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Not your mother’s pregnancy: Shifts in pregnancy guidelines


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Women have always gotten pregnant, but the advice pregnant women receive from their families, communities, and healthcare providers has changed dramatically. Here are a few major changes in the last few decades.

Bed rest

Many healthcare providers used to encourage women with multiples or complications like high blood pressure and premature labor to go on bed rest. Bed rest could mean anything from regular rest time at home to full-time monitoring in a hospital bed. The idea was that certain activities like, well, moving, might make these existing conditions worse.

As it turns out, there is no solid, scientific evidence that bed rest improves outcomes for pregnant women and their babies. If anything, bed rest can have harmful emotional, psychological, and financial effects on expecting moms. Some providers still float bed rest as an option. If you’re experiencing pregnancy complications and your provider suggests it, you might want to talk through some of the other treatment options as well.

Third trimester exercise

For years, healthcare providers have recommended that women in their third trimesters stick to low or moderate intensity exercise like yoga or tai chi, if they were going to exercise at all. The thinking was that the risks associated with high intensity exercise could do harm to a baby.

More recent research has determined that the benefits of exercise, even vigorous exercise, promote significant health benefits and help prevent comorbidities. When exercising during the third trimester, it’s important to prioritize safety in addition to wellness. Your bump will likely have affected your balance, so make sure to use a little more support than you might usually.

Noninvasive prenatal testing

And then there’s the emergence of noninvasive prenatal testing (NIPT). For many years, prenatal genetic testing options were limited to CVS and amniocentesis which both involve contact with either the umbilical cord or the baby themselves. NIPT is noninvasive because some pieces of your baby’s DNA from the placenta enter your bloodstream during pregnancy.

NIPT is a simple blood test that looks at a baby’s DNA in his mother’s blood to identify whether the baby is at increased risk of having a genetic disorder. Not only does NIPT itself pose no risk of miscarriage, it leads to 89% fewer invasive tests compared to traditional serum screening. NIPT is the most accurate prenatal aneuploidy screening test available. In fact, it has the highest detection rate of all currently available chromosomal screening tests. It can even tell you your baby’s sex as early as week 10!

When you get advice from friends and family members, it’s always a great idea to check with your healthcare provider. So many guidelines have changed over the years, and it’s your providers job to be in the loop.

To learn more about NIPT, tap the link below.


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Noninvasive prenatal testing (NIPT) is a screening test; it is not diagnostic. Results should be confirmed by diagnostic testing prior to making any pregnancy management decisions.


Sources
  • Alison Kodjak. “Rethinking Bed Rest For Pregnancy.” National Public Radio. National Public Radio. November 26, 2018. https://www.npr.org/sections/health-shots/2018/11/26/669229437/rethinking-bed-rest-for-pregnancy
  • McCall CA, Grimes DA, Lyerly AD. “Therapeutic” bed rest in pregnancy: unethical and unsupported by data.” Obstet Gynecol. 2013 Jun;121(6):1305-8.
  • Field T, Diego M, Delgado J, Medina L. Tai chi/yoga reduces prenatal depression, anxiety and sleep disturbances. Complement Ther Clin Pract. 2012;19(1):6-10.
  • Artal, R. “Exercise in Pregnancy: Guidelines.” Clin Obstet Gynecol. 2016 Sep;59(3):639-44.
  • American College of Obstetricians and Gynecologists. Screening for fetal aneuploidy. Practice Bulletin No. 163. Obstet Gynecol. 2016; 127(5):e123-137.
  • Benn P, Borrell A, Chiu RWK, et al. Position statement from the Chromosome Abnormality Screening Committee on behalf of the Board of the International Society for Prenatal Diagnosis. Prenat Diagn. 2015;35(8):725-734.
  • Gregg AR, Skotko BG, Benkendorf JL, et al. Noninvasive prenatal screening for fetal aneuploidy, 2016 update: a position statement of the American College of Medical Genetics and Genomics. Genet Med. 2016: doi:10.1038/gim.2016.97.
  • Bianchi DW, Parker RL, Wentworth J, et al. DNA sequencing versus standard prenatal aneuploidy screening. N Engl J Med. 2014;370(9):799-808.
  • Chudova DI, Sehnert AJ, Bianchi DW. Copy-number variation and false positive prenatal screening results. N Engl J Med. 2016;375(1):97-98.
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