Severe bleeding during pregnancy can be placenta previa

27
Jul
Posted by Lauren

contemplative pregnant woman During my mom’s pregnancy with me, she was diagnosed with placenta previa, a condition in which the placenta lies very low in the uterus and covers all or part of the cervix. The cervix is the opening to the uterus that sits on the top of the vagina. If you have placenta previa, when your labor starts, your cervix begins to thin out and dilate (open up), and the blood vessels connecting the placenta to your uterus may tear. This can cause severe bleeding.

My mom remembers the day I was born, like it was yesterday. She remembers my Aunt running down the hall to get towels for her while she stood in the bathroom bleeding during her third trimester. She was rushed to the hospital and had an emergency Cesarean section (C-section) performed. My mom says she can still remember what the pressure felt like on her lower abdomen during the procedure.

We don’t know what causes placenta previa, which happens in about 1 in 200 pregnancies. If you have placenta previa early in pregnancy, it usually isn’t a problem. However, it can cause serious bleeding and other complications later in pregnancy.

Diagnosis and symptoms

The most common symptom of placenta previa is painless bleeding from the vagina during the second half of pregnancy. If you have spotting or bleeding during pregnancy, it’s important you call your provider right away. But, not all women with placenta previa have vaginal bleeding. In fact, about one-third of women with placenta previa don’t have this symptom. An ultrasound can usually pinpoint the placenta’s location to determine if you have placenta previa.

Is there treatment?

Treatment depends on how far along you are in your pregnancy, the seriousness of your bleeding and the health of you and your baby. The goal is to keep you pregnant as long as possible, but at any stage of pregnancy, a C-section may be necessary if you have dangerously heavy bleeding or if you and your baby are having problems.

How can I reduce my risk?

We don’t know how to prevent placenta previa, but you may be able to reduce your risk by not smoking or doing illicit drugs such as cocaine. If you have a healthy pregnancy, and there isn’t a medical reason for you to have a C-section, it’s best to let labor begin on its own. The more C-sections you have, the greater your risk of placenta previa.

As soon as my mom held me in her arms, she said she forgot all about the scary hours beforehand. She was so grateful that she had gone to the hospital when she did.

Remember, if you have spotting or bleeding at any point in your pregnancy, call your provider right away or go to the emergency room.

Maternal PKU

24
Jul
Posted by Sara

newborn-screening-picture1PKU or phenylketonuria is a condition in which your body can’t break down an amino acid called phenylalanine.

In the US, about 3,000 women of childbearing age have PKU. A woman with PKU can have a healthy baby but it is very important that she stay on a special diet to control her phenylalanine intake while she is pregnant. According to MotherToBaby, babies born to mothers with untreated PKU (women who are not on the special diet) are commonly born smaller, have microcephaly (an abnormally small head), intellectual disabilities, behavior problems, facial features similar to those of fetal alcohol syndrome, and have higher risks of heart defects.

Managing PKU during pregnancy

If you have PKU and are planning to get pregnant, it is very important that you talk to your health care provider. Many people with PKU now maintain their special diets throughout life. But if you have not been following your PKU diet, it is best to return to your PKU meal plan at least 3 months before you try to get pregnant.

PKU meal plans are different for everyone because people with PKU can tolerate different amounts of phenylalanine. For this reason, it is very important that you talk to health care providers who are familiar with managing PKU during pregnancy. Blood tests throughout pregnancy can help to monitor your phenylalanine levels and make sure that they are not too high. And your prenatal care provider may order ultrasounds to monitor your baby’s growth.

Will my baby have PKU?

If you have PKU, your baby has a chance to have PKU. Your baby has to inherit a mutation for PKU from both parents to have PKU. Whether or not your baby will have PKU depends on if your partner has PKU or is a PKU carrier. (A PKU carrier has one copy of the PKU mutation but does not have PKU.)

  • If you and your partner both have PKU, your baby will have PKU.
  • If you have PKU and your partner is a carrier, than there is a 50% chance your baby will have PKU and a 50% chance your baby will be a PKU carrier.
  • If you have PKU but your partner does not carry the gene change for PKU, then your baby will be a PKU carrier but will not have PKU.

If you are not sure if your partner is a PKU carrier, there are tests available that can help you find out. A genetic counselor can better help you understand your chances of passing PKU to your baby.

All babies born in the United States are tested for PKU through the newborn screening program. Babies born with PKU are immediately placed on a special diet that significantly reduces the amount of phenylalanine they consume. Babies who have PKU may never show symptoms if they are transitioned to a low-phenylalanine diet soon after birth.

Questions? Send them to AskUs@marchofdimes.org.

 

Happy 25th Anniversary ADA!

22
Jul
Posted by Barbara

wheelchair symbolThere is so much that we have in our country that enables individuals with disabilities to access buildings, streets and facilities safely and without difficulty. A sidewalk ramp, an elevator, handicapped parking spots, wider doors to allow wheelchairs to pass through, sign language interpreters, tweeting sounds at street crosswalks, and braille on elevators are just a few of the enhancements that people with disabilities utilize today.

But it was not always this way.

I remember a time when my classmate who was in a wheelchair, could not enter a bathroom stall in a public restroom, because the door was not wide enough for her wheelchair to pass through. I’m sure other people remember times when individuals with disabilities could not get on a bus, get down a curb to cross a street, or find an elevator instead of stairs to get to the second floor of a building. Simply put, daily life was so much harder and often prohibited a person from going places, being independent or living life similar to a person without disabilities.

But all of this changed on July 26, 1990, when the American with Disabilities Act, or ADA, was signed into law by President George H. W. Bush.

The ADA prohibits discrimination on the basis of disability in employment, transportation, public accommodation, communications, and governmental activities. The law removes barriers and establishes that reasonable accommodations be made available to people with disabilities.

What is a disability under the ADA?

The ADA defines a disability as “a physical or mental impairment that substantially limits one or more major life activities, a person who has a history or record of such an impairment, or a person who is perceived by others as having such an impairment. The ADA does not specifically name all of the impairments that are covered.” In addition, the disability does not have to be severe or permanent, either. For example, a pregnant woman who is temporarily unable to perform her job due to pregnancy must be treated the same way as another temporarily disabled employee.

How does the ADA help people with disabilities?

The ADA is not only there for physical enhancements in our environment; it seeks to eliminate discrimination on the basis of disability, much the same way the Civil Rights Act of 1964 outlawed discrimination based on sex, race or religion.

The ADA website describes in detail the ways in which this law helps individuals with disabilities access jobs, schools, public places (such as day care centers, recreation facilities, movie theaters, restaurants, hotels, pools and many other places), and services such as telephones, cell phones, pagers, call-waiting, and operator services.

You can read more about how this law is far reaching and important in the lives of individuals with disabilities at ADA.gov or Disability.gov.

So, happy anniversary ADA. And thank you for helping to become an equalizer when it comes to access and opportunity for so many Americans.

 

Baby it’s hot outside

21
Jul
Posted by Barbara

heatExtreme heat can be dangerous. High temperatures, especially coupled with humidity, can cause heat related illnesses. If you live in the northeast, you are familiar with the brutally hot weather we have been experiencing.

Here is what you need to know to stay safe, especially if you are pregnant, have a medical condition, or have a baby or young children.

Know the signs of heat illness and what to do:

Heat cramps

  • Symptoms: Muscle cramps in legs or abdomen (stomach area), with or without sweating.
  • To do: Get the person out of the heat – into an air conditioned room, if possible. Gently massage the cramped muscles. Sips of water are ok unless the person is nauseous.

Heat exhaustion

  • Symptoms: Sweating; clammy but cool skin; cramping; dizziness; nausea and/or vomiting; fainting; weak pulse.
  • To do: Bring the person into a cool room with air conditioning. Let them lie down and sponge them with a cool, wet cloth. Let them sip water slowly. If they continue to vomit, get medical attention.

Heatstroke or sunstroke -This is the most serious of heat illnesses. Call 911 or go to the nearest hospital.

  • Symptoms: confusion nausea; dizziness; a fever; headaches; difficulty breathing; rapid pulse; hot, dry skin, sweating or both. Take steps to cool the person off by loosening or removing clothing, going inside an air conditioned room, or cooling them down with a sponge bath. Do not give water or fluids.
  • To do: Seek medical attention immediately.

Avoid heat illness by being prepared -an ounce of prevention goes a long way:

  • NEVER leave a person of any age or a pet in a parked car, even if the windows are open a little. Children die needlessly this way every year. Do not leave them in a car even for a minute!
    Here are potentially lifesaving tips for never leaving your child in your car.
  • Stay inside, in an air condition room. If you must go outside, do so in the early or late hours of the day when it is cooler. Wear sunscreen. Keep outdoor stays brief.
  • Drink plenty of water all day. Limit drinks containing sugar or caffeine and avoid alcoholic beverages.
  • Eat light foods which are easier to digest.
  • If you must be outside, take time to relax in a shady area or go inside a cool building often.
  • Wear lightweight clothing. This is very important for children – if overdressed, their body temperature can rise to over 105 degrees Fahrenheit in a very short time.
  • Take a cool bath or shower.

Here are more tips on how to keep your child cool and safe in extreme heat, from the AAP.

With a little planning and care, you can stay safe and avoid a serious problem.

Silent but dangerous bacteria

20
Jul
Posted by Lauren

Pregnant woman with doctorAbout 25% of pregnant women carry Group B streptococcus (also called Group B step or GBS). GBS may come and go quietly in your body without any symptoms, so you may not be aware that you are carrying it. GBS may never make you sick and we don’t know exactly how the bacteria is transmitted. But while GBS may not be harmful to you, it can be very harmful to your baby.

How can GBS affect you during pregnancy?

GBS lives in the rectum or vagina and can cause a bladder or urinary infection (UTI). Women who have symptoms can receive antibiotics from their provider. If you don’t have symptoms of an infection, you may not know you need treatment. Without treatment, a uterine infection during pregnancy can increase your chances of:

• Premature rupture of the members – When the amniotic sac breaks after 37 weeks of pregnancy but before labor starts
• Preterm labor – Labor that happens too early, before 37 weeks of pregnancy
• Stillbirth – When a baby dies in the womb before birth, but after 20 weeks of pregnancy

Is there any good news?

Yes, you can be tested for GBS. If you are pregnant, you will be tested for GBS at 35 to 37 weeks of pregnancy. Your provider will take a swab of your vagina and rectum and the sample will be sent to the lab. The process is simple and painless and results will be available in 1 to 2 days. If you go into preterm labor, your provider can use a quick screening test during labor to test you for GBS.

If the test is positive:

You will receive an antibiotic from your provider during labor and birth through an IV, which helps prevent your baby from getting the infection. Remind your health care provider at the hospital when you go to have your baby; this way you can be treated quickly. It may be helpful to make a note and stick it on top of your hospital bag so you remember as you walk out the door. If you have GBS and a scheduled cesarean birth (C-section) before labor starts and before your water breaks, you probably don’t need antibiotics.

With treatment, a woman has only a 1 in 4,000 chance of delivering a baby with group B strep, compared to a 1 in 200 chance if she does not get antibiotics during labor.

If you are worried about GBS, speak with your health care provider. Have questions? We are here; email AskUs@marchofdimes.org.

Banking your baby’s umbilical cord blood–should you do it?

17
Jul
Posted by Sara

newborn-2The umbilical cord connects your baby to the placenta. Umbilical cord blood contains stem cells, which may be used to treat certain diseases. Because of this, many people consider storing or banking the cord blood so that it may possibly be used in the future.

What are stem cells?

Stem cells can grow into specific kinds of cells in your body and may be used to treat some diseases, like cancer. In healthy people, bone marrow makes stem cells. But sometimes a person’s bone marrow stops working and doesn’t make enough healthy stem cells. For people with conditions like cancer, treatments like chemotherapy or radiation can kill healthy stem cells.

If a person needs new stem cells, he may be able to get a stem cell transplant from cord blood. New stem cells from the transplant can go on to make new, healthy cells.

Storing cord blood

There are two options for storing cord blood:

Public cord blood bank: This option is appropriate for most families and is recommended by the American Academy of Pediatrics (AAP). Cord blood donation is used for research or to help others. There’s no cost to you to donate. If you or a family member ever needs cord blood, you can’t use the blood you donated, but you may be able to use cord blood donated by others. Several cord blood banks participate in this program.

Private cord blood bank: This may be a good option for you if you have a child or family with a health condition that may need to be treated with a stem cell transplant. Depending on the bank you choose, the cost is about $2,000, plus a yearly fee of about $125. The chance that your baby or a family member may need to use your stored cord blood is very low – about 1 in 2,700.

Planning for cord blood collection

If you decide to store your baby’s cord blood (through either a public or private bank), you will need to plan ahead of time and make sure your provider is aware of your choice. Between your 28th and 34th week of pregnancy, talk to your provider about your decisions and learn if you meet the donation guidelines.  Put your decision about cord blood on your birth plan. The March of Dimes birth plan includes a question about storing umbilical cord blood.

Your provider usually uses a collection kit that you order from the cord blood bank. To collect the cord blood, your provider clamps the umbilical cord on one side and uses a needle to draw out the blood. The blood is collected in a bag and then sent to the cord blood bank. Your provider can collect cord blood if you have either a vaginal delivery or a C-section.

According to Be the Match, each year in the United States, more than 10,000 people are diagnosed with life-threatening diseases that may be treated with a stem cell transplant. When a patient with leukemia, lymphoma or other life-threatening disease needs a transplant, cord blood may be an option. Today, 15% of transplant patients receive cord blood that was generously donated to a public cord blood bank.

Questions? Email us at AskUs@marchofdimes.org.

Fathers help mold their children’s future

15
Jul
Posted by Barbara

dad and babyAlthough this blog is called “News Moms Need,” this week we’d like to give a shout-out to dads. Fathers provide a specific kind of nurturing and support to babies and children. Research suggests that fathers who are active and present in their children’s lives may have a positive effect on their future development.

All fathers, and especially those of children who are born prematurely, with medical conditions or disabilities, play a vital role in their children’s care. They diaper, feed and soothe babies, attend IFSP or IEP meetings, advocate for their children, help with homework, and pitch in when and where they are needed.

In a study that looked at the experiences of first-time fathers of late preterm infants, the authors noted “Fathers believed they had the ‘best job in the world,’ yet saw fathering as the ‘biggest job ever.’ Fathers viewed fatherhood as an opportunity for personal growth and reflected on how their lives had changed since the arrival of their infant.”

Just as fathers are instrumental in molding their young children, they are also deeply affected when something goes wrong. We have heard from dads who lost a baby or child, and the grief they experience is deep and constant. Although they may grieve in different ways from the mom, they nevertheless experience profound pain.

Here are some facts about the increasing role of dads in the lives of their children:

  • Twenty percent of fathers (1 out of 5) are now the primary caregivers of preschool-aged children when the mother is employed.
  • The number of stay-at-home dads (in a home where the mom works) has doubled in the last 25 years.
  • In the last 40 years, the number of father-only families has more than tripled.
  • In one national survey, 95% of fathers reported they participate in bathing and diapering their children several times per week.
  • A recent government report stated “Although fathers continue to spend less time on childcare than mothers, this gap has narrowed over the past 10 years and dads are increasingly performing caregiving activities traditionally done by mothers.”
  • A Pew Research study reports, “The amount of time parents spend with their children continues to go up. Fathers have nearly tripled their time with children since 1965.”

There is no doubt about it – mothers and fathers bring a different dynamic to parenting. Both are critically important in the long, joyous but often arduous road of parenting, and deserve to be acknowledged.

To all the dads out there: what advice would you give a man as he is about to become a father for the first time?

 

Comments or questions? Send them to AskUs@machofdimes.org.

View posts in the series on Delays and Disabilities, here.

Cleft lip and palate awareness

13
Jul
Posted by Lauren

baby with cleft lipI remember seeing a thin scar on my friend’s upper lip, and wondering how she had gotten it. “I was born with a cleft lip,” she said. I became curious about her cleft lip and how it turned into one tiny scar.

A cleft lip is a type of craniofacial abnormality. These are birth defects of the head (cranio) and face (facial) that are present when a baby is born. Another common type is a cleft palate (roof of the mouth). As July is National Cleft and Craniofacial Awareness and Prevention Month, it is a good time to learn more about these birth defects.

How does a cleft lip or palate form?

The lips of a baby form by about 6 weeks of pregnancy. When the lip doesn’t form completely and is left with an opening, this is called a cleft lip. A baby’s palate is formed by about 10 weeks of pregnancy. When the palate doesn’t form completely and has an opening, it’s called a cleft palate. A baby can be born with just one of these abnormalities or with both.

Each year in the U.S., about 2,650 babies are born with a cleft palate and 4,440 babies are born with a cleft lip with or without a cleft palate. The causes of clefts with no other major birth defects among most infants are unknown.

In most cases, cleft lip and cleft palate can be repaired by surgery. Each baby is unique, but surgery to repair cleft lip usually is done at 10 to 12 weeks of age. Surgery for cleft palate usually is done between 9 and 18 months of age. A child may also need more surgery for his clefts as he grows.

My friend had corrective surgery to repair her lip when she was still a baby. Now all that is left is one thin scar above her upper lip leading to her nose, which you can hardly see.

Can these birth defects be prevented?

We are not always sure what causes a cleft lip or palate.  However, there are steps a pregnant woman can take to decrease her chance of having a baby with a cleft lip or palate.

• Before pregnancy, get a preconception checkup. This is a medical checkup to help make sure you are healthy before you get pregnant.
• Take a multivitamin that contains folic acid. Take one with 400 micrograms of folic acid before pregnancy, but increase to one with 600 micrograms of folic acid during pregnancy. Your provider may want you to take more – be sure to discuss this with him.
• Talk to your provider to make sure any medicine you take is safe during pregnancy. Your provider may want to switch you to a different medicine that is safer during pregnancy.
• Don’t smoke.
• Don’t drink alcohol.
• Get early and regular prenatal care.

If you have any question about cleft or craniofacial defects, causes or prevention, read more here or email us at AskUs@marchofdimes.org.

New study looks at link between antidepressants and birth defects

10
Jul
Posted by Sara

pregnant woman with MDThe use of certain antidepressants during pregnancy is associated with a higher risk of birth defects, according to a new study. But other antidepressants do not carry the same risk.

The study looked at a specific group of antidepressants called selective serotonin reuptake inhibitors (SSRIs). SSRIs are medications used to treat depression and other mental health conditions. Previous studies gave conflicting evidence about potential links between the use of SSRIs during pregnancy and certain birth defects.

In this study, researchers from the CDC analyzed data from 17,952 mothers of infants with birth defects and 9,857 mothers of infants without birth defects, born between 1997 and 2009.

The researchers found that some birth defects occur about two or three times more frequently among babies born to women who took certain SSRI medications, like Prozac (fluoxetine) and Paxil (paroxetine) early in pregnancy. It is important to note that the actual risk for a birth defect among babies born to women taking Prozac or Paxil is still very low. For example, the risks for a specific heart defect could increase from 10 per 10,000 births to about 24 per 10,000 births among babies of women who are treated with Paxil early in pregnancy. Since these specific types of birth defects are rare, even doubling the risk still results in a low overall chance.

Researchers did not find a link between birth defects and other SSRIs such as Zoloft (sertraline).

“A pregnant woman should be reassured that she can choose a safe drug to treat her depression and not have to go off her medication because she is afraid her baby may develop a birth defect,” Dr. Edward McCabe, Chief Medical Officer of the March of Dimes said. “Not treating depression can be unhealthy for both the mom and her baby. It can cause stress, and stress during pregnancy is associated with early births and low-birthweight babies.”

If you are currently taking an antidepressant and are concerned, do not stop taking the medication until you talk to your health care provider. And if you are planning to become pregnant and are taking an antidepressant, schedule a preconception checkup and discuss what medications may be best for you.

Living with loss

08
Jul
Posted by Barbara

yellow butterflyFor families that suffer from the unspeakable pain of losing a baby, their grief continues for a lifetime. It may ebb and flow; it may be more acute at anniversaries or when something triggers a memory. It may even seem to be out of mind for periods of time, but it is never gone completely. A woman starts loving her baby from the moment of conception and this love continues throughout her entire life. Similarly, the feelings of sadness and loss continue because a parent’s love has no end.

At the March of Dimes, women have written to us after suffering a miscarriage or stillbirth, asking when they will “get over” the loss of their baby. This is a question that is impossible to answer. Your life will go on – all the chores, jobs, responsibilities and even parties continue. But, the reminders will be there always, with the sadness and deep disappointment to go along with it.

I know a woman who lost her baby boy 31 years ago. She had tried for years to become pregnant, so her pregnancy was an especially joyous time for her. The immense happiness was followed by intense grief on the day of her son’s birth, as he lived for only a few hours. Even though she eventually went on to have a healthy baby, she still mourns the loss of her son. She marks her son’s birth and death every year, and continues to remember him. Her pain is palpable, even though so many years have gone by since that heartbreaking time.

Acknowledging and talking about the loss of her baby has helped her to know that her son was real, and that her grief is legitimate. She had bonded with her baby from the moment she learned she was pregnant. To ask her to forget about this tiny person would be ridiculous.

The pain of losing a baby is one that many women struggle with for life. Perhaps it is because the baby never got the chance to grow up and follow his dreams. Or, maybe it is because the mom is denied the natural desire to nurture her child and watch him grow up. Losing a child is like a double wallop- you lose your child and the dreams that go along with him.

It’s so unfair.

If you have suffered a pregnancy or infant loss, you may want to reach out to others who will understand your unique pain. You may find a local support group in your area, or you can join our online community, Share Your Story where you will meet other women who know what living with loss is all about. You are not alone.

The March of Dimes has written a booklet called From Hurt to Healing to help families understand their grief. It explains grief and how men and women grieve differently. It talks about how to deal with your feelings, tells you how to ask for help, how to deal with family and friends, how to help other children understand. And it suggests ways to remember your baby. Two other booklets, What Can You Do? and When You Want to Try Again are part of a packet the March of Dimes offers free to bereaved parents who have suffered a loss. If you would like to receive a packet, send your name and address to AskUs@marchofdimes.org.

You will never forget your baby, but in time the power of love will help you find the strength to move forward and love again.

 

Comments or questions? Send them to AskUs@machofdimes.org.

View posts in the series on Delays and Disabilities: How to get help for your child.