Articles filed under 'PREGNANCY & BIRTH'
Women who are obese may experience longer labors than women of normal weight when their labor is induced. Recent findings of a study at Saint Louis University were presented at the American College of Obstetricians and Gynecologists in May.
In research conducted by OB/Gyn physician Erin Brousseau, obese women who elected to have labor induced appeared to be at higher risk of longer labor and may require a Cesarean section.
Dr. Brousseau indicated that obese women needed more medication to activate labor. Of the 195 patients taking part in the study, medication given to those who were obese also took longer to begin working. She recommended that their doctors wait for labor to begin spontaneously.
Obese women who wish to conceive would be wise to lose significant weight before attempting to get pregnant. They should be carefully checked by their physicians in a pre-pregnancy physical exam.
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May 21st, 2006
Women who have abnormal Pap or cervical smear tests are usually sent for further investigation. Doctors use one of four different techniques to remove suspicious cells for further examination. All have been shown to be equally successful in preventing progression to cervical cancer. Women should be aware, however, that three of the techniques carry a small risk of complications with a future pregnancy.
In Great Britain, researchers from the Royal Preston Hospital in Lancashire analyzed results from 27 studies. They looked at various treatments used to remove abnormal cells and sometimes a margin of healthy cells around them. Their conclusions were published in the Lancet medical journal.
Laser ablation, which destroys the abnormal cells, was the only treatment not linked to any pregnancy risks. Cold knife conisation uses a scapel to remove a cone-shaped wedge of tissue, and laser conisation employs the laser to do the same thing. Researchers found that in subsequent pregnancies, cold knife conisation increased the risk of giving birth prematurely, of having a low birthweight baby, or needing a Caesarean. Laser conisation had similar risks, although not to the same extent.
The most common procedure, called LLETZ (large loop excision of the transformation zone), removes the area with abnormal cells from the cervix by employing a small tool and electric current. This procedure was also found to raise the risks of having a premature or small baby. In addition, it increased the chances of early rupturing of membranes.
Professor Peter Sasieni, a UK cancer research expert, stressed the importance of women being aware of potential side-effects. They should discuss various options with their doctor prior to treatment for cervical precancerous cells. The most important consideration is that a woman gets the treatment she needs to prevent cervical cancer. The chances of pregnancy risks are very small, he concluded.
Source:Â BBC News
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May 10th, 2006
More American women than ever are giving birth by C-section delivery, now accounting for 30 % of all births in the U.S. In the past decade, the rate of C-section births has doubled, despite the Center for Disease Control’s goal to lower the rate to 15 % among first-time mothers. Only about one in 10 of these surgical deliveries is estimated to be “elective.â€
C-sections are major abdominal surgeries, once performed as a last resort during a medical emergency. Yet, their numbers continue to climb for a variety of reasons.
Today, some women want the convenience of scheduling their delivery day, while others choose to avoid labor pains. A doctor may recommend a C-section due to fear of malpractice lawsuits stemming from vaginal deliveries. Obstetricians are more likely to operate if a baby is in the breech position or if the mother has had a previous C-section. Â
Experts do not agree on the amount of risk inherent in extracting a baby through incisions in the mother’s abdominal wall and uterus. Associated potential risks include bleeding and infection, as well as problems with anesthesia. Hospital stays are also longer following a Cesarean delivery.
The more C-sections a woman has, the more her chance of hemorrhaging during delivery or requiring a hysterectomy after the birth. Serious complications are usually rare and primarily occur during emergency surgery, says Dr. Gary Hankins, chair of the American College of Obstetricians and Gynecologists’ Committee on Obstetrics Practice.
He points out that vaginal childbirth can also pose risks such as tears and pelvic damage, problems which generally are temporary.
Following a 1996 British study, in which incontinence and sexual problems were thought to be more common after vaginal birth, more women began to opt for a C-section delivery.
Recent evidence contradicts those earlier findings. Myths about childbirth are still influencing women’s choices. It is important to replace them with strong scientific evidence, according to a presenter at a recent National Institutes of Health conference.
Newsweek magazine; April 3, 2006, page 45.
April 6th, 2006
Most miscarriages occur during the first few weeks of pregnancy. Sometimes women aren’t even aware they were pregnant.
They may think they were having an unusually heavy menstrual period. The cause of miscarriage is often due to health problems with the mother or defects in the developing fetus.
In a small study of 61 married women aged 18-32 in rural Guatemala, researchers measured cortisol levels in the women’s urine three times a week.
Measurements of this hormone produced by stress began before the women got pregnant and continued for three weeks post pregnancy. Over a year, 16 of these women had 22 pregnancies, in which 9 of them resulted in live births and 13 resulted in miscarriages.
This study found that miscarriages were 2.7 times more likely among women with high cortisol levels. Ninety percent of the women with high cortisol experienced miscarriages in the first three weeks of their pregnancy. Only 33 percent of women with normal stress levels miscarried in the first three weeks.
Researchers are calling for bigger studies to determine whether maternal stress contributes to miscarriage. Cortisol in the urine could indicate that a woman’s body isn’t in the best condition to carry a child to term.
Source:Â WebMD. Inc.;Â (original article by Miranda Hitti and reviewed by Louise Chang, M.D.); 2/21/06; Dr. Dean Edell, San Francisco-KGO weekday broadcasts.
March 30th, 2006
Accutane is a highly effective drug to treat severe acne, but it has disastrous consequences if a woman becomes pregnant while taking it. The drug has been linked to miscarriages and severe birth defects. The system, called iPledge, set up to guard against such possibilities is flawed. Each year, hundreds of women who receive prescriptions from their physicians for Accutane become pregnant while taking it.
The Federal government has vainly tried over the last two decades to institute safeguards against pregnancies in women on Accutane. The iPledge system requires women to take pregnancy tests and to be on birth control. Doctors complain that this inconvenient, cumbersome process is often impossible to manage.
The iPledge program is flawed, in some cases requiring pregnancy tests for male patients. Confusing instructions, lengthy delays in responding to complaints, and extensive waiting time on the telephone help line are common problems.
Some doctors advocate more regulation of Accutane. Others are fearful that the drug will become unavailable for the 6,000 patients — most of them male — with severe, disfiguring acne. For them, Accutane is a near-miraculous cure.
Physicians write more than 170,000 Accutane prescriptions each month, half of those for women.
Dr. Sidney Wolfe, director of health research at Public Citizen, complains that dermatologists are prescribing Accutane to “way too many people.†For this reason, he believes that efforts to limit pregnancies have failed.
Many dermatologists emphasize that Accutane can transform the lives of patients with even mild forms of acne by restoring their self-esteem. The controversy continues and may ultimately result in having Accutane withdrawn from the market.
New York Times, 2/11/06; from an article by Gardiner Harris
March 19th, 2006
When the time seems right to start a family, you can take steps toward a healthy and happy outcome. Pre-conception planning helps to set the stage for your baby’s birth.
You don’t need to be a first-time mother to benefit from a pre-pregnancy check with your doctor. New medical information is always becoming available that can help ensure the health of mother and baby.
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1. Meeting with Your Doctor
Your doctor will examine your present state of health, as well as your family medical history and potential risk factors. You want to be in the best possible physical condition before you conceive. If you have chronic conditions such as high blood pressure or diabetes, you need to get these under control months in advance. Your doctor will discuss with you any medications you are taking and your past immunizations that will protect you and your developing baby.
If you need to lose significant weight, the best time is before you stop your birth control method. Beginning or continuing a moderate exercise program is also important. In most cases, you should be able to safely engage in gentle exercise such as walking or swimming throughout most of your pregnancy. Let your doctor be your guide.
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2. Special Precautions
Some medications may make it harder to get pregnant, and others may cause birth defects. Your doctor will advise you as to drugs and substances such as alcohol which you should avoid if you are “with child.†Some vaccines are unsafe to receive during pregnancy. In addition, various natural herbs can have unknown risks. When in doubt, don’t consume them. What you eat and drink will be especially important to your child’s development.
You should eat a balanced diet, including foods from all five food groups. Fresh fruits and vegetables, as well as good calcium intake are especially important. Prenatal vitamins containing 1miligram of folic acid are recommended. Start taking folic acid as soon as you are thinking of getting pregnant.
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3. Genetic Testing
If your family history indicates a possibility of carrying a child with certain genetic defects such as Sickle Cell Anemia, Cystic Fibrosis, or Tay-Sachs Disease, you may want to go in for genetic testing. Screening tests for these potential diseases are now widely available.
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4. General Health Practices
You improve your chances of having a healthy baby if you observe the following healthy practices. You might want to make a reminder list and post it on your refrigerator:
· Maintain a healthy weight
· Eat a balanced diet
· Take multivitamins containing 1 mg folic acid before and after conception
· Get plenty of sleep
· Exercise at least 30 minutes four times a week
· Avoid cigarettes, alcohol and drugs four months prior to conception and during pregnancy
· Avoid exposure to toxins and radiation at work
· Avoid emptying cat litter boxes that can potentially transmit the parasite toxoplasmosis
Remember that not all problems are preventable, even with careful planning. However, your chances of a having a healthy baby are greater if both mother and father are healthy before the pregnancy begins.
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5. Doing What Comes Naturally
You’ve had your pre-pregnancy exam and taken steps to be as healthy as possible. It’s time to relax and enjoy with your partner the experience of creating a baby together. Remember, many couples in their prime reproductive years may require between six and twelve months to conceive. A woman in her mid-thirties or older may take even longer. The more relaxed you are in approaching conception, the more likely the two of you will be successful in your goal. If your periods are regular, it is easier to determine the best time of month to try. Charting your temperature and other methods can help you determine whether you are ovulating (releasing an egg).
Your most fertile period is generally between 10 and 14 days from the time of your last menstrual cycle. After trying for two years or longer without becoming pregnant, you may want to consult a fertility specialist. Many new reproductive technologies are available to help you and your partner have the baby you desire.
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March 19th, 2006
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