Showing posts with label birth defects. Show all posts
Showing posts with label birth defects. Show all posts

Saturday, January 03, 2009

Timely tests can avoid miscarriages and help you ‘carry’ safely

A miscarriage can be medically defined as a ‘pregnancy loss’ and a lady aged above 35 definitely stands at a greater risk than a woman of 25 years of age. Furthermore, the chances of a conception of a pregnancy are also very few in an older woman.

As far as the causes of miscarriages are concerned,
a chromosome abnormality in conception is among the most common reasons of any pregnancy loss and the egg usually is responsible for giving an unsuitable number of chromosomes.

With less than half of the eggs of a woman really being reproductive and capable of conception, many of these chromosomally abnormal eggs’ fail to be recognized as pregnancies as very often they are not able to divide for an embryo or fetus production, and sometimes even if the embryo is implanted, a conception loss occurs very soon.

What most often happens is that during the
formation of a gamete, i.e. the collection of the egg and sperm, certain genetic material is lost. Now there arise possibilities wherein the lost genetic material can get attached to another chromosome, resulting in an excess of the genetic matter in another gamete. Such surpluses and losses of genetic material are inapt and result in a pregnancy loss. Those couples who have faced many miscarriages should have their chromosomes tested in order to ascertain whether there is any risk attached to their chromosomes of forming ‘incorrect’ gametes with an inappropriate number of chromosomes. Such an evaluation will help the couple decide in time if they need to go for a donor sperm or donor egg.

As mentioned earlier, increasing age also raises the
risk of a miscarriage or pregnancy loss as women over 35 face more risk of chromosome abnormalities.

Also, certain abnormalities in the functioning of the uterus raise the chances of a miscarriage. Women with
fibroid uterine tumors also stand endangered as far as miscarriages are concerned. However, an incomplete uterus fusion is even more risky. In the case of the duplication of only the uterine body and cavity, called bicornuate” or two horned uterus, the risk is about one third. Similarly, another incomplete uterus fusion form named septate uterus’ has deficient blood supply to the septum, due to which there is a two-third risk of a pregnancy loss. A partial septum is found to be 60%-75% risky, while a total septum faces huge risk of up to 90%. Nevertheless, there are easy surgical operations available today to remove a uterine septum and clear all risks of a miscarriage.

Source: http://www.littleabout.com/2009/01/02/timely-tests-can-avoid-miscarriages-and-help-you-carry-safely/



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Sunday, September 21, 2008

BMI linked to recurrent miscarriages

Photo by www.presstv.ir
UK scientists have found that in the absence of any underlying disease, obese women are more vulnerable to recurrent miscarriagesUK scientists have found that in the absence of any underlying disease, obese women are more vulnerable to recurrent miscarriages.

According to a study presented at the Royal College of Obstetrics and Gynecology's international meeting, obese women with a positive history of miscarriage are at a greater risk of subsequent pregnancy loss.

Findings show the risk of a second miscarriage is increased by 73 percent in such individuals.

Previous studies had reported that the mother's higher BMI is associated with a lower fertility rate along with an increased risk of pregnancy-related complications and fetal malformations.

The study revealed that the mother's age is another factor contributing to miscarriage.

Researchers at the London's St Mary's Hospital concluded that women with recurrent miscarriages should be weighed at their first consultation, adding that losing weight is dangerous in pregnant women.

Source: http://www.presstv.ir/detail.aspx?id=70156§ionid=3510210



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Friday, May 02, 2008

Miscarriage spurred Brenda Panone to help

Portage's Brenda Panone experienced a nightmare more than two years ago -- the loss of an infant shortly after birth.

But she has turned that experience around and has used it to become a volunteer with the Kalamazoo Division of the March of Dimes and is working to prevent birth defects, premature birth and infant mortality.

Panone was just 22 weeks pregnant when the premature delivery took place.

Dana DeLuca, Kalamazoo March of Dimes division director, wrote about the rest of the story. ``Their son was born and only lived for one hour,'' DeLuca wrote. ``When he passed away, Brenda and her husband experienced a gamut of emotions ranging from sorrow to anger, helplessness and, ultimately, despair. ...

``Eventually, Brenda's aim became to trade all of her negative feelings to positive ones. She felt she owed it to her son to honor and celebrate his life and not consistently grieve over his death.''

Then Panone saw the TV commercial. It was about the March of Dimes and its mission to give every baby a healthy start on life. She went to the Kalamazoo Division of the March of Dimes and inquired about volunteering to help others. She has been a volunteer for more than two years.

She has been a volunteer force in the annual WalkAmerica event, now the March for Babies. She has also worked the Signature Chefs Auction, the Change for Babies and the annual Breadlift.

``I've gotten a deep sense of satisfaction knowing that some of the children I have met who were born prematurely are now raising funds to help their babies,'' Panone said. ``It is my hope that the work the March of Dimes accomplishes continues to give the problem of pre-term labor, birth defects and infant mortality a voice, so that one day all babies can be born healthy.''

WalkAmerica, the March of Dimes largest fund-raising event, has been renamed the March for Babies this year.

In Kalamazoo, the event is May 3. Registration begins at 8 a.m. in Kalamazoo's downtown Arcadia Creek festival site. Last year, more than 500 area residents gathered to raise more than $71,000 for the organization. The March for Babies Web site -- www.marchforbabies.org -- has more information on signing up to take part or call 1-800-525-9255 to sign up for the walk or donate. Sponsor forms are also available at Kmart -- a major sponsor of the march -- or Famous Footwear. Many other businesses, nationwide, are behind the event.

DeLuca stressed that the mission priority of is to fight the growing incidence of premature birth. ``Premature birth is the leading cause of newborn death,'' she said. ``We are committed to reducing its toll. By engaging more people in our mission and educating more pregnant women and moms about healthy babies, we hope to reach that goal much sooner.''

Source: http://www.mlive.com/news/kzgazette/index.ssf?/base/columns-3/120918362695640.xml&coll=7


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Friday, February 22, 2008

Miscarriages are not tragedies, they are a hellish natural event

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sadness at loss, miscarriage"LILY ALLEN LOSES BABY"

So shrieked The Sun this month at the distressing news the nation's number one ska-pop favourite had suffered a miscarriage. The reaction in my mind, as a woman who's had two miscarriages in the past two years, was three-fold.

One: Noooo! What a terrible shame, she probably had no idea this was even possible, at 22.

Two: Lily will be absolutely fine, she's 22.
And Three: Shame on you, The Sun "news"paper, for announcing to the planet that Lily was pregnant in the first place.

When the news arrived, on December 19 (her spokesman forced to confirm the pregnancy was at "a very, very early stage"), we can safely assume it wasn't Lily herself who made the call to their ever-throbbing showbiz bat-phone: "Alright mate, guess what?! I'm two months pregnant and I've only been going out with my boyfriend for three months but I'm all excited anyway and I just wanted you to be the first to know!"

There's a reason why you don't make a pregnancy official until you've passed the generally-accepted first three months all-clear and that's because finding out you're pregnant is not the same thing as "going to have a baby". And if you do have a miscarriage, which is staggeringly common, seeing the falling faces of your family and friends as they struggle to find words to console you is almost as harrowing as hearing the bad news in the first place.

Imagine, then, being Lily Allen, who not only had to tell her close friends and family but know the news of her miscarriage was now being reported across at least 24 separate countries worldwide (which it was), including the not-particularly ska-pop-fixated Azerbaijan. Until you become pregnant (which goes for dads too) you have no idea how little you know about being pregnant. Like walking through the back of a secret wardrobe, here's a kaleidoscopic new world of infinite possibilities, unbound joy and pan-dimensional terror.

Here, in this mysteriously hidden landscape, are millions and millions of other women doing exactly as you now are, grasping outwards for tendrils of information (mostly via websites) on just what the hell is suddenly going on; why you're so tired, what the repercussions of the wine-fuelled birthday party dance-floor knees-up the weekend before you knew you were pregnant might be and why has your chest gone all "Jordan" (the FF years) and you're only five weeks in?

Here, too, you learn a new and vital statistic - that one in four pregnancies will end in the inexplicable early miscarriage, anywhere up until week 12. One in four. Which means "the miracle of life" is a great deal more miraculous than any of us even know. And it also means the generally perceived "tragedy" of miscarriage is actually far more of a hellish natural phenomenon that everyone should be aware of and one we should be far less hysterical about and considerably more realistic.

And if we need the comfort of perspective, there's a million stories "out there" that almost defy belief. Glaswegian actress Claire Grogan suffered six miscarriages before adopting a baby two years ago. Former Blue Peter presenter Janet Ellis-Bextor, mother to several children, also endured 10 miscarriages in-between.

Judy from Richard n' Judy (a mother of four) had her first pregnancy with Richard end in early miscarriage and the second at five months, after which Judy endured the horror of having her dead baby induced. A friend of mine, meanwhile (before finally having a healthy baby girl last year), saw her first pregnancy end at six months (the baby had severe deformities) and the following year had a full-term pregnancy end in a second stillbirth.

These are the real tragedies, the real "losing the baby" experiences and those of us who've had an early miscarriage are not in the same position; we've never seen a child, heard a heartbeat, or giggled in the baby clothes section at the cut of a comedy bobble-hat.

What we've lost, in those early months, is the chance of having a child, a hope that has filled your every daydream for what suddenly seems an eternity, to the exclusion of everything else. And with that lost chance comes a paralysing emptiness, where everything else seems pointless, but the emptiness, eventually, begins to once again fill up with hope. You now know, for certain, you can become pregnant, where so many women can't, like another two friends who discovered their infertility in their late 30s and have both now adopted with inspirationally tremendous results.

For those who've been through the worst, too, it's a mighty testament to the strength of ordinary women that they live through these extraordinary traumas with far less display of weeping devastation than the heroic courage it takes to keep on trying for that highly elusive miracle.

The Sun, meanwhile, is following the fortunes of newly-named "Sad Lily" with its customary concern, reporting this week that rehearsals are now under way for her imminent chat-show, Lily Allen And Friends, "just days after her devastating miscarriage". The subtext being: "How dare she lift her head off the pillow! The heartless strumpet is probably back on the fags and booze and everything!"

And if she is, I heartily sympathise, as someone who twice walked out of a hospital distraught and twice went straight to the pub. Good luck to you, Lily Allen; you're 22 and you'll almost certainly be alright, still.

Source: http://www.sundayherald.com/oped/opinion/display.var.1997297.0.losing_a_baby_isnt_news_its_painful_and_confusing.php


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Thursday, February 14, 2008

Mother speaks of anger over miscarriage blunder

A mum told she had had a miscarriage found that the foetus was still alive four weeks later.

Catherine Kent, 27, was offered an abortion or pills to shorten her miscarriage after medics said her baby had died inside her during the eighth week of pregnancy.

Instead, she left the foetus to leave her body naturally. A month later a further check revealed the unborn child was alive.

Now Catherine and partner Kevin Gray, 28, claim the blunder by Sunderland Royal Hospital could have had tragic consequences.

Mum of two Catherine, of Houghton le Spring, has complained. She said: "It was utter hell.

"They could have aborted my baby while it was alive or the pills could have left it disabled."

The hospital said: "We're investigating."

Source: http://www.mirror.co.uk/news/topstories/2008/02/13/mother-speaks-of-anger-over-miscarriage-blunder-89520-20317670/


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Tuesday, February 05, 2008

Tug-of-war that can wreck a fetus

ABOUT half of all miscarriages and many common human birth defects occur because embryos receive too many or too few chromosomes from their mother. Now geneticists in the US believe they know why. They have identified a hiccup in the production of human egg cells that triggers a tug of war over a single chromosome.

Human cells normally have 46 chromosomes. But egg and sperm cells have 23. This is because their precursors divide twice to produce four cells, each with half the normal number of chromosomes. This process, known as meiosis, is designed to ensure that each parent donates only one copy of each chromosome to their child.

In practice, however, this equable allocation of chromosomes sometimes breaks down. The best known example is Down's syndrome, caused by an embryo inheriting an extra copy of chromosome 21. "Until now we haven't had a clue what causes these chromosome segregation errors," says Terry Hassold of Case Western Reserve University in Cleveland, Ohio.

Hassold's group joined forces with a team led by Stephanie Sherman of Emory University in Atlanta, Georgia, to study chromosome 16. Although less well-known than Down's syndrome, faulty chromosome 16 segregation is even more common. More than one in 100 embryos have an extra copy of chromosome 16, and this inevitably results in spontaneous abortion.

The researchers examined 62 miscarried embryos for some hint of what went wrong. They knew that in the early part of meiosis, chromosomes line up like pairs of shoes set instep to instep at the centre of the cell. The outer edge of each chromosome then attaches to protein cables that pull it towards one end of the cell, so that each chromosome ends up in the correct daughter cell when cell division is completed.

Hassold, Sherman and their colleagues suspected that the problem might lie in a feature of meiosis called crossing over. In this process, which occurs many times in each chromosome pair, the two chromosomes break and reattach to each other, thus swapping portions of their genetic material. This introduces extra genetic variability and also serves two other functions. First, the crossovers weave the two chromosomes together and prevent them from moving away from one another before the cell is ready to divide. And secondly, by holding the "instep" sides of the paired chromosomes closely together, the crossovers ensure that each chromosome can only attach to a protein cable on one side.

The researchers compared the genetic sequence of parts of chromosome 16 from the miscarried embryos and their mothers. This revealed that the rate of crossing over for the eggs that gave rise to these embryos had been normal near the ends of the chromosomes, but reduced by about one-third near the middle (American Journal of Human Genetics, vol 57, p 867).

This dearth of crossing over could explain the problem, says Hassold, as it would mean that the two copies of chromosome 16 were not properly anchored together at the start of meiosis. The chromosomes would have flopped around, he says, exposing their inner edges. Hassold speculates that the exposed inner edge of one copy of chromosome 16 became attached to a protein cable. Because the same chromosome was also attached on its other side, a tug of war began between the two daughter cells. If the wrong cell won the battle, the loser would be left without chromosome 16 and would soon die. The other would end up with two copies, and after dividing again would give two abnormal eggs.

But what could cause the lack of crossing over? Hassold believes the culprit could lie among the proteins that help bring paired chromosomes together, or which cut and splice DNA to form the crossovers. In simpler organisms such as yeast, similar abnormalities can result if one of these meiosis proteins is missing or mutated.

From issue 2000 of New Scientist magazine, 21 October 1995, page 20


Source: http://www.newscientist.com/article/mg14820002.900-tugofwar-that-can-wreck-a-fetus.html



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Friday, February 01, 2008

The Mysteries of Miscarriage

From too much caffeine to faulty chromosomes, the list of things that can contribute to a lost pregnancy is long. What you need to know about the many risk factors.

Each year, 4 million parents welcome new babies. More than 1 million others lose theirs before they're born. Why? It's the question of the month, after a headline-grabbing study said women who reported consuming more than 200 milligrams of caffeine a day doubled their risk of
miscarriage -- from the 12 percent among non-using participants to 25 percent. (A 12-ounce "tall" Starbucks coffee contains 260mg.) Latte lovers flooded doctors' offices with anguished queries. The hysteria is "like an epidemic," says Yale University Ob-Gyn Mary Jane Minkin, author of "The Yale Guide to Women's Reproductive Health."

Caffeine, of course, isn't the only culprit. The list of factors that plays a role in miscarriage is long, and not all of them can be controlled. Or understood. More than half of all miscarriages are caused by chromosomal abnormalities. "It's nature's way of saying, 'this isn't working, so we're going to let it go'," says Duke University Ob-Gyn Susann Clifford. Random chromosomal error causes 70 percent of pregnancies that end before six weeks of gestation, 50 percent of pregnancies that stop between six and 10 weeks and only 5 percent of pregnancies that end after 10 weeks.

Women cannot do much about some risk factors, such as previous miscarriages and advanced maternal age. "You can't change your age, and you can't change your history. It's a frustrating business," says Mount Sinai School of Medicine epidemiologist David Savitz. Older women are simply more likely to conceive embryos with chromosomal abnormalities, such as Down syndrome. In the general population, the risk of miscarriage after six weeks gestation is 15 percent. At age 35, it's 25 percent and at age 40 it's 42 percent.

There are steps that women of all ages can take to lessen other potential risks--even before they conceive. "Good preconception care is probably your best bet," says
Dr. Uma Reddy, a medical officer for the National Institute of Child Health and Development. "By the time you come and see your Ob at 11 weeks, it's already too late." Before and after conception, take prenatal vitamins (which include folic acid), don't smoke, avoid second-hand smoke and toxic chemicals, and maintain an ideal body weight. Obesity increases the risk of miscarriage (and birth defects) and is emerging as a significant risk factor for stillbirth, says Reddy. Eating undercooked meat can increase exposure to the bacteria listeria, to E. coli and to the toxoplasma parasite. Cleaning the litter box of an outdoor cat, who may eat an infected bird or rodent, also increases the risk of toxoplasmosis.

Staying calm is important, as well: a British study last year added to the mounting evidence that stress may increase miscarriage risk. (This is the kind of advice that drives already-anxious women crazy, unfortunately.) Avoid alcohol and illicit drugs, such as marijuana, cocaine and heroin. And use acetaminophen (Tylenol) instead of ibuprofen (Advil), which can decrease the amount of amniotic fluid around the baby, says the NICHD's Reddy. To be safe, avoid sushi and limit consumption of fish high in mercury levels, such as canned tuna, says
Dr. Diane Ashton, deputy medical director of the March of Dimes. And avoid soft cheeses like brie and gorgonzola, which may contain the bacteria listeria. Limit exposure to chemicals such as home pesticides, mercury and gasoline--but be realistic. "We're not going to recommend that pregnant women never fill their car," says Ashton. Make sure you're vaccinated against chicken pox and rubella (before trying to conceive) since anything that can cause birth defects may also cause miscarriage. And, to repeat the latest news, don't overdo caffeine, which crosses the placental barrier and increases blood pressure and heart rate.

Other potential risk factors require further study. Hot tubs and microwaves ovens, for example, have not received much research attention. Dr. De-Kun Li, the lead author on the caffeine study, has examined them, however, and he tells women to stand at least five feet from a microwave oven, and to stay out of hot tubs since they may raise core body temperature. (In a hot tub, a woman can't sweat to cool off.)

After a woman has miscarried two or more times, doctors may conduct tests of the woman and her partner (or of the miscarriage tissue) to detect chromosomal problems. They may also look for infection of the uterus. And blood tests can detect diabetes, autoimmune disease and hormone imbalance. About one in five women with recurrent miscarriage suffers from a clotting problem that can interfere with implantation; doctors can use blood thinners as treatment.


Many women who've suffered miscarriages think women should ask for a medical workup after a single loss. Darci Klein, founder of PreventPregnancyLoss.org and author of "To Full Term: A Mother's Triumph Over Miscarriage," lost three pregnancies (including a set of twins) before finding out through a blood test that she had a condition that resulted in abnormal clotting. She took a blood thinner--and delivered a healthy son.

"The biggest cause of loss is that women aren't tested after suspicious miscarriage. That leaves women like me to lose pregnancy after pregnancy. Some of them stop trying." She considers factors like caffeine and cat litter "such a small part" of the miscarriage issue. "There may be a few people who cleaned a cat box every year who ended up having problems with their pregnancies," she says. "There are hundreds of thousands of women losing pregnancies to undiagnosed but treatable disorders."

Carrying twins or triplets increases the risk of miscarriage during that pregnancy. So do assisted reproductive technologies, such as in vitro fertilization. With follicle-stimulating drugs called gonadotropins, we may be pushing eggs that are sitting dormant in the ovary to mature," says Dr. Mary Stephenson, director of the recurrent pregnancy loss program at the University of Chicago's Medical Center. "In IVF, we make more than one egg a cycle. Maybe those eggs, we just should have left them alone." Prenatal testing for chromosomal disorders like Down syndrome can also causes miscarriage -- one in 300 procedures for amniocentesis and one in 100 for chorionic villus sampling (CVS).

Fortunately, there's more to avoiding miscarriage than living a life of, well, avoidance. Enjoy exercise and sex, which research shows do not increase the risk of miscarriage. The usual advice for women who've miscarried is to try again. "If you keep trying, the odds are in your favor," says Minkin. Try not to give in to guilt and blame. Sadly, pregnancy loss is incredibly common -- and often mysterious. Says Kaiser Permanente pernatologist David Walton: "Women should consider one miscarriage just a normal event that happens during their reproductive life."

Source: http://www.newsweek.com/id/104816



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Sunday, December 30, 2007

Mothering After Miscarriage

The pain of my miscarriages is in the past now. Four years and three children later, it is hard to recall the sharpness of loss, the huge question mark of the future, not knowing whether to dread more a negative or positive result from a pregnancy test. Now when I remember the miscarriages, I mostly just feel guilt. Guilt for not remembering more clearly, guilt for not using the suffering of the past as a vehicle of growth in the present.

There is a powerful statement in Psalms: "The mother of her children is happy" - "Aim habonim sameichah" (113). How can I be filled with anything but joy from the beautiful family G‑d has granted me? One can favorably judge someone who has known nothing but blessing, baby after baby, sometimes giving a kvetch about her very full life. But how can someone who has longed for children feel overwhelmed and inadequate? How dare she await, even in her secret thoughts, the time when the pitter-patter of little feet will be replaced by the clomping of youth-sized shoes. Isn't that ungracious?

But the day-to-day reality is a glaring mockery of my best intentions. Before all the miscarriages, I was granted two healthy children. I found their toddlerhood and preschool years very challenging. During the years of waiting and of loss, I was sure that if only G‑d would listen to my tears, I would do better this time. I would have more patience, I would invest myself into providing more consistent and patient discipline, I would provide more nutritious meals.

Yet here I am, once again, struggling with the guilt and depression in the face of my maternal failings. Don't I remember the waiting, the prayers recited, the personal work undertaken, and, of course, the tears shed? Why can't I reach back into the past experience, to draw something good out of it, to appreciate my children better now, instead of calculating how many years until even the youngest children are speaking clearly and rationally, until I am past the physical challenges of diaper changes and protecting children from the physical aggression of their siblings?

Of course, there is a certain dishonesty in comparing the circumstances with my first two children in contrast to the next three. You see, the first child we received after the waiting, the one we prayed and prayed for, the only child we had a chance to really ask for from our hearts since all the rest came with such rapidity, this much anticipated child has PDD-NOS (PDD-NOS stands for Pervasive Development Disorder Not Otherwise Specified.) It used to be called "autistic spectrum," and without getting into all the details of the diagnosis, it means that he is very difficult to raise, although we have high hopes that he will grow to be a normal, functioning member of society.

Often, the literature about special needs children tends to romanticize raising a special needs child, perhaps in response to the years where special children were considered a stigma. But there are different types of special needs that a child can have, and you cannot compare hearing impairment to autism to Down's Syndrome to Cystic Fibrosis. Each type of challenge is different, and even though from reading some of the literature, you might think that all special needs children are giving and sweet and bring out the best in your other children, day-to-day reality is a little less glamorous. While I sincerely believe that my son was given to my family to raise because that is what is best for all of us, I find raising him to be stressful and difficult and replete with feelings of inadequacy.

And I think that this is the real reason for the guilt when I remember my miscarriages. Because at the time I thought I would be happy with any baby, even one with special needs. But now that I have been granted the child that I prayed for, and he does have special needs, I am finding that specialness more than I bargained for.

Perhaps one day I will have a better perspective, when I am not immersed in the daily struggle of coping. Then, when the challenge is past, when intellect can once again dominate over emotions, when I can articulate the correct perspective and mean it, I might be able to reconcile the different chapters of my history. Perhaps I will see that all those years of praying really were to have a child with PDD, because he really is so special that he needed to be prayed for with an extra measure of passion, and I really needed extra merit to be granted such a child.

Or perhaps I will realize that the waiting was for me, to build me into a stronger person so I could better mother my special son. Or perhaps I will come to an altogether different understanding of circumstances, which, of necessity, is concealed from me while I am immersed in the struggle. And perhaps, as is so often the case, clarity will be denied me in this world, and I will come to realize the true level of faith where I don't need to understand, because I will feel with certainty that whatever the reason, it was really for everyone's ultimate good. Perhaps.

Source: http://www.chabad.org/theJewishWoman/article_cdo/aid/618231/jewish/Mothering-After-Miscarriage.htm


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Monday, December 17, 2007

Why Do Miscarriages and Stillbirths Happen?

The most common cause of pregnancy loss is a random chromosome abnormality that occurs during fertilization. For fertilization to occur, the chromosomes in the nucleus of both the egg and the sperm need to join into 23 pairs (46 total chromosomes). Sometimes this pairing does not happen correctly and that can impede the development of the fetus.

Other factors that could contribute to a miscarriage include:

• fertilization late after ovulation
• low or high levels of the thyroid hormone
• uncontrolled diabetes
• exposure to environmental and workplace hazards, such as radiation or toxic agents
• uterine abnormalities
• incompetent cervix, or when the cervix begins to open (dilate) and thin (efface) before the pregnancy has reached term
• certain medications (mostly prescription), such as the acne drug Accutane

Certain behaviors also increase the risk of a miscarriage. Smoking, for example, puts nicotine and other chemicals into the bloodstream that cause the blood vessels in the placenta to spasm, which decreases the blood flow to the uterus. Smokers also have a lower level of oxygen in their blood, which means the fetus gets less oxygen. Alcohol and illegal drugs have been proved to lead to miscarriages. There is no evidence that stress or sexual activity contributes to miscarriage.

Some of the common causes of a stillbirth include:

• pre-eclampsia and eclampsia, disorders of late pregnancy that involve high blood pressure, fluid retention, and protein in the urine
• uncontrolled diabetes
• abnormalities in the fetus caused by infectious diseases - such as syphilis, toxoplasmosis, German measles, rubella, and • influenza - or by bacterial infections like listeriosis
• severe birth defects (responsible for about 20% of stillbirths), including spina bifida
• postmaturity - a condition in which the pregnancy has lasted 41 weeks or longer
• chronic high blood pressure, lupus, heart or thyroid disease

Full article: http://www.kidshealth.org/parent/medical/sexual/miscarriage.html

Friday, December 07, 2007

Miscarriage Myths Persist Despite Prevalence Of Medical Information

ScienceDaily (Dec. 7, 2007) — More than a third of women surveyed about their beliefs surrounding miscarriage and birth defects said they thought that a pregnant woman's foul mood could negatively affect her baby.

One in four of these women thought a pregnant woman's exposure to upsetting situations could hurt her unborn child, and one in five believed excessive exercise could cause a woman to miscarry.

Despite those beliefs, relatively few of the women surveyed blamed mothers for a poor pregnancy outcome. Ten percent suggested pregnant women are responsible for their miscarriages, and 3 percent said mothers should be blamed for their babies' birth defects. Women with less formal education were more likely to hold mothers responsible for bad pregnancy outcomes.

The recent Ohio State University study points to the persistence of folklore surrounding pregnancy despite advances in medical interventions and evidence that most miscarriages and defects result from circumstances beyond a woman's control, said study author Jonathan Schaffir, a clinical assistant professor of obstetrics and gynecology at Ohio State.

“The survey shows that a sizable proportion of the population believes maternal thoughts and actions contribute to adverse fetal outcomes – but despite these feelings, few assign responsibility to the mother,” Schaffir said. “I think it's kind of amazing that people out there still believe that a pregnant woman seeing something frightening could cause her baby to have a birthmark. That was an 18th-century belief and it's still circulating, even today.

“I had a call not long ago, before Halloween, from a pregnant woman asking if it would be OK to go to a haunted house. I told her it was fine.”

Most miscarriages result from genetic or chromosomal abnormalities in the fetus, or from medical complications relating to hormonal imbalances or problems with the uterus or placenta, Schaffir noted.

“Most of these things are beyond anyone's control and can happen to anyone,” he said. “In general, minor day-to-day experiences don't have an effect on whether a pregnancy is successful or not.”

Exceptions, of course, would include the abuse of alcohol or drugs during pregnancy, which can lead to complications, he said.

Schaffir surveyed 200 women by circulating a questionnaire in the waiting area of a Midwestern obstetrics and gynecology clinic. He asked respondents to rate their level of agreement with common folk beliefs about prenatal influences on fetal outcomes, and whether or not respondents had a history of an adverse pregnancy outcome.

The folkloric beliefs the participants considered included whether a pregnant woman's stress, bad mood, viewing of upsetting TV programs or attending upsetting events, excessive exercise, unfulfilled food cravings, or exposure to ugly or frightening sights could have a negative effect on her unborn baby. An additional item for consideration was whether a baby's appearance is determined at conception. Two final entries gauged whether respondents thought miscarriages and birth defects should be blamed on mothers.

Six percent of respondents thought a mother's unfulfilled food cravings could have an adverse effect on a fetus and 5 percent believed a pregnant woman's exposure to a scary sight could hurt her unborn baby. Thirty-eight percent of the women surveyed believed that a baby's appearance is determined at conception. More than three-fourths (76 percent) of women believed stress could cause a bad pregnancy outcome.

Schaffir expected women who had miscarried or delivered a baby with serious birth defects to be more inclined to believe that they had somehow contributed to their misfortune. But the survey results did not support his expectation. Instead, the level of a woman's education appeared to affect her belief system, with a lower level of education resulting in a higher likelihood of blaming mothers for bad pregnancy outcomes.

“Women with less education were more likely to think problems were a mother's fault. This isn't necessarily because women learn more about pregnancy during formal education, but reflects that women who have pursued higher education might read more and rely on more stringent sources for information about what they choose to believe. They might be more scientifically guided,” he said.

Education levels among respondents included some high school (33 women), high school graduate (46), some college (59), college graduate (40) and graduate school (19). Women with less education were also more likely to believe that stress can adversely affect pregnancy.

The pregnancy history of survey respondents appeared to have no bearing on beliefs in any but two areas. Women with no history of bad pregnancy outcomes were more likely to believe a bad mood or a fright could lead to birth defects or miscarriages, suggesting to Schaffir that women who had received medical care for an adverse pregnancy outcome were provided with more fact-based explanations for what had happened to them.

The mere existence of these beliefs suggests there is an opportunity for education in the exam room, Schaffir said.

“I do think there is room for educating women more, particularly those who have less formal education, to prevent them from feeling any guilt in association with their pregnancy,” he said. “Health care providers can reassure patients that these ‘old wives' tales' should not contribute to any feelings of personal responsibility.”

The survey respondents' belief that stress can affect pregnancy outcomes mirrors more conventional societal beliefs as well as a growing body of research about the effects of stress on health, Schaffir noted. But because he was gauging opinions and not facts about pregnancy, he did not explore that finding.

“A majority of people agree that stress can contribute to a bad outcome, and for more long-term behavioral disorders, it's not all that farfetched. But I was studying what people believe rather than what actually causes poor outcomes,” he said.

The study appears online in the journal Archives of Women's Mental Health.

Source: http://www.sciencedaily.com/releases/2007/12/071206145204.htm

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Saturday, December 01, 2007

Three special reasons to keep smiling

BANGING their plates gleefully against the table in anticipation, like any other boisterous energetic babies, the hungry triplets certainly know how to make demands.

But mum Sarah Jackson doesn't mind because not a day goes by when she doesn't marvel at the "little miracles" that have finally brought her so much joy.

Still haunted by the death of her daughter Rachael, who passed away at just ten days old, and an earlier miscarriage, Sarah is no stranger to heartache.

So when the triplets were born 20 months ago, she was understandably delighted.

"It was pure release to give birth to three breathing babies - I was just ecstatic, in a cloud," beams the former nursery nurse. "It was overwhelming. My husband John and I couldn't quite believe it when we were looking at them. It was very emotional."

During her pregnancy, Sarah, of Newtongrange, remained haunted by the memories she has of Rachael's last moments.

"Rachael was in my arms when she took her last breath," the 31-year-old recalls. "John was singing a lullaby to her, and just as he finished she died. It was just heartbreaking."

Rachael was born on July 9, 2004, weighing 5lb and 11oz. However, just five minutes after she came into the world, she stopped breathing. She was suffering from spinal muscular atrophy - a rare condition which resulted in the nerves surrounding Rachael's spinal cord being so damaged the infant was unable to move her muscles.

After four days of intensive treatment, Sarah and John were told Rachael had no chance of survival.

"We were told it was up to us how and when Rachael died, what time we wanted the ventilator switched off, where we wanted her to die and who we wanted to be there," says Sarah, fighting back tears. "We decided the machine would be turned off at 7pm to enable the family to visit and say their goodbyes.

"After the ventilator tube was taken out, Rachael was wheeled through to the hospital's family room and I held her. The whole time she was looking straight at me. They had given her pain relief and relaxants and we were told she might live for six hours, but she was dead within 20 minutes."

Rachael died on July 19, 2004 at the Simpsons Maternity Unit. After she passed away, Sarah and John took plaster cast prints of their daughter's hands and feet.

"We bathed her and cuddled her and dressed her and we got her all cosy," recalls Sarah. "It just looked like she was ready to go on an outing.

"It was a day I'll never ever forget,"
adds John. "I was offered the chance to hug Rachael myself but I thought it was the right thing for her mum to cuddle and cradle her. I was singing Five Sleepy Heads - it's an Elvis lullaby - and just after I finished the song she passed away."

It was a double blow for John, 44, because ten years earlier he and his first wife had lost a son who was stillborn. "To then lose a daughter, it was a hard thing to deal with," he says quietly. "But I think I had to be strong for Sarah to get her through it."

While the couple concentrated on caring for their eight-year-old daughter Morghan, Sarah also had counselling sessions run by the Stillbirth and Neonatal Death Society (Sands) in the Lothians.

"It helped me a lot because I was surrounded by people who knew where I was coming from," she says. "It didn't matter if you laughed, cried or fell apart, screamed or shouted, everyone there knew exactly how I felt."

Sarah is now preparing to join with other parents at a memorial service on Sunday and will light a candle in memory of Rachael.

The couple decided to try for another baby and they attended a clinic at Guy's Hospital in London, where Sarah was screened to ensure her embryos would be free from spinal muscular atrophy. Two weeks after receiving fertility treatment, Sarah discovered she was pregnant.

"I was delighted and terrified of being pregnant again," she says. "I was so frightened because the chances of something going wrong again, especially with a multiple birth, are so high."

Despite Sarah's fears, her pregnancy went smoothly and the triplets were born ten weeks early on March 29 last year.

Eden was the first to come into the world, weighing just 2lb 13oz. Her identical twin sister Skye was next, weighing 2lb 6oz, followed by Mark, who was 3lb 7oz.

All the babies were taken to intensive care but, while the girls were soon given a clean bill of health, Mark's condition deteriorated. He had contracted a dangerous infection.

When he was ten days old, he endured a two-hour, life-saving operation to remove the majority of his bowel. "Rachael was ten days old when she died so we were thinking that this was a ten-day curse," shudders Sarah.

"He was extremely frail because he was so dehydrated and we nearly lost him because of that. The treatment that was keeping him alive also gave him serious liver disease and we were told he would need a liver transplant to survive."

The youngster remained at the Sick Kids Hospital for 14 months, but just six weeks after being put on the transplant register, Mark made a remarkable recovery.

"His improvement was so great he was taken off the transplant register, and in the last five months he has spent just one week in hospital," says Sarah. "We couldn't believe it - he's just a miracle baby.

"Last November we were told he didn't have six months to live and now he's crawling around.

"We've been told he might yet need a transplant by the age of five but he'll be so much stronger by then."

Sadly, the couple have since separated due to the strain of recent years but John, who is experiencing mental health problems, remains an active member of the family and helps Sarah look after the children.

"We're going to have a nice family Christmas - the first one where we'll all be together," says Sarah.

CHANCE TO REMEMBER


ON Sunday, parents who have been affected by the death of a baby will gather for a special memorial service in the Capital.

The event has been organised by Sands Lothians, a charity that offers support to bereaved parents who have experienced the death of a baby through miscarriage, stillbirth or soon after birth.

As well as individual counselling, the charity organises group meetings to give bereaved parents the opportunity to speak with others who have found themselves in the same situation.

Support and reassurance is also available to help those through their next pregnancy.

Some of the parents attending the 3pm service at Craiglockhart Parish Church on Craiglockhart Drive North, will read poems dedicated to their lost children, while others will light candles in memory of their children.

The event is open to anyone who has been affected by the death of a baby, no matter how long ago, and further information about Sands Lothians is available at www.sands-lothians.org.uk or by calling 0131-622 6263/6264.

Source: http://living.scotsman.com/index.cfm?id=1870022007

Tuesday, October 30, 2007

CellCept Gets New FDA Warning on Miscarriage, Birth Defects

CellCept, a drug used to prevent organ rejection after a transplant, has been linked to an increased risk of miscarriage and birth defects. The new findings have prompted the Food & Drug Administration (FDA) to add a new boxed warning to the CellCept label, and Roche Holding AG, the drug’s maker, has sent a letter to physicians informing them of the CellCept risk and labeling changes. The potential for these drug side effects are so great that the FDA is advising women of childbearing age to use two methods of birth control before, during and after their treatment with CellCept.

CellCept, also known by its generic name mycophenolate mofetil, is part of a class of drugs called immunosuppressants. It was approved in 1995 to prevent rejection of solid organ transplants, including kidney, heart and liver. When used in combination with cyclosporine and corticosteroids, CellCept can greatly reduce the chance that a patient’s immune system will attack a transplanted organ. However, like all immunosuppressant drugs, CellCept does carry certain risks, including the development of lymphoma and other malignancies. Like other drugs in its class, CellCept is also linked to an increased risk of developing opportunistic infections and sepsis.

A recent analysis of data regarding CellCept from the National Transplantation Pregnancy Registry has led the FDA to conclude that pregnant women taking CellCept have a significantly higher risk of miscarriage during the first trimester, and that their babies are more likely to develop birth defects, including external ear and facial abnormalities such as cleft palate and lip, and problems with the distal limbs, esophagus and kidney. While it was known previously that CellCept could cause problems during pregnancy, the FDA had classified the risk as Category C (Risk of Fetal Harm Cannot be Ruled Out). These side effects are now classified as Category D (Positive Evidence of Fetal Risk).

The FDA is now warning that doctors should tell female patients of childbearing age about CellCept miscarriage and birth defect risks. Women of childbearing age who receive CellCept must be counseled on contraceptive use, and they should be made aware that the drug can interfere with the effectiveness of oral contraceptives.

The FDA is also now requiring women of childbearing age to undergo pregnancy testing within one week of beginning CellCept therapy. A female patient prescribed CellCept should begin using contraceptives four weeks prior of starting the drug, and for six weeks after stopping. The FDA is also advising that female patients of child bearing age use two methods of birth control while taking CellCept. Finally, the FDA is advising that a woman planning a pregnancy should not be prescribed CellCept unless no other immunosuppressant drugs have been successful in avoiding organ rejection.

Finally, to further monitor fetal outcomes of pregnant women exposed to CellCept, a National Transplantation Pregnancy Registry has been established. The FDA is encouraging doctors to register their female CellCept patients by calling 1-877-955-6877.

Source: http://www.newsinferno.com/archives/1971

Sunday, May 27, 2007

New Controversy Over Cervical Cancer Vaccine

UPDATED: 6:03 pm PDT May 24, 2007 - The self-described conservative group called Judicial Watch publicized information today about 18 women who may have miscarried after getting the vaccine.

Critics of the group say the information comes at time when many States are deciding if the vaccine should be mandatory for schoolgirls.

Gardasil is the first Food and Drug Administration-approved vaccine to prevent cervical cancer.

"It’s recommended for all girls between ages 9 and 26," said OBGYN doctor Chrysten Cunningham.

She said evidence shows the vaccine is safe and effective "and because it's not a live virus you're not going to catch warts or cervical cancer from the vaccine."

But, 18 women who got the vaccine while pregnant reported to the FDA complications ranging from miscarriage to fetal abnormalities.

Since its introduction in 2006 Merck, the makers of the vaccine reported 5 million doses of Gardasil have been dispensed.

Of those, 136 women have had serious side effects including life- threatening immune responses. Eighteen have reported pregnancy complications, and 16 of those were miscarriages.

But Merck, the FDA and the Centers for Disease Control all said they don't believe the vaccine caused the miscarriages, because loss of pregnancy often occurs naturally in the first trimester of pregnancy.

"Twenty-five percent of women will have a miscarriage during their reproductive life and 20 percent will have two miscarriages," said Dr. Cunningham.

Merck dismissed the pregnancy problems, but in a statement to the press said they do not recommend pregnant women get the vaccine.

Source: http://www.nbcsandiego.com/health/13386988/detail.html

Saturday, May 12, 2007

Folic acid should be added to flour, says watchdog

Folic acid should be added to all flour to help reduce birth defects, the UK's official food watchdog said last night.

The addition of the vitamin to all flour would be the first mandatory fortification of a food since the second world war.

Following much debate, the Food Standards Agency today issued its judgment which its board will consider next Thursday. If the board backs the evidence it could make the recommendation officially to ministers as early as next week.

Research has shown that adding folic acid to bread via white and brown wheat flour would help cut neural tube defects (NTDs), which include spina bifida and leave people severely disabled.

Between 700 and 900 pregnancies are affected by NTDs every year, with most diagnosed women opting for abortions.

Mandatory fortification has been introduced in the US, Canada and Chile, where it cut NTD rates by between 27% and 50%. But there is some scientific evidence that there could be unwanted side effects.

In papers to be submitted to next week's board meeting, FSA officials say that advice to pregnant women to take folic acid supplements has failed and recommends fortification of flour because four other vitamins have already been added to flour since the 1940s.

"Some might object to forced fortification," the FSA warns. Some health groups have objected to it being added to all flour to catch the women who are failing to take folic acid pills prescribed by doctors when they fall pregnant, but evidence suggests that it can help prevent spina bifida if taken before conception too.

An FSA consultation on the issue drew 202 responses from industry, consumer groups and individuals.

The baking industry raised practical concerns about the fortification of bread. It said bread-making flour could not easily be separated from other flours in mills.

The FSA's board previously considered the issue in 2002 and decided at that time not to go ahead with mandatory fortification due to concerns about the potential risks that folic acid can mask vitamin B12 deficiency in older people, as well as the move limiting consumer choice.

The board said that it wished to further review emerging evidence on the impact of fortification in other countries such as the US that had already moved to mandatory fortification.

The Scientific Advisory Committee on Nutrition (SACN), which drew up the advice, said it had addressed these concerns and the measure should be brought in alongside controls on voluntary fortification, advice on use of supplements, and long-term monitoring.

It recommends a review of the policy after five years which would include monitoring whether there were any links with changes in rates of cancers.

The report says: "Although supplementation with folic acid is advised prior to conception until the 12th week of pregnancy approximately half of all pregnancies are unplanned, which limits the value of recommendations.

"European Union countries with policies recommending women to consume folic acid supplements to reduce NTDs have observed no effect on NTD reduction."

It also rules that although folic acid can mask the effects of vitamin B12 deficiency, particularly anaemia, in older people, the quantities which would be added to bread were not enough to pose a risk. It says that voluntary fortification which currently exists would have to stop to make sure people were not getting too much.

The agency found public opinion divided, with slightly more people backing the move towards fortification.

Backstory

Folates - folic acid - are water-soluble forms of vitamin B9. These occur naturally in food, particularly vegetables and pulses and can also be taken as supplements. Folate is necessary for the production and maintenance of new cells - particularly important during periods of rapid cell division and growth such as infancy and pregnancy. Low intake of folic acid can cause neural tube defects during pregnancy which can result in miscarriage, neonatal death and lifelong disability.

From:
http://www.guardian.co.uk/food/Story/0,,2078145,00.html?gusrc=rss&feed=networkfront