Dr. Siobhan Dolan talks with a new mom about her experience with induction. Dr. Dolan also suggests questions a pregnant woman can ask her health care provider when planning for an induction or c-section.
Archive for December, 2011
When a pregnant woman has polyhydramnios, the level of amniotic fluid surrounding her baby is too high. To understand why this can be a problem, it’s important to first understand the basics of amniotic fluid.
The amniotic fluid that surrounds your baby plays an important role in her growth and development. This clear-colored liquid protects the baby and provides her with fluids. Your baby actually breathes this fluid into her lungs and swallows it. This helps her lungs and digestive system grow strong. Your amniotic fluid also allows your baby to move around, which helps her to develop her muscles and bones.
The amniotic sac that contains your baby begins to form about 12 days after conception. Amniotic fluid begins to form at that time, too. In the early weeks of pregnancy, amniotic fluid is mainly made up of water supplied by the mother. After about 12 weeks, your baby’s urine makes up most of the fluid. The amount of amniotic fluid increases until about 36 weeks of pregnancy. At that time you have about 1 quart of fluid. After that time, the level begins to decrease.
Polyhydramnios (too much amniotic fluid) occurs in about 1 out of 100 of pregnancies. Most cases are mild and result from a slow buildup of excess fluid in the second half of pregnancy. But in a few cases, fluid builds up quickly as early as the 16th week of pregnancy. This usually leads to very early birth.
Polyhydramnios is diagnosed with ultrasound. Medical experts do not fully understand what causes this condition. In about half of cases, the cause is not known. Here are some of the known causes:
- Birth defects in the baby that affect the ability to swallow. Normally, when the fetus swallows, the level of amniotic fluid goes down a bit. This helps to balance out the increase in fluid caused by fetal urination.
- Heart defects in the baby
- Diabetes during pregnancy
- Infection in the baby during pregnancy
- Blood incompatabilities between the pregnant woman and the fetus (examples:
- Rh or Kell disease)
Women with mild polyhydramnios may have few symptoms. Women with more severe cases may have discomfort in the belly and breathing problems. That’s because the buildup of fluids causes the uterus to crowd the lungs and the organs in the belly.
Polyhydramnios may increase the risk of pregnancy complications such as:
- Preterm rupture of the membranes (PROM) (breaks or tears in the sac that holds the amniotic fluid)
- Premature birth
- Placental abruption (The placenta peels away from the uterine wall before delivery.)
- Poor positioning of the fetus
- Severe bleeding by the mother after delivery
The best thing you can do is to go to all your prenatal care appointments. Your health care provider can monitor the size of your belly and how much amniotic fluid is in your womb. If you have a problem, your provider can take steps to help prevent complications in you and your baby.
If you have diabetes, talk to your health care provider about your increased risk of polyhydramnios.
If your health care provider thinks you might have polyhydraminos, you will probably need extra monitoring during your pregnancy. In many cases, polyhydramnios goes away without treatment. Other times, the problem may be corrected when the cause is addressed. For example, treating high blood sugar levels in women with diabetes often lowers the amount of amniotic fluid. Other treatments include removing some amniotic fluid or using medication to reduce fluid levels.
I recently read that Michelle Duggar had a miscarriage with her 20th child. While many women choose to have babies later in life, there are risks associated with pregnancy in older women and risks associated with spacing children too close together. Sadly, miscarriage is common (as many as 40 percent of all pregnancies may end in miscarriage), but that doesn’t change the fact that losing a baby is painful.
Whether it is your first pregnancy or your last, whether you just recently learned of your pregnancy or you were many months along, whether you have a houseful of children or none, the loss of a baby is not an easy thing.
Reading about the Duggar’s loss made me think to remind you that the March of Dimes has created bereavement materials for families who have suffered a loss. We have written a booklet called From Hurt to Healing to help families understand their grief. It explains grief and how men and women grieve differently. It talks about how to deal with your feelings, tells you how to ask for help, how to deal with family and friends, how to help other children understand. And it suggests ways to remember your baby. Two other booklets (What Can You Do? and When You Want to Try Again) are part of a packet the March of Dimes offers free to bereaved parents. We hope our booklets, fact sheets, and list of resources help parents find ways to heal and think about the future.
If you would like one of these helpful and free bereavement packets, please send an email requesting it to Askus@marchofdimes.com. Be sure to include your complete U.S. mailing address.
The Back to Sleep Campaign was launched in the early 1990s to help prevent Sudden Infant Death Syndrome, SIDS. Since the American Academy of Pediatrics started recommending placing babies on their backs when putting them to bed, the number of cases of SIDS has been cut in half, according to the CDC. That’s wonderful!
But something that has increased since then is the number of cases of babies with flat head syndrome, sometimes referred to as positional plagiocephaly. If babies spend all of their time on their backs, it can lead to positional flattening or molding of the head. The good news is that a new report published in the journal Pediatrics, has been written to help guide pediatricians in recognizing, managing and even preventing skull deformities in otherwise healthy children.
Babies’ skulls are soft and are made up of several skull plates. These movable plates have space between them, called sutures, that allow the head to be flexible so that the brain can grow. If the head is left in the same position for long periods of time, the plates move in a way that leaves a flat spot.
Most cases of positional plagiocephaly can be prevented (and sometimes corrected) by repositioning, which relieves pressure from the back of an infant’s head. Techniques for repositioning include:
- Making sure your baby gets more tummy time
- Changing the direction your baby lies in her crib from one week to the next.
- Changing the location of the crib in your baby’s room so that she will turn her head to look in other directions.
- Avoiding too much time in carriers, car seats and bouncers while your baby is awake
- Getting “cuddle time” with your baby by holding her upright over your shoulder several times a day.
More severe cases of positional plagiocephaly can be corrected by having the baby wear a custom helmet or band for two to four months. Be sure to chat with your baby’s provider about head shape at each well-child checkup.
If your home is small and you don’t have room or are allergic to dogs or cats, many children like hamsters or guinea pigs. Rodents, such as mice, hamsters and guinea pigs, are popular pets in lots of 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. Pets 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 it to their unborn baby. LCMV can cause severe birth defects or even loss of pregnancy.
Pregnant moms can 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) is important.
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.
- 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. For more information on pets and other animals during pregnancy, click on this link.
It’s raining here and the temperature is dropping. It’s not a good day to go for a walk, so many of you may be wondering how to keep the little ones occupied and exercised. I’ve got a few ideas that don’t involve the TV:
Find a giant box and turn it into a space ship, a race car, a choo-choo train… then take off for fantasyland with your little one in tow.
Play a counting/color game. Tell your little one to find three things in your room that are red and put them in a box. Find three things that are blue and put them in the box, then green. Take one red, one blue and one green thing out of the box and put them on the table. Take one of each and put them under the table. Take the other three and put them on a chair. Now take the first three on the table and put them back where you originally found them. Then return the next three, then the last three.
Create lovely gift wrap. Open up paper shopping bags and draw on them with colorful pencils or crayons. You can use these works of art to make holiday cards or wrapping paper.
Read a story to your child then have your child “read” to a doll or read it back to you.
Build a fort with blankets over some of your furniture. If you’re feeling brave, have a picnic lunch in your new fort.
Play music and dance. Try different types of music so you can dance slowly and then dance fast, glide around gracefully and then shake your booty! Kids love this. And they love the Hokey Pokey. The object is to move and giggle and have fun.
Have you got any other rainy day ideas?
At one point or another, many of us have felt this way. Backache is one of the most common problems for pregnant women. Nearly half of all women have back pain at some point during pregnancy. There are three types of back pain related to pregnancy:
- Low-back pain when you stand or sit
- Pain that is worst in the back of your pelvis and deep in your buttocks
- Pain in your lower back when you are in bed at night
Back pain can be caused by:
- The strain on the back from carrying the extra weight of pregnancy
- Changes in posture to offset the extra weight of pregnancy. This shifts your center of gravity forward and puts more strain on the lower back.
- Strain on the weakened and stretched muscles in the abdomen that support the spine
Click on this link to lots of tips for lessening the normal backache that most of us face at some point during pregnancy.
Although some amount of backache is normal, severe back pain is not. It can be a warning sign of infection or complications, especially when a woman also has fever or other symptoms. Make sure to let your doc or midwife know about whatever backache you may have.
U.S. Senators Kay Hagan (D-NC) and Susan Collins (R-ME) were joined by Senate co-sponsors Chuck Schumer (D-NY), Mark Kirk (R-IL) and Daniel Akaka (D-HI) in introducing the March of Dimes Commemorative Coin Act of 2011 (S.1935), which would honor the 75th anniversary of the March of Dimes. The bipartisan legislation would mint coins to recognize the March of Dimes’ landmark accomplishments in maternal and child health and provide resources to continue its vital work.
“Once again, a coin has the opportunity to help this nation fight a threat to its children,” said Dr. Jennifer L. Howse, President of the March of Dimes. “During the Great Depression, citizens sent their precious dimes – four billion of them – to the White House to fund research in the successful fight against polio. This time, the sale of these commemorative coins will help fund research and programs to identify the causes of premature birth. A dime defeated polio; this special dollar will help fight premature birth. We thank Senators Kay Hagan (D-NC) and Susan Collins (R-ME) for introducing the March of Dimes Commemorative Coin Act.”
The legislation authorizes the U.S. Mint to strike up to 500,000 $1 silver commemorative coins in 2014 to mark the March of Dimes’ 75th Anniversary. A surcharge of $10 added to the coin’s cost will go to the March of Dimes. The design of the coin will be selected by the Treasury Secretary in consultation with the March of Dimes and the Commission of Fine Arts.
If all the coins are sold during 2014, up to $5 million would be directed towards vital programs and scientific research to improve the health of women, infants and children by preventing birth defects, premature birth, and infant mortality. The March of Dimes is required to match these funds through private contributions, which would result in a total of $10 million going to research, community services, and education.
A good friend of mine had polio as a child and I remember playing cards with her while she was bedridden. Now she is coping with post-polio syndrome. I have sent her information to try to understand what’s going on and links to support groups.
Post-polio syndrome (PPS) is a condition that affects a lot of people who had polio many years earlier. Polio (short for poliomyelitis, once called infantile paralysis) is a disease caused by a virus that can infect the nervous system, sometimes resulting in paralysis. Until the 1950s, polio disabled or killed thousands of people, mostly children and young adults, each year in the United States and countless others worldwide. Thanks to the Salk vaccine, and soon afterward the Sabin oral vaccine, natural polio infections have been eliminated from the United States for nearly thirty years. Both vaccines were developed fifty years ago with funding from the March of Dimes. However, many survivors of past polio epidemics are developing new problems.
The main symptom of PPS is new muscle weakness that gradually worsens. It often is paired with decreased muscle strength during activities, muscle and joint pain, muscle wasting and severe fatigue. Even muscles that were believed to be unharmed by the first bout with polio may be affected. Less often, breathing difficulties and swallowing problems may occur. These symptoms usually develop 15 years or more after the original illness.
The causes of PPS are not completely understood. Many researchers believe that PPS symptoms result, at least in part, from the unusual stress placed on surviving nerve cells. During the first attack of polio, some of the nerve cells (called motor neurons) in the spinal cord that control muscles are damaged or destroyed. Without impulses from these nerve cells, a muscle cannot function. Fortunately, some motor neurons usually survive the polio attack and send out new nerve connections to the orphaned muscle cells in an attempt to take over the work of the nerve cells that were destroyed. This process makes it possible for an individual to regain at least some use of affected muscles. But, after many years, the overburdened nerve cells may begin to fail, resulting in new muscle weakness.
The normal aging process also may play a role. With age, most people have a decrease in the number of motor neurons in their spinal cords. Persons who have not had polio can lose a considerable number of motor neurons as they age without experiencing any serious muscle weakness. However, among polio survivors who already have lost many motor neurons, this age-related loss may contribute to new muscle weakness.
The March of Dimes provides information to PPS patients and concerned professionals, and has provided grant support for research projects seeking improved treatments for PPS. In May 2000, the March of Dimes, in collaboration with the Roosevelt Warm Springs Institute for Rehabilitation, held an international conference on PPS, during which leading experts in the field shared information on its causes, diagnosis and treatment. A report of the conference’s proceedings has been published and distributed to medical professionals in order to help improve the care of PPS patients.
If you would like more information on post-polio syndrome, send a request to Askus@marchofdimes.com.
The March of Dimes established our own information and referral service in 1996. The Pregnancy & Newborn Health Education Center is here to answer your questions about pre-conception health, pregnancy, postpartum care, newborn care, birth defects, genetics and a host of related topics.
Our health education specialists all have Master’s degrees in health related fields, some with expertise in genetics or nutrition. Each year the Center is contacted by over 20,000 individuals from around the world. While we are not physicians and cannot diagnose or recommend treatment to individuals, we do our best to research information for you. We utilize our medical library, on-line journal subscriptions, and certain Internet sites to provide answers to questions and referrals to other organizations that might be of further assistance to people looking for answers.
Even the federal government now recognizes how important information and referral services are to all of us. On November 15th, the Senate passed S.RES.241 designating November 16th as “National Information and Referral Services Day.” (To view the text of the resolution in the congressional record, CLICK HERE.)
If you have a question for the staff at the Pregnancy & Newborn Health Education Center, you can submit it through the learn box on our website http://www.marchofdimes.com/ , or you can send us a direct email to Aksus@marchofdimes.com. As you can imagine, we have a high volume of requests, so it may take up to three business days to get back to you.