- Properly cook food to kill bacteria. Use a meat thermometer to determine the appropriate temperature, although cooking until well done is safe for most meat. Ground beef should be cooked to at least 160°F, roasts and steaks to 145°F, and whole poultry to 180°F.
- Cook eggs until they have a firm yolk and are white. Eggnog and hollandaise sauce have raw or partially cooked eggs and are not considered safe.
- Eat liver in moderation. Liver can contain extremely high levels of vitamin A.
- Avoid products containing unpasteurized milk, including soft cheeses like brie, feta, and blue cheese. Also avoid unpasteurized juice.
- Carefully wash all fruits and vegetables to eliminate harmful bacteria. Avoid raw sprouts altogether.
- Limit caffeine intake. Caffeine crosses the placenta and can affect fetal heart rate. Some clinicians recommend limiting caffeine to less than 200 mg/day (about 2 cups of coffee).
Treatment is heat and ice, acetaminophen, massage, proper posturing, good support shoes, and a good exercise program for strength and conditioning. Pregnant women may also relieve back pain by placing one foot on a stool when standing for long periods of time and placing a pillow between the legs when lying down.
ACOG specifically cautions that a woman should limit or avoid sex if she has a history of preterm labor or birth, more than one miscarriage, placenta previa, infection, bleeding, and/or breaking of the amniotic sac or leaking amniotic fluid. ACOG discusses that, as part of natural sexuality, couples may need to try different positions as the woman’s stomach grows. Vaginal penetration by the male is not as deep with the male facing the woman’s back, and this may be more comfortable for the pregnant woman.
Removing fibroids minimally invasively requires advanced surgical skill.
Its not well known, but removing fibroids minimally invasively actually calls for quite advanced surgical skills and experience. The fact that so many laparotomies and hysterectomies are performed each year merely for fibroids suggests that only a small minority of surgeons are able to treat this condition minimally invasively and while sparing the uterus. Although these hysterectomy statistics are disappointing, we really should not condemn surgeons too much because fibroids can be, indeed, rather tricky to treat. This is because they usually bleed extensively due to their densely packed vascularization. Extensive bleeding during surgery is definitely not something any surgeon looks forward to. But, for those less experienced, its an especially dreaded possibility because, as you can imagine, uncontrolled bleeding during surgery can be life-threatening. In some cases, for example, a surgeon only has a few minutes to control bleeding before more serious consequences ensue. This is particularly true for certain types of myomas, like interligamentous fibroids, which are especially difficult to remove without injuring other organs or vital blood vessels. Unusually large fibroids also present challenges because their vascular system can become intertwined with and therefore difficult to distinguish from the body’s major blood vessels. Such complex surgeries can be exacerbated when co-morbidities like endometriosis, excessive adhesions, and/or adenomyosis are present,all ofwhich often co-exist with fibroids.
Its because of these potential difficulties and the inability to control intra-operative bleeding that can cause less experienced surgeons to convert laparoscopic procedures to laparotomies; or simply avoid fibroid surgeries altogether and begin favouring hysterectomies instead.
However, in the hands of an expert minimally invasive surgeon, any size or type of fibroid can be treated with minimally invasive, organ-sparing techniques. Of course, the caveat is this: it takes a practically supernatural ability to remain sublimely calm under pressure, while delivering exquisitely deft and safe surgical skill that makes all the difference.