more on pregnancy

Traditional a

• First visit within the first trimester (12 weeks)

• Monthly visits weeks 16 through 28

• Every 2 weeks from weeks 29 to 36

• Weekly visits week 36 to birth

Centering Pregnancy b

• First visit within the first trimester (12 weeks)

• Every 4 weeks—weeks 16 to 28

• Every 2 weeks—weeks 29 to 40

Signs of Potential Complications: First, Second, and Third Trimesters Signs and Symptoms Possible Causes

First Trimester

Severe vomiting Hyperemesis gravidarum

Chills, fever Infection

Burning on urination Infection

Diarrhea Infection

Abdominal cramping, vaginal bleeding Miscarriage, ectopic pregnancy

Second and Third Trimesters

Persistent severe vomiting Hyperemesis gravidarum, hypertension, preeclampsia

Sudden discharge of fluid from vagina before 37 weeks Prelabor premature rupture of membranes (PPROM)

Vaginal bleeding, severe abdominal pain Miscarriage, placenta previa, abruptio placentae

Chills, fever, burning on urination, diarrhea Infection

Severe backache or flank pain Kidney infection or stones; preterm labor

Change in fetal movements: absence of fetal movements after quickening, any unusual change in pattern or amount of fetal movements Fetal jeopardy or intrauterine fetal death

Absence of fetal heart rate Intrauterine fetal death

Uterine contractions, pelvic pressure, cramping before 37 weeks Preterm labor

Visual disturbances: blurring, double vision, or spots Hypertensive conditions, preeclampsia

Swelling of face or fingers and over sacrum Hypertensive conditions, preeclampsia

Headaches: severe, frequent, or continuous Hypertensive conditions, preeclampsia

Muscular irritability or seizures Hypertensive conditions, preeclampsia

Epigastric or abdominal pain (perceived as heartburn or severe stomachache) Hypertensive conditions, preeclampsia; abruptio placentae

Glycosuria, positive glucose tolerance test reaction Gestational diabetes mellitus