Archive for the ‘Pregnancy’ Category

Do you know the signs of preterm labor?

Wednesday, April 19th, 2017

If you’re pregnant, it’s important to know the signs of preterm labor and what to do if you experience any symptoms. Watch our video with Dr. Siobhan Dolan to learn more:

You can get more information about preterm labor and premature birth on our website.

Have questions? Text or email AskUs@marchofdimes.org.

Spring is here and so are ticks

Friday, April 7th, 2017

pregnant women walkingI remember the anxiety I felt after discovering a tick attached to my skin. I was reaching my hands behind my head and found a tick at the top of my neck where my hairline begins. The tick had already bitten me and was enlarged with blood. I never even felt the bite. That’s the tricky part about ticks, they crawl onto you and are so small they may be hard to see and nearly impossible to feel.

Why are these little creatures so dangerous?

Ticks can spread Lyme disease. Lyme disease is caused by a bacteria carried by an infected black-legged tick (also called a deer tick). This type of tick usually lives in wooded areas, like forests, or in places with high grass and bushes. A tick with Lyme disease can spread Lyme by biting you and has to be on your body for about 2 days before you can get infected.

If you get infected with Lyme disease during pregnancy, it may cause complications, including:

  • An infection in the placenta. The placenta grows in your uterus (womb) and supplies your baby with food and oxygen through the umbilical cord.
  • Stillbirth. This is when a baby dies in the womb after 20 weeks of pregnancy.
  • Congenital heart defects. These are heart conditions that are present at birth. They can affect the heart’s shape or how it works, or both.
  • Urinary tract defects. The urinary tract is the system of organs (like the kidneys and bladder) that helps your body get rid of waste and extra fluids. Urinary tract defects can cause pain, urinary tract infections, kidney damage and kidney failure.
  • Problems with your baby’s blood, like hyperbilirubinemia, which is when your baby’s blood has too much bilirubin in it. Bilirubin is a yellow substance that forms as red blood cells break down. Too much bilirubin can cause your baby to have jaundice. This is when your baby’s skin and the white parts of his eyes look yellow because his liver isn’t fully developed or working properly.

Untreated Lyme disease also may cause your baby to have a rash after he’s born.

How do you know if you have Lyme disease?

Early signs may include: headache, fever and chills, fatigue, muscle and joint pain, swollen lymph nodes  (glands throughout the body that help fight infection), and/or a rash called erythema migraines (also called EM). This rash looks like a bull’s eye around where the tick bit you.

Later signs may include: being short of breath, dizziness, stiff neck, severe headache, EM rash, joint pain and swelling, and/or facial paralysis (when you can’t feel or move parts of your face.)

If you have any signs or symptoms of Lyme disease, or you find a tick attached to your skin, call your health care provider. You can get a blood test to see if you have Lyme disease. Antibiotics are available and most women who get treatment during pregnancy have healthy babies.

Prevent Lyme disease by protecting yourself from tick bites

  • Use an EPA registered insect repellant.
  • Shower and check your body and clothes for ticks after being outside.
  • If you find a tick on you, remove it with tweezers – be sure to grab the tick near its head. Slowly pull the tick up and off your skin and be sure not to squeeze or crush the tick. Check with your healthcare provider or local Department of Health as to whether you should bring it in to be examined and tested for Lyme disease.  If not, flush the tick down the toilet. After removing the tick, clean the area with soap and water or rubbing alcohol.

For more information about Lyme disease and pregnancy, see our article.  

Have questions? Text or email AskUs@marchofdimes.org.

The latest Zika news: pregnant women still need to take precautions

Wednesday, April 5th, 2017

microcephalyJust when you may have thought that Zika was a thing of the past, a new report provides a wake-up call.

Here are the facts:

  • Last year in the United States, 1,300 pregnant women were infected with the Zika virus.
  • The virus was reported in pregnant women in 44 states; most of these women became infected as a result of travel to an area with Zika.
  • Of women with confirmed Zika evidence during pregnancy, 1 in 10 gave birth to a baby with birth defects.
  • Confirmed infections in the first trimester posed the highest risk – with about 15% of the babies having Zika-related birth defects.
  • Only 1 in 4 babies with possible congenital Zika syndrome were reported to have received brain imaging after birth.

What we know

If a pregnant woman becomes infected with Zika, the virus can pass to her baby.

Zika virus during pregnancy can cause damage to the baby’s brain, microcephaly (smaller than expected head) and congenital Zika syndrome, which includes eye defects, hearing loss, and limb defects.

Zika virus during pregnancy has also been linked to miscarriage and stillbirth.

What we don’t know

A very troubling aspect of this virus is that we don’t know the long-term effects it has on babies.

Dr. Siobhan Dolan, OB/GYN and medical advisor to the March of Dimes says “We don’t yet know the full range of disabilities in babies infected with Zika virus. Even babies who don’t have obvious signs of birth defects still may be affected.”

Care for babies

The report emphasizes that babies born to moms who have laboratory evidence of Zika virus during pregnancy will need additional medical monitoring and care after they are born. They should receive a comprehensive newborn physical exam, hearing screen, and brain imaging. Follow-up care with specialists is extremely important, as the full extent of congenital Zika virus on babies is not known.

Dr. Dolan emphasizes “Babies should receive brain imaging and other testing after birth to make a correct diagnosis, and to help us understand how these babies grow and develop.”

If you’re pregnant or trying to conceive, how can you protect yourself and your developing baby from the Zika virus?

Avoid Zika exposure.

The most common way Zika spreads is through mosquito bites, but it can also spread through unprotected sex, blood transfusions or lab exposure.

  • Do not travel to a Zika-affected area unless you absolutely have to. If you must travel, talk to your health care provider first, and take precautions to prevent mosquito bites.
  • Don’t have sex with a partner who may be infected with the virus or has recently travelled to a Zika-affected area.
  • If you live in an area where Zika is present, take precautions to avoid mosquito bites.

Bottom line

Prevent infection to protect your baby.

Dr. Dolan puts it in perspective: “Protect yourself from Zika before and during pregnancy, and that includes avoiding travel to affected areas. But remember — it’s not forever. Yes, you may miss a family event now, while you’re pregnant. But after the baby is born, in a few months, you’ll be able to travel safely and with peace of mind.”

Our website has detailed information on Zika and pregnancy, microcephaly and congenital Zika syndrome.

Stay tuned to learn about the Zika Care Connect website coming soon.

Have Questions? Text or email AskUs@marchofdimes.org.

Pregnant? Drinking alcohol is not worth the risk to your baby

Tuesday, April 4th, 2017

alcoholThere is NO safe amount of alcohol to drink during pregnancy and there is NO safe time to drink alcohol during pregnancy. If you are pregnant, trying to get pregnant, or think you might be pregnant, the best thing to do for your baby is to avoid alcohol.

When you drink alcohol during pregnancy, the alcohol in your blood quickly passes through the placenta and the umbilical cord to your baby. According to the National Organization on Fetal Alcohol Syndrome (NOFAS), “When you drink alcohol, so does your developing baby. Any amount of alcohol, even the alcohol in one glass of wine, passes through the placenta from the mother to the growing baby. Developing babies lack the ability to process or metabolize alcohol through the liver or other organs.”

Drinking any amount of alcohol at any time during pregnancy can harm your baby’s developing brain and other organs. Drinking alcohol during pregnancy increases your baby’s chances of:

  • Premature birth. This is when your baby is born before 37 weeks of pregnancy. Premature babies may have serious health problems at birth and later in life.
  • Brain damage and problems with growth and development.
  • Birth defects, like heart defects, hearing problems or vision problems.
  • Fetal alcohol spectrum disorders (also called FASDs). Children with FASDs may have a range of problems, including intellectual and developmental disabilities. They also may have problems or delays in physical development. FASDs usually last a lifetime.
  • Low birthweight (also called LBW). This is when a baby is born weighing less than 5 pounds, 8 ounces. Being low birthweight can cause serious health problems for some babies.
  • Miscarriage.
  • Stillbirth.

The good news is that FASD is entirely preventable. If you stop drinking alcohol before and during pregnancy, you can prevent fetal alcohol spectrum disorders (FASD) and other conditions caused by alcohol.

Remember, there is no safe amount, no safe time, and no safe alcohol during pregnancy. If you need help to stop drinking, talk to your health care provider. And if you are looking for some fun, non-alcoholic alternatives, check these out.

Questions? Email AskUs@marchofdimes.org.

Why is 39 weeks so important?

Thursday, March 30th, 2017

midwife measuring pregnancy bellyIf your pregnancy is healthy, it is best to wait for labor to begin on its own. And if you do decide to induce labor, ask your provider if you can wait until at least 39 weeks.

Most people think that pregnancy lasts 9 months. But that isn’t exactly true. Pregnancy usually lasts about 40 weeks (280 days) from the first day of your last menstrual period (also called LMP) to your due date. A first trimester ultrasound can also help to determine your due date.

In the past, a pregnancy that lasted anywhere between 37 to 42 weeks was called a term pregnancy. Health care providers once thought this 5-week period was a safe time for most babies to be born.

But experts now know that scheduling your baby’s birth a little early for non-medical reasons can cause problems for both mom and baby. Getting to at least 39 weeks gives your baby the time he needs to grow.

Why is 39 weeks so important?

Here’s why your baby needs 39 weeks:

  • Important organs, like his brain, lungs and liver, get the time they need to develop. At 35 weeks, a baby’s brain weighs just two-thirds of what it does at 39 weeks.
  • There is more time to gain weight. Babies born at a healthy weight have an easier time staying warm than babies who are born too small.
  • Your baby will be able to feed better. Babies born early can sometimes have difficulties with sucking, swallowing, and staying awake long enough to eat.
  • Your baby is less likely to have vision and hearing problems after birth.

Why can scheduling an early birth cause problems?

There are some risks associated with inducing labor:

  • Your due date may not be exactly right. Even with an ultrasound, your due date can be off by as much as 2 weeks. If you schedule an induction and your due date is wrong, your baby may be born too early.
  • Pitocin, the medication used to induce labor, can make contractions very strong and lower your baby’s heart rate.
  • You and your baby have a higher risk of infection if labor doesn’t begin soon after your water breaks.
  • If the medications used to induce labor do not work, you may need to have a c-section.

What if there are problems with your pregnancy?

You may not have a choice about when to have your baby. Your provider may need to induce labor to help keep you and your baby safe. If your provider does decide to induce labor for the health and safety of you and your baby, you can learn more about how labor is induced on our website.

Remember: If your pregnancy is healthy, it is best to let labor begin on its own. If you and your baby are healthy, and you and your provider decide to induce labor, make sure you wait until at least 39 weeks. Healthy babies are worth the wait!

Have questions? Email us at AskUs@marchofdimes.org.

Managing diabetes during pregnancy

Tuesday, March 28th, 2017

glucose screeningDiabetes is a serious health concern. About 9 out of 100 people (9 percent) in the U.S. have diabetes – a condition in which your body has too much sugar (called glucose) in the blood. Glucose is your body’s main source of fuel for energy. Insulin is a hormone that helps the glucose get into your cells to give them energy. If your body does not produce insulin or cannot use it efficiently, then over time, high blood sugar can lead to serious problems with your heart, eyes, kidneys, and nerve cells. You can develop diabetes at any time in your life, including during pregnancy.

There are three different types of diabetes:

  • Type 1 diabetes happens most often in children and young adults but it can develop at any age. With type 1 diabetes, your body does not make insulin.
  • Type 2 diabetes is the most common type of diabetes. In this case, your body does not make insulin or can’t use it normally. You are at an increased risk for type 2 diabetes if you are older, overweight, have a family history of diabetes, or do not exercise.
  • Gestational diabetes occurs during pregnancy. Seven out of every 100 pregnant women (7 percent) develop gestational diabetes. Gestational diabetes is tested for at 24-28 weeks of pregnancy. It usually goes away after you give birth. However, if you have it in one pregnancy, you’re more likely to have it in your next pregnancy. You’re also more likely to develop diabetes later in life.

Managing your diabetes during pregnancy

If you have diabetes, it is very important that you control your blood sugar. High blood sugar can be harmful to your baby, especially during the first few weeks of pregnancy when the brain, heart, kidneys and lungs begin to form.

Your blood sugar is affected by pregnancy, by what you eat and drink, and how much physical activity you get. If you have preexisting diabetes (diabetes BEFORE pregnancy), what worked to control your blood sugar before you became pregnant, may not work as well during pregnancy.
Here are some things that you can do to have a healthy pregnancy:

  • Go to all your prenatal care visits, even if you’re feeling fine.
  • Follow your provider’s directions about how often to check your blood sugar. Call your provider if your blood sugar is too high or too low.
  • Tell your provider about any medicine you take, even medicine that’s not related to your diabetes. Some medicines can be harmful during pregnancy, so your provider may need to change them to ones that are safer for you and your baby.
  • If you don’t already have a registered dietician (RD), your provider can recommend one for you. An RD is a person specially trained in nutrition. An RD can help you learn what, how much and how often to eat to best control your diabetes.  She can help you make meal plans and help you know the right amount of weight to gain during pregnancy. Check to see if your health insurance covers treatment from an RD.
  • Do something active every day. With your health provider’s OK, being active every day can help you manage your diabetes.

Diabetes can be a challenge, especially when you are pregnant. But it is possible to manage it and have a healthy pregnancy.

Have questions? Email us at AskUs@marchofdimes.org.

U.S. study shows fewer babies are dying in their first year of life

Wednesday, March 22nd, 2017

The death of a baby before his or her first birthday is called infant mortality. A new report released by the CDC shows that the infant mortality rate in the U.S. dropped 15% from 2005 to 2014. In kangaroo-care-242005 the rate was 6.86 infant deaths per 1,000 live births. In 2014, the rate dropped to 5.82 deaths per 1,000 live births.

While the study did not look at the underlying causes of the decline, it did report valuable information:

  • Infant mortality rates declined in 33 states and the District of Columbia. The other 17 states saw no significant changes.
  • Declines were seen in some of the leading causes of infant death including birth defects (11% decline), preterm birth and low birthweight (8% decline), and maternal complications (7% decline).
  • The rate of sudden infant death syndrome (SIDS) declined by 29%.
  • Infant mortality rates declined for all races, except American Indian or Alaska Natives.
  • Infants born to non-Hispanic black women continue to have an infant mortality rate more than double that of non-Hispanic white women.

“On the surface, this seems like good news. But it is far from time to celebrate,” said Dr. Paul Jarris, chief medical officer for the March of Dimes. “What is concerning, though, is that the inequities between non-Hispanic blacks and American Indians and the Caucasian population have persisted.” Dr. Jarris adds, “This report highlights the need to strengthen programs that serve low income and at-risk communities, especially those with the highest infant mortality rates.”

The infant mortality rate is one of the indicators that is often used to measure the health and well-being of a nation, because factors affecting the health of entire populations can also impact the mortality rate of infants.

What can you do?

Having a healthy pregnancy may increase the chance of having a healthy baby. Here are some things you can do before and during pregnancy:

Have questions? Text or email us at AskUs@marchofdimes.org.

Zika and sperm – a new concern

Wednesday, March 15th, 2017

spermThe latest news about the Zika virus is that there is a potential risk that some semen donated to sperm banks in South Florida might be contaminated with Zika.

Here’s why:

  • Zika can remain in semen for several months;
  • men who donated semen may not have shown signs or symptoms of Zika yet they could have been infected with the virus;
  • semen is not tested for Zika, unlike blood and tissue donations.

Therefore, it is possible that an infected man may have unknowingly donated semen contaminated with the Zika virus.

Where is the risk?

Although the Zika virus has been identified in Miami-Dade County, the risk of it spreading to other neighboring areas is possible, since individuals in this part of the state often travel to and from Broward and Palm Beach counties.

CDC says “This analysis has led to CDC identifying that since June 15, 2016, there has been a potential increased Zika risk for residents in Broward and Palm Beach counties because of local travel to areas of active transmission in Florida and challenges associated with defining sources of exposure.” The increased risk in the overall numbers of people exposed to the virus means that donor sperm may be at risk, too.

What does this mean to women trying to become pregnant by donor sperm?

Semen contains sperm, which is necessary for a woman to become pregnant. Although the risk of Zika transmission is small, if a woman wishes to become pregnant or currently is pregnant by donor sperm from these areas in Florida, she should speak with her healthcare provider. There have not been any confirmed cases of the Zika virus infecting a pregnant woman from donor sperm, but the possibility exists that it could occur.

The CDC emphasizes that Zika virus infection during pregnancy can cause brain problems, microcephaly, and congenital Zika syndrome, a pattern of conditions in the baby that includes brain abnormalities, eye defects, hearing loss, and limb defects.

See our website for more information on Zika during pregnancy, microcephaly, and congenital Zika syndrome.

The CDC website offers detailed guidance for people living or traveling to South Florida.

Have questions? Send them to AskUs@marchofdimes.org.

 

March is Trisomy Awareness Month

Monday, March 13th, 2017

chromosomesWhat is trisomy?

Babies with trisomy are born with an extra copy of a specific chromosome in most or all of their cells. This means that they have three copies of this chromosome in each cell rather than the typical number, which is two. Health conditions that may be associated with trisomy include heart defects, vision or hearing problems, and intellectual and developmental disabilities.

Chromosomes are the structures in cells that contain genes. Each person normally has 23 pairs of chromosomes, or 46 in all. An individual inherits one chromosome from the mother’s egg and one from the father’s sperm. When an egg and sperm join together, they normally form a fertilized egg with 46 chromosomes.

Sometimes a mistake in cell division occurs before a woman gets pregnant. A developing egg or sperm ends up with an extra chromosome. When this cell joins with a normal egg or sperm cell, the resulting embryo has 47 chromosomes instead of 46.

Common trisomy conditions

Although trisomy can occur with any chromosome, here are the conditions that are most often associated with an extra chromosome:

  • Trisomy 21 or Down syndrome: Down syndrome is one of the most common birth defects. In the US, about 6,000 babies (or 1 in 700) are born with Down syndrome each year. Most affected individuals have intellectual disabilities within the mild to moderate range. Although health conditions such as heart defects and vision and hearing problems are associated, most of these can be treated, and life expectancy is now about 60 years.
  • Trisomy 18 is also called Edward syndrome: Trisomy 18 occurs in about 1 in 5,000 live births each year. Affected individuals may have heart defects, significant intellectual and developmental delays, and other life-threatening medical problems.
  • Trisomy 13, also known as Patau syndrome: Trisomy 13 occurs in about 1 in 10,000 to 16,000 live births each year worldwide. Individuals with trisomy 13 often have heart defects, brain or spinal cord abnormalities, severe intellectual and developmental disabilities, and multiple physical problems in many parts of the body.

It is important to understand that every individual with a trisomy is unique and not all of them will have the same symptoms. The severity of the condition and the associated problems depend on:

  • Which chromosome is duplicated: An extra copy of certain chromosomes, like chromosome 1, is not compatible with life and the embryo will not develop.
  • How much of the extra chromosome is present: If only part of the chromosome is present, symptoms may be milder. If the complete chromosome is present, the symptoms may be more severe.
  • How many cells have the extra chromosome: If the copy of the extra chromosome is in only a few cells (mosaicism), the symptoms are usually less severe than if all of the cells in the body are affected.

In the past 10 years, the March of Dimes has invested over 15  million dollars into research for chromosomal conditions, including trisomy. And many March of Dimes grantees are studying basic biological processes of development. This important research should improve our understanding of how genes and other factors affect the development of a baby.

Have questions? Text or email us at AskUs@marchofdimes.org.

Do you need carrier screening?

Friday, March 10th, 2017

preconception healthRecently the American College of Obstetrics and Gynecology (ACOG) updated their recommendations for carrier screening.

A gene is a part of your body’s cells that stores instructions for the way your body grows and works. Genes come in pairs—you get one of each pair from each parent.

Sometimes the instructions in genes change. This is called a gene change or a mutation. Parents can pass gene changes to their children. Sometimes a gene change can cause a gene to not work correctly. Sometimes it can cause birth defects or other health conditions.

For certain conditions, if you inherit a gene change from just one parent, you have the gene change but not the disease. When this happens, you’re called a carrier. A carrier of a genetic mutation does not have any symptoms of the disease or condition. But, if their partner carries a change in the same gene, then they are at risk to have a baby with the condition.

If you and your partner both carry the gene change for a condition, your baby may get two gene changes (one from each of you) and have the disease. If both you and your partner are carriers (you both have the gene change), there is:

A 1-in-4 chance (25 percent) that your baby can have the disease

A 1-in-4 chance (25 percent) that your baby won’t have the disease and won’t be a carrier

A 1-in-2 chance (50 percent) that your baby won’t have the disease but will be a carrier

Who should get carrier screening?

Carrier screening is simply a blood test. The updated recommendations for carrier screening include:

  • All pregnant women should be offered information about carrier screening. They may then choose to have some screening or none at all.
  • Ideally, carrier screening should be done before pregnancy.
  • If a woman is a carrier for a specific condition, her partner should be offered carrier screening as well.
  • If both parents are found to be carriers of a specific disorder, they should meet with a genetic counselor. This will allow them to better understand the condition, the possible risks to their children, and how other family members may be affected.

What conditions should be tested for?

ACOG now recommends ALL WOMEN be offered carrier screening for the following conditions:

  • Spinal Muscular Atrophy (SMA): SMA is a disease that attacks nerve cells in the spinal cord. These cells communicate with your muscles. As the neurons die, the muscles weaken. This can affect walking, crawling, breathing, swallowing, and head and neck control.
  • Cystic fibrosis (CF): CF is a condition that affects breathing and digestion. It’s caused by very thick mucus that builds up in the body. This thick and sticky mucus builds up in the lungs and digestive system and can cause problems with how you breathe and digest food.
  • Hemoglobinopathies: These are blood conditions that are caused by problems with hemoglobin. Hemoglobin is a protein in the blood that carries oxygen. There are different kinds of hemoglobin in the blood, and there are many kinds of hemoglobin disorders. Some are caused when hemoglobin doesn’t form correctly or when your body doesn’t make enough hemoglobin.

Additional carrier screening should be offered for other conditions based on family history. If you are planning a pregnancy or are pregnant already, make sure you talk to your health care provider about the new guidelines and discuss any questions or concerns you may have.

Have questions? Text or email us at AskUs@marchofdimes.org.