Obsessive jealousy

It is very difficult to explain what jealousy is. The most common definition would be that jealousy is an emotion by one who perceives that another person is giving something that he or she feels is due to them to an alternate. The examples of jealousy are everywhere around us. Children may become j...
It is very difficult to explain what jealousy is. The most common definition would be that jealousy is an emotion by one who perceives that another person is giving something that he or she feels is due to them to an alternate. The examples of jealousy are everywhere around us. Children may become jealous when their siblings get something that they haven%26rsquo;t. An adult may become jealous if their lover is flirting with someone else. Although a small amount of jealousy is not considered to be pathological, this emotion, when seriously expressed, can invade every relationship, whether it be with husbands, wives, boyfriends, girlfriends, brothers, sisters, mothers or fathers. A form of jealousy called Delusional jealousy or Othello syndrome is a psychiatric disorder in which a person thinks that their spouse or sexual partner is being unfaithful. In some cases this type of behaviour is acquired through past experiences - people who have already been cheated on tend to be more possessive and controlling for fear of repetition. In most cases however, jealousy is a byproduct of one's own issues with self-confidence and self-esteem.

Fear and lack of trust

Fear is the number one cause of unfounded jealousy. The person who is jealous may not be willing to admit it at first, but at the core of almost all jealousy is a fear that they may lose their partner and their needs for love, friendship and affection will no longer be met. The second ingredient that is almost always present when someone is jealous is a lack of trust in a relationship. This can either be a lack of trust in their partner because of past actions or a lack of trust in their partner's ability to make conscious choices and decisions about their conduct when they are with other people.

Jealousy and envy

Some experts strictly distinguish between jealousy and envy on the ground that jealousy involves the wish to keep what one has while envy involves the wish to get what one does not have.







To oversimplify, jealousy causes anger, envy causes wistfulness. Jealousy is destructive, but envy rarely is. Envy is the desire for something in general, whereas jealousy is the desire to have something in particular.

Some even claim a distinction between jealousy and envy insofar as while envy is the carnal desire to possess something that is not yours, jealousy is the righteous feeling that one has towards that which is rightly his.. For this reason, some have suggested that jealousy mostly concerns one's perception of oneself.

Jealousy and self-esteem

Scientific research has not clearly established a link between jealousy and self-esteem although some experts claim that there is a strong link between thess two.

Is jealousy insecurity?

Several psychiatric studies have come to the conclusion that feelings of jealousy always appear to stem from one's sense that something about their life is not secure. In some cases, the insecurity is not founded on realistic dangers to the relationship and if that is the case, the jealous partner may wish to consider where the insecurities are coming from. Of course, solving these sorts of insecurities isn't easy, but until a person does it there is no chance for a healthy relationship without the excessive jealousy.

Totally non-jealous!

By the late 1960s and the 1970s, jealousy, particularly sexual jealousy, had come to be seen as irrational and shameful among the proponents of free love. People who practiced those non-exclusive sexual relationships believed that they ought not to be jealous and sought to banish or deny jealous reactions to their partners' sexual involvement with others. Many found this unexpectedly difficult. For some, conscious blocking of the jealous reaction is relatively easy from the start, and over time the reaction can be effectively extinguished.

Multiple intimate relationships

Several studies suggest that jealousy may be reduced in multilateral relationships. Contemporary practitioners of what is now called multiple intimate relationships for the most part treat jealousy as an inevitable problem, best handled by accommodation and communication.

Delusional jealousy

Delusional jealousy is a psychiatric disorder in which a person holds a delusional belief that their spouse or sexual partner is being unfaithful. Delusional jealousy is also known as the Othello syndrome, erotic jealousy syndrome, morbid jealousy, Othello psychosis, or sexual jealousy. This syndrome may appear alone or in the course of paranoid schizophrenia, alcoholism, or cocaine addiction.

The most common symptoms of Othello syndrome:

%26bull; recurrent accusations of infidelity,
%26bull; searches for evidence,
%26bull; repeated interrogation of the partner,
%26bull; tests of partner's fidelity,
%26bull; stalking


The affected person typically makes these accusations based on insignificant or minimal evidence. They may also frequently monitor their partner%26rsquo;s behavior and movements. This may be taken to extremes. This type of behaviour is more often found in males than females and it has a strong association with violence.
Some studies have also found that the constant accusations and suspicion from the delusional partner have driven some partners to actually have an affair.

Treatment of jealousy

The first step is that the person stops denying jealousy and starts dealing with it. There are several ways in which jealousy can be treated.

%26bull; Self-treatment

It is proven that one of the biggest mistakes that jealous person can make is to try and hide it. It is important to figure out that jealousy is usually a signal that something in the life of this person needs to be fixed. Ignoring usually only makes things worse. Jealous persons should ask themselves the following questions:

%26bull; What do I feel insecure about?
%26bull; Do I feel unattractive or uninteresting myself?
%26bull; Do I doubt the other persons love for me?
%26bull; Do I doubt that I can have the type of relationship I want?

Once a person figures out what the reason of discomfort is, they should ask themselves if these fears are well-founded. If the person is really sure that fears are unwarranted, but they feel insecure anyhow, they should try to change in order to avoid the situations which cause their insecurity in the future!

Sometimes jealous feelings can be triggered because we have unspoken expectations from our partner that aren't met. In such cases it may be helpful to ask the partner how they feel about it and, by clarifying the partners intentions, ending up feeling disappointed and hurt will be less likely. There is a lot of hope in being able to change ourselves, whether we are working on our personal defects of character, or we just need to change our attitude.

Some useful tips are:


%26bull; Learn from past experiences.
It is important to look at how your behavior affected the past relationships. You may soon discover that these frequent suspicions are the cause of your troubled love life.
You should realize that getting upset with your partner for no reason won't help your situation.
%26bull; Deal with reality
Focusing on what is really happening, not what you perceive to be happening is crucial. This is because with time, person may end up having difficulty distinguishing fact from fiction.
%26bull; Respect yourself
The partner chose you for a reason and there is no need for them to be so easily tempted elsewhere.
%26bull; Get a third party's opinion
It might be useful to ask a good friend to take note of your behavior around your partner. It may help you to fully understand the extent of your actions. Neutral perspective is the most objective criteria.

%26bull; Psychiatric therapy
Therapy can be another good way of dealing with unfounded internal fears. Unfortunately, there is often a stigma attached to therapy but you need to know that visiting a therapist doesn%26rsquo;t mean that you are crazy.

%26bull; Medications

Some patients with pathological jealousy have a predominant obsessional component to their jealous thoughts. Since obsessions and compulsions often respond to medications called serotonin reuptake blockers, these drugs may also be useful for obsessional jealousy. It is proven that obsessional jealousy has phenomenological similarities to other obsessions and compulsions, and therefore jealousy may respond to standard anti-obsessional medications.

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Antisocial Personality Disorder

Antisocial personality disorder is a specific psychiatric disorder characterized by antisocial and impulsive behaviors. This is a pathological disorder which means that modern psychiatry defines no potential benefits of positive antisocial behavior. Professional psychiatry generally compares Antisoc...
Antisocial personality disorder is a specific psychiatric disorder characterized by antisocial and impulsive behaviors. This is a pathological disorder which means that modern psychiatry defines no potential benefits of positive antisocial behavior. Professional psychiatry generally compares Antisocial Personality Disorder to sociopathy. That%26rsquo;s why the term %26ldquo;sociopath%26rdquo; is sometimes used to describe an individual with anti-social personality disorder. People with anti-social personality disorder show a chronic lack of concern for the rules and expectations of society, and repeatedly violate the rights of others. Anti-social personality disorders are difficult to treat. Group counseling and treatment of coexisting conditions may help some people.

Personality disorders

A personality disorder is a severe disturbance in the logical constitution and behavioral tendencies of an individual, usually involving several areas of the personality, and nearly always associated with considerable personal and social disruption. Personality disorder tends to appear in late childhood or adolescence and continues to manifest into adulthood.

Currently, there are 10 distinct personality disorders identified in the DSM-IV:

1. Antisocial Personality Disorder
2. Avoidant Personality Disorder
3. Borderline Personality Disorder
4. Dependent Personality Disorder
5. Histrionic Personality Disorder
6. Narcissistic Personality Disorder
7. Obsessive-Compulsive Personality Disorder
8. Paranoid Personality Disorder
9. Schizoid Personality Disorder
10. Schizotypal Personality Disorder

Incidence

Approximately 3% of men and 1% of women are thought to have some form of antisocial personality disorder according to DSM-IV.





The incidence of antisocial personality is higher in people who have antisocial biological parents.

The cause of Antisocial Personality Disorder

The cause of this disorder is unknown, although most experts believe that the biological or genetic factors may play a role.

%26bull; Genetic factors
The incidence of antisocial personality is higher in people who have antisocial biological parents. There is almost always a history of similar behaviors before age 15, such as repetitive lying, truancy, delinquency, and substance abuse. Several researches have confirmed the genetic factors of antisocial behavior in adults and shown that genetic factors are more important in adults than in antisocial children. Antisocial Personality Disorder in the biological parents predicted antisocial disorder in the adopted away children.

Symptoms of the condition

%26bull; Antisocial behavior
People with this disorder appear to be charming at times, and make relationships, but to them, these relationships are not filled with true emotions. The relationships of the persons with this disorder including marriages, are shallow and meaningles and are ended whenever it suits them. They have the ability to find the weakness in people, and are ready to use these weaknesses to their own ends through manipulation.
%26bull; Lack of true emotions
These people appear to be incapable of any true emotion. They are quick to get angry, but just as quick to let go, without holding grudges.
%26bull; Living for the moment
The are rarely able to have a steady job. They live for the moment, forgetting the past, and not planning the future, not thinking ahead what consequences their actions will have. They want immediate rewards and gratification.

Most commonly, the sociopath:

%26bull; Repeatedly breaks the law
%26bull; Displays reckless or impulsive behavior
%26bull; Exhibits persistent irritability and aggressive behavior
%26bull; Repeatedly lies to and manipulates others
%26bull; Is unable to sustain long-term relationships
%26bull; Shows consistent irresponsibility, such as failing to pay bills or hold a steady job
%26bull; Abuses alcohol or drugs
%26bull; Shows little or no remorse for their actions

Five-factor model of personality

1. High Neuroticism

Some of the common symptoms are:

%26bull; chronic negative affects, including anxiety, fearfulness, tension, irritability, anger, dejection, hopelessness, guilt, shame;
%26bull; difficulty in inhibiting impulses: to eat, drink, or spend money;
%26bull; irrational beliefs: for example, unrealistic expectations, perfectionistic demands on self,
%26bull; unwarranted pessimism;
%26bull; unfounded somatic concerns;
%26bull; helplessness and dependence on others

2. Low Extraversion

This is characterized by social isolation, interpersonal detachment, and lack of support networks, flattened affect, lack of joy for life, social inhibition and shyness.

3. Low Openness

It is characterized by low tolerance or understanding of different points of lifestyles, emotional blandness and inability to understand and verbalize own feelings.

4. Low Agreeableness

The most common symptoms are cynicism, paranoid thinking and inability to trust even friends or family.

5. Low Conscientiousness

It is characterized by poor academic performance relative to ability.

The person with APD is hardly fulfilling their intellectual or artistic potential.

Aggressive sociopaths

These people derive strong gratification from harming others. It is proven that they like to hurt, frighten, tyrannize, bully, and manipulate. They do it for a sense of power and control, and will often only drop subtle hints about what they are up to. They seek out positions of power, such as parent, teacher, bureaucrat, supervisor, or police officer.

Diagnosis of APD

Most of the manuals for diagnosing mental and behavioral disorders, define antisocial personality disorder as a pervasive pattern of three (or more) of the following:

%26bull; failure to conform to social norms with respect to lawful behaviors
%26bull; deceitfulness, repeated lying, use of aliases,
%26bull; impulsivity or failure to plan ahead
%26bull; irritability and aggressiveness, as indicated by repeated physical fights or assaults
%26bull; reckless disregard for safety of self or others
%26bull; lack of remorse
%26bull; The individual is at least age 18 years.
%26bull; There is evidence of conduct disorder with onset before age 15 years.

Differential Diagnosis

Some disorders have similar symptoms. That is why the clinician has to differentiate against the following disorders to establish a precise diagnosis.

These conditions are:

%26bull; Substance-Related Disorder;
%26bull; Schizophrenia
%26bull; Manic Episode
%26bull; Narcissistic Personality Disorder
%26bull; Histrionic Personality Disorder
%26bull; Borderline Personality Disorders
%26bull; Paranoid Personality Disorder
%26bull; Adult Antisocial Behavior.

Treatment of Antisocial personality disorder

Treatment Goals

Experts are saying that the treatment for all individuals with personality disorders should include:

%26bull; preventing further deterioration,
%26bull; establishing or regaining an adaptive equilibrium,
%26bull; alleviating symptoms,
%26bull; restoring lost skills,
%26bull; fostering improved adaptive capacity

Another treatment goal is to assist family members and significant others to set limits.

Counseling and Psychotherapy

The effective treatment of antisocial behavior and personality is limited but it is proven that group psychotherapy can be helpful.
The main goal of the psychotherapy is for the patient to develop a sense of trust. Only then the individual psychotherapy or cognitive behavioral therapy can be beneficial. It is likely, that intensive, psychoanalytic approaches are inappropriate for this population.

Pharmacotherapy

There is no research that supports the use of medications for direct treatment of antisocial personality disorder. It is proven that medications should only be utilized to treat clear, acute and serious diagnoses.

Self-Help

There are several self-help methods for the treatment of this disorder. Unfortunately they are often overlooked by the medical profession. Group therapy could be the key because individuals feel more at ease while discussing their problems in front of their peers..

Prognosis

The prognosis is not very good mostly because this disorder is characterized by a failure to conform to society's norms. People with this disorder are often incarcerated because of criminal behavior. A lack of insight into the disorder is also very common. People with antisocial personality disorder rarely seek treatment and rarely realize that they have a problem in the first place.

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Effexor - experiences

Venlafaxine (Effexor®) is a new antidepressant with a chemical structure that does not resemble those of any currently used antidepressants. Effexor XR® (Venlafaxine HCL) is a medication available to treat depression and generalized anxiety disorder .It is important to know that Effexor®...
Venlafaxine (Effexor%26reg;) is a new antidepressant with a chemical structure that does not resemble those of any currently used antidepressants. Effexor XR%26reg; (Venlafaxine HCL) is a medication available to treat depression and generalized anxiety disorder .It is important to know that Effexor%26reg; is not a tricyclic antidepressant or an MAO inhibitor. The fact is that everyone responds to medications differently. Effexor XR%26reg; will work well for some people, and not so well for others. Research has shown that Venlafaxine is the most effective among six commonly prescribed antidepressants.

What makes it so different from other antidepressants?

Effexor seems to have the relative freedom from side-effects associated with the:

%26bull; SSRIs such as fluoxetine (Prozac%26reg;), sertraline (Zoloft%26reg;), paroxetine (Paxil%26reg;), and fluvoxamine (Luvox%26reg;) and
%26bull; The impact on both serotonin and norepinephrine associated with the tricyclic antidepressants [amitriptyline (Elavi%26reg;l), imipramine (Tofranil%26reg;).

Effexor is different than other antidepressants because it contains the drug known as Venlafaxine which should be prescribed only to people suffering from major depression or extreme anxiety. This drug has been successful in treating people with depression that have not responded to other antidepressants.

Metabolism and mechanism of action

This drug belongs to a class of antidepressants called serotonin-norepinephrine reuptake inhibitors (SNRI). As Venlafaxine and its active metabolite have relatively short half-lives, 4 hours and 11 hours respectively, Effexor should be administered in divided does, two or three times a day. Venlafaxine is well absorbed, with peak plasma concentrations occurring approximately 2 hours after dosing. Structurally different from any other antidepressant, it affects two neurotransmitters involved in depression, serotonin and norepinephrine. Several researches have proven that this medication works by correcting the balance of two brain chemicals serotonin and norepinephrine.

Why are these substances so important? It is proven that these two chemicals help control moods, concentration, impulses, appetites, irritability and emotions.
That%26rsquo;s why imbalances of these substances create the cycle of depression and the nervousness and irritability associated with anxiety disorders.





It is proven that at low and medium dosages, Effexor diminishes serotonin reuptake alone and at higher dosages, it inhibits the reuptake of norepinephrine as well as serotonin and dopamine.

Like most other medications used for depression, Effexor may take several weeks before it is fully effective and that%26rsquo;s why it is important to give the medication sufficient time before judging whether it works for a given person.

Before using this medicine

Before you start taking Effexors, there are several things you should know about it and it%26rsquo;s side effects:

%26bull; Allergies
The doctor needs to be informed about any allergic reaction to Venlafaxine or about allergy to any other substances, such as foods, preservatives, or dyes.
%26bull; Pregnancy
Some research conducted on animals showed that Effexor may have serious side effects on pregnancy. You need to inform your doctor that you%26rsquo;re pregnant before he prescribes you this medicine.
%26bull; Breast-feeding
This medicine passes into breast milk and may cause unwanted effects.
%26bull; Children
Venlafaxine must be used with caution in children with depression because several studies have shown occurrences of suicidal tendencies in children who participated in clinical trials for this medicine.
%26bull; Other medicines
You should consult the physician if you plan to start taking Effexor while already on:

%26bull; Buspirone
%26bull; Bromocriptine
%26bull; Certain tricyclic antidepressants
%26bull; Dextromethorphan
%26bull; Levodopa
%26bull; Lithium
%26bull; Meperidine
%26bull; Nefazodone
%26bull; Pentazocine
%26bull; Selective serotonin reuptake inhibitors
%26bull; Street drugs (LSD, MDMA [e.g., ecstasy], marijuana)
%26bull; Sumatriptan
%26bull; Tramadol
%26bull; Trazodone
%26bull; Tryptophan
%26bull; Clozapine
%26bull; Monoamine oxidase (MAO) inhibitor activity
%26bull; Warfarin

Effexor indications

%26bull; Depression and generalized anxiety disorder
Effexor XR is recognized as an effective first-time medication for patients who suffer from depression or who have generalized anxiety disorder. It doesn%26rsquo;t matter whether they are hospitalized or treated on an outpatient basis.
%26bull; Longstanding depressive illness
It can also be useful for patients who have had longstanding depressive illness and have not responded adequately to previous treatments.
%26bull; Unsuccessful previous treatments
A great deal of so-called refractory patients or those who have not had positive results from past treatment have had success with Effexor XR.

Recommended dosage

%26bull; Effexor%26reg;
The usual starting dose is 75 milligrams a day, divided into 2 or 3 smaller doses. It should always be taken with food. If needed, the doctor may gradually increase the daily dose in steps of no more than 75 milligrams at a time up to a maximum of 375 milligrams per day.
%26bull; Effexor XR%26reg;
For both depression and anxiety the usual starting dose is 75 milligrams once a day, although some people begin with a dose of 37.5 milligrams for the first 4 to 7 days. Your doctor may gradually increase the dose, in steps of no more than 75 milligrams, up to a maximum of 225 milligrams daily.

Possible side effects of Effexor

A warning is being issued with Effexor and with other SSRI and SSRN anti-depressants advising of risk of suicidality. Family members should be advised of this potentially fatal side effect so they may bring the patient to a hospital emergency for surveillance and protection.

Common side effects include:

%26bull; Nausea
%26bull; Dizziness
%26bull; Sleepiness
%26bull; Insomnia
%26bull; Vertigo
%26bull; Dry mouth
%26bull; Sexual dysfunction
%26bull; Sweating
%26bull; Vivid dreams
%26bull; Increased blood pressure
%26bull; Electric shock like sensations

Less Common side-effects include:

%26bull; Panic Attacks
%26bull; Drowsiness
%26bull; Depressed feelings
%26bull; Cardiac arrhythmia
%26bull; Increased serum cholesterol
%26bull; Gas or stomach pain
%26bull; Abnormal vision
%26bull; Nervousness, agitation or increased anxiety
%26bull; Suicidal thoughts suicidal ideation
%26bull; Confusion
%26bull; Neuroleptic malignant syndrome
%26bull; Loss of appetite
%26bull; Constipation
%26bull; Tremor
%26bull; Tardive dyskinesia
%26bull; Difficulty swallowing
%26bull; Lack of sexual desire
%26bull; Raised blood pressure
%26bull; Allergic skin reactions
%26bull; External bleeding
%26bull; Serious bone marrow damage
%26bull; Hepatitis
%26bull; Pancreatitis
%26bull; Seizure

Effexor and other medications

Effexor XR%26reg; does not interact significantly with many other medications, including Lithium%26reg;, Valium%26reg; (diazepam), and Tagamet%26reg; (cimetidine, an anti-ulcer medication). While taking Tagamet %26reg; for high blood pressure or liver disease the patient should be cautious in taking Effexor XR%26reg; because the interaction may be more pronounced when these disorders are present. Effexor XR%26reg; definitely should not be taken at the same time as the MAOIs (Parnate%26reg; or Nardil%26reg;). Interactions with these compounds could be lethal.

Physical and Psychological Dependence

Although no researches have been conducted on humans, several in vitro studies revealed that Effexor has virtually no affinity for opiate, benzodiazepine, phencyclidine (PCP), or N-methyl-D-aspartic acid (NMDA) receptors.

There was no indication of drug-seeking behavior in the clinical trials. However, it is not possible to predict on the basis of experience the extent to which a CNS active drug will be misused, diverted, or abused once marketed.

Withdrawal symptoms

Effexor%26reg; may cause potentially serious withdrawal symptoms upon sudden discontinuation. These withdrawal symptoms have a tendency to be significantly stronger than the withdrawal effects of other antidepressants including the tricyclic antidepressants.

Discontinuation effects may include:

%26bull; irritability,
%26bull; hostility,
%26bull; headache,
%26bull; nausea,
%26bull; fatigue,
%26bull; dysphoria
%26bull; brain shivers

Rarer withdrawal symptoms include:

%26bull; shaking legs,
%26bull; tremor,
%26bull; vertigo,
%26bull; Abdominal or stomach pain;
%26bull; agitation;
%26bull; black, tarry stools;
%26bull; bleeding gums;
%26bull; blistering,
%26bull; peeling,
%26bull; loosening of skin;
%26bull; bloating of abdomen;
%26bull; blood in eye;
%26bull; bloody urine;
%26bull; confusion
%26bull; dizziness
%26bull; paresthesia
%26bull; impaired concentration,
%26bull; bizarre dreams,
%26bull; agitation
%26bull; suicidal thoughts

Effexor and suicide

The possibility of a suicide attempt in seriously depressed patients is inherent to the illness and may persist until significant remission occurs.
Close supervision of high-risk patients should accompany initial drug therapy, and consideration should be given to the need for hospitalization. In order to reduce the risk of overdose, prescriptions for Effexor should be written for the smallest quantity of tablets consistent with good patient management.


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Am I pregnant?

“Am I pregnant” is a favorite question of anyone who is trying to get pregnant and a good question for everyone. Since there are so many different signs and symptoms, many women do not know how to be sure. That is why you should read this article if you are interested in signs and sympto...
%26ldquo;Am I pregnant%26rdquo; is a favorite question of anyone who is trying to get pregnant and a good question for everyone. Since there are so many different signs and symptoms, many women do not know how to be sure. That is why you should read this article if you are interested in signs and symptoms of pregnancy.
While a missed period is one of the biggest clues that a woman is pregnant, it is not the first sign. Some women suspect they are pregnant before their menstrual cycle is late, but also symptoms that might indicate you are pregnant include tenderness of the breasts and nipples, fatigue that occur 1-6 weeks after conception, frequent urination occurring 6-8 weeks after conception, nausea, queasiness, vomiting in first half of pregnancy and food cravings that happens during entire pregnancy. While some women are sure they are pregnant from the moment of conception, others may take five positive pregnancy tests, as well as a host of symptoms, until they are really sure. You must remember that all women are different so you may not experience all, or even any of these common signs of pregnancy.

Missed period

This is probably one of the more reliable signs that pregnancy has happened. Although some women will experience implantation bleeding about the time of their period, it is usually lighter and shorter than normal period. This is why each woman who suspects she might be pregnant will be asked for the first day of last normal period she has had. There are even a few women who will have periods throughout their pregnancy. This is a rare occurrence but it can happen. When a woman is planning for pregnancy, the day that she expects her period is probably well marked in her mind, and that it is the official day that she can take a home pregnancy test. These tests measure the levels of hCG (human chorion gonadotropine), a hormone secreted during pregnancy in woman%26rsquo;s urine.

The amount of urine each test can detect varies widely and amount of hormone each woman secret may also vary, but not as widely.






The better tests on the market will measure 25-50 mIUs of hCG, which is usually the amount found in urine between the 4thand 5th weeks of pregnancy. The levels of hCG in your urine and blood will be different. First morning urine will always contain the highest concentration of hCG but most tests do not require that you use first morning urine.

You can help better your chances of having enough hCG in your urine by waiting four hours after you last urinated, and then taking the home pregnancy test. This will allow hCG to build up in your urine if you really are pregnant. These tests rarely give false results but it would be better for your gynecologist to confirm that you are pregnant. A negative answer that is later revealed to be a pregnancy is usually the result of the test being performed too early, while positive ones that later prove to be false signs of pregnancy usually indicate a very early miscarriage. You can always talk to your practitioner if you have questions about your pregnancy tests. You must know also that blood tests are the most accurate and can be performed 7-10 days post-ovulation.

Tender breasts or nipples

If you are pregnant you will notice that your breasts and nipples become tender. It happens around three weeks after conception or when your period is about one week late. They may also feel swollen similar to the way they feel when you expect your period.

Slight spotting or cramping

If you are pregnant, light pink spotting can occur at the time of implantation. This happens when the embryo attaches to the lining of the uterus. Most commonly woman will notice it around eight to ten days following ovulation, a bit earlier than menstrual period is due. Women can usually differentiate implantation bleeding from menstrual period if it occurs a bit earlier than expected. Moreover, this will probably be cramping if it is scanty, spotty, pinkish and not red and heavy like a period, and does not follow the normal pattern of a period that should be light, progressing to heavy and then again to light. Cramping can also be common in early pregnancy, until the uterus assumes its mid-position and becomes better supported by the bony pelvis in the second trimester. During that time, it is prone to menstrual-like cramping. Contractions of the uterus occur regularly, increasing with exercise, orgasm, and even simple changes in position of the woman.

Darkening areolas

This is a famous and very common sign in very early pregnancy, around the time of your expected period. At this time the woman may notice that her areola (darker areas that ring the nipples) begin to darken and increase in diameter. It is believed that the darker color of the areola helps the newborn to find the nipple for breastfeeding after the baby is born.
You may also notice that the veins in your breasts become more visible and that Montgomery's tubercles (the tiny bumps scattered around the areola) enlarge and may increase in number. The number is averaging between 4 and 28 per areola.

Extreme fatigue

If a woman is pregnant, a very common symptom in the first eight to ten weeks is exhaustion, s her body is going through significant metabolic changes. Her entire body needs to adjust to the new process of growing a baby. For most women fatigue starts to go away by the 12th week of their pregnancy.

Nausea and vomiting

When a woman is pregnant, she may find quite early on, as early as a week after conception, that she is experiencing morning sickness. She may also find that morning sickness is a misnomer. Nausea can occur at anytime, day or night.

Frequent urination

By the time the woman%26rsquo;s period is one to two weeks late, she may find that she is peeing more frequently than usual. This is because the baby growing in uterus is putting pressure on the bladder.

Constipation

Women commonly notice a change in bowel movement in early pregnancy. The extra hormones produced during pregnancy cause the intestines to relax and become less efficient, so constipation could occur.

Raised basal body temperature

A woman may very well be pregnant if her basal body temperature remains elevated even past the time her period is due. She may notice that it does not decline to pre-ovulatory levels. When woman conceive, the egg is fertilized in the fallopian tube. After that, it takes about a week to travel to the uterus, where it will implant. It is at this time that the woman%26rsquo;s body is finally able to detect that she is pregnant. When hCG or human chorionic gonadotropine is released, women often experience a third temperature rise. This is not as dramatic as the first, but can usually be seen anywhere from about a week to 12 days after the first temperature rise at ovulation.

A positive pregnancy test

This is something each woman should do if her period is late and she could expect to become pregnant. She could do it after her period is at least a day late, and when she is ready to know the truth. In this case, she may want to take a home pregnancy test.
A urine pregnancy test can be accurate as early as 10 to 14 days after fertilization happened. If woman cannot wait until a missed period, a blood pregnancy test can be accurate as early as 8 to 10 days after fertilization. However, you should keep in mind that pregnancy tests are not 100 percent foolproof, and neither are blood tests. If you have a negative result and still feel pregnant, be sure to retest a week later and check in with your health care provider.

What if I am pregnant?

When a woman suspects that she is pregnant, she should visit a doctor to confirm her condition as soon as possible; after that she should change her life style a little bit. Laboratory blood tests can verify pregnancy as soon as 6 or 7 days after conception, while urine test may detect pregnancy as early as 10 days after conception. The blood and urine test both measure the level human chorionic gonadotropin or HCG. This is a hormone produced only in a woman%26rsquo;s body when she has placental tissue growing there. The placenta is the tissue within the uterus or womb through which the mother provides nourishment to the fetus.

The importance of prenatal care

One of the most important things that woman can do for herself and her baby is to seek proper prenatal care. Prenatal care consists of regular appointments starting early and continuing throughout the pregnancy. Laboratory testing for potential problems with the developing baby or herself and monitoring for problems such as abnormal changes in blood pressure, blood chemistry, urine chemistry, and weight are very important. Getting plenty of exercise and eating properly, giving up bad habits such as smoking, drinking alcohol, or using street drugs is something that doctor should definitely recommend. It is also important for a woman to alert her doctor immediately if anything unusual occurs during pregnancy, such as if the baby%26rsquo;s movement greatly reduce or stop, if she experiences vaginal bleeding or cramping, develops swelling of her hands and face, or persistent headaches, if she leaks amniotic fluid from her vagina, or if she develops pain in abdomen. Improved technologies and more accurate prenatal tests now make it possible to spot complications earlier. This also helps to get appropriate action in time to save the fetus and mother. A woman%26rsquo;s habits greatly influence the health of her unborn child, so when pregnant, woman should avoid few things. Alcohol is the first thing because consuming alcohol while pregnant can cause birth defects and other problems. In fact, consistent alcohol use during pregnancy can cause fetal alcohol syndrome, a permanent and lifelong condition. Cigarettes, medications, narcotics, caffeine and contact with cat feces are also things pregnant women should avoid.


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Guillain-Barre Syndrome: Causes, Symptoms & Treatment

The Guillain-Barre syndrome can affect anybody; it can strike at any age and both sexes are equally prone to the disorder. The syndrome is rare, afflicting only about one person in 100,000. Usually Guillain-Barre occurs a few days or weeks after the patient has had symptoms. It is not so hard to rec...
The Guillain-Barre syndrome can affect anybody; it can strike at any age and both sexes are equally prone to the disorder. The syndrome is rare, afflicting only about one person in 100,000. Usually Guillain-Barre occurs a few days or weeks after the patient has had symptoms. It is not so hard to recognize symptoms of a respiratory or gastrointestinal viral infection. Occasionally surgery or vaccinations will trigger Guillain-Barre syndrome. This disorder can develop over the course of hours or days, or it may take up to 3 to 4 weeks. Most people reach the stage of greatest weakness within the first 2 weeks after symptoms appear. By the third week of the illness 90 percent of all patients are at their weakest.

What is the Guillain-Barre syndrome?

Guillain-Barre syndrome is disorder in which the body%26rsquo;s immune system attacks part of peripheral nervous system. The first symptoms of this disorder include varying degrees of weakness or tingling sensations. These symptoms most commonly occur in the legs. In many instances the weakness and abnormal sensations spread to the arms and upper body while disease progresses. These symptoms can increase in intensity until certain muscles cannot be used at all. When it is severe the patient could be almost totally paralyzed. In these cases the disorder is life threatening. It is potentially interfering with breathing and, at times, with blood pressure or heart rate. That is why Guillain-Barre syndrome is considered as a medical emergency. Such a patient is often put on a respirator to assist with breathing. Patient should also be watched closely for problems such as an abnormal heart beat, infections, blood clots, and high or low blood pressure. Most patients, recover from even the most severe cases of Guillain-Barre syndrome. However, some patients continue to have a certain degree of weakness.

Causes of Guillain-Barre syndrome

No one yet knows why Guillain-Barre syndrome strikes some people and not others.





Moreover, nobody knows exactly what sets the disease in motion. What scientists do know is that the body%26rsquo;s immune system begins to attack the body itself. It causes what is known as an autoimmune disease. Usually the cells of the immune system attack only foreign material and invading organisms but with the Guillain-Barre syndrome the immune system starts to destroy the myelin sheath that surrounds the axons of many peripheral nerves. This disease could even destroy the axons themselves. Axons are long, thin extensions of the nerve cells, which carry nerve signals. The myelin sheath surrounding the axon speeds up the transmission of nerve signals and allows the transmission of signals over long distances of the body. In diseases in which the peripheral nerves%26rsquo; myelin sheaths are injured or degraded, the nerves cannot transmit signals as efficiently as they should. That is why the muscles begin to lose their ability to respond to the brain%26rsquo;s commands. These commands should be carried through the nerve network. The brain also receives fewer sensory signals from the rest of the body. This is resulting in an inability to feel textures, heat, pain, and other sensations. Alternately, the brain may receive inappropriate signals that result in tingling, crawling-skin, or even painful sensations. Because the signals to and from the arms and legs must travel the longest distances they are most vulnerable to interruption due to Guillain-Barre syndrome. Therefore, muscle weakness and tingling sensations usually first appear in the hands and feet, after those areas they could progress upwards. When Guillain-Barre is preceded by a viral or bacterial infection, it is possible that the virus has changed the nature of cells in the nervous system. That is why the immune system treats them as foreign cells. It is also possible that the virus makes the immune system itself less discriminating about what cells it recognizes as its own. It allows some of the immune cells, such as certain kinds of lymphocytes and macrophages, to attack the myelin. Sensitized T lymphocytes cooperate with B lymphocytes to produce antibodies against components of the myelin sheath. That may contribute to destruction of the myelin. Scientists are investigating these and other possibilities to find why the immune system goes awry in Guillain-Barre syndrome as well with other autoimmune diseases. The cause and course of Guillain-Barre syndrome is an active area of neurological investigation. This topic incorporates the cooperative efforts of neurological scientists, immunologists, and virologists.

Diagnosis of Guillain-Barre syndrome

Guillain-Barre is called a syndrome rather than a disease because it is not clear whether or not a specific disease-causing agent is involved. A syndrome is a medical condition characterized by a collection of symptoms that the patient feels. It is also characterized by signs which a doctor can observe or measure. The signs and symptoms of the syndrome can be quite varied, so doctors may on rare occasions find it difficult to diagnose Guillain-Barre. This is especially difficult in its earliest stages. The problem is what several disorders have symptoms similar to those found in Guillain-Barre. Therefore, doctors examine and question patients carefully before making a diagnosis. Collectively, the signs and symptoms form a certain pattern that helps doctors differentiate this syndrome from other disorders. For example, physicians will note whether the symptoms appear on both sides of the body that is most common in Guillain-Barre syndrome, and the quickness with which the symptoms appear.
It is important to know that in other disorders, muscle weakness may progress over months rather than days or weeks. In Guillain-Barre syndrome, reflexes such as knee jerks are usually lost. Because the signals traveling along the nerve are slower, a nerve conduction velocity test can give doctor clues to aid the diagnosis. In Guillain-Barre patients, the cerebrospinal fluid that bathes the spinal cord and brain contains more protein than usual so a physician may decide to perform a spinal tap - a procedure in which the doctor inserts a needle into the patient%26rsquo;s lower back to draw cerebrospinal fluid from the spinal column.

Treatment of Guillain-Barre syndrome

There is no known cure for the Guillain-Barre syndrome but there are therapies that lessen the severity of the illness and accelerate the recovery in most patients. There are also a number of ways to treat the complications of Guillain-Barre. Currently, plasmapheresis and high-dose immunoglobulin therapy are used as the best treatment option. Both of them are equally effective, but immunoglobulin is easier to administer for most doctors.
Plasmapheresis is a method by which whole blood is removed from the body and processed. This way red and white blood cells are separated from the plasma, or liquid portion of the blood. The blood cells are then returned to the patient without the plasma, which the body quickly replaces. Scientists still do not know exactly why plasmapheresis works. However, this technique seems to reduce the severity and duration of the Guillain-Barre episode. This may be because the plasma portion of the blood contains elements of the immune system that may be toxic to myelin.
In high-dose immunoglobulin therapy, doctors give intravenous injections of the proteins. The immune system naturally produces these proteins in small quantities to attack invading organisms. Investigators have found that giving high doses of these immunoglobulin to Guillain-Barre patients can lessen the immune attack on the nervous system. Investigators do not know why or how this works, although there are several hypotheses proposed.
The use of steroid hormones has also been tried as a way to reduce the severity of Guillain-Barre syndrome. However, controlled clinical trials have demonstrated that this treatment is not only ineffective, but may even have a deleterious effect on Guillain-Barre syndrome.
The most critical part of the treatment of this syndrome consists of keeping the patient%26rsquo;s body functioning during recovery of the nervous system. This can sometimes require placing the patient on a respirator, a heart monitor, or other machines to assist body function. The need for this sophisticated machinery is one of the reasons why Guillain-Barre syndrome patients are usually treated in hospitals. In the hospital, doctors can also look for and treat the many problems that can afflict any paralyzed patient. These are complications such as pneumonia or bed sores. Often, even before recovery begins, caregivers may be instructed to manually move the patient%26rsquo;s limbs. This is recommended to help keep the muscles flexible and strong. Later, as the patient begins to recover limb control, physical therapy for Guillain-Barre syndrome begins. Carefully planned clinical trials of new and experimental therapies are the key to improving the treatment of these patients. Such clinical trials begin with the research of basic and clinical scientists who identify new approaches to treating patients with the disease. The problem is, the Guillain-Barre syndrome can be a devastating disorder because of its sudden and unexpected onset. In addition, recovery is not necessarily quick, so patients usually reach the point of greatest weakness or paralysis days or weeks after the first symptoms occur. Symptoms then stabilize at this level for a period of days, weeks, or months. The recovery period may be as short as a few weeks or as long as a few years, where about 30 percent of those with Guillain-Barre still have a residual weakness after 3 years.


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Ear Piercing by infants: Pros and cons

It is common for adults to have piercings and tattoos, but it could be a little bit different when it comes to children and infants. People who have had many piercings and tattoos in the past could feel that it’s a bad idea to pierce infant ears. Although the advisors experiences worked for th...
It is common for adults to have piercings and tattoos, but it could be a little bit different when it comes to children and infants. People who have had many piercings and tattoos in the past could feel that it%26rsquo;s a bad idea to pierce infant ears. Although the advisors experiences worked for them, the children in question are clearly very sensitive. In fact, some of them have allergic problems. That is why when you decide to have your child pierced, you should discuss or think about each problem you could face with.

Cons of infant ear piercing

First you should know that gold is not really the best metal to use, as many people have allergic reactions to it. Stainless steel is best for piercings, because stainless steel is hypoallergenic. It is also non-porous and smooth, unlike gold, so detritus does not stick as vigorously, and it is easier to keep clean. Hoops are the best shape, as they slide easier, and you can move them around. As for cleaning the piercing, alcohol is far, far too harsh for new piercings but obviously, many people do fine with it. However, for those with tender, sensitive skin, particularly with a fresh wound, alcohol is too caustic and drying, and can thus hinder the healing process as well as cause additional irritation problems.

There are specific piercing products recommend. The use of piercing guns, such as those usually used at Beadazzled, is entirely antiquated, even condemned by the piercing community. The gun causes a different type of wound than piercing needles do, but in addition, the piercing can take much longer to heal. The gun is a poor option also because it is very tight against the swollen earlobe, and the shaft is ridged creating a great place for pus and scabs to accumulate. These are hard to turn, and when turned often pull away the healing scabs, leaving newly exposed raw areas so healing takes longer. Moreover, you must know that piercing at home is not a good idea. There is no way for the needle of the novice piercer to get as sterile as it must be for optimum healing that the human organism needs.





If we factor in an infant%26rsquo;s sensitivity, this could be disastrous.
Lastly, reputable piercing parlors are found all over the place, and they generally do not charge too much. This makes alternatives obsolete and dangerous. Therefore, it is recommended to have all piercings done by a professional. You should find one who has sterile equipment and years of experience.

However, maybe the best option is to wait. There are many reasons for that, such as tetanus. Even though the disease is not very common thanks to immunizations, the tetanus bacteria is everywhere. That bacteria usually enters the body through puncture wounds. Most people prefer that a baby has at least one, preferably two tetanus shots behind her before her big day. Two would put the event at 3-5 months old for most kids, and also babies are better at handling the more common minor skin infections they might get once they are more than 3 months old.

Ear piercing and infection

Women, children and even men have worn earrings dating back to Biblical times and ear piercing used to be considered a rite of passage into adulthood. However, we now see young children and even babies with pierced ears. Even if it is quite common to see infants with earrings, there are some health issues parents should consider before proceeding with the piercing of their infant%26rsquo;s ears. The major concerns are infections their babies could catch. Piercing should be done by a reputable expert who follows aseptic procedures. This means he or she should wear gloves, sterilize equipment, and use alcohol or another antiseptic on the skin. Earring posts should be hypo-allergenic stainless steel or gold to reduce the chances of an allergic reaction. This could also lead to infection. The initial posts should stay in place for about six weeks, and the pierced area of the ear should be cleaned, front and back, with alcohol several times a day during this time. You should try to keep the baby%26rsquo;s hands away from her newly pierced ears to avoid complications.

Second to infection, it is very important that the piercing not be done before infants have completed their DPT shots as you might have already heard. Infants should only wear stud earrings, or earrings that lie close to the skin because loops or dangling earrings can get caught in clothing or on objects and tear the ear lobe. Children are also much more prone to play with and pull on dangling earrings, so avoid those. With any earring, parents should make sure the back of the earring is secure and does not become loose or fall off, creating the risk of swallowing the earring and further complications.

Parents may also be confronted by older children who not only want to pierce their ear lobes, but the cartilage on the outer ear as well. It is recommended to avoid this, since cartilage is easily injured, easily infected, and has such poor blood supply that it will heal very poorly. There are known instances where cartilage piercings have lead to severe infection and ultimate disfiguration of the ear itself as side effects. Some people, regardless of age, are prone to form keloids, which are scar tissue-like growths. These keloids possibly occur after tissue injury and become large, unsightly growths that are difficult to correct. If there is any family history of keloid formation, it is advisable not to pierce your infant%26rsquo;s ears until it is much older - a teenager or young adult.

It may make good sense not to pierce your child%26rsquo;s ear until he or she is old enough to make the personal decision herself. In our society, ear piercing is considered a fashion statement and is popular among both boys and girls, as well as among men and women. If you do consider ear piercing for your child, no matter what their age, you should discuss the pros and cons with your child once he or she is old enough. You could also discuss it with your physician and make sure you take the necessary steps to prevent infection or injury. There is no reason to risk a serious health problem for a cosmetic effect. Some people pierce their children%26rsquo;s ears while they are still newborns if there is no medical reason to wait. But the procedure is not without risk because not all ear-piercing operations have the proper equipment or staff trained to work specifically with young children. For example, ear piercing guns cannot be sterilized. This means it is possible to contract hepatitis or some other infection from them. If you wish to have your infant%26rsquo;s ears pierced, it is probably safer to ask you pediatrician if she would do it for you with a needle.

Ear piercing is usually done without painkillers because the piercing itself hurts less than a shot of anesthetic would. However, you can give your baby a dose of infants%26rsquo; acetaminophen or ibuprofen before the procedure if you want. Another thing to remember is that your child will be constantly touching her ears and the pierced area. This is why it can easily become infected. To help guard against this, you will need to clean the posts and the area around the ear with alcohol or hydrogen peroxide several times a day. You could clean it as often as your doctor recommends though. Watch for increased redness or tenderness around the piercing hole and on the earlobe that could indicate infection of your infant%26rsquo;s ear. There is also a chance that your child will have an allergic reaction to metal. This is a common problem after someone gets their ears pierced. If your infant develops a rash around the piercing, you will need to take the earrings out. To avoid this, you can try to make sure that the parts of the earrings that touch her ear are made of surgical steel or 14karat gold, and this includes not only the posts but the backs as well. If the rash does not subside, your child will probably not be able to wear earrings.

It is also a common problem that babies rip one earring out of the ear during the night. After that the hole seems a little black and blue so you might find it hard to put her earrings back in.

Pros of infant ear piercing

Although you might find it scary, it is most often that an infant%26rsquo;s ear piercing is worth the hassle. Your child would have nice earrings, but in any case, each parent should check what is most important for them and their child first. Is it better to look nice or to be sure there will be no side effects after you decide to have your infant%26rsquo;s ears pierced? You could find it useful to read more about the anatomy of the ear and local nerves. Maybe you would also like to hear more about ear piercing instruments of modern design.

It is interesting that until the rise of the professional body piercing industry in the early 1990s, most piercings were performed either with guns, at home, or by medical professionals. Before the advent of piercing instruments most piercings have been done using a sharp implement, such as a needle or a blade. This was used to make an entry through which jewelry is placed. In Western culture, visiting a mall store to get an ear piercing is a common experience for both girls and boys. Amongst body modification and body piercing enthusiasts and professionals, there is a strong bias against the use of mechanical piercing instruments, although body piercers generally operate their businesses to much higher standards of sterility. They usually have more experience or training than the intended users of piercing instruments. A commonly seen sticker in body piercing circles is a red circle with a line crossing out the silhouette of a piercing gun so when legal regulation is placed upon the body piercing industry, exemptions are usually made for these devices or the businesses that use them.


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Exercise During Pregnancy

Although women may not feel like running a marathon, most of them benefit greatly from exercising throughout their pregnancies. However, during that time, pregnant women should discuss exercise plans with their doctors or another health care provider, and make a few adjustments to their normal exerc...
Although women may not feel like running a marathon, most of them benefit greatly from exercising throughout their pregnancies. However, during that time, pregnant women should discuss exercise plans with their doctors or another health care provider, and make a few adjustments to their normal exercise routine. The level of exercise recommended will depend, in part, on woman's level of pre-pregnancy fitness. However, many people wonder if there are more benefits or side effects of exercising during pregnancy.

What are the benefits of exercising during pregnancy?

Off course, exercise is a big plus both for the woman and for her baby, especially if complications limit her ability to exercise throughout the pregnancy. Moreover, exercise during pregnancy can help one feel better. At a time when the woman wonders if this strange body can possibly be her own, exercise can increase her sense of control.
Exercise could also boost a pregnant woman%26rsquo;s energy levels. Not only does it make her feel better by releasing endorphins (chemicals occurring naturally in the brain), but appropriate exercise can also relieve backaches and improve the woman%26rsquo;s posture by strengthening and toning the muscles in her back, butt, and thighs. It could reduce constipation by accelerating intestine movements, prevent wear and tear on the joints (which become loosened during pregnancy due to normal hormonal changes) by activating the lubricating synovial fluid in them.
Exercise could also help a pregnant woman sleep better by relieving the stress and anxiety that might make her restless at night. She will probably look better because exercise increases the blood flow to the skin, giving a healthy glow.

Prepare yourself and your body for birth

Each pregnant woman should know that strong muscles and a fit heart can greatly ease labor and delivery. Gaining control over her breathing can help a woman manage pain and in the event of a lengthy labor, increased endurance can be a real help.







Therefore, a woman should try to regain her pre-pregnancy body more quickly. By continuing to exercise, she will gain less weight during the pregnancy (assuming she used to exercise before becoming pregnant). However, a woman should not expect or try to lose weight by exercising while pregnant. For most women, the goal is to maintain their fitness level throughout the pregnancy.

Exercise has become a vital part of many women's lives. However, theoretic concerns have been raised about the safety of some forms of exercise during pregnancy. Because of the physiologic changes associated with pregnancy, as well as the hemo-dynamic response to exercise, some precautions should be observed with exercise. The physician should screen for any contraindications to exercise. The doctor should also encourage patients to avoid overly vigorous activity, especially in the third trimester. During that time most pregnant women have a decreased tolerance for weight-bearing exercise. Adequate hydration and appropriate ventilation are important in preventing possible teratogenic effects of overheating and over-exercising. Pregnant women should avoid exercise that involves the risk of abdominal trauma, falls, or excessive joint stress. This happens in contact sports and vigorous racquet sports.
In the absence of any obstetric or medical complications, most women can maintain a regular exercise regimen during their pregnancies. Some studies have found a greater sense of well-being, shorter labor and fewer obstetric interventions in physically well-conditioned women.

More about exercise during pregnancy

The benefits of regular exercise for non-pregnant women are generally acknowledged, and an exercise regimen has become an integral part of daily life for many women. However, theoretic concerns arise regarding the effects of exercise on pregnant women. Objective data on the impact of exercise on the mother, the fetus and the course of pregnancy are limited. The results of the few studies in humans are often equivocal or contradictory. Although various exercise guidelines are available, they are usually conservative and frequently based on controversial opinions, so consequently, the pregnant woman and her physician may be uncertain about the safety of exercise during pregnancy.

Physiologic changes of pregnancy

There are some important physiological changes during pregnancy that a woman should keep in mind.

Musculoskeletal changes %26ndash; This is one of the most obvious changes in pregnancy, an alteration of the woman's body, including mechanical changes related to the weight of growing breasts, uterus, and fetus. This could also increase lumbar lordosis, resulting in a shift in the woman's center of gravity, causing problems with balance. In addition, weight-bearing exercise becomes a greater concern when vertical impact forces are further increased during pregnancy. These vertical impact forces, which should usually be taken at twice an individual's body weight, are further increased during pregnancy. Sudden movements may exacerbate these mechanical difficulties and increase the potential for injury for pregnant woman.

Most women report greater discomfort with exercise in the later stages of their pregnancies. Abdominal and pelvic discomfort from weight-bearing exercise is most likely secondary to tension on the round ligaments, increased uterine mobility, or even pelvic instability. Increases in joint laxity may lead to a higher risk of strains or sprains, because during pregnancy, hormonal changes are thought to induce a greater laxity in joints. This assists the softening of the pubic symphysis to accommodate delivery. One study has demonstrated increased mobility of the metacarpophalangeal joints, but an increased injury rate in pregnant patients has not been documented.

Maternal and fetal temperature %26ndash; The metabolic rate increases during both exercise and pregnancy. This results in greater heat production. Fetoplacental metabolism generates additional heat, which maintains fetal temperature at 0.5 goes to 1.0%26deg;C or 0.9 to 1.8%26deg;F above maternal levels. Theoretically, when exercise and pregnancy are combined, a rise in maternal core temperature could decrease fetal heat dissipation to the mother and some data suggest a teratogenic potential when maternal temperatures rise above 39.2%26deg;C or 102.6%26deg;F. This is especially the case in the first trimester.

Hemodynamic %26ndash; Exercise acts in concert with pregnancy to increase the heart rate, stroke volume, and cardiac output, but during exercise, blood is diverted from abdominal viscera, including the uterus, to supply exercising muscles. The decrease in splanchnic blood flow can reach 50 percent and raises concerns about fetal hypoxemia. Studies of flow velocity profiles in the fetal aorta and umbilical circulation have yielded contradictory and inconclusive results still. Several factors may mitigate exercise-induced decreases in splanchnic blood flow, and these factors are increases in maternal plasma volume and heart rate, as well as decreased systemic vascular resistance. The resultant changes maximize cardiac output and optimize blood flow to the placenta and the developing fetus where these alterations in cardiovascular response to exercise may take as long as seven months to return to ante-partum levels. Maternal body position also affects cardiac output during pregnancy because after the first trimester, the supine position is associated with a 9 percent decrease in cardiac output.
Cardiac output is optimal when the patient assumes a left or right side-lying position and prolonged, motionless standing during pregnancy is associated with a decrease in cardiac output of up to 18 percent. The effect of exercise on cardiac function during pregnancy remains uncertain, despite decades of studies.

Oxygen demands %26ndash; It is important to understand that adaptive changes occur in the pulmonary system during pregnancy and exercise. During rest, pregnant and non-pregnant women have an equivalent respiratory frequency, but mild increases in tidal volume and oxygen consumption are noted in pregnant women. This is presumably as an adaptive response to the increased oxygen requirement of the fetus. With mild exercise, pregnant women have a greater increase in respiratory frequency and oxygen consumption to meet their greater oxygen demand she has as pregnant. As exercise increases to moderate and maximal levels, however, pregnant women demonstrate decreased respiratory frequency. They will also demonstrate lower tidal volume and maximal oxygen consumption. The oxygen demand at high levels of activity appears to overwhelm the adaptive changes that occur at rest and this may be partially due to the obstructive effect of an enlarged uterus on diaphragmatic movement.

Energy demands %26ndash; Both exercise and pregnancy are associated with a high demand for energy a woman needs. In the first two trimesters, an increased intake of 150 calories per day is recommended. An increase of 300 calories per day is required in the third trimester. Caloric demands with exercise are even higher, although no studies have focused on exact requirements, so competing energy demands of the exercising mother and the growing fetus raise the theoretic concern that excessive exercise might adversely affect fetal development.

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