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Pregnancy Complications

Infant mortality is a difficult subject to talk about.  No one wants to think about the bad things that can happen.  It is often easier to sugar coat the statistics and pretend like it is something that only happens to other people.  However, in order to combat problems like preterm births and stillbirths we have to talk about them.  We have give those tiny babies and their families a voice so that hopefully one day it won’t happen at all.

Globally, 13 million babies are born premature and approximately 3.2 million stillbirths occur.  Preterm birth accounts for approximately 1 million infant deaths yearly and is the leading cause of infant death worldwide.   Though preterm births and stillbirths are more common in low and middle income countries they are growing problems in higher income countries, like the United States.  In the US approximately 1 in 8 babies is born prematurely and the health care costs associated with preterm births accounts for more than $26 billion annually making it the 7th leading healthcare expense in this country.

The Global Alliance to Prevent Prematurity and Stillbirths (GAPPS) recently funded a study conducted by maternal and child healthcare experts from around the world that looked at the causes of both premature and stillbirths and the possible interventions that could be used to help combat preterm and stillbirths globally.  The study found that not enough is known, globally, about what causes most preterm and stillbirths and calls for action, particularly in the area of research.  The more people know the greater the chances of preventing both stillbirths and preterm births will be.

However, researchers lack access to quality tissue samples in order to conduct the research necessary to determine the most common causes of preterm and stillbirths and ultimately what measures can be taken to help prevent them.  As a result, GAPPS is partnering with hospitals, research labs, universities both here in the United States and around the world to establish a tissue repository.  The hope is collect a large cross sample of specimens from pregnant women and newborns from around the world so researchers have access to the date they need.

Infant death is a tragic and heartbreaking issue that we need to talk about, think about and address.   The more we know the better off our children will be.  I hope one day we know enough to prevent these tragedies from occurring so every pregnant woman will know the joy of holding her healthy infant in her arms and every baby gets the best start at life.

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.

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

Depression during pregnancy, or antepartum depression, affects 10-20% of women, and 25-50% of these women will suffer from major depression.  Antepartum depression, just like clinical depression, is a mood disorder.   It affects not only your mood and thoughts but your physical body as well.  Because of all the hormone changes during pregnancy and the mood swings women often experience it isn’t uncommon for depression to go unnoticed or undiagnosed.  Many women, their partners, and their health care providers may just attribute the mood changes to pregnancy hormones and leave it at that.  Depression during pregnancy can cause harm to both mother and baby so it should not be left untreated.  If you think you might be suffering from depression during your pregnancy be sure to talk to your health care provider.

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:

It is one of the most common symptoms during pregnancy, back pain.  The pain isn’t isolated to one part of the back.  Some women experience lower back pain, some middle back pain, others pain in their upper backs, and still others pain all over.  Lower back pain is the most common form of back pain during pregnancy, caused for the most part by our changing body.  As your pregnant belly grows the way you carry your weight, as well as how much weight you are carrying, changes.  This added pressure on your lower back understandably causes some pain.

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. Continue reading