9. Your Nutrition

Carbohydrate foods provide the primary source of energy for your growing baby. These foods also help your body use protein efficiently. Foods from this group are almost interchangeable, so it should be easy to get all the servings you need. Some carbohydrate foods you may choose, and their serving sizes, include the following:

• tortilla—1 large

• pasta, cereal or rice, cooked—½ cup

• cereal, ready-to-eat—1 ounce

• bagel—½ small

• bread—1 slice

• roll—1 medium

10. Instant Risk Assessment (IRA)

There is a screening test for Down syndrome called IRA (Instant Risk Assessment) that offers women faster results at an earlier stage in pregnancy. It has a 91% accuracy rate. IRA has two parts, a blood test and an ultrasound. Women receive a collection kit from a healthcare provider or the hospital.

The woman pricks her finger and marks a card in the kit with her blood, which is sent to the lab for analysis. It is tested for levels of HCG (human chorionic gonadotropin) and a substance called pregnancy-associated plasma protein A (PAPP-A). Elevated levels have been associated with Down syndrome.

The second part of the test, the ultrasound, is a nuchal translucency exam, in which an ultrasound measures the space on the back of the baby’s neck.The larger the space in this area, the higher the chance of the baby having Down syndrome. Your healthcare provider can schedule the ultrasound.

If you’re feeling down, take a look at the carbohydrates you eat. Complex carbohydrates that are used slowly by the body result in more-stable blood-sugar levels, which is better for baby. They may also help a bit with mood swings. Complex carbohydrates to choose from include fruits and vegetables as well as beans, lentils and oats.

Fragile-X Syndrome

Fragile-X syndrome is one of the most common inherited causes of mental retardation. The condition can occur in both boys and girls.

Testing for the gene that causes it is done with DNA analysis. Prenatal diagnosis requires DNA from amniotic fluid. Prenatal testing should be offered to known carriers of the fragile-X gene and to families with a history of mental retardation.

11. Ultrasound in Pregnancy

By this point, you may have discussed ultrasound with your healthcare provider. Or you may already have had an ultrasound test. Ultrasound (also called sonography or sonogram) is one of our most valuable tools for evaluating a pregnancy. Healthcare providers, hospitals and insurance companies (yes, they get involved in this too) don’t agree whether ultrasound should be done or if every pregnant woman needs an ultrasound test during pregnancy. It is a noninvasive test, and there are no known risks associated with it. In the United States, millions of obstetrical ultrasounds are performed each year!

Ultrasound involves the use of high-frequency sound waves made by applying an alternating current to a transducer. A lubricant is rubbed on the skin to improve contact with the transducer. The transducer passes over the tummy, above the uterus. Sound waves are sent from the transducer through the tummy, into the pelvis. As sound waves bounce off tissues, they are directed toward and back to the transducer. The reflection of sound waves can be compared to “radar” used by airplanes or ships.

Different tissues of the body reflect ultrasound signals differently, and we can distinguish among them. Motion can also be seen, so we can detect motion of the baby or parts of the baby, such as the heart. With ultrasound, a fetal heart can be seen beating as early as 5 or 6 weeks into the pregnancy. Your baby’s body and limbs can be seen moving as early as 4 weeks of embryonic growth (6th week of pregnancy).

Your healthcare provider uses ultrasound in many ways in relation to your pregnancy, such as:

• helping in the early identification of pregnancy

• showing the size and growth rate of the baby

• identifying the presence of two or more babies

• measuring the fetal head, abdomen or femur to determine the stage of pregnancy

• identifying some fetuses with Down syndrome

• identifying some birth defects

• identifying some internal-organ problems

• measuring the amount of amniotic fluid

• identifying the location, size and maturity of the placenta

• identifying placental abnormalities

• identifying uterine abnormalities or tumors

• determining the position of an IUD

• differentiating between miscarriage, ectopic pregnancy and normal pregnancy

• in connection with various tests, such as amniocentesis, percutaneous umbilical-cord blood sampling (PUBS) and chorionic villus sampling (CVS), to select a safe place to do each test

You may be asked to drink a lot of water before an ultrasound examination. Your bladder is in front of your uterus. When your bladder is empty, your uterus is harder to see because it’s farther down inside the pelvic bones. Bones disrupt ultrasound signals and make the picture harder to interpret. With your bladder full, your uterus rises out of the pelvis and can be seen more easily. The bladder acts as a window to look through to see the uterus and the fetus inside.

Other Ultrasound Tests. The ultrasound vaginal probe, also called the transvaginal ultrasound, can be used in early pregnancy for a better view of the baby and placenta. A probe is placed inside the vagina, and the pregnancy is viewed from this angle.

The UltraScreen test identifies babies at increased risk of having certain birth defects. The test combines maternal blood tests and an ultrasound measurement at 11 to 13 weeks. The UltraScreen test is fairly effective in detecting Down syndrome.

Fetal nasal-bone evaluation is another type of ultrasound exam that increases Down syndrome detection accuracy to 95%, with a small percentage of false-positives. The benefit of first trimester screening is earlier diagnosis.

Three-dimensional ultrasound is also available in many areas.

Can Ultrasound Determine the Baby’s Sex? Some couples ask for ultrasound to determine whether they are going to have a boy or girl. If the baby is in a good position and it’s old enough for the genitals to have developed and they can be seen clearly, determination may be possible. However, many healthcare providers feel this reason alone is not a good reason to do an ultrasound exam. Discuss it with your healthcare provider. Understand ultrasound is a test, and test results can occasionally be wrong.

12. Fetal MRI

Ultrasound is the standard test used to diagnose birth defects and other problems. It is often the first test used. However, there are some limitations to ultrasound. If a woman is obese, if there is less amniotic fluid or baby is in an abnormal position, ultrasound may not reveal problems. In addition, midpregnancy is the best time to use ultrasound, so earlier or later use may not be as helpful.

Tip for Week 11

You may be able to get a “picture” of your baby before birth from an ultrasound test. Some facilities can even make a DVD or videotape for you. Ask about it before the test, if you’re scheduled to have one.

Relax and Have a Great Pregnancy!

It’s natural to feel nervous about being pregnant and what lies ahead—labor and delivery, and going home with baby. It’s important to deal with any anxieties you may have, and focus on having a great pregnancy. Below are some guidelines to help you do just that.

•  Don’t panic if someone bumps you in the tummy. Your baby is well protected.

•  It’s OK to lift things—just don’t lift heavy objects. Sacks from the market and a young child won’t hurt you. Stay away from heavy lifting.

•  You don’t have to worry about using a computer, a cell phone, a microwave oven or going through airport security. None of the machines involved in these procedures produce enough “bad vibes” to hurt you or your baby.

•  Coloring or perming your hair is OK. The chemicals used in these preparations won’t hurt you. However, if the fumes make you sick, wait until you aren’t bothered so much by smells to have a perm or color your hair.

•  Ask your partner to take pictures of you as you move through pregnancy. It’s fun to look back at them and remember how big you were when.

•  Even though you may not feel sexy, wear a beautiful, supportive bra made for expecting moms. It can help you feel pretty and desirable (which you are anyway!). For added comfort for your breasts, check out sleep bras. They can add support to sore breasts while you sleep.

•  Pamper your feet. Wear good, comfortable shoes. Get a pedicure or foot massage. Soak your feet when they’re sore. Use foot cream to help

Another test healthcare providers use has fewer limitations—fetal MRI. Fetal MRI (magnetic resonance imaging) is most helpful when findings from ultrasound are unclear or cannot be seen clearly.

MRI does not use radiation. Several studies have shown MRI is safe to use during pregnancy. To be cautious, MRI is still not advised during the first trimester. The test is most useful in diagnosing babies with specific birth defects.

It is important to note that ultrasound is more widely available and lower in cost than MRI. Ultrasound is still the first choice for discovering problems. However, MRI can be helpful in special situations, as mentioned above.

13. Exercise for Week 11


Place your left hand on the back of a chair or against the wall. Lift your right knee up, and put your right hand under your thigh. Round your back, and bring your head and pelvis forward. Hold position for count of 4, straighten up, then lower your leg. Repeat with your left leg. Do 5 or 8 times with each leg. Reduces back tension, and increases blood flow to the feet.


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