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Rare Pregnancy Complications

Most pregnancies progress normally without complications while other pregnancies occur with rare complications that interfere with normal fetal development. These may be related to a genetic disorder, problems with the fetus’s chromosomes, or abnormal placental development. Sometimes, diseases or conditions the mother had before she became pregnant can lead to complications during pregnancy. Identical twin pregnancies can also be susceptible to issues related to the sharing of a single placenta and common blood vessels.

A few women experienced very unusual complications in pregnancy, sometimes with a risk of stillbirth. Even with complications, early detection and prenatal care can reduce any further risk to you and your baby.

7 of the rarest complications of pregnancy include:

Lower Urinary Tract Obstruction  (LUTO) is A rare birth defect in which the fetus has a blockage in the urethra, the tube that carries urine out of the baby’s bladder and into the amniotic sac. LUTO is also known as bladder outlet obstruction.

Fetal Hydrothorax is when abnormal amounts of fluid from within the chest of a fetus. This fluid may be in the space between the lungs and the chest wall (pleural space) or within the core of the lung or chest masses. Fetal hydrothorax may also be referred to as a pleural effusion.

Twin Reversed Arterial Perfusion (TRAP) is a rare condition of monochorionic twin pregnancies. It arises when the cardiac system of one twin does the work of supplying blood for both twins. The twin supplying the blood is known as the “pump twin” and develops normally in the womb.

Twin-to-Twin Transfusion Syndrome (TTTS)  is a rare pregnancy condition affecting identical twins or other multiples. TTTS occurs in pregnancies where twins share one placenta (afterbirth) and a network of blood vessels that supply oxygen and nutrients essential for development in the womb.

Twin Anemia Polycythemia Sequence (TAPS)  is a rare but severe complication in identical twin pregnancies that share a single placenta (monochorionic). TAPS is caused by an imbalance in red blood cells exchanged between the twins through tiny placental blood circulations (anastomoses).

Congenital Diaphragmatic Hernia is a birth defect where there is a hole in the diaphragm (the large muscle that separates the chest from the abdomen). Organs in the abdomen (such as intestines, stomach, and liver) can move through the hole in the diaphragm and upwards into a baby’s chest.

Selective Intrauterine Growth Restriction is a condition that can occur in some identical twin pregnancies. These pregnancies are known as monochorionic, which means the twins share a placenta (afterbirth) and a network of blood vessels.

Treatments and procedures during labor and delivery

Sometimes the vaginal opening does not stretch enough for the baby’s head. In this case, an episiotomy aids your healthcare provider in delivering your baby. An episiotomy makes the opening of the vagina a bit wider, allowing the baby to come through it more easily. Sometimes a woman’s perineum may tear as their baby comes out. In some births, an episiotomy can help to prevent a severe tear or speed up delivery if the baby needs to be born quickly. Normally, once the baby’s head is seen, your healthcare provider will ease your baby’s head and chin out of your vagina. Once the baby’s head is out, the shoulders and the rest of the body follow.

Doctors will perform a cesarean when the low-lying placenta partially or completely covers the cervix (placenta previa). A cesarean is also necessary when the placenta separates from the uterine lining, causing the baby to lose oxygen (placenta abruption). Health care providers use it when they believe it is safer for the mother, the baby, or both.

Fetal ultrasound is a test used during pregnancy. It creates an image of the baby in the mother’s womb (uterus). It’s a safe way to check the health of an unborn baby. During a fetal ultrasound, the baby’s heart, head, and spine are evaluated, along with other parts of the baby. The test may be done either on the mother’s abdomen (transabdominal) or in the vagina (transvaginal).

Fetal heart rate monitoring measures the heart rate and rhythm of your baby (fetus). This lets your healthcare provider see how your baby is doing. Fetal heart rate monitoring is especially helpful if you have a high-risk pregnancy and may be used to check how preterm labor medicines are affecting your baby. The average fetal heart rate is between 110 and 160 beats per minute. It can vary by 5 to 25 beats per minute. The fetal heart rate may change as your baby responds to conditions in your uterus. An abnormal fetal heart rate may mean that your baby is not getting enough oxygen or that there are other problems.

Most pregnant women with rare complications want to do everything right for their baby, including eating right, exercising regularly, and getting good prenatal care. If the complications you encountered in your pregnancy are causing your mood disorder, you may benefit from speaking with a reproductive psychiatrist that may also be trying to manage your psychiatric symptoms as you prepare to welcome your new baby. 

Disclaimer

The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. The purpose of this website is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

References: 

https://www.hopkinsmedicine.org/health/conditions-and-diseases/rare-pregnancy-complications

https://healthtalk.org/pregnancy/rarer-complications

https://www.healthline.com/health/pregnancy/delivery-complications

Treatment for Pregnant COVID-19 Patients

Treatment for Pregnant COVID-19 Patients

Pregnancy can be a time of joyous anticipation and excitement for women and their families. But the coronavirus pandemic raises concerns. If you haven’t had a COVID-19 vaccine, take steps to reduce the risk of infection. Pregnant women who have known or suspected COVID-19 infection need to be evaluated quickly to determine the severity of their symptoms and if they have risk factors that put them at risk for severe disease. Treatment for Pregnant COVID-19 Patients varies the severity of their symptoms.

Avoiding the Coronavirus During Pregnancy

Avoiding infection with the coronavirus is a top priority for pregnant women. You should do everything you can to protect yourself from getting COVID-19. Pregnant women can experience changes to their immune systems that can make them more vulnerable to respiratory viruses. 

Pregnant women should be vaccinated against influenza (the flu) because if they get the flu they can get very sick, and having a high fever raises the risk of harm to your baby.

If you think you have been exposed to an infected person, and you are having COVID-19 symptoms such as fever, cough, HA, sore throat, the new loss of taste or smell, fatigue, myalgias, GI symptoms (diarrhea, nausea, vomiting), rhinorrhea, chills, difficulty breathing and/or SOB, should be tested for infection with the SARS-CoV-2. You must call your doctor and follow his or her advice. Adhere to precautions carefully. Stay at least 6 feet from others, wear a mask, and avoid large gatherings and indoor socializing outside of your household. 

Outpatient Treatment of Pregnant COVID-19 Patients

For COVID-19 in pregnancy, we can provide treatment. Several medications currently in use are also being used for our pregnant women, and early studies have shown they can provide some benefit.

Patients who are stable and not in an increased risk situation can continue to be monitored at home. Video conferencing communication is preferred to phone calls. A minimum, daily temperature with values over 38.3°C warranting further evaluation. If the patient can acquire medical devices such as a thermometer, a doppler monitor for fetal heart rate recording, she can be instructed to monitor fetal activity to reassure herself about fetal well-being. Report the findings to the OB provider during telemedicine visits. Monitoring can be completed every 2-3 days depending on the severity of COVID-19 infection. Telemedicine visits can be done more frequently for at-risk patients. Many rural and urban health institutions have already established at-home self-testing

If the patient has comorbidities known to increase the risk of severe COVID-19 infection, she is considered to be a moderate risk and should be evaluated as soon as possible in an ambulatory setting where she can test the pulse rate. Social environments where there are limited resources for remote at-home care and monitoring, no internet access, who live alone or are undomiciled, and who have limited or no transportation, may increase a pregnant woman’s risk for severe COVID-19 symptoms. Patients at risk for obstetrical complications, poor outcomes, stillbirth, and premature labor may need to be evaluated in person. 

Above all, focus on taking care of yourself and your baby. Contact your health care provider to discuss any concerns. If you’re having trouble managing stress or anxiety, talk to your health care provider or a mental health counselor about coping strategies.

Disclaimer

The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. The purpose of this website is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

References:

https://blog.thesullivangroup.com/treatment-for-pregnant-covid-19-patients-not-requiring-hospitalization

https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-and-covid-19-what-pregnant-women-need-to-know https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/pregnancy-and-covid-19/art-20482639

AMNIOTIC FLUID

AMNIOTIC FLUID: What you need to know

What is amniotic fluid?

The Amniotic fluid is the fluid that surrounds your baby during pregnancy. It’s very important for your baby’s development. It is a clear, yellow fluid that is found within the first 12 days following conception within the amniotic sac. It is the protective liquid contained by the amniotic sac of a gravid amniote. This fluid serves as a cushion for the growing fetus but also serves to facilitate the exchange of nutrients, water, and biochemical products between mother and fetus. It also helps keep the umbilical cord floating freely so that it doesn’t get squished between the baby and the side of your uterus.

Facts

  • At first, it consists of water from the mother’s body, but gradually, the larger proportion is made up of the baby’s urine.
  • It also contains vital components, such as nutrients, hormones, and infection-fighting antibodies and it helps protect the baby from bumps and injury.
  • If the levels of amniotic fluid levels are too low or too high, this can pose a problem.
  • When it is green or brown, this indicates that the baby has passed meconium before birth. Meconium is the name of the first bowel movement. Meconium in the fluid can be problematic. It can cause a breathing problem called meconium aspiration syndrome that occurs when the meconium enters the lungs. In some cases, babies will require treatment after they are born.

Amniotic fluid is responsible for:

  • Protecting the fetus: The fluid cushions the baby from outside pressures, acting as a protective function against external trauma or shock.
  • Temperature control: It helps maintain fetal temperature stable.
  • Protection and defense against infection. The amniotic fluid contains antibodies. 
  • Lung and digestive system development: It contributes to lung maturation by breathing and swallowing it, the baby practices using the muscles of these systems as they grow.
  • Muscle and bone development: It allows fetal musculoskeletal, gastrointestinal, and lung development.
  • Lubrication it prevents parts of the body such as the fingers and toes from growing together; webbing can occur if amniotic fluid levels are low. 
  • Umbilical cord support: Fluid in the uterus prevents the umbilical cord from being compressed. This cord transports food and oxygen from the placenta to the growing fetus.

How much amniotic fluid should there be?

Normally, the level of fluid is at its highest around 36 of pregnancy, measuring around 1 quart. This level decreases as birth nears. After that, the amount usually begins to decrease. Sometimes you can have too little or too much amniotic fluid. Having too little fluid is called oligohydramnios. Having too much fluid is called polyhydramnios. Either one can cause problems for a pregnant woman and her baby. Even with these conditions, though, most babies are born healthy. 

Oligohydramnios. Amniotic fluid deficiency. This condition is associated with complications, such as:

  • Early labor induction.
  • Low birthweight.
  • Fetal bradycardia during delivery.
  • It can even cause fetal death.

Polyhydramnios. An excess of amniotic fluid. This condition is associated with complications, especially maternal, such as:

  • Gestational diabetes.
  • Hypertension during pregnancy.

Sometimes, fluid leaks before the waters break. When the waters break, the amniotic sac tears. It is contained within the sac then begins to leak out via the cervix and vagina. Anyone who is concerned about leaking or levels of amniotic fluid during pregnancy should discuss this with their healthcare provider.

Therefore, Amniotic fluid has a very important role in the fetus’s development and well-being during pregnancy.  Any alteration can cause major damage. In addition, its prenatal study and analysis can detect congenital defects, such as chromosome disorders. This is performed through amniocentesis. However, this technique is also associated with major risks that the medical professional must evaluate before performing it on a patient.

Disclaimer

The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. The purpose of this website is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

References:

https://www.healthline.com/health/pregnancy/how-to-increase-amniotic-fluid

https://www.marchofdimes.org/pregnancy/amniotic-fluid.aspx

https://www.medicalnewstoday.com/articles/307082

First Time Pregnancy: Tips for a Healthy Pregnancy

Having a child is the most precious, amazing, and scariest thing ever. The basic logic here is to be healthy and stay healthy for you and your baby. Here are some tips for you for a first-time pregnancy. These will help you get through your first time being pregnant with little worrying. Let’s face it, we’re women and we worry but don’t get so worked up, it will upset the baby. Good luck and congratulations.

Take Care of Yourself

The basic premise here is to be healthy and stay healthy for you and your baby.  Don’t smoke or be around secondhand smoking or be around heavy smokers. You should not drink either.  You should sleep and rest as much as possible because you will NEED it! If you’re not, start taking prenatal vitamins, with folic acid.  When you buy these, always make sure they contain folic acid. It is vital to your pregnancy. Taking care of yourself will ensure that you have a healthy baby growing inside of you.  Your baby’s neural cord turns into the brain and spinal cord, developing in the 1st month you’re pregnant. Therefore, essential vitamins and minerals are very important from day one.

Exercise 

Having a baby is rough both physically and mentally. Staying active is important for your general health and can help you reduce stress, control your weight, improve circulation, boost your mood, and sleep better. Low impact exercise can help ease back pain, increase circulation, and improve your mood. It will also strengthen your muscles and ligaments in preparation for labor. Take pregnancy exercise or walk at least 15-20 minutes every day at a moderate pace, in cool, shaded areas or indoors in order to prevent overheating. Aim for 30 minutes of exercise most days of the week. Listen to your body, though, and don’t overdo it.

Take a Prenatal Vitamin

Even when you’re still trying to conceive, it’s smart to start taking prenatal vitamins. Within the first month of pregnancy, your baby’s neural cord, which becomes the brain and spinal cord, develops, so it’s important you get essential nutrients, like folic acid, calcium, and iron from the very start.

Eating Healthy

If you’re pregnant or thinking about getting pregnant, you need to start taking care of yourself. Don’t smoke or be around secondhand smoke, don’t drink, and get your rest. You may drink 8-10 glasses of water each day, you should eat five or six well-balanced meals with plenty of folate-rich foods like fortified cereals, asparagus, lentils, wheat germ, oranges, and orange juice. Limit your caffeine during pregnancy since it can have harmful effects on you and the baby. Add fish to your diet since fish is high in omega 3s, a nutrient critical to brain development. There’s just one catch: Some kinds of fish contain mercury, which can be toxic to both babies and adults.

To be safe, the FDA recommends that pregnant women eat no more than 12 ounces of fish per week. Stick with canned light tuna, shrimp, salmon, pollack, or catfish. Avoid swordfish, shark, king mackerel, and tilefish, which are all high in mercury.

Track Your Weight Gain

During your pregnancy, it’s okay to gain weight, you’re eating for two, however, gaining too much weight can be unhealthy for you. If you don’t gain enough weight, your baby’s birth weight and health could be in jeopardy. You’re eating for two. But packing on too many extra pounds may make them hard to lose later.  

Here’s what the IOM recommends, based on a woman’s BMI (body mass index) before becoming pregnant with one baby:

– Underweight: Gain 28-40 pounds

– Normal weight: Gain 25-35 pounds

– Overweight: Gain 15-25 pounds

– Obese: Gain 11-20 pounds

Check-in with your doctor frequently to make sure you’re gaining at a healthy rate.

Eliminate Toxins

Avoid tobacco, alcohol, illicit drugs, and even solvents such as paint thinners and nail polish remover while pregnant because they are linked to birth defects, miscarriage, and other problems. Smoking cigarettes, for example, decreases oxygen flow to your baby; it’s linked to preterm birth and other complications. A doctor can offer advice and support, as well as refer you to a program that helps pregnant women stop smoking.

Make a Birth Plan

Being a mother begins during the birth of your baby. You want to make this moment special and safe. That is why making a birthing plan is essential. Do your own research online about your options before taking any advice from friends and family. This is your decision so you should have an unbiased view of the ways to give birth.

While a hospital birth is traditional, a rise in the use of midwives and even home births is occurring. The decisions to use an epidural, have a water birth, or a delayed cord clamping are just a few more.

Since it’s your first time being pregnant, it’s scary. As you progress in your pregnancy, more questions will pop up daily. To find more tips for first-time pregnancies visit online forums and mom’s groups to get anecdotal advice from moms who have been in your shoes.

If you don’t know what your pains are, call the doctor or talk to a  nurse in the office and ask them about the pains.  Enjoy your pregnancy!

Disclaimer

The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. The purpose of this website is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

References:

https://www.parents.com/pregnancy/my-body/pregnancy-health/healthy-pregnancy-tips/

https://ferny.com/life-style/tips-for-first-time-pregnancies/

Getting Pregnant During COVID-19 Pandemic

COVID-19 is still a new disease that we are learning more about each day. We know this has been a scary time for most people globally. Many people are living through their first pandemic, and even just getting household essentials has been a challenge some days.

During this time of the coronavirus (COVID-19) pandemic, people have questions about whether or not they should get pregnant. If you are pregnant or thinking about becoming pregnant, you’re likely concerned about how the pandemic will impact your pregnancy. We still have relatively little information about how this virus affects pregnant people and their pregnancies. It’s common to feel alarmed and stressed throughout this time, as starting or expanding a family brings up new questions. 

Are pregnant people at higher risk for COVID-19?

The overall risk of COVID-19 to pregnant women is low. However, the physiologic changes of pregnancy make pregnant people appear more likely to develop respiratory complications requiring intensive care than women who aren’t pregnant. Pregnant people who have other medical conditions might be at further increased risk for severe illness. More research is needed to know specifically how this virus impacts pregnant people since this virus COVID-19 is new.

Labor and delivery risks to the mother’s and the baby’s health?

If you have COVID-19 and are pregnant, your treatment will be aimed at relieving symptoms and may include getting plenty of fluids and rest, as well as using medication to reduce fever. If you’re very ill, you may need to be treated in the hospital. There is no definite evidence that the COVID-19 virus can be passed from the pregnant parent to the fetus through the placenta, called vertical transmission. If you give birth while you are positive for COVID-19, you do not need to have a cesarean section, or c-section, unless otherwise medically indicated. However, some research suggests that pregnant women with COVID-19 are also more likely to have a premature birth and cesarean delivery, and their babies are more likely to be admitted to a neonatal unit. 

If you are healthy as you approach the end of pregnancy, some aspects of your labor and delivery might proceed as usual. But be prepared to be flexible. You might be screened again before entering the labor and delivery unit to protect the health of you and your baby, definitely the facilities will limit the number of people you can have in the room during labor and delivery.

Preterm birth is the most common side effect on the fetus of a pregnant parent positive for COVID-19.

Postpartum Considerations

This is a stressful time, pay attention to your mental health. Reach out to family and friends for support while taking precautions to reduce your risk of infection with the COVID-19 virus. Access to early prenatal care is important and should be accessible during this time. However, public health experts are recommending avoiding unnecessary medical visits.  Talk to your health care provider about virtual visit options for checking in after delivery, as well as your need for an office visit. However, It’s recommended that postpartum care after childbirth be an ongoing process.

Disclaimer

The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. The purpose of this website is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

References

https://www.mayoclinic.org/

https://helloclue.com/articles/pregnancy-birth-and-postpartum/is-it-safe-to-get-pregnant-during-coronavirus