Obstetrics

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“Braxton-Hicks” are occasional, mild, irregular contractions and are normal in the second half of pregnancy. However, it is not normal to have frequent contractions prior to 37 weeks.

Symptoms of Premature Labor include regular uterine tightening or contractions occurring more than 4 times per hour. This may feel as though the baby is “rolling up into a ball”. Your uterus may become tight and hard to the touch. You may also perceive contractions as a rhythmic low backache or persistent pelvic pressure. Contractions may feel like severe menstrual cramps. A large amount of mucus or watery discharge leaking from the vagina may be of a concern. This is especially concerning if the discharge has a red, pink, or brown color. You may have a minimal amount of spotting after intercourse or following a pelvic exam. If you have any other vaginal bleeding, contact our office immediately.

If you are having these symptoms, stop any strenuous activity, rest on your left side, and drink 4 glasses of water. You may also follow the self care instructions in preventing preterm labor. If your symptoms persist, you should contact the office at 817-467-7300.

After hours, call the office, call the office and leave a message with the answering service and a doctor will return your call. A physician will help you determine whether you should go to the hospital for evaluation.

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Rest two to three times a day, lying on your left side.

Drink 2 to 3 quarts of water each day and avoid caffeinated beverages.

Empty your bladder regularly.

Avoid lifting anything greater than 10 pounds.

Avoid nipple stimulation; this can increase the potential of uterine irritability.

Sexual activity may need to be modified or eliminated.Find ways to help compensate for the limitation of activities to help boost your spirits. Suggestions include a prenatal massages, manicures, pedicures, books, videos, puzzles, or crafts such as a cross stitch pattern.

Try to focus on the present day or week rather than the duration of time until your due date.

To keep your spirits up, it may be helpful to rest on the couch rather than becoming isolated in the bedroom while on bed rest.

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Labor Precautions. Consistent, regular, painful contractions which have been occurring every 5 minutes (from the start of one contraction until the start of the next contraction) for at least one hour. Each contraction should last from 30 to 60 seconds.

Vaginal Bleeding. A small amount of spotting can occur after intercourse or a vaginal examination. If you have vaginal bleeding, you should contact our office immediately.

Rupture of membranes. If you break your bag of water, or if you think you might be leaking amniotic fluid, you should contact our office immediately. You will need to be evaluated at either the office or the hospital.

Decreased fetal movement. The baby should move at least 15 times a day. If you think that your baby's movement is decreasing, lie down on your left side after eating or drinking, and count fetal movements for a 30 minute period. You should feel at least 3 -5 movements during this period. If you don't, eat or drink something with a high sugar content and then lie down on your left side again and count the movements for a second 30 minute period. If you still don't feel at least 4 movements in this hour, contact our office immediately. You will need to be evaluated at either the office or the hospital.

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During office hours 7:30 am to 11:15 am and 12 noon to 4:00 pm -Monday through Thursday.

You may call the office (817-467-7300) to speak with the nurse. She will return your call promptly and help direct your course of action.

After hours, call the office to speak with the answering service and a doctor will return your call. The doctor will help you determine whether you should go to the hospital.

Please speak with an office nurse or the doctor prior to going to the hospital. In an emergency, contact 911 or go to the nearest hospital.

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You may travel by any means, including air travel up until 8 weeks before your due date, if your pregnancy is uncomplicated. After 36 weeks, one month before your due date, we recommend that you remain within one hour of a hospital.

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The usual weight gain in pregnancy is 25 to 35 pounds for the entire pregnancy. Most of this weight gain comes in the second and third trimester at a rate of about 1-2 pounds per week. Weight gain is variable in the first trimester. You may even lose some weight as your appetite may be decreased. Patients who are underweight pre-pregnancy usually gain 18-40 pounds, while overweight patients usually only gain 15-25 pounds.

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We recommend that you wear your seatbelt whenever you are riding in or driving a car. Even in the third trimester, it is fine to have the shoulder strap go across the uterus.

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You may exercise throughout your pregnancy. Walking, running, swimming, aerobics and moderate weight training are all acceptable as long as you avoid any abdominal exercises. We do not recommend participation in contact sports or sports where you are likely to fall such as snow skiing, snow boarding, water skiing, hockey, soccer, basketball, or horseback riding beyond the first trimester. Scuba diving should be avoided throughout your pregnancy. You may have sex throughout the pregnancy if your pregnancy has been uncomplicated.

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Although it is not mandatory, we suggest that you wait until the second trimester to color or perm your hair. Tanning, at any stage in life, is not recommended because of its potential to cause skin cancer. If you do decide to tan, remember that your skin is more sensitive during pregnancy and it may be appropriate to reduce the amount of time spent in the sun or tanning bed.