News Moms Need

Premature rupture of membranes (PROM) is the breaking open of the bag of waters surrounding the baby, the amniotic sac, before labor begins. If PROM occurs before 37 weeks of pregnancy, it is called preterm premature rupture of membranes (PPROM).  With few exceptions, once the membrane ruptures a woman usually delivers her baby within one week.

In a full-term pregnancy, membranes rupture because their strength has weakened over time and the force of contractions becomes too difficult to withstand.  Before term, however, membranes can rupture for some reasons we understand and for other reasons we still haven’t grasped.  Some contributing factors to PPROM are previous preterm birth, sexually transmitted infections, vaginal bleeding, and smoking cigarettes.   That’s right, smoking cigarettes has been linked to PPROM.  So here is another good reason to quit. Women in a lower socioeconomic setting may be at higher risk for PPROM if they receive late or no prenatal care.

Preterm PROM is not only dangerous for the baby who will be born premature, but it can also pose a serious threat to the mom because it increases her risk of infection.  Chorioamnionitis is a uterine infection that can cause a high fever, uterine pain and rapid pulse and it is important to receive treatment to avoid this.

The most common signs of PROM are a gush of water from the vagina or steady leaking, a constant wetness in your underwear no matter how many times you change it.  If you experience any symptoms, check in with your doc or midwife right away.  They can analyze the fluid, check your cervix, even do an ultrasound to see if something is going on.

To learn more about preterm birth, read our fact sheet.

Thanksgiving is just two weeks away! Where did the time go? Between family get-togethers, holiday gift shopping and my husband’s birthday (which usually falls on or around Thanksgiving), the end of the year feels like one big race to New Year’s. Thankfully, both my and my husband’s families are just a few hours drive from our home. But plenty of my girlfriends are hopping on a plane to see their loved ones.

The American College of Obstetricians and Gynecologists (ACOG) recently strengthened its position on air travel during pregnancy. The organization reassures women that air travel is safe for most pregnant women. So long as a woman’s pregnancy is healthy and free of complications, it’s safe for her to travel by air. Most airlines allow women who are up to 36 weeks in their pregnancy to travel, but it’s a good idea to double check with your air carrier.

If you’re pregnant and plan to travel by air this holiday season, follow these tips (which are helpful for everyone as well):
• Wear comfortable, loose clothing. You may want to wear support stockings.
• When it’s safe to move about the plane’s cabin, take a walk up and down the isle. This can help improve your circulation and avoid the risk of blood clots.
• Stay hydrated, but avoid foods and beverages that may cause gas. Gas in your belly expands at high altitudes, making you feel less comfortable.
• Always wear a seat belt when seated to avoid injury in the case of turbulence.
• When making air travel arrangements, try getting an isle seat so you don’t have to climb over other passengers to go to the bathroom. Also, try sitting towards the front of the plane, where the ride feels smoother.
• If you’re experiencing nausea during pregnancy, you may want to take a preventative anti-nausea medication before getting on the plane. Talk to your health provider about a medication that’s safe during pregnancy.

Some H1N1 flu vaccines have a preservative called thimerosal. Although some people have suggested a link between thimerosal and autism,  medical experts from the Institutes of Medicine (IOM) have thoroughly researched the issue and concluded that thimerosal-containing vaccines are NOT associated with autism. However, if you’re still concerned, a thimerosal-free version of the H1N1 vaccine is available.

The 2009 H1N1 influenza vaccines that FDA is licensing (approving) will be manufactured in several formulations. Some will come in multi-dose vials and will contain thimerosal as a preservative. Multi-dose vials of seasonal influenza vaccine also contain thimerosal to prevent potential contamination after the vial is opened.

Some vaccine manufacturers will be producing 2009 H1N1 influenza vaccine in single-dose units, which will not require the use of thimerosal as a preservative. In addition, the live-attenuated version of the vaccine, which is administered intranasally (through the nose), is produced in single-units and will not contain thimerosal.  The nasal spray version, however, is not recommended for pregnant women.

An exploratory study has found that two types of antibiotics taken during pregnancy are linked to an increased risk of several birth defects. 

The two types of antibiotics are:

* Nitrofurantoins, including Macrobid and Furadantin 

* Sulfonamides (also known as sulfa drugs), including Bactrim 

Penicillins appear to be the safest of the drugs studied.

Antiobiotics are used to treat bacterial infections, such as urinary tract infections. Bacterial infections can be dangerous to the fetus if untreated. So antibiotic treatment is sometimes appropriate for pregnant women.

If a pregnant woman needs to take an antibiotic, she should talk about the pro’s and con’s of the various choices with her health care provider.

It is too early to say if the antibiotics linked to birth defects in the study are the cause of the defects. Something else may be the cause. Researchers are continuing to study the question.

One of the authors of the study told U.S. News & World Report, “The most important message is that most commonly used antibiotics do not seem to be associated with the birth defects we studied.”

The study was published in the November issue of the medical journal Archives of Pediatrics & Adolescent Medicine.

My girlfriend Joyce had a pet guinea pig named Rambo.  He was a weird little dude with majorly funky hair, but we all liked him a lot.  One day we were told that Rambo had been given to a neighbor because my friend was hoping to become pregnant soon.  Apparently, pet rodents can pose a health challenge to pregnant women (who knew?) and moving Rambo out was Joyce’s way of dealing with the issue.

Rodents, such as mice, hamsters and guinea pigs, are popular pets in many homes. But women who are pregnant or who plan to become pregnant should be very careful with rodents. These animals may carry a virus called lymphocytic choriomeningitis (LCMV).

The house mouse, a wild rodent found near and in homes, is the main source of the virus. Pet rodents like hamsters and guinea pigs can become infected with LCMV after being in contact with wild rodents at a breeding facility, pet store or home.  People can get LCMV through contact with a rodent’s urine, blood, saliva, droppings or nesting materials. The infection can also spread when a person breathes in dust or droplets that have LCMV.  (Examples: while sweeping up mouse droppings or cleaning out the hamster cage.)  Pregnant women who get LCMV can pass the infection to their unborn baby.  LCMV can cause severe birth defects or loss of pregnancy.

Pregnant moms can keep their pet and lower their chance of getting LCMV by:

• Keeping pet rodents in a separate part of the home
• Asking another family member to care for the pet and clean its cage
• Washing hands with soap and water after handling pet rodents
• Keeping rodent cages clean and free of soiled bedding
• Cleaning the cage in a well-ventilated area or outside
• Keeping pet rodents away from your face
• Avoiding contact with wild rodents
• If a house has rats or mice, taking care of the problem quickly with either mouse traps or calling a professional pest control company (talk to your health care provider before using any pest control chemicals in your home)

If you have children, especially under the age of 5, be sure an adult closely watches them when they are around pet rodents.  No one should kiss pet rodents or hold them close to the face, no matter how cute they are.  Anyone who plays with the animals or cleans their cages or bedding should wash their hands afterwards.

The U.S. Centers for Disease Control and Prevention (CDC) has more information, including how to safely handle pet rodents and clean cages.

Do you get a knot in your stomach when you hear about people getting sick from eating unsafe hamburger meat? Do you worry when you hear that some canned food has been recalled?

Well, now there’s one place to help you get answers. Several federal agencies are working together on a new Web site about food safety.  Everything in one place. Great idea!

And here are some March of Dimes resources:

   * Food-borne risks in pregnancy
   * Food safety dring pregnancy
   * Feeding and food safety for baby

Nope.  Sometimes genetics plays a part (for example, you and your mom both have a uniquely shaped uterus, a liver disease, diabetes or high blood pressure), but usually your mom’s birthing history will not impact yours. 

C-section, or cesarean delivery, can be a lifesaving operation when either you or your baby face certain problems before or during labor and delivery. Read more about reasons for cesarean section and watch our videos at this link.   Many women who deliver surgically never planned to do so, but an emergency made it necessary.  Some health care experts, however, believe that other, non-emergent c-sections are not medically necessary. A cesarean section is major surgery and should be done only when the health of the mother or baby is at risk.  Even if you had your first baby via cesarean delivery, you may or may not need to deliver a second baby that way. It all depends on the reasons for performing the first cesarean and how the incisions were placed in your body.  It’s important to discuss this with your health care provider before your next birth experience.

You may have seen our previous post explaining how flu (both seasonal and H1N1) affects women during pregnancy, or understanding the facts vs. myths about flu vaccines. Earlier this week, the New York Times published an article about one woman’s tragic experience with H1N1 during her pregnancy. The young woman featured in this piece tells her sad story in an effort to encourage pregnant women to get both the seasonal and H1N1 flu vaccines.

Some areas of the country have started to receive their shipments of the H1N1 vaccine. But other areas are still waiting. My husband, who works in health care, is among those who should get the H1N1 vaccine first. But when he called his doctor last week to make an appointment, he was told they still hadn’t received the H1N1 vaccine shipment. They asked him to call back in November.

While some people may have a delay in access to the H1N1 vaccine, keep calling your health provider, watch for news reports or contact your local health department to find out when the vaccine is coming to your area. In the meantime, follow these tips to help avoid the flu. If you’re pregnant and have flu-like symptoms, contact your health provider right away so that s/he can start you on flu medications. You must have a prescription from your health provider to get this medication. 

Also, beware of any advertisements for H1N1 flu products that you may see either online or in print. Some of these products are fake and may contain ingredients that can be harmful to your pregnancy. Again, only your health provider can prescribe your flu medication. Never take any medications or herbal remedies without talking with your health provider first.

It used to be that pregnancy finally offered a good reason to sit down and put your feet up. But times have changed.  Most pregnant women in good health should try to get 30 minutes of aerobic exercise (walking, swimming, dancing) on most, if not all, days. Dang!  No excuse to snooze here!

Most of us are aware of the many benefits of exercise, but when you’re pregnant and feeling wiped out?  Actually, regular exercise gives you a healthy buzz helping you feel better physically and emotionally, and the calories burned help prevent outrageous weight gain.  Exercise can relieve stress (what stress?) and build up stamina needed for labor and delivery.  It can help prevent gestational diabetes, a form of diabetes that sometimes develops during pregnancy. It can also help women cope during the postpartum period (did someone say stress again?) Exercise can help new moms keep the “baby blues” at bay, regain their energy and lose the weight they gained during pregnancy. All good stuff, so go for it!

But before you go out and run a marathon, talk with your health care provider. Not all pregnant women should exercise, especially if they are at risk of preterm labor or suffer from a serious ailment, such as heart or lung disease. So check with your doc or midwife before you start an exercise program.

Next, pick things you think you’ll like. Who’s going to stick with a routine that’s a total drag, even if it is good for you?  Make it fun - try several things. Check out running, hiking or dancing, if you like.  (Belly dancing for pregnant women is an absolute hoot!)  Brisk walking for 30 minutes or more is an excellent way to get the aerobic benefits of exercise, and you don’t need to join a health club or buy any special equipment. I found swimming at the local YWCA a great sport, especially in the third trimester when my knees were hurting me. The water supports the weight of your growing body, protects your joints and provides resistance that helps bring your heart rate up. Our colleague Anne got a real charge out of yoga classes designed for pregnant women. You may find that a variety of activities helps keep you motivated to continue exercising throughout your pregnancy - and beyond.

Be careful when choosing a sport. Avoid any activities that put you at high risk for injury, such as horseback riding or downhill skiing. Stay away from sports in which you could get hit in the belly, such as ice hockey, kickboxing or soccer. Especially after the third month, avoid exercises that require you to lie flat on your back. Lying on your back can restrict the flow of blood to the uterus and endanger your baby. Finally, never scuba dive. As great as the water feels to you, this sport may lead to dangerous gas bubbles in the baby’s circulatory system.

When you exercise, pay attention to how you feel. Don’t overdo it—try to build up your level of fitness gradually. If you have any serious problems, such as vaginal bleeding, dizziness, headaches, chest pain, decreased fetal movement or contractions, stop exercising and contact your health care provider immediately.

With a little bit of caution, you can achieve or maintain a level of fitness that would shock your grandmother. You’ll feel and look better. And yes, you can still put your feet up—after you’ve come back from your walk.

For more information, read the March of Dimes fact sheet Fitness for Two.

Short of surgery, not really, no.  If your skin is not as elastic as some other women’s skin (you can thank your genes for that), this evidence of expansion and contraction will remain to some degree.  Many products imply that they can make these not so lovely lines vanish completely, but they really can’t. These marks are caused by tiny tears in the tissue that lies just below your skin and helps the skin stretch. There are products that will smooth your skin, moisturize and make the marks itch less, cover them and make them less noticeable, etc. but they won’t get rid of them all together.  Time is what will help the most, so save your money on expensive products.  They will fade from red or purple to silver, white or light brown (depending on your skin color) and may shrink a bit in size. 

The best thing you can do during pregnancy to try to avoid stretch marks, or keep them at a minimum, is to eat a healthy diet, take your prenatal vitamins, try to gain weight gradually and not in big spurts, moisturize your skin and drink lots of water.