November is Prematurity Awareness Month, and today, November 17th, bloggers are banding together to Fight For Preemies.  We are taking a moment today to spread the word about prematurity, bring a little awareness about the impact prematurity has on the babies born too soon, on the parents struggling as they watch their babies fight for their lives and on their families and friends who stand behind them in support and to spread the word about March of Dimes and the tremendous things they do to help premature babies and to help prevent prematurity so that “one day all babies may be born healthy”.

I was one of the lucky, my daughter was born full term and healthy and I am thankful every day for that fact because I know so many aren’t so lucky.  I know people who weren’t so lucky, those who had babies born too soon and too sick.

I have witnessed prematurity first hand when my baby brother was born 8 weeks early.  My mother had to have an emergency c-section when complications developed in her pregnancy and she went into premature labor.  After only a brief glimpse of her tiny new baby boy she watched as they whisked him away to be airlifted to a hospital with a Neonatal Intensive Care Unit that was adequate to meet his needs, over 2 hours away.  Luckily my brother only had to spend a week in that NICU before being transported back to our local hospital and their lesser equipped NICU.  I remember being so scared for my mom and for my little brother.  I remember how tiny he was, and how fragile he seemed.  I remember what it was like when he finally came home a few weeks later and wondering if his fight was over or if he would continue to struggle.  I remember my mom being so upset that she couldn’t breastfeed him because it wasn’t encourage with preemies back then.  I remember crying, a lot.  My brother is now 18 years old and you would never know he was born premature to look at him.  But I know it and now that I am older and know so much more about prematurity and what can happen I know how lucky we are to have him with us, how lucky we are that we didn’t learn the very worst about prematurity back then.  So, for him I fight for preemies, I march for babies, and I do what I can to spread the word.

I have seen so many people touched by prematurity both in my real life and through the blogging community.  I have seen those whose children fought and won and those whose children fought but sadly lost their fight. A former co-worker of mine delivered her daughter 12 weeks early.  She fought in the NICU for almost 3 months before finally being able to come home.  Today she is a happy, healthy 4 year old and her parents are so grateful for each moment they have with her because they know how close they came to having her here. Through the wonderful world of blogging I encountered and became friends with Heather Spohr.  I started reading Heather’s blog a little less than 2 years ago.  Through her stories about her life with Maddie, born 11 weeks early, I learned so much about prematurity and the long term effects it can have on a child and on the family.  As many of you probably know, Maddie Spohr, passed away unexpectedly on April 7th, she was just 17 months old.  Maddie was my inspiration for walking in my first ever March for Babies earlier this year and will continue to be my inspiration as I walk in future marches.  I just wish she was inspiring me from earth instead of from heaven.

What happened to Maddie and the Spohrs should never have to happen to any family.  Preemies (and their families) need our help.  They need us to fight for them so they don’t have to.  Visit the March of Dimes website to see what you can do to help Fight for Preemies.  Help them reach their goal of a future where every baby is born healthy and no baby has to fight for their life.

]]> http://www.letstalkbabies.com/2009/11/17/fight-for-preemies/feed/ 1 http://www.letstalkbabies.com/2009/08/07/ectopic-pregnancy/ http://www.letstalkbabies.com/2009/08/07/ectopic-pregnancy/#comments Fri, 07 Aug 2009 15:00:20 +0000 Lisa Mitchell http://www.letstalkbabies.com/index.php/?p=245 [Read the rest]]]> An ectopic pregnancy occurs when a fertilized egg implants outside of the uterus.  The egg can become implanted in the fallopin tubes, in the ovary, or in the cervix.  The most common form of ectopic pregnancy is when the egg implants in the fallopin tube, often referred to as a tubal pregnancy.  Ectopic pregnancies occur in about every 1 in 60 pregnancies.

Often a woman experiencing an ectopic pregnancy will experience all the regular early signs of pregnancy, however, they will often also experience a few other symptoms that would be red flags that something is wrong with the pregnancy.  These ectopic pregnancy symptoms include:

• Sharp or stabbing pain that may come and go and vary in intensity.
• Vaginal bleeding.
• Gastrointestinal symptoms.
• Feeling of weakness, dizziness or possibly fainting.

If you are experiencing any of the above symptoms along with regular early signs of pregnancy you should contact your doctor right away.

If your doctor feels that an ectopic pregnancy is possible he or she will conduct a few tests including a blood test to check your hCG levels (pregnancy hormone).  A low hCG level is an indication that something may be wrong with the pregnancy.  Your doctor will also conduct a pelvic exam to feel for any unusually lumps, tenderness or bleeding.  Some doctors also conduct a culdocentesis where a needle is inserted into the vaginal area behind the uterus to check for bleeding (a sign of a possible ruptured fallopian tube).

An ectopic pregnancy is not a viable pregnancy and must be treated to prevent injury or worse to the mother.  How your ectopic pregnancy is treated will depend on whether the pregnancy has already caused damage to your fallopian tube.  These are a few of the ways your doctor may treat your ectopic pregnancy:

• If your doctor has determined that no damage has been done to the fallopian tubes he or she will administer methotrexate a drug that will allow your body to reabsorb the pregnancy.
• If your fallopian tube has been damaged some or all of the fallopian tube will need to be removed.
• If your fallopian tube has ruptured and you are bleeding internally emergency surgery will be necessary to stop the bleeding and remove the fallopian tube.  Most doctors will try to preform this surgery with the less invasive laproscopic surgery if possible.

Be sure to talk with your doctor in detail about your symptoms and get all the correct tests done to make sure your ectopic pregnancy is probably diagnosed and treated.

There are several reasons that an ectopic pregnancy might occur.  Some of the most common causes are:

• An infection or inflammation in the fallopian tube that caused it to be partially or completely blocked.
• Scar tissue left behind from a previous infection or surgery that causes the movement of the egg to be impeded.
• An abnormality in the shape of your tubes that caused the eggs movement to be hindered.

Some women are at an increased risk of experiencing an ectopic pregnancy.  The common risk factors are:

• Over age 35.
• Have had a previous ectopic pregnancy.
• Have had pelvic or abdominal surgery in the past.
• Have or have had pelvic inflammatory disease (PID).
• Have had several induced abortions.
• Women who become pregnant after a tubal ligation or while using an IUD.

Talk to your doctor if you have any of the common risk factors to find out if there is anything you can do to help prevent an ectopic pregnancy.

You can become pregnant after an ectopic pregnancy provided at least one of your fallopian tubes is left intact.  Your chances of becoming pregnant are lower after an ectopic pregnancy, about 60%.

Please talk to your doctor if you have any questions or concerns and especially if you think you are experiencing an ectopic pregnancy.

Ectopic pregnancies can be caused by an number of things

So what are the signs of depression?  You may have depression if you experience some of the following for more than 2 weeks.

• Persistent sadness
• Loss of concentration
• Sleeping too much or too little
• Loss of interest in normally enjoyable activities
• Recurring thoughts of death, suicide or hopelessness
• Anxiety
• Feelings of guilty or worthlessness
• Changes in your appetite
• Loss of energy

Women with a personal or family history of depression are at greater risk of suffering from depression during pregnancy, however, there are other risk factors as well, including:

• Problems in your relationship with your spouse or partner
• You had infertility treatments to conceive the pregnancy
• Prior loss of pregnancy
• Stressful life events
• Pregnancy complications
• A history of trauma or abuse

As stated earlier, depression during pregnancy can cause harm to both the mother and the baby if left untreated.  There are many treatment options available to women.  Talk to your health care provider about your options and choose a treatment plan that works best for you.  Some of your treatment options include:

• Private psychotherapy
• Support groups
• Medication

There are medications that have been used during pregnancy with no adverse effects.  Talk to your doctor about what, if any medications are right for you.  You may want to try talk therapy first, or your depression may be severe enough to warrant immediately going on anti-depressants.  It is a good idea to involve the health care provider who is treating during your pregnancy, your therapist, and even your child’s future pediatrician in your care.  By involving all parties you can ensure the best treatment for you with the best outcome for both you and your baby.

The most important thing is to talk to someone about your symptoms and how you are feeling.  If you don’t feel comfortable talking to your doctor find someone who you trust and who can help you.  The longer your depression goes untreated the bigger the risk to you and your baby.

Sources and other helpful websites:

• American Academy of Pregnancy
• March of Dimes
• US Department of Health and Human Services

Always talk to your doctor about your back pain, especially if it is isolated to your lower back and seems to wrap around to your stomach as this can be a sign of premature labor.

Since back pain during pregnancy is pretty much guaranteed at some point or another the key is to finding a way to minimize the pain and manage it.  Here are a few tips for helping you prevent, manage and minimize back pain during pregnancy.

• Be aware of your posture.  Good posture during pregnancy is very important to minimizing and managing back pain.  Remember that you are carrying more weight out front now.  Watch your posture while sitting as well as standing.
• Wear supportive, non-restrictive clothing.  Invest in a supportive bra.  As your breasts grow you will need added support.  Also make sure your clothing fits well and doesn’t put any unnecessary pressure on your lower back.
• Invest in a maternity belt.  These belts help you carry the added weight of your growing belly.
• Wear comfortable, supportive shoes.  You may not be able to get away with those sexy little heels while you are pregnant!  Wearing comfortable shoes can make all the difference.  Your aching back, and feet, will thank you.
• Sleep on your side and use extra pillows to support your legs and belly.  There are special pregnancy pillow that wrap around your body to give you extra support.
• Put your feet up when you can to help take the pressure off your lower back.
• Get your husband involved by requesting a little back rub every now and then.
• Take a warm bath at the end of the day to help ease your aching back muscles before your head to bed.
• Consider getting prenatal massages.  These can be done throughout your pregnancy, after your first trimester.
• If you sit at a desk all day for work make sure you take plenty of breaks.  Get up and stretch and walk around.
• Talk to your doctor.

It can be difficult to deal with back pain when you are tired and sore all over.  By doing a few things to help prevent and minimize back pain you can make it a little easier to deal with.  When I was pregnant I found the way I slept made a huge difference, as did making sure I took plenty of breaks during the day to get up from my desk and stretch.  Find those things that work best for you.

During your mid-pregnancy ultrasound, usually done around 19 or 20 weeks, the doctor will determine where your placenta is lying.  If your placenta is low in the uterus, right next to or covering the cervix, your doctor will need to monitor your pregnancy more closely.  It is possible for the placenta to migrate into a more normal, higher, position later in the pregnancy so being diagnosed with placenta previa during your second trimester doesn’t necessarily mean you will still have placenta previa later in your pregnancy.  The placenta itself does not move, but as your uterus continues to expand it may end up further away from your cervix.  Only about 10% of women who are found to have placenta previa during their mid-pregnancy ultrasound still have it when they deliver their baby.

You will be scheduled for a follow up ultrasound so that your doctor can keep an eye on the location of your placenta, depending on if the placenta previa resolves itself or not you may have multiple ultrasounds throughout the remainder of your pregnancy.  If placenta previa persists your doctor will likely prescribe pelvic rest and you’ll be advised to take it easy, being especially careful to avoid any activities that may provoke vaginal bleeding.  Your doctor will monitor you for bleeding throughout the remainder of your pregnancy. If you do have bleeding or contractions you will be hospitalized so you can be monitored closely. With placenta previa you will not be able to deliver vaginally, which is why your doctor will want to keep an eye out for any signs of preterm labor.

Placenta previa can happen to any one, however, there are a few factors that increase your risk of placenta previa, they are:

• You are pregnant with multiples (twins or higher)
• You have previously had a c-section
• You have previously had uterine surgery (such as D&C or fibroid removal)
• You smoke
• You use cocaine
• You age and the number of kids you have had can also increase your risk

If you are diagnosed with placenta previa talk to your doctor about what that means for you, what you need to do to ensure a safe delivery, etc.  As stated above, placenta previa found earlier in pregnancy often resolves later in pregnancy, however, it may persist so your doctor will monitor you closely throughout your pregnancy so they can ensure they are on top of any complications that may arise.

Several studies have been conducted to determine the effect of caffeine on early pregnancy, however, previous research studies did not control for morning sickness (which often results in a reduced risk of miscarriage).  In this particular study they did control for morning sickness and found an increased risk of miscarriage based on caffeine consumption even among those women who reported having morning sickness in early pregnancy.

Not a lot is known about why caffeine causes an increased risk of miscarriage, however, it is thought that since caffeine crosses the placenta is affects cell development and may even impact the blood flow from mom to baby.

Doctors have long cautioned women against consuming too much caffeine during pregnancy, but didn’t really know how much was too much.  The results of the study seem to indicate that any amount of caffeine increases the risk of miscarriage, but that 200mg or more causes the greatest increased risk.  200mg of caffeine is equivalent to 2 cups of coffee, 4 caffeinated sodas, or 4 cups of tea.

I wasn’t a caffeine drinker before my pregnancy so it was easy for me not to consume any caffeine during my pregnancy.  Women who rely on caffeine to get them going in the morning are likely to have a harder time staying away from or reducing the amount of caffeine they consume during pregnancy.  A few things you can do to combat the exhaustion of the first trimester without turning to coffee are: get enough sleep (nap more, adjust your schedule so you can sleep more, etc), eat a healthy, balanced diet, and exercise.

Talk to your doctor about the results of this study and determine what you can do to reduce your own risk for miscarriage.

Now that I have had and passed my glucose tolerance test (no gestational diabetes for me) I thought I would share some of the information I learned from my experience and what the tests were like for me.  I have found that it is always better to have a little knowledge about what to expect than to go into a test blindly.

As with anything else you should always discuss your concerns, fears, and questions with your doctor.  They know your situation and pregnancy best and can advise you on the specifics for you.

Glucose Screening Test: In a majority of cases your prenatal care provider will send you for a glucose screening test some time toward the end of your second trimester (this is the time when gestational diabetes most often begins).  This may vary depending on your particular situation.  I had my glucose screening test done at 25 weeks.  This test does not require you to fast.  You will go into either your doctor’s office, the hospital, or a lab (I had mine done at Quest Diagnostics).  When you arrive you will be given a 50 gram serving of the glucose drink.  You will be asked to drink this glucose drink and let the phlebotomist know when you have finished at which time a timer will be set for 60 minutes.  You will have to sit around and wait, when 60 minutes has past your blood will be drawn.  I had one small vile of blood taken from my test and from what I understand this is pretty typical.  In my case the lab sent my results to my doctor’s office a few days later.  What is considered a high result on the glucose screening test will depend on what gauge your doctor uses.  Some doctors use 140mg/dl as the cut off while others use 130mg/dl.  If your test results are higher than the cut off you will be sent in for a glucose tolerance test.  The screening tells the doctor that you may be at risk for having gestational diabetes; however, it does not tell your doctor that you do indeed have gestational diabetes.  The screening test, like many other screening tests, results in a lot of false positives, which is why you will be sent in for the more accurate glucose tolerance test for a definitive answer.

Glucose Tolerance Test: This test will be ordered if you test high on the glucose screening or if you have blood in your urine before the screening test was done.  The glucose tolerance test is much more accurate and of course a much longer test.  This test takes 3 hours in most cases and requires you to fast prior to going in for the test.  You will be asked to fast for 8-12 hours prior to the test time (I was told 12 hours but I have seen information indicating that some women are told 8 hours).  When you arrive for the test your blood will be immediately drawn (again about one small vile), this is your fasting test.  You will then be given twice as much of the glucose drink as you were given at the screening test, 100 grams.  Again, you will be asked to drink the glucose drink and a timer will be set when you have finished the drink, this time to go off at 1 hour intervals for the next 3 hours. At each hour your blood will be drawn, for a total of 4 including the fasting test.

Here is what is typically considered abnormal results on the glucose tolerance test (check with your doctor to see what they use)

• Fasting: 95mg/dl or higher
• 1 Hour: 180 mg/dl or higher
• 2 Hour: 155 mg/dl or higher
• 3 Hour: 140 mg/dl or higher

If you have abnormal an result (which is considered high on two or more of the blood draws) on this test then you will be diagnosed with gestational diabetes and your doctor will work out a treatment plan with you.   Gestational diabetes is typically treated primarily with changes in diet and exercise.  If this does not work then other options such as medication or insulin injections will be considered.  You will be required to routinely test your blood sugar throughout the day to help monitor your condition.  Women who have gestational diabetes typically have larger than average babies.   Be sure to discuss any questions or concerns you have with your doctor.

One personal recommendation I can make is that you take a good book or something else to occupy yourself to both the screening test and the glucose tolerance test.  It can seem like you are there a very long time, especially at the glucose tolerance test which is 3 hours or more and you haven’t eaten anything in over 12 hours.

You can read my previous article on gestational diabetes for more information on causes, treatment, and possible complications associated with gestational diabetes.  You can also visit the American Diabetes Association website for more information as well.

Here are a few signs that may indicate a problem and should not be ignored.  If you experience any of these symptoms or others that you are concerned about you should immediately call your doctor.

• Your baby is not moving or is moving less frequently than normal
• Severe or persistent abdominal pain or cramping
• Vaginal bleeding or spotting
• An increase or change your vaginal discharge
• Pelvic pressure
• Pain or burning during urination, or a decrease in the amount of urine
• Severe or persistent vomiting, or any vomiting accompanied by a fever
• A fever above 100 degrees Fahrenheit
• Visual disturbances
• Persistent or severe headache
• Swelling of your face or hands, any sudden swelling of your feet, or rapid weight gain
• Persistent or severe leg cramps
• Fainting, frequent dizziness, or heart palpitations
• Difficulty breathing
• Chest pain
• Severe constipation accompanied by abdominal pain
• Diarrhea that lasts more than 24hrs
• Persistent and intense itchiness

As stated above these symptoms should not be ignored and you should call your doctor immediately if you experience any of them.  You should also call your doctor any time you are concerned or unsure about something you are experiencing.  It is always better to get checked out than to let something become a problem.

Babies born at or close to 37 weeks often have limited or no prematurity related problems, whereas babies born closer to 32 weeks (or earlier) often have prematurity related problems and require much more care.

So what causes a premature birth? There can be many causes of a premature birth, and sometimes the cause isn’t known at all, it just happens. A few of the more common causes of preterm birth include; placenta problems, a pregnancy of multiples, an infection in the mother, pregnancy complications, problems with the uterus or cervix, or drug and alcohol use during pregnancy.

If a baby is born premature it is often moved to a neonatal intensive care unit where it can be evaluated and then cared for based on its needs. The baby’s breathing and heart rate will be closely monitored, if it is not breathing well on its own it will likely be hooked up to a machine to help with its breathing. Premature babies often have trouble maintaining their body temperature and are put into special isolette beds that will help with body temperature control until they can do it on their own.

Each preemie is different and will require special care of varying degrees. Some babies will simply need to be monitored closely for a little while. Some babies will need to be hooked up to machines such as ventilators, feeding tubes, and IVs. Others will require surgery. Depending on how early your baby is born, what complications occur and whether or not your child has any birth defects will greatly impact on the type, degree and length of care needed.

Neonatal units are staffed with nurses and doctors that specialize in premature infant care. Be sure to ask questions and be involved in your baby’s care. Understanding what is happening, what is being done for your baby and why will help make it a lot easier to deal with. Hospitals often have psychologists that you can talk to about your feelings as well, which can be a big help too.

There are possible long term effects for preterm babies, such as physical and mental disabilities, blindness, hearing loss, brain damage and more. Talk to your baby’s neonatalogist to get the details of your child’s specific case and what to expect short term and long term.

Here are some helpful websites for more information on premature births.

• March of Dimes
• Prematurebaby.org
• Prematurity.org

(source: WebMD)

Here are few things symptoms that shouldn’t be taken lightly. 

• If you notice a change in how often your baby is moving.  A reduction in or a lack of movement can be a sign of a problem. 

• Severe and persistent abdominal cramping or tenderness, especially if accompanied by bleeding.

• Vaginal bleeding or spotting.  Some spotting is common during early pregnancy, however, it is a good idea to call you doctor anyway just to be safe.

• An increase or change in vaginal discharge.  If it becomes water, mucousy or bloody it can be a sign that labor will start soon.

• Pelvic pressure, lower back pain, menstrual-like cramping, or more than 4 contractions in an hour.  All are signs of labor.

• Painful or burning urination or a lack of urination.

• Severe or persistent vomiting, or any vomiting that is accompanied by a fever.

• Chills or a fever of 100 degrees or more.

• Visual disturbances such as double vision, blurring, dimming, flashing lights or spots in your field of vision.

• Severe or persistent headache or a headache accompanied by blurred vision, slurred speech or numbness.

• Any swelling in your face, more than a little swelling of the hands, severe or sudden swelling of the feet or ankles or rapid weight gain.

• Trauma to the abdomen.

• Fainting or frequent dizziness.

• Difficulty breathing or chest pains.

• Intense and persistent itching. 

If you experience any of these symptoms or anything else that concerns you call your doctor immediately.  You should always call your doctor if you have questions or concerns about something you are experiencing or feeling. 
 

(source: Baby Center)