孕妇学校课程2

孕妇学校课程2 (孕13-27周) 目的: 使学员了解: 1、 产前检查的意义 2、 孕期合理营养的原则与方法 3、 胎教的意义与方法 4、 母乳喂养的好处，树立母乳喂养信心 一、 母体主要的生理变化 1、早孕反应消失，食欲增进。因肠蠕动减慢，会出现便秘。 2、 腰部变粗，腹部隆起并迅速增大。 3、 皮肤色素沉着，面部出现蝴蝶斑，乳头及乳晕皮肤颜色变黑，乳房增大。腹部出现妊娠纹。 4、 孕16周时，在腹部可听到胎心音;20周左右时，孕妇可感觉到胎动。 二、胎儿的生长发育 孕16周末时，胎儿身长16cm，体重约100克，头皮长出毛发，开始出现呼吸运动。20周末时，胎儿身长25cm，体重约300克，全身有毳毛，出现吞咽、排尿功能。24周末时胎儿身长约30cm，体重约700克。各脏器均已发育，因皮下脂肪量少皮肤呈皱缩状。 三、 按时产前检查 进入孕中期后，孕妇要定期去医院作产前检查。每次作产前检查，都要测量血压、称体重和化验小便，并将测量和化验结果记录在孕妇保健手册上。每次医生还要作腹部检查，观察子宫大小，胎儿在子宫内的位置和生长情况，羊水量多少以及全身的健康状况。妊娠28周前，产前检查通常是每月一次;28周以后为每2周1次;yan Zhen and other places. Shan Bao Zhuang Shaozhen ban during the evening, offered to help make teaching preparation, such as take a stool, greeting students, cleaning up the classroom, trainees carry out various cultural activities and organizations. Zhuang Shaozhen in Dai Xiuchang home, ate and lived with juvenile Dai Xiuchang Zhuang Shaozhen, get along with long, Dai Xiuchang was coming under the influence of revolutionary thoughts. Zhuang Shaozhen also loved and trusted the bright teenager, often let him assist services. Zhuang Shaozhen out active at a time, Dai Xiuchang row a boat send him. Zhuang Shaozhen to contact party letters sent out by Dai Xiuchang. Directed by the Zhuang Shaozhen, Dai Xiuchang keep in touch with enter the confidential code clerk of the County Government of the Kuomintang Shen Wenjing. Zhuang Shaozhen in Che Jia BA spent 3 years, Dai Xiuchang help from start to finish. (15) Shao work running underground library in October 1940, in Jiangsu, Zhejiang and special branch of the Communist Party, under the leadership of young founded the "Youth Club" Al read progress books, publishing mimeographed letters of the justice. In November, another nearby rural big "adult literacy" to promote anti-Japanese way. Being a strict party branch members of the publicity of the tomb of Shao deeply shoulder 36周以后为每周1次。整个孕期共要作7-10次产前检查。每次产前检查，通常包括以下项目: 1、化验小便:正常的尿液中不应有蛋白。如果尿中出现蛋白，可能是尿路感染，也可能是 妊娠高血压综合征。如果尿糖呈阳性，可能是糖尿病。这都要做进一步检查。 2、 称体重:每次产前检查都要称体重，以了解孕妇体重增加情况。体重增加速度快慢可 间接反应腹中胎儿的生长发育情况。如体重不增或增长过慢，则反映胎儿发育迟缓，同时也反映营养摄入可能不足;但如体重增长每周过500克，则要注意可能有水肿现象。 3、测血压:每次产前检查，医生必定要测血压。妊娠期的正常血压如超过 17.3/12.0KPa(130/90mmhg)或比基础血压上升4.0/2.0kp(30/15mmhg)，皆为异常。如果血压升高，同时伴有水肿和蛋白尿则可能是妊娠的一种并发症，称为“妊娠高血压综合征”，需要进行治疗。 4、 测宫高、腹围:子宫底的增高和腹围的加宽都间接反映胎儿生长发育的情况。如宫底增 高停止、腹围加宽停止，或者宫底、腹围增长过快或过慢，都表示了胎儿生长发育不良或有其他异常情况。 5、 查胎位:医生通过腹部触诊，可以查出胎儿在子宫内的位置。孕中期时，由于羊水较多、 胎儿较小、胎儿在子宫内的活动范围大，胎儿位置和姿势易变，胎位可以是头位，也可以是臀位或横位。到孕28周以后特别是32周以后，胎儿在子宫内通常都是头位，即头朝下。如果胎儿是臀位或横位，则应设法纠正。 6、 听胎心:每次产前检查，医生都要借助仪器或听筒监听胎儿心音，以了解胎儿在母亲子 宫内的健康状况。除此以外，医生还将根据孕妇不同孕周和具体情况，为孕妇做血液化验，主要是检查血常规、血红蛋白、血型、血糖以及肝功能、肝炎表面抗原、甲胎蛋白等项目。如果发现异常再作进一步检查，孕妇应积极配合。在一定的孕周时，医生还会为孕妇做超声检查，以检测胎儿生长情况，胎龄是否符合，发现胎儿有无畸形，以及胎儿、胎盘位置。 四、 合理营养 yan Zhen and other places. Shan Bao Zhuang Shaozhen ban during the evening, offered to help make teaching preparation, such as take a stool, greeting students, cleaning up the classroom, trainees carry out various cultural activities and organizations. Zhuang Shaozhen in Dai Xiuchang home, ate and lived with juvenile Dai Xiuchang Zhuang Shaozhen, get along with long, Dai Xiuchang was coming under the influence of revolutionary thoughts. Zhuang Shaozhen also loved and trusted the bright teenager, often let him assist services. Zhuang Shaozhen out active at a time, Dai Xiuchang row a boat send him. Zhuang Shaozhen to contact party letters sent out by Dai Xiuchang. Directed by the Zhuang Shaozhen, Dai Xiuchang keep in touch with enter the confidential code clerk of the County Government of the Kuomintang Shen Wenjing. Zhuang Shaozhen in Che Jia BA spent 3 years, Dai Xiuchang help from start to finish. (15) Shao work running underground library in October 1940, in Jiangsu, Zhejiang and special branch of the Communist Party, under the leadership of young founded the "Youth Club" Al read progress books, publishing mimeographed letters of the justice. In November, another nearby rural big "adult literacy" to promote anti-Japanese way. Being a strict party branch members of the publicity of the tomb of Shao deeply shoulder 孕期合理营养不但关系着母亲身体健康，还关系着胎儿的生长发育以及以后的一生，为此应引起特别注意。孕期合理营养指导中应注意的几个原则性问题是: (一)各种营养食品的合理搭配 人体的生长发育需要提供必要的营养素。营养素包括有碳水化合物、蛋白质、脂肪、维生素、矿物质(微量元素)、水和纤维素。而不同的营养素存在于不同的营养食品中。现在还没有发现有哪一种营养食品是含有全部营养素的。为此，为了获得较全面的营养素就必须进食多种营养食品，不能偏食和挑食，否则容易造成某些营养素缺乏。同时选择营养食品时要多样化，膳食中要不断更换花样，避免千篇一律的膳食影响食欲。 (二) 孕期营养补充的原则 孕期营养的补充首先要保证有足够的热能供给。热能主要是由碳水化合物、脂肪和蛋白质提供的/三者供热的比例大约分别为60-70%20-25%和20%左右。 其次，孕期营养补充中要有合适的蛋白质和维生素。蛋白质是生命的物质基础。适量的蛋白质供给不但满足孕妇本身生理需要，还要构成胎儿组织、器官的生长发育以及为产后恢复、乳汁分泌做储备。各种维生素都有它不同的功能，如缺少容易引起维生素缺乏症。此外钙的补充也十分值得重视。 (三)不同的孕期营养的需要量不一样 孕中晚期，胎儿生长发育加速，各种营养物质的需要量都要增加。膳食要荤素兼备，粗细搭配。接近分娩期，适量减少碳水化合物而增加蛋白质，以避免胎儿体重过度增长，膳食质量要好，品种应齐全。 (四)烹调要合理以减少营养素损失蔬菜要先洗后切，即切即炒和红锅快炒。 (五)饮食要有规律性 每日以三餐为主，每餐的热量分配要适当。一般早、中、晚餐的热量分配30%、40%和30%。为宜。 (六) 针对个人不同情况而适当调节膳食 yan Zhen and other places. Shan Bao Zhuang Shaozhen ban during the evening, offered to help make teaching preparation, such as take a stool, greeting students, cleaning up the classroom, trainees carry out various cultural activities and organizations. Zhuang Shaozhen in Dai Xiuchang home, ate and lived with juvenile Dai Xiuchang Zhuang Shaozhen, get along with long, Dai Xiuchang was coming under the influence of revolutionary thoughts. Zhuang Shaozhen also loved and trusted the bright teenager, often let him assist services. Zhuang Shaozhen out active at a time, Dai Xiuchang row a boat send him. Zhuang Shaozhen to contact party letters sent out by Dai Xiuchang. Directed by the Zhuang Shaozhen, Dai Xiuchang keep in touch with enter the confidential code clerk of the County Government of the Kuomintang Shen Wenjing. Zhuang Shaozhen in Che Jia BA spent 3 years, Dai Xiuchang help from start to finish. (15) Shao work running underground library in October 1940, in Jiangsu, Zhejiang and special branch of the Communist Party, under the leadership of young founded the "Youth Club" Al read progress books, publishing mimeographed letters of the justice. In November, another nearby rural big "adult literacy" to promote anti-Japanese way. Being a strict party branch members of the publicity of the tomb of Shao deeply shoulder 孕时个人情况不相同，在掌握营养基本知识的基础上，根据个人不同情况而调节膳食。如发生便秘时应多食含纤维素多的蔬菜;强夜间小腿抽筋，应补充钙;出现贫血适当补充铁质较多的食品等等。 五、卫生保健: 1、产前检查:在整个孕期，应按照医生的嘱咐按时到医院检查。当发生头痛、恶心、胸痛、 阴道流血等情况应及时到医院就诊。 2、 衣着:质地柔软、式样简单、尺寸宽松，勿紧束裤腰，勿穿化纤内裤。穿坡跟鞋或2-3cm 高的低跟鞋。 3、个人卫生:经常洗头、洗澡、勤换衣服、保持皮肤清洁。每天清洗外阴，选用卫生护垫。早晚刷牙，预防龋齿。 4、 乳房护理:不要束胸、佩戴宽大的乳罩。 5、 足够的睡眠:保证8-9小时的睡眠。采用左侧卧位，不要仰卧。 6、 心理保健:孕中期是孕妇感到最舒服的时期，此时早孕反应已过，体型的变化还不十分 明显，体力的负担还不太重，孕妇的心情好，体力也较好。心理压力主要产生于担心胎儿畸形的孕妇，通过产前诊断及健康指导，让孕妇了解自己胎儿的状况，使其解除心理负担。 六、胎教 (一)什么是胎教, 胎教是利用现代科学知识簸箕技术，根据胎儿各时期发育特点，有针对性地、积极主动地给予胎儿各种信息剌激，】促进胎儿身心健康地发育。为出生后早期教育打下良好的基础。胎教是提高出生人口素质的有效措施。 (二)胎教的方法: 1、音乐胎教:音乐胎教对胎儿智力开发具有特殊功能。包括孕妇听音乐、给胎儿上音乐课、 唱歌给胎儿听等方法。以选择旋律柔和、节奏明快、轻松悦耳的乐曲为佳。反复聆听同一首乐曲，让逐渐长大的胎儿不断受到音乐的强化，使胎儿出生后易于回忆。yan Zhen and other places. Shan Bao Zhuang Shaozhen ban during the evening, offered to help make teaching preparation, such as take a stool, greeting students, cleaning up the classroom, trainees carry out various cultural activities and organizations. Zhuang Shaozhen in Dai Xiuchang home, ate and lived with juvenile Dai Xiuchang Zhuang Shaozhen, get along with long, Dai Xiuchang was coming under the influence of revolutionary thoughts. Zhuang Shaozhen also loved and trusted the bright teenager, often let him assist services. Zhuang Shaozhen out active at a time, Dai Xiuchang row a boat send him. Zhuang Shaozhen to contact party letters sent out by Dai Xiuchang. Directed by the Zhuang Shaozhen, Dai Xiuchang keep in touch with enter the confidential code clerk of the County Government of the Kuomintang Shen Wenjing. Zhuang Shaozhen in Che Jia BA spent 3 years, Dai Xiuchang help from start to finish. (15) Shao work running underground library in October 1940, in Jiangsu, Zhejiang and special branch of the Communist Party, under the leadership of young founded the "Youth Club" Al read progress books, publishing mimeographed letters of the justice. In November, another nearby rural big "adult literacy" to promote anti-Japanese way. Being a strict party branch members of the publicity of the tomb of Shao deeply shoulder 音量以75-80分贝为宜。每天2次，随孕龄的增长，上课时间也可逐渐从5分钟延长到20分钟。 2、语言胎教:语言胎教是使胎儿不断接受语言波的信息。优美的语言不但可以促使胎儿大 脑发育，还可陶冶孕妇自身情操，调节情绪进入一个安静的精神状态。进行语言胎教时，父母可用胎教器话筒直接贴在孕妇腹壁与胎儿对话，为胎儿朗读优秀的文学作品，朗诵诗歌，讲童话故事、可以激发胎儿的生长发育，培养他的美感。父母还可为胎儿取个小名，讲话时重复叫他的小名，并将出生后生活中要对他讲的话不断重复，如喝水、洗澡、吃奶、换尿布等等，对孩子出生后牙牙学语会有帮助。 3、抚摸胎教:抚摸是把信息输入胎儿体内，剌激大脑细胞的生长发育。孕妇及丈夫可抚摸孕妇腹部，对胎儿触压、拍打、抚摸、使胎儿产生条件反射。每天两次，每次5分钟，把父母的关爱传递给胎儿，在出生前就建立母子、父子间密切的感情联系。 4、记胎儿日记:从怀孕开始，每天将孕妇的身体情况、心理状态、饮食起居、休息娱乐都 记下来。开始产前检查和胎教以后，还可记录检查情况，如孕期用药、胎动开始时间、胎教实施情况等。不强调文字华丽，而要真实记录父母的思想感情和胎儿的情况。 5、胎教不仅是母亲的事，与父亲的关系也很密切，父亲要积极参与，关心体贴妻子。保证妻子有充分合理的营养，帮助妻子选好胎教音乐、文学书籍、儿歌等，陪同妻子参加音乐会，短途旅游，使妻子保持良好的心理状态。 七、孕妇体操: 孕妇要进行适当的体操活动，这对胎儿生长发育，开发智力有很大好处。孕妇可以在医生指导下，从怀孕3个月左右开始做，每天都要做，但不要勉强，不要做得过分，以不感到疲劳为宜，在做操之前，要先排尿、排便。孕妇做保健体操，可以防止由于孕期体重增加和重心改变而引起的肌肉疲劳低还可以松弛腰部和骨盆肌肉，为分娩时孩子能顺利通过产道做准备。凡是认真坚持做操的孕妇，可以在精神上增强自然分娩的信心。 1、 脚部运动:通过脚尖和踝关节的柔软运动，可以增强血液循环。 具体做法:(1)深坐在椅子上，腿和地面呈垂直状态，两脚并拢，脚心平放在地板上(2)脚尖使劲向上翘，深呼吸一次后，再恢复原状。(3)把一条腿放在另一条腿上，上侧腿的脚尖慢慢地上下活动，然后换另一条腿，再重复此动作。(4)不必特yan Zhen and other places. Shan Bao Zhuang Shaozhen ban during the evening, offered to help make teaching preparation, such as take a stool, greeting students, cleaning up the classroom, trainees carry out various cultural activities and organizations. Zhuang Shaozhen in Dai Xiuchang home, ate and lived with juvenile Dai Xiuchang Zhuang Shaozhen, get along with long, Dai Xiuchang was coming under the influence of revolutionary thoughts. Zhuang Shaozhen also loved and trusted the bright teenager, often let him assist services. Zhuang Shaozhen out active at a time, Dai Xiuchang row a boat send him. Zhuang Shaozhen to contact party letters sent out by Dai Xiuchang. Directed by the Zhuang Shaozhen, Dai Xiuchang keep in touch with enter the confidential code clerk of the County Government of the Kuomintang Shen Wenjing. Zhuang Shaozhen in Che Jia BA spent 3 years, Dai Xiuchang help from start to finish. (15) Shao work running underground library in October 1940, in Jiangsu, Zhejiang and special branch of the Communist Party, under the leadership of young founded the "Youth Club" Al read progress books, publishing mimeographed letters of the justice. In November, another nearby rural big "adult literacy" to promote anti-Japanese way. Being a strict party branch members of the publicity of the tomb of Shao deeply shoulder 意安排时间，任何时候坐在椅子上都可做这个动作，每次最好3分钟左右。 2、盘腿坐运动:这个动作可以松弛腰关节，伸展骨盆的肌肉，使胎儿在娩出时容易通 过产道，顺利生产具体做法:(1)盘腿坐好，把背部挺直，抵住下颌，两手轻轻放在膝盖上。(2)每呼吸一次，手就按压一次，反复进行。(3)按压时要用手腕向下按膝盖，一点点加力，同时让膝盖接近床面(4)每天早、中、晚各做3分钟。 3、 扭动骨盆运动:这个动作能够加强骨盆关节和腰部肌肉的柔软作用。具体做法:(1)仰卧床上，两腿直立，双膝并拢。(2)双膝并拢带动大小腿左右摆动，似象用膝盖画半圆形，要慢慢有节奏地运动，双肩紧靠在床上。(3)着左脚伸直，右膝直立，右脚心平放在床上。(4)右腿的膝盖慢慢向右侧倾倒。(5)待膝盖从右侧恢复原状后，再向左侧倾倒。此后左右腿可交替进行。(6)运动时间最好在早上和晚上，各做5-10次。 4、 振动骨盆运动:这个运动除了松弛骨盆和腰部关节外，还可使产道口肌肉柔软，并 强健下腹部肌肉。具体做法:(1)孕妇呈趴下体位，深深地俯着头，后背成圆形。(2)抬头挺腰，使后背翘起。(3)上肢向前方慢慢移动翘起，保持重心前移的姿势，每呼吸一次做一次，可以反复做。(4)运动时间最好在早晨和晚上，5-10次为宜。 八、母乳喂养的好处: 1、 含有婴儿所需要的全部营养物质，容易消化吸收有利于婴儿生长发育。 2、含有抗体，可以增强婴儿的抗病能力。 3、 母乳喂养促使子宫收缩，有利于产后恢复。 4、母乳清洁无菌，温度适宜，经济方便。 5、 可增进母子感情 yan Zhen and other places. Shan Bao Zhuang Shaozhen ban during the evening, offered to help make teaching preparation, such as take a stool, greeting students, cleaning up the classroom, trainees carry out various cultural activities and organizations. Zhuang Shaozhen in Dai Xiuchang home, ate and lived with juvenile Dai Xiuchang Zhuang Shaozhen, get along with long, Dai Xiuchang was coming under the influence of revolutionary thoughts. Zhuang Shaozhen also loved and trusted the bright teenager, often let him assist services. Zhuang Shaozhen out active at a time, Dai Xiuchang row a boat send him. Zhuang Shaozhen to contact party letters sent out by Dai Xiuchang. Directed by the Zhuang Shaozhen, Dai Xiuchang keep in touch with enter the confidential code clerk of the County Government of the Kuomintang Shen Wenjing. Zhuang Shaozhen in Che Jia BA spent 3 years, Dai Xiuchang help from start to finish. (15) Shao work running underground library in October 1940, in Jiangsu, Zhejiang and special branch of the Communist Party, under the leadership of young founded the "Youth Club" Al read progress books, publishing mimeographed letters of the justice. In November, another nearby rural big "adult literacy" to promote anti-Japanese way. Being a strict party branch members of the publicity of the tomb of Shao deeply shoulder