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.

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. 

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.

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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.

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.

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.

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. 

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.

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.

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.

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.

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.

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.”

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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.

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.

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

Follow this Twitter page for Dr. Cristian Andronic for more links to articles on fertility and pregnancy.

REPOST: Why Women Get Diabetes During Pregnancy

This US News article discusses gestational diabetes and its possible effects on newborns and their mothers.

Image Source: health.usnews.com

Gestational diabetes is a form of diabetes that occurs for the first time when a woman is pregnant. This type of diabetes is caused by a change in the way a woman's body responds to the hormone insulin during her pregnancy. This change results in elevated levels of blood sugar, also known as blood glucose.

Gestational diabetes affects an estimated 18 percent of women during pregnancy. It is important to diagnose and treat gestational diabetes to avoid health complications for you and your baby.

What are the risk factors?

The risk factors commonly associated with an increased chance of developing gestational diabetes include:

• Having a history of gestational diabetes in previous pregnancies.

• Being overweight or obese.

• Being older than 25 years.

• Having a family history of diabetes (especially if a parent or sibling has diabetes).

• If you previously delivered a baby weighing more than 9 pounds.

• Having glucose in your urine.

• Being African-American, Hispanic, Native American or Asian.

• Having "prediabetes," also known as impaired glucose tolerance.

How do I know if I have gestational diabetes?

If you are at high risk for developing gestational diabetes, your blood glucose levels will likely be checked at your first prenatal visit. The American Diabetes Association recommends screening for gestational diabetes at the first prenatal visit for women with known risk factors.

If your blood glucose results are normal, your levels will be checked again between the 24th and 28th weeks of your pregnancy. It is recommended that all pregnant women be screened for gestational diabetes at that time.

What happens at a screening?

To screen for gestational diabetes, your doctor will order a glucose challenge screening test. This test requires you to drink a glucose solution and then have your blood drawn an hour after drinking the solution. No fasting is required for this test. If the results are normal, no other tests are done.

If the results are positive, some doctors may order another test called an oral glucose tolerance test. This test is conducted by measuring your fasting blood glucose level, then measuring it again one, two and three hours after drinking a glucose drink.

If the results are positive, your doctor will recommend a treatment plan. Treating and managing gestational diabetes is critical to your health and your baby's health.

What effect can gestational diabetes have?

Gestational diabetes can increase your chances of delivering a baby weighing more than 9 pounds and increase the need for a cesarean section. In addition, hypertension and preeclampsia occur more commonly in women with gestational diabetes. However, effectively managing and treating gestational diabetes can significantly reduce the likelihood of these complications.

Treating Gestational Diabetes

Typically, gestational diabetes is treated and managed through daily blood glucose monitoring and by making dietary changes to help keep your blood glucose levels within the normal range. Some doctors may also recommend an exercise regimen. Sometimes, when dietary changes do not control the blood glucose levels, you may need to start insulin therapy or take other medications. Your physician will determine the best treatment plan for your gestational diabetes, including how often per day you should check your blood glucose levels. Your physician and pharmacist can teach you how to monitor your blood glucose levels at home, how to use the recommended blood glucose meter and how to give yourself insulin injections if needed.

Stick With Your Treatment Plan

To avoid the complications associated with gestational diabetes, it is very important that you monitor and control your blood glucose levels. You also need to receive proper treatment and be screened regularly.

Both you and your baby will be closely monitored throughout your pregnancy. It is very important to adhere to the treatment plan your doctor prescribes to ensure good health for you and your baby. You should discuss any concerns with your doctor.

Staying Healthy

Although it may seem overwhelming and challenging, the majority of women with gestational diabetes are able to successfully control their blood glucose levels and have healthy babies without any complications if they receive proper treatment and routine monitoring. After delivery, most women with gestational diabetes have normal blood glucose levels and no longer require treatment.

The American Diabetes Association recommends that women who are diagnosed with gestational diabetes be screened for diabetes six to 12 weeks after giving birth. In addition, it's recommended that women with a history of gestational diabetes receive routine screening for the development of diabetes or prediabetes at least every three years. Remember the importance of adhering to your therapy if you have gestational diabetes, so you and your baby can enjoy healthy lives.


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

REPOST: Breast Cancer's Dirty Little Secret: Fertility Loss

How does breast cancer affect one's future offspring? This Health.com article elaborates the risks posed by cancer treatments and ways on how they might affect fertility.

Image Source: health.com

I recently edited a story for Health magazine about what it’s really like to have breast cancer. The survivor stories were both inspiring and heartbreaking. But the women who haunted me most were those who were not only worrying about staying alive, but about whether they could get pregnant.

"Learning that I may not be able to have a baby was the hardest thing I had to deal with," says Stephanie Gensler, a 39-year-old ad executive who was diagnosed with stage II aggressive breast cancer at age 34. She underwent a lumpectomy, six months of chemo, and 36 radiation treatments. "My doctor says it's possible," says Gensler, "but I’m not sure it is."

That kind of uncertainty drove many women to a recent Web seminar hosted by BreastCancer.org on breast cancer and fertility. Their questions were wide-ranging:

I’m having chemotherapy treatment for six months. Can I still hold out hope for a pregnancy after treatment? Does insurance pay for freezing my eggs if I have breast cancer? If I do get pregnant, will my child have a higher risk of breast cancer? Fertility experts answered them: Kutluk Oktay, MD, a professor of obstetrics and gynecology and the director of the Division of Reproductive Medicine & Infertility at New York Medical College; and psychologist Leslie R. Schover, PhD, a professor of behavioral science at the University of Texas M.D. Anderson Cancer Center in Houston, who helps cancer survivors make decisions about fertility preservation, cope with fertility-related distress, and resolve cancer-related sexual problems.

There is good news

There have been great advances in the fertility-after-breast-cancer field—from freezing embryos (fertilized eggs) and oocytes (unfertilized eggs) for later in vitro fertilization, to experimental procedures such as removing and freezing some ovarian tissue so that it can be re-implanted once treatment has been completed. Dr. Oktay pioneered some of these developments as founder of the Institute for Fertility Preservation at the Center for Human Reproduction in New York City.

But for some, it’s too late

Most of the women getting the information via the Web seminar were getting it way too late. It was painful to see these women's fertility hopes dashed because they had already undergone treatment that put them into permanent early menopause or otherwise compromised their ability to conceive.

When one woman undergoing chemotherapy asked if she would be able to get pregnant afterward, Dr. Oktay said, "If you’re receiving one of the standard chemotherapy regimens...your ovaries will behave after chemotherapy as if you’re in your 40s. And based on my experience and studies, you will have a very small chance of conceiving. If there’s a possibility, any woman in this situation should consider freezing eggs or embryos before treatment has begun."

That means it’s critical for women to get this information before they undergo treatment, and many don't.

"I didn’t get it," says Stephanie Gensler, who wishes someone had put egg preservation on her radar. "No one said anything about it, and I wasn’t thinking about it."

Finding out what you need to know 

Since oncologists are focused on saving lives first, and fertility second, breast cancer survivors need to find other sources of information to fill the void.

FertileHope.org offers reproductive information and support to cancer patients and survivors whose medical treatments present the risk of infertility.

The American Cancer Society offers comprehensive information on preserving fertility in men and women who undergo treatment.

MyOncoFertilty.org intersperses the advice of experts with much-needed friendliness, such as comforting videos from survivors like Laurie.

"When I met with my oncologist the first two times, I didn’t even think to ask her about fertility. It was all about me. It was about saving my life," says Laurie. She was lucky to get fertility advice after her mastectomy but before her chemotherapy began, and she is now pregnant. That’s the kind of happy ending that I hope we’ll be hearing more of in the future.

Dr. Cristian Andronic is known for his expertise in all aspects of general gynecology and obstetrics. More links to articles on women's health, pregnancy, and child birth are available on this Facebook page.

REPOST: Looking for pregnancy drug safety info online? Good luck

The first trimester is the most delicate period of pregnancy.  Women have to take extra precaution when taking medication, like decongestant pills.  This article from Today has some suggestions:

An awful cold? Don't panic if you used decongestant pills, but doctors advise a nasal spray in early pregnancy.

And don't abandon antidepressants or epilepsy medicines without talking to your doctor first. Some brands are safer during pregnancy than others — and worsening depression or seizures aren't good for a mom-to-be or her baby.

"To come off of those medications is often a dangerous thing for the pregnancy itself," warns Dr. Sandra Kweder of the Food and Drug Administration. "They need information on what to expect, how to make those trade-offs."

A new study shows how difficult that information is to come by.

Women often turn to the Internet with pregnancy questions. But researchers examined 25 pregnancy-related websites and found no two lists of purportedly safe drugs were identical. Twenty-two products called safe on one site were deemed risky on another.

Worse, specialists couldn't find evidence to back up safety claims for 40 percent of the drugs listed, said Cheryl Broussard of the Centers for Disease Control and Prevention, who led the recent study.

"The reality is that for most of the medications, it's not that they're safe or not that's the concern. The concern is that we just don't know," she said.

Broussard experienced some of that confusion during her own two pregnancies — when different doctors handed over different lists of what was safe to use.

It's a growing dilemma. The CDC says medication use during the first trimester — especially vulnerable for birth defects because fetal organs are forming — has jumped 60 percent in the last three decades. Plus, women increasingly are postponing pregnancy until their 30s, even 40s, more time to develop a chronic health condition before they're expecting.

The CDC is beginning a Treating for Two program to explore how to get better information, and the FDA plans to revamp prescription drug labels with more details on what's known now. But people want an easy answer — use it or don't — and for many drugs, they won't get one anytime soon.

"Women agonize over it," said Dr. Christina Chambers of the University of California, San Diego. She helps direct California's pregnancy risk information hotline that advises thousands of worried callers every year.

Some drugs pose particular birth-defect risks. For example, the FDA requires versions of the acne drug isotretinoin, first marketed as Accutane, to be sold under special tight controls. Similarly, last year FDA said women who want to use a new weight-loss drug, Qsymia, need testing first to be sure they're not pregnant.

Other medications are considered safe choices. Obstetricians say pregnant women need a flu shot, for example. A recent massive study in Denmark offered reassurance that taking the anti-nausea drug Zofran for morning sickness won't hurt the baby.

But many drug labels bear little if any details about pregnancy. Drugmakers shy from studying pregnant women, so it can take years for safety information to accumulate. Moreover, the CDC says 1 in 33 babies has some type of birth defect regardless of medication use. It can be hard to tell if a drug adds to that baseline risk.

Consider antidepressants, used by about 5 percent of pregnant women. Certain brands are suspected of a small risk of heart defects. Studies suggest a version called SSRIs may increase risk of a serious lung problem at birth — from 1 in 3,000 pregnancies to 3 in 3,000 pregnancies, Chambers said. Also, some babies go through withdrawal symptoms in the first days of life that can range from jitteriness to occasional seizures.

Women have to weigh those findings with the clear risks of stopping treatment, she said.

"The time to be thinking about all this is when you're not pregnant," when your doctor can consider how to balance mom's and baby's health and might switch brands, Chambers said.

That's what heart attack survivor Kelli Tussey of Columbus, Ohio, did. The 34-year-old takes a variety of heart medications, including a cholesterol-lowering statin drug that the government advises against during pregnancy.
 

So when Tussey wanted a second child, she turned to doctors at Ohio State University who specialize in treating pregnant heart patients. They stopped the statin and switched her to a safer blood thinner.

"They said my heart could take it," Tussey said. Now four months pregnant, "it seems everything's fine."

Sometimes it's a question of timing. That painkiller ibuprofen, sold as Advil and other brands, isn't for the third trimester but isn't a big concern earlier on, said Dr. Siobhan Dolan, an adviser to the March of Dimes.

And women should watch out for over-the-counter drugs with multiple ingredients, like decongestants added to allergy medicines, Dolan said. While any potential risk from decongestant pills seems small, "the question is, 'Do you really need it?'" she asked, advising a nasal spray instead.

Ask your doctor about the safest choices, Dolan said. Also, check the Organization of Teratology Information Specialists, or OTIS — www.otispregnancy.org — for consumer-friendly drug fact sheets or hotlines to speak with a specialist.

Stay tuned: The FDA has proposed big changes to drug labels that now just say if animal or human data suggest a risk. Kweder said adding details would help informed decision-making: How certain are those studies? What's the risk of skipping treatment? Is the risk only during a certain trimester?

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 on reproductive health.

Pregnancy and the permanent change in foot structure

Image Source: huffingtonpost.com

 
After giving birth, some women complain of having bigger feet. Indeed, pregnancy can sometimes cause the arch to flatten, making the feet grow one or two sizes bigger. And many of them stay that way permanently.

The American Journal of Physical Medicine and Rehabilitation published a study affirming that the decrease in the arches of the feet can be associated with pregnancy and that porous women have an increased risk for other structural and functional changes in the lower limbs. This is especially evident during a woman’s first pregnancy. The reason: a combination of increased weight on the joints with a greater laxity during pregnancy.

Image Source: backandneck.ca

Additionally, this pregnancy-related arch drop explains why women are at a high risk for arthritis and pain in the hips, knees, and spine.

“A flattened foot can strain the ligaments in the foot's sole, causing changes in gait that put extra strain on the knees,” says researcher Neil Segal, an associate professor of orthopedics and rehabilitation at the University of Iowa.

With further research, soon women all over the world will know whether preventive rehabilitation for these structural changes can have an impact on better body, better health, and better-looking feet.

Image Source: diabetes.webmd.com

Know more about the changes that commence in your body during and after pregnancy from this Facebook page for Cristian Andronic.

REPOST: Pregnancy Takes a Turn on the Red Carpet

Women celebrate their pregnancy in various ways, and some do it in style. This New York Times article features pregnant celebs who strutted the red carpet round and proud.

Last week, the most talked-about moment from the Met Gala, the annual black-tie event to benefit the museum’s Costume Institute, did not involve Anna Wintour, the host committee headlined by Rooney Mara and Beyoncé or Madonna going pantless.

Rather, Kim Kardashian, the reality TV star and girlfriend of the musician Kanye West, stole the spotlight when she climbed the red-carpeted staircase in a printed floral long-sleeved gown with matching gloves and heels, punctuated by a very prominent baby bump.

Soon after, her head-to-toe look was compared to chintzy upholstery (a doctored image of Ms. Kardashian blending into a sofa pattern circulated in social media) and also to Mrs. Doubtfire, the frumpy cross-dressing housekeeper played by Robin Williams in a 1993 movie. “I think I wore it better,” Mr. Williams wrote on Twitter, attaching a side-by-side image of him in character next to the reality star. Vogue might have agreed. In the magazine’s post-gala Best Dressed roundup, Mr. West made the cut, but Ms. Kardashian was cropped out of the photo.

“I think she looked amazing,” Riccardo Tisci of Givenchy, who designed the gown, told Women’s Wear Daily after the event. “She was the most beautiful pregnant woman I dressed in my career,” he added, “People can say what they want.”

Though Ms. Kardashian, through her publicist, declined to comment, she has other people talking. Actresses, like other women, once did their best to camouflage pregnancies in tented smocks. “In the 1930s and ’40s, movie stars often hid the fact that they were pregnant,” Kay Goldman, a Texas researcher, wrote in “Dressing Modern Maternity,” a book about a leading maternity label called Page Boy, which became known for a signature smock with Peter Pan collar.

But now celebrities in advanced stages of pregnancy tend to make the scene, often swathing their bellies in head-turning fashion. “It used to be ‘Stay at home and don’t be seen,’ ” said Janice Min, editorial director of The Hollywood Reporter. “Today, it’s a red carpet perfect storm. If you’re pregnant and you go out to an event, you get so much attention. People love to see pregnant celebrities flaunt it.”

A few pioneering actresses in the 1950s stepped out while showing (Eva Marie Saint in 1955 accepted her Oscar for best supporting actress, two days before her delivery, in a skirt suit). Lucille Ball persuaded CBS executives to write that she was “expecting” into “I Love Lucy.” And Ms. Goldman writes of how “the year 1963 became the year of tent dresses and shifts, and depending on exactly how the dresses were cut, many of them could be worn by any woman — pregnant or not.” With an emphasis on fitness and body-consciousness, the 1980s moved pregnancy away from the shift somewhat.

But Bonnie Fuller, the editor in chief of HollywoodLife.com, said the coming-out of celebrity pregnancy wasn’t really complete until Demi Moore posed full-bellied and nude for the cover of Vanity Fair’s August 1991 issue.

Before then, “you didn’t see women pregnant on the cover of magazines,” Ms. Fuller said. On set, slightly pregnant actresses would block their abdomens with furniture or props (“They would shoot the women from the neck up,” she said), while very pregnant actresses, to conceal weight gain, would shun the public eye completely. “Maybe it was so they wouldn’t lose out on a job,” Ms. Fuller said.

And when Annette Bening appeared at the Academy Awards in 2000, gloriously enceinte in a dark gown, it sparked “a revolution,” Ms. Fuller said. The Oscars have since functioned as a kind of runway for the expectant. (“Celebrities can be very lemming-like,” Ms. Min said.) Catherine Zeta-Jones (eight months pregnant, wearing cleavage-baring black Versace in 2003), Cate Blanchett (in royal purple Dries Van Noten with embellished neckline in 2008) and Natalie Portman (in Rodarte, also purple, in 2011) have all attended the awards show while visibly expecting. The arrivals are obsessively chronicled; the “bump” a point of pride, the ultimate accessory for someone who clearly has it all.

Indeed, “The Baby Bump is the New Birkin,” was the title of a 2012 essay by Renée Ann Cramer, an associate professor at Drake University, who wrote, “Celebrity pregnancy fashion provides welcome relief from treacly-sweet, pastel-hued, and shapeless maternity clothes of the past.”

While not everyone felt that way about Ms. Kardashian’s flower bomb, it’s hardly surprising that her pregnancy has been closely parsed. She rose to fame on a sex tape, Ms. Min said, adding: “It’s not like she’s the lead soprano at the Met Opera. Her whole purpose in life is to be photographed and scrutinized.”

And in turning the klieg lights on her condition, she certainly has company. Holly Madison, the former Playboy model whose Mother’s Day special, “Holly Has a Baby,” was shown on E, documented her recent pregnancy and delivery.

Last year during her first pregnancy, Jessica Simpson posed nude for Elle’s April cover, a copycat of Ms. Moore’s shoot, and became a spokeswoman for Weight Watchers to lose the baby weight. By September, she had introduced a maternity collection through a deal with Destination Maternity, which expanded this spring. Now carrying her second child, Ms. Simpson wears clothing from her line and has become something of a maternity cheerleader. “Your body is constantly changing, but you can look cute and feel good the entire time,” she said in an e-mail. One of her favorite looks from her collection seems ready for a party: a sexy black mini dress with tight lace sleeves that she wore recently on “Jimmy Kimmel Live.”

But for those less involved in retail, handling the attention stylishly can be a challenge. When asked if finding a gown for the Oscars was difficult, Ms. Bening told Newsweek at a Hollywood round table two years ago: “Oh, God, yeah. They kind of made something for me. And it was more like, how am I going to get out of a car and walk in?”

“I just remember it was a lot of attention on being so pregnant,” Ms. Bening added. “It wasn’t my favorite thing. Being slightly pregnant is easier. I was so big.”

Image Source: NYTimes.com

Actresses have significantly more selection now, with even designers in haute couture like Mr. Tisci getting involved. Kate Young, a stylist who worked with Ms. Portman on her 2011 look, said that “red carpets are easier than day-to-day because designers make the dresses for them.”

“Everyone gets pregnant in a different way,” Ms. Young said. “Some get super-busty, but some just look heavy.” For those clients with more ample décolletage and protruding bellies, Ms. Young said she keeps “the sides of the look really narrow.” Moreover, she’s vigilant about fit. “You have to watch because the body changes, about every two weeks,” she said.

The Marchesa designer Georgina Chapman, who last month gave birth to her second child with Harvey Weinstein, said that fit and comfort are the same goals as dressing any actress for an important appearance. But “there are additional factors to consider, the main one being whether she wants to slightly hide the bump or accentuate it,” Ms. Chapman said via e-mail. “I’ve worked with both types of women.”

About 18 weeks pregnant with her second child, Ivanka Trump advised highlighting other assets. For her, showing leg is an option (she attended the Met Gala, wearing a Juan Carlos Obando navy blouse and green skirt with a daring thigh-high slit) because it’s the area where “I tend to not gain too much weight,” Ms. Trump said.

And experience helps. “I learned a lot from my first pregnancy on how to dress and how not to dress,” she said. “Especially when you’re going through it the first time, you have a tendency to dress how your body used to look as opposed to how it currently does.” Even so, she hopes to move away “from traditional maternity” wear this time and risk more experimental styles that “would accommodate a growing belly.” There can be closet boredom, especially for celebrities who are photographed often. “How many wrap dresses can you buy essentially?” she said.

For everyday, Liz Lange, the maternity designer for Target who started an eponymous line in 1997 (now defunct) dressing pregnant celebrities like Cindy Crawford, Teri Hatcher and Kelly Ripa, suggested comfortable stretchy fabrics in bright hues. Personal style should carry through, Ms. Lange said, pointing to Kate Middleton. “It’s not like suddenly you’re supposed to hide in a big muumuu.”

While Ms. Young avoids dressing her pregnant clients in print fabrics, Ms. Lange said that a pattern was doable if strategic with scale and placement. Tie-dyes and ombré are more approachable, she said.

As for Ms. Kardashian’s red carpet look, Ms. Lange said, “It was a lot of print, literally down to her fingertips,” but she likes that the reality star “isn’t hiding in oversize shapes.”

In maternity wear, celebrities push the envelope, Ms. Lange said. “Kim Kardashian is an edgy dresser,” she said. “So why are we surprised?”

Dr. Cristian Andronic of Milford, Delaware, is known for his expertise in all aspects of
general gynecology and obstetrics. More articles about women's health, pregnancy, and child birth can be found in this blog site.