We are the regional referral center for high-risk obstetrics and referrals from Blanchfield Army Community Hospital at Fort Campbell, Kentucky.  Jennie Stuart Medical Center is staffed with a Neonatologist, Dr. Alejandro Soriano,  and an Advanced Neonatal Nurse Practitioner and provides a full-service Neonatal Intensive Care Unit for preterm and special needs newborns.  Please call to schedule an obstetrical visit as soon as you suspect you may be pregnant or for pre-conceptual counseling prior to attempting pregnancy. Lab Work During early pregnancy the following routine blood tests are conducted:

• Prenatal bloodwork:  consists of a complete blood count, blood type, and antibody screen to determine Rh factor as well as screenings for rubella, syphilis, HIV, and hepatitis B.
• Triscreen/Alpha Feto-protein: a blood test performed at approximately 16 weeks into pregnancy to detect specific abnormalities. This test is optional.
• Screening Ultrasound: a basic anatomy and dating ultrasound performed between 18 and 20 weeks gestation.
• Glucose screening test: a blood test performed at approximately 24 - 28 weeks into pregnancy to determine if you are at risk for gestational diabetes. You will be given a 50-gram Glucola drink or jelly beans when you arrive for your appointment and a finger stick glucose will be performed after one hour.
• Hemoglobin: done routinely between 24 and 28 weeks into pregnancy to determine the need for supplemental iron.

Routine Schedule of Appointments:

• Every 4 weeks until the 28th week of pregnancy.
• Every 2 weeks from the 28th to 36th week of pregnancy.
• Every week from 36 weeks until delivery.

Nausea and Vomiting During Pregnancy:

1. What is it?
2. What causes it?
3. What can I do to prevent it?
4. Are there any remedies?
5. What is the suggested meal plan to combat nausea and vomiting during the early part of pregnancy?
6. What foods should I avoid?

1. What is it?

Nausea and vomiting are common complaints during early pregnancy, affecting 50-80% of women.  It is often referred to as "morning sickness" because the symptoms are frequently worse early in the day.  It generally disappears by the 16th week of pregnancy.

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2. What causes it?

Although the cause of nausea and vomiting during pregnancy is unknown, it seems to be associated with hormone changes that occur in early pregnancy. Also, it appears that women are most frequently troubled when their blood sugar is low.

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3. What can I do to prevent it?

You may try one of the approaches listed below to help prevent or reduce nausea and vomiting during pregnancy.

• Eat small amounts of food every 2-3 hours (whether you are hungry or not).
• Eat low-fat protein foods (lean meat, broiled or canned fish, poultry without skin, eggs, boiled beans) and easily digested carbohydrates (fruit, fruit juices, breads, cereals, rice, pasta, potatoes). Such foods provide important nutrients (including B vitamins) and may help prevent low blood sugar, which can cause nausea.
• Drink soups and other liquids between meals, rather than with meals, so as not to overly distend the stomach and trigger vomiting.
• Avoid greasy or fried foods, which may produce nausea because they are hard to digest.  Even the aroma from cooking such foods for others can cause nausea.
• Eat lightly seasoned foods, but salt to taste.
• Sit upright after meals, to reduce the frequency of gastric reflux.
• Have a snack (e.g., yogurt, milk, juice, bread, a small sandwich) before going to bed in the morning or when nauseated.
• Get out of bed slowly.  Avoid sudden movements.
• Avoid brushing teeth immediately after eating.

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4. Are there any remedies?
• Rest as needed with feet up and head slightly elevated.
• Slowly, sip a carbonated beverage or carbonated water when feeling nauseated.
• Take 1 - 2 tbsp of Emetrol every 15 minutes until nausea subsides.
• Fresh air may help. Take a short walk or try sleeping with a window open. When cooking, open windows or use the exhaust fan to get rid of odors.
• Drink herbal teas(spearmint, raspberry leaf, peppermint, chamimile, ginger root)
• Consider use of an accupressure band, such as "Seaband".

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5. What is the suggested meal plan for nausea and vomiting during the early part of pregnancy?

Breakfast:	1 fruit
	Small serving cooked or dry cereal
	2 - 3 tbsp. skim milk on cereal
	2 slices of toast, lightly buttered or with jelly (if desired)
10 a.m.:	Cheese or peanut butter and crackers
Lunch:	1 serving (2 - 3 ounces) lean beef, chicken, fish, tofu or egg
	Small serving potato, baked or mashed, rice, noodles or poi
	Small serving cooked vegetables
	Small tossed salad with small amount of salad dressing
	Bread or roll, lightly buttered (if desired)
	Fruit
3 p.m.:	Hard cooked egg, cheese, yogurt and crackers
Dinner:	1 serving (2 - 3 ounces) lean beef, chicken, fish, tofu or egg
	Small serving potato, baked or mashed, rice, noodles or poi
	Small serving cooked vegetables
	Small tossed salad with small amount of salad dressing
	Bread or roll, lightly buttered (if desired)
	Fruit
8 p.m.:	1 serving Jello or crackers and cheese or peanut butter
	Skim milk
10 p.m.:	If needed, 4 ounces graham crackers, saltines, or soda crackers
Note:  Drink fluids 30 - 60 minutes before or after eating.  Try to include 8 (4 ounces) servings of milk each day to meet calcium requirements.

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6. What foods should I avoid?
• Greasy, fatty, or fried foods
• Highly seasoned or spicy foods

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