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	<title>Purnawan Senoaji's Weblog Corner</title>
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		<link>http://psenoaji.wordpress.com/2009/01/05/124/</link>
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		<pubDate>Sun, 04 Jan 2009 16:59:32 +0000</pubDate>
		<dc:creator>psenoaji</dc:creator>
				<category><![CDATA[Computer Tips & Tricks]]></category>
		<category><![CDATA[english premier league]]></category>
		<category><![CDATA[epl]]></category>
		<category><![CDATA[epl live streaming]]></category>
		<category><![CDATA[live sports]]></category>
		<category><![CDATA[video soccer streaming]]></category>

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		<description><![CDATA[Hi Guys.. Are you an English Premier League fans? But having trouble watching live matches on TV (read: have to pay for it)? Dont you worry now&#8230; Here a link to a live streaming football matches, no need to install any software&#8230; Just click on it and enjoy&#8230;. http://mvp-funzone-livesports.blogspot.com/<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=psenoaji.wordpress.com&amp;blog=4898572&amp;post=124&amp;subd=psenoaji&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p>Hi Guys..</p>
<p>Are you an English Premier League fans? But having trouble watching live matches on TV (read: have to pay for it)?</p>
<p>Dont you worry now&#8230; Here a link to a live streaming football matches, no need to install any software&#8230;</p>
<p>Just click on it and enjoy&#8230;.</p>
<p><a href="http://mvp-funzone-livesports.blogspot.com/" target="_blank">http://mvp-funzone-livesports.blogspot.com/</a></p>
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		<title>Pregnancy Month by Month Guide : Fourth Month</title>
		<link>http://psenoaji.wordpress.com/2008/12/12/pregnancy-month-by-month-guide-fourth-month/</link>
		<comments>http://psenoaji.wordpress.com/2008/12/12/pregnancy-month-by-month-guide-fourth-month/#comments</comments>
		<pubDate>Thu, 11 Dec 2008 23:40:18 +0000</pubDate>
		<dc:creator>psenoaji</dc:creator>
				<category><![CDATA[Obstetrics & Gynecology]]></category>
		<category><![CDATA[antenatal care]]></category>
		<category><![CDATA[Obstetrics]]></category>
		<category><![CDATA[pregnancy]]></category>
		<category><![CDATA[pregnancy guide]]></category>

		<guid isPermaLink="false">http://psenoaji.wordpress.com/?p=119</guid>
		<description><![CDATA[Mother You will probably be noticeably pregnant now, as your waistline disappears and your muscles and ligaments begin to relax. Your appetite may increase as you begin to feel better, and rapid weight gain may follow. Eat carefully to ensure optimal nutrition for you and your growing baby. You may want to switch to looser [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=psenoaji.wordpress.com&amp;blog=4898572&amp;post=119&amp;subd=psenoaji&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p align="justify"><span style="font-family:verdana,arial;"><strong>Mother </strong><br />
You will probably be noticeably pregnant now, as your waistline                disappears and your muscles and ligaments begin to relax. Your appetite                may increase as you begin to feel better, and rapid weight gain                may follow. Eat carefully to ensure optimal nutrition for you and                your growing baby. You may want to switch to looser clothing, but                be sure your maternity bra is properly fitted and provides adequate                support. At this stage of the pregnancy, you may notice changes                in skin pigmentation on your face, breasts and arms, and your nipples                and areola may darken. </span></p>
<p align="justify"><span style="font-family:verdana,arial;"> Tests and Scans: At about 16 weeks, you may undergo                a blood test to check the level of alpha-fetoprotein in your blood                (called an AFP Screening), an indicator of Down&#8217;s syndrome or spina                bifida. The Triple Test, also known as the Bart&#8217;s triple test, is                similar to the AFP <img src="http://www.1to9months.com/images/m42.jpg" alt="" hspace="10" vspace="10" align="right" />screening                but measures other hormones in your blood, such as oestriol and                human chorionic gonadotrophin. If you are over 35 or there is a                history of chromosomal abnormalities in your family, you may be                offered an amniocentesis test at about 16 weeks. </span></p>
<p align="justify"><span style="font-family:verdana,arial;"> <strong>Baby</strong><br />
Your baby is about 6 inches long and is fully formed. He can hear                your voice now. He is covered with fine hair called lanugo, and                his skin is transparent. His tiny fingernails are now visible. </span></p>
<p align="justify"><a href="http://www.1to9months.com"><br />
</a></p>
<p align="justify"><span style="font-family:verdana,arial;font-size:x-small;"><a href="http://www.1to9months.com">1to9months.com</a><br />
</span></p>
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		<title>Windows XP Speed Boost Tips #2 : Speed-up file browsing</title>
		<link>http://psenoaji.wordpress.com/2008/12/01/windows-xp-speed-boost-tips-2-speed-up-file-browsing/</link>
		<comments>http://psenoaji.wordpress.com/2008/12/01/windows-xp-speed-boost-tips-2-speed-up-file-browsing/#comments</comments>
		<pubDate>Mon, 01 Dec 2008 14:41:38 +0000</pubDate>
		<dc:creator>psenoaji</dc:creator>
				<category><![CDATA[Computer Tips & Tricks]]></category>
		<category><![CDATA[windows speed tips]]></category>
		<category><![CDATA[windows xp]]></category>
		<category><![CDATA[xp speed boost]]></category>
		<category><![CDATA[xp tips]]></category>

		<guid isPermaLink="false">http://psenoaji.wordpress.com/?p=114</guid>
		<description><![CDATA[You may have noticed that every time you open “My Computer” to browse folders that there is a slight delay. This is because Windows XP automatically searches for network files and printers every time you open Windows Explorer. To fix this and to increase browsing speed significantly: 1. Double-click on My Computer 2. Click the [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=psenoaji.wordpress.com&amp;blog=4898572&amp;post=114&amp;subd=psenoaji&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p>You may have noticed that every time you open “My Computer” to browse folders that there is a slight delay. This is because Windows XP automatically searches for network files and printers every time<br />
you open Windows Explorer. To fix this and to increase browsing speed significantly:<br />
1. Double-click on My Computer<br />
2. Click the Tools menu<br />
3. Select Folder Options<br />
4. Click on the View tab.<br />
5. Uncheck the Automatically search for network folders and<br />
printers check box<br />
6. Click Apply<br />
7. Click OK<br />
8. Reboot your computer</p>
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		<title>Optical Illusions #3 : Old People or A couple?</title>
		<link>http://psenoaji.wordpress.com/2008/12/01/optical-illusions-3-old-people-or-a-couple/</link>
		<comments>http://psenoaji.wordpress.com/2008/12/01/optical-illusions-3-old-people-or-a-couple/#comments</comments>
		<pubDate>Mon, 01 Dec 2008 14:11:08 +0000</pubDate>
		<dc:creator>psenoaji</dc:creator>
				<category><![CDATA[Optical Illusions]]></category>
		<category><![CDATA[illusions]]></category>
		<category><![CDATA[optical]]></category>

		<guid isPermaLink="false">http://psenoaji.wordpress.com/?p=110</guid>
		<description><![CDATA[Can you see Two old people? Or A sitting Couple?<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=psenoaji.wordpress.com&amp;blog=4898572&amp;post=110&amp;subd=psenoaji&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p><a href="http://psenoaji.files.wordpress.com/2008/12/old-people-or-a-couple.jpg"><img class="alignnone size-full wp-image-111" title="old-people-or-a-couple" src="http://psenoaji.files.wordpress.com/2008/12/old-people-or-a-couple.jpg?w=544" alt="old-people-or-a-couple"   /></a></p>
<p>Can you see Two old people? Or A sitting Couple?</p>
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		<title>Prenatal  Pregnancy Visits #2</title>
		<link>http://psenoaji.wordpress.com/2008/11/28/prenatal-pregnancy-visits-2/</link>
		<comments>http://psenoaji.wordpress.com/2008/11/28/prenatal-pregnancy-visits-2/#comments</comments>
		<pubDate>Fri, 28 Nov 2008 00:37:55 +0000</pubDate>
		<dc:creator>psenoaji</dc:creator>
				<category><![CDATA[Obstetrics & Gynecology]]></category>
		<category><![CDATA[antenatal care]]></category>
		<category><![CDATA[complains in pregnancy]]></category>
		<category><![CDATA[Obstetrics]]></category>
		<category><![CDATA[pregnancy]]></category>
		<category><![CDATA[pregnancy guide]]></category>

		<guid isPermaLink="false">http://psenoaji.wordpress.com/?p=105</guid>
		<description><![CDATA[Common Complaints during Pregnancy Most of the minor complaints during pregnancy can be minimized with patient education and prompt treatment. Ptyalism Excessive salivation (sialism, ptyalism) is an infrequent but troublesome complaint of pregnant women. The cause is unknown but it is strongly associated with severe nausea and vomiting of pregnancy. Frequency of Urination Urinary frequency [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=psenoaji.wordpress.com&amp;blog=4898572&amp;post=105&amp;subd=psenoaji&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p class="contenthead3"><img src="http://www.1to9months.com/images/m21.jpg" alt="" hspace="10" vspace="10" align="left" /></p>
<p class="contenthead3"><strong>Common Complaints during Pregnancy</strong></p>
<p class="contentbody"><a name="2384513"></a>Most of the minor complaints during pregnancy can be minimized with patient education and prompt treatment.</p>
<p class="contenthead5"><a name="2384514"></a><strong><em>Ptyalism</em></strong></p>
<p class="contentbody"><a name="2384515"></a>Excessive salivation (sialism, ptyalism) is an infrequent but troublesome complaint of pregnant women. The cause is unknown but it is strongly associated with severe nausea and vomiting of pregnancy.</p>
<p class="contenthead5"><a name="2384516"></a></p>
<p class="contenthead5"><a name="2384518"></a><strong><em>Frequency of Urination</em></strong></p>
<p class="contentbody"><a name="2384519"></a>Urinary frequency is a common complaint throughout pregnancy. Vascular engorgement of the pelvis and hormonal changes are responsible for altered bladder function. Late in pregnancy, when pressure on the bladder by the enlarging uterus and the fetal presenting part decreases bladder capacity, urination becomes even more frequent.</p>
<p class="contentbody"><a name="2384520"></a></p>
<p class="contenthead5"><em><strong>Varicose Veins</strong></em></p>
<p class="contentbody"><a name="2384541"></a>Varicosities may develop in the legs or in the vulva. A family history of varicosities is often present. Pressure by the enlarging uterus on the venous return from the legs is a major factor in the development of varicosities. The physician should warn the patient early in pregnancy of the need for elastic stockings and elevation of the legs if varices develop. Specific therapy (injection or surgical correction) usually is contraindicated during pregnancy. Superficial varicosities may rarely signal deeper venous disease. These patients should be examined carefully for signs of deep vein thrombosis.</p>
<p class="contenthead5"><a name="2384542"></a><em><strong>Joint Pain, Backache, &amp; Pelvic Pressure</strong></em></p>
<p class="contentbody"><a name="2384543"></a>Although the main bony components of the pelvis consist of 3 separate bones, the symphysial and sacroiliac articulations permit practically no motion in the nonpregnant state. In pregnancy, however, endocrine relaxation of these joints permits some movement. The pregnant patient may develop an unstable pelvis, which produces pain. A tight girdle or a belt worn about the hips, together with frequent bed rest, may relieve the pain; however, hospitalization is sometimes necessary.</p>
<p class="contentbody"><a name="2384544"></a>Improvement in posture often relieves backache. The increasingly protuberant abdomen causes the patient to throw her shoulders back to maintain her balance; this causes her to thrust her head forward to remain erect. Thus, she increases the curvature of both the lumbar spine and the cervicothoracic spine. A maternity girdle to support the abdominal protuberance and shoes with 2-inch heels, which tend to keep the shoulders forward, may reduce the lumbar lordosis and thus relieve backache. Local heat and back rubs may relax the muscles and ease discomfort. Exercises to strengthen the back are most rewarding.</p>
<p class="contenthead5"><strong><em><a name="2384545"></a>Leg Cramps</em></strong></p>
<p class="contentbody"><a name="2384546"></a>The cause of leg cramps in pregnancy is unknown but may be the result of a reduced level of diffusible serum calcium or elevation of serum phosphorus. Treatment for this includes curtailment of phosphate intake (less milk and nutritional supplements containing calcium phosphate) and an increase of calcium intake (without phosphorus) in the form of calcium carbonate or calcium lactate tablets. Alternatively, a randomized trial showed that magnesium citrate, 300 mg/d, reduces leg cramps. Symptomatic treatment consists of leg massage, gentle flexing of the feet, and local heat. Tell the patient to avoid pointing toes when she stretches her legs (eg, on awakening in the morning) as this triggers a gastrocnemius cramp. She should also practice &#8220;leading with the heel&#8221; in walking.</p>
<p class="contenthead5"><a name="2384547"></a><strong><em>Breast Soreness</em></strong></p>
<p class="contentbody"><a name="2384548"></a>Physiologic breast engorgement may cause discomfort, especially during early and late pregnancy. A well-fitting brassiere worn 24 hours a day affords relief. Ice bags are temporarily effective. Hormone therapy is of no value.</p>
<p class="contenthead5"><a name="2384549"></a><strong><em></em></strong></p>
<p class="contenthead5"><a name="2384551"></a></p>
<p>Source : Current Obstetrics and Gynecology, 2007</p>
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		<title>Pregnancy Month by Month Guide : Third Month</title>
		<link>http://psenoaji.wordpress.com/2008/11/23/pregnancy-month-by-month-guide-third-month/</link>
		<comments>http://psenoaji.wordpress.com/2008/11/23/pregnancy-month-by-month-guide-third-month/#comments</comments>
		<pubDate>Sun, 23 Nov 2008 15:33:54 +0000</pubDate>
		<dc:creator>psenoaji</dc:creator>
				<category><![CDATA[Obstetrics & Gynecology]]></category>
		<category><![CDATA[antenatal care]]></category>
		<category><![CDATA[obgyn]]></category>
		<category><![CDATA[Obstetrics]]></category>
		<category><![CDATA[pregnancy]]></category>
		<category><![CDATA[pregnancy guide]]></category>

		<guid isPermaLink="false">http://psenoaji.wordpress.com/?p=95</guid>
		<description><![CDATA[Mother By the end of the third month, you should be beginning to perk up a bit if you&#8217;ve experienced fatigue. Morning sickness and frequent urination should both begin to subside. At around twelve weeks, you should have your first visit to the antenatal clinic. Remember, you are entitled to paid leave for antenatal checkups [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=psenoaji.wordpress.com&amp;blog=4898572&amp;post=95&amp;subd=psenoaji&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p align="justify"><span style="font-family:verdana,arial;"><strong>Mother</strong><br />
</span><span style="font-family:verdana,arial;">By the end of the third                month, you should be beginning to perk up a bit if you&#8217;ve experienced                fatigue. Morning sickness and frequent urination should both begin                to subside. At around twelve weeks, you should have your first visit                to the antenatal clinic. Remember, you are entitled to paid leave                for antenatal checkups and classes. A number of tests and scans                are done between 11 and 13 weeks. Your first ultrasound may be done                at this time to determine the baby&#8217;s age. Other tests which screen                for possible birth defects can include a nuchal translucency scan                or a chorionic villus sampling.<br />
</span></p>
<p align="justify"><span style="font-family:verdana,arial;"><img src="http://www.1to9months.com/images/m32.jpg" alt="" hspace="10" vspace="10" align="right" /></span></p>
<p align="justify"><strong>Baby</strong><br />
By twelve weeks, your developing baby is about 3 inches long and                still weighs less than an ounce. His eyes are completely formed                and his fingers and toes are becoming distinct. His genital organs                can be seen quite clearly with an ultrasound an his internal organs                are functioning.</p>
<p style="text-align:left;"><a href="http://www.1to9months.com" target="_self">1to9months.com</a></p>
<p style="text-align:left;">Continues to The Fourth Month</p>
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		<title>Optical Illusions #2 : Animal mountain</title>
		<link>http://psenoaji.wordpress.com/2008/11/23/optical-illusions-2-animal-mountain/</link>
		<comments>http://psenoaji.wordpress.com/2008/11/23/optical-illusions-2-animal-mountain/#comments</comments>
		<pubDate>Sun, 23 Nov 2008 15:21:41 +0000</pubDate>
		<dc:creator>psenoaji</dc:creator>
				<category><![CDATA[Optical Illusions]]></category>
		<category><![CDATA[optical]]></category>

		<guid isPermaLink="false">http://psenoaji.wordpress.com/?p=89</guid>
		<description><![CDATA[How many animals can you see in this picture?<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=psenoaji.wordpress.com&amp;blog=4898572&amp;post=89&amp;subd=psenoaji&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p><a href="http://psenoaji.files.wordpress.com/2008/11/optical_ill_29.jpg"><img class="alignnone size-full wp-image-90" title="optical_ill_29" src="http://psenoaji.files.wordpress.com/2008/11/optical_ill_29.jpg?w=544" alt="optical_ill_29"   /></a></p>
<p>How many animals can you see in this picture?</p>
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		<title>Optical Illusions #1 : A three legged soldier</title>
		<link>http://psenoaji.wordpress.com/2008/11/22/optical-illusions-1-a-three-legged-soldier/</link>
		<comments>http://psenoaji.wordpress.com/2008/11/22/optical-illusions-1-a-three-legged-soldier/#comments</comments>
		<pubDate>Sat, 22 Nov 2008 07:15:53 +0000</pubDate>
		<dc:creator>psenoaji</dc:creator>
				<category><![CDATA[Optical Illusions]]></category>
		<category><![CDATA[illusions]]></category>
		<category><![CDATA[optical]]></category>

		<guid isPermaLink="false">http://psenoaji.wordpress.com/?p=74</guid>
		<description><![CDATA[A three legged soldier..? It&#8217;s your eyes that fooled you..;))<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=psenoaji.wordpress.com&amp;blog=4898572&amp;post=74&amp;subd=psenoaji&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p><a href="http://psenoaji.files.wordpress.com/2008/11/305-3.jpg"><img class="alignnone size-full wp-image-73" title="305-3" src="http://psenoaji.files.wordpress.com/2008/11/305-3.jpg?w=544" alt="305-3"   /></a></p>
<p>A three legged soldier..? It&#8217;s your eyes that fooled you..;))</p>
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		<title>Pregnancy Month by Month Guide : Second Month</title>
		<link>http://psenoaji.wordpress.com/2008/11/19/pregnancy-month-by-month-guide-second-month/</link>
		<comments>http://psenoaji.wordpress.com/2008/11/19/pregnancy-month-by-month-guide-second-month/#comments</comments>
		<pubDate>Wed, 19 Nov 2008 15:29:15 +0000</pubDate>
		<dc:creator>psenoaji</dc:creator>
				<category><![CDATA[Obstetrics & Gynecology]]></category>
		<category><![CDATA[antenatal care]]></category>
		<category><![CDATA[obgyn]]></category>
		<category><![CDATA[Obstetrics]]></category>
		<category><![CDATA[pregnancy]]></category>
		<category><![CDATA[pregnancy guide]]></category>

		<guid isPermaLink="false">http://psenoaji.wordpress.com/?p=62</guid>
		<description><![CDATA[Mother By the end of the second month, you may begin to feel pregnant. Your breasts may be tender, and you might be experiencing morning sickness or nausea during the day. Don&#8217;t be surprised if you undergo some raging mood swings as well. Fatigue is also an issue throughout the first trimester. You may be [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=psenoaji.wordpress.com&amp;blog=4898572&amp;post=62&amp;subd=psenoaji&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p align="justify"><span style="font-family:verdana,arial;"><strong>Mother</strong><br />
By the end of the second month, you may begin to feel pregnant.                      Your breasts may be tender, and you might be experiencing                      morning sickness or nausea during the day. Don&#8217;t be surprised                      if you undergo some raging mood swings as well. Fatigue is                      also an issue throughout the first trimester. You may be just                      a bit more tired than usual, or you may be so exhausted that                      four-hour naps every afternoon are the rule. Those constant                      trips to the loo continue, no doubt Nature&#8217;s way of training                      you to wake up several times during the night in preparation                      for your baby&#8217;s feeding schedule! </span></p>
<p><img src="http://www.1to9months.com/images/m22.jpg" alt="" hspace="10" vspace="10" align="right" /></p>
<p align="justify"><span style="font-family:verdana,arial;"><strong> Baby</strong><br />
Your unborn baby has now graduated to being called a foetus.                      His internal organs are already in place and ready for further                      development. If you have an ultrasound scan, you may see your                      baby wiggling and waving like mad, but you won&#8217;t feel anything                      yet. An eight-week-old foetus already has distinct facial                      features.</span></p>
<p style="text-align:left;"><a href="http://www.1to9months.com" target="_self">1to9months.com</a></p>
<p style="text-align:left;">Continues to The Third Month</p>
<p align="justify"><span style="font-family:verdana,arial;"><br />
</span></p>
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		<title>Prenatal Pregnancy Visits #1</title>
		<link>http://psenoaji.wordpress.com/2008/11/19/prenatal-pregnancy-visits-1/</link>
		<comments>http://psenoaji.wordpress.com/2008/11/19/prenatal-pregnancy-visits-1/#comments</comments>
		<pubDate>Wed, 19 Nov 2008 14:50:25 +0000</pubDate>
		<dc:creator>psenoaji</dc:creator>
				<category><![CDATA[Obstetrics & Gynecology]]></category>
		<category><![CDATA[antenatal care]]></category>
		<category><![CDATA[maternal fetal]]></category>
		<category><![CDATA[Obstetrics]]></category>
		<category><![CDATA[pregnancy]]></category>
		<category><![CDATA[prenatal visit]]></category>

		<guid isPermaLink="false">http://psenoaji.wordpress.com/?p=56</guid>
		<description><![CDATA[Maternal Well-Being as a Sign of Fetal Well-Being In modern obstetric practice, fetal well-being has been determined mainly by direct monitoring and testing, but it is important not to overlook the status of the mother when determining fetal well-being. Maternal Height &#38; Weight Maternal height and prepregnancy weight and amount of weight gain during pregnancy [...]<img alt="" border="0" src="http://stats.wordpress.com/b.gif?host=psenoaji.wordpress.com&amp;blog=4898572&amp;post=56&amp;subd=psenoaji&amp;ref=&amp;feed=1" width="1" height="1" />]]></description>
			<content:encoded><![CDATA[<p class="contenthead3"><img src="/DOCUME~1/AWANG-~1/LOCALS~1/Temp/moz-screenshot-3.jpg" alt="" /></p>
<p class="contenthead3"><img src="http://www.1to9months.com/images/m21.jpg" alt="" hspace="10" vspace="10" align="left" /></p>
<p class="contenthead3"><strong>Maternal Well-Being as a Sign of Fetal Well-Being</strong></p>
<p class="contentbody"><a name="2384477"></a>In modern obstetric practice, fetal well-being has been determined mainly by direct monitoring and testing, but it is important not to overlook the status of the mother when determining fetal well-being.</p>
<p class="contentbody">
<p class="contentbody">
<p class="contenthead5"><a name="2384478"></a><strong><em>Maternal Height &amp; Weight</em></strong></p>
<p class="contentbody"><a name="2384479"></a>Maternal height and prepregnancy weight and amount of weight gain during pregnancy are important in fetal development. Women who are underweight or of short stature tend to have smaller babies, and are at risk for low birthweight and preterm delivery. A teenage mother is compromised if her diet is inadequate to meet her own growth requirements and those of her fetus. In such circumstances, women less than 157 cm (5 ft) tall, especially those weighing less than 45 kg (100 lb), should be encouraged to gain at least a minimum of 11–12 kg (25 lb), if not more.</p>
<p class="contentbody"><a name="2384480"></a></p>
<p class="contenthead5"><a name="2384481"></a><strong><em>Blood Pressure</em></strong></p>
<p class="contentbody"><a name="2384482"></a>Blood pressure levels may provide a clue to subtle circulatory compromise. Normally, the mean arterial pressure drops somewhat from prepregnancy or early pregnancy values during the middle trimester. It is important to note this decline so that it does not mask a subsequent rise in blood pressure that may signal the onset of hypertension. In the third trimester, blood pressure recordings taken in the supine position may be higher than those taken in the recumbent or seated position; this also may indicate the onset of hypertension. Normal patients may have a significant drop in blood pressure in the supine position (supine hypotensive syndrome), which is corrected when the patient is in the left lateral position.</p>
<p class="contenthead5"><a name="2384483"></a><strong><em>Fundal Height</em></strong></p>
<p class="contentbody"><a name="2384484"></a>Fundal height should be measured and recorded at each visit after 20 weeks&#8217; gestation. Measurements should be made with a centimeter tape (<strong>McDonald&#8217;s technique</strong>) from the pubic symphysis to the top of the uterine mass over the curvilinear abdominal surface. Progress is especially important in the third trimester, when fetal growth retardation is most easily determined.</p>
<p class="contenthead5"><a name="2384485"></a><em><strong>Fetal Heart Tones</strong></em></p>
<p class="contentbody"><a name="2384486"></a>FHTs can usually be heard by 10–12 postmenstrual weeks using a hand-held Doppler device. This may be helpful when gestational age is in doubt or in the presence of threatened abortion or other abnormal observations in the late first trimester. Attention should be paid both to rate and rhythm and to any accelerations, decelerations, or irregularities. Significant abnormalities may be further assessed by ultrasonography, fetal echocardiography, or electronic fetal heart rate monitoring, depending on gestational age.</p>
<p class="contenthead5"><a name="2384487"></a><strong><em>Edema</em></strong></p>
<p class="contentbody"><a name="2384488"></a>At each prenatal visit, abnormal or potentially abnormal findings should be noted, and a careful record should be made of any unusual events that have occurred since the last visit. Transient episodes of general edema or swelling should be noted. Lower-extremity edema in late pregnancy is a natural consequence of hydrostatic changes in lower body circulation.</p>
<p class="contentbody"><a name="2384489"></a>Edema of the upper body (eg, face and hands), especially in association with relative or absolute increases in blood pressure, may be the first sign of preeclampsia. A moderate rise in blood pressure without excessive fluid retention may suggest a predisposition to chronic hypertension.</p>
<p class="contenthead5"><a name="2384490"></a><strong><em>Fetal Size &amp; Position</em></strong></p>
<p class="contentbody"><a name="2384491"></a>Manual assessment of fetal size and position is always indicated after about 26 weeks&#8217; gestation. The fetus may assume a number of positions before late gestation, but persistence of an abnormal lie into late pregnancy suggests abnormal placentation, uterine anomalies, or other problems that should be investigated by ultrasound. If an abnormal lie persists, consider external version after 37 weeks&#8217; gestation. Suspected abnormal fetal size should also be investigated; a difference between gestational age and fetal heart size by 2 cm or more should prompt consideration of ultrasound evaluation.</p>
<p class="contentbody">
<p class="contentbody">Source : Current Obstetrics and Gynecology, 2007</p>
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