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Week 10 If you've just found out you're pregnant, you might want to start by reading the previous sections. How Big Is Your Baby? By the 10th week of pregnancy, the crown-to-rump length of your growing baby is about 1.25 to 1.68 inches (31 to 42mm). At this time, we can start measuring how much the baby weighs. Before this week, weight was too small to measure weekly differences. Now that the baby is starting to put on a little weight, weight is included in this section. The baby weighs close to 0.18 ounce (5g) and is the size of a small plum. How Big Are You? Changes are gradual, and you may still not show much. You may be thinking about and looking at maternity clothes, but you probably don't need them just yet. Molar Pregnancy A condition that can make you grow too big too fast is a molar pregnancy, sometimes called gestational trophoblastic neoplasia (GTN) or hydatidiform mole. The occurrence of GTN is easily monitored by checking HCG levels (see Week 5). Molar pregnancy can be cured with medications or by surgery. When a molar pregnancy occurs, an embryo does not usually develop. Other tissue grows, which is abnormal placental tissue. The most common symptom is bleeding during the first trimester. Another symptom is the discrepancy between the size of the mother-to-be and how far along she is supposed to be in pregnancy. Half the time, a woman is too large. Twenty-five percent of the time, she is too small. Excessive nausea and vomiting are other symptoms. Cysts may also occur on the ovaries. The most effective way to diagnose a molar pregnancy is by ultrasound. The ultrasound picture has a ôsnowflakeö appearance. A molar pregnancy is usually found when ultrasound is done early in pregnancy to determine the cause of bleeding or rapid growth. When a molar pregnancy is diagnosed, a D&C (dilatation and curettage) is usually done as soon as possible. After a molar pregnancy occurs, effective birth control is important to be sure the molar pregnancy is completely gone. Most doctors recommend using reliable birth control for 1 year before pregnancy is attempted again. In addition to D&C, hysterectomy may be considered when childbearing is concluded. This is uncommon, but it is a treatment. Ovaries are usually left untouched. Some medications, such as methotrexate and Actinomycin D«, are effective in the treatment of molar pregnancy. The good news about molar pregnancy is that treatment is very effective. Cure rates are close to 100%! How Your Baby Is Growing and Developing The end of week 10 is the end of the embryonic period. At this time, the fetal period begins. It is characterized by rapid growth of the fetus when the three germ layers are established. (See Week 4 for further information.) During the embryonic period, the embryo was most susceptible to things that could interfere with its development. Most congenital malformations occur before the end of week 10. It is encouraging to know that a critical part of your baby's development is safely behind you. Few malformations occur during the fetal period. However, drugs and other harmful exposures, such as severe stress or radiation (X-ray), can destroy fetal cells at any time during pregnancy. Continue to avoid them. By the end of week 10, development of organ systems and the body are well under way. Your baby is beginning to look more human. Changes in You Pregnancy Brings Many Changes When your pregnancy is confirmed by an exam or a pregnancy test, you may be affected in many ways. Pregnancy can change many of your expectations. Some women see pregnancy as a sign of womanhood. Some consider it a blessing. Still others feel it is a problem to be dealt with. You will experience many changes in your body. You may wonder if you are still attractive. Will your partner still find you desirable? (Many men believe pregnant women are very beautiful and desirable.) Will your partner help you? Clothing may become an issue. Can you look attractive? Can you learn to adapt? If you aren't immediately excited about pregnancy, don't feel alone. You may question your conditionùthat's common. Some of this reaction is because you're not sure of what lies ahead. When and how you begin to regard the fetus as a person is different for everyone. Some women have told me it is when their pregnancy test is positive. Others say it occurs when they hear the fetal heartbeat, usually at around 12 weeks. For still others, it happens when they first feel their baby move, at between 16 and 20 weeks. You may find you are very emotional about many things. You may feel moody, cry at the slightest thing or drift off in daydreams. Emotional swings are normal and continue to some degree throughout your pregnancy. Dealing with Emotional Changes How can you help yourself deal with emotional changes? One of the most important things you can do is to get good prenatal care. Follow your doctor's recommendations. Keep all your prenatal appointments. Establish good communication with your doctor and his or her office staff. Ask questions. If something bothers you or worries you, discuss it with someone reliable. How Your Actions Affect Your Baby's Development Vaccinations and Immunizations Many vaccines are available that help prevent illness. A vaccine is a substance given to provide you with protection against foreign substances (infection). A vaccine is usually given by injection or taken orally. Most women of childbearing age in the United States and Canada should be immune to measles, mumps, rubella, tetanus and diphtheria. Most people born before 1957 were exposed to and infected naturally with measles, mumps and rubella and can be considered immune. They have antibodies and therefore are protected. For women born after 1957, the situation may not be quite so clear. A physician-diagnosed case of measles, documentation of vaccination with measles vaccine or a positive blood test for measles is necessary to determine immunity. The diagnosis of rubella is difficult without a blood test because many other illnesses may have similar symptoms. Physician-diagnosed mumps or mumps vaccination is necessary evidence of immunity. Vaccination for measles, mumps and rubella (MMR) should be administered only when a woman is practicing birth control. She must continue to use contraception for at least 3 months after receiving this immunization. Other vaccinations are also important, such as the tetanus (DPT; diphtheria, pertussis [whooping cough], tetanus) vaccine. Marcia called my office very upset. She had cut her leg on a rusty piece of pipe and thought she might need a tetanus shot. We checked her records and assured her she was up to date on her vaccinations. A person is considered immune to tetanus, diphtheria and whooping cough if she has received at least three doses of the DPT vaccine and if the last dose was given at least a year after the previous dose. A booster is required every 10 years. Marcia had had a booster shot 2 years before. If you aren't sure when or if you've been vaccinated, check with your doctor. Risk of Exposure It's important to consider your risk of exposure to various diseases when you are deciding whether to have a particular vaccination. Try to decrease your chance of exposure to disease and illness. Avoid visiting areas known to have prevalent diseases. Avoid people (usually children) with known illnesses. It's impossible to avoid all exposure to disease. If you have been exposed, or if exposure is unavoidable, the risk of the disease must be balanced against the potential harmful effects of vaccination. After that, the vaccine must be evaluated in terms of its effectiveness and its potential for complicating pregnancy. There is little information available on harmful effects on the developing fetus from vaccines. In general, killed vaccines are safe. Live-measles vaccine should never be given to a pregnant woman. The only immunizing agents recommended for use during pregnancy is the DPT vaccine. MMR vaccine should be given before pregnancy or after delivery. A pregnant woman should receive primary vaccination against polio only if her risk of exposure to the disease is high; only inactivated polio vaccine should be used. You Should also Know Chorionic Villus Sampling Chorionic villus sampling (CVS) is a test used to detect genetic abnormalities before delivery. Sampling is done early in pregnancy, usually between the 9th week and the 11th week. CVS is done for many reasons. The test helps identify problems related to genetic defects, such as Down syndrome. This test offers an advantage over amniocentesis because it is done much earlier in pregnancy; results are available in about 1 week. If the pregnancy will be terminated, it can be done earlier and may carry fewer risks to the woman. Chorionic villus sampling involves placing an instrument through the cervix or abdomen to remove fetal tissue from the placenta. There is a small risk of miscarriage after this procedure, so the test should be performed only by someone experienced in the technique. If your doctor recommends you have CVS, ask about its risks. The risk of miscarriage is smallùbetween 1% and 2%. Fetoscopy Fetoscopy provides a view of the baby and placenta inside your uterus. In some cases, abnormalities and problems can be detected and corrected. The goal of fetoscopy is to correct a defect before the problem worsens, which could prevent a fetus from developing into a normal baby. A doctor can see the problem more clearly with fetoscopy than with ultrasound. The test is done by placing a scope, like the one used in laparoscopy or arthroscopy, through the abdomen. The procedure is similar to amniocentesis, but the fetoscope is larger than the needle used for amniocentesis. If your doctor suggests fetoscopy to you, discuss possible risks, advantages and disadvantages of the procedure with him or her. The test should be done only by someone experienced in the technique. Risk of miscarriage is 3% to 4% with this procedure. It is not available everywhere.
Dieting during Pregnancy? Don't diet to lose weight during pregnancy! You should be gaining weight now; it can be harmful to your baby if you don't. As I've stated before, a woman of normal weight can expect to gain between 25 and 35 pounds while pregnant. Watching your weight gain gives your doctor an indication of your well-being and that of your baby. Pregnancy is not a time to experiment with different diets or cut down on calories. However, this doesn't mean you have the go-ahead to eat anything you want, any time you want. Exercise and a proper nutrition plan, without ôjunk food,ö will help you manage your weight. Be smart about food choices. It's true you're eating for twoùhowever, you must eat wisely for both of you!
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