation, it is necessary to refrain from the sexual intercourses. The sexual life as well last 2 months of pregnancy as it can lead to its premature interruption and инфицированию sexual ways of the woman is counter-indicative . In other terms of pregnancy the rhythm of the sexual intercourses will depend on a state of health of the woman.

Many women questions interest: whether it is possible to sunbathe and bathe during pregnancy, will not cause l and it is harm to the future child? To sunbathe and bathe it is possible, if pregnancy passes without complications and the woman has possibility of regular supervision at the doctor-gynecologist. However about 10—15 minutes are expedient to reduce to the sun in the morning (8-ę) and in the afternoon (17-19) At other o'clock duration of one-stage stay air baths and walks in the places protected from the sun are useful.

In pregnancy smoking to alcoholic drinks should be completely excluded. Under the influence of alcohol sexual and genital functions of the woman suffer. The use conducts it to infringement менструального a cycle, to barreness, невынашиванию.

In many countries of the world long since there were the customs forbidding newly married to drink spirits. During wedding in Russia to the young gave only kvass. It became for the only purpose that there were no defective children after a ritual feast that the posterity was born the healthy.

Not only the frequent use of alcohol, but even its unitary reception in early terms of pregnancy many times over increases probability of congenital anomalies of development in a fruit (uglinesses). Thus the most dangerous and artful are latent defects of various bodies and systems of the child. In the beginning defeats can be outwardly imperceptible, but further they are necessarily shown in the form of infringements of various functions of its organism.

By science it is proved, that alcohol breaks fruit development in various terms of pregnancy unequally. Especially big danger to a fruit is represented by the use of spirits to early terms of pregnancy when there is a bookmark and formation of the basic bodies and fruit systems.

The embryo (germ) is most sensitive to alcohol influence in the first weeks, especially in the first days of the existence. At this time the woman can not know yet about the come pregnancy and to take alcoholic drinks not being careful, not thinking about possibility of their fatal influence on a fruit, thereby putting an irreparable harm to the future child. Alcohol considerably reduces protective forces of the woman, raises its susceptibility to various infections, adversely affects a current and an outcome of pregnancy and sorts. From here an inevitable conclusion: the woman, wishing to have the child, should refuse the alcohol use completely.

The use of alcoholic drinks during pregnancy represents huge danger to a developing fruit. The alcoholism of mothers leads to a birth of children with a so-called alcoholic syndrome which is characterised недоразвитием the top jaw, acting forehead, a squint. Growth delay, sharp reduction of the sizes of a head and intellectual backwardness at children is thus observed. Тератогенной the alcohol dose considers its daily reception in quantity 60 80г.

Smoking during pregnancy is not less dangerous. Opinion of physicians unanimously: smoking does terrible harm to health of the future child. Here the given statisticans: at women, even smokers moderately (from 1 to 9 cigarettes in day), death of newborns on 20,8 % above, than at women who do not smoke. And this figure increases to 25,9 % if the woman smokes over 10 cigarettes in day. And it means, that smoking of a half-pack of cigarettes in day conducts by a birth of the dead child in every fourth case. Whether even more weighty proofs of harm of smoking are necessary ? Nicotine is allocated with milk of mother, therefore the feeding woman if she smokes, poisons the child who will grow to weak, sickly and more subject various diseases, than children which parents do not smoke.

 How the pregnant woman should behave to give birth to the healthy child?

Supervision at the doctor. For the purpose of maintenance of optimum conditions the complex of the preventive and medical measures united by the general name is developed for pre-natal development of a fruit — антенатальная (antenatal) protection of a fruit. The basic actions directed on protection of a fruit, are spent in female consultations. However even under condition of the good organisation of work of female consultations the leading role in realisation антенатальной fruit protection belongs to the woman, preparing to become mother. The operational experience of doctors has shown, that the favorable current of pregnancy and sorts is defined by accuracy degree from which future mother carries out all medical instructions in mode observance.

At the women who were not observed in female consultation during pregnancy, death rate of born children was in 5 times above, than at the women regularly visiting the doctor.

One of causes of a failure of pregnant women from visitings of female consultation is the aspiration to hide heavy disease at which pregnancy is counter-indicative, and its uncontrolled preservation can end with death of the woman.

That is why at occurrence of first signs of pregnancy it is necessary for woman to address to the doctor to pass medical examination and to reveal the obvious or latent pathology.

At the early reference in female consultation the doctor divides pregnant women into those to whom serious danger (the raised risk) threatens, and those who is in smaller danger (small risk). In case of revealing of contra-indications to preservation of pregnancy the woman can always interrupt its artificial by. The reference of the pregnant woman in consultation till 12 weeks is of great importance as for preservation of health of the woman, and its future child.

Successes in medicine development for last years have allowed to save up many data on a pre-natal life of a fruit. Now the fruit from "mute" object of supervision of the doctor has turned to pre-natal "patient" who requires medical supervision and the help as any other patient. Long time was considered, that the fruit is reliably protected in an organism of mother from all damaging factors and the placenta in this sense is a powerful barrier. However in 1941 classical supervision has been spent: at disease of mother краснухой in an early stage of pregnancy at a fruit further it was observed недоразвитие some bodies. Now transition processes through a placenta of many chemical, medicamentous means, some bacteria and viruses are well studied. Influence of harmful substances when the fruit worries the critical periods of the pre-natal life is especially dangerous. These periods fall to 7-14th day of a life of an embryo (the implantation period), then on 3 — 12th weeks of pregnancy when there is a bookmark of fabrics and bodies (a fruit which cannot function yet independently.

It is possible to consider as the third vulnerable period terms of pregnancy 18—20 and 22—24 нед, in this interval at a fruit the functions of bodies peculiar to the newborn are formed.

After 12 нед pregnancy at a fruit sensitivity to damaging factors that is caused by occurrence and development of adaptive mechanisms decreases, however owing to their immaturity it can have some diseases which symptoms have the general lines with diseases of an adult organism.

So, starvation and a defective food of the pregnant woman adversely affect development of a fruit which is especially sensitive to a lack of an organism of mother of fibers, vitamins, various microcells. In such cases fruit growth is slowed down, infringements in development of eyes and ears are observed, formation сердечнососудистой systems, a brain lags behind. The germ especially suffers at a defective food of the woman in first half of pregnancy.

Among numerous factors of the environment, capable to cause infringement in fruit development, not last place belongs to medical products.

Now about 80 % of women during pregnancy receive various medical products, including such active, as hormones, antibiotics, soporific, etc.

In a number of the countries special researches on revealing тератогенных properties of medical products, the Majority of the medical products recommended to pregnant women are carried out, are harmless to a fruit. Moreover, medical products make positive impact on fruit development at heavy illnesses of mother. Along with it there are many medical products which application during pregnancy should be limited and even it is forbidden. So, some antibiotics negatively influence a fruit owing to their permeability through a placenta. Antibiotics concern that тетрациклинового a number. Quite often under influence тетрациклина the fruit growth inhibition, splitting of the top sky, сращение fingers on hands and feet is observed. Thus it is especially frequent at children caries develops and occurs недоразвитие enamels of a dairy teeth. Long reception of the pregnant woman of other antibiotic — streptomycin can lead to defeat of an acoustical nerve at a fruit and cause deafness. Application левомицетина causes changes in a liver of a fruit and influences it кроветворную system.

Sometimes pregnant women without appointment of the doctor and sufficient indications to that independently accept medical products, at all not thinking of what influence can render it on a fruit and the newborn. It is necessary to remember that doctors should appoint medicines only.

Especially perniciously on a fruit ionising radiation operates. As a direct occasion to such conclusion the analysis of outcomes of pregnancy at women, подвергшихся has served beam influence of nuclear bombs in the cities of Hiroshimas and Nagasaki. All pregnant women who were in radius 1 km from epicentre of explosion, had premature birth or spontaneous abortions. At other pregnant women who were further from a place of explosion, born children suffered микроцефалией (a small head) or — a growth inhibition. Taking into consideration, that the embryo of the person is most sensitive to beam influence within the first 2—7 weeks of pre-natal development, in these terms it is necessary to refrain from radiological inspection completely.

It is known, that heavy and long diseases at women are reflected in the further development of their posterity. Numerous supervision show, that at serious diseases and complications during pregnancy conditions of a food and fruit gas exchange first of all are broken. Quite often the fruit has frustration of functions of those bodies and systems which are amazed at mother. So, congenital heart diseases are observed more often at the newborns which mothers are sick of a heart disease. Now heart diseases meet at 2 5 % of pregnant women. Successes кардиальной to surgery have led to increase in number of the pregnant women who have transferred operation on heart at defects at which earlier pregnancy was considered as the counter-indicative. Frequent complications of pregnancy at heart diseases are недонашивание pregnancy and a birth of children with insufficient weight of a body.

Among the cardiovascular diseases, making adverse impact on fruit development, the big place is occupied with hypertensive illness. Fluctuations of arterial pressure cause blood-groove infringements in a children's place that leads to its premature ageing. Thus the fruit is not provided in sufficient volume with nutrients and oxygen owing to what quite often perishes внутриутробно. Against hypertensive illness or other diseases of mother late toxicoses of pregnant women which are till now one of the most terrible complications often develop, meeting at 8—10 % of pregnant women. The late toxicosis is shown by one or several symptoms which concern occurrence of hypostases on a body, increase of arterial pressure and allocation of fiber with urine. In development of a late toxicosis the considerable role belongs to vascular spasms that leads to oxygen starvation of bodies of mother owing to what the fruit too has a chronic oxygen starvation. At среднетяжелых forms of toxicoses 40 from 1000 children perish, and at heavy forms death rate increases to 100 persons, in 20 % of cases children are born недоношенными.

Infringements of development of a fruit and the newborn are often observed at эндокринных diseases of mother, especially a diabetes, illnesses of a thyroid gland.

Until then while at a fruit the placenta as gland, секретирующая hormones is not generated, its glands of internal secretion are under the influence of similar glands of mother. So, in the first weeks of pregnancy the fruit thyroid gland is formed under the influence of hormones of a thyroid gland of mother. When the placenta starts to develop hormones, the fruit already becomes independent. In this connection the reference to the doctor in early terms of pregnancy for treatment of the amazed body is very important for pregnant women with various hormonal infringements.

Besides the diseases set forth above by the frequent reason of damage of a pre-natal fruit and the newborn infectious diseases of mother are.

The Pyoinflammatory infection at the pregnant woman is usually established in the course of its inspection in female consultation when the infection centres in миндалинах come to light, кариозных teeth, мочевыводящих ways. Along with sanitation of these centres sometimes at the phenomena of the general infectious disease there is a question on treatment by antibiotics which should steal up taking into account their influence on a fruit,

Each woman during pregnancy passes certain volume of researches. So, at the first appearance of the pregnant woman to the accoucheur-gynecologist it necessarily should hand over analyses of urine, blood, to check up group of blood and to define its Rhesus factor-accessory, and also reaction of blood to a syphilis. It is necessary to pass survey at the therapist, the dentist, the otolaryngologist, the oculist. This circle of inspections gives the chance to reveal available or latent diseases at the pregnant woman and in due time to start their treatment. At revealing of chronic or sharp diseases the doctor-therapist takes such woman from the pregnant woman on the special account and during pregnancy observes it more often, than healthy women, appointing those or other necessary medical means. During pregnancy supervision over blood and urine analyses is especially attentively established.

The steadfast attention to the blood analysis is caused by that during pregnancy at women the anaemia (anaemia) often develops. Frequency of anemias ' is high enough and fluctuates within 15—30 %. The anaemia at pregnancy is connected by that the part of iron of mother is spent for construction of bodies кроветворения a fruit. Especially the requirement of a fruit for gland increases in 16—30 weeks when actively is under construction its marrowy кроветворение. In these terms of the pregnant woman it is necessary to repeat analyses of blood and at haemoglobin decrease more low 110 г/л (66 %) to begin treatment антианемическими means, and also to strengthen a food by the products containing iron.

The urine analysis is checked at the pregnant woman at each next appearance. As it has been told above, kidneys at pregnancy test the big I will load, especially last 2 months before sorts, therefore regular analyses of urine help to reveal early infringements of their function.

At each visiting the doctor examines the pregnant woman: measures at it arterial pressure upon both hands. Defines weight of a body, height of standing of a bottom of a uterus, a stomach circle, position of a fruit in a uterus, listens to its palpitation.

It is rather important to watch change of height of a bottom of a uterus as this indicator very well reflects well-being of development of a fruit, specifies in conformity of its pre-natal age to calendar terms of pregnancy.

From this point of view for the pregnant woman the early appearance in female consultation also is important, i.e. In the first 3 months of pregnancy. In these terms it is possible to establish most precisely term of pregnancy and further more correctly to carry out the control over growth and weight of a body of a fruit.

From 15-16th weeks of pregnancy it is expedient to woman to visit «school of mothers», employment in which are spent by the accoucheur-gynecologist, the children's doctor and the lawyer. On employment show the visual aids including subjects of a toilet for the pregnant woman, subjects of care of newborns etc.

The accoucheur-gynecologist gives recommendations about a mode of a life during pregnancy, tells about preparation for forthcoming sorts and about behaviour at sorts. Recently with success with pregnant women employment practise children's polyclinics where future mums are invited, and the children's doctor acquaints them with rules of care of newborns. It is desirable, that the future fathers and other members of a family who will take part in education of the expected child, also visited «school of mothers».

The lawyer acquaints women with all rules to the laws existing in the country, on protection of interests of mother and the child.

The majority of women, especially первородящих, are insufficiently informed on process of sorts, heard about pains in sorts and consequently unfairly fear their approach. Really, patrimonial fights can be painful, childbirth demands physical energy from the woman. However preliminary mental and physical preparation for sorts does their operated the lying-in woman owing to what fights are perceived less painfully and childbirth passes without special work for the woman.

For the purpose of physical preparation for sorts carrying out of a certain complex of gymnastic exercises is recommended to pregnant women.

Within 9 months the woman lives in expectation of day of sorts, and at last this day comes. Usually in female consultation term of sorts is established according to last менструации, the moment of the first шевеления a fruit and pregnancy term at the first appearance to the doctor. Pregnancy lasts 280 days (40 weeks), considering from the first day of last менструации. However the woman can give birth for 2 weeks earlier or after a target date. If childbirth has come in 37 week of pregnancy, they are considered as urgent sorts, i.e. Come in time as the child born in this term, is доношенным. Therefore the woman should be ready to approach of sorts already after 37 weeks of pregnancy.

So, he was born, the long-awaited kid. For you it is the best than others. However, that you have tested it with what not comparable feeling of motherhood, it is necessary to observe a healthy way of life before its origin, and then patiently within 9 months to create to it all conditions for normal development and a birth.

Women should remember, that health of their future children in many respects depends on them.

The author: O.G.Frolov, the doctor of medical sciences