Pregnancy Week By Week (Week 28)

Some Basic Pointers (Week 28)

Maternal Asthma

Asthma is a respiratory disorder that occurs when the trachea and the bronchi are extra sensitive to stimulations, and hence breathing becomes affected. Problems associated with asthma include difficulty in breathing, shortness of breath, coughing and wheezing. It comes and goes, occurs at any age but nearly half of the cases happen before the age 10. Pregnancy does not worsen the situation; either the mother gets better or her condition stays the same. When the attack is severe, it can cause high BP in the mother and premature birth or smaller babies. Medications to treat asthma are safe for use during pregnancy. Most cases go through a safe pregnancy and delivery despite having this condition. Since oxygen consumption increases by 25%, treatment is important during pregnancy so that baby can receive adequate oxygen it needs. Treatment in the form of medication prior to becoming pregnant can be continued. Bring this up in your early prenatal visits with your doctor so that you are on the right path.

The Placenta

The placenta plays a crucial role in the growth, development and survival of the baby. The placenta is formed with trophoblastic cells; these cells grow through the walls of the mother's blood cells. Fetal circulation is separate from the mother's circulation but the blood flow from the fetus in the placenta is close to the mother's blood flow. Placenta growth is rapid; at 10 weeks the placenta weighed about 20g and grows to weigh about 650g at full term. The connection between the fetus' cells and the placenta begin at the 2nd and 3rd week of development and around this time, the villi at the bottom of the placenta attaches to the bottom layer of the uterus. Villi have a very important function - it absorbs nutrients and oxygen from the mother's blood and this is in turn transported to the baby through the umbilical cord.

Baby's waste is transferred from the umbilical arteries to the maternal bloodstream. Placenta is responsible for transporting oxygen and carbon dioxide to and from the baby. It is also involved in the supply of nutrients and removal of excreta from the baby. Placenta is responsible in the production of important hormones; HCG, a hormone that will determine your pregnancy after a pregnancy test is produced by the placenta. It also produces the hormones estrogen and progesterone at the 8th week of pregnancy. It is flat and cake like in appearance, either round or oval in shape. However its shape and size varies widely. It is red or reddish brown in tone. It is about 2-3cm thick at the thickest part and weighs about 500-650g on average. Around the time of birth it may have white patches on it - these are calcium deposits. If you are carrying more than one fetus, there may be more than one placenta playing its role or there may be one placenta with more than one umbilical cord attached to it. Usually there are 2 separate sacs for twins with 2 cords attached to the fetuses from one placenta. The umbilical cord which attaches the baby to the placenta is about 22 inches or 55cm long and it is usually white in color. It carries blood to and from the baby. Problems linked to placenta include placental abruption and placenta previa, both serious complications. After delivery, a retained placenta can become a problem

Your Nutrition (Week 28)

Certain foods you should eliminate altogether and some you should make it a point to include are outlined below.

Foods to Eat Chart	Daily Serving
Dark green, dark yellow fruits & vegetables	1
Fruits and vegetables with Vitamin C (tomatoes and citrus fruits	2
Other fruits and vegetables	2
Bread and cereals (whole grain variety)	4
Dairy products including milk	4
Protein (meat, eggs, fish)	2
Dried beans, peas, nuts, seeds	2

Foods to Eat in Moderation Chart

Caffeine 200 mg

Fat in limits

Sugar in limits

Foods to Avoid

ANYTHING WITH ALCOHOL, ADDITIVES

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