Fertility Cure

Pregnancy Miracle By Lisa

Lisa Olson developed Pregnancy Miracle which is based on clinically proven, natural and holistic method of getting pregnant no matter if you are in your 30s or 40s or having Tubal Obstruction, High Level of FSH, Uterine Fibroids or any other infertility causes. This Pregnancy Miracle is taught to you step by step with an e-book meant for this specific purpose of helping infertile women get one of the biggest joys of their lives, i.e. their own children. You will really find it no less than a Pregnancy Miracle as you will synergistically overturn your infertility. This e-book will also teach you about natural help getting pregnant fast relying on modern alternative medicine as well as the potent, and ages old Chinese wisdom of trying to get pregnant. It is Continually Updated, Lisa learn new things every single day from continued research, testing and experimentation. She also get a lot of ideas as to how she can improve Pregnancy Miracle from the women that she counsel. She is therefore constantly in the process of refining and perfecting Pregnancy Miracle. More here...

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Getting Ready to Get Pregnant The Preconceptional Visit

Sometimes you can schedule this visit during a routine gynecological appointment When you go in for your annual PAP test, mention that you're thinking about having a baby, and your practitioner will take you through the preliminaries. If you aren't due for your annual exam for several more months and you're ready to begin trying to get pregnant now, go ahead and schedule a preconceptional visit with your practitioner, and bring along the father-to-be, if at all possible, so both of you can provide health histories and know what to expect from this adventure.

Conception the other side of family planning

Contraception and the myth of family planning It is perhaps true that the success of the contraceptive pill, which brought with it the idea of 'family planning', has contributed to the growth of problems with conception. That is not to suggest any adverse affects from the pill itself, more that the ability to avoid conception has created the erroneous belief that we control conception.With contraception came the idea of family planning that couples decide, not 'God' or 'nature', as our grandparents may have believed. These factors set up certain expectations that children will arrive 'when I plan them' or 'when I stop taking the pill'. This, combined with technological medical advances in assisted conception, has created a climate where we believe we can have babies on demand timed to fit our life plan, ordered via the Internet if all else fails. How cruel then it is when months roll on and that longed-for pregnancy does not arrive. some time after we have decided that we want...

The emotional impact of fertility problems and treatments

Again, there isn't room here to cover the vast array of treatments and procedures that are involved in assisted conception. However, it is clear that the emotional costs of fertility problems can be significant. Those diagnosed with fertility problems are more likely to be diagnosed as depressed to have anxiety problems to report relationship problems and specifically higher levels of difficulty with their sexual relationship. The treatments themselves can exert extreme physical and psychological pressures and as many as two-thirds of procedures do not result in a baby. For some couples, despite massive intervention at great personal and financial cost, a baby is never achieved. Sadly, fertility issues are also not uncommon for those who already have a child. The sense of loss and disappointment and personal failure can be just as intense for the individual or couple even though they already have a child. India had her first baby at 36 with IVF tenyears after they first started trying...

531 Infertility and Risk of Miscarriage

Adverse effects of obesity on natural conception and assisted reproductive therapy in women are well documented in the literature 5-8 (see Table 5.1). For example, Rich-Edwards et al. 7 found that, among 2,500 married, infertile nurses, those with pregestational obesity experienced more frequent anovulation and had longer mean time to pregnancy than did normal-weight women. Also, higher rates of early miscarriage have been found among obese women as compared with women of normal weight. In a case-control study of 1,644 obese women compared with 3,288 normal weight, age-matched controls, Lashen et al. 9 found an increase risk of first trimester and recurrent miscarriage associated with pregestational obesity. Similarly, a Swedish population-based cohort study of over 800,000 women showed that obesity was associated with a twofold greater risk of spontaneous abortion compared with normal weight mothers 10 . Potential Reasons for Infertility in Obese Women Decreased conception rates...

Threatened Miscarriage

Women who present in the first trimester with vaginal bleeding with or without lower abdominal pain are given the label of a threatened miscarriage. This is a common first trimester problem occurring in up to one-third of pregnancies.19 This condition requires an ultrasound scan to establish the viability of the pregnancy. If the uterus contains an embryopositive cardiac activity, then the woman can be reassured that she has a viable intrauterine pregnancy. If the crown-rump length (CRL) is at least 6 mm and there is no fetal cardiac activity or if the crown rump length is > 6 mm with no change at the time of a repeat scan 7 days later, this was formally classified as a missed miscarriage or more recently as 'early fetal demise'.20 Care must be taken when making this diagnosis, as approximately one-third of embryos with a CRL of less than 5 mm have no demonstrable cardiac activity under such circumstances a repeat scan should be performed in 7 days.21 If the uterus contains an empty...

Medical management of miscarriage

Medical treatment for miscarriage with prostaglandins alone or in combination with the antiprogesterone mifepristone has been explored. There are a few randomized studies comparing expectant with medical management, the success rate varies probably due to different doses and inclusion criteria.86,94-96 It seems, however, that medical treatment is slightly more effective than expectant management alone. Treatment with misoprostol is potentially dangerous to a normal ongoing pregnancy, due to its abortifacient effect and teratogenicity. Careful assessment with an exact diagnosis is mandatory before treatment with misoprostol. This is not always available at an emergency room. In addition it seems that medical treatment is accompanied with more pain than expectant management. It would therefore seem reasonable to propose a strategy whereby misoprostol could be used as second line treatment after an initial attempt to manage things expectantly for at least a week.95 In this way...

46 Anxiety Problems Associated With Miscarriage

Pregnancy loss may be a risk factor for elevated symptoms of anxiety or the development of an anxiety disorder (28-30). Most studies of women's psychological functioning following miscarriage have focused on depression rather than the anxiety disorders. However, one study compared rates of anxiety disorder in a matched comparison group of community women who had not been pregnant in the past year and a group of women who attended a hospital following a miscarriage (28). Results indicated that women experiencing miscarriage were at a greater risk for a recurrent episode of OCD (relative risk 8.0), whereas the incidence of panic disorder, phobic disorders, or agoraphobia was not statistically different between groups (28). Studies with larger samples are warranted so that the prevalence of anxiety disorders in this population may be better understood.

Surgical Management Of Miscarriage

Surgical management includes dilatation and curettage (D& C, using a sharp metal curette) and suction curettage (using a metal or more commonly plastic cannula and a vacuum, via an electric or foot-pump, or with a hand-held manual vacuum device). D& C has been replaced by suction curettage as the usual surgical technique for early fetal demise, but is still used for the management of incomplete miscarriage.28 Suction curettage for incomplete miscarriage has however been shown to be associated with less blood loss and pain than sharp curettage.29 In a meta-analysis of women undergoing surgical curettage as the control group in RCTs of expectant and medical management of pregnancy failure, the rate of complete evacuation was 97 .26 This makes it the most efficacious option in the management of miscarriage.

IVF pregnancy complications

The use of ART in industrialised countries has become a routine infertility treatment. In the last 10 years there have been many research articles comparing pregnancy complications and obstetric risk in twin and singleton IVF ICSI pregnancies, with those of a natural conception (Lambers et al 2007, Ochsenkuhn et al 2003, Tallo et al 1995). A recent study from Canada (Allen et al 2006) which reviewed articles from 1995 to 2005 on the effect of ART on perinatal outcomes and obstetric risk showed that there is a definite link to a higher risk of perinatal complications, due mainly to the higher incidence of multiple pregnancies. These include pregnancy-induced hypertension, preterm birth, low birthweight, abruptio placentae and placenta praevia. The outcomes of that study and others have lead to a push from the medical world for single embryo transfer in ART, especially at blastocyst stage (Jansen & Sullivan 2006, Pinborg et al 2004). However, the study stated 'it remains unclear if...

The Chinese viewpoint on infertility

In Chinese medicine the menstrual cycle is divided into four phases - period, post-menstrual, mid-menstrual and premenstrual. The Kidney energy is the most vital aspect 'The treatment of infertility according to the four phases is always based principally on treating the Kidneys, because the phases are a result of the waxing and waning of Kidney-Yin and Kidney-Yang and because the Kidneys are the source of the Heavenly Gui which is the basis for reproduction' (Maciocia 1998, p. 695). Acupuncture treatment through an IVF cycle can help in many ways. There are now a number of research articles pertaining to acupuncture treatment and an increased success rate of IVF. The treatments below are only a basic starting point as each patient will present with varying patterns of disharmony, at different stages of their treatment.

Getting Pregnant Again

Doctors and parents haven't come to a consensus on the optimal time to get pregnant again. Probably the most important consideration is your overall health. If you can get back to your pre-pregnancy or ideal body weight quickly after you deliver, and if you can replenish any lost nutrients and vitamins (particularly folate, iron, and calcium) from your last pregnancy, you can probably consider getting pregnant again fairly soon in about 12 to 18 months. A recent large study showed getting pregnant again in less than 18 months was associated with an increased risk of adverse pregnancy outcomes. If you've had a complicated pregnancy, a difficult delivery, or excessive loss of blood, wait until you're in better shape before trying again.

Protecting Your Fertility

Many women who are concerned that their cancer treatment may cause infertility are advised to store either embryos (fertilised eggs) or eggs, before their treatment starts. Embryos and unfertilised eggs are usually frozen for up to ten years, although in some situations this can be extended until the woman reaches 55. Your doctor or nurse can discuss the possibility of infertility and the collection and storage of eggs or embryos with you and can refer you to a fertility clinic. Sometimes the NHS will pay for storage of the eggs or embryos, but some health authorities will not.

Expectant Management Of Miscarriage

For many years there was a consensus that prevailed in the Western world concerning the approach to miscarriages and custom has dictated that inevitable and incomplete miscar riages must be completed, usually by curettage. Many physicians considered curettage mandatory to prove that a miscarriage is complete. Expectant management of first-trimester miscarriages had not been evaluated since Peckham stated in 1936 that women without profuse bleeding or signs of infection could avoid hospitalization.42 The justification for surgical evacuation as the correct management of first-trimester miscarriages was based on case reports and uncontrolled studies from a time when general health, parity, availability of health services, antibiotics and the incidence of criminal abortions differed greatly from now. The consensus has changed during the last decade and expectant management as well as different medical regimens for the conservative management of miscarriage have been evaluated. In another...

Treatment Of Miscarriage A historical perspective

In an analysis of 2287 cases of miscarriage including an unknown number of illegal abortions registered in Baltimore from 1896 to In the 1930s Collins managed 1304 cases of miscarriage medically with oxytocics. There were six deaths due to infection.43 He described 14 additional deaths during an earlier period with only one death due to haemorrhage, the rest being due to infections. Roussel treated 3739 cases of miscarriage between 1933 and 1944 with oxytocics and reported an average hospital stay of 14 days. There were 51 deaths, ten of them because of blood loss and the rest mainly again because of infection.12 It is reasonable to conclude that prior to the antibiotic era, infection and not haemorrhage was the predominant threat to women undergoing miscarriage. To prevent miscarriage and other pregnancy problems such as toxaemia, premature delivery and intrauterine fetal death, about six million pregnant women were exposed to diethylstil-boestrol (DES) from 1940 until 1971....

TCM and Habitual Miscarriages

A miscarriage may be triggered by several reasons, which greatly depend on the health status of both the mother and the fetus. Miscarriage may also be related to unhealthy lifestyles such as excessive alcohol intake and smoking. If three consecutive miscarriages occur, this condition is known as habitual (recurrent) miscarriages.

Vdvise and counsel on family planning

Explain to the woman thatshe can become pregnant soon afterthe abortion - as soon as she has sexual intercourse - if she does not use a contraceptive - Any family planning method can be used immediately after an uncomplicated first trimester abortion. information on options, see Methods for non-breastfeeding women on Effl. Make arrangements for her to see a family planning counsellor as soon as possible, or counsel her directly, (see The decision-making tool for family planning clients and providers for information on methods and on the counselling process).

Infertility

The average length of time that most couples take to conceive is around 6 months. However, figures suggest that around one in six couples suffers from infertility and is childless (Balen & Jacobs 2003). In other words, it may take far longer to conceive, and 18 months is not unusual. Some couples never manage to conceive at all and will turn to assisted reproductive techniques (ART). These technologies include ovulation induction (OI), intrauterine insemination QUI), in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI). Further techniques include the use of sperm and or egg donation (see Ch. 8 for more details). But failure to conceive, even after months or years of trying, does not automatically mean complete infertility. If and when a woman conceives depends on a whole range of factors, both physical and psychological. The nutritional status of both partners is almost certainly a key factor. Recent studies have shown that there has been a marked increase in...

Miscarriage

Most pregnancies that miscarry are lost in the first trimester. Some women experience a slight bleeding during these first few weeks and the pregnancy continues without any problem. For others it signals the end of the pregnancy. Some women unfortunately discover that they have miscarried when they go for a first scan. The baby has died but there have yet to be any signs of the loss. Most parents will not know exactly why the miscarriage has occurred and only if you have three miscarriages in a row is it considered medically necessary to investigate why it happened. The emotional experience of miscarriage is more complicated. Many parents-to-be are devastated by their loss and take many months to recover. Often recovery is hampered by guilt about having in some way caused the miscarriage or fears about what this means. Is there something wrong with me Will I ever conceive again

Vf And Icsi

ICSI involves a single sperm being injected into the egg using a fine glass needle under a microscope. ICSI involves a single sperm being injected into the egg using a fine glass needle under a microscope. undergoing in vitro fertilization In vitro fertiliz ation (IVF) i nvolves an egg bei n g removed from your body and fertilized i n a labor atory un der c arefully c ontrolled conditions.

How Ivf Works

Day 14 IVF or ICSI method used to fertilize mature eggs Day 14 IVF or ICSI method used to fertilize mature eggs Relaxation and stress relief are key to your preparation for IVF find techniques that fit easily into your life. h ormonal system shuts down to prep are for IVF. Do gentle forms of exercise, such as walking, swimming, and yoga. Reflexology can be helpful in prep arati on for IVF,

Complete Miscarriage

Miscarriage Scan

This should not be based on an ultrasound diagnosis. Women who present with heavy vaginal bleeding with clots and undergo an ultrasound scan which suggests a complete miscarriage (i.e. an empty uterus with an endometrial thickness less than 15 mm), should be followed up with serum hCG levels until the diagnosis is established.24 We have described how 5.9 of women with an apparent complete miscarriage have an underlying ectopic pregnancy. A diagnosis of complete miscarriage based on history and scan findings alone is unreliable. Our data highlight the need to classify these cases as PULs. The term 'complete miscarriage' should no longer be used in the context of an ultrasound scan report. All such women should be managed under the umbrella term of PUL until serum hCG levels demonstrate the outcome of the pregnancy. In the most recent CEMD, one potentially avoidable death was in a woman in whom an ultrasoni-cally empty uterus was interpreted as showing a complete miscarriage. According...

Dov Feldberg Helen Schneider Hospital For Women

Avi Ben-Haroush, md Infertility & IVF Unit, Helen Schneider Hospital for Women, Rabin Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Petah-Tiqva, Israel Frank A. Chervenak, md New York Presbyterian Hospital, Weill Medical College of Cornell University, New York, NY, USA Graziano Clerici, md Centre for Perinatal & Reproductive Medicine, University of Perugia, Italy Antonio Cutuli, md Centre for Perinatal & Reproductive Medicine, University of Perugia, Italy Gian Carlo Di Renzo, md phd Professor and Chairman, Department of Obstetrics and Gynecology, Director, Centre of Perinatal and Reproductive Medicine, University Hospital, Perugia, Italy Benjamin Fisch, md phd Infertility Unit, Helen Schneider Hospital for Women, Rabin Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Petah-Tiqva, Israel Nino Loia, md Department of Ophthalmology, Rabin Medical Center, Petah Tiqva, Sackler Faculty of Medicine, Tel Aviv University, Israel Roberto Luzietti, md...

Planning for a healthy baby

Natural family planning Optimum nutrition Infertility This chapter looks at the way in which parents can influence the health of their unborn child by optimising their own health before conception occurs. It examines the simple measures that can be taken to eliminate toxins, allergies and environmental pollutants from the body, along with all the other negative influences on prenatal health. It discusses methods of natural family planning and the vital role that nutrition plays, both preconceptually and throughout pregnancy. It explains

16 Effects and manifestations

A wide variety of responses characterizes developmental toxicity. Infertility, chromosomal and genetic disorders, spontaneous abortion, intrauterine death, prematurity, low birth weight, birth defects and functional disorders arc the effects of such drug interference with the developmental and reproductive processes. The manifestation of a developmental or reproductive toxicant can either be seen immediately after exposure, or will be expressed at a much later date. Interfering with male or female germ cell development might result in infertility, decreased sperm activity and or libido, and impaired gamctogenesis. The effects on the pre-implantation stage will cause early embryonic death, extra-uterine implantation, or delayed transport of the fertilized zygote. Fetal tissues are intrinsically highly vulnerable to carcinogens because of their high rate of cellular proliferation. This phenomenon has been demonstrated in rats, mice, hamsters, rabbits, pigs, dogs, and monkeys. About 25...

The beginning of our journey

There are many books on the market that take us through the process of becoming pregnant and giving birth and this information is an important Our journey, however, begins with deciding to have a baby.There may be no right way to decide but it is certainly an issue that many people spend many hours pondering. You may already be pregnant when you read this book but the decision to become pregnant is often revisited once pregnant why did we do it Why don't I feel so certain now Chapter 2 looks at conception. The area of conception and problems with conception probably merits an entire book and here the issues of the pain and disappointment of fertility problems are only touched upon.

What does it mean to be a family

Just when we might think the nuclear family unit is doomed, however, there are new types of nuclear families coming to take its place. Many more gay and lesbian couples are now openly becoming nuclear family units through assisted conception or adoption and fostering. Many couples who previously would not have had children are doing so through fertility treatment. The largest new group is said to be the single parent household. However, statistics can be misleading and it is probably only a small number of these families that remain static throughout the life of the child. The 'reconstituted family', where one family is formed from other family units, is becoming much more common.

122 Water Soluble Vitamins

Neural tube defects (NTDs), a group of heterogeneous malformations involving neural tissue in the brain and or spinal cord, occur in less than 1 per 1,000 births in the United States 16 . The etiology of NTDs is an ongoing area of research however, inadequate maternal folate status prior to and in the first few weeks after conception appears to play a role in at least some cases of neural tube defects. According to 1999-2000 National Health and Nutrition Examination Survey (NHANES) data, the average folate intake of 20- to 39-year-old women in the United States is 327 mcg day 17 . Results from supplementation studies suggest that women capable of becoming pregnant should consume an additional 400 mcg day of folic acid from supplements and or fortified foods in addition to consuming food folate from a varied diet.**

Isnt the decision different for everyone

We all approach parenthood from our own unique position, so does that make it more difficult for some than for others Most people are now aware of the possibility of post-natal depression following the birth of a baby and many try to take steps to have extra help and support at this time. We do, however, tend to overlook the fact that many women become pregnant while experiencing emotional difficulties or these problems develop in the pregnancy. Some women may be depressed, they may have had a manic episode that required hospital treatment, they may be struggling with an eating disorder or dealing with the effects of a difficult relationship the list is endless. This may be related to the pregnancy in some way there may be fears about the health of the baby, the pregnancy may have been ill-timed or these psychological difficulties may have been due to external factors the loss of a job, relationship difficulties, family problems, financial worries, and...

From Here to Maternity

A ongratulations If you're already pregnant, you're about to embark upon one of the most exciting adventures of your life. If you're thinking about getting pregnant, you're probably excited at the prospect and also a little nervous at the same time. In this chapter, we go over what you need to know before you conceive. (We also provide some information on medications and vaccines that those who are already pregnant may be interested in, too.) The first step is to visit your practitioner and go over your family and personal health history. That way, you can discover whether you're in optimal shape to get pregnant, or whether you need to take some time to gain or lose weight, improve your diet, quit smoking, or discontinue medications that could be harmful to your pregnancy. We also give you some basic advice about the easiest way to conceive, and we touch on the topic of infertility.

Information And Protocols

Becomes independent of staff turnover. Individual protocols for all early pregnancy complications should be compiled into a file and placed in every assessment room for reference. These protocols will include fine details such as dosage regimens and timings between visits. Protocols relating to referral criteria, initial assessment, management of miscarriage, ectopic pregnancies, pregnancies of unknown location, gestational trophoblastic disease and hyperemesis gravidarum should be developed and made available to all members of the early pregnancy team. The evidence for each protocol is stated at the end of each section and the date of compilation also stipulated. Protocols should be revised on an annual basis according to current NHS recommendations. A suggested series of protocols will be offered in the following chapters.

16 lifecycle approach to nutrition

The 2005 Dietary Guidelines makes two specific recommendations for women of reproductive age 33 . The first focuses on the high prevalence of iron deficiency in this population. About 9-11 of adolescent girls and women of childbearing age have laboratory evidence of iron depletion 49 . Consequently, it was recommended that women of childbearing age who may become pregnant should eat foods high in heme iron and or consume iron-rich plant foods or iron-fortified foods, with an enhancer of iron absorption, such as vitamin C-rich foods. The second recommendation focused on reducing the risk of NTDs. Specifically, women of childbearing age who may become pregnant or those in the first trimester of pregnancy should consume adequate synthetic folic acid daily (from fortified foods or supplements) in addition to food forms of folate from a varied diet. The new folic acid fortification program may influence the need for obtaining folic acid from supplements. However, until further data are...

Emergency gynaecology operating list

Week can dramatically reduce the number of inpatient beds used while waiting for cases to be performed on the emergency operating lists in otherwise stable women. This can be run as a day-case list for stable women so they do not require a bed preoperatively and can leave 2 to 4 hours postoperatively if escorted. There should be a named consultant covering or performing the list with a named registrar or resident also allocated to it. All surgical evacuations of the uterus after miscarriage and cases with stable ectopic pregnancies suitable for laparoscopic salpingectomy salpingotomy can be performed on these lists. Day surgery for ectopic pregnancy is safe. In our unit we run lists on a Monday, Wednesday and Friday, and the majority of ectopic pregnancies can be fitted into this schedule. They do not all need to undergo surgery on the day of diagnosis. This offers an ideal training opportunity under senior supervision during normal working hours. This reduces the number of procedures...

Preconception Counseling

If you have epilepsy and you are planning to have a baby, make an appointment to see your neurologist or epileptologist (a physician who specializes in the treatment of epilepsy) for preconception counseling before trying to become pregnant. Many important issues need to be discussed and understood before you become pregnant, some of which you may be aware of, but many of which you may not be. Unfortunately, women often wait until they are already pregnant before calling their doctor. This is a good time to talk about any changes in your epilepsy treatment that might be necessary. The baby's main organs and skeleton develop during the first 4 months of pregnancy, a period during which AEDs may affect the fetus the most. This is one of the major reasons your epilepsy treatment should be evaluated before you get pregnant.

When pregnancy doesnt happen

Having made the decision to become pregnant, most of us will have an idea of how long we think that it might take to conceive. This is probably based on what we know from our families and friends or any information we may have gained from books or television. Therefore, to some extent, problems of conception or'infertility'are self-defined by our expectations. John and Rosemary (whose story was in the last chapter) waited 13 years before their baby arrived other couples are surprised if a baby is not conceived within the first month of trying. Most specialist medical services will have definitions of fertility problems but clearly a simple definition will not work for every couple. A number of factors are relevant for each individual. However, whatever your age, if you are absolutely set on having a baby, then you may see every period that arrives as an unexplainable failure. Many women expect to get pregnant from the first month of trying. Often in a couple one partner is more...

Considering nutritional supplements

Some herbal medications should not be used during pregnancy because they can cause uterine contractions or even miscarriage. A short list of agents that are not recommended during pregnancy includes mugwort, blue cohosh, tansy, black cohosh, Scotch broom, goldenseal, juniper berry, pennyroyal oil, rue, mistletoe, and chaste berry.

Introducing Sperm to Egg Timing Is Everything

This book's title notwithstanding, we're going to assume that you know the basics of how to get pregnant. What many people don't know, though, is how to make the process most efficient, so that you give yourself the best chance of getting pregnant as soon as you want to. To do that, you need to think a little about ovulation the releasing of an egg from your ovary which happens once each cycle (usually once per month). After leaving the ovary, the egg spends a couple of days gliding down the fallopian tube, until it reaches the uterus (also known as the womb). Most often, pregnancy occurs when the egg is fertilized within 24 hours from its release from the ovary, during its passage through the tube, and the budding embryo then implants in the uterus's lining. (See Figure 1-1 for a quick look at the anatomical aspects.) In order to get pregnant, your job (and the father-to-be's) is to get the sperm to meet up with the egg as soon as possible (ideally, within 12 to 24 hours) after...

Taking an effective and fun approach

In most cases, parents-to-be are well advised to just relax and enjoy the process of trying to conceive. Don't get too anxious if it doesn't happen right off the bat. We often tell our patients Think about stopping birth control a few months before you actually plan on getting pregnant. This way, you have some carefree months of enjoying great sex without worrying each month about whether you're pregnant. And if you do conceive ahead of schedule, enjoy the nice surprise

2 Unintended Pregnancy

More than 50 of pregnancies in the United States are unplanned (10), and many women become pregnant while taking medications. Clinicians working with chronically mentally ill women should keep in mind their relatively high incidence of unprotected sex and inadequate use of contraception (11). For women who do not wish to conceive, it is wise to provide education about methods of contraception and to inquire about recent missed menstrual periods. Adequate contraception has become particularly important following the widespread use of the atypical antipsychotic medications (e.g., olanzapine, quetiapine) that, unlike the older antipsychotic agents, do not raise prolactin levels and therefore do not interfere with women's ability to conceive.

Quitting birth control

How soon can you get pregnant after you stop using birth control It depends on what kind of birth control you use. The barrier methods such as condoms, diaphragms, and spermicides work only as long as you use them as soon as you stop, you're fertile. Hormone-based medicines including the Pill, Depo-Provera, NuvaRing, and the birth control patch (for example, Ortho-Evra) take longer to get out of your system. You may ovulate very shortly after stopping the Pill (weeks or days, even). Usually, hormones from pills aren't detectable several days after the last active Pill or the last patch. On the other hand, it can take three months to one year to resume regular ovulatory cycles after stopping Depo-Provera. We know of no hard-and-fast rules about how long you should wait after stopping birth control before you start trying to conceive. In fact, you can start to try to conceive right away. If you're Fertile Myrtle, you may get pregnant on the first try. But keep in mind that if you...

Forbidden points of pregnancy

There is much debate about the points that should be used in pregnancy. Some schools of thought say that you should not treat at all during the first 3 months of pregnancy, as acupuncture may cause miscarriage. I disagree with this view and have had some wonderful results in the treatment of severe morning sickness, which can be utterly debilitating for some women. Women who have had recurrent miscarriages can also be helped greatly by acupuncture, if treatment is given to tonify Kidney weakness. The same applies to women with IVF pregnancies, who I often find suffer greatly from sickness in the first 3 months.

Stacey Chillemis Experience

Many women with epilepsy have polycystic ovary syndrome, a condition characterized by irregular ovulation and menses. The ovaries of women with this condition fail to release an egg at a regular time each month, making conception difficult. The infertility caused by this syndrome is treatable. Polycystic ovary syndrome may be more common in women with epilepsy, and there is some evidence that one particular medication that is used to control seizures (sodium valproate) may also bring on this syndrome. If this is true and not all experts agree this effect may be reversible. It is worth noting that many doctors warn women who stop taking sodium valproate that they may get pregnant easily, and that they should use contraception if they do not wish to become immediately pregnant. The policy of some doctors is to screen all adolescent girls with epilepsy as well as women seeking preconception counseling for the presence of polycystic ovaries and the associated hormonal changes, and advise...

Refighting Yesterdays

Truth and fairness are no more provinces of the Left than the Right. MSNBC's Rachel Maddow declared that in Texas, where abstinence was righteously preached, a teenager gets pregnant every 12 minutes.52 (Understated, actually figures from the Alan Guttmacher Institute suggest it is every six minutes.) True, Texas has the fifth-highest teen pregnancy rate in the country, 20 percent above the national average. However, the problem is, next door New Mexico, whose sex education curriculum is not limited to abstinence-only, has the nation's fourth-highest teen pregnancy rate, 23 percent above the national average. As for Palin's gravid daughter, the sex-versus-abstinence arguers exploited Bristol's pregnancy as a prime example upholding whatever they advocated without mentioning that the Wasilla, Alaska, high school Bristol attended provided comprehensive sex education and abstinence classes. Though I am pretty sure no one cares, Guttmacher Institute figures show Alaska's teen pregnancy...

Frequently Asked Questions

Assisted reproductive techniques (ARTs), such as intra-uterine inseminations or in-vitro fertilizations (test tube babies), may be employed by reproductive specialists in certain cases. In cases of severe male factor, intra-cytoplasmic sperm injection (ICSI) can be used. This refers to the injection of a single sperm to fertilize the egg. All these can only happen after detailed counseling of the procedural risks and benefits.

Twin and multiple pregnancies

Today many multiple pregnancies are the result of fertility treatment and therefore may have been expected. The meaning here can be different too. You may be delighted with more than one baby if you have struggled for years with the prospect of no children or if this is your last attempt at assisted conception. Alternatively you may have agreed to the

Teen Sex Pregnancy Do Not Exist

Of course, some teenagers have sex, and a fraction of these teens get pregnant. So do Missourians, Rastafarians, and people whose last names start with C. Individuals born on Monday account for a shocking one in seven unwed pregnancies, abortions, and sexually transmitted diseases. We might as well single out any or all identifiable groups for stigma and intervention.

JM Duncan On puerperal diabetes Trans Obstet Soc London 1882 24 2568529

Matthews Duncan 1882

From his own experience first identified the serious problem of diabetes to the obstetrical world. He recorded at least 22 pregnancies in 15 mothers between the ages of 21 and 38 (the data are confused in places) the mother survived the pregnancy for long enough to become pregnant again in nine instances, in five she died at the delivery and in six within a few months. The cause of maternal death was usually diabetic coma, although it is not possible to exclude eclampsia, and some must also have developed puerperal sepsis and one died from exacerbation of tuberculosis. Twelve of the 22 babies died, usually in utero, and they were usually of a large size at least 10 survived and only three miscarriages are recorded another 20 pregnancies seem to have occurred before the recorded cases, so some of these mothers must represent late-onset Type 2 or gestational diabetes, and these seemed to have a better prognosis for both mother and child.

Incidence And Mortality Of Ectopic Pregnancy

Probability of an ectopic pregnancy is higher in women with clinical symptoms. For example, a woman with a previous ectopic pregnancy who presents with unilateral iliac fossa pain is more likely to have an ectopic pregnancy than an asymptomatic woman in her first pregnancy. Hence the result of an ultrasound scan is influenced by the prior odds.12 According to a meta-analysis, risk factors for ectopic pregnancy include previous ectopic pregnancy, previous tubal surgery, documented tubal pathology and previous genital infections, including PID, Chlamydia and gonorrhoea.13 In another study, contraception and the risk of ectopic pregnancy has also been evaluated.14 Although women becoming pregnant after sterilization or while currently using an intrauterine contraceptive device are at an increased risk of ectopic pregnancy should they become pregnant, neither is a risk factor for ectopic pregnancy.14 Pregnant women whose ultrasound in the first trimester demonstrates haemoperitoneum...

Three Reasons Why Teen Pregnancy Does Not Exist

Here is teen pregnancy, the short take. Teen birth, unwed birth, abortion, total pregnancy, and sexually transmitted disease (STD) rates closely parallel those of adults of their community, class, and era.1 In fact, 6 in 10 men who impregnate teenagers are adults.2 The younger the pregnant teen, the bigger the partner age gap and the more likely she was to have suffered family chaos, including sexual abuse and other violence.3 In 2005, among females under age 20, 60 percent of all live births, 64 percent of abortions, 62 percent of fetal losses, and 61 percent of all pregnancies involved black, Hispanic, and other nonwhite minorities.4 More than four in five involve impoverished and low-income teens. Teenagers living in more affluent areas have very low pregnancy rates comparable to those in Western European countries.

Sarah C Couch and Richard J Deckelbaum

Summary Obesity in pregnancy is associated with numerous maternal and neonatal complications including difficulty conceiving, increased risk of miscarriage, fetal anomalies and mortality, higher rates of gestational hypertension, gestational diabetes and preeclampsia, and an increased risk of cesarean section and delivery related complications. Nevertheless, more women are entering pregnancy with excessive weight and are gaining weight above the Institute of Medicine (IOM) recommendations during pregnancy. Weight loss is not recommended during pregnancy however, overweight and obese women should be advised to aim for a moderate weight loss prior to conception and during the postpartum period. Strategies for achieving moderate progestational and postpartum weight loss include a low-calorie, low-fat diet and at least 45 min of daily physical activity. Benefits to mother and child are achieved with even a moderate weight loss. Importantly, health care professionals should counsel women...

Risk Factors And Aetiology For Pregnancy Failure

The aetiology of pregnancy failure is complicated and could be the subject of an entire chapter. Suffice it to say that it can be associated with chromosomal abnormalities. Pregnancies associated with trisomy 21, 18 and 13 are the most likely to survive. All other trisomies end in early pregnancy failure. Congenital anomalies are also a source of pregnancy failure. Maternal endocrinopathies, especially diabetes, and haemoglobin A1C levels at conception correlate with risk of pregnancy failure. Other related conditions include uterine abnormalities (adhesions, septae and submucous fibroids). Acute or chronic maternal illness and or infection can result in early pregnancy failure. Thrombophilia as well as auto-immune disorders are controversial as to their role, if any, in early pregnancy failure and recurrent miscarriage in particular. clinical recognition. However, of these, 35 became clinically pregnant the next cycle, 65 clinically pregnant by the third cycle and 83 by the sixth...

Change from physiology to pathophysiology

It is not too surprising that GDM develops in genetically susceptible women when they become pregnant. They probably have some degree of insulin resistance prior to pregnancy and normal pregnancy is associated with severe insulin resistance. Catalano et al.15 found an approximate 21 decrease in insulin sensitivity occurring by 12-14 weeks of gestation and a 56 decrease in insulin sensitivity occurring by 34-36 weeks. Others have found similar results.16-18

Nursing an Adopted Infant

Others may feel that going to such lengths to breast-feed gives too much weight to the biological aspects of parenthood and adds tension to the adoption process. Parents who are adopting, especially after a difficult period of infertility, need to remember that millions of people revel in parent-child love, closeness, and bonding without breast-feeding. It doesn't take breast-feeding to make a real mother.

Polycystic ovary syndrome and gestational diabetes mellitus

PCOS is a heterogeneous disorder affecting 5-10 of women of reproductive age. It is characterized by chronic anovulation with oligo- amenorrhea, infertility, typical sonographic appearance of the ovaries, and clinical or biochemical hyper-androgenism. Insulin resistance is present in 40-50 of patients, especially in obese women.23

Meg and Richards story

Meg and her husband Richard came to see me when she was advanced in her pregnancy. Initially they sought help with arguments between themselves but it became clear that their fighting, sometimes physical, was generated by the pressure that their extended families were putting them under and they were being pulled in different directions to provide support. Meg's mother had been looking after her sister, a recovering heroin addict, and would constantly phone Meg if Alice were 'missing' for too long. Richard's father had died suddenly not long after Meg had become pregnant. Richard's mum expected him to call around every night after work and Meg was worried that this would not change after the baby was born. The more that Meg and Richard attempted to pull away and think about their new roles and responsibilities, the more their respective families seemed to fall into crisis.

Speaking of pregnancy competing truthclaims

Rowlandson

Free from other disorders and that labour, though painful, is almost always natural, and the event happy' (p. xxiv). Repeatedly, women are urged to trust themselves to nature so Denman confirms that 'in every thing which relates to the act of parturition Nature, not disturbed by disease, and unmolested by interruption, is fully competent to accomplish her own purpose'.10 However, as has been noted in the Introduction, 'nature' is a slippery ideological construction. Here, in a paradox which continued to structure antenatal care, the authoritative professionals can do little more than suggest faith in nature, that is, non-intervention, as a medical strategy. Other than this, the advice in these texts consisted of bland injunctions to eat a balanced diet and exercise moderately. Venesection (blood-letting) was still sometimes recommended, and much attention was paid to constipation.11 This latter was considered a serious matter, as it might lead women to use strong purgatives, which...

Sanjog Kalra and Adrienne Einarson

Depression has been identified by the World Health Organization as a major cause of morbidity in the 21st century. As women between 25 and 44 yr represent the population at highest risk for depression, a substantial number are likely to become pregnant while suffering from this illness. In this chapter, we summarize the prevalence and clinical course of depression during pregnancy. We also document evidence-based information regarding the safety and efficacy of both pharmacological and nonpharmacological treatments of prenatal depression. In addition, we discuss other issues surrounding the treatment of depression, such as abrupt discontinuation syndrome, poor neonatal adaptability, and an increase in the rate of spontaneous abortions, associated with the use of certain antidepressant drugs. Of equal importance, we also review the emerging literature on the potential adverse effects of untreated depression during pregnancy. Depression is an important issue that must be addressed when...

Baby Pricing And The New Eugenics

From its inception a century ago, the birth control and family planning movement has presented Jekyll and Hyde faces. The movement's contribution to the liberation of women from perpetual childbearing, families from mistimed children, and societies from rising fertility beyond what environments could absorb must be regarded as one of the crowning achievements of health science and politics. A truly optimistic trend has been the demographic transition, in which rising prosperity produces falling birth and death rates, promising a safer, less starvation-edged future. The sinister face of family planning and birth control is eugenics that is, efforts to improve a society's population stock by preventing the births of babies of disfavored populations. Negative eugenics is defined by Merriam-Webster's Medical Dictionary as the improvement of the genetic makeup of a population by preventing the reproduction of the obviously unfit. Positive eugenics consists of encouraging the fit to breed....

Screening Tests FTS or MSS

Baby Has Long Nasal Bone Down Syndrome

Screening tests do not tell you if your baby has Down Syndrome. Their purpose is to tell you if your fetus belongs to a low or high risk group. If the screening test shows that there is a high risk of your baby being affected, you will be offered a diagnostic test (see below) to confirm it. Screening tests are noninvasive hence, there is no risk of miscarriage to the baby. These are tests that obtain cell samples from the baby and can tell you for sure if the baby is affected with Down Syndrome. It is only performed for high-risk cases detected on screening due to the inherent risks of miscarriage associated with these procedures. Amniocentesis Down syndrome can be diagnosed early in pregnancy from 15-20 weeks of pregnancy by amniocentesis. This involves a very fine needle being passed into the womb, under ultrasound guidance, and sampling of the amniotic fluid (water bag) around the baby. It takes about 2-3 weeks for the results to be ready although rapid tests (PCR) can also be done...

Specific psychological difficulties in pregnancy

The popular image of pregnancy is of the parents-to-be perpetually in 'spring', a time of optimism, new replacing the old, new beginnings, and so on. It's not really like this most women feel a range of different things through their pregnancy as do fathers-to -be. Chapter 3 has tried to identify themes and issues that are common to many pregnancies, but certainly not all. Reading so far, you may have found certain things that you recognised and others that were not your personal experience. However, for some couples, the entire pregnancy can be very different. A pregnancy can be seen as complicated for very many reasons the mother may have a history of miscarriage or perinatal death, a previous termination of pregnancy or health problems such as pre- eclampsia.The baby may already be identified as having health problems or disabilities or may have been conceived through assisted conception. However, this chapter will concentrate on significant emotional problems.These may either...

Diagnostic Measures Clinical

As long ago as 1895, Hegar meticulously described the clinical diagnosis of early pregnancy. Since it is difficult to date a pregnancy before the 8th week by vaginal examination, the length of an early pregnancy is usually estimated from the last menstrual period (LMP).1,18 Because vaginal bleeding occurs in 25 of normal pregnancies and in the majority of pathological pregnancies, the exact length of a pregnancy complicated by bleeding is often difficult to establish.19 As Goldstein has previously discussed in Chapter 4, before the era of ultrasound, inevitable miscarriage was considered to be present when pain or bleeding threatened the mother's wellbeing. Incomplete miscarriage when part of the products of conception had passed the cervix, and complete miscarriage when the products of conception had been passed, the uterus was contracted toward normal size and the cervix was closed.20 As has been discussed in previous chapters, relying on clinical measures alone does not enable the...

83developmental considerations for the adolescent

Erickson proposed the developmental tasks of teenagers as accepting body image, determining and internalizing sexual identity, developing a personal value system, preparing for productive function, achieving independence from parents and, finally, developing an adult identity 8 . Pregnancy, planned or unplanned, has a tremendous impact on all of these tasks, both positive and negative. How does a young woman accept a body image that is changing every week How does she deal with a rapid weight gain in a culture that is fraught with skinny images and advertisements for weight loss products It has been reported in the literature that lesbian and bisexual young women are at higher risk for pregnancy compared with their peers, although it is unclear why this is the case how do their attempts to internalize their sexual identity impact on this risk 10 Some young women may plan their pregnancy to demonstrate their complete rejection of their parents' value system (thus stating their own) and...

Treatment of Mood Disorders During Pregnancy

Be used prior to conception to facilitate the gradual tapering and discontinuation of an antidepressant medication in women planning to become pregnant. These modalities of treatment may reduce the risk of recurrent depressive symptoms during pregnancy, although this has not been studied systematically. Close monitoring during pregnancy is essential, even if all medications are discontinued and there is no apparent need for medication management. Women with histories of mood disorder who discontinue antidepressant treatment are at high risk for relapse, and early detection and treatment of recurrent illness during pregnancy may attenuate the morbidity associated with antenatal mood disorder. When considering the use of a psychiatric medication during pregnancy, the clinician must address four primary types of risk with respect to the developing fetus 1) risk of pregnancy loss or miscarriage, 2) risk of organ malformation or teratogenesis, 3) risk of neonatal toxicity or withdrawal...

The Eastern philosophy of childbirth

The Yellow Emperor (1963) said 'After the person's connection, the Jing is first composed. Then the Jing composes the brain and the bone marrow. The bones become the Stem, the vessels become the Ying, the muscles become firm. The flesh becomes a wall, the Jing is hard and then the hair and body grow'. The chapter on preconception discusses the importance of getting healthy, regulating periods and correcting imbalances before becoming pregnant. In my experience, a woman's physical and emotional state when she enters pregnancy will have a huge effect on the outcome of that pregnancy.

Jane Scullion BAHons RGN MSc

They include rising numbers of older or obese mothers, women whose lifestyles put them at risk of poorer health and a growing proportion of women with serious underlying medical conditions who would not have chosen, or have been able to become pregnant in the past. The rising numbers of births to women born outside the UK also affects the underlying general level of maternal health as these mothers often have more complicated pregnancies, more serious underlying medical conditions or may be in poorer general health.

Preformationism epigenesis and Frankenstein

It has been pointed out that, despite the development of obstetrics in this period, many of the clinical aspects of pregnancy were little understood. There was little knowledge of the causes of foetal death, of miscarriage or of deformity at birth. However, the understanding of very early life (embryology) was changing rapidly and it was a subject which was fiercely debated. In the seventeenth century the invention of the microscope had enabled close study of the ovum and spermatozoon, and while scientists such as the Dutch naturalist

Fetal Risk Summary

One manufacturer has received 441 reports of in utero exposure to alprazolam or triazolam, two short-acting benzodiazepines, almost all of which occurred in the 1st trimester (5,6). Although most of the women discontinued the drugs when pregnancy was diagnosed, 24 continued to use alprazolam throughout their gestations (5). At the time of publication, about one-fifth of the 441 cases were still pregnant one sixth had been lost to follow-up and one sixth had been terminated by elective abortion for various reasons (5). Spontaneous abortion or miscarriage (no congenital anomalies were observed in the abortuses) occurred in 16 women two pregnancies ended in stillbirths and one newborn infant died within 24 hours of birth. Most of the remainder of the reported exposures ended with the delivery of a normal infant. The manufacturer also received two retrospective reports of congenital defects after alprazolam exposure (5). One of the cases involved an infant with Down's syndrome after...

Pregnancy and your cat

If you are immune to toxoplasmosis by previous infection before pregnancy, then you are not likely to be infected again. Thus, if you are a cat owner and trying to get pregnant, ask your doctor for a simple Birds can transmit infections like campylobacter and salmonella. They can cause miscarriage in early pregnancy or stillbirth in advanced pregnancy. Farm animals are known to transmit listeria, campylobacter and also salmonella infections. Listeria infection can cause severe infection, miscarriage or stillbirth.

Preconception Issues And Care

Ideally, all women should be able to make an informed choice about pregnancy based on both maternal and fetal risks, long term prognosis and alternative options such as contraception, termination of pregnancy, adoption, surrogacy and IVF. Encourage realistic expectations, and advocate active preparation for pregnancy. This includes

94anorexia and bulimia nervosa during pregnancy

AN and BN are typically manifested in the early postpubertal to young adult years 12 and continue throughout the reproductive years 13 . Amenorrhea is a diagnostic criteria for AN, suggesting that pregnancy is of little concern in a woman with this eating disorder. However, approximately 10 of women who sought treatment in an infertility clinic presented with AN or BN 14 . Moreover, 60 of women with oligomenorrhea had eating disorders 14 , indicating the desire for fertility despite any dysmenorrhea associated with AN or BN. Studies confirm that women with AN may become pregnant 15, 16 , particularly those women who are undergoing active treatment or are in remission 17 . While pregnancies in women with active BN are more common than in women with active AN, women with histories of AN and BN have similar pregnancy rates compared to the general population of women of childbearing age 17, 18 .

Possible mechanisms of action of diabetes on the early embryo

It can be concluded that the significant loss of progenitor cells from the ICM makes the embryos more sensitive to later developmental deficiencies. Furthermore, it was reported that normal embryogenesis can occur only if sufficient number of functional ICM cells are available.21 Increased apoptosis at this early stage of development may lead to spontaneous miscarriage or congenital malformations. Figure 22.1 summarizes the steps leading to diabetes-induced increased apoptosis.

Effects on male fertility

Studies suggest that sexual dysfunction is frequently associated with diabetes in men and in experimental animals.45 Many of these problems result from diabetes-induced changes in the vascular system as well as in the peripheral and central nervous system that are related to changes in endocrine function.46 Numerous studies have documented abnormalities in testicular function and spermatogenesis in diabetic animals.47 In addition, studies demonstrated reduction in the activity of ATPases and phosphatases in the epidermis and in spermatozoa.48 Impotence, infertility, and retrograde ejaculation have been described in diabetic men, but the etiology remains unclear. The reduction in the fertility of men with long standing diabetes, by affecting spermatogenesis, seems to be similar to the effects of diabetes on the ova.

Maternal and fetal morbidity and mortality

Gestational AI has been associated with high rates of intrauterine growth retardation, low birth weight 31,32 , and fetal mortality 33 . A recent Italian series reported improved miscarriage rates (16 of 104 pregnancies) compared with intrauterine death rates in the 1950s of 40 to 50 34 . Most of the earlier reports consisted of previously unrecognized cases or preceded the availability of modern glucocorticoid regimens 35 . These differences have led to the speculation that, treated properly, women do not have increased complications of gestation. There does not appear to be an increased risk of preterm abortion or congenital anomalies resulting from AI alone, when patients are treated adequately 36 . However, when AI is associated with other autoimmune conditions, including positive circulating anticar-diolipin antibodies, lupus anticoagulant, and diabetes, there may be additional risks of preterm abortion 37-39 .

296 Vitamin K antagonists

The largest controlled, prospective study until now includes 666 pregnancies with 670 exposures to different vitamin K antagonists. In this multicenter study, pregnancies were compared, with respect to their outcome, with 1049 controls. In most cases, treatment occurred from the beginning. This study confirmed the teratogenicity of coumarins, and revealed a three-fold miscarriage rate after firsttrimester treatment. The rate of elective terminations was also higher. Live births occurred in only 53 . Prematurity was more frequent. The rate of major birth defects was significantly increased (OR 3.86 95 CI 1.86-8.00). There were only two coumarin embryopathies observed among 356 live births (0.6 ), and exposure to a vitamin K antagonist in these cases was later than 6 weeks postconception. The risk for coumarin embryopathy seems to be small, however, and the outcomes of this study confirmed that when exposure was limited to the first 6 (postconceptional) weeks, the risk of major...

Pregestational diabetes

The model for diabetes preconception and early pregnancy health care includes four main elements (1) education of the patient about the interaction between diabetes, pregnancy, and family planning (2) education in diabetes self-management skills (3) physician-directed medical care and laboratory testing and (4) counselling by a mental health professional, when indicated, to reduce stress and improve adherence to the diabetes treatment plan.70 Women with incipient renal failure (serum creatinine > 265.2 mol L or creatinine clearance < 50 mL min) should be counselled that pregnancy may induce a permanent worsening of renal function in > 40 of patients. In subjects with less severe nephropathy, renal function may worsen transiently during pregnancy, but permanent worsening occurs at a rate no different from the background. Therefore, it should not serve as a contraindication to conception and pregnancy. As mentioned above, the presence of proteinuria in excess of 190 mg 24 h before...

Inpatient medical management

A smaller trial reported a success rate of 82 following the administration of a single vaginal dose of 800 mg misoprostol. Eight to ten hours were allowed for completion of miscarriage. This time period was similar to the average time period (14 hours) from diagnosis to surgical management in the control group.4

2101 Epilepsy and antiepileptic drugs in pregnancy

It lias been known for several decades tbat infants of epileptic mothers are at an increased risk of major and minor malformations. This is mainly attributable to the teratogenicity of antiepileptic drugs (AED), the disease in itself increasing the risk mildly, if at all (Morrow 2006, Artama 2005, Fried 2004, Holmes 2001). No epidemiological technique, though, is ideal to separate the effects of the disease from those of the drugs on the fetus. Few epileptic patients can live without treatment, and it might be questioned whether those who can are indeed actually epileptic. Lindhout and Omtzigt (1992) described a marked increase in malformations amongst infants exposed to first-trimester seizures. However, most investigators have found that maternal seizures during pregnancy had no impact on the frequency of malformations (Canger 1999, Kaneko 1999, Dansky 1991), or on the development of infant epilepsy or febrile convulsions (Dansky 1991). There have been reports of maternal seizures...

General nutritional guidelines for pregnancy

Normal pregnancy nutritional guidelines focus on several dietary elements. Major topics include caloric intake, macronutrient proportion, vitamins and minerals, and alcohol consumption. The energy requirements of the fetus must be met to ensure proper development and provide for postpartum lactation without causing excessive maternal weight gain. The energy standard to support a pregnancy has been debated heavily and will be explored in the GDM nutritional therapy section below. The American College of Obstetricians and Gynecologists advocates several basic concepts for a balanced diet for pregnant women. They suggest eating three to four servings of fruits and vegetables, nine servings of whole grains for energy, three servings of dairy for calcium, and three servings of meat to reach daily protein requirements. Vitamin supplementation to achieve daily nutrients, as an adjunct to a healthy diet, is encouraged when recommended by the woman's physician. Certain foods should be avoided...

Explanation Of Condition

The clinical features are due to hyperprolactinaemia and the space-occupying effects of the tumour. Hyperprolac-tinaemia causes secondary amenorrhoea and infertility it inhibits pulsatile GnRH (gonadotropin releasing hormone) release which results in anovulation and low oestrogen levels. Raised PRL levels can also cause galactorrhoea.

Complications Of Medical Management Infection

Most published trials are underpowered to detect the infection rate following medical management. The MIST trial24 (Miscarriage Treatment Trial) reported an infection rate of 2 at 14 days (3 at 8 weeks) based on clinical assessment parameters. The rate of infection was similar to that found in the expectant and surgical groups. A similar infection rate of 3 was reported in a retrospective observational

Why Are Married Teens Having Fewer Babies

Traditionally, teenage women got married, mostly to adult men, to establish a household and to get pregnant or legitimize a pregnancy. Yet, census figures showed teen marriage was changing rapidly. Rising numbers of married teens did not live with their spouses, not because of separations but developments possibly related to employment or education. Mothers age 20 and older also trended away from marital childbearing, also for reasons not entirely clear.

Medical Management In Practice

The alternative management option would be medical management in an outpatient setting. This appears to be successful and acceptable to women.18 In terms of management of incomplete miscarriage, there appears to be little increased efficacy over expectant management and therefore managing these women medically may lead to unnecessarily increased rates of gastrointestinal side effects.3

Should My Partner Use a Condom

Ting as well as cramping during this time. This is harmless but the bleeding may also signify other problems such as a miscarriage or an ectopic pregnancy which is a life threatening condition (whereby the pregnancy occurs outside the womb frequently in the fallopian tubes). It is important that you seek medical advice promptly (Figures 20.1 and 20.2).

44 First Trimester Of Pregnancy

Decreased Interest In Sex Due To Bodily Changes. Nausea, vomiting, fatigue, and fear of injury to fetus may cause a loss of interest in sex. Increased vascularity to breast may yield breast tenderness or discomfort initially but this decreases as the pregnancy continues. Increased vascularity to the genitalia area may also be of concern. Fear of a miscarriage may cause the patient not to want sexual intercourse.

2133 Vinca alkaloids and structural analogs

Vinblastine is an alkaloid derived from the periwinkle plant. Like the related vincristine, it inhibits cell division by interfering with the mitotic spindle. There are more than 15 case reports concerning the use of vinblastine during the first trimester, mostly in combination with other cytostatic drugs. In most cases, the coursc of pregnancy was apparently norma (Aviles 1991). However, there are also reports of children with malformations a child with hydrocephalus after intrauterine exposure to vinblastine alone in week 3 a second with cleft palate whose mother had received vincristine and other cytostatic drugs from week 9 until delivery, following treatment with vinblastine until week 6 and a spontaneous miscarriage shortly after injection of vinblastine in week 6 (Mulvihill 1987). There is also a report of a spontaneous miscarriage of a male fetus with only four toes on each foot and syndactyly in week 24 of pregnancy (Garrett 1974), as well as a male infant delivered at 37...

2138 Cytotoxic anthracydine antibiotics

Re-examination of 13 children of this group when aged between 6 months and 9 years demonstrated that their development was normal. Zuazu (1991) describes two other pregnancies exposed during the first trimester one ended in a spontaneous miscarriage 20 days after the end of multi-agent chemotherapy, and the other proceeded to delivery of a healthy premature baby in week 34. Artlich (1994) describes a patient who underwent treatment with daunorubicin and cytarabine at the time of conception, and received cytarabine and thioguanine 5 weeks later. The child had craniosynostosis and radial aplasia. When administered during the second third trimester, daunorubicin may occasionally elicit myelo-suppression. There are at least 20 case reports on epirubicin in combination therapy, including two exposures during the first trimester which ended in spontaneous miscarriage. Regarding the other pregnancies, there was 1 abortion, 1 stillbirth and 1 child who died shortly after...

21310 Folate antagonistic antimetabolites

Ten articles describe pregnant women who had received methotrexate as part of cancer therapy during the first trimester. It is notewor thy that 16 healthy children were bom in this high-risk group (Zemlickis 1992, Aviles 1991, Feliu 1988, Dara 1981, Pizzuto 1980) 1 child had inguinal hernia (Giannakopoulou 2000), there was 1 spontaneous miscarriage (Giacalone 1999), and 1 stillbirth without malformations (Peres 2001). Only 1 child had characteristic malformations (Bawlc 1998) this child's mother had been treated for breast cancer with a weekly dose of 80 mg MTX from weeks 8-29. Moreover, she had received irradiation treatment from weeks 16-25, with the fetal dose estimated at 14 rad. In contrast to these publications, there are case reports of 14 healthy children whose mothers had a dosage of between 7.5 and 15 mg per week (Ostensen 2000, Donnenfeld 1994, Feldkamp 1993, Kozlowski 1990), 4 spontaneous miscarriages (Ostensen 2000, Kozlowski 1990), and 2 induced abortions without...

5 Treatment Guidelines

To minimize risk to mother and child, the best type of conception is a planned conception. Some patients and their clinicians may feel comfortable attempting to taper off of medications prior to attempts to get pregnant and to see if the woman is at a phase of her illness that may be quiescent. Because of the severity of prior episodes, other women may feel that this will not be safe for them and will prefer to be put on the safest medication possible while attempting to get pregnant. Tapering off or transitioning to medications can be done in a thoughtful and conservative way if clinicians and patients are given the time. Often, however, patients will find that they are pregnant while on a medication and feel the need to abruptly discontinue their treatment. It is clear that an abrupt discontinuation of antimanic agents, at least of lithium, rather than a slow taper, is associated with an increased risk for relapse (14,15).

Should a pregnant woman with diabetes use an artificial pancreas

It was feared that the high incidence of DKA in pregnant women with diabetes would carry a significant risk, including death. An external device may add to the risk of DKA. Since there is no long-acting insulin in an insulin infusion device, ketosis develops in a matter of hours, if the infusion set dislodges. To ensure that there is no interruption during the night, it is suggested that when women with Type 1 diabetes are using an external insulin pump, that 0.1 U kg of NPH be given before bed. Overnight basal

21312 Pyrimidinederived antimetabolites pyrimidine antagonists

Of cytosine, from which it differs by its sugar component, arabinose. There have been 11 published reports on pregnancies following cytarabine exposure in the first trimester. Six children were healthy (Aviles 1991, 1990), and one spontaneous miscarriage occurred 20 days after the end of cytotoxic therapy (Zuazu 1991). There were two induced abortions, one of which was induced after 20 weeks with an apparently normally developed fetus (Zemlickis 1992, Lilleyman 1977). Three children had limb anomalies one of them also had bilateral microtia and atresia of the exterior auditory canal (Wagner 1980). The mother had received cytarabine three times in connection with maintenance therapy for acute lymphatic leukemia at the time of conception, in week 6 7, and in week 10. This is the only case report of a mono-drug therapy all the other cases received multi-agent chemotherapy. The second anomalous child had radial aplasia on both sides and four fingers on each hand, with a hypoplastic thumb,...

Treatment with acupuncture

If the cause is stagnation of Qi, the symptoms will be a distending pain in the lower abdomen. Such women are usually very irritable and depressed, and probably suffered a lot of Liver Qi stagnation prior to getting pregnant. Use even technique on PC-6 and LR-3 together, to calm the mind and move the Qi. One woman I treated was admitted to hospital with severe abdominal pain. She was very irritable and depressed. Although given every test possible, no medical explanation could be found for her pain. I treated her with acupuncture and there was a definite improvement using the above points.

More Teen Sex Less Pregnancy Disease And Drama

Are more teens having sex, getting pregnant, getting diseases, and suffering debilitating emotional consequences from sexual experimentation We begin with an interesting conundrum. Teens today do report having more sex at younger ages than their parents or grandparents did (or admitted to), but today's teens appear to suffer far fewer consequences from sex than did past generations. Table 6.1 shows the trends since 1930, around the time when the national birth registration system first became reasonably complete.14 Teen birth rates (the only outcome consistently reported) are at their lowest levels today since the first national statistics compiled 90 years ago, while pregnancy rates are at their lowest level since first reliably reported in 1973. Regardless of what teens say they do, clearly measurable outcomes from teenage sex stand at all-time lows, and the youngest teens show the biggest declines. A good case could be made that Boomer and older Generation-Xer teens had trouble...

And Kidney also become deficient Use GB41 on the right side and TE5 on the left side obtain Deqi and leave the needles

Vicki has been pregnant seven times (including two miscarriages and twins in her fourth pregnancy). On each occasion she suffered from preterm labour and or an irritable uterus that kept on contracting, and had to be repeatedly admitted to hospital from 20 weeks on for complete bedrest. Throughout the last three pregnancies, I have given her a weekly treatment from about 8 weeks of pregnancy. Annabel was an IVF pregnancy with a history of infertility. She came to me at 24 weeks suffering frequent contractions and an irritable uterus. Problems with contractions are often linked to Kidney deficiency and an excess of heat. However, in Annabel's case, she was also very angry and frustrated by the contractions. She was suffering greatly from back ache and a feeling of heaviness in the abdomen she felt like the baby was going to drop out. She also had a number of Yin symptoms, such as a dry mouth, thirst and heat at night. Movement made the contractions worse so I treated her at home.

2151 Hypothalamic releasing hormones

Releasing hormones are responsible for regulating the synthesis and secretion of FSH and LH. Many synthetic human GnRH agonists are marketed, including buserelin, gonadorelin, goserelin, leuprore-lirt, nafarelin, and triptorelin. Cetrorelix and ganirelix are inhibitors of GnRH. In women, GnRH agonists have been used to treat estrogen-dependent breast cancer, endometriosis, hirsutism, and polycystic ovarian syndrome, but the widespread use of protocols using GnRH agonists antagonists in assisted reproductive technologies has led to an increasing number of pregnant women being exposed to these types of drugs. Most of the data concerning the safety of the GnRH analogs have not demonstrated serious side effects, such as increase in the incidence of miscarriage, birth defects, or fetal growth restriction, in human pregnancies exposed to GnRH (Tarlatzis 2004, The available information concerning children exposed to GnRH antagonist is still rare. In a study carried out on the perinatal...

Focus On Visualization

Vis ua I i zati on i s a powerfu I tool u sed by many athletes to en ha nc e th e i r performance. It can be used in conjunction with hypnotherapy to improve mind-set. I see many women stuck in a negative mind-set in early pregnancy. Th ey a r e a nx i o u s a bo u t h avi n g s c a n s o r, i f t h ey 've h a d a miscarriage previously, they doubt their ability to carry a b a by to t e r m.

2153 Prolactin antagonists

Infertility resulting from hyperprolactinemia is reversible after treatment with centrally acting dopamine agonists. Among these, bromocriptine, cabergoline, lisuride, metergoline, and quinagolide are Ihe more frequently used in Ihe clinic. In a study of 2587 pregnancies in which bromocriptine was administered during the first weeks of pregnancy, there was a slight increase in the rate of early miscarriage but no increase in the rate of birth defects (Krupp 1987). Because most women stop therapy as soon as pregnancy is confirmed, this study also suggests that continuing hyperprolactinemia has no adverse effects on the fetus. A more recent report concerning 27 pregnancies also demonstrated effectiveness and apparent lack of adverse effect of continuing therapy for micro- or macroprolaetinoma with bromocriptine or lisuride through early pregnancy. If, during the course of the pregnancy, ophthalmologic problems occur in connection with macro-prolactinoma, restarting medication therapy is...

7Is it normal to have blocked ears during pregnancy

This is defined as vaginal bleeding or spotting that happens in the first 12 weeks of your pregnancy. Most of these bleeds are not significant and your baby is not affected in anyway. However, if persistent or associated with pain, it may indicate underlying problems such as a miscarriage or an ectopic pregnancy (pregnancy that exists outside the womb). It is imperative that you seek medical attention so that the necessary investigations can be performed. In most cases of early pregnancy bleeding, the baby is unaffected and the scan shows the presence of the fetal heart. In such cases of 'threatened miscarriage', the prognosis is good and usually, the baby will be fine. prognosis is guarded. Very often, this will lead to a spontaneous miscarriage. Even if the pregnancy continues, it may cause infection, limb contractures and poor development of the lungs (pulmonary hypoplasia), which could be fatal.

Getting Used To The Idea

No one is sure why identical twins occur, but a dominant maternal gene may cause a single fertilized egg to split. Fraternal (dizygotic) twins are easier to explain because they tend to run in families or occur when fertility treatment boosts the number of eggs released or when two or more fertilized eggs are returned to the uterus during IVF (see page 45). Th w t o x w m Many women, especially those who have had IVF, e ke y

Popular Books On Teen

Contrary to the book cover's promise, The Sex Lives of Teenagers does not reveal the secret world of adolescent boys and girls. It simply recounts some lurid stories from her more extreme clients that she misrepresents as signs of the times. Teenagers, she says, are taking greater risks with sex, with consequences that include sexually transmitted diseases, unwanted pregnancy, and pathological relationships, among others. She claims that HIV infections are falling in the United States, but they are not falling for young people and that half of the forty thousand people being infected with HIV in the United States are twenty-four years old or younger. As we have seen, this simply is not the case. Teens today display substantially lower rates of pregnancy, birth, abortion, HIV, and other STDs we can measure over time, which are fairly solid measures of sexual risk-taking. Far from being younger and younger, teens who get pregnant today tend to be older (18 or 19) than in the past....

21513 Progestins gestagens Pharmacology and toxicology

For about 40 years, progesterone and its partially or completely synthesized derivatives (i.e. 17-hydroxyprogesterone) have been used to treat threatened or habitual miscarriage, although there is still no proof of the effectiveness of this therapy. A WHO Symposium on Drug Treatment during Pregnancy established the ineffectiveness of this sort of therapeutic effort, which was widespread in Germany. France and Italy, but not in Scandinavia (WHO Report 1984). The only indication for hormonal prevention of miscarriage which is currently discussed is hCG therapy for the rare corpus luteum insufficiency. However, therapy with progestins continues to be recommended, nowadays mostly with natural progesterone. In addition, it is common to use a progestin to support corpus luteum function after in vitro fertilization and embryo transfer. A possible association between hormone therapy and hypospadias has been previously debated (Kallen 1992). More recently, a statistically significant risk for...

21514 Diethylstilbestrol

Diethylstilbestrol (DES) is a synthetic nonsteroidal estrogenic drug that was used therapeutically in the USA in the 1970s for threatened miscarriage and for maternal diabetes mellitus. The discovery of increased rates of vaginal clear-cell adenocarcinoma in adolescence among daughters whose mothers had received DES during pregnancy produced an international sensation (Herbst 1975). This drug provides the only proven example in human beings of prenatally-caused cancer (transplacental carcinogenesis). At least 25 of those young women who had prenatal exposure in the first trimester were born with vaginal, uterine, or fallopian tube anomalies. With male offspring, there appears to be an increased risk for ciyptorchidism, testicular hypoplasia, and abnormal semen cell morphology (Bibbo 1981).

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