Archive for August, 2007
Although still very small, the risk of dying in childbirth is rising in the U.S. Between 2003 and 2004, maternal mortality rates rose from 12 deaths in 100,000 live births to 13 in 100,000 (Fewer than 600 American women giving birth in 2004 died in the process.) Infant mortality is actually more common than death of the mother. In 2004, the rate of infant deaths was 679 per 100,000.
Compared to a century ago, when about 1 in every 100 live births resulted in the mother’s death, the small rise may seem insignificant. But, with our modern technology and outstanding medical care, we should be concerned that the maternal mortality rate has risen at all.
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Looking at possible causes for deaths related to childbirth, three factors may be at least partially responsible:Â the rising rates of Caesarean-section births (now accounting for about 29% of all births); increasing maternal obesity, and more women giving birth in their late 30s and into their 40s.
Today, C-section births are far higher than what public heath experts consider appropriate. As with other surgeries, Caesarean births carry risks from anesthesia, infection, and blood clots. Mothers with several previous C-sections may also be at risk of excessive bleeding or blood vessel blockages.
Women who are heavier can develop diabetes and other complications. In addition, they may have excess tissue. Generally, their babies are larger, making a vaginal birth more difficult. This factor, in turn, can lead to more C-sections.
More women are waiting longer to have their babies than even a few decades ago. Risks of complications to mother and baby are greater to a woman in her late-30s and 40s.
Studies show than at least 40% of maternal deaths could have been prevented had quality of care been better. Sometimes, despite excellent prenatal care and a healthy pregnancy, the mother dies for no apparent reason.Â
The woman’s race and economic status may also be factors. Maternal deaths are at least three times higher for Black women than for white women. Because they often do not get adequate prenatal care, Black women are more susceptible to complications such as high blood pressure.
Getting risk factor – especially diabetes, obesity and high blood pressure – under control before becoming pregnant and obtaining good prenatal care will help to ensure a healthy outcome for both mother and baby.
Source:Â Â Yahoo News
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August 26th, 2007
Several decades ago, doctors routinely told their pregnant patients to gain about 25 pounds but no more than 35 pounds. Today, however, more expectant mothers may already be overweight or obese before conceiving. In these instances, weight gain guidelines should be reduced.
According to the March of Dimes, carrying too much weight while pregnant increases risks to mother and baby. These complications can include birth defects, problems with labor and delivery, death of the fetus, or delivery of very large babies. Overweight mothers are also more likely to produce babies who are too heavy as toddlers.
Setting appropriate pregnancy weight gain guidelines can be aided by referring to the woman’s body mass index (BMI) at the time she conceives. BMI is a combination of height and weight. Women with a “normal†body mass index are still encouraged to gain between 25 and 35 pounds. Women who are especially thin may be encouraged to gain up to 40 pounds. For those with a higher BMI (over 26), 15 pounds of weight gain may be more appropriate.
In 2003, about 1 in 4 expectant women in the U.S. gained more than 40 pounds during their pregnancy, up from 1 in 5 in 1990. Many women are putting on 50 or 60 pounds with their pregnancies, which can cause complications such as gestational diabetes. Obstetricians point out that an obese woman already has stored nutrients and does not need much additional weight to provide for her developing baby.
Women would do well to get their weight under control before becoming pregnant. Once conception has occurred, eating a healthy diet and engaging in moderate exercise are important for both mother and developing child.
Source:Â CNN.com
August 17th, 2007
A German study indicates that women at high-risk for breast cancer can benefit from magnetic resonance imaging (MRI) scans by detecting a nonmalignant tumor called ductal carcinoma in-situ (DCIS). If the pre-cancerous growth is discovered and removed before it becomes malignant, breast cancer could be prevented. Almost all malignant breast cancer is believed to begin with DCIS.
Because MRI is expensive, about $1,000 to $1,500 per scan, the technology does not yet make sense as a routine screening tool for all women. However, for women who have a strong family history of cancer or a genetic mutation found through testing, MRI can be especially effective. Apart from the expense, MRI has a high rate of false positives – often detecting lesions that are harmless. MRI scanning of breasts should always be paired with mammography, which finds things that MRI doesn’t.
The German study of 7,319 women took place over a five-year period. MRI scanning found DCIS in 90% of the 167 high-risk women discovered to have the condition, while mammograms detected only 56% of DCIS cases.
Two Dutch researchers involved with the study published their findings and recommendations in Lancet medical journal. They suggested that MRI be tested in more women to determine whether the technology should be used as a standard screening tool. They also noted that autopsy results show 9% of women have undetected DCIS.
The American Cancer Society recommends for women at high risk that MRI screening be performed annually in conjunction with mammography starting at age 30.
About 1.2 million cases of breast cancer are diagnosed annually, and each year 500,000 women (and a small percentage of men) die of the disease.
Source: Yahoo News
August 11th, 2007