X-Rays:  If x-rays are necessary, they should be taken with a lead shield over the abdomen if possible.  The dose of radiation from standard x-rays is actually quite small and is very unlikely to cause harm to a fetus, even if the abdomen was not shielded during x-rays taken before you knew you were pregnant.  MRI (magnetic resonance imaging) is considered safe in pregnancy after the first trimester.

Heat:  Prolonged exposure to heat above body temperature may theoretically cause damage to the developing fetus and should be avoided.  Prolonged high fevers (over 102° Fahrenheit) should be treated with Tylenol and reported to your doctor.

Painting:  Mercury and lead paints should be avoided.  Also avoid inhaling and handling solvents, which can cause numerous complications.  Use good ventilation and avoid standing on ladders, stools, etc. to decrease the risk of falling.

Perms and Hair dyes:  Controlled studies have not been done to evaluate the safety of these products during pregnancy.  The few observational studies that have been done do not suggest any particular harm to patients who have used these products once or twice during pregnancy.  Your decision to use dyes or perms should weigh these facts against their potential to enhance your sense of well-being during your pregnancy.

Dental Work:  Necessary dental work may be done during pregnancy.  Be sure the dentist and technician know you are pregnant.  Elective procedures should be postponed until after delivery.

TB Tine test:  This test is safe in pregnancy and should be performed if there is concern about tuberculosis exposure or history.

Head Lice:  Head lice live on the scalp and hair.  Adults are rarely infected, but are not immune.  Permethrin is the recommended therapy.  It is available as Nix -- an over-the-counter creme rinse.  It is applied to the scalp after the hair has been shampooed and dried.  After ten minutes, it is rinsed out with water.  It kills the lice eggs and has residual activity for seven to ten days.  Repeat applications are usually not necessary.  Combs, brushes, all clothes, headgear, towels, and bed linens should be washed in hot water.  There is no need to use an insecticide in the home.

Flu Vaccine:  Influenza immunization is recommended by the Centers for Disease Control and Prevention for women who will be in the second or third trimesters of pregnancy during flu season (November through April).  Our office does not currently offer this service.  The vaccine is usually offered by primary care physicians and numerous other entities for minimal fees.

Chicken Pox:  Chicken pox can cause very severe, even fatal, infections in adults, especially pregnant women.  If you have already had chicken pox, you are immune and will not become infected again.  However, if you have no history of chicken pox, it is important to call the office or the physician on call if you are exposed.  Many persons who believe they never had this infection actually are immune, probably as a result of a very mild infection earlier in life, which they did not realize was caused by the chicken pox (varicella) virus.  A simple blood test can determine if you are actually immune and do not need to worry.  A medicine called "globulin" can be administered to exposed non-immune individuals in order to lessen the chance of a serious infection.  Immunization should be considered post-delivery.

Fifth Disease:  Fifth Disease is a common childhood rash, usually associated with fever and flu-like symptoms.  It is caused by parvovirus B19.  Most adults are immune to this infection because they had it as children.  If a pregnant woman who is not immune becomes infected, complications of pregnancy may rarely develop.  Blood tests can document whether immunity is present, and antibody levels to this virus should be checked if you come into close contact with an infected individual.  If infection is documented, more-frequent ultrasounds are usually all that is necessary to verify that your baby is not affected.

Rubella Vaccine:  In early pregnancy, each patient is checked for immunity to rubella (German measles).  This viral infection can cause serious problems for a developing fetus.  Therefore, the Centers for Disease Control and Prevention recommend that all children and susceptible adults be immunized against rubella.  If your prenatal blood work indicated that your are not immune, the vaccine will be offered to you before you leave the hospital.  It is acceptable to receive the vaccine even if you are breastfeeding.

Domestic Violence:  It has been reported that one in four women in the United States will be physically abused at some time during her life and that pregnancy is a risk factor for abuse.  If you are experiencing any type of abuse, there are many resources in our community that can provide help for you.  For more information, contact the Florida Domestic Violence Hotline at (800) 500-1119, or the Florida Abuse Hotline at (800) 962-2873.

Seatbelts:  It is imperative to use seatbelts while traveling at all times, but especially during the second and third trimesters, when the abdomen is large and very vulnerable to trauma.  The lap belt portion of the restraint should be placed snugly but comfortably under the abdomen and across the upper thighs;  the shoulder restraint should be positioned between the breasts and across the shoulder.

Car Seat:  Florida law requires use of a federally approved infant safety seat.  Please obtain an approved restraint to be used when your baby is discharged.

Circumcision:  Circumcision is an elective procedure, which consists of surgically removing a small piece of a male infant's foreskin.  There is controversy on whether this procedure is useful in preventing bladder infections in young children.  Many authorities on the subject feel it is unnecessary and potentially harmful.  Like any surgery, there can be complications related to bleeding or infection, and it is possible to remove too much or too little foreskin.  We recommend that you discuss this issue with your pediatrician.

Pediatrician:  It is necessary to select a pediatrician to ensure the health and continued care of your baby post-delivery.  Finding someone that you're comfortable with may take some time.  Start by asking friends and co-workers who have children to recommend someone.  Set up an appointment for a consultation prior to your delivery so you have an opportunity to get to know the physician and ask any questions you may have.