Posts Tagged ‘ACOG’

Postpartum care: What you need to know about the new guidelines

Thursday, August 16th, 2018

The American College of Obstetricians and Gynecologists (ACOG) recently released new guidelines calling for changes to improve the postpartum care women receive after giving birth. Postpartum care is important because new moms are at risk of serious and sometimes life-threatening health complications in the days and weeks after giving birth. Too many new moms suffer or die from causes that could have been prevented.

How have ACOG’s postpartum care guidelines changed?

In the past, ACOG recommended that most women have a postpartum checkup 4 to 6 weeks after giving birth. A postpartum checkup is a medical checkup you get after having a baby to make sure you’re recovering well from labor and birth. ACOG now says that postpartum care should be an ongoing process, rather than a one-time checkup. Your postpartum care should meet your personal needs so that you get the best medical care and support. Seeing your health care provider sooner and more often can help prevent serious health complications.

ACOG recommends that all women should:

  • Have contact with their health care provider within 3 weeks of giving birth
  • Get ongoing medical care during the postpartum period, as needed
  • Have a complete postpartum checkup no later than 12 weeks after giving birth

How can you get ready for postpartum care?

Make a postpartum care plan with your provider. Don’t wait until after you have your baby — make your plan while you’re pregnant at one of your prenatal care checkups. To make your plan, talk to your provider about:

Learn more about postpartum care at marchofdimes.org.

What are antenatal corticosteroids?

Friday, February 9th, 2018

Preterm labor is labor that happens too early, before 37 weeks of pregnancy. If you have preterm labor, your health care provider may recommend antenatal corticosteroids to help speed up your baby’s lung development and reduce the chances of some complications.

How do antenatal corticosteroids work?

There are two types of corticosteroids that may be used if you’re in preterm labor, betamethasone and dexamethasone. Both of these steroids help your baby’s lungs produce surfactant. Surfactant is a protein that helps keep the small air sacs in the lungs from collapsing. When a baby is born full-term, her lungs produce surfactant naturally. But babies born premature do not produce enough surfactant, and that means the air sacs in the lungs do not expand the way they should. This results in premature babies having breathing difficulties.

When should you get antenatal corticosteroids?

The American College of Obstetrics and Gynecology (ACOG) recommends a single course of corticosteroids for pregnant women who are at-risk of premature birth within the next 7 days. This includes women whose membranes have ruptured and women pregnant with twins or other multiples. If you’re pregnant and at-risk for giving birth early, talk to your health care provider and discuss the best treatment options for your specific situation.

Are antenatal corticosteroids effective?

If you’re in preterm labor and you receive antenatal corticosteroids, your baby’s chances of having certain health problems after birth are reduced, including:

  • Respiratory Distress syndrome (RDS). This is a breathing problem most common in babies born before 34 weeks of pregnancy. Babies with RDS don’t have enough surfactant and it results in breathing problems.
  • Intraventricular hemorrhage (IVH). This is bleeding in the brain. It usually happens near the ventricles in the center of the brain. A ventricles is a space in the brain that’s filled with fluid.
  • Necrotizing enterocoloitis (NEC). This is a problem with a baby’s intestines. It can cause feeding problems, a swollen belly and diarrhea. It sometimes happens 2 to 3 weeks after a premature birth.

Are there side effects?

Possible side effects of medicines like betamethasone and dexamethasone for mom may include fluid build-up in the body and increased blood pressure. There are no side effects for your baby.

If you’re at risk of giving birth early, talk to your provider about antenatal corticosteroids and how they may be able to help your baby. You can learn more about other treatments for preterm labor on our website. And all pregnant women should learn the signs and symptoms of preterm labor. If you have even one sign or symptom, call your health care provider. If you’re having preterm labor, getting help quickly is the best thing to do.

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.

Can you turn a breech baby?

Friday, December 4th, 2015

DoctorPregnant_zps3ac96800You may have heard recently about a technique that can be used to “flip” a breech baby. This procedure is called external cephalic version (ECV) and is done by your prenatal care provider.

When is a baby breech?

As your due date approaches, your baby usually moves into a head down position. During a vaginal delivery, this means that the baby’s head comes out first. But in about 3-4% of full-term births, the baby doesn’t move into a head-down position. This is called a “breech presentation.” A breech baby can be positioned so that the baby’s bottom, feet, or both are facing down.

What is ECV?

Since it is best for your baby to be in a head down position for a vaginal delivery, if the baby is breech, a C-section may be medically indicated. To improve your chances of giving birth vaginally, your provider may decide to perform an external cephalic version. According to the American Congress of Obstetricians and Gynecologists (ACOG) “external cephalic version (ECV) is an attempt to turn the baby so that he or she is head down.”

Your health care provider may attempt an ECV when you are between 36-38 weeks of pregnancy. He or she will apply firm pressure on the outside of your belly to try to get the baby to roll into a head-down position. Two people may be needed to do this and ultrasound may be used to help guide the turning.

When is ECV not safe?

An ECV will not be attempted if:

  • You are pregnant with more than one baby
  • There are concerns about the health of the baby
  • You have certain uterine or cervical problems
  • The placenta is in the wrong place or has detached from the wall of the uterus (placental abruption)

Can complications occur with ECV?

ECV typically takes place in the hospital in case complications arise.  The baby’s heart rate will be monitored both before and after the procedure.  Some problems that may occur with an ECV include:

ACOG states that over 50% of all ECV attempts are successful. However sometimes the baby moves back into a breech position. While ECV can be tried again, it gets more difficult as the baby gets bigger.

If your baby is in a breech position, talk to your health care provider. You can discuss if you are a candidate for ECV as well as what delivery options may be best for you.

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

Eating during labor

Wednesday, October 28th, 2015

Woman in laborYou may have heard a news report saying that it is okay for a pregnant woman to eat a light meal during labor. In fact, they even said it may be a good idea for some women, based on new research from Canada (not yet published). But, don’t rush out for a cheeseburger on your way to the hospital; you need to know all the details.

Current medical guidelines say that a woman should not eat solid food once she is in labor. The reason is to protect her from aspirating (breathing) food into her lungs. If a woman eats and then needs an emergency C-section, she could be at risk of aspirating during the surgery. Aspiration may lead to pneumonia, too. So, not eating any solid foods during labor is a guideline to protect the mother. (It is also the rule for scheduled C-sections and other surgeries.)

Labor is physically demanding, even grueling. A particularly long labor can leave a woman totally exhausted and lacking in energy, especially for when she needs to push. A little bit of food may go a long way in boosting her energy level. And, this study found that due to medical advances in anesthesia, eating a little bit of light food would probably not have a bad effect on a woman in labor.

The Canadian review looked at 385 prior studies and concluded that anesthesiologists and obstetrical doctors (OB/GYN) should work together to identify women for whom a light meal may be beneficial. They emphasized that doctors must identify women at low risk for aspiration – this is extremely important. And, each woman needs to be assessed individually.

But what does ACOG say?

As of the writing of this blog post, the American College of Obstetrics and Gynecologists (ACOG) has not changed their position on eating during labor. Their position remains that “solid foods should be avoided in laboring patients.”

How about liquids?

ACOG says “Although there is some disagreement, most experts agree that oral intake of clear liquids during labor does not increase maternal complications…modest amounts of clear liquids may be allowed for patients with uncomplicated labor.” So, if you can’t eat solid foods, clear liquids (such as broth) may help increase your energy level. But whether it is safe for you to drink anything at all is something you should discuss with your prenatal health care provider.

What’s the bottom line?

Remember, this study has not been published yet, and ACOG has not changed its guidelines.

As with all medical procedures, talk with your health care team to determine what is best for you.