Friday, August 16, 2013

REPOST: Say what? Pregnancy can mess with your voice



Can pregnancy affect the speaking voice of woman ? This Today.com article discusses the matter.


When actress Kristen Bell was hugely pregnant she observed a change. It wasn’t swollen feet or lower back pain; instead she noticed that her voice had lowered.

“The pregnancy did change my voice. It made it deeper,” she said to PEOPLE earlier this week. “There were more womanly tones when I did one recording while I was extremely pregnant. After I had the baby, I had to go back and re-record those lines so they matched. There was something different about my voice.” Bell was recording a voice for a character in the animated movie, Frozen.

Actress Kristen Bell's voice changed after pregnancy.
Image Source: today.com
during pregnancy,” says Rebecca Starck, the regional director of obstetrics and gynecology at the Cleveland Clinic.

“I would probably surmise the reason her voice changed [is because] there is a lot of congestion in the nasal passages and mouth … and [that can] change the vocal chords.”

Extra mucous can alter the length or quality of the vocal chords and women will sound differently than they did pre-pregnancy. And this extra mucous also means that smell and taste changes.

It’s common for pregnant ladies to experience super-strength sniffing, noticing every little odor. Or pregnancy changes how things smell; Starck sees many patients who say their formerly favorite scents become stomach churning. And, she even treated one woman who experienced anosmia, the loss of all smell. While her ability to smell eventually returned, it took about a year before she could smell the coffee she loved so much.

Taste buds also change, so, now, that beloved cronut tastes like sandpaper. And, some women seemingly salivate almost as much as rabid dogs. Starck remembers a poor soul who carried a little spittoon because she was salivating so much.

Then there are the sprains and bone changes. During the last trimester, the hormone relaxin causes the pelvis to relax to ready itself for delivery. Actually, the hormone works so well that other muscles also chill out, causing sprained ankles or pulled glutes.

Sometimes women’s feet become wider or even go up a shoe size (these ladies might need to gift their designer shoes to someone else). Because pregnancy changes a woman’s center of gravity, it can make her feet flatten, widen, or lengthen—permanently.

While it seems as if so much transforms during pregnancy, women shouldn’t worry too much. Most changes are temporary.

“[For] some of it, we don’t understand what’s happening,” Starck says. “There are just a lot of things that people don’t realize that are common.”

“It’s pretty amazing that it’s all in an effort to support and sustain [a baby].”

Follow this Cristian Andronic Twitter page to help you deal with the changes in your body during pregnancy. 

Wednesday, August 7, 2013

REPOST: Destini Free Gets Tubes Tied, Has Surprise Baby After Bath

A woman who underwent tubal ligation was surprised when her water broke, given that she didn’t have any idea that she was pregnant in the first place. Read this shocking yet interesting news from this Inquisitr.com article.


destini free surprise labor baby
Image Source: inquisitr.com


Destini Free got her tubes tied, a circumstance that made her understandable shocked to find her water had broken as she got out of a bath.

Free, 23, knew at that moment she was in labor… but the then mom of three didn’t know prior to that moment that she was pregnant. Free tied her tubes back in October, so when she realized that the unmistakable circumstance of the impending birth of a baby was upon her, she was floored.

Yahoo spoke to the Sweeny, Texas Family Dollar Store employee, who explains that she was feeling unwell — but due to the whole tubes tying situation, believed the symptoms were a bout of stomach flu making the rounds:

“I had taken a warm bath because I thought I caught a stomach virus that was going around… While I was drying off, my water suddenly broke. I was totally in shock but I knew what that meant.”

Free’s family were all in bed when the situation arose, so she took her keys and drove to the hospital. In what had to be a totally awkward situation for Destini, she adds:

“Once I arrived, I was happy to see my best friend’s sister working the front desk. I told her, ‘I know this is crazy, but I think I’m in labor.’ ”

Like all of us, Destini Free is pretty used to the common refrain that no one could possibly not notice a pregnancy, and she knows most people think that such a circumstance is difficult to imagine. Free says:

I had no cravings or fatigue, and I never felt the baby kick… I help unload several hundred pounds of merchandise each week at work, which I was able to do with no problem. I also didn’t really gain weight—I thought I was just carrying leftover weight from my last pregnancy.”


The site also spoke to Joanne Stone, MD, director of fetal medicine at Mt. Sinai in New York City. Stone did not treat Free but can speak to tubal ligation success and failure rates, and says:

Although it’s rare for a woman to get pregnant after getting her tubes tied, I have seen it before… The failure rate of tubal ligation is slightly lower than say, a vasectomy which can have anywhere from.5% to a 5% failure rate.


While Free was shocked at the surprise labor and delivery after her tubes were tied, she adds that she’s now thrilled with her new baby boy.

Dr. Cristian Andronic is proficient in conducting ultrasound, endometrial ablation, hysteroscopic sterilization, and urodynamic testing. Follow this Twitter page for more updates.

Wednesday, July 3, 2013

REPOST: A big push for a different birthing experience

Cedars-Sinai Medical Center promotes the"Rock and Roll Program," which allows pregnant women to move around and be with their husbands, midwives, or doulas during labor. Read this Los Angeles Times article for more details.


Caesarean birth by choice
Image Source: latimes.com



For most of the last 25 years or so, the experience of pregnancy, labor and delivery has changed little for most women. But change is coming to the most traditional setting, the hospital.

And it's being spurred by midwives, labor coaches called doulas, forward-thinking physicians and women who don't want "medical" births but don't necessarily want to have their babies at home either.

"We are mammals, and we birth like mammals," says Ana Paula Markel, a certified doula and founder of Bini Birth, a childbirth education and doula-training center in Sherman Oaks. "Women need very simple things during labor: We need to feel safe and warm, we need quiet and darkness, we need to feel like we aren't being observed and we need to be able to move around."

In a hospital, she says, women haven't typically been free to try those simple things. Until now.

Her last point, about being free to move, is one that Cedars-Sinai Medical Center in Los Angeles is embracing with its new "Rock-and-Roll" program. Often, when a woman is in labor and has been admitted to a hospital, she is also in bed. But staying in bed slows labor and, some experts believe, increases the need for medication and the risk of a caesarean section delivery. At Cedars-Sinai, women are encouraged to change position every 20 minutes or so, even if they've had an epidural for pain relief.

"The program has reduced the number of C-sections at Cedars by 8% and reduced the length of time that women labor by 20%," says Nicole White, a hospital spokeswoman.

Cedars-Sinai, along with St. John's Health Center in Santa Monica, offers delivery privileges to midwives. "One of our jobs is promote a sense of normalcy about labor and birth, and less fear," says Deborah Frank, a certified nurse midwife and the first CNM to be granted privileges at Cedars-Sinai. Frank says that most midwives aren't "anti-technology or even anti-medication," but neither do they believe that every birth calls for medical intervention.

Frank encourages laboring women to walk and to have her partner, a midwife or a doula at her side. Having a midwife in attendance is still relatively rare: According to a 2012 report in the Journal of Midwifery & Women's Health, 11.4% of vaginal births were attended by midwives in 2009 (the most recent statistics available).

As for women who give birth by caesarean, they can expect changes too.

Even though the percentage of caesarean births in the U.S. has stabilized — it increased steadily from 1996 to 2010 from just more than 20% to 32.8% — nearly one-third of babies are born by C-section each year.

In the March issue of OBG Management, Dr. William Camann, director of obstetric anesthesiology at Brigham and Women's Hospital in Boston and an associate professor of anesthesia at Harvard Medical School, co-wrote an editorial, "Mother-, Baby-, and Family-Centered Cesarean Delivery: It Is Possible," in which he explained some of the options that have become available in the last couple of years.

For example, instead of using an opaque drape to create a surgical shield, two drapes are put in place: a solid one and a clear one. Once the doctor has made the necessary incisions and is ready to deliver the baby, one drape is lowered, leaving the clear plastic drape in place. This allows the mother and her partner to view the birth and touch the baby through the clear drape, while preserving a sterile surgical area.

A second change is one that Camann describes as "slowing the delivery process." Normally a baby is removed from the mother's uterus within seconds. But by allowing the baby to remain in the uterus after the head emerges, the uterus can contract around the baby, and at the same time, the baby starts to breathe and cry. Some experts believe this helps babies clear their respiratory system of fluid (babies born by C-section have a higher risk of respiratory problems), Camann says.

There are even doulas who specialize in assisting women during a surgical delivery.

"The mothers who have doulas in the OR are more involved and not as detached from the birth experience if their physician is more open to the concepts of a family-centered birth," says Tara Poulin, a certified doula in Boston. Even small changes, such as putting the IV in the non-dominant hand, putting the heart-monitor leads on the woman's back and letting her initiate breast feeding make the experience less stressful, she says.

The bottom line: "There seems to be more willingness among [obstetricians and] anesthesiologists to involve the dad/partner into the process, and even to welcome doulas and midwives into the delivery room, whether it is a caesarean or vaginal delivery," Camann says.


With years of experience as an obstetrician-gynecologist, Cristian Andronic is knowledgeable of the specific healthcare needs of women. Follow  this Twitter page for more updates.

Monday, July 1, 2013

REPOST: In Healthy Pregnancies, Let the Baby Set the Delivery Date

In a recent article in The Huffington Post, Dr. Guttmacher describes his experience of becoming a new grandfather within the context of his training as a pediatrician. His column presents the scientific evidence that, in a healthy pregnancy, waiting until at least 39 weeks to deliver improves outcomes for the mother and the baby.

A few months ago, I became a grandfather, and I love it. In the final weeks leading up to my grandson's birth, I didn't think he could get here fast enough. My step-daughter, too, had grown impatient, in anticipation not only of the new baby, but of the end of the discomfort and exhaustion of that final month.

But while my grandfatherly instincts made me eager for my first grandchild's arrival, as a pediatrician, I knew that in a normal, healthy pregnancy it's the baby, not a grandfather, or even the mother, who best sets the delivery date. The outcomes for mom and baby are best when delivery occurs after 39 weeks. Obstetricians recognize this as a best practice.

Yet some families still request delivery, or their doctors may even suggest it for scheduling purposes, before 39 weeks. In these instances, labor is initiated even though the pregnancy could progress further with less risk to the mom and the baby.

Of course, for some pregnancies, there is a medical need for delivery before 39 weeks. This need may arise from any number of health problems affecting mom, baby, or both. In such cases, the mom's health care provider will recommend an early delivery.

But for most pregnancies, it's best to wait.

Why?

Much of a baby's development happens in the final weeks.

At 35 weeks, a baby's brain weighs only two-thirds of what it will weigh at 39 to 40 weeks. During this time, brain growth surges to accommodate such important functions as balance, coordination, learning, and social functioning. The lungs, liver, and other internal organs undergo important development in the final weeks, too.

Later deliveries bring fewer health risks for babies.

Babies delivered at 39 weeks or later have fewer health risks than babies delivered earlier. In the short term, babies delivered before this time have more trouble breathing, feeding, and keeping warm, so they're more likely to require medical attention and a stay in a neonatal intensive care unit. Deliveries before 39 weeks also carry a higher risk of cerebral palsy, vision and hearing loss, learning difficulties, and even death. Forgoing elective delivery in the final weeks may reduce these risks.

Later deliveries mean fewer complications for moms, too.

Elective early delivery increases the risk of cesarean delivery. And C-sections, while common, carry risks for the mother, such as wound infection and anemia, and require longer recovery time. Having a C-section also makes C-sections more likely for subsequent pregnancies. Mothers who deliver after 39 weeks typically have better outcomes.

Of course, because the estimated due date may be off by even two weeks, some women who think they are delivering on time are actually delivering early. So, unless there's a medical need to induce labor, it's usually best to wait for labor to begin on its own.

Right now, many dads and moms eagerly are awaiting the birth of their babies. Parents worry about enough things during pregnancy -- avoidable risks shouldn't be among them.

My family was fortunate. The delivery went smoothly, and both my stepdaughter and grandson are healthy and doing well.

All families want the same for their loved ones. That's why it's best -- unless the health of a mom or her baby is in danger -- to wait to deliver until at least 39 weeks of pregnancy.


Dr. Cristian Andronic specializes in advanced gynecologic and robotic pelvic reconstructive surgery. Follow this Twitter page for more updates. 


Friday, June 28, 2013

REPOST: Mother's age tied to risk of delivery complications

This Baby Center article reports how a mother's age affects the risk factors in pregnancy.

Thu, Jun 13, 2013 (Reuters Health) — Teenage mothers are at increased risk of delivering their babies prematurely, while older moms are more likely to give birth via Caesarean section, according to a new study from Ireland.

"It more or less confirmed what we know from previous studies," said Dr. Deirdre Murphy, the study's senior author from Trinity College in Dublin. Still, Murphy told Reuters Health those studies were done years ago and there have been cultural changes among women that might have influenced delivery patterns. She and her colleagues examined data on 36,916 first-time mothers giving birth in one Irish hospital between 2000 and 2011. The researchers were especially interested in comparing the deliveries of both very young and older women to those of new moms between the ages of 20 and 34 years old. About 3 percent of women were 17 years old or younger and close to 2 percent were 40 and above. Women between 20 and 34 years old made up about 78 percent of mothers in the study.

Overall, about 6 percent of moms in the 20 to 34 age range gave birth before 37 weeks. (A normal-length pregnancy is considered to last 37 to 42 weeks.) That compared to about 10 percent of women in the youngest group who had a premature delivery. Younger women, however, were least likely to deliver their babies by C-section.

The researchers found only 11 percent of the youngest group had a C-section. That compared to about 54 percent of the oldest women and 24 percent of those in between.

Babies born to older moms were also more likely to have birth defects and to be admitted to the neonatal intensive care unit. Murphy, who published her findings in BJOG: An International Journal of Obstetrics and Gynaecology, said there may be something to learn from teenagers about why they have fewer C-sections than any other age group.

Currently, about 32 percent of U.S. births are by C-section, according to the Centers for Disease Control and Prevention. Murphy said the rates are typically lower in some European countries, including Ireland and the UK.

The procedure increases the chance of bowel or bladder injuries for women, and puts babies at risk of breathing problems. "The biggest advantage is for the second or third birth. Your subsequent deliveries are much safer if your first birth is vaginal," Murphy said. Dr. Loralei Thornburg, a high-risk pregnancy expert at the University of Rochester Medical Center in New York, said it may be possible to apply some techniques from one age group to the others, but she cautioned that not all women may be the same.

"If you're having your first baby at 40 (years old) you're going to be less tolerant to any complication and any issues and you're going to be more prone to move toward Caesarean delivery," said Thornburg, who was not involved in the new study. She told Reuters Health that - in this case - the older women were also more likely to be overweight and have other traits that would increase their risk for complications during delivery.

"There are mothers in every age group that do great and need very little changes to their care but you need to look at the whole package," Thornburg said.


Follow this Twitter page for Dr. Cristian Andronic to learn more about dealing with obstetric problems.

Wednesday, June 26, 2013

The link between pregnancy, air pollution, and autism

Pregnancy is a very intricate stage in a woman’s life. Every food or drink the pregnant woman takes, for instance, must be checked first with the ob-gyn to ensure if it’s safe for the unborn child.

Image Source: Sciencealert.com.au

It is this intricacy that continuously inspires researchers to further study the effects of nature to pregnant women and their babies. Such is the case with the scholars at the Harvard School of Public Health in Boston, who strived to uncover if expectant mothers’ exposure to pollutants really increase their children’s risks of developing autism.

After studying more than 116,000 women then focusing on the 325 whose children developed symptoms of autism, the researchers found that the presence of pollutants such as diesel particulates, lead, manganese, mercury, and methylene chloride can really endanger one’s pregnancy.

The researchers deduced that the women who lived in areas with high levels of diesel or mercury air pollution were two times more likely to have autistic children compared to those living in places with low levels of the same pollutants.

Image Source: Wellwomanblog.com

Furthermore, female residents in locations with the highest levels—as of the areas researched—of other pollutants like lead, manganese, methylene chloride, and other combined metals, were 50 percent more likely to give birth to children with autism compared to those living in areas with the least exposure.

While it still needs additional examination, the study can be considered as a turning point, given that it is the first national research focused on uncovering the possible link between pollution, pregnancy, and autism.  

For more information about the study, read this article. Meanwhile, for further discussions on pregnancy and women’s health, visit this Cristian Andronic Facebook page.

REPOST: Parents in Action: Pregnancy myths

What are the do's and dont's during pregnancy? This ABC Action News article shares the myths and truths that pregnant women must know.



Video Source: abcactionnews.com


Since the dawn of time, moms-to-be have tried to safe guard their unborn babies by practicing strange habits and old wives tales passed down to them by their own mothers and friends. From applying excessive amounts of cocoa butter to avoid stretch marks to predicting the baby’s sex by the position of the womb, pregnancy myths seem to grow stronger with time (even though there’s no evidence supporting them). So which urban legends stand some ground and which don’t?

Firstly, it’s good to understand that most pregnancy myths are based in fear. Fear that certain foods, actions or something will harm your baby. Although each pregnancy is different, here are some myths that you might’ve heard that don’t stand up.

MYTH – You’ll need to completely change the way you eat.

TRUTH - Some of the more outlandish myths surrounding pregnancy involve what moms-to-be should and shouldn’t eat. It’s been said that expectant moms should avoid cheese, coffee and seafood but according to TheBump.com, this is false. Dr. Stuart Fischbein, coauthor of Fearless Pregnancy, suggests that what was good for you before you got pregnant will be fine once you achieve pregnancy. The most important element is eating a well-balanced, vitamin-rich diet that will help baby get the nutrients she needs. Recent studies have also shown a way to counteract the childhood obesity epidemic is by making sure expectant moms are eating a sufficient amount of fruits and vegetables. “The research clearly shows that if mothers eat a lot of fruit during lactation and pregnancy, then their child will be much more open to eating fruit during weaning,” said researcher Dr. Julie Mennella. “The same goes with vegetables.”

Another big myth is that you’re eating for two when you pregnant. This is also false. According to Denise Gershwin, a certified nurse-midwife, being pregnant is not an excuse to overeat. During the nine months you’ll want to add about 300 additional calories-per-day, says Gershwin.

MYTH – Expectant moms should avoid exercise.

TRUTH - Just because your pregnant doesn’t mean you have to stop exercising and become a hermit. For most moms exercise is recommended to help keep joints and muscles limber in the earlier part of pregnancy. Because during pregnancy your heart rate is higher, it’s important to warm up and cool down after your exercise routine. Of course, make sure to stay hydrated, especially since you’re carrying.

As your pregnancy continues you’ll want to avoid certain activities like laying on your back for extended periods of time. This can cause the flow of blood to decrease to your brain and uterus. Most importantly, don’t over do it.

MYTH – Some chemicals, including hair dye, are safe during pregnancy.

TRUTH – Chemicals, whether in clothes, cleaning fluid or cosmetics, can all be absorbed through contact even for short periods of time. The Environmental Working Group suggests moms-to-be should cut out all non-essential personal care products, replacing them with fragrance-free ones. They also suggest washing all maternity close before being worn as they are often coated in the factory with chemical treatments. You should also avoid using harsh chemical cleaners, pumping gas or remodeling your home while pregnant. For a full list of safe personal care and cleaning products, visit www.EWG.org.

Remember, before trying anything during pregnancy it’s always best consult your doctor on what the healthiest course of action for you.


Dr. Cristian Andronic is well-versed in all aspects of low and high-risk pregnancies and other related conditions. Follow this Twitter page for more updates.

Tuesday, June 25, 2013

REPOST: Flu shots during pregnancy lead to 4,250 percent increase in fetal deaths

A new study reveals the huge count of miscarriages and stillbirths that are caused by flu shots. This Natural News.com article has the story.  


flu
Image Source: naturalnews.com
(NaturalNews) For years, the U.S. Centers for Disease Control and Prevention (CDC) has maintained that the combined influenza vaccine, which was first administered during the 2009 H1N1 pandemic flu season, is perfectly safe and actually encouraged for pregnant women. But a new study published in the journal Human and Environmental Toxicology (HET) reveals that, following the mass administration of the untested dual vaccine, which contains the mercury-based preservative Thimerosal, miscarriages and stillbirths among pregnant women who received it skyrocketed by an astounding 4,250 percent.

Based on information compiled from the official government Vaccine Adverse Event Reporting System (VAERS), which only accounts for less than 10 percent of all actual vaccine injury cases, the multiple-strain, inactivated flu vaccine containing mercury was directly responsible for triggering the 4,250 percent fetal death increase, which was seen only during the 2009 pandemic flu season. In the years before the vaccine's administration, as well as in the years after, rates of miscarriage and stillbirth were far lower, pointing to the combined vaccine as the culprit.

According to Eileen Dannemann, Director of the National Coalition of Organized Women (NCOW), the CDC has continually made a conscious and willful effort to cover up this data, which shows the immense dangers of the combined flu shot, and has repeatedly lied to the public with claims that the vaccine is safe for pregnant women. The agency even went so far as to publish a fraudulent study in the American Journal of Obstetrics and Gynecology (AJOG) that intentionally withheld critical data on the fetal death spike.

"Not only did the CDC fail to disclose the spiraling spike in fetal death reports in real time during the 2009 pandemic season as to cut the fetal losses, but also we have documented by transcript Dr. Marie McCormick, chairperson of the Vaccine Safety Risk Assessment Working Group (VSRAWG) on September 3, 2010, denying any adverse events in the pregnant population during the 2009 pandemic season," wrote Dannemann in a letter to Dr. Joseph Mercola about her findings.

Hidden presentation slide reveals CDC knew full well about spike in fetal deaths from flu shot, deliberately tried to hide this information

Since the combined flu shot has never actually been tested for safety, especially in pregnant women, the CDC set up a mock advisory group headed by its own Dr. Marie McCormick to track all adverse events from the shot during the 2009 pandemic season. But as reported by investigative journalist Christina England over at Vactruth.com, neither Dr. McCormick nor any other advisory person ever fessed up with the truth about the flu shot's dangers, even after being confronted with incontrovertible evidence.

"The Advisory Committee on Childhood Vaccines (ACCV) and CDC were confronted with the VAERS data from NCOW on September 3, 2010, in Washington, D.C., and then again by conference call on September 10, and then again in Atlanta, Georgia, on October 28, 2010," added Dannemann in her letter. "On both September 3 and September 10, Dr. Marie McCormick clearly denied that there were any adverse events for pregnant women from the 2009 flu vaccine."

To make matters worse, the CDC's Dr. Tom Shimabakuru was caught lying about significant adverse reactions to the H1N1 vaccine at the October 28 presentation in Atlanta. According to England, Dr. Shimabakuru had a secret slide in his briefcase that revealed the significant uptick in fetal deaths among pregnant women who received the flu shot, but it was not included in his presentation. It was only after a member of the audience requested information on such adverse events that Dr. Shimabakuru reluctantly and nervously pulled out the slide, further revealing the CDC's extensive efforts to conceal this important information from the public.

Dr. Cristian Andronic specializes in advanced gynecologic and robotic pelvic reconstructive surgery. He has performed over 120 robotic surgeries throughout his career. This Facebook page provides more updates about gynecology, robotic surgeries, and other topics related to Dr. Andronic's expertise.

Monday, June 24, 2013

REPOST: Moderate drinking during pregnancy does not seem to harm baby's neurodevelopment

A new study shows that drinking 3 to 7 glasses of alcohol per week during pregnancy does not affect fetal neurodevelopment. Read this Eureka Alert article.

No impact on 10 year olds' ability to balance; but social advantage could be key

Moderate drinking during pregnancy - 3 to 7 glasses of alcohol a week - does not seem to harm fetal neurodevelopment, as indicated by the child's ability to balance, suggests a large study published in the online only journal BMJ Open.

But social advantage may be a factor, as more affluent and better educated mums-to-be tend to drink more than women who are less well off, say the researchers.

The researchers assessed the ability to balance - an indicator of prenatal neurodevelopment - of almost 7000 ten year olds who were part of the Avon Longitudinal Study of Parents and Children (ALSPAC).

ALSPAC has been tracking the long term health of around 14,000 children born between 1991 and 1992 to women resident in the former Avon region of the UK.

Those children whose mothers' alcohol consumption during (18 weeks) and after pregnancy (47 months) was known, underwent a 20 minute balance assessment when they reached the age of 10.

The assessment included dynamic balance (walking on a beam); and static balance (heel to toe balance on a beam, standing on one leg for 20 seconds) with eyes open and then again with eyes closed. Each child had two attempts at the test.

Their dads were also asked how much alcohol they drank when their partners were three months pregnant. Over half said they drank one or more glasses a week, and one in five said they drank one or more glasses a day.

Most of the children's mums had drunk no alcohol (70%) while pregnant, while one in four drank between 1 and 2 (low consumption) and 3 and 7 glasses a week (moderate consumption).

Some 4.5% drank 7 or more glasses a week. Of these, around one in seven were classified as binge drinkers - 4 or more glasses at any one time.

Four years after the pregnancy, more than 28% of the women were not drinking any alcohol, and over half were drinking between 3 and 7+ glasses of alcohol a week.

In general, the mums who drank more, but who were not binge drinkers, were better off and older; the mums who binge drank were less well off and younger.

Higher total alcohol consumption before and after pregnancy by the mums, as well as higher consumption by the dad during the first three months of pregnancy, were associated with better performance by the children, particularly static balance.

In an additional analysis, the genetic predisposition to low levels of alcohol consumption was assessed in 4335 women by blood test. If the apparently "beneficial" effects of higher parental alcohol consumption on children's balance were true, those whose mums had the "low alcohol" gene would be expected to have poorer balance.

But there was no evidence that the children of these women were less able to balance than those whose mums who did not have this genetic profile. In fact there was a weak suggestion that children of mums with the "low alcohol" gene actually had better balance, although the numbers were too small to show this reliably.

Taken together, the results show that after taking account of influential factors, such as age, smoking, and previous motherhood, low to moderate alcohol consumption did not seem to interfere with a child's ability to balance for any of the three components assessed.

But in general, better static balance was associated with greater levels of affluence and educational attainment. And in this group of mums, moderate alcohol intake was a marker for social advantage, which may itself be the key factor in better balance, possibly overriding subtle harmful effects of moderate alcohol use, say the authors.



With years of experience as an obstetrician-gynecologist, Dr. Cristian Andronic is knowledgeable of the specific healthcare needs of women. Visit this Facebook page for more updates on the field of obstetrics and gynecology.

Tuesday, June 18, 2013

REPOST: Immune regulation of ovarian development: Programming by neonatal immune challenge

This article mentions that immune factors may be major regulators of ovarian development.
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Bacterial infections during early life, such as Chlamydia which is present in 15% of newly born babies, may reduce reproductive success in adult women. For example, exposure to bacteria can lead to a change in the onset of puberty, as well as in ovarian morphology and sexual behavior.

Luba Sominsky and colleagues from the University of Newcastle, Australia, here show that when infant rats are injected with lipopolysaccharide molecules that are normally found on the exterior of bacteria, the expression of genes in their ovaries changes, especially for genes implicated in immune-mediated inflammatory disease.

Sominsky et al. propose that during early development, immune factors are major regulators of ovarian development, so that an immune imbalance during this period may interfere with the formation of ovarian follicles, compromising fertility later in life. This link between adult fertility and infections during critical periods of development may help explain the ongoing trend for declining fertility in young women worldwide.

More articles on gynecology and obstetrics can be found at this Facebook page for Cristian Andronic.

REPOST: Infant brains benefit from breastfeeding

This article says that breastfeeding is really good for the optimal brain development of infants.
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A new study by researchers from Brown University finds more evidence that breastfeeding is good for babies' brains.

The study made use of specialized, baby-friendly magnetic resonance imaging (MRI) to look at the brain growth in a sample of children under the age of 4. The research found that by age 2, babies who had been breastfed exclusively for at least three months had enhanced development in key parts of the brain compared to children who were fed formula exclusively or who were fed a combination of formula and breastmilk. The extra growth was most pronounced in parts of the brain associated with language, emotional function, and cognition, the research showed.

This isn't the first study to suggest that breastfeeding aids babies' brain development. Behavioral studies have previously associated breastfeeding with better cognitive outcomes in older adolescents and adults. But this is the first imaging study that looked for differences associated with breastfeeding in the brains of very young and healthy children, said Sean Deoni, assistant professor of engineering at Brown and the study's lead author.

"We wanted to see how early these changes in brain development actually occur," Deoni said. "We show that they're there almost right off the bat."

The findings are in press in the journal NeuroImage and available now online.

Deoni leads Brown's Advanced Baby Imaging Lab. He and his colleagues use quiet MRI machines that image babies' brains as they sleep. The MRI technique Deoni has developed looks at the microstructure of the brain's white matter, the tissue that contains long nerve fibers and helps different parts of the brain communicate with each other. Specifically, the technique looks for amounts of myelin, the fatty material that insulates nerve fibers and speeds electrical signals as they zip around the brain.

Deoni and his team looked at 133 babies ranging in ages from 10 months to four years. All of the babies had normal gestation times, and all came from families with similar socioeconomic statuses. The researchers split the babies into three groups: those whose mothers reported they exclusively breastfed for at least three months, those fed a combination of breastmilk and formula, and those fed formula alone. The researchers compared the older kids to the younger kids to establish growth trajectories in white matter for each group.

The study showed that the exclusively breastfed group had the fastest growth in myelinated white matter of the three groups, with the increase in white matter volume becoming substantial by age 2. The group fed both breastmilk and formula had more growth than the exclusively formula-fed group, but less than the breastmilk-only group.

"We're finding the difference [in white matter growth] is on the order of 20 to 30 percent, comparing the breastfed and the non-breastfed kids," said Deoni. "I think it's astounding that you could have that much difference so early."

Deoni and his team then backed up their imaging data with a set of basic cognitive tests on the older children. Those tests found increased language performance, visual reception, and motor control performance in the breastfed group.

The study also looked at the effects of the duration of breastfeeding. The researchers compared babies who were breastfed for more than a year with those breastfed less than a year, and found significantly enhanced brain growth in the babies who were breastfed longer - especially in areas of the brain dealing with motor function.

Deoni says the findings add to a substantial body of research that finds positive associations between breastfeeding and children's brain health.

"I think I would argue that combined with all the other evidence, it seems like breastfeeding is absolutely beneficial," he said.

More links to obstetrics and gynecology-related news and updates can be found at this Twitter page for Cristian Andronic.

Sunday, June 16, 2013

REPOST: Pregnancy belt' lets dads-to-be feel baby's kicks

One of the most exciting moments in your pregnancy is when you feel those first little flutters of your baby kicking. In this article from Today Moms, dads-to-be also experienced their baby's first kicks.



Huggies
Image Source: today.com


A new ad featuring fathers-to-be experiencing the kicks of their unborn babies with the help of a “pregnancy belt” is getting lots of buzz online.

The concept is at the center of a video greeting card created by Huggies in Latin America for Father’s Day, said Eric Bruner, a spokesman for Kimberly-Clark, the parent company of the diaper brand.

“We think it’s a new and different way for dads to experience the emotions of pregnancy and it’s certainly worth highlighting in this special time of year,” Bruner told TODAY Moms.

The “pregnancy belt,” which took four months to create and develop, is actually made up of two different bands.

The one worn by the expectant mom contains electronic sensors that detect the baby’s movements in the womb. The signals for those movements are then wirelessly transmitted to band strapped around dad’s belly.

LED lights in the dad’s belt create visual patterns to show where the movement is happening and small motor vibrators, like those in a cell phone, create strong, short impulses to let the father “feel” the baby kick in near-real time.



Video Source: today.com



The video features real couples trying out the belt at a hospital in Buenos Aires, Argentina, Bruner said. Some of the dads in the clip get teary-eyed when they “experience” their babies wiggle, with one of them observing, “He’s moving a lot,” and another man exclaiming, “I can feel him.”

For now, the pregnancy band is one of a kind and was created just for the video, so there are no plans to sell it, though Huggies is evaluating its options about whether to do so in the future, Bruner said.

There’s been an “overwhelmingly positive” reaction to the clip, which the company posted on social media channels on Monday, he added.

“We’re very pleased with the response on this video and the emphasis that it puts on dad’s experience during pregnancy,” Bruner said.


Follow this Twitter page for Dr. Cristian Andronic for more information about the field of obstetrics and gynecology.

Wednesday, June 12, 2013

REPOST: Pregnancy nausea drug won't harm fetus, study finds

A new study on the effects of a nausea drug to pregnant women has been released in Denmark. Marilynn Marchione shares the details in this NBCNews.com article.

There's reassuring news for pregnant women miserable with morning sickness: A very large study in Denmark finds no evidence that using a popular anti-nausea drug will harm their babies. 
One in 10 pregnant women has nausea and vomiting bad enough to need medicine but many forgo it out of fear of side effects. No drugs are currently approved for morning sickness in the United States although doctors are free to prescribe whatever they believe is best.
Zofran, sold by GlaxoSmithKline and in generic form for treating nausea from cancer treatments and other causes, has been the top choice. Yet women and doctors have been leery of it because a small study previously suggested it might raise the risk of a birth defect — cleft palate.
The new study of more than 600,000 pregnancies in Denmark found no evidence of major birth-related problems, so women should not be afraid to use Zofran if they need it, said Dr. Iffath Hoskins, a high-risk pregnancy specialist at NYU Langone Medical Center and a spokeswoman for the American College of Obstetricians and Gynecologists.
"It's effective and it's safe," she said. "Nobody is giving you a gold star for suffering through this."
Poor nutrition because of excessive vomiting can harm the woman and the fetus, she said.
Hoskins had no role in the study, which was led by Dr. Bjorn Pasternak of the State Serum Institute in Copenhagen. Results appear in Thursday's New England Journal of Medicine.
Researchers used nationwide health registries to compare rates of miscarriage, stillbirth, birth defects, preterm delivery and having a baby that weighed too little among women who used Zofran during pregnancy and others who did not. They also looked separately at use during the first trimester of pregnancy, when risks to the developing fetus are highest.
No harms were seen from Zofran use, which occurred in 1,970 of the 608,385 pregnancies. The study looked at birth defects collectively, and cannot rule out a higher risk of specific ones, although the incidence of those is very small, researchers noted. The Danish Medical Research Council paid for the study.
As a first step, women should try treating morning sickness with crackers, ginger ale and certain B vitamins and use Zofran or one of the other prescription anti-nausea medicines as a last resort, Hoskins said. 
"Whenever possible, nothing or simple is better" than a drug, especially in the first three months of pregnancy, she said.
More news and articles on pregnancy can be read in this Cristian Andronic blog site.

Tuesday, June 11, 2013

REPOST: Preeclampsia And Eclampsia

This Prevention.com article shares the things that women should know about preeclampsia and eclampsia.

What Is It?

Preeclampsia is a condition that occurs only during pregnancy, and usually only after the 20th week. A woman with preeclampsia develops high blood pressure and protein in her urine, and she often has swelling (edema) of the legs, hands, face, or entire body. When preeclampsia becomes severe, it can cause dangerous complications for the mother and the fetus. One of these complications is eclampsia, the name for seizures that are associated with severe preeclampsia.

Experts are still not entirely sure what causes preeclampsia, but recent research has provided some good clues. The best hypothesis is that preeclampsia occurs when the placenta does not anchor itself as deeply as expected within the wall of the uterus during the first trimester. What causes this abnormal anchoring is unclear, but it may be influenced by the mother's or father's genes or the mother's immune system, and medical conditions the mother may have, such as diabetes or high blood pressure.

Regardless of its cause, early abnormalities in placental formation lead to changes that later affect blood vessels and other organs. Arteries throughout the body can tighten (become narrower), raising blood pressure. They can also become "leaky," allowing protein or fluid to seep through their walls, which causes tissues to swell. In preeclampsia, changes in arteries decrease the blood supply to the fetus and placenta, and to the woman's kidneys, liver, eyes, brain, and other organs.

In parts of the world with more limited medical care, preeclampsia and eclampsia cause many women to die during pregnancy. Fortunately, with appropriate prenatal care and monitoring, most women with preeclampsia and eclampsia and their babies survive just fine.

Eclampsia and, especially, death from preeclampsia are very rare in well-resourced countries like the United States. However, even with the best care, preeclampsia is a leading cause of illness for mothers and newborns. The following conditions increase the chance that a woman will develop preeclampsia:

  • Chronic (long-lasting) high blood pressure 
  • Obesity 
  • Diabetes 
  • Kidney disease 
  • Being under 15 years old or over 35 years old 
  • It being the woman's first pregnancy 
  • Having had preeclampsia in a previous pregnancy
  • Multiple gestations: twins, triplets, or a greater number of multiples (These pregnancies have more placental tissue. This suggests that the placenta or things it produces may play a role.) 
  • Certain autoimmune conditions, including antiphospholipid antibody syndrome and some autoimmune arthritis conditions 
  • African-American or Hispanic ethnicity 
  • Having a sister, mother, or daughter who had preeclampsia or high blood pressure during pregnancy
  • Having a male partner whose previous partner had preeclampsia (this suggests that the father's genetic material, passed to the fetus and its placenta, may play a role) 
  • Having a male partner with whom you were sexually active for only a short length of time prior to becoming pregnant (this may be due to a change in the way a woman's immune system reacts to genes from the father after repeated exposure to his semen)

Symptoms

A woman with mild preeclampsia may not notice any symptoms, or she may have only mild swelling of the hands or feet. However, most pregnant women have some degree of swelling of the feet. So not all swelling indicates preeclampsia.

Symptoms of severe preeclampsia can include:

  • Headache 
  • Visual changes 
  • Nausea and abdominal pain, usually in the upper abdomen 
  • Difficulty breathing 
Eclampsia causes seizures, which are jerking movements of the arms and legs. During a seizure, a woman is likely to lose consciousness, and she may lose control of her bladder or bowels.

Diagnosis

Because preeclampsia doesn't always cause noticeable symptoms, it is crucial that all pregnant women see a health care professional regularly during pregnancy for prenatal care. This gives you the best chance of having preeclampsia diagnosed and managed before it becomes severe. Your doctor or midwife will measure your blood pressure and test your urine for protein at each prenatal visit because abnormal results are the earliest, most common signs of preeclampsia.

Preeclampsia can be especially difficult to detect in women who have a history of high blood pressure (hypertension) before pregnancy. One in four women with high blood pressure develops preeclampsia during pregnancy, so it is essential that these women be monitored closely for changes in blood pressure and for protein in the urine.

Your doctor or midwife will diagnose preeclampsia depending on your symptoms and the results of certain tests. There is no one blood test currently available to determine if someone does or does not have preeclampsia. Since a simple blood test is not available, here is how the diagnosis is determined:

  • Mild preeclampsia is characterized by the following: Blood pressure of 140/90 or above Swelling, particularly of the arms, hands, or face that is reflected in greater than expected weight gain, which is a result of retaining fluid. (Swelling in the ankle area is considered normal during pregnancy.)Protein in the urine 
  • Severe preeclampsia is characterized by: Blood pressure of 160/110 or higher in more than one reading separated by at least six hours A 24 hour urine collection that has more than 5 grams of protein Symptoms such as severe headache, changes in vision, reduced urine output, abdominal pain, fluid in the lungs and pelvic painSigns of the "HELLP" syndrome, which means the liver and blood-clotting systems are not functioning properly. HELLP stands for Hemolysis (damaged red blood cells), Elevated Liver enzymes (indicating ongoing liver cell damage) and Low Platelets (cells that help the blood to clot). It occurs in about 10% of patients with severe preeclampsia. 
  • Eclampsia is diagnosed when a woman with preeclampsia has seizures. These seizures usually happen in women who have severe preeclampsia, though they can occur with preeclampsia. Eclampsia also can happen soon after a woman gives birth. Approximately 30% to 50% of patients with eclampsia also have the HELLP syndrome.

Expected Duration

Preeclampsia can begin as early as the 20th week of pregnancy, or very rarely even earlier. But it is more likely to develop during the last three months of pregnancy. In fact, the majority of cases are diagnosed in the last weeks of pregnancy. When a diagnosis of preeclampsia is made long before delivery, the pregnancy usually can be managed with a combination of bedrest and careful observation. Because preeclampsia can quickly worsen, doctors will often recommend that women with preeclampsia be admitted to the hospital for such rest and observation. If the condition worsens and threatens the health of the mother, delivery is usually recommended. Delivery will also be recommended as a pregnancy approaches its due date, to prevent worsening preeclampsia. In most cases preeclampsia goes away after delivery, although, as noted above, for reasons that are poorly understood, some cases of preeclampsia occur after delivery.

Prevention

Currently there are few recommendations that can be made to prevent preeclampsia. Because certain health problems (diabetes, high blood pressure, lupus) are associated with preeclampsia, women should be in the best health possible before becoming pregnant. This includes not being overweight and gaining the appropriate weight once pregnant. Some experts suspect that low-dose aspirin may provide slight protection to women who are at especially high risk of preeclampsia (for example, women who have had severe or early preeclampsia with a previous pregnancy. However, any benefit of aspirin treatment is small, and it has not been shown to work for women at average risk.

Getting prenatal care is one of the most important things you can do to keep yourself health during pregnancy. Preeclampsia is one of the many things your doctor or midwife will be on the lookout for.

In women whose preeclampsia is getting markedly worse, magnesium sulfate is given to prevent eclamptic seizures. Magnesium sulfate may be given either through an intravenous line or as an injection.

Treatment

The only cure for preeclampsia and eclampsia is to deliver the baby. (Actually, the cure is the delivery of the placenta, but one can't deliver the placenta without delivering the baby.) How you proceed depends on the severity of your preeclampsia.

  • Mild preeclampsia. The goal of treating mild preeclampsia is to delay delivery until the fetus is mature enough to live outside the womb. You most likely will be put on bedrest and your doctor or midwife will monitor your blood pressure, weight, urine protein, liver enzymes, kidney function, and the clotting factors in your blood. Your provider also will monitor the well-being and growth of your fetus. Some women need to be hospitalized for adequate treatment and monitoring, while others can remain in bed at home. If you are not hospitalized, you will need to be seen by your health care professional frequently.
  • Severe preeclampsia. The overall goal is to prevent serious consequences to the mother's and fetus' health, including eclampsia, stillbirth, and liver and kidney failure. Women with severe preeclampsia are carefully monitored, and high blood pressure is treated with medication. If the condition of the mother or baby gets worse, the baby may need to be delivered early. If the pregnancy reaches a gestational age at which the consequences of premature delivery are outweighed by the risks of continuing the pregnancy (generally about 32 to 34 weeks of gestation), an obstetrician may also recommend delivery. Your physical health and well-being will begin returning to normal after the baby is delivered.
  • Eclampsia. Magnesium sulfate is used to prevent eclamptic seizures in women with preeclampsia at highest risk for them. When eclamptic seizures occur, magnesium sulfate will be started (for those not on it already) or given again (for those in whom seizures have occurred in spite of initial treatment) in an effort to prevent recurrent seizures. Other medications, such as lorazepam (Ativan), may be used to stop ("break") a seizure in progress.

When To Call a Professional 

You should schedule your first prenatal care visit with a health care professional as soon as you know you are pregnant. If you have swelling, severe headache, changes in vision, or other symptoms of preeclampsia, contact your doctor or midwife immediately.

Prognosis

The outlook for full recovery from preeclampsia is very good. Most women begin to improve within one to two days after delivery, and blood pressure returns to their normal pre-pregnancy range within the next one to six weeks in almost all cases.

About one of every five women with preeclampsia during a first pregnancy will have preeclampsia during a second pregnancy. Those with early or severe preeclampsia, or who have other medical conditions such as high blood pressure or diabetes, are at greatest risk for recurrence.

Women who have had preeclampsia are at risk for developing high blood pressure and other cardiovascular diseases later in life. You should let your primary care provider know if you have had preeclampsia. Although at present no specific treatments are recommended for women who have had preeclampsia to prevent later problems, it is prudent to adopt a healthy lifestyle. This includes:

  • Maintaining a healthy weight 
  • Exercising regularly and being physically active 
  • Eating a well-balanced diet 
  • Not smoking 
  • Using alcohol in moderation
High-risk pregnancies is one of the expertise of Dr. Cristian Andronic. Follow this Twitter page for more updates.

Monday, June 10, 2013

Standardizing home delivery



Homebirth is generally frowned upon by physicians. Considered crude and outdated in a time when obstetric care is almost universally accessible, homebirth has been discouraged by many obstetricians and pediatricians. Despite this medical warning, it is still being performed in rare instances, comprising less than 1 percent of all deliveries in the country, and a majority of them aren’t attended by doctors but by midwives.



Image Source:  sheknows.com


To help standardize and regulate the process of home delivery, the American Academy of Pediatrics (AAP) formulated the following guidelines and published it in its official journal, Pediatrics:

• There should be at least one person who will be held accountable for tending to the newborn.

• A phone line should be kept handy to provide for immediate communication in cases of untoward emergency.

• The healthcare professional in charge should also check the weather situation, just in case delivery complications may arise and the mother and newborn need to be transferred to a hospital.

• Standard post-delivery procedures routinely done in hospitals should also be performed in home deliveries, such as temperature monitoring and regulation, vitamin K administration, and heel-prick newborn screening tests, among others.



Image Source: scienceandsensibility.org



For the AAP, it is important to ensure that the delivery care being given is the same regardless of the setting. “No matter where a baby is born, they deserve the same standard of care,” said Dr. Kristi Watterberg, lead author of the revised AAP guidelines. “It’s our best shot for the best outcomes for babies and moms.”


Image Source: ecochildsplay.com



Learn more about obstetric practice by logging on to this Facebook page for Dr. Cristian Andronic.

Friday, June 7, 2013

REPOST: Acupuncture and moxibustion greatly improve chances of pregnancy when IVF has failed: Study


How can acupuncture and moxibustion help in improving one's chances of getting pregnant? Read this Natural New.com article.


IVF
Image Source: naturalnews.com
(NaturalNews) Most NaturalNews readers have anywhere from a vague understanding to a first-hand experience of acupuncture. But moxibustion needs to be explained a little.

With moxibustion, heat is applied to acupuncture points instead of needles. The purpose is to move Qi or chi as needle stimulations do, but also to remove cold from one's system. More details are available from source (1) below.

In vitro fertilization is codified as IVF. In vitro refers to lab glass containers, usually petri dishes; in vivo is a reference to live whole organisms, from rats to humans.

IVF takes an ova or ovum (egg or eggs) from an infertile woman's ovaries, fertilizing it or them into a petri dish (in vitro), then removing the zygote (fertilized egg or eggs) from the lab environment and inserting into the woman's uterus. (2)

In vivo procedures to circumvent infertility involve a real human donor who is impregnated with the injected sperm of the infertile woman's husband or another donor's sperm. As the embryo begins to form in the donor's ovaries, it is removed and inserted into the infertile woman.

The embryo in vivo technique was accomplished a few years before IVF was created in 1978. IVF became the preferred infertility intervention because lab controls minimized infections, the biological status of the newborn was less questionable, and the occasional donor pregnancy was eliminated. (3)

But the success rate of IVF alone is not so great, around 20 percent. And it is expensive. Most health insurance plans won't even go there. (4)

However, TCM (Traditional Chinese Medicine) has quietly been establishing efficacy at increasing fertility in both men and women. This has come to the attention of the western medical scientific community, which must "prove" empirically established procedures by randomized double blind testing.

IVF needs a boost and seeks TCM as an adjuvent (support) 

A San Paulo, Brazil randomized clinical study, "Influence of acupuncture on the outcomes of in vitro fertilisation (sic) when embryo implantation has failed: ..." was recorded by PubMed March 19, 2013.

They used 84 women on whom IVF had failed at least twice and divided them into three groups of 28 each. The rates of pregnancy were 35.7 percent among those who were administered correctly-applied acupuncture/moxibustion with IVF, 10.7 percent among the sham (false) TCM applications, and 7.1 percent within the control group receiving only IVF.

Their conclusion: "In this study, acupuncture and moxibustion increased pregnancy rates when used as an adjuvant treatment in women undergoing IVF, when embryo implantation had failed." (5 - 5a)

Is IVF necessary? 

This Brazilian study was formed because of IVF's low rate of success and word on the medical street that TCM was working better without either in vitro fertilization (IVF) or in vivo embryo transfer.

So the study does enable Western medical practitioners to still get bucks for their IVF while boosting their success with TCM as an adjuvant. It could be considered a win-win for both sides.

But either Brazilians have universal health coverage or many are well off. Here in the USA, that 10 grand or more for IVF comes from private piggy banks. So what if TCM alone works well with much less expense? Short answer - it does.

An interesting example is Dr. Randine Lewis, who ditched Western medicine and went fully TCM to form The Fertile Soil group after her own infertility issues had led her to TCM for solutions.

Again, TCM performs without invasive treatments or pharmaceutical drugs with less costs and often achieves fertility goals with side effects of overall health improvements.

Dr. Lewis and others are listed below with more information under the heading Sources below are TCM for infertility options. If you or your partner have fertility concerns, find your local area TCM clinics and inquire.


Dr. Cristian Andronic can help you deal with problems in fertility and early signs of pregnancy. See this Twitter page for more updates.

Thursday, June 6, 2013

REPOST: Some Morning-After Pills Are Now Allowed For Everyone

This article from Time.com shares an order issued by the 2nd U.S. Circuit Court of Appeals in Manhattan which allowed some emergency contraception pills to be sold without restrictions. Read the full details below:



Generic versions of emergency contraception can be sold without a prescription or age restrictions while the federal government appeals a judge’s ruling allowing the sales, an appeals court said Wednesday.

The brief order issued by the 2nd U.S. Circuit Court of Appeals in Manhattan permitted two-pill versions of emergency contraception to immediately be sold without restrictions, but the court refused to allow unrestricted sales of Plan B One-Step until it decides the merits of the government’s appeal. It did not specify why the two-pill versions were being allowed now, though it said the government failed to meet the requirements necessary to block the lower-court decision.

The order was welcomed by the Center for Reproductive Rights, where President Nancy Northup called it a “historic day for women’s health.”

“Finally, after more than a decade of politically motivated delays, women will no longer have to endure intrusive, onerous and medically unnecessary restrictions to get emergency contraception,” she said in a statement.

The center’s litigation director, Julie Rickelman, said the government has two weeks to decide whether to appeal the 2nd Circuit’s decision on the stay to the full appeals court or the Supreme Court. Even if there is no appeal of the stay ruling, it was unclear how soon drugstores would move the two-pill emergency contraception from behind the counter. She said she hoped the pills would be available without restriction within a month.

“What it does mean is that generic two-pill products are going to be readily available to women without age restrictions, on any drugstore shelf,” Rickelman said. “It’ll be like buying Tylenol. You’ll be able to go get it off the drugstore shelf, no ID, at the regular counter.”

Justice Department spokeswoman Allison Price said the government was reviewing the court’s order.

The government has appealed U.S. District Judge Edward Korman’s underlying April 5 ruling, which ordered levonorgestrel-based emergency contraceptives be made available without a prescription, over-the-counter and without point-of-sale or age restrictions.

The government asked Korman to suspend the effect of that ruling until the appeals court could decide the case, but the judge declined, saying the government’s decision to restrict sales was “politically motivated, scientifically unjustified and contrary to agency precedent.” He also said there was no basis to deny the request to make the drugs widely available.

The government had argued that “substantial market confusion” could result if Korman’s ruling was enforced while appeals were pending, only to be later overturned.

The Food and Drug Administration was preparing in 2011 to allow over-the-counter sales of the morning-after pill with no limits when Health and Human Services Secretary Kathleen Sebelius overruled her own scientists in an unprecedented move.

The FDA announced in early May that Plan B One-Step could be sold without a prescription to those 15 and older. Its maker, Teva Women’s Health, plans to begin those sales soon. Sales had previously been limited to those who were at least 17.

Korman later ridiculed the FDA changes, saying they established “nonsensical rules” that favored sales of the Plan B One-Step morning-after pill and were made “to sugarcoat” the government’s appeal.

He also said they place a disproportionate burden on blacks and the poor by requiring a prescription for less expensive generic versions of the drug bought by those under age 17 and by requiring those over age 17 to show proof-of-age identification at a pharmacy.

Plan B One-Step is the newer version of emergency contraception – the same drug, but combined into one pill instead of two.



Find more news on issues affecting women's fertility and pregnancy on this Twitter page for Dr. Cristian Andronic.

Wednesday, June 5, 2013

Pregnant women, beware: Migraine medication might reduce your child's intelligence



As a general rule, pregnant women aren’t supposed to be taking in medications, as it is still not certain if these substances can affect the fetus that they are carrying. There have been many cases where some drugs and substances exhibited teratogenicity (a drug’s ability to cause fetal malformation), hence bringing it to become a matter of medical concern.



Image Source: pharmacytechnician.org


Adding to the long list of fetus-damaging drugs are anti-migraine medications Depakote and Depacon, both of which have been noted by the Food and Drug Administration for potentially causing mental retardation to children. This came after a study showing a pattern of reduced IQ scores among children whose mothers used the abovementioned drugs during pregnancy.

The culprit: a sodium salt called valproate sodium—originally an anticonvulsant which is also being used as a prophylaxis for migraines. Drugs containing this ingredient already come with FDA warnings that tell of its teratogenic effects. Apparently, some uninformed pregnant women would still take these drugs to ease the pain which is brought about the migraines.



Image Source: foxnews.com


When stuck in such quandary, mothers are advised to consider all the potential risks which might come from taking these drugs.

Dr. Russell Katz, FDA’s director for neurology drugs, recognizes the likely damage incurred by the medication. “We have even more data now that show the risks to the children outweigh any treatment benefits for this use,” he said. The FDA also said in a statement: “Women who can become pregnant should not use valproate unless it is essential to managing their medical condition.”



Image Source: bu.edu


There are many ways by which prospective mothers can keep their pregnancies healthy. Keep abreast with pregnancy-related updates by visiting this Facebook page for Dr. Cristian Andronic.

Sunday, June 2, 2013

REPOST: Will You Still Be Fertile in 5 Years?

Are you beginning to wonder if you can still get pregnant? This Parenting.com article will help you detect your fertility rate, which can boost your chances of getting pregnant.


couple relaxing together and talking
Image Source: parenting.com
Thinking of having another child? You may have less time than you imagine to conceive without difficulty. Still, you may be able to take steps now to improve your chances.

To help judge the state of your fertility, consider these questions:

1. How old are you? 

Age is by far the biggest factor in fertility, and even the most advanced infertility treatments aren't always able to turn back the clock. "Women are postponing childbearing until later in life - that's the very reason we see more problems today," says Pamela Madsen, executive director of the American Infertility Association.

Some researchers believe that fertility peaks as early as a woman's late 20s, and there's a consensus that by her early 30s, both the quantity and the quality of her eggs have begun to decline.

It's a gradual process, so there's certainly no need to panic. But if you're 30, you may not want to wait ten years to start trying to get pregnant again. At age 35 about three-quarters of women will be able to conceive without treatment, but by age 40 only half will, says Owen Davis, M.D., director of the IVF Program at Cornell Medical Center in New York City. By age 45 it's under 10 percent.

The risk of miscarriage also goes up with age. At 35, about one in five pregnancies doesn't result in a live birth; by age 42 more than half fail, according to a study of over 500,000 women million women in Denmark. An older egg becomes an embryo that's more prone to genetic damage, researchers believe.

Infertility is traditionally defined as the inability to conceive after one year of unprotected sex. "In my opinion, a woman under thirty-five should try to conceive for that amount of time before she seeks medical help to find out why she's not getting pregnant," says Magdy Milad, M.D., a reproductive endocrinologist and an associate professor of obstetrics/gynecology at Northwestern University Medical School, in Chicago. "Between the ages of thirty-five and thirty-nine, she should try for six months. And after the age of forty, she should try for three months and then see a doctor for an evaluation, just to make sure that nothing's wrong and she doesn't run out of time to try treatment."

2. Do you smoke? 

If so, you're hurting your chances of getting pregnant at any age. Exposing your eggs to nicotine will not only affect the quality of your eggs but decrease your ovaries' supply. The more cigarettes a woman smokes daily, the lower her chances of conceiving. Smoking can also speed up the age at which menopause begins, prematurely closing your lifetime window of fertility.

The good news is that quitting now can restore much of your fertility. It's not immediate, though. "Once a woman quits, it can take several months for smoking-related toxins to be cleared from the body," says Dr. Milad.

Passive smoking interferes too: In one study, women exposed to smoke at work or at home were less likely to conceive within a year than peers who were exposed to little or none.

3. Are you at a healthy weight? 

Being seriously over- or underweight - for a woman who's 5 foot 4, for instance, being heavier than 175 pounds (a body mass index of 30) or lighter than 105 pounds (a body mass index of 18) - may have a bearing on fertility, but only if it affects ovulation.

If your periods are normal, your weight is unlikely to impact your ability to get pregnant, says Bryan Cowan, M.D., chairman of the department of obstetrics and gynecology at the University of Mississippi Medical Center, in Jackson. But if you're overweight and your periods are irregular, talk to your doctor. On the other hand, if you're very thin or have recently lost a lot of weight and your periods have become irregular or have stopped, gaining weight may be the first step toward fertility.

4. What medications or remedies are you taking? 

Thousands of prescription and over-the-counter medications - as well as herbal remedies - can have an effect on fertility. But the main concern is a class of drugs that affect your body's production of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) - key players in your ovulatory cycle. These include steroids (for asthma and rheumatoid arthritis), as well as prescription medicines that contain metoclopramide (for gastrointestinal upset) or phenothiazines (for anxiety.) It's always a good idea to talk with your doctor about which medications you are taking - or have taken - that might have an impact on fertility.

Contraceptives may also have an effect. If you've been on the Pill for a long time, it may take two to five months for your body to start ovulating normally once you go off it; that's also true for the newer hormone-based contraceptives like the Mirena IUD or the Nuva ring. "It's a myth that taking the Pill will prevent you from getting pregnant in the future," says Helane Rosenberg, Ph.D., egg donor coordinator at IVF New Jersey, in Somerset "But if you've been taking it for a long time, it could be masking a problem that would make you ovulate irregularly if you weren't taking the contraceptive."

The exception is if you've been treated with Depo Provera - in that case, the wait could be much longer. "Since the drug is injected into muscle, the hormone absorption may be so slow that it could take as long as a year for your fertility to return to normal," says William Gibbons, M.D., chairman of the department of obstetrics/gynecology at Eastern Virginia Medical School, in Norfolk. Norplant, though, has no adverse effect on fertility once it's removed.

If you're using herbal remedies, be wary: They're not regulated, so there's no requirement that their effects on conception and pregnancy be properly researched. Some reports have suggested that popular supplements - Saint-John's-wort, ginkgo, Echinacea - may negatively affect fertility, but other studies have found no effect, so there's no way to tell yet. "If you're having trouble conceiving and you're taking herbal supplements, you might want to stop, just in case," says registered dietitian Paul Thomas, editor of The Dietary Supplement, a newsletter for health professionals and consumers.

5. Have you ever had a sexually transmitted disease (STD)? 

If it was caught early and treated, an STD will probably not affect your ability to get pregnant. But one that was untreated for a long period of time may cause problems; untreated chlamydia, for instance, can lead to pelvic inflammatory disease, which may make you infertile. Chlamydia and gonorrhea can also cause scarring of the fallopian tubes or low-grade infections that can change how receptive your uterine lining is, says Carolyn Salafia, M.D., director of EarlyPath Diagnostics, a research facility in Larchmont, NY.

That's why it's important to be checked for STDs by your doctor before you try to get pregnant. Your partner should get checked too: STDS can also block production of sperm.

6. Was your last delivery difficult? 

Even if you've had a c-section, you won't necessarily find it harder to conceive your next child, unless there was tissue scarring, which can potentially impair fertility. (Nor do the vast majority of abortions affect conception.)

On the other hand, even a problem-free pregnancy doesn't mean it'll be easy to get pregnant the next time. "If your first pregnancy was uneventful, it excludes certain problems in the future, such as specific congenital abnormalities, but it's not a guarantee - other factors, like age, can affect your chances," says Dr. Davis.

7. Is your period regular? 

If you have an irregular cycle that is very long (more than 36 days) or short (less than 22 days), it's possible that your ovaries aren't functioning normally, and that could have an impact on the viability of your eggs when you try to get pregnant. Every woman's cycle is different, but see your doctor to rule out possible medical causes, such as thyroid disease or polycystic ovarian syndrome; both can be detected by blood tests and treated. Fibroids, which can cause heavy periods, may also interfere with fertility and are also easily treated. Fortunately, if you are not ovulating normally when you want to conceive, there are a number of medications that can correct the problem.

8. Are you under a lot of stress? 

It isn't clear whether daily stress has an effect on one's chances of getting pregnant. Some experts think it may decrease the production of estrogen, but others find no link. It's a bit of a chicken-and-egg issue: Infertility itself is stressful, so it's not surprising that women who seek help may report feeling tense.

Depression is another matter: "A number of studies link depression and trouble conceiving," says Alice Domar, Ph.D., director of the Mind/Body Center for Women's Health at Boston IVF, Harvard Medical School, and coauthor of Conquering Infertility. "If you want to conceive in the future and you're having emotional problems, try to see a mental health professional," says Dr. Domar. But if you're sure that your emotional stress is related to pregnancy worries, you may want to join a fertility support group. It will not only give you a place to talk about your experiences but also teach you coping techniques for stress management and relaxation. To find a group in your area, visit, the website of the National Infertility Association, and click on Local Chapters.

9. Are you a healthy eater? 

A well-balanced diet with plenty of fruits and vegetables is always a good idea, but the average American diet provides the necessary vitamins and minerals for fertility, says Dr. Cowan. Of course, every woman of childbearing age should take a multivitamin with at least 400 micrograms of folic acid - it helps prevent neural tube defects only if you take it before you get pregnant.

Caffeine remains controversial. Some studies indicate that it can delay conception, but others show - you guessed it - no effect. Once you do become pregnant, though, caffeine matters: As little as two cups a day can double your risk of miscarriage. Says Dr. Milad, "I give my patients who are trying to get pregnant the same advice I give those who are pregnant - keep caffeine intake in check and take your vitamins."

So, will you be fertile in five years? There's no way to be absolutely sure, of course. The more you know, the easier it is to plan your future. And the healthier your lifestyle, the better your chances will be.

Kristyn Kusek writes about women's health issues for a number of magazines. This is her first feature for PARENTING.

The Dad Factor 

The male contribution to infertility has only recently received the scientific attention it deserves. Here are some questions worth asking about the aspiring father:

Does he smoke? 

Infertility rates are three times higher in men who smoke compared with those who don't. Just as tobacco use affects a woman's eggs, it can also cause a reduction in the number of sperm as well as damage those being formed. After a man quits, it takes about three months for his sperm to return to normal, says Dr. Davis. If he was a heavy smoker, it can take longer. What's his health history? Mumps can cause sterility, according to Dr. Davis. Also, about 1 in 500 men have Klinefelter's syndrome, a genetic disorder that causes them to be born sterile.

How old is he? Although a man can impregnate a woman into his 70s and older, new studies make it clear that a man's fertility declines with age, beginning around 35. Both the quality and the quantity of sperm are affected.

Is he okay "down there"? One of the biggest causes of male infertility is varicoceles - varicose veins in the scrotum. These affect one in ten men. Some get them around their testicles, which can reduce sperm production. Have him see a urologist for treatment options.

How's his diet? Men who get enough folic acid, vitamin C, and zinc produce more sperm, studies show. The amounts for each in a healthy diet - or a standard multivitamin - are fine.

Is he regularly exposed to heat? For men who use hot tubs often - or truck drivers who spend a lot of time sitting above a vehicle's engine - there may be a reduction in the number of sperm produced.

Does he drink a lot or smoke pot? In some men, even moderate drinking affects fertility; some researchers believe men should limit themselves to one drink a day for optimal fertility. Marijuana use can reduce the production of sperm, and heavy use is associated with infertility, says Dr. Davis.

Timing the Test for Pregnancy 

If you're using a home pregnancy test, wait at least ten days after your period is due to try it. If you test too soon, the result may signal that you're not pregnant when you really are, says epidemiologist Donna Day Baird, Ph.D. "The fertilized egg may not yet be implanted in the uterus by the time a woman expects her period," she says, "so the test can't detect the pregnancy." - Rachelle Vander Schaaf

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