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01.02.2015


The exact cause of edema in pregnancy is unknown but it is usually attributed to changing levels of estrogen and progesterone (read about the effects of estrogen).
Many women experience swelling in the days after delivery - particularly in the hands, fingers, legs and ankles, but also in incision sites like their episiotomy incision or C-section incision.
Severe edema is potentially a sign of an underlying life-threatening disorder called preeclampsia. Also call your doctor if you notice one leg is more swollen than the other - especially if it is tender to touch. Women diagnosed with heart disease during pregnancy (or before pregnancy) are more prone to developing severe edema, and so will be monitored closely. With all that extra fluid in your legs and feet your skin is extra fragile, so you need to mind them. Over the counter or prescription water pills (called diuretics) are not recommended in pregnancy and could actually harm your baby. My legs, hands and ankles swelled up in the last 2 months of pregnancy and it got worse after birth for about 3 weeks. My ankles were very swollen when I was pregnant but it got worse after delivery and my blood pressure also shot up. Please Note: Information provided on this site is no substitute for professional medical help. Dr Penelope Law, The Portland Hospital’s Consultant Obstetrician, shares exercise advice for pregnancy including which exercises are best for mums-to-be and information on precautions that pregnant women should consider taking when exercising.
Yes - the expanding uterus compresses the maximum lung volume and can lead to some women experiencing breathlessness.
Women who have a greater maximum lung volume to start with as a result of regular exercise will be much less likely to suffer from shortness of breath and will be better prepared for the physical exertion of labour and delivery.
When should a woman stop exercising - and are there any warning signs mums-to-be should look out for? If you feel lightheaded or experience any pain of any sort (especially abdominal) during exercise, stop at once. For exercise to be doing you good, you need to be slightly out of breath and for your heart rate to rise (should be over 100 beats per minute ) If you feel any pain in your chest or palpitations you should stop to ensure it subsides (and tell you Dr or midwife). A cardiovascular warm up with some gentle stretches is always a good idea- and some cooling down stretches at the end of your session.
Really any form of aerobic exercise is beneficial however, avoid starting a new sport, other than swimming, and yoga and Pilates for pregnant women. Once again, listen to your body – your expanding abdomen will probably tell you when you should stop a particular sport or activity. How soon should women start exercising after giving birth if they want to get back into shape? Often women are advised to wait for six weeks before exercising again - there is no good medical reason for this, and remember that women are expected to often go home by 24 hours after delivery and start normal activities again.
I would suggest you wait until you have some of your energy back and are getting a few hours uninterrupted sleep each night before embarking on an exercise programme, but certainly brisk walking or even running with a pram before then can actually make you feel less tired.
Your abdominal and back muscles will have become weakened during pregnancy, so start strengthening them gently and gradually, otherwise you risk straining them. Women should aim to put on no more than 11kg overall during their pregnancy (equals an extra banana a day from 32 weeks onwards), approx. Half a kilo per week is realistic especially if you breastfeed, and this can be achieved eating healthy food and not even dieting. There are now many post natal exercise classes where babies and prams are encouraged and even form part of the exercise.
You should not feel pressurised to immediately start exercising frantically; remember you have just done something amazing.
If your doctor tells you that you have cervical dysplasia it means the cells that line your cervix have undergone abnormal changes.
Dysplasia of the cervix is most often seen in women between the ages of 25 and 35, but it can develop at any age. The first you are likely to hear of your condition is when your doctor phones to say your 'Pap smear test result isn't quite normal'.
No single test can determine for sure if there are cancer cells present, but several tests used together can reduce the chance of missing it. After your tests your doctor will refer to your dysplasia as cervical intraepithelial neoplasia (or CIN for short!). The type of treatment you receive depends on the type of CIN present, the exact location of the abnormal cells, your age and future desire for children.
Once the most common treatment for CIN, hysterectomy (removal of the womb and cervix), is still offered to women who are past childbearing years.
CIN 2 and 3: You will be offered a Pap test 6 and 12 months after treatment and then every year for 9 years (that's a total of 10 years follow up). As cervical dysplasia can come back, following your doctor's follow-up recommendation is very important. Women's Physiotherapy at the Women's and Children's Hospital (South Australia) provides this advice and recommends the following exercises to help with your recovery after pregnancy and birth. Rest flat (on your back or side) regularly while you are in hospital and continue this every day once you have gone home until your stitches are healed. Ice packs can be applied to the perineum every 1 - 2 hours - only leave the icepacks on for 10 - 15 minutes at a time. Compression from your pad(s) or rolled towel placed between the legs when sitting helps reduce swelling and bruising and also gives gentle support to the perineum.
Elevate the perineum area regularly during the day by lying on your tummy for at least 15 - 20 minutes, with a pillow or two underneath the hips. There are a few simple exercises and tips that can help make you more comfortable for the first 24 - 48 hours after your delivery. Support your wound with your hands or a pillow if you need to cough, sneeze, laugh or go to the toilet to open your bowels. Relaxed abdominal breathing (feeling the tummy gently rise and fall with deep breaths in through the nose and out through the mouth, up to 5 breaths at a time) can help to relieve the discomfort of wind pain and after birth pains. It is important to get out of bed and moving early after your delivery to promote circulation. When rolling over or getting in and out of bed, it is important to support your wound using your abdominal muscles.
While in hospital, this is made easier by having the head of the bed raised up - you can do this using the remote control next to your bedside. You will be asked to measure at least the first two wees that you do - please pass urine into the grey pot in the toilet and ask the midwife to record the volume of urine in the pot. Your bowels can take a few days to return to normal - the most important thing is to not strain when opening your bowels. Eating a high fibre diet (fruits, vegetables, wholegrain foods) and going for short regular walks will help with your bowels.
Sit correctly when opening your bowels with your bottom to the back of the toilet seat, legs apart, up on toes (or feet flat on a footstool), keeping a straight back and then leaning forwards with your tummy and pelvic floor muscles relaxed.


Women's Physiotherapy recommend the following exercises for helping you get back in shape following the birth of your baby.
Your pelvic floor muscles stretch like a trampoline across the floor of the pelvis, running from the coccyx (tailbone) at the back through to the pubic bone at the front, and sideways to the sitting bones. In a woman, the pelvic floor muscles help to support the bladder, the uterus (womb) and the bowel. The pelvic floor muscles play a large part in bladder and bowel control, as well as sexual function.
Tighten your pelvic floor muscles by squeezing around the birth canal, vagina and back passage all at once, lifting up and towards your pubic bone ('squeeze and lift!').
If you cannot hold the squeeze for 3 seconds, don't worry - do your best and hold for as long as you feel comfortable. It is important to continue to breathe normally through the exercise and keep the muscles in your legs, buttocks and tummy relaxed. Tighten your pelvic floor muscles every time you lift your baby, cough, sneeze or laugh to protect your pelvic floor and help prevent leakage of urine or wind.
Stretching of the tummy muscles during pregnancy may mean that they are unable to effectively protect your back from injury and maintain good posture. Exercise your tummy muscles regularly after the birth of your baby to regain strength and your pre-pregnancy shape.
Sit up exercises (or 'crunches') are not recommended for the first 6 - 8 weeks postnatally.
This exercise can also help to relieve back pain when it is performed as a gentle stretch (pelvic rocking), as well as wind pain in the first few days after Caesarean Section. Abdominal bracing uses your deep tummy muscles to help protect your back and pelvis from pain and injury.
Let your tummy muscles soften and relax and then gently draw your lower tummy at the level of the bikini line back towards your spine.
If sitting to feed your baby or expressing, sit in a comfortable chair with good back support.
Whenever you are lifting, remember to bend your knees, keeping your back straight, brace your pelvic floor muscles and low tummy muscles, and hold the object you are lifting close to your body. We recommend avoiding high impact exercise (eg running, aerobics), contact sports (eg netball) or heavy weights for at least 3 - 4 months after the birth of your baby.
Women's Physiotherapy can provide services for up to 3 months following the birth of your baby at the Women's and Children's Hospital. And there are a lot more out there, passed down from generation to generation by families across the world! Also, your growing baby will put pressure on the veins in your pelvic area and the vena cava (the big vein on the right side of the body that carries blood back from the legs and feet to the heart). Preeclampsia is associated with sudden weight gain (at least 2.2 pounds in a week) and swelling of the face, puffiness around the eyes and hands. Put the stockings on first thing in the morning before fluids have a chance to pool in the legs, ankles and feet. Ideally they should be raised higher than the level of the heart for periods of 20 minutes throughout the day. Water aerobics is particularly good because the water pressures pushes the excess fluid back into the veins for dumping by the kidneys. It took 4 months postpartum before it finally disappeared and I could put my wedding ring back on. If tightenings or contractions start and do not subside in a few minutes it would be appropriate to stop and tell your doctor or midwife.
Avoid lifting heavy weights, as ligaments and tendons soften during pregnancy (as a result of pregnancy hormones) and these can become permanently stretched by excessive weight-lifting.
Avoid abdominal exercises by midway through the 2nd trimester, as this can damage the band of muscles that run down vertically down the abdomen. However, if you have had a Caesarean section, you should wait a little longer before starting on any abdominal exercises, and be careful not to overdo things. In all cases, you should be aware of how your body is feeling during and after the exercises. If you can afford it, a personal trainer that comes to you at home can sometimes be cheaper than membership of a gym.
The cervix is positioned at the top of the vagina and is the opening into the lower part of the womb (uterus).
It is widely accepted that 95 percent of all cervical cancers (and by definition dysplasia) are caused by a virus called the human papillomavirus (HPV). This is why an accurate diagnosis involves a step by step process that includes colposcopy-directed biopsy, endocervical curettage (EEC) or loop electrocautery excision procedure (LEEP).
A speculum is inserted; this is, an instrument which stretches the vaginal opening so that the doctor can look more easily inside. In an EEC a large speculum is inserted into the vagina to gain access deep into the cervical canal. During this procedure suspicious cells are removed for biopsy and the area is cauterized (burned). Because many low grade CIN revert to normal without treatment, this wait and see option is reasonable. An electric current is passed through a metal rod that touches, burns and destroys suspicious cells. A probe called a cryoprobe is inserted through the vagina into the cervix and a liquid is squirted through the probe which freezes the cells.
The follow up is called cervical cytology - cytology is just a fancy word which means study of cells. If you have a positive result at any time, you should be offered a colposcopy and cervical biopsy. Childbirth is an exciting time in your life but it can have a significant and profound effect on your body. Do sets of pelvic floor muscle exercises with daytime feeds - gradually increase the length of the squeezes and the number in your set.
Brace your lower tummy muscles often each day and gradually increase the length of the hold to strengthen and flatten your tummy.
Your stitches will begin to dissolve and fall out after around 7 days and your wound should be well healed after 2 - 4 weeks (depending on the size of the wound). Wrap some toilet paper (or a clean maternity pad) around your hand and give firm upward support to your stitches to help you to relax. This can be useful for the first 24 - 48 hours for swelling and bruising, and as a 'natural' pain reliever at anytime in your recovery period. Always try and sit up as tall as you can, rather than slumping in your chair or in the bed. This will help prevent some of the common complications associated with abdominal surgery (of any kind). The urethra (front passage), the vagina (birth canal) and the rectum (back passage) all pass through the pelvic floor muscles.


Hold each contraction for 2-3 seconds and then release and relax - you feel a definite 'letting go' of the muscles. It is useful to combine these exercises with everyday activities such as feeding your baby or brushing your teeth to help you to remember to do them often in your day. Your physiotherapist will check your tummy muscles when you attend the Postnatal Physiotherapy Education class. Do this often during the day and gradually increase the length of hold, up to 5 - 10 seconds. If you have a toddler, squat, kneel down or let your toddler climb onto your lap if they need comforting, rather than lifting.
You may like to start a walking program or join a Postnatal Exercise class, run by a physiotherapist, close to home.
The main symptoms of edema are swelling in the extremities (ankles, feet, hands and fingers) and weight gain. This pressure slows down the return of blood, causing excess fluids to leak from the veins into the tissues of the ankles and feet. Most swelling tends to clear within a week or two, although some new mothers complain of swollen hands or fingers for some months. Note: sitting with your feet on a footstool restricts circulation at the hips and as a result is NOT effective. I had to have an IV during labor and the doctor said that was the cause for the extra fluids in my body. It was a weird condition - my legs became so swollen that there was nowhere for the fluid to go so it was leaking out of a scrape on my ankle. Better to do a little and often than do too much and have to stop because you have injured yourself.
A special lighted magnifying instrument called a colposcope is used to magnify the cervix.
They will select from a variety of outpatient treatments including laser treatment (vaporization), electrocautery, LEEP and cryosurgery. However, while the incidence of dysplasia is on the rise, the rates of cervical cancer are declining dramatically. Make a lifelong habit of tightening your pelvic floor muscles and bracing your lower tummy before lifting. Even if you don't have stitches, there may be internal swelling and bruising around the perineum that can be uncomfortable. Starting gentle pelvic floor muscle exercises can also provide some compression to this area. During pregnancy, the pregnancy hormones and the growing weight of the baby has a weakening effect on the pelvic floor. Repeat ('squeeze and lift!') and relax, resting for about 5 seconds between each contraction. As you practice and your muscles get stronger, you should be able to hold each contraction for longer - aim for 5-6 seconds by six weeks postnatal.
Once you are more than 6 weeks postnatal, you may like to start gentle bike riding or swimming but please wait until your stitches (tummy or perineum) have healed.
You must be confident that your tummy and pelvic floor muscles have returned to normal strength, and you are not experiencing any back pain, before resuming these high impact activities. For this reason edema tends to be more common in women pregnant with twins and those with excessive amniotic fluid (polyhydramnios). But then in the last month I've been exercising, going to the gym and Ia€™m wondering if thata€™s what finally kicked things into gear and caused the edema to go. The cervix is rinsed with a solution of acetic acid (similar to vinegar) to clear away any mucus. The main disadvantage is that it can cause cervical scaring which reduces the ability of the cervix to stretch during childbirth.
On the downside the cryoprobe may be too large or too small for the area to be treated with the consequence that some women are over treated and others are undertreated. This is due to better Pap test screenings which identifies dysplasia in the early stages before it has a chance to develop into cancer. It is important to keep this area clean and dry while it is healing, and change your maternity pads regularly.
Yoga or Pilates may also be useful but please speak with your instructor before starting your first session.
If you press down on the swelling with your thumb for 30 seconds and then remove it, the area compressed will stay indented for longer than normal.
After about 4 hours on Lasix I started to deflate :) and felt like a new woman after a couple of days. Types 16, 18, 31, 33 and 45 specifically increase the risk of dysplasia and cervical cancer.
The failure rate to cure by cryosurgery is 5 percent for CIN 1, 7 percent for CIN II and 12 percent for CIN III.
For these reasons, it may be reserved for cases where suspicious cells are found deep within the cervix or where large areas need to be destroyed.
Mild edema is very common in women, particularly before a period (PMS) and in late pregnancy (75 percent of pregnant women develop some swelling).
Cervical dysplasia can take a few years to turn to cancer or it can do so in less than a year (if the dysplasia is severe).
It is estimated that one third of American college women are infected with HPV and about 1 in 10 men between the ages of 15 and 49.
Conization is nearly always necessary for postmenopausal women (women who have gone through menopause) with abnormal Pap smears because cancer cells are usually located deep in the cervix in this age group. Although being diagnosed with dysplasia may be scary, going through the correct diagnosis procedure and getting the right treatment as soon as you can is important. Scientists believe that the HPV virus weakens cervical cells so that they mutate and make abnormal changes. Your doctor may ask you to put an estrogen cream inside your vagina for several days before the operation to help highlight cervical tissue changes. As to why these changes eventually turn into cancer in some women but not in others is still not understood. You may find you urinate and sweat a lot in the first few days while your body eliminates excess fluid.
The risk seems to increase in young female smokers - it may be smoking introduces toxic chemicals into the body which makes cells more vulnerable to damage by the HPV virus. But, dona€™t panic if it takes several weeks (even a month or more) for your body to return to normal.



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