During pregnancy with a desired child, every woman is beautiful. Close people around her provide comfortable conditions for life, trying to alleviate her condition in some way, because cardinal changes occur in all organs and systems of a pregnant woman, which are tolerated individually. The body is rebuilt psychologically and physically to a temporary state. Now he must ensure the normal functioning of not one person, but two.

The most noticeable changes are the skin and mucous membranes characteristic of the external genital organs and the vagina, then there are changes in the hormonal background, a decrease in immunity and local protective factors due to which the microflora and acid-base balance in the vagina are disturbed. Now the protective functions of the mucous membrane are reduced, the sensitivity to the effects of infections is increased, so hygiene during pregnancy takes on a slightly different character.

Rules of intimate hygiene that it is important for a pregnant woman to know

Every future mother is obliged to wash herself in the morning and in the evening, every day, using warm running water (shower or jug). The hand in the process of making the toilet should move in the direction of the pubis - the anus. Otherwise, the likelihood of getting infections characteristic of the rectum into the vagina increases.

You should not take long baths, as in this case, an infectious bacillus can also get into the genital area immersed in water.

It is required during pregnancy to pay special attention to the choice of means for intimate hygiene. Experts recommend buying these at a pharmacy. In addition, each trip to the toilet should be accompanied by the treatment of the labia with a damp cloth, the pH level of which coincides with the acid-base composition of the mucous membranes of the external genital organs. It is these wet wipes that are hypoallergenic, therefore they do not violate the structure of the microbial landscape of the mucous membrane and have, in a sense, a preventive effect. Such wipes are necessary not only for pregnant women, but also for those who are prone to fungal infections.

It is important to pay special attention to the choice of underwear for a pregnant woman. It should be made of natural fabric, as only it has good breathable properties. It is important to provide the skin with good air exchange to prevent the occurrence of allergic reactions that can develop into an infectious disease.

Hygiene of a pregnant woman provides for the use of only an individual personal bath towel, as well as toiletries. For example, soaps, washcloths and so on. Toiletries of a pregnant woman should not come into contact with the skin of other family members.

Many women prefer disposable sanitary napkins. So during pregnancy, they should be abandoned, as they are provocateurs of the development of irritations and infectious diseases. Observing pregnancy, doctors recommend once again to wash or change underwear.

Sports and nutrition of pregnant women

Many women during pregnancy prefer to visit the pool for water aerobics. If there are no contraindications for this by the attending physician, this is a completely acceptable way to lead a healthy lifestyle during pregnancy. But there are some conditions that every pregnant woman who visits a public pool must comply with.

When leaving the water, you should immediately remove wet things, take a shower, dry yourself and put on dry clothes. Public pools contain disinfectant solutions that can cause irritation, and the humid environment creates favorable conditions for the development of fungal infections. That is why taking a shower after water activities is the key to cleanliness and health of the genitals and mucous membranes. The temperature of the water in the pool should not bring discomfort to a woman, but, on the contrary, pleasure. Hypothermia is unacceptable.

Hygiene during pregnancy is directly related to nutrition, since even the foods that a pregnant woman eats every day can become a consequence of changes in the microflora in the vagina. For example, a large number of eaten sweets or smoked foods cause the development of fungal infections, so you should control your diet, trying to consume acceptable food norms. This does not mean that a pregnant woman should refuse junk food, but simply control the amount of her consumption.

Skin care during pregnancy

The rules of personal hygiene of a pregnant woman include not only special care for the cleanliness of the genitals. The cleanliness of the skin is important. After all, it is he who performs a protective function from the effects of harmful factors that are around us. The skin regulates heat and the absorption of a certain amount of oxygen necessary for a pregnant woman, so dirty skin loses its functional ability.

All pregnant women face an increase in secretions from the genitals. That is why during this period special attention should be paid to the cleanliness of this part of the body. Many experts recommend completely shaving the bikini area because hair is the cause of persistent odor and other discomfort. If a pregnant woman does not pay due attention to personal hygiene, she develops diaper rash, rashes, and also develops severe gynecological diseases.

Important importance during pregnancy is the hygiene of the mammary glands. This part of the body should be washed at least twice a day, using warm water and soap. After the procedure, the breast should be thoroughly wiped with a hard towel, but so as not to injure the delicate skin of the nipples.

The second trimester of pregnancy is characterized by the appearance of yellow or white discharge from the mammary glands, which is called colostrum. That is why the expectant mother should use special absorbent pads at this time and wash her breasts more often, removing excess fluid. At night, you should use special underwear made from natural fabrics.

Bed linen should be changed at least once a week. In the summer, a pregnant woman suffers from increased sweating, so she should always have dry and wet wipes with her to wipe the sweat. Every pregnant woman should wash her hands frequently and keep the room where she spends most of her time clean.

The hygiene of a pregnant woman also includes the observance of the correct daily routine, nutrition and walks. Fresh air is necessary to normalize blood pressure, which is directly related to the general condition of the expectant mother.

In this lesson.

Nutrition during pregnancy, diet of the last month, during childbirth, after childbirth. Hemoglobin - diet, fresh air. Hygiene of a pregnant woman. Bath and sauna. How to relieve the "inconvenience" that occurs during pregnancy: sleep, constipation

Breathing exercises, relaxation technique. Vocal therapy. Gymnastics.
Printed material for home reference: breathing exercises.

Nutrition

(Source: kid.ru/)

The inconveniences of pregnancy can be reduced with the help of proper, nutritious nutrition, because many of them arise precisely from the fact that the rebuilding organism lacks vitamins or trace elements. And nature is arranged in such a way that first everything necessary goes to the fetus, and then what is left goes to the mother. Therefore, an increased need for nutrition during pregnancy is undeniable.

Pregnancy leads to an increase in body weight over the entire period by an average of approximately 11 kg. It is considered optimal if this increase is 230-460 g per week. However, it should be noted that a pregnant woman with a significantly reduced body weight can add more than 11 kg without harm to health, while a full, sedentary woman should not increase her already excessive body weight by 11 kg, so an individual approach to the diet of a pregnant woman is necessary. .

Calorie content of food and weight gain or loss correlate with each other. The adequacy of food intake with a certain amount of calories can be assessed depending on the change in body weight. Maternal malnutrition (low hemoglobin or hypoproteinemia) is a contributing factor to abnormal bleeding and spontaneous preterm birth. Pregnant women with insufficient weight are precisely the category of women who are most likely to have a premature birth. Pre-eclampsia and eclampsia may be partly the result of malnutrition, most likely protein (S. I. Babson et al., 1979). The former view that fetal growth could be satisfactory despite maternal weight loss has now been scientifically refuted. The health of the mother and fetus depends more on the quality and less on the quantity of the food she takes. It is known that normal fetal weight doubles over the next two months of pregnancy. This weight gain can be greatly reduced by a starvation diet.

Good nutrition for the pregnant woman is more important for the growth and development of the fetus than nutrition for the nursing mother for the growth and development of the newborn.

Pregnant women are advised to increase the calorie content of food by 300 kcal (compared to non-pregnant women), taking optimal doses of proteins, fats, carbohydrates and 16 other food components (vitamins A, D, E, C, group B, folic acid, nicotinic acid, calcium, phosphorus, iodine, iron, magnesium, zinc).
Giving an important role to proteins in the anabolism of pregnancy, often undeservedly underestimate the importance of carbohydrates and fats in excessive weight loss. It is known that protein deficiency can develop even with sufficient protein intake if the calorie content of food is reduced, since most of the amino acids will be deaminated to cover energy needs. A short half-starvation (less than 1500 kcal) can cause a decrease in the amount of proteins, enzymes and even hormones in the body. If fasting lasts several weeks or months, fluid retention and weight gain occur, which can be misinterpreted by the doctor and lead to a more restrictive diet. It is quite difficult to provide pregnant women with good nutrition. Lack of knowledge, general culture, upbringing, money, etc. are the reasons why a pregnant woman does not receive well-balanced food rich in proteins, vitamins and minerals. The amount of products containing carbohydrates (especially easily digestible ones) should be limited. Here is a list and the number of staple foods for pregnancy and lactation per day (Brewer, 1989):

• four glasses (or more) of milk (any);
• two eggs;
• one or two servings of fish, liver, chicken, lean meat or any cheese;
• one or two servings of fresh vegetables (green leafy) - turnips, lettuce, cabbage;
• two or three pieces of bread;
• one orange (grapefruit), lemon or a glass of juice of these citrus fruits;
• one serving of margarine fortified with vitamin A.

During pregnancy and lactation, a woman should consume

• a portion of porridge (millet, wheat, semolina or oatmeal), 4 times a week;
• yellow or red vegetables (turnips, beets, etc.), 5 times a week;
• liver - 1 time per week;
• whole baked potatoes - 3 times a week.

The opinion that existed for many years that an excess of table salt in food contributes to the development of toxicosis in pregnant women is currently being refuted. If you eat well, especially if you eat enough protein, sodium ions will be neutralized.

Poor nutrition of a pregnant woman can be the reason for the birth of a child with reduced body weight or psychomotor retardation.

A favorable diet before conception and in the first three months of pregnancy is often not given due importance as a vital necessity for the fetus, since this period escapes the supervision of a family doctor. In addition, the mother's childhood, spent in poverty, affects the growth of the fetus, slowing it down, even if her social and living conditions improve in the future.
A sparing diet for pregnant women, aimed at improving the quality of nutrition, and not increasing the number of calories, is needed for the fetus to limit its size and prevent the risk of birth injury.
It should be noted that small intervals between pregnancies can lead to the depletion of nutrients in the body and adversely affect the offspring.

Diet of the last month before childbirth

I would like to add about the need to reduce the consumption of meat, flour and fat in the last month of pregnancy, up to a complete refusal, if possible. This will facilitate the work of the kidneys and liver, which are already under a lot of pressure from the child. It is especially worth worrying about the lightness of food in the last two weeks before childbirth, when contractions can begin at any moment. As a rule, in the first weeks after childbirth, bowel movements cause very unpleasant sensations, and in order to make life easier for yourself, it is better not to eat heavy and dry food, eat more liquid food, fiber (however, remember that in the second half of pregnancy, it is not advisable to take more liquid than 1, 2 liters per day, and it is also necessary to limit salt intake). Of course, before giving birth in the maternity hospital, you will be given a cleansing enema so that the overflowing intestines do not interfere with the normal course of childbirth.
As for the effect of nutrition in the last month on the child, it is in the last month that the child gains the most weight, and this moment should also be controlled. Remember that when it is said that nutrition should be sufficient and complete, this does not mean that you can overeat. At the 36th week, all the systems of the child's body are already quite well formed, and now is the time to take care of the comfort of the woman after childbirth, providing her with complete, but light nutrition: vegetables, fruits, herbs, juices, meat broths. And try to replace sweets with fruits.

Features of nutrition and hygiene during childbirth and immediately after them

Childbirth is accompanied by a large expenditure of energy, so the woman in labor needs nutrition during the period of cervical dilatation. Food should be very easily digestible: jelly, egg broth, semolina, bun, dairy products, sweet tea, etc. Portions are small. The expectant mother often forgets about food, it is necessary that someone monitor the timely intake of her food. In the maternity hospital, this function is performed by a midwife, but you yourself must provide for everything.

It is very important to go to the toilet in a timely manner, at least once every 2-3 hours "in a small way." After that, it is desirable to wash, preferably with a weak solution of potassium permanganate.

The first 3-5 days after childbirth, the breasts overflow with milk, so you should not drink a lot of liquid at this time, on the contrary, drink as little as possible. The baby most often cannot empty the breast yet, so relieve tension in the chest with a breast pump or express some milk with your hands using circular massaging movements from the periphery to the center. Do not empty your chest, but make sure it is not stone. So you keep good lactation for a long time and reduce the likelihood of inflammation.

Hemoglobin

The exit of the placenta is accompanied by natural blood loss. The midwife immediately after the birth of the placenta checks its integrity. The placenta is usually monochromatic. If there are white spots on it or it is small in size, then something was missing, for example, oxygen.

If the placenta is not damaged, then blood loss will be minimal, but still noticeable for an anemic woman. Therefore, the mother's body must be prepared in advance for this.
Eating foods rich in iron during the last month of pregnancy promotes plethora and makes blood loss less painful.

The level of hemoglobin can be raised with the help of the following products: black caviar, buckwheat, pomegranates, meat and fish dishes (including liver, better veal, poultry meat), legumes (peas, beans, etc.), germinated wheat grains , onions and greens, pumpkin and sunflower seeds, plum juice, plums, apricots, dried apricots, raisins, nuts (including almonds), bran and rye bread. In addition, green apples, wheat porridge, dark chocolate, beets, tomato juice, Brussels sprouts, broccoli, peanut butter, oatmeal, pineapples contain iron. Kalina increases hemoglobin (binds iron).

It must be taken into account that no matter how much you eat iron-containing foods, but if the body does not absorb it well, the amount of them will not save you. Therefore, it is necessary to know that vitamin C helps to absorb iron, and with its deficiency, iron is practically not absorbed.
In addition, from products of animal origin, our body absorbs iron much better than from flour foods: in the first case, about 20% of iron is “beneficial”, and in the second - no more than 5%. Nutritionists, giving recommendations on the formation of the menu, advise maintaining the ratio of products of plant and animal origin as three to one: this balance is closest to the “ideal diet” and has a positive effect on the functioning of internal organs.

Let's take a closer look at some products.
Buckwheat can help to cope with anemia faster than many drugs. However, it should be used for a long time to achieve the desired effect - at least a month daily.
Meat products, in addition to iron itself, also contain proteins necessary for its absorption. However, they should not be fatty, so as not to increase the load on the liver.
Legumes contain vegetable protein. However, not every body can absorb a large amount of legumes, so you should not abuse it, otherwise heaviness in the stomach and bloating may appear.
We offer you a good menu of dishes that help cope with anemia. This article also contains an exercise, which, according to the coordinator of courses for pregnant women at the White Wings Center for Creative Pedagogy, also helps to raise the level of hemoglobin.

Hygiene of a pregnant woman

During pregnancy, many women experience increased sweating, often with a change in odour. It is very likely that there is an increase in vaginal discharge. Also, in most women, the frequency of urination increases. These changes are natural and are associated with changes in the body - a powerful restructuring of the hormonal system occurs, the volume of blood flow increases, there is a gradual displacement of the internal organs, pushed aside by the growing uterus.

However, in addition to discomfort, these changes create conditions for the reproduction of bacteria, fungi, etc. Therefore, during pregnancy, it is necessary to increase the frequency of procedures that maintain the cleanliness of the woman's body. It can be baths, showers, even a sauna or bath. Contraindications to visiting a bath or sauna are acute inflammatory diseases, conditions after recent surgical interventions, complicated pregnancy. The influence of the bath in traditional medicine is reduced to a negative one, but we will talk about this a little lower.

It is advisable to lay a special mat on the floor under your feet, which reduces slipping. Remember that you need to be careful in your movements. Toward the end of pregnancy, showering becomes more difficult, be sure to ask your spouse for help, this will not only make your life easier, but also bring you even closer.
Be a little more careful about hygiene products - follow the reaction of the body and try to choose soft colors and unexpressed smells.

In order to try to improve the condition of the skin, use soft creams and lotions, special cosmetic creams. During the day, spray your face with filtered or boiled water using a spray bottle, humidify the air in the room. The most important contribution to improving your skin is a proper diet, sufficient vitamins and a good hygiene regimen. If you are worried about spots on the skin (for example, before going out), you can use a cosmetic color corrector, and then apply foundation powder or cream to this area. However, do not overdo it and try to just accept these changes now.

At hair care keep in mind that perms and hair coloring are contraindicated during the first trimester of pregnancy due to the potential risk to the fetus. And before doing them at a later date, think about it - is it really necessary? You may find that your natural hair color is no worse than the one you are used to.

If you are concerned about the increased amount of hair on the shins or other places where you do not want to see them, you can carefully remove this hair, but in no case do not use chemical depilators in any form (creams, gels, etc.).

A very important point - oral hygiene. Bad teeth can become a source of infection and cause complications in the postpartum period. Therefore, in addition to the one-time obligatory visit to the dentist, which is recommended for all pregnant women, do not hesitate to contact him several times in terms of prevention, not to mention those cases when it becomes necessary. Don't delay! It is advisable to bring your teeth and gums in full order even before conception, because. painkillers are undesirable during pregnancy. If you do not have time, then contact your dentist, and do not forget to let him know about your pregnancy. Discuss with your doctor all the manipulations and means that he is going to use during your treatment - X-ray and other studies, anesthesia and anesthesia, other medications. We advise you to go to the dentist just before the birth, after you may not have time to do it.

During pregnancy, brush your teeth at least twice a day. Do not ignore toothpastes "recommended by dentists of the world", as well as specially designed brushes for cleaning hard-to-reach places on crowns. You can use flosses - special threads of different thicknesses for brushing your teeth. An irrigator can replace threads and brushes of a special design - a device that cleans food debris with the pressure of a trickle of water. Dentists recommend using it 1-2 times a day.

An important contribution to the condition of your teeth and gums is made by a proper diet rich in vitamins and microelements (fluorine, phosphorus and calcium are especially important, and from vitamins - ascorbic and nicotinic acids; the latter should not be confused with nicotine). Limit the use of sweets, especially caramel, lollipops, drinks such as Cola or Fanta. After them, you need to brush your teeth or at least just rinse your mouth with plain water. Many obstetrician-gynecologists believe that it is enough for a future mother to eat 200 g of cottage cheese per day, and her body will more than replenish all the necessary reserves of calcium and other trace elements. And an excess of calcium in the body of a pregnant woman leads to a thickening of the baby's head, because of which the head will not be elastic enough to pass through the birth canal. Dentists, on the contrary, consider this opinion of obstetricians and gynecologists to be stupid and advise taking phosphorus-calcium complexes ... It is difficult to figure out who is right in this dispute. But you have to make some decision.

In addition to the well-known truths about the cleanliness of the skin of the face, the whole body and the genitals, there is information about the need armpit care. This is necessary because it is here that the thrush fungus (candidomycosis) can be located, which in the postpartum period can cause nipple cracks in the mother and damage to the oral cavity of the newborn.

Besides, “harden” your nipples: to do this, after washing the mammary glands for a minute, massage the nipples with a clean, hard towel, then lubricate them with boron petroleum jelly. It has been established that women who prepare their nipples during pregnancy in the manner described above suffer from mastitis 4-5 times less often. This is especially necessary for those women whose nipple is small and flat. (On the Motherhood.Ru forum, many women say that such hardening of the nipples did not save them from mastitis. At the same time, others did not prepare the nipples in any way, and they did not have any special problems with their breasts, except for soreness at the first time of feeding - approx. ShM "Makosh").

Some women feel great during pregnancy, celebrate a creative upsurge and do not worry about changes in their appearance. However, many women are depressed by weight gain, lost proportions, skin problems, discharge, etc. Self-doubt, layering on the usual emotional instability for pregnant women, can become a serious source of anxiety and irritability. And no one needs this - neither you, nor the fetus, nor the household.

By keeping yourself in hygienic shape, you will reduce these temporary disadvantages to a minimum. And with the remaining minimum will help to cope ... a sense of humor! Record on a video camera a tango or a samba in your execution (week on the thirtieth). Only at the same time smile and boldly look directly into the lens. They always said about us - a people who can laugh at themselves are strong!
If you do not agree with the statement that pregnancy makes a woman beautiful, then at least try to look critically at the problem - these changes in your body are not at all ugly, they can cause a kind smile, and not a grin at all.

Obstetrics, gynecology and bath

The bath (sauna) in the life of many peoples not only played a hygienic role, but was also a place where people were born and died. In particular, at one time in Russia it was customary to give birth to children in a bathhouse not only among commoners, but also among boyars and in royal families. Many other peoples of the world did the same. Among the Maya, bathhouse was also the birthplace of children. And the habit of Finnish women to give birth in the sauna has recently become the subject of attention of doctors. It turned out that a sauna, especially a home sauna, is a sterile space from a bacteriological point of view. In the sauna, good conditions were created for childbirth: there is a lot of warm water, the right air temperature, and other hygienic conditions not only for the woman in labor, but also for the newborn.

If during pregnancy a woman used the sauna (bath) correctly, her childbirth is much easier and the time of childbirth itself is about 1/3 shorter. Pregnant women who visited the bath during childbirth are much less likely to experience pain that requires the use of antispasmodics and analgesics. This is due to the psyche, an increase in the elasticity of the ligamentous apparatus, a decrease in excessive muscle tension, and a positive effect of the bath (sauna) on the autonomic nervous system.

Bath (sauna) causes an increase in lactation in nursing mothers, which is observed in about 80% of cases.

It is known that approximately 1/3 of pregnant women get varicose veins or its complications during pregnancy. When a pregnant woman visits a bath, these disorders decrease, which is associated with an increase in the tone of the vascular system, which helps to reduce the tendency to a collaptoid state. In women who visited the bath (sauna), thrombosis and their complications are less common, which indicates the influence of the sauna (bath) on the mechanisms of blood coagulation. When visiting the sauna, pregnant women showed a decrease in headache, fatigue and gastrointestinal disorders. The course of some infectious diseases during pregnancy is easier if a woman visits a bath. So, for example, the course of influenza in women visiting the bath is much easier. Under the influence of a sauna (bath), skin diseases during pregnancy, such as urticaria, dermatotoxicosis, itching, and others, may regress or disappear completely.

Bath (sauna) is used in the treatment of gynecological diseases. Basically, we are talking about chronic processes. The positive effect of the bath on the course of gynecological diseases is associated with an increase in blood circulation in the skin, the inclusion of redistributive and compensatory mechanisms that change blood circulation in the internal organs, with changes caused by rapid cooling. This leads to an improvement in blood circulation in chronic diseases of internal organs and the removal of inflammatory components from tissues.

Indications for the appointment of a bath (sauna) in gynecology and obstetrics: primary and secondary sterility and infertility, ovarian dysfunction and associated disorders of the uterus, primary and secondary amenorrhea, ovarian dysmenorrhea and insufficiency, chronic inflammatory diseases of the internal genital organs, chronic complications after abortion, climacteric syndrome with tolerance to hyperthermic procedures, normal pregnancy up to childbirth.

Contraindications: acute inflammatory diseases, conditions after recent surgical interventions, complicated pregnancy.

How to bathe pregnant

I would like to warn expectant mothers: in the antenatal clinic, you will most likely be discouraged from visiting the steam room - doctors, as they say, know better. But if you are drawn to the steam room - look for an experienced instructor, do not experiment alone.

• you need to bathe not only in a hat, but also in a good company, the psychological climate is very important
• to begin with, go to the steam room (temperature is about 90 degrees) for five to seven minutes. Watch the pulse - no more than 120 beats per minute
• then you have to go out, put on a sheet, sit on the couch, drink herbal tea (with mint, chamomile, lemon balm). Heart, pulse return to normal
• under the shower, wash off the released salt, wipe yourself
• go back to the steam room for ten minutes. Watch your pulse
• then you need to go out, rest, drink or eat fruit
• after that you get up under the shower, dry off
• return to the steam room for the third time. With a pre-soaked birch broom, you do a light massage of the feet, shins and thighs. Ask your friends to gently slap you on the back (you can get on all fours). Continue light massage on the shoulders and even on the tummy
• come out. Now you can plunge into the cold font with your head. At this moment, the peripheral vessels constrict, and the vessels of the internal organs expand. There is a redistribution, which means that the blood improves, hemoglobin rises
• further - a pool with warmer water (28-30 degrees) water or a warm shower. Enjoy, relieve stress

Whether to continue further, intuition will tell. Basically, you can stop there. Dry your head with a hairdryer - and go home to a warm bed. With every part of your body you feel that you have been cleansed, detoxified. The realization that thanks to the bath, water of contrasting temperatures and a broom, your immune defense with your child has increased, it warms the soul ...

Hygiene of a pregnant woman

Throughout pregnancy, the expectant mother should especially monitor the frequency of her body and clothes. Clean skin, fresh underwear not only facilitate skin breathing, improve the functioning of internal organs, but also contribute to good health and cheerful mood.

The skin is able to perform the functions of gas exchange (absorption of oxygen and release of carbon dioxide), excretion of fluid through the sweat glands, which reduces the load on the kidneys. Therefore, it is advisable to take a shower in the morning and evening or wipe the whole body with water at room temperature, especially the mammary glands. Be sure to wash with boiled water at least 2 times a day.

From the first day of pregnancy, it is necessary to be in the fresh air as much as possible, but walks should not tire. Air baths are especially useful, they should be done in the summer in the shade of trees, avoiding open sunlight. In inclement weather, you can take air baths for the mammary glands indoors. Their duration is 15-20 minutes. Air baths well harden the skin of the mammary glands, reduce the appearance of cracks around the nipples during the future feeding of the baby.

It is also useful to wash the mammary glands every day with water at room temperature and then rub with a hard towel. For the same purpose, pieces of terry cloth can be sewn into the bra cups. With flat and inverted nipples, gentle massaging and thawing forward is helpful. Sometimes it is even recommended to use a breast pump to stretch the nipples, leaving the nipple in an extended position for a while. However, massage should be applied very carefully., because excessive irritation of the nipples can cause uterine contractions.

A pregnant woman should also change the mode of sexual activity. In the first three and last two months, sexual intercourse is contraindicated, because. they can cause miscarriage. In other periods, sexual intercourse should be limited, the woman's genital tract should be protected from infection as much as possible. For most couples, a woman's pregnancy brings changes in sexual relationships, but these changes are individual for all couples. Pregnancy can be a time to explore new ways of showing love to each other, a time to express sexual desires and needs more openly.

Diet

In the first half of pregnancy, 4 meals a day are recommended, in the second - 5-6 meals a day with the exception of heavy meals (more than 30-35 percent of the daily energy value and weight). After eating, you should not lie down, the rest should be active. For healthy women, there are no forbidden foods (except alcoholic beverages), only more or less preferred ones. So, the body better absorbs easily digestible milk fats and vegetable oils. The latter are not only a source of essential linoleic acid, but also vitamin E, which has a positive effect on the course of pregnancy, preventing its breakdown. During normal pregnancy, the motor function of the intestine may decrease, which is accompanied by constipation, so the diet should be enriched with sources of dietary fiber (fiber, pectins) - vegetables and fruits, buckwheat and oatmeal. In the second half of pregnancy, it is necessary to limit sugar, confectionery, products made from premium flour, rice, semolina. We limit the diet of extractive substances contained in meat, fish (broths, fried meat, fish), because. during this period, the liver and kidneys of a pregnant woman function with tension due to the neutralization and excretion of metabolic products of the fetus and the pregnant woman herself. In case of early toxicosis in mild cases, accompanied by vomiting, the diet prescribed in the second half of pregnancy is recommended, but with a restriction of 20-25 percent of carbohydrates and an increase in the content of table salt (15 g). The food is well boiled and consumed mostly in pureed form. It should be taken with a break of 2 - 3 hours, in small portions and slightly warmed up. The liquid is not limited, but given in small portions (50 - 100 mg). It is advisable to arrange fasting days: apple (in the form of mashed potatoes), compote, cottage cheese and sour cream. With late toxicosis, the diet should contain the amount of protein required for pregnant women, primarily due to dairy products, especially cottage cheese. Fats are limited to 60 g or less, with excess weight - up to 40 g. A dairy-vegetarian diet with a high content of vegetables and fruits is desirable. Replace sugar with honey.

Pregnancy is very beautiful for a woman. During this period, a woman becomes the most beautiful, she does not need to draw in her stomach, go on diets, go to exhausting fitness. She can afford to eat whatever she wants, enjoy shopping for children's things, and decorate a room for her future child.

But pregnancy is not only pleasant chores, it is a laborious process that requires constant monitoring. The hygiene of a pregnant woman, her state of health and positive emotions deserve special attention during this period. There are several main areas that relate to the hygiene of a pregnant woman.

Food hygiene

Food hygiene meansT:

1. Hand hygiene
2. Properly formulated diet
3. Food quality
4. The right approach to diet

Let's take a look at what is most important in the nutrition of a pregnant woman:

1. Proteins of animal origin. These products include meat, dairy products, fish.
2. Vegetable proteins. Such products include various cereals and legumes.
3. Cellulose. Foods that contain the maximum amount of fiber include fruits and vegetables, natural sushi rice and greens.
4. Calcium. Baby calcium is very necessary for growth and good life.
5. Folic acid. Pregnant women should take folic acid tablets for the good development of the baby. Since you can only take one tablet per day, you can increase the amount of folic acid by eating cereals and bran bread.
6. Iron. So that the body does not have a lack of iron, it is necessary to include meat, cereals, various types of dried fruits and eggs in the daily diet.
7. Vitamins. For the body of the future mother, and the developing baby, vitamins are very necessary. How to choose complex vitamins can be read in the topic.
8. Water. Drinking water is very important for a pregnant woman. Purified water, with minerals, without any impurities and chemicals. During the period of bearing a child, it is best to use bottled water, or mineral water without gas.

Nutritional hygiene of a pregnant woman:

• Wash your hands with soap before every meal. Hands must be carefully treated from the wrist to the very tips.
• After washing, dry or wipe dry. Excessive moisture on the hands forms new bacteria.
• Follow your diet. Distribute the required amount of food per day for 4-5 main meals, and the rest for snacks.
• Do not eat expired and questionable products, fruits or vegetables with pesticides. Choose homemade or farm food.
• Do not store unwashed food.
• Prepare food immediately before taking, it is better not to eat "yesterday's" food.
• Products of dubious production are best avoided.

Such simple hygiene rules for a pregnant woman will protect you from many diseases and problems.

General hygiene: body care during pregnancy and clothing selection

In pregnant women, all the processes that take place in a woman's body become more active: the metabolism becomes faster, sweating becomes more abundant, the skin, figure, and breasts change. That is why the hygiene of a pregnant woman is an extremely important aspect of life in an interesting position.

Tips for general hygiene during pregnancy:

1. Do not buy bright colorful shower gels, do not choose strongly saturated smells. Such funds in a pregnant woman can not only cause allergies, but also nausea. For this period, it is better to buy special, hypoallergenic hygiene products.
2. A pregnant woman should not use strong-smelling deodorants. Limit the use of perfume to a minimum.
3. Many women begin to produce colostrum before giving birth. If you see his discharge, you must use special breast pads. The chest should always be dry, irritation of the nipples should not be allowed.
4. A pregnant woman is not recommended to walk in heels. During this period, the load on the spine is already large, and heels increase it. Shoes should be comfortable, you should buy either orthopedic or use silicone linings that replace orthopedic insoles.
5. Clothing should be comfortable and convenient. When choosing clothes, do not pinch your tummy. If you love fashionable and stylish clothes, then there is a way out for you too. The modern market offers a huge range of clothes for pregnant women. You can read about how to choose beautiful, fashionable clothes for pregnant women in the topic.
6. Choose your laundry detergent carefully. You should not buy a powder with a strong odor and with additives. It is better to buy phosphate-free powders or gel laundry detergents.

Intimate hygiene of a pregnant woman

At birth, the baby passes through the birth canal. The baby is in close contact with the female genital organs. Accordingly, maintaining the microflora and observing intimate hygiene is extremely important for a pregnant woman.

Basic Rules:

1. Take warm showers daily. Hot showers are contraindicated for pregnant women. Pregnant women can take a bath if there are no contraindications.
2. Do not use new brand panty liners.
3. Do not wipe the genitals with wet wipes, only if they are special wipes for intimate hygiene
4. Don't use colored toilet paper
5. Periodically, depilation of the intimate area should be done. Currently, there are many ways to carry out this procedure.

Simple rules will help you stay healthy and not resort to treatment during pregnancy. Intimate hygiene also includes regular visits to a personal gynecologist. The first visit should be done before 3 months. Further, the doctor appoints visits in accordance with the course of pregnancy. Doctor's examinations cannot be ignored. If you have anxiety symptoms, you should contact your doctor immediately.

Alarm symptoms:

• Drawing pain in the abdomen
• The waters have broken
• Blood discharge
• Large swelling
• Bad feeling
• Temperature too high

You can read about the pain that a pregnant woman may experience in the article.

Sexual hygiene

The sexual hygiene of a pregnant woman deserves great attention.

You can resume sexual activity from the second trimester, but carefully, choosing the right positions in which the pregnant woman will not feel discomfort.

At 9 months, it is also desirable to give up sex. This can cause preterm labor. But if there is no contraindication, you can have sex until the very birth. Sexual life makes it easier to endure contractions.

Dental care during pregnancy

The oral hygiene of a pregnant woman is a very important aspect. The pregnant body loses calcium and phosphorus, which causes teeth to crumble.

Hygiene rules for dental care:

1. Brush your teeth twice a day. Use mouthwash between meals. Rinses will have a positive effect on the gums, preventing inflammation from developing, they will also wash away food debris and give you fresh breath.
2. Get scheduled check-ups with your dentist.
3. Dental treatment can only be done in the second trimester. It is impossible to start caries during pregnancy. Because the infection that is in the mother's mouth may not have a beneficial effect on the child. The use of anesthesia during pregnancy is contraindicated. The health of your teeth is the key to the health of the baby and his bones. You can read more about dental treatment in the topic.

Hygiene of the soul of a pregnant woman

Hygiene of mind is one of the unrealistically important points that is often overlooked. Indeed, throughout the entire period, the baby experiences everything the same as the mother. All your thoughts, moods and actions do not pass by him. If you are worried, nervous or worried - the baby experiences the same thing. Try to make the pregnancy period the happiest in your life. This is the best hygiene for a pregnant woman to follow. Walk more often, watch your favorite movies, indulge in shopping, get creative. Listen to music, sing, and just be happy. Your baby will be very grateful to you.

Author of the publication: Svyatoslav Sitnikov

12. Clinical examination of pregnant women in the antenatal clinic. Continuity in the work of the antenatal clinic and the obstetric and gynecological hospital.

13. Diagnosis of early pregnancy.

14. Diagnosis of late pregnancy.

15. Determination of the term of childbirth. Granting a certificate of incapacity for work to pregnant women and puerperas.

16. Fundamentals of rational nutrition of pregnant women, regimen and personal hygiene of pregnant women.

17. Physiopsychoprophylactic preparation of pregnant women for childbirth.

18. Formation of the functional system "mother - placenta - fetus". Methods for determining the functional state of the fetoplacental system. Physiological changes in the "mother-placenta-fetus" system.

19. Development and functions of the placenta, amniotic fluid, umbilical cord. Placenta.

20. Perinatal protection of the fetus.

21. Critical periods in the development of the embryo and fetus.

22. Methods for assessing the condition of the fetus.

1. Determination of the level of alpha-fetoprotein in the mother's blood.

23. Methods for diagnosing fetal malformations at different stages of pregnancy.

2. Ultrasound.

3. Amniocentesis.

5. Determination of alpha-fetoprotein.

24. Impact on the fetus of viral and bacterial infections (influenza, measles, rubella, cytomegalovirus, herpes, chlamydia, mycoplasmosis, listeriosis, toxoplasmosis).

25. Influence of medicinal substances on the fetus.

26. Impact on the fetus of harmful environmental factors (alcohol, smoking, drug use, ionizing radiation, high temperatures).

27. External obstetric examination: articulation of the fetus, position, position, type of position, presentation.

28. Fetus as an object of childbirth. The head of a full-term fetus. Seams and fontanelles.

29. Female pelvis from an obstetric point of view. Planes and dimensions of the small pelvis. The structure of the female pelvis.

The female pelvis from an obstetric point of view.

30. Sanitary treatment of women upon admission to an obstetric hospital.

31. The role of the observational department of the maternity hospital, the rules for its maintenance. indications for hospitalization.

32. Harbingers of childbirth. Preliminary period.

33. The first stage of childbirth. The course and management of the disclosure period. Methods for registering labor activity.

34. Modern methods of labor pain relief.

35. Second stage of labor. The course and management of the period of exile. Principles of manual obstetric perineal protection.

36. Biomechanism of labor in anterior occipital presentation.

37. Biomechanism of labor in posterior occiput presentation. Clinical features of the course of childbirth.

The course of childbirth.

Birth management.

38. Primary toilet of a newborn. Apgar score. Signs of a full-term and premature newborn.

1. Afo full-term babies.

2. Afo premature and overdue children.

39. The course and management of the afterbirth period of childbirth.

40. Methods for isolating the separated placenta. Indications for manual separation and removal of the placenta.

41. Course and management of the postpartum period. Rules for the maintenance of postpartum departments. Joint stay of mother and newborn.

Coexistence of mother and newborn

42. Principles of breastfeeding. Methods for stimulating lactation.

1. Optimal and balanced nutritional value.

2. High digestibility of nutrients.

3. The protective role of breast milk.

4. Influence on the formation of intestinal microbiocenosis.

5. Sterility and optimal temperature of breast milk.

6. Regulatory role.

7. Influence on the formation of the maxillofacial skeleton of a child.

43. Early gestosis of pregnant women. Modern ideas about etiology and pathogenesis. Clinic, diagnosis, treatment.

44. Late gestosis of pregnant women. Classification. Diagnostic methods. Stroganov's principles in the treatment of preeclampsia.

45. Preeclampsia: clinic, diagnostics, obstetric tactics.

46. ​​Eclampsia: clinic, diagnostics, obstetric tactics.

47. Pregnancy and cardiovascular pathology. Features of the course and management of pregnancy. Delivery tactics.

48. Anemia in pregnancy: features of the course and management of pregnancy, tactics of delivery.

49. Pregnancy and diabetes mellitus: features of the course and management of pregnancy, delivery tactics.

50. Features of the course and management of pregnancy and childbirth in women with diseases of the urinary system. Delivery tactics.

51. Acute surgical pathology in pregnant women (appendicitis, pancreatitis, cholecystitis, acute intestinal obstruction): diagnosis, treatment tactics. Appendicitis and pregnancy.

Acute cholecystitis and pregnancy.

Acute intestinal obstruction and pregnancy.

Acute pancreatitis and pregnancy.

52. Gynecological diseases in pregnant women: the course and management of pregnancy, childbirth, the postpartum period with uterine myoma and ovarian tumors. Uterine fibroids and pregnancy.

Ovarian tumors and pregnancy.

53. Pregnancy and childbirth with breech presentation of the fetus: classification and diagnosis of pelvic presentation of the fetus; course and management of pregnancy and childbirth.

1. Breech presentation (flexion):

2. Foot presentation (extensor):

54. Incorrect positions of the fetus (transverse, oblique). Causes. Diagnostics. Management of pregnancy and childbirth.

55. Premature pregnancy: etiology, pathogenesis, diagnosis, prevention tactics of pregnancy management.

56. Management of preterm labor.

57. Post-term pregnancy: etiology, pathogenesis, diagnosis, prevention tactics of pregnancy management.

58. Tactics of managing late delivery.

59. Anatomical and physiological features of a full-term, premature and post-term newborn.

60. Anatomically narrow pelvis: etiology, classification, methods for diagnosing and preventing anomalies of the bone pelvis, the course and management of pregnancy and childbirth.

61. Clinically narrow pelvis: causes and diagnostic methods, tactics of childbirth.

62. Weak labor activity: etiology, classification, diagnosis, treatment.

63. Excessively strong labor activity: etiology, diagnosis, obstetric tactics. The concept of fast and rapid childbirth.

64. Discoordinated labor activity: diagnosis and management of labor.

65. Causes, clinic, diagnosis of bleeding in early pregnancy, management of pregnancy.

I. Bleeding not associated with the pathology of the fetal egg.

II. Bleeding associated with the pathology of the fetal egg.

66. Placenta previa: etiology, classification, clinic, diagnosis, delivery.

67. Premature detachment of normally located placenta: etiology, clinic, diagnostics, obstetric tactics.

68. Hypotension of the uterus in the early postpartum period: causes, clinic, diagnosis, methods of stopping bleeding.

Stage I:

Stage II:

4. Placenta accreta.

69. Coagulopathic bleeding in the early postpartum period: causes, clinic, diagnosis, treatment.

70. Amniotic fluid embolism: risk factors, clinic, emergency medical care. Amniotic fluid embolism and pregnancy.

71. Injuries of the soft birth canal: ruptures of the perineum, vagina, cervix - causes, diagnosis and prevention

72. Uterine rupture: etiology, classification, clinic, diagnostics, obstetric tactics.

73. Classification of postpartum purulent-septic diseases. Primary and secondary prevention of septic diseases in obstetrics.

74. Postpartum mastitis: etiology, clinic, diagnosis, treatment. Prevention.

75. Postpartum endometritis: etiology, clinic, diagnosis, treatment.

76. Postpartum peritonitis: etiology, clinic, diagnosis, treatment. obstetric peritonitis.

77. Infectious-toxic shock in obstetrics. Principles of treatment and prevention. Infectious-toxic shock.

78. Cesarean section: types of surgery, indications, contraindications and conditions for the operation, management of pregnant women with a scar on the uterus.

79. Obstetric forceps: models and device of obstetric forceps; indications, contraindications, conditions for applying obstetric forceps; complications for mother and fetus.

80. Vacuum extraction of the fetus: indications, contraindications, conditions for the operation, complications for the mother and fetus.

81. Features of the development and structure of the female genital organs in different age periods.

82. The main symptoms of gynecological diseases.

83. Tests of functional diagnostics.

84. Colposcopy: simple, extended, colpomicroscopy.

85. Endoscopic methods for diagnosing gynecological diseases: vaginoscopy, hysteroscopy, laparoscopy. Indications, contraindications, technique, possible complications.

86. X-ray methods of research in gynecology: hysterosalpingography, radiography of the skull (Turkish saddle).

87. Transabdominal and transvaginal echography in gynecology.

88. Normal menstrual cycle and its neurohumoral regulation.

89. Clinic, diagnosis, methods of treatment and prevention of amenorrhea.

1. Primary amenorrhea: etiology, classification, diagnosis and treatment.

2. Secondary amenorrhea: etiology, classification, diagnosis and treatment.

3. Ovarian:

3. Hypothalamo-pituitary form of amenorrhea. Diagnosis and treatment.

4. Ovarian and uterine forms of amenorrhea: diagnosis and treatment.

90. Clinic, diagnosis, methods of treatment and prevention of dysmenorrhea.

91. Juvenile uterine bleeding: etiopathogenesis, treatment and prevention.

91. Dysfunctional uterine bleeding of the reproductive period: etiology, diagnosis, treatment, prevention.

93. Dysfunctional uterine bleeding in menopause: etiology, diagnosis, treatment, prevention.

94. Premenstrual syndrome: clinic, diagnosis, methods of treatment and prevention.

95. Post-castration syndrome: clinic, diagnosis, methods of treatment and prevention.

96. Climacteric syndrome: clinic, diagnosis, methods of treatment and prevention.

97. Syndrome and disease of polycystic ovaries: clinic, diagnosis, methods of treatment and prevention.

98. Clinic, diagnosis, principles of treatment and prevention of inflammatory diseases of nonspecific etiology.

99. Endometritis: clinic, diagnosis, principles of treatment and prevention.

100. Salpingo-oophoritis: clinic, diagnosis, principles of treatment and prevention.

101. Bacterial vaginosis and candidiasis of the female genital organs: clinic, diagnosis, principles of treatment and prevention. Bacterial vaginosis and pregnancy.

candidiasis and pregnancy.

102. Chlamydia and mycoplasmosis of female genital organs: clinic, diagnosis, principles of treatment and prevention.

103. Genital herpes: clinic, diagnosis, principles of treatment and prevention.

104. Ectopic pregnancy: clinic, diagnosis, differential diagnosis, management tactics.

1. Ectopic

2. Abnormal uterine variants

105. Torsion of the pedicle of an ovarian tumor clinic, diagnosis, differential diagnosis, management tactics.

106. Ovarian apoplexy: clinic, diagnosis, differential diagnosis, management tactics.

107. Necrosis of the myomatous node: clinic, diagnosis, differential diagnosis, management tactics.

108. Birth of a submucosal node: clinic, diagnosis, differential diagnosis, tactics of management.

109. Background and precancerous diseases of the cervix.

110. Background and precancerous diseases of the endometrium.

111. Uterine fibroids: classification, diagnosis, clinical manifestations, methods of treatment.

112. Uterine fibroids: methods of conservative treatment, indications for surgical treatment.

1. Conservative treatment of uterine fibroids.

2. Surgical treatment.

113. Tumors and tumor-like formations of the ovaries: classification, diagnosis, clinical manifestations, methods of treatment.

1. Benign tumors and tumor-like formations of the ovaries.

2. Metastatic tumors of the ovaries.

114. Endometriosis: classification, diagnosis, clinical manifestations, methods of treatment.

115. Artificial termination of early pregnancy: methods of termination, contraindications, possible complications.

116. Artificial termination of pregnancy of late terms. Indications, contraindications, methods of interruption.

117. Purpose and objectives of reproductive medicine and family planning. Causes of female and male infertility.

118. Barren marriage. Modern methods of diagnostics and treatment.

119. Classification of methods and means of contraception. Indications and contraindications for use, effectiveness.

2. Hormonal drugs

120. The principle of action and method of use of hormonal contraceptives of different groups.

16. Fundamentals of rational nutrition of pregnant women, regimen and personal hygiene of pregnant women.

Nutrition for pregnant women.

During pregnancy, a woman's body undergoes a restructuring of metabolic processes, so special attention should be paid to rational nutrition, which is one of the main conditions for a favorable course and outcome of pregnancy, childbirth, the development of the fetus and unborn child. It plays a significant role in the prevention of anemia, toxicosis of pregnant women, intrauterine fetal malnutrition, anomalies in labor and other complications.

Balanced diet- a complete set of various food products in accordance with the gestational age and the correct distribution of the food ration during the day. The diet is compiled individually, taking into account the height and body weight of the pregnant woman, the size of the fetus, the nature of the course of pregnancy and the work of the woman.

The intensity of the basic metabolism during pregnancy increases by about 10%, and the total energy costs are 2500 kcal per day. This is due to increased oxygen consumption and fetal activity. Energy costs are associated with the growth of the fetus, placenta, uterus, mammary glands. With the onset of pregnancy, the amount of energy expended constantly increases up to the 30-week period, then there is a slight decrease. Additional costs incurred during pregnancy are covered mainly by fats (50%) and carbohydrates (about 33%). Proteins are used almost exclusively for the formation of fetal tissues and only about 6.5% is spent on energy expenditure.

When overweight, the diet should be designed in such a way as to prevent unwanted weight gain, i.e. reduce its calorie content due to carbohydrates and fats; pregnant women with low body weight need to increase the calorie content of the diet while maintaining the necessary ratios between the main ingredients. On average, in the second half of pregnancy, weight gain should not exceed 250-300 g per week.

Weight gain by the end of pregnancy in women is 8-12 kg:

Due to the fetus - 3.5 kg

Masses of the uterus and amniotic fluid - 650-900 g

Breast Enlargement - 400 g

The increase in the volume of circulating blood and interstitial fluid - 1.2-1.8 kg

Due to the increase in fat and other reserves of the maternal body - 1.6 kg.

An essential condition for a balanced diet- adherence to a certain diet, the violation of which not only harms the mother's body, but also adversely affects the development of the fetus and newborn.

In the first half During pregnancy, a woman's diet should not differ significantly from her diet before pregnancy. It should be remembered that in the first trimester, the laying of the organs of the fetus (the period of organogenesis) occurs, therefore it is especially important - a sufficient intake of complete proteins, vitamins, and minerals into the body of a pregnant woman. The most rational mode of four meals a day.

In the second half Pregnancy increases the need for proteins, not only their quantity (2 g per 1 kg of pregnant weight), but also their quality matters. The completeness of a protein is determined by its content of essential amino acids. The diet includes 50% animal protein and 50% vegetable protein. The need for carbohydrates is satisfied by foods rich in vegetable fiber, which contain vitamins, trace elements, and mineral salts. With excess body weight of a pregnant woman, the amount of carbohydrates decreases to 300-400 g per day, since carbohydrates are the main source of fat formation. A pregnant woman needs 100-110 g of fat per day. It is recommended to use vegetable fats (up to 40% of the total amount) - sunflower, corn and olive oil, butter and ghee are preferable from animal fats. It is advisable to eat 5-6 times a day. Breakfast should be 30% of the daily caloric intake, second breakfast - 15%, lunch - 40%, afternoon tea - 5% and dinner - 10%. The menu is recommended to take into account the time of year. Dishes containing extractive substances (broths, spices, smoked meats), salty and spicy foods are not recommended, alcoholic beverages are not allowed, since alcohol quickly crosses the placenta and adversely affects the fetus.

Liquid (water, soups, compotes, tea, juices, milk, jelly) in the first half of pregnancy is almost not limited. You can use it up to 1.5 liters per day. In the second half of pregnancy, fluid intake is limited to 1-1.2 liters, and in the last weeks - up to 0.7-0.8 liters per day. Table salt is limited in the second half of pregnancy to 8 g per day (normal 12-15 g).

The daily dose of calcium in the first half of pregnancy is 1 g, in the future - 1.5 g, and at the end of pregnancy - 2.5 g.

Phosphorus is spent on the formation of the skeleton of the fetus, its nervous tissue. It is found in nuts, bread, cereals, milk, meat, liver. The daily dose of phosphorus is 2 g.

The daily requirement for iron is 15-20 mg, for magnesium 0.3-0.5 mg, for cobalt - 5 mcg.

vitamins- biocatalysts that regulate the functions of many organs and systems of the human body. Vitamins are especially important for the body of a pregnant woman.

Vitamin A (carotene) is found in the liver, kidneys, butter, milk, eggs, carrots, fish oil, apricots and cheese. Its daily dose is 500 IU (about 1.5 mg). In the last 2 months of pregnancy, the daily dose may be increased to 10,000-20,000 IU.

Vitamin C (ascorbic acid) is found in many fruits, berries, vegetables, especially rose hips, blackcurrants, lemons, and green onions. The daily requirement of a pregnant and lactating woman is 100-200 mg of this vitamin. In the second half of pregnancy, the need for it increases significantly, and you can prescribe ready-made vitamin C preparations in pills or tablets.

Vitamin B 1 (thiamine) is found in the liver, kidneys, milk, egg yolk, bread and brewer's yeast. The daily requirement is at least 10-20 mg.

Vitamin B 2 (riboflavin) is found in yeast, liver, kidneys, meat, eggs, and dairy products. The daily dose is at least 2-3 mg. Vitamin B 2 is of great importance for the normal course of pregnancy and childbirth.

Vitamin B 6 (pyridoxine) is found in wholemeal bread. The daily dose - not less than 5 mg, is necessary for normal metabolism.

Vitamin B 12 (cyanocobalamin) is involved in the formation of nucleic acids, has a beneficial effect on the functions of the liver, nervous system, is found in buckwheat, yeast, liver. The daily dose is 0.003 mg.

Vitamin PP (nicotinic acid) is found in yeast, rye bread, meat, liver, lungs, wheat grains, potatoes. The average daily requirement of a pregnant and lactating woman is 18-23 mg.

Hygiene of pregnant women.

Physiological changes that occur during pregnancy have a beneficial effect on the body of a healthy woman, contributing to the full development of the most important functional systems. Under these conditions, pregnancy is usually tolerated easily. However, hygiene violations, malnutrition, excessive mental and physical stress can cause a violation of physiological processes and the occurrence of pregnancy complications. In women with signs of delayed development of the reproductive system, who have had abortions, gynecological and extragenital diseases, stressful situations and other pathological conditions, a violation of the physiological processes inherent in pregnancy can occur even with minor violations of the general regimen and hygiene rules.

A pregnant woman must observe the rules of hygiene that contribute to the preservation of health, the normal development of the fetus, and the prevention of complications of pregnancy and childbirth.

With the right lifestyle for a pregnant woman, there is no need to make significant changes to the general regimen. Healthy pregnant women perform the usual physical and mental work, which is the need of every person. Work contributes to the proper functioning of the nervous, cardiovascular, muscular, endocrine and other systems, muscles, joints, ligamentous apparatus, etc. Labor, especially associated with motor activity, is necessary for normal metabolism. Physical exercises that have a positive effect on the course of pregnancy and childbirth should be recommended. At the same time, a pregnant woman should avoid increased stress that causes physical and mental overwork.

The antenatal clinic doctor monitors the implementation of legislation protecting the health of the expectant mother. Pregnant women are not involved in night work, overtime work, as well as work associated with lifting and moving weights, vibration, exposure to high temperatures, radiation, a number of chemicals and other agents that can have a harmful effect on the body of the mother and fetus. Pregnant women are prohibited from cycling and other modes of transport, associated with vibration and shaking of the body, all sports associated with running, jumping, sudden movements and emotional stress.

It is recommended to take walks at any time of the year, as well as to use other opportunities for a long stay in the fresh air. The duration and pace of walking should be commensurate with the degree of fitness, age and health of the pregnant woman.

Good sleep of at least 8 hours a day is very important. In case of sleep disturbances, hygienic measures are preferable (walking before going to bed, optimal temperature and fresh air in the room, etc.). The use of hypnotics is undesirable due to the possibility of their effect on the fetus. According to indications, preparations of motherwort and valerian are prescribed.

Issues of sexual hygiene deserve attention. Theoretically, abstinence from sexual activity throughout pregnancy is justified, because significant fluctuations in hemodynamics in the basin of the vessels of the reproductive system cannot be considered physiological. Moreover, they can contribute to the termination of pregnancy, especially in women with signs of infantilism, who have had inflammatory and other diseases of the genital organs, and who have a complicated obstetric history. However, a complete renunciation of sexual activity is practically unrealistic, so it should be limited during the first 2-3 months and stopped in the last months of pregnancy.

Hyperemia of the genital organs, loosening of the mucous membranes of the vagina and cervix contribute to the development of inflammatory diseases in the case of the introduction of pathogenic flora during sexual intercourse.

A pregnant woman should avoid contact with patients with general and focal infectious diseases. It is necessary to eliminate all foci of infection that occurred before and during pregnancy (angina, tonsillitis, caries and other inflammatory diseases of the dental profile, colpitis, furunculosis, etc.).

Skin care during pregnancy is very important. To ensure the complex functions of the skin, it is necessary to monitor its cleanliness (shower, bath, wiping). This contributes to the implementation of excretory, respiratory and other functions of the skin, has a beneficial effect on the vascular and nervous system, regulates sleep and other activities of the body. Healthy pregnant women are recommended air and sunbathing. The duration of the air baths is at first 5-10 minutes, and as it hardens - 15-20 minutes at an air temperature of 20-25 ° C. Under other temperature conditions and depending on the degree of fitness, the mode of air baths changes (or they are not recommended). Intensive exposure to sunlight should be avoided. In winter, general ultraviolet irradiation under the supervision of a physiotherapist is desirable.

Prevention of cracked nipples and mastitis begins in the antenatal clinic. Basically, it comes down to daily washing of the mammary glands with room temperature water and soap (children's) and subsequent wiping with a hard towel. With dry skin, 2-3 weeks before childbirth, it is useful to daily lubricate the skin of the mammary glands, including the areola, with a neutral cream (for children, etc.). Air baths for the mammary glands are carried out for 10-15 minutes several times a day. With flat and inverted nipples, massage is recommended, which a woman is taught by a doctor or midwife. Comfortable bras (preferably cotton) should be worn that do not restrict the chest. To avoid congestion, the mammary glands should be in an elevated position.

In order to prevent mastitis, it is necessary to identify pregnant women who previously suffered from this disease, with the presence of a purulent infection of any localization during this pregnancy, with mastopathy and other pathologies of the mammary glands. In the exchange card of such pregnant women, the risk of mastitis is noted.

Clothes for pregnant women should be comfortable, not restrict the chest and stomach. Cotton products are preferred, which can be changed and washed frequently. You should not wear clothes made of fabrics that impede the respiratory, excretory, thermoregulatory and other functions of the skin (from acetate, viscose and other fibers). In the second half of pregnancy, wearing a bandage is recommended.