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Pregnancy Complications

coffee

For many people, women and men alike, caffeine is absolutely essential to their day.  Going without their usual cups of coffee or tea or soda throughout the day is out of the question.  However, for pregnant women, or women trying to conceive, caffeine may not be safe.  You should talk to your doctor about your caffeine consumption early in your pregnancy and determine if you need to make changes.

Caffeine is a stimulant and a diuretic.  As a stimulant it elevates your heart rate and your blood pressure, both of which can have a negative effect on your pregnancy.  Also, as a diuretic caffeine causes your to urinate more frequently, affects your bodies ability to absorb calcium and iron and decreases your bodies fluid levels which can lead to dehydration.  Several studies suggest a link between caffeine consumption and an increase risk of miscarriage and preterm births.  Although there is no hard and fast rule when it comes to caffeine consumption during pregnancy most doctors recommend that you stay away from caffeine if you can, and if you must consume some caffeine you should limit your intake to less than 200mg (or about 2 regular cups of coffee) per day.

Many people forget all the things that caffeine can be found in and think mostly about coffee when thinking about caffeine.  However, caffeine is found in all sorts of products including coffee, tea, hot chocolate, lots of sodas, chocolate, ice cream and some pain relievers like Excedrin.  So when you are trying to avoid caffeine be sure to remember it is in a lot more than you think.

If you are a big coffee drinker be sure to talk to your doctor about his or her recommendations regarding caffeine consumption during pregnancy.  When we are caring for this tiny life growing inside of us we want to do everything we can to give it the best start to life.  Sometimes we have to give up the things we love during pregnancy, but it is all worth it.

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.

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

With summer right around the corner and temperatures already on the rise now seems like a good time to talk about beating the summer heat during pregnancy.  Most pregnant women will tell you that just being pregnant makes every thing feel hotter to begin with.  Even on a cool spring day (or a cold winter one) pregnancy often makes you feel like it is hot outside already.  Being pregnant in the summer can be very uncomfortable, especially if you are in the final months of your pregnancy.  Being uncomfortable already the added the hot summer heat to the mix will likely just make you feel down right miserable.  When I was pregnant with my daughter I spent my 5th – 7th months of my pregnancy battling the heat and humidity of a St. Louis summer.  It actually wasn’t as bad as some people had warned me it would be, but I definitely felt the heat more than usual.  I think the key to surviving the summer heat is to avoid spending too much time out in it and dressing to stay cool.

Surviving the heat of the summer while pregnant is possible.  All it takes is a little planning and some creativity.  Here are a few things you can do to survive the hot summer heat:

  • Wear cool, breathable, comfortable clothing.  Buy clothing that is light-weight, loose and breathes well.
  • Avoid spending a lot of time outside during the hottest part of the day.  Plan your errands and outdoor activities for the early morning or the evening when it is a little cooler.
  • Stay hydrated.  Drink lots of water.  Take water with you when you go out.
  • Don’t over do it.  It is important not to over do it while pregnant any way, but the heat makes it even more important to know your limits.
  • Exercise is important during pregnancy but exercising outside during a hot summer day is probably not a good idea.  Consider keeping your exercising inside where it is cool, or in the water.
  • Take the time to rest and put your feet up to avoid lower leg swelling.
  • If you are over heated take a quick, cool shower and lay down for a few minutes too cool down and relax.

The most important thing is to do what you can to stay cool and don’t over do it.  Staying hydrated is super important.  Being pregnant puts you at an increased risk of over exposure illnesses such as heat exhaustion, dehydration and heat stroke.  Doing your best to stay cool and avoid spending too much time in the heat and sun will help you avoid these heat and sun related illness.  If you have any concerns be sure to discuss them with your doctor.

What did you do to keep cool during the hot summer months of your pregnancy?  Any tips for other moms-to-be?

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.

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