Showing posts with label chromosome abnormalities. Show all posts
Showing posts with label chromosome abnormalities. Show all posts

Saturday, July 11, 2009

The Miscarriage Test

Tampa (myFOXla.com) - It's such a sad reality some families must face, up to fifteen percent of pregnancies end in miscarriage. Most are due to problems with the DNA. The fetus can't develop normally because of defects in the genes. But when a woman has two or three miscarriages, it may be a clue something else is very wrong. Fox's Dr. Joette Giovinco has more on a simple test that may prevent repeats from happening.

Video:
http://www.myfoxla.com/dpp/health/The_Miscarriage_Test_20090710


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Saturday, June 27, 2009

Couple’s grief for babies

Couples grief for babiesJO HALL never expected supporting Red Nose Day would one day help her in hour of need, but it has.

The Avonsleigh woman has been struggling to cope after
miscarrying two babies in two years.

Ms Hall may not have given birth, but she still grieves.

She couldn’t believe it when she lost her first child in 2007 to discover that SIDS and Kids offered counselling services.

“When you are in hospital they give you a booklet to read about miscarriages … I saw it was produced by SIDS,” Ms Hall said.

Read more:
http://www.starnewsgroup.com.au/story/75806


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Tuesday, May 19, 2009

Embryos that self-destruct can lead to miscarriages

Picture by H2OLily_2008
Embryos that self-destruct can lead to miscarriagesMiscarriage, the most common type of pregnancy loss, can be a horrible and hugely depressing experience for any woman. But, ever wondered why do women have more miscarriages than females of other species? It’s all in the chromosomes, a new study says.

Researchers in Belgium have found that it’s normal for human embryos to contain cells with the wrong number of chromosomes, which can actually cause them to self-destruct. As women age, their eggs are more likely to have the wrong number of chromosomes, which can lead to miscarriages.

For their study, the researchers examined 23 embryos from nine young, fertile couples who were undergoing IVF for screening purposes and found 21 had chromosomal abnormalities, the New Scientist reported. The study, led by Joris Vermeesch from the Centre for Human Genetics in Leuven, has been published in the latest issue of the Nature Medicine journal.

Abnormal chromosome structure in human embryos is quite common. Chromosomal instability is marked by duplications, deletions, or translocations of whole chromosomes, or of chromosome pieces.

Source:
http://timesofindia.indiatimes.com/Health--Science/Embryos-that-self-destruct-can-lead-to-miscarriages/articleshow/4480254.cms


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Sunday, May 03, 2009

Chromosome clue to 'human miscarriage'

Chromosome clue to human miscarriageLONDON: Miscarriage, the most common type of pregnancy loss, can be a horrible and hugely depressing experience for any woman.

But, ever wondered why do women have more miscarriages than females of other species? It's all in the chromosomes, a new study says.

Researchers in Belgium have carried out the study and found that it's normal for human embryos to contain cells with the wrong number of chromosomes, which can actually cause them to self-destruct.

As women age, their eggs are more likely to have the wrong number of chromosomes, which can lead to miscarriages.

For their study, the researchers examined 23 embryos from nine young, fertile couples who were undergoing IVF for screening purposes and found 21 had chromosomal abnormalities, the 'New Scientist' reported.

The study, led by Joris Vermeesch from the Centre for Human Genetics in Leuven, has been published in the latest issue of the 'Nature Medicine' journal.

Source:
http://timesofindia.indiatimes.com/Health--Science/Chromosome-clue-to-miscarriage/articleshow/4478938.cms


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Wednesday, February 18, 2009

Fish study proves “the pill” is NOT man’s best friend

Sperm from rainbow trout exposed to the synthetic estrogen in birth control pills can have the wrong number of chormosomesResearchers report that very minute quantities of the hormone found in the birth control pill alter sperm development in rainbow trout by changing the number of chromosomes, which can lead to lower survival and long-term health problems in the offspring. This error in cell division is called aneuploidy.

In people, aneuploidy is the largest known source of spontaneous miscarriage. Importantly, it highlights the need to develop new, and use existing, green chemistry technologies to better clean effluent released from water treatment facilities.

Full story:
http://www.environmentalhealthnews.org/ehs/newscience/EE2-changes-trout-chromosome-number



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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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Friday, October 17, 2008

The Claim: A Woman Is More Fertile After a Miscarriage

This popular claim, floated in many online fertility forums, does not appear to hold up.

One explanation for the claim is that after a
miscarriage, levels of hormones like progesterone, which facilitates gestation, are still elevated, increasing fertility. But no studies have shown that to be the case.

Unsuccessful pregnancies, sometimes called missed pregnancies, are common, occurring in 30 to 50 percent of conceptions. (Some occur so early that the woman may not notice.) Many are caused by chance chromosomal abnormalities in the embryo that are unlikely to affect the next pregnancy. Others result from progesterone deficiencies; according to a 2007 review of other studies, the effectiveness of progesterone supplements in preventing future problems is somewhat unclear.

But the science is encouraging. According to a report by the Royal College of Obstetricians and Gynecologists, the probability of a second miscarriage is just 2.25 percent, and the odds of a third are less than 1 percent. Another study in The New England Journal of Medicine followed a large sample of healthy women seeking to conceive and found that of those who miscarried, 95 percent became pregnant within two years.

THE BOTTOM LINE
There is no evidence that fertility is greater after a missed pregnancy.

Source: http://www.nytimes.com/2008/10/14/health/14real.html?ref=science



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Wednesday, April 30, 2008

Preventing Miscarriages

The test that could be your first step toward having a healthy baby

Women who miscarry during the first tri-mester are often told that it was due to random chromosomal error. And in 50 to 70 percent of first-trimester miscarriages, this is true. But women who go on to have a second or even third miscarriage are likely given the same explanation, since many doctors wait until at least three losses to investigate the issue further, says Darci Klein, author of To Full Term: A Mother's Triumph Over Miscarriage.


But experts say action can be taken sooner, and you should ask your doctor for further testing, because nearly one-third of pregnancy losses are caused by undiagnosed yet treatable disorders.

"I recommend that a second loss be sent for chromosomal testing; this is underutilized in this country, but it's the one test that can tell you whether further evaluation is needed," says Mary Stephenson, M.D., director of the University of Chicago Recurrent Pregnancy Loss Program.

How testing works: The tissue from the miscarriage is sent to a genetics lab. If the results show that there is a random chromosomal error, then you don't have an increased chance of a future miscarriage. If no chromosomal error is found, however, then your doctor will know to do additional testing before you try to conceive again. Other possible causes of miscarriage include an inherited genetic abnormality, an endocrine disorder, a uterine problem, or an immunological issue. Since these conditions may be treatable, getting an early diagnosis could be your first step toward having a healthy baby.

Source: http://www.parenting.com/article/Mom/Fertility/Preventing-Miscarriages-1206379464543


See also: Can You Prevent a Miscarriage? - Increase your odds of having a successful pregnancy - Parenting.com

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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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Monday, January 14, 2008

Losing a baby

Why miscarriages occur, and what can we do to minimise its occurrence.

AS an obstetrician, my job is to help pregnant mothers welcome their babies into this world. Therefore, I have always found that the hardest part of the job is when the pregnancy ends in a miscarriage, and my patients turn to me and ask, “Why did this happen?”

If dealing with miscarriage is difficult for me, I can’t imagine how heartbreaking it must be for the women who have this precious gift snatched right out of their hands.

In this article, I will talk about how to recognise when you’re having a miscarriage and reducing your risk factors for miscarriage.

Defining a miscarriage

A miscarriage is the loss of a baby before the 20th week of pregnancy, with most miscarriages occurring in the first trimester.

Up to 15% of all recognised pregnancies end in miscarriage – however, many more miscarriages actually occur, but women are not aware of them because they did not know that they were pregnant in the first place.

The most obvious signs of a miscarriage are vaginal bleeding or spotting, pain or cramping of the abdomen, passing of tissue from the vagina and fluids draining out from the vagina.

If you are pregnant and experience any of these signs, go to your obstetrician immediately.

When a miscarriage occurs, the first instinct is to ask, “Why did this happen? What did I do wrong?” Relatives or friends may make things worse by telling you that you should not have eaten this or done that during your pregnancy.

Some old wives’ tales may blame a miscarriage on “bad” foods, sex, too much exercise, bad feng shui or even astrological signs! However, these are unfounded beliefs. Even we doctors do not really know the cause of most miscarriages.

We do know that they are often caused by chromosomal abnormalities in the unborn baby, but we do not know what specifically causes these abnormalities.

The result is that the baby cannot develop normally, and the body spontaneously terminates the pregnancy.

There are some things that have been identified as definite risk factors for miscarriage.

Although there are no guarantees against a miscarriage, you can try to change your lifestyle or seek medical advice to reduce as many of these risk factors as possible.

Here are three things that you should definitely do during pregnancy to prevent a miscarriage: don’t smoke, don’t use illegal drugs and don’t drink too much alcohol.

You may have certain medical problems, hormonal disorders or chronic diseases that can affect your pregnancy – talk to your obstetrician before you get pregnant about your options for medical or surgical treatment to treat these conditions.

Certain infections during pregnancy, such as rubella, can also cause miscarriage, which is why it is very important that you be tested for these infections and take precautions to avoid being infected while you are pregnant.

Finally, getting pregnant at an older age, and above, puts you at higher risk of having a miscarriage.

However, I wish to stress again that these are only risk factors; just because you are an older mother-to-be does not mean you will definitely miscarry.

What if I have repeated miscarriages?

Some women have several subsequent miscarriages, which can be very distressing for them and their families.

I comfort my patients by telling them that 85% of women who miscarry go on to have a healthy next pregnancy.

Unfortunately, there are some women who have repeated miscarriages, due to medical problems that have not been treated.

For instance, if the repeated miscarriages are caused by cervical incompetence, you can undergo a procedure to keep the cervix closed throughout the pregnancy.

If you have a chronic disease like diabetes, you have to keep the condition under control (such as by maintaining healthy glucose levels) to reduce the chances of another miscarriage.

If you have several miscarriages, your doctor should conduct a complete medical check to try and determine the cause.

Often, however, your doctor will not have an answer. Do not blame him or her, as miscarriages still remain a mystery in medical science.

It may be Mother Nature’s way of ensuring that your pregnancy will not go on to harm you or your unborn baby.

This is not a time for anger and recrimination between you and your partner. You will both need time to grieve and to come to terms with the fact.

Cast out thoughts such as, “I should not have eaten that food”, “I should not have done that exercise” or even “I should not have had sex during pregnancy”.

Blaming yourself or each other will only make the pain worse.

In my next article, I will talk about the emotional impact of a miscarriage, and how women and men can cope with it.

- Datuk Dr Nor Ashikin Mokhtar is a consultant obstetrician & gynaecologist (FRCOG, UK). She is co chairman of Nur Sejahtera, Women & Family Healthcare Program, Ministry of Women, Family and Development.


Source: http://thestar.com.my/health/story.asp?file=/2008/1/13/health/19984767&sec=health



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Tuesday, January 08, 2008

Helping heal the pain of miscarriage

EDITH Carrick's daughter Ruth talks excitedly about the arrival of her baby brother or sister in just a few months' time.

Looking at them, it is hard to imagine that anything is wrong in this happy family scene.

But a cloud hangs over them. Having gone through four miscarriages and a stillbirth, Mrs Carrick knows about the things that can go wrong when having a baby. At the same time she is optimistic about her pregnancy, and the prospects for other women as researchers look for answers into why some have to go through the pain of miscarriage and stillbirth.

Tommy's, the baby charity, is opening a new research centre in Edinburgh later this year and is hoping to play a major part in finding some of these much-needed answers.

Mrs Carrick, 42, from Strathkinness, near St Andrews, had her first miscarriage in 1999.

In 2003 she gave birth to her daughter Ruth, now a healthy, bubbly four-year-old, proving that women who have had serious problems in previous pregnancies can go on to have a family.

Mrs Carrick and her husband, John, desperately wanted a brother or sister for Ruth and in 2005 they were eagerly awaiting their arrival when the news came that no parent wants to hear.

"The first I knew about it was when I went to my GP who said he could not find a heart beat. I was sent to Forth Park maternity and they did a scan.

"The consultant just stopped the scan and turned to me and said 'I'm so sorry.'

"It was just an unreal experience. Finding out was the worst moment of my life."

Carrying a baby who had died in the womb, Mrs Carrick still had to give birth. Aidan was stillborn at 35 weeks.

"Watching me give birth was worse for my husband John," Mrs Carrick said. He found it very, very hard. I don't think he believed it until then. The reality did not kick in until the birth. John held Aidan and what happens is that the baby just goes cold in your arms.

"The hospital had a camera and we took pictures for us to keep, and we also had footprints and handprints and a bit of hair to keep, like you would have with other babies."

After he was born, doctors discovered that Aidan suffered from the chromosome abnormality Trisomy 18, also known as Edwards syndrome.

Mrs Carrick said that after leaving hospital, she did not know how to react. "I had four weeks off and then went back to work as a teacher, which was a bit insane," she said. "It is hard going back when everyone was expecting you to have a baby and then there is just nothing there. Some people just do not know how to react. They are just like 'la la la', and trying to ignore it."

Later Mrs Carrick decided to go part-time and has now left work completely to have a career break and spend more time with her daughter.

After Aidan, she also suffered three more miscarriages before becoming pregnant again. Her new baby is due later this year.

Mrs Carrick said going for scans was a very stressful experience now.

"One of the first things I say is 'Is there a heartbeat?' It may seem fatalistic but it is just such a relief when there is.

"But the hospital staff have been wonderfully supportive and have helped us cope with everything that has happened and that we are very grateful to them all."


She does not know why she suffered so many miscarriages.

"It could be my age, it could be because I have a bone-marrow disease, it could be any number of reasons, but nobody knows for sure. That is why we need more research into these kind of things so that other women do not have to go through what I have gone through. I would not wish it on my worst enemy."

Mrs Carrick said she lives in fear of having to tell her daughter that she has lost another brother or sister.

"Ruth still talks about her little brother. He is part of our lives. She has quite a sense of loss. We had to come home and tell her that her brother would not be coming home. She used to sit and kiss my bump and talk to him. I would dread having to tell her she had lost another baby brother or sister."

It is experiences like this that Tommy's researchers hope will become less frequent with work to be carried out in Edinburgh.

Andrew Calder, a professor of obstetrics and gynaecology at Edinburgh University who will head the new Tommy's centre, said they would be looking at the things that happen to babies before they are born which can lead to tragedy.

"It is going to be a long process and it would be wrong to expect instant solutions," he said. "But we hope we will make steady progress. It is a really exciting prospect. We have prominent scientists and clinicians wanting to come to Edinburgh to join us in this work."

If you want to help Tommy's new research centre in their efforts to help more mothers and babies, this is how you can donate:

Website: www.tommys.org/edinburgh-centre.htm
E-mail: Tom Custance at Tommy's – tcustance@tommys.org
Phone: Tommy's on 08707 70 70 70, quoting "Scotsman appeal".

Full article: http://news.scotsman.com/latestnews/Helping-heal--the-pain.3648281.jp



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Tuesday, January 01, 2008

Miscarriage: Why It Happens and How Best to Reduce Your Risks

I just noticed that you can find book reviews online with Google, so I thought I would share a few books I found on miscarriage and loss. Have you read this one? What did you think of it?

Published 2003, 256 pages, ISBN 0738206342

- Whether it happens in the first trimester or later on in pregnancy, a miscarriage is an emotionally traumatic event. It may also be a physically daunting experience, resulting in the need for surgical intervention.

In the aftermath of a miscarriage there are almost always unanswered questions: Why did it happen? Did I do anything to cause my miscarriage? Will I have a miscarriage the next time I get pregnant? Most important of all,

You will want to know, "What can I do to best prevent miscarrying again?" This compassionate and authoritative guide fills the information void. From the causes of miscarriage -- chromosomal, illness-related, immunologic -- to the diagnostic tests and surgical procedures now available to help prevent you from miscarrying again, Dr. Henry Lerner has compiled the most current medical information on why miscarriages do and don't happen, and explains the best methods for recovering and preparing to conceive again.

He also includes reassuring and practical advice from an expert in women's reproductive psychology on coping with the disappointment and depression that often accompany the loss of your pregnancy, and the anxiety that may come with your next positive pregnancy test.

Book Reviews, Previews & more: http://books.google.com/books?id=uLlldF7YKKwC


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Thursday, December 27, 2007

'My joy at finally becoming a mother after losing eight babies'

After eight miscarriages, Sarah Whitman feared she would never become a mother.

She and her husband Martin had endured 15 years of heartbreak as she became pregnant again and again, only to miscarry.

Even with extensive drug treatments, they were unable to achieve their dream.

But then somehow their luck changed and Maya was born - a 7lb 1oz bundle of perfect, healthy baby.

Mrs Whitman, 37, said: "I can't believe we finally have our beautiful daughter with us at last, after losing our eight previous babies.

"It just seemed like after 15 years we would never be parents - so to have our daughter now after all this heartbreak is really a miracle."


The couple, who live in Banbury, Oxfordshire, began trying for a family in 1991, two years after they were married.

The following year Mrs Whitman became pregnant but miscarried at 12 weeks. She said: "I just accepted that it was one of those things, and concentrated on getting pregnant again."

In June 1993, she became pregnant again, but at ten weeks suffered her second miscarriage.

Mrs Whitman, a full-time mother who lives with Martin, 37, a factory worker, then lost a third baby.

Afterwards, she went to see her GP and blood tests were carried out to see if there was a medical reason why she had had the miscarriages - Mrs Whitman said: "They couldn't find anything wrong, so we just assumed that we were unlucky.

"But two years later, in June 1996, I suffered my fourth miscarriage. I knew by now that something must be wrong."


Mrs Whitman was referred to St Mary's Hospital in London, which has a specialist miscarriage centre.

She was diagnosed with antiphospholipid syndrome, where the body's immune system thinks that the foetus is a foreign body and tries to expel it. Blood clots build up in the placenta and cause a miscarriage.

Doctors told her that when she conceived again, they would give her medication to thin the blood in her placenta.

Mrs Whitman said: "I was so relieved that I finally had an answer to why I was losing my babies like this. I was confident that the next time I fell pregnant, then this time I would finally become a mum."

Despite the medication, however, over the next few years the couple lost another four babies.

Eventually they discussed adoption, but while on holiday in May 2006 decided to have one last try.

Mrs Whitman said: "We came home and I felt different. I knew I was pregnant, but this time instinctively everything just felt right."

The pregnancy went smoothly until the 22nd week, when complications threatened to bring on an early labour. To prevent this, she had to stop her medication - at the risk of starving the baby of nutrients.

Doctors at Horton General Hospital in Banbury carried out a caesarean to deliver Maya at 38 weeks, in January this year.

Mrs Whitman said: "It was so emotional when she was born. We had waited 15 long years."

Maya is now eleven months old and in perfect health, said her mother, adding: "One day we will tell her how special she is."

Source: http://www.dailymail.co.uk/pages/live/femail/article.html?in_article_id=504524&in_page_id=1879&ICO=FEMAIL&ICL=TOPART

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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Wednesday, November 28, 2007

New Embryo Screening Method Gives Parents Better Shot at Pregnancy

Science may be one step closer to providing the best start for babies conceived through in vitro fertilization. Researchers have developed a way to evaluate the full genetic make-up of an embryo before it is implanted in the womb.

"We believe the most limiting step in an embryo becoming a baby is whether is has the right genetic compliment -- whether it is the right total amount of material. So if we can diagnose that before we put the embryo back it should raise pregnancy rates," explained Dr. Richard Scott.

By identifying which embryos are likely to succeed, researchers believe miscarriage will be less likely. They say identifying the healthiest embryo may also eliminate the need to implant several embryos.

"By putting fewer embryos back you have fewer twins and that should greatly reduce the risk for prematurity to couples that have a tough time conceiving," said. Dr. Scott.

Here's how it works:

First a cell is taken from the embryo. Then the DNA is amplified a million fold so that it can be analyzed. The data then allows researchers to determine the number of chromosomes on that single cell.

"Now we can look at all 23 where previously we could only look at less than half of the chromosomes," explained researcher Dr. Nathan Treff.

This technology won't be available for some time, but will help couples using IVF in the future avoid problems.

Source: http://www.firstcoastnews.com/news/health/news-article.aspx?storyid=96624

Friday, November 23, 2007

Lower your miscarriage risk with new tests, treatments

When Kori Morrison had her first miscarriage, she and her husband, Tom, were upset but still hopeful. After all, she knew that 15 to 50 percent of all pregnancies end in miscarriage, and most of these women who've miscarried go on to have healthy babies. But in the next eight years, Morrison had four more miscarriages. Sadness and self-blame set in. "I wondered if I was eating the wrong things, if I was overstressed, or, worst of all, if my body just wasn't cut out for pregnancy," she says.

Morrison was eventually found to have a hormone imbalance: Low progesterone during pregnancy kept her uterus from nourishing the embryo. With treatment, she went on to have four children.

Although Morrison went through agony for years before discovering what was wrong, her story illustrates that there are ways to identify what causes miscarriages and what can be done to prevent them. Important to know because, while most women will go on to have a successful pregnancy, about 5 percent are likely to lose another baby. And the use of assisted reproductive technology such as in vitro fertilization (common among women 35-plus) seems to boost miscarriage risks even more.

1. Do a little detective work

When you're planning to get pregnant, your first move should be a careful prepregnancy checkup to reveal potential risk factors like diabetes-related problems, high blood pressure, polycstic ovary syndrome, fibroids, or thyroid abnormalities -- all of which are mostly treatable, says Mary Stephenson, M.D., professor of obstetrics and gynecology and director of the recurrent-pregnancy-loss program at the University of Chicago Medical Center.

Health.com: Simple steps can help when you're having trouble getting pregnant

Go over your medical history with your doctor, and also mention any medications, herbs, and supplements you are taking. You might learn something about potentially risky non-prescription meds such as ibuprofen or herbs such as ginkgo. Even taking a little time to discuss a family history of miscarriages with your doctor might uncover a correctable problem.

2. Stop the stress

We've all heard that being stressed isn't a good thing if you're trying to get pregnant. That's also true of trying to stay pregnant. British researchers recently found that feeling happy, relaxed, or in control is linked to a 60 percent reduction in a woman's miscarriage risk. What helps when you can't kick back with a glass of wine? Gentle workouts, dining with friends, or watching your favorite TV show might work (stick with The Office instead of nerve-janglers like 24 or ER).

Health.com: The Pill is dangerous, and other myths

And what about sex? If you've had a miscarriage in the past, says Jonathan Scher, M.D., assistant clinical professor of obstetrics and gynecology at Mount Sinai Medical Center in New York, it's probably best to skip nookie during your first trimester, when a hormone in semen may stimulate contractions. It's OK later, after the embryo is fully implanted.

Health.com: Is your fertility window closing?

3. Do some chromosome testing

After a miscarriage, a chromosome analysis of fetal tissue can provide some useful information, says Scher.

The test can reveal if there was an unavoidable chromosome problem -- the cause of as many as 50 percent of miscarriages. If the test result is abnormal (the tissue has an abnormal number of chromosomes), it's good news. This is a random event, and the chance of it happening again is no higher than normal. Time to try again. A normal test result, however, may require further investigation (there's more information on this in "Take a Few More Tests," below).

Unless you insist, you may not be offered chromosome analysis. "It's the most important thing we can do," Stephenson says, "But, unfortunately, it's very seldom done."

Why? Medical guidelines don't recommend it unless you've had multiple miscarriages. Even then, if you're healthy, doctors might beg off. But Scher and Stephenson advise any woman who has two or more miscarriages to get the test.

Health.com: A calendar method that works

4. Take a few more tests

- MayoClinic.com: Health Library
- Healthology: Health Video Library


If the chromosomes are normal and it's your second or third miscarriage, there's a good chance you have a fixable problem. But you won't find out without additional tests. You might be screened for a genetic tendency for blood clots, a weak cervix, a hormonal imbalance, or even an autoimmune problem such as lupus. If you have a blood-clotting disorder, anticlotting medication may cut your risk of miscarriage by up to 75 percent. If it's a weak cervix, a stitch applied at the end of the first trimester can prevent the cervix from opening early and starting premature labor.

To uncover these kinds of problems, you may need to go to a specialized, recurrent-pregnancy-loss clinic, Stephenson says. Most important, though, keep pushing for answers. That's what Darci Klein did after suffering three miscarriages, including the loss of twins at 20 weeks. Eventually, tests showed she had an inherited blood-clotting disorder and a weak cervix. After treatment -- injections of a blood thinner and a cervical stitch -- she carried a pregnancy to term and gave birth to a healthy baby boy. "You don't ever get over losing a child," says Klein, author of "To Full Term: A Mother's Triumph Over Miscarriage." "But you need to ask for testing."

Source: http://edition.cnn.com/2007/HEALTH/conditions/08/17/healthmag.baby.maybe/index.html

Tuesday, November 06, 2007

Pregnancy: An informative protocol for the investigation of recurrent miscarriage: preliminary experience of 500 consecutive cases

A total of 500 consecutive women (mean age 32.9 years; SD 5 years) presenting with a history of recurrent miscarriages (median 4; range 3–17) were investigated for the presence of antiphospholipid antibodies (APA), polycystic ovaries (PCO), hypersecretion of luteinizing hormone (LH) and chromosome abnormalities in order to detect an underlying cause of their pregnancy losses.

All women had details of their previous reproductive history, investigations and treatment documented: 76% of the women had experienced only early pregnancy losses (miscarriage less than 13 weeks gestation); 32% had a history of subfertility; and significant parental chromosome rearrangements were present in 3.6% of couples.

An ultrasound diagnosis of PCO was made in 56% of women, 58% of whom were demonstrated to hypersecrete LH, based on early morning urinary LH analysis. Circulating APA were found in 14% of women.

An underlying cause of recurrent miscarriage — genetic, endocrine or autoimmune — was found in greater than 50% of couples. Women in the latter two groups are being recruited to randomized treatment trials which are discussed.

Source: http://humrep.oxfordjournals.org/cgi/content/abstract/9/7/1328