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Doppler Ultrasound In Pregnancy

Doppler Ultrasound In Pregnancy

A Doppler Ultrasound in pregnancy is a scan that can be given alongside the typical ultrasound scan, with the Doppler measuring the flow of blood to the parts of your unborn babies’ body. To find out more about the scan please read on.

What Is A Doppler Scan?

A Doppler Ultrasound in pregnancy should not be confused with the typical ultrasound scan that most women have more than once during their pregnancy. The typical ultrasound will allow you a first glimpse of your unborn baby and possibly tell you the sex, while the Doppler measures the flow of blood around the body of your unborn baby and shows if enough oxygen and nutrients are reaching the unborn baby through the placenta.

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    A Doppler Ultrasound in pregnancy is conducted in the same way as an ultrasound scan and in fact the same equipment is used as the majority of scanners have the Doppler function on them.

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    During the scan you will have to lie down on a table with your belly exposed and the technician will rub gel onto your tummy before then moving a device called a transducer, over your tummy. This will send sound waves which bounce off the flow of blood to the body of your unborn baby along with their blood circulation system. The technician is then able to read the screen and see how the blood is flowing and this gives an indication of how well the baby is doing.

    The Doppler ultrasound in pregnancy will add on just a few minutes to your regular ultrasound and the technician will advise you of the results there and then.

    Are Doppler Scans Safe?

    Providing the Doppler ultrasound scan is carried out in the hands of a technician who has been trained they are considered to be just as safe as a typical ultrasound scan and it should not pose any risk to the unborn baby when carried out during the 2nd and 3rd trimester.

    If you are at all worried about any part of the ultrasound scan or the Doppler scan you should talk with a medical professional or the technician beforehand.

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    Why You Might Need A Doppler Scan

    There may be numerous reasons why your Doctor may ask you to have a Doppler ultrasound in pregnancy. Reasons typically include:

    • You are a smoker.
    • You had a miscarriage late in a previous pregnancy or lost a baby during birth.
    • You suffer from a high or low BMI, aka body mass index.
    • You have had a baby that was underweight.
    • You are having more than one baby, twins, triplets, for example.
    • Your baby doesn’t seem to be growing at a rate that is considered healthy.
    • Your baby has been diagnosed with slapped cheek disease, aka parvovirus.

    What Does The Doppler Scan Look For and Why?

    The Doppler ultrasound scan in pregnancy is undertaken so that the doctor can check if everything is going to plan to allow your baby to develop healthily. Depending on your situation the sonographer, the person doing your scan, will check over different areas. Typically such a scan is only offered to women if their doctor has any concerns about the baby and pregnancy.

    doppler ultrasound

      There are different scans and these generally include

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      • Uterine artery Doppler scan – Checks the uterine arteries, which are the vessels that take blood to the uterus, aka womb. This is to check that there is enough blood going to the placenta.
      • Umbilical artery Doppler scan – This is to check the rhesus antibodies if your baby seems to be growing at a slow rate. It is to check the umbilical cord as the blood flows from the placenta.

      Should I Use A Doppler At Home?

      Just as with a typical ultrasound machine, there is a portable Doppler machine that you can purchase or hire for use within the home. Typically this is used for the parents to listen in to the heartbeat of their unborn baby. Generally the majority of midwives and doctors will advise against the use of one at home.

      Of course the machine can give the mother to be and partner great peace of mind by listening to the heartbeat of the baby. However there are some downsides and these include:

      • Finding the heartbeat is not always easy and this can cause undue stress and worry in the event you cannot find the heartbeat.
      • A common mistake can also be made with the machine at home and this is that you can pick up the sound of blood going through the placenta and think this is the sound of the heartbeat.
      • A more sound and reliable way to get peace of mind if you are worried is to contact your midwife instead of trying to find the heartbeat of your baby at home.

      What Is a Cardiotocograph?

      There is another type of Doppler ultrasound in pregnancy that can be used and this is the Cardiotocograph. While it may have a fancy unpronounceable name, it simply monitors the heartbeat of the baby to make sure that the heart is beating normally. It doesn’t produce an image, it only uses sound.

      If the pregnancy is going as normal and there is no cause for concern then you probably won’t have the CTG. This type of scan is not typically used until after the 13th week as earlier than this and there is a lot of difficulty in finding the heartbeat.

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      How Is A CTG Used During Labor?

      The CTG can come into its own during labor, where it is typically called electronic fetal monitoring, aka EFM. Here its typical use is in monitoring the contractions along with the heartbeat of your unborn baby. However if all has gone well with the pregnancy this type of monitoring may not be used as there are other ways that are less invasive to monitor mother and baby.

      The CTG may however be used when you are first admitted onto the ward in labor, typically for around 30 minutes, with the readings being used as a base if it is needed at a later stage in the labor.

      Featured photo credit: Flickr via flickr.com

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      Published on October 19, 2018

      The Most Critical Do’s and Don’ts of Working Out While Pregnant

      The Most Critical Do’s and Don’ts of Working Out While Pregnant

      Are you scared of working out whilst pregnant? Or simply not sure how to proceed? Everything seems slightly more daunting once you’re carrying and creating a whole other person.

      In this article I will give you specific advice, tips and strategies for working out while pregnant. Ensuring that you, and your baby, are safe. Not only that but you will both benefit.

      Benefits of Working Out While Pregnant

      It is clear that everyone, not just you but your baby, and probably your partner and other kids will benefit from you working out while pregnant. If you’re sleeping better and feel less stress, you can guarantee everyone in the household is going to feel better.

      How you benefit from working out while pregnant:

      • Reduced incidence of lower back pain
      • 30% reduction in the risk of gestational diabetes
      • Reduced likelihood of unplanned cesarian
      • Lower incidence and reduce severity of depression
      • Less pregnancy weight gain
      • Lower risk of urinary incontiennce
      • Reduced pregnancy constipation
      • Less pregnancy tiredness
      • May have a shorter labour

      How your baby benefits from working out while pregnant:

      • A healthier heart
      • Normal birth weight
      • Quicker neurological development
      • Reduced risk of respiratory distress syndrome (for infants of high-risk women)
      • Less maternal stress could reduce impact on immune system development

      Instant Big-Rocks for Working out While Pregnant

      Before we get cracking into what really will benefit, here are some instant ‘big-rocks’ when it comes to working out while pregnant.

      Safety first: Check with your midwife

      Each person and pregnancy is individual – and as I”m not speaking to you in person, the first pre-qualifier is that you check with your doctor that you’re ok to work out while pregnant. In certain circumstances, it is not recommended due to potential complications arising from exercise.

      If you’re new to exercising or have just fallen pregnant do check with your GP or midwife before commencing or recommencing your exercise program.

      Exercise Check In Second – No lying Flat or Crunches

      Crunches are a whole other issue in regards to pre and post natal training that I’ll get into during another article.

      For now, know that lying flat on your back puts pressure on your body, especially after 16 weeks. The weight of your bump pressing on certain blood vessels can reduce cardiac output, make you feel dizzy and affect the flow of blood that carries nutrients and oxygen to your baby.

      While this means traditional stomach crunches are out, you can and should still include core and pelvic floor strengthening exercises in your routine. These I’ll get to later in the article.

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      Third Intensity Check In – No High Intensity Workouts

      When it comes to exercise intensity, it is best to abide by the guideline “to be able to comfortably hold a conversation” whilst working out. Unless you are an athlete and extremely used to very high heart rates whilst you workout, keeping your rate of perceived exertion to a 7 out of 10 is best practice.

      Experts agree that you should avoid undertaking activities that will raise your core temperature by more than 2°C – or above 38.9°C. This is because such a temperature change may result in hyperthermia (the opposite of hypothermia). Hyperthermia during pregnancy has been linked to a twofold increase in the risk of birth defects impacting the spine or brain.

      As such, it is not advisable to use hot tubs or spas during pregnancy, and hot yoga should be avoided as well as parking in only moderate intensity exercise.

      Final & Fourth Point – No high contact/dangerous sports

      For obvious reasons, contact sports or sports in which it’s likely you can fall or have an accident should be avoided.

      For example scuba diving while pregnant should be avoided as your baby will have no protection against decompression sickness (‘the bends’) or gas embolism – bubbles in the bloodstream that can cut off blood supply or cause breathing difficulties.

      Similarly, horse riding, climbing, cycling, gymnastics and other activities that require extreme balance are best avoided as your centre of gravity shifts and affects your balance.

      Certainly, sports like kick boxing, jujitsu or rugby in which contact is prevalent should be avoided for bump protection.

      Actual Workouts You Can Do While Pregnant

      1. Let your personal trainer or group exercise instructor know that you’re pregnant

      In doing so they can assist you in providing expert advice or refer you to a qualified practitioner in your area. If you’re unsure ask your GP or Midwife for a referral.

      2. Use your breath to engage your core and pelvic floor throughout your workout programs

      Your breath plays a big part in controlled core to assist with labour and reduce back pain. We each take thousands of breaths per day, as as your baby grows pressure is placed upon the lungs and pelvic floor.

      Preparing and practicing proper breath ensures that your core remains as integrated and activated as possible throughout and after your pregnancy.

      3. Find a Holistic Core Restore Coach

      The reason the Holistic Core Restore® programmes are more effective than performing keels or traditional abdominal exercise alone for true core restore and pelvic floor activation. A Hollisitc Core Restore Coach will work with you to integrate your core and pelvic floor with your whole body through a series of movements and lifestyle factors.

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      4. Join a Pre & Post Natal Class

      Join a Pre & Post Natal Class in order to move in specific ways designed to boost your health and recovery post birth.

      This not only provides you with a chance to connect with other pre & post natal women in your area to and create a community; but also provides you access to pre & post natal experts who can give you tailored advice for exercising whilst pregnant.

      5. Focus on strengthening the glute muscles

      Focus on strengthening the glute muscles to counteract the anterior tilt produced by your expanding bump.

      Most people will simply focus on keeping the core engaged and active to help the ‘pre-mummy-tummy’ bounce back. When in actual fact the synergist muscle to the core for pelvic stability is the butt.

      Really focus on strengthening the glute muscles in order to support the core, posture and back.

      Hinge movements such as single leg romanian deadlifts are a brilliant way to do so. You can do this holding a Kettlebell or Dumbell but also, once the bump is big enough just using your bodyweight.

      6. Enjoy swimming

      Enjoy swimming, especially in your third trimester, to remove weight and boost lymphatic drainage of your feet and ankles.

      It’s well known that your ankles swell during the last months of pregnancy. This is due to the changes in posture from the weight of the stomach pulling down towards the floor.

      Consequently, this causes the front of the hip to become compressed. And this in turn reduces circulation of the lymphatic fluid in the lower body.

      One way to improve this circulation is to get into water as the pressure from the water removes the weight of the bump whilst providing pressure to the legs improving circulation.

      7. Bring layers to your workouts

      Bring layers to your workouts so that you can add and remove layers as you warm up and cool down.

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      As previously mentioned, changes in body temperature can be dangerous for the baby – using layers so that you can keep your temperature constant is one the the most simple and best things you can do whilst working out while pregnant.

      8. Practice the 7 fundamental primal movement patterns in your workouts

      Practice the 7 fundamental primal movement patterns in your workouts – squat, lunge, anti-rotate, push, carry, hinge, pull.

      “We love pregnant mamas to be regularly training their squats, since a low squat is the ideal position for working through contractions and pushing during labor.”

      They also improve pelvic floor strength and elasticity to help prevent tearing during the natural labor process and teach abdominal strength relative to hip mobility for an easier labor and faster postnatal recovery.

      Kiberd and her team prefer front squats done with at least a 12-kilogram kettlebell held at the chest. (Choose an appropriate weight for your level.)

      “The kettlebell gives great feedback to the muscles that need to engage to stand you back up and to stabilize your weight while you’re down in the squat,” she explains.

      And once the bump gets big? “No weight on the front is needed,” she says. “The belly is that natural weight.”

      9. Do exercise that your enjoy

      Because really if you’re enjoying it so will bump and you’ll feel less stressed.

      Do not making working out while pregnant a chore – if it becomes that way, seek advice from an expert in your gym or area on some new varied things that you can try.

      10. Practice anti-rotation exercises

      Practice anti-rotation exercises whilst focussing on the breath for core integration and activation.

      The Palloff press (a core stabilizer done on a cable machine) and the bear crawls offer the same degree of effectiveness.

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      “These two exercises engage the external and internal obliques, which are involved in stabilizing the torso in rotation and help stabilize the shoulders down and back.”

      11. Make sure to wind down properly

      Cooling down slowly after your workouts and providing a little leeway time before your next appointment will reduce your stress levels and help you feel more balanced.

      It will also stop sharp changes in body temperature that are non-beneficial to your baby.

      Take your time and enjoy each session for what it is.

      The Bottom Line

      You will have to make fitness modifications as your body changes, but deep down, you know that’s ok. Dr Dawn Harper says

      “We’re now seeing evidence that exercising in pregnancy may be one of the best things you can do for your baby’s future health. Pregnancy exercise can have a huge impact on your personal experience of pregnancy, too. Provided you follow the expert guidelines, it’s safe for most women to continue and even start exercising in pregnancy. Just make sure you check with your midwife or doctor first, in case there are any specific medical reasons why you should avoid being physically active in pregnancy.”

      There are certain things that are essential. The first being to check with your Dr/Midwife to be given the ‘OK’ to exercise.

      There are definite ‘no-nos’ such as abstaining from contact or dangerous sports as well as performing extreme high intensity workouts that bring your heart rate and temperature very, abnormally high for you. It is also contraindicated that you perform any exercises lying on your back.

      The exciting thing is that you can and should exercise. You simply have to adapt to what is possible by seeking advice of a local pre & post natal expert. If you take one sentence away let it be this:

      Focus upon your breath, workout at a 7/10 level, strengthen your glutes and perform whole body integrated exercises preferentially led by a pre & post natal expert.

      And finally, if in doubt, get in the pool for some weight off your feet and relax!

      References

      1. Pennick V, Liddle SD. Interventions for preventing and treating pelvic and back pain in pregnancy. Cochrane Database Syst Rev 2013(CD0011):1-100.
      2. Sanabria‐Martínez G et al. Effectiveness of physical activity interventions on preventing gestational diabetes mellitus and excessive maternal weight gain: a meta‐analysis. BJOG 2015;122(9):1167-74.
      3. Price BB et al. Exercise in pregnancy: effect on fitness and obstetric outcomes-a randomized trial. Med Sci Sports Exerc 2012;44(12):2263-9.
      4. Domenjoz I et al. Effect of physical activity during pregnancy on mode of delivery. Am J Obstet Gynecol 2014;211(4):401.e1-e11.
      5. Gaston A, Prapavessis H. Tired, moody and pregnant? Exercise may be the answer. Psychol Health 2013;28(12):1353-69.
      6. Robledo-Colonia AF et al. Aerobic exercise training during pregnancy reduces depressive symptoms in nulliparous women: a randomised trial. J Physiother 2012;58(1):9-15.
      7. Perales M et al. Benefits of aerobic or resistance training during pregnancy on maternal health and perinatal outcomes: A systematic review. Early Hum Dev 2016;94:43-8..
      8. Shi W et al. Epidemiology and risk factors of functional constipation in pregnant women. PloS one 2015;10(7):e0133521
      9. Gaston A, Prapavessis H. Tired, moody and pregnant? Exercise may be the answer. Psychol Health 2013;28(12):1353-69.
      10. Barakata et al. Exercise during pregnancy is associated with a shorter duration of labor. A randomized clinical trial 2018, 224 33-40
      11. May LE et al. Aerobic exercise during pregnancy influences fetal cardiac autonomic control of heart rate and heart rate variability. Early Hum Dev 2010;86(4):213-7.
      12. Bisson M et al. Physical activity volumes during pregnancy: A systematic review and meta-analysis of observational studies assessing the association with infant’s birth weight. AJP Reports 2016;6(02):e170-e97.
      13. Labonte-Lemoyne E et al. Exercise during pregnancy enhances cerebral maturation in the newborn: A randomized controlled trial. J Clin Exp Neuropsychol 2016:1-8.
      14. Muktabhant B et al. Diet or exercise, or both, for preventing excessive weight gain in pregnancy. Cochrane Database Syst Rev 2015 Jun 15;(6):CD007145.
      15. Marques AH, Bjorke-Monsen AL, Teixeira AL, Silverman MN. Maternal stress, nutrition and physical activity: impact on immune function, CNS development and psychopathology. Brain Research. 2015;1617:28–46

      Featured photo credit: Jernej Graj via unsplash.com

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