Weight Gain in Pregnancy
In normal pregnancy, variable amount of weight gain is a constant phenomenon. In early weeks the patient may loose weight
because of nausea and vomiting. During subsequent months, weight gain is progressive until the last one or two weeks, when the weight remains static.
The total weight gain during the course of a normal pregnancy averages from 11 Kg. (24 lb) to 12.5 kg. (27.5 lb). The fetal weight gain at term is distributed as follows.
1. Reproductive weight gain: 6 Kg.
(A) Foetus - 3.3 Kg, Plcenta - 0.6Kg, Liquor - 0.8 Kg.
(B) Uterus - 0.9 Kg and Breasts - 0.4 Kg.
2. Net maternal weight gain: 6 Kg.
(A) Increase in blood volume - 1.3 Kg.
(B) Increase in extracellular fluid - 1.2 Kg.
(C) Accumulation of fat(mainly) and protein - 3.5 Kg.
Recommended weight gain for
--> Underweight women - 12.5 to 18 Kg. (28 to 30 lb)
--> Normal weight woman - 11.5 to 16 Kg. (25 to 35 lb)
--> Overweight woman - 7 to 11.5 Kg (15 to 25 lb)
Water is the chief component of the net weight gain. The amount of water retained during pregnancy at term is estimated to be 6.5 litres.
Weight gain is 0.7 lb/week in early months of pregnancy (0 -20 weeks) and 1 lb/week in later months of pregnancy (20-40 week). Weight gain is distributed to approximately 1 Kg in first trimester and 5 Kg each in second and third trimester.
Rapid gain in weight of more than 0.5 kg (1 lb)/ week or > 2 Kg (5 lb) a month in later months of pregnancy warrants investigation as it may be an early manifestation of toxemia of pregnancy.
Stationary or falling weight / low weight gain is suggestive of low birthweight / preterm infant or intrauterine death of the foetus. It could also be due to poor nutrition of the mother.
Excessive weight gain is linked to large for gestational age infants and is associated with an increased caesarean delivery rate.
Not all the weight put on during pregnancy is lost during and immediately after delivery. The normal woman who gains 12.5 kg in pregnancy is about 4.4 kg (9 lb) above her Pre-pregnant weight after delivery.
Nipples and Areola:
The nipples become larger, erectile and deeply pigmented.
Secretions:
Secretions can be squeezed out of the breast at about 12th week which becomes sticky. Later on by 16th week, it becomes thick and yellowish.
Exercise In Pregnancy
In general, it is not necessary for the pregnant woman to limit exercise, provided she does not become excessively fatigued or risk injury to herself and her fetus. Well-conditioned women who perform aerobics or run regularly were found to have shorter active labors and fewer cesarian deliveries and less fetal distress. However, continuation of regular aerobic and running exercise programs results in reduced birth weight of the baby.
It is recommended that light exercise like walking, moving her limbs & back is good for pregnant worman. The women who are accustomed to aerobic exercises before pregnancy can be allowed to continue this with less intensity and no new aerobic exercise should be started.
In some cases of complicated pregnancy, the mother is not advised exercise but she may benefit from rest. Like, multiple pregnancy, pregnancy induced hypertension, heart disease and women suspected of having a growth retarded fetus.
Diet In Pregnancy
Diet is very important in pregnancy to maintain health status of the mother and to ensure proper growth of the fetus. Pregnant women should be advised:
--> To eat what she wants in amounts she desires and salted to taste.
--> Make sure that there is ample food to eat.
--> By serially weighing every pregnant mother that she is gaining weight. Ideal gains in pregnancy are 22-27 pounds.
--> Periodically, explore the food intake by dietary recall to uncover the ingestion of any bizarre diet.
Nutrients in the diet:
Pregnant should take adequate amount of calories, milk and milk products, high protein sources like pulses, eggs, paneer (cottage cheese) and green leafy vegetables and fruits like banana, apple, grapes, etc. for vitamins and iron and minerals.
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