News Moms Need

A while ago, someone wrote in to the March of Dimes with a wonderful idea. She was pregnant, and was on her way to the doctor’s office for an ultrasound where the sex of her baby would most likely be revealed. However, she and her husband were not yet ready to know if it was going to be a girl or boy.  But, they would want to know sometime before the baby was born…just not that day. Also, they had envisioned that the day they learned the sex of their baby would be somewhat more special, and not something that would occur in a doctor’s office. So, they came up with this novel idea that I thought was worth sharing.

They suggest you have the ultrasound tech or doctor write the gender of the baby on a piece of paper, and seal it in an envelope.  Then, on a special occasion (Christmas morning, Valentine’s Day, anniversary, birthday, etc.), you would open the envelope together or with the family or friends of your choice, and celebrate.  You control when, where and how you learn the momentous news. This gives you the ability to make an occasion out of learning the sex of your baby, but still gives you time to paint the baby’s room pink or blue before the baby’s arrival.

It seems like such a simple, obvious idea, yet I had never heard it before.  Hopefully, it is something worth passing on to anyone who is pregnant and is wondering if they should ask to know the sex at the ultrasound visit.

But, just remember that sometimes the sex is not clearly identifiable from an ultrasound due to the baby’s positioning or the ultrasound technician’s skill.  To be absolutely certain of the sex, you would need a diagnostic test, such as a CVS or amniocentesis.  With these tests you might be able to let your doctor know in advance not to reveal the sex to you at the time he/she receives the test results. 

But, then again, if you are particularly stressed about knowing the baby’s sex, or you simply want to hear the words “it’s a girl!”  or “it’s a boy! “ after your hours of labor and delivery, there is always purple or yellow paint.

Sometimes technology can be a double-edged sword.  For instance, we all love seeing those first ultrasound pictures of our babies—it is so exciting and amazing!  But ultrasound can also show us things that may or may not have consequences.  Choroid plexus cysts are an example. 

The choroid plexus is the area of the brain that produces the fluid that surrounds the brain and spinal cord. This is not an area of the brain that involves learning or thinking. Occasionally, one or more cysts can form in the choroid plexus. These cysts are made of blood vessels and tissue. They aren’t a problem by themselves and they do not cause mental retardation or learning problems.

Using ultrasound, a health care provider can see these cysts in about 1 in 120 pregnancies at 15 to 20 weeks gestation. Most disappear during pregnancy or within several months after birth and are no risk to the baby.

However, if choroid plexus cysts are present and maternal blood testing (such as the quad screen) and/or the ultrasound itself shows other signs of risk, together it may all indicate a possible genetic defect. In this case, testing with higher-level ultrasound and amniocentesis may be offered to confirm or rule out serious problems.

Hearing your baby has choroid plexus cysts can be scary but don’t panic!  Just remember that most of the time this is a benign finding and does not mean that there is a problem.

Today we are pleased to have a guest post from Beth Frazer, a preeclampsia and HELLP syndrome survivor, and a volunteer with the Preeclampsia Foundation.

I remember the first time I heard the word “preeclampsia:” it was November 10, 2008, and I was blissfully pregnant with twins.  Although this was my first pregnancy, I am a practicing attorney with a propensity to research and so considered myself to be an “educated” patient.  I believed that everything was progressing perfectly.  I thought that my headaches, blurred vision, shortness of breath, sudden weight gain, and swelling were all a normal part of pregnancy.  In actuality, however, these were all signs that my kidneys and liver were shutting down, my red blood cells were destroying themselves, and my brain was swelling. 

Fortunately, I was scheduled to have a routine OB appointment that day, at which time a urine test revealed that I was spilling protein.  Several hours later I was diagnosed with HELLP Syndrome,  a severe variant of preeclampsia, and was told that I was dying.  Two days later our beautiful twins were born, 20 weeks premature and too small to survive.  My doctor said that, had my OB appointment been scheduled even 48 hours later I would have suffered a massive seizure or hemorrhage.  I had no idea that my symptoms were actually serious warning signs. 

I now know that preeclampsia, often described as a hypertensive disorder of pregnancy or by the old fashioned term “toxemia,”  is a known cause of premature births in the U.S. and is a leading cause of maternal and neonatal death.  It is the reason that a pregnant woman’s urine and blood pressure are tested at every OB appointment.  But I never heard of it before.  I was left physically weak, heartbroken, and completely confused. 

I set out to learn everything I could about what had happened to me, and figure out whether it would happen again.  In doing so I found the Preeclampsia Foundation,  and I realized that I wasn’t alone.  I found tens of thousands of women have suffered situations similar to mine, most of whom had also been unaware of preeclampsia before their own diagnosis. 

I learned that preeclampsia has no known cause, and has no known cure other than immediate delivery of the baby.  If it is diagnosed early enough, however, preeclampsia can often be managed, allowing the pregnancy to progress a bit further and result in better outcomes for both mother and baby.  I studied the signs and symptoms of preeclampsia.  I analyzed the different ways it presents itself, from the classic case of a pregnant woman whose blood pressure creeps up during her third trimester, to more unusual cases like my own.  I researched the latest tests and theories and medical developments. 

And, finally, my husband and I met with our Maternal Fetal Medicine specialist (“MFM”), a high-risk OB, to discuss our future.  We discussed the risk factors for preeclampsia, which include a history of preeclampsia, particularly preeclampsia before the third trimester.  I underwent testing and learned that I might have blood-clotting disorders, which might also put me at risk for preeclampsia.  Nonetheless, my MFM felt that awareness and treatment of these risk factors would allow us to successfully manage a future pregnancy. 

Armed with the blessing of my MFM and knowledge of preeclampsia’s signs and symptoms, I became pregnant again.  Those first few months were terrifying and anxiety-ridden.  My MFM monitored my blood pressure, blood work, and urine protein levels constantly, as well as the development of my baby– first every other week, then every week, then twice a week.    Being informed empowered me, and I was reassured knowing that I recognized those symptoms that needed to be reported and acted upon. 

We all held our breath as slowly but surely milestones were met.  First, 20 weeks, when I previously developed preeclampsia, then 24 weeks: viability.  Then 28 weeks.  Then 30 weeks and 32 weeks, then 34. . . 

And, urprisingly, preeclampsia never developed!  I sit here now with a beautiful baby boy snuggled up on my lap.  Born full term and healthy, he is a true testament to the power of preeclampsia education and awareness.   

It is possible to have a healthy mother and baby after a preeclampsia diagnosis, or even after a preeclamptic pregnancy!   The key is to not only receive regular prenatal care, but also be your own advocate.  Know the signs, know the symptoms, know your body, and trust yourself.

Scared of needles?  Wondering why they take so much blood?  Worried about everything you hear?  Join us tomorrow for our first-ever pregnancy chat on Prenatal Tests: Why and How. 

It’s on Twitter March 16th at 3pm EDT.  Just follow #pregnancychat to learn about all the tests, ask questions and jump in the conversation.  The Health Information Specialists at the Pregnancy & Newborn Health Education Center will be on hand to explain and respond in 140 characters or less.  Follow us @marchofdimes for pregnancy tips in English or @nacersano for pregnancy tips in Spanish.

At my last prenatal appointment I had a combination of tests done to screen for birth   defects such as Down syndrome and Trisomy 13 and 18. I was nervous going, but my husband was with me for support. My visit started with an ultrasound. The doctor rubbed a hand-held device (called a transducer) across my belly. The baby was face up and the doctor needed him/her to turn to the side in order to measure the thickness at the back of the neck (called nuchal translucency).  We waited and waited, but he/she wouldn’t budge. I certainly didn’t mind because I was able to admire the beautiful image on the screen longer.

After several minutes, the doctor finally called for a nurse. She brought me a very sweet orange drink and the doctor said he would be back in less than 10 minutes. I was thinking, “yeah right, this isn’t going to work.” Well, wouldn’t you know it. When he came back and put the transducer on my belly, there it was — the most perfect profile. I guess the baby just needed a little energy. Using the mouse on the ultrasound machine, he was able to measure the back of the neck.

Then I was passed off to the nurse who took a blood sample. I don’t know if this is always the case with maternal blood screening, but she pricked my finger and placed about 5 or 6 drops of blood on a card. The office sent the blood sample to a lab and I would get the results back in about four days. The lab calculated my risk of chromosomal birth defects, using the combined results of my blood test and ultrasound exam.

I received a call a few days later. I was told that based on my age, blood work and ultrasound my risk for Down syndrome was 1 in 1, 610 and my risk for Trisomy 18/13 was 1 in > 10,000. I know that no test can gaurantee the birth of a healthy baby, but I was so relieved. It’s always nice to here reassuring news. Waiting for test results can be so stressful.

Continuing our post on the ABC’s of a healthy pregnancy A-G (July 10), here are guidelines H-Q to help increase your chances of having a healthy baby.

H: History can teach us a lot! Understanding your family history can make an important difference in your life and the lives of your children.

I: Iron is a mineral that helps create red blood cells, which are needed to carry oxygen to your baby. Be sure to get enough iron in your diet to prevent getting anemia.

J: Join a childbirth education class to help you understand what to expect during labor and birth.

K: Keep you and your baby safe during a disaster by planning ahead of time. Prepare for a disaster by making a list of medications you’re taking and having a handy contact sheet with your health provider’s information.

L: Lots of back pain? Backache is one of the most common problems for pregnant women. Avoid heavy lifting and standing for long periods of time. Wear comfortable shoes and consider a pregnancy massage to ease some of your pain.

M: Medical conditions, such as gestational diabetes and high blood pressure, should be carefully monitored by you and your health provider. Also, talk to your provider about any medications that may need to be adjusted during pregnancy.

N: Nausea is very common during pregnancy and certain foods can trigger the feeling. Try substituting other nutritious options for the foods that make you feel ill. Eat 5-6 small meals a day, rather than three large ones.

O: Oh, baby! Get ready to care for your baby before you bring her home from the hosital. Choose a health provider for her and make sure your home environment is all set and safe for your new baby.

P: Prenatal care is essential for having a healthy baby, so be sure to make all of your visits. During these appointments, prenatal tests will be given to help your provider know how you and your baby are doing.

Q: Quit bad habits such as smoking and drinking. Smoking can cause your baby to grow more slowly and gain less weight in the womb. Drinking alcohol while pregnant can lead to fetal alcohol syndrome, which can cause your baby to be born with both physical and mental birth defects.

Visit us next Thursday for the final part of our series, the ABC’s of a healthy pregnancy R-Z.