Altitude

The physiologic effects of high altitude begin when the oxygen saturation of arterial blood falls below that of sea level. The altitude at which this change occurs depends primarily on a person's preexisting medical conditions and the duration of high-altitude exposure. Permanent residents of high-altitude areas become acclimatized after a variable amount of time, which raises arterial oxygen saturation. Oxygen saturations fall below 90 for permanent residents at about 8,400 feet and 5,800 feet...

The Women Infants And Children Program

In the United States the major food program for pregnant women is the Special Supplemental Food Program for Women, Infants, and Children, better known as WIC (1). This program is sponsored by the Food and Nutrition Service of the Federal Department of Agriculture. WIC was originally authorized in 1972. Current legislation lists the target population as pregnant and postpartum women (up to 6 months after delivery if not breastfeeding and up to 12 months if breastfeeding), and infants and...

Congenital Disorders Associated With Elevated

Brock and Sutcliffe first observed elevated amniotic fluid a-fetoprotein (AFAFP) concentrations in a pregnancy in which the fetus had an open NTD (131). Confirmation of this observation soon followed from many other laboratories, and the AFP assay was introduced as a routine test for prenatal diagnosis of open NTDs (132). Alpha-fetoprotein, a major protein in fetal serum by the third month of gestation, is measured immunologically in cell-free amniotic fluid. Its structure is similar to that of...

Chapter References

Blair SN, Chandler JY, Ellisor DB, Langley J. Improving physical fitness by exercise training programs. South Med J 1980 73 1594-1596. 2. Dye TD, Knox KL, Artal R, Aubry RH, Wojtowycz MA. Physical activity, obesity and diabetes in pregnancy. Am J Epidemiol 1997 146 961-965. 3. ACOG Technical Bulletin no. 189. Washington DC American College of Obstetricians and Gynecologists, Feb 1994. 4. American College of Sports Medicine. Position stand The recommended quantity and quality of exercise for...

Maternal Physiological Responses To Exercise In Pregnancy

Pregnancy is associated with progressive anatomic changes the most significant change that can impact the ability to exercise is the progressive shift in the body's center of gravity, which shifts anteriorly and cephalad. These changes result in compensatory lordosis, which frequently contributes to acute or chronic low back pain. This anatomic adaptation also causes the pelvic bones to rotate progressively on the femur to prevent falling forward. There is consequently increased strain on the...

Summary

Nutrition is one aspect of pregnancy management over which a woman has considerable control. It is a fact that optimizing nutritional status during this time and often earlier will reduce the risk of an adverse reproductive experience. The role of the health care provider is to expose each pregnant or prepregnant client to resources that will aid her in achieving the best possible nutritional status. This includes as appropriate individualized nutritional assessment and counseling referral to...

Techniques Used In Prenatal Diagnosis

The procedures used for prenatal diagnosis may be classified as invasive and noninvasive. The invasive procedures include amniocentesis, CVS, fetoscopy, and fetal biopsy. These procedures are performed to obtain cells or cell-free amniotic fluid. The common noninvasive procedure, ultrasonography, is especially valuable for the intrauterine diagnosis of a variety of congenital anomalies not associated with known chromosomal or metabolic defects. Amniocentesis is the most common means of...

Contributing Authors

Director, Division of Gynecologic Oncology Sinai Hospital of Baltimore Baltimore, Maryland Professor of Obstetrics, Gynecology, and Reproductive Sciences University of Maryland School of Medicine Medical Director, Labor and Delivery University of Maryland Medical Systems Associate Professor of Gynecology and Obstetrics The Johns Hopkins University School of Medicine Baltimore, Maryland Professor and Chairman Department of Obstetrics and Gynecology St. Louis University School of Medicine St....