When Something Goes Wrong

For many women, pregnancy comes and goes. Although it is an unforgettable experience, most women find pregnancy to be uneventful. However, there are some women who face issues and conditions during pregnancy, that aren't common. When something does go wrong, how do you cope?

Once you encounter a complication in pregnancy, you are never able to relax again. Every twinge, ache, or odd feeling will lead you to believe that something is going terribly wrong. With all four of my miscarriages, they occurred at exactly the same point in the pregnancy, with the same onset of symptoms. I could literally look at my calendar and calculate when a miscarriage was going to begin. As terrible as that sounds, it is the honest truth. So, when the cause of my miscarriages was diagnosed, and I was pregnant with Hannah, I still worried. But, days, weeks and months passed, with no complications. She was, very much, an "uneventful" pregnancy. I imagined that this is what most women experienced, but due to my history, I had a difficult time enjoying the early part of pregnancy. I was constantly rushing to the bathroom, to see if any bleeding had started. When she was born, happy and healthy, a rush of relief came over me. I was thrilled that the doctors were able to find out why I was losing my pregnancies, and enabling me to carry a happy, healthy, full-term baby.

When I found out I was pregnant with our second baby in April of this year, I expected much the same experience as with Hannah. I begin my daily injections of Heparin, and was careful not to overdo it (very hard with a toddler!). My beta Hcg levels were rising as they should, and everything was going along as my doctor had hoped. On Mother's Day, I noticed I was spotting. I couldn't believe this was happening, and tried my best not to panic. My parents were in for the weekend, and I didn't want to upset them. After they left, I called my doctor, who asked that I go to the hospital for an immediate check on my Hcg levels. My doctor put me on bed rest, and demanded that I take it easy. Thankfully, everything was fine. However, I found that I had begun "preparing" myself for the worst. The spotting continued on and off until I was 10 ½ weeks pregnant. There was no known cause, and it stopped as quickly and unexpectedly as it had started. I am now 4 months pregnant, and have had no problems since the earlier episode.

Compared to what some women face, my situation seems rather mild. I have a friend who had such a severe case of hypermesis; she was unable to eat anything (liquid or solid) throughout her entire pregnancy. She was fed through a feeding tube, connected directly to her stomach. Luckily, her baby girl was born healthy, but my friend endured a great deal of pain and discomfort through her pregnancy. Through all of our troubles, scares, and confusion, it definitely helps to talk with others who have been in the same (or similar) situation. For me, on-line message boards became my support group. I found that, in talking with others about my fears, I was better able to cope with the complications I was dealing with at the time. Often times, seeking out support from friends and family will not give you the peace of mind you are so in need of. I know that, as much as my Mom wanted to help, she couldn't begin to understand my concerns and fears. She insisted I leave the "medical" situations up to the doctors, and just try to enjoy my pregnancy. Although she had the best of intentions, all her advice did was make me wonder if I was being overly paranoid.

If complications arise in your pregnancy, seek out support. You may know a friend of a friend who went through the same thing. Perhaps there is a local support group in your area. Of course, there are many online forums that offer message boards and special/topical chats. Don't feel that you need to handle the fear and pressure on your own. Look for support, do your research and don't be afraid to ask questions. By becoming an informed patient, you will better be able to understand the realm of your complications, and your doctor may feel more comfortable going into greater detail about your condition. You are almost guaranteed to locate what you need on the Internet. Good luck.

Source : thebabycorner.com

Lady In Waiting:Coping With Bedrest

"Bedrest," she said, stoically. Incredulous, I asked my doctor to clarify. "You mean I can't go back to work?" "I mean you can get up to use the bathroom and to take the occasional short shower. Other than that, I want you lying on your left side at all times." Before I knew it, I was in the front office holding a packet of disability forms and scheduling weekly OB visits.

My husband and I started the car trip home in stunned silence, but we soon found ourselves joking about how I'd single-handedly keep the video rental store afloat, how I'd finally get to tackle that mountain of magazines beside the bed, and just how high I might be able to wrack up our phone bill. I'll admit to giddy pleasure that afternoon in alerting my boss that I wouldn't be coming in the next day -- or any day thereafter in the relatively near future. It felt sneaky and indulgent, a bit like cutting class back in high school, only this time I was armed with a legitimate excused absence, signed by the good doctor herself.

But as I put down the receiver and prepared to "go lie down," I looked around the house at all the things left undone -- mounds of dishes in the sink, the soon-to-be nursery that was still a catch-all junk room, the baby book that hadn't even been cracked open, my work bag brimming with half-finished paperwork…. They taunted me. It became evident that being a forced lady of leisure wouldn't be all peaches and cream.

Singing the Bedrest Blues

Bedrest is a pain -- practically, physically, and emotionally. Typical bedresters include expectant moms experiencing preterm labor, preeclampsia, placenta previa, gestational diabetes, etc., all of which come with more than their fair share of worry, fear, frustration, and guilt. Sentenced to bed until your baby's birth, you have nothing but time to dwell on your anxieties.

Most striking to me and to many other fellow bedresters was the feeling of being robbed of a "normal" pregnancy. I resented that I couldn't show off my belly, which had finally reached that cute, clearly pregnant but not too big stage. I mourned the fact that we'd miss out on prenatal classes. I longed to be a part of the stories I'd read about where moms meet up in Lamaze, and they and their babies become lifelong friends.

Also overwhelming was the jealousy I felt -- of my friends, who still got together for girl's night out while I stayed in, and even of my husband, who continued on with literal business as usual as he headed out the door for work each morning.

Bedrest blues are natural and warranted. Expect them and accept them -- but listen hard for any cheery notes in between (such as the fact that you're likely to be much more intimately aware of your baby's every hiccup, kick, and tumble than your on-the-go, out-in-the-world pregnant mom counterparts). Revel in all the time you've been granted to talk to your sweetie, sing to her, read to her, dream of her….

Designing Bedrest Central

Whether in bed or on the couch, you'll want a few staples within easy reach at all times: · An amply stocked cooler (one with plenty of drinks and a variety of healthy snacks -- and a few naughty ones, too, just in case an irrepressible craving strikes).A telephone and address book.A computer with Internet access: get your home computer moved to your bedside or beg, borrow, or steal a laptop. The computer can be your lifeline, allowing you to browse articles, connect with others in chat rooms, bulletin boards, or instant messaging, build a free homepage, or just pass some hours with mindless computer games. You can even order your groceries and stamps online. An extendable grabber to lend you a "hand" when you need something just out of reach. (I also recommend a squirt bottle or water pistol for when unsuspecting kitties act out!)A clock and calendar.

robe and slippers. Paper and pens. Lotion, lip balm, mascara, nail polish and remover, a brush, a mirror -- anything that makes you feel pampered and attractive.Cups and flexible straws. Napkins. A wastebasketThe remote control and TV Guide.

What to Do While You're Doing Time

Many of the usual suggestions for bedrest activities (jigsaw puzzles, scrapbooking, reading the classics, knitting, or quilting…) require a level of concentration and interest that I could rarely muster when I was on bedrest. I think the focus should be less on how productive you are and more on your approach to getting through this challenging time in your life:

· Know your limits. For instance, don't tell your boss you'll work from home if you don't have the energy to do so; likewise, if reading a book seems too daunting when you're distracted by contractions or you're just grumpy or tired, read a magazine in short spurts or tackle a simple crossword puzzle instead.·

Look into getting a break on your auto insurance. If you're not driving it, why pay for it? Get dressed. Some bedresters choose to get dressed every day to feel more "put together;" others take advantage of this chance to wear comfy pj's day and night. Try meditation. Books and online tutorials make it easy to get started in this stress-reducing technique -- and meditation may even help prepare you for childbirth!Encourage friends and family to come by (but don't book so many visits that you become overwhelmed). When friends and family offer to help, accept graciously and be honest about what specifically they might do for you. Let your husband know what you need from him. Whether it's a shoulder to cry on, fresh flowers, a massage, or a slurpee, be straightforward about what you want, and you're much more likely to get it. Learn the words to your favorite lullabies and practice your Dr. Seuss reading voice.Get good at doing nothing at all. Just be with your baby.

Source : thebabycorner.com

The Facts About High Risk Pregnancy

There are many factors that constitute a high risk pregnancy. Some depend on the physician you have and their current opinions. Some stem from chronic conditions that was in place before pregnancy occurred. And some crop up during pregnancy. Even though you may have a high risk pregnancy - with today's medical knowledge and help - chances are your outcome will be a healthy baby in the end.

Age
The age of the mother if she is over 35 constitutes high risk to some doctors. The reason being is that certain conditions such as downs syndrome occurs more often. Also, miscarriages happen more with older women, because of the declining hormone levels. A physician will probably see an older women more often and will run non-stress tests and offer amniocentesis.

Prepregnant Chronic Conditions
Conditions that were in place before pregnancy occurred will put a mother in a high risk category. Sexually transmitted diseases, sickle cell anemia, cancer, lupus, maternal PKU, diabetes, uterine fibroids, hypertension, and urinary tract infections are some of the conditions that will constitute a high risk pregnancy. With these illnesses your doctor will be seeing you more often and will monitor and run more tests to insure as healthy a baby as possible.

Pregnancy Induced Conditions
Sometimes a perfectly healthy mother will come down with symptoms during pregnancy that will put her in a high risk situation. These include pregnancy induced hypertension (toxemia or preeclampsia), gestational diabetes, toxemia, infections such as urinary tract infections, problems with the placenta, incompetent cervix and preterm labor.

There are some cases where a previous cesarean or a breech or transverse presentation of the baby will be categorized as high risk. Again - this depends upon your circumstances and your doctor.

The pregnancy induced conditions will occur later on in pregnancy - often surprising an otherwise healthy mom. In most all cases there is nothing you can do to prevent certain conditions - they simply occur and have to be dealt with. I've had to deal with gestational diabetes, breech presentation, previous cesarean and preterm labor and in all instances I kept asking if I could have done something to prevent it. I was always reassured that it was nothing I did - just something that happened.

With the onset of most of these conditions - you will see your doctor more often. A lot of the cases, such as placenta problems (previa - where the placenta lays over the cervix - and abrupto - when the placenta tears away from the uterine wall), preterm labor and occasionally toxemia requires bedrest - at the hospital or at home depending on it's severity.

Close monitoring of both mother and baby will often keep a check on all the conditions of high risk pregnancy. Most high risk pregnant moms will go through a number of tests or at least be offered these tests- nonstress and stress tests, amniocentesis, blood tests, urine screenings, CVS (chorionic villus sampling) and level 2 ultra sounds. Some of these tests - CVS and amniocentesis do not come without risk - and you may need to weigh the benefit of having the test to the possible risk involved. However with today's medical technology - there is a certain assurance that everything possible is being done to help baby to come to maturity - healthy and whole.

Whether you are facing a high risk pregnancy due to preexisting conditions or due to pregnancy induced conditions - rest assured that if you seek the proper medical help and if you follow doctors orders you stand as good a chance of a healthy outcome as a normal woman with a normal pregnancy.

Source : thebabycorner.com

Anemia in Pregnancy

Feeling tired, exhausted, fatigued, getting short of breath and experiencing dizzy spells can all be symptomatic of anemia. Anemia is defined as "a condition in which there is an abnormally low proportion of red corpuscles in the blood, treated by iron (Fe) supplements."

However, it may be difficult to assess if you are anemic or not, as many of the associated symptoms are symptoms typically associated with the state of pregnancy anyway. The blood count your doctor routinely checks will reflect the late stage of anemia. You may still be deficient in iron even though your blood count is reading as normal.

If you do think you are anemic, consult your doctor about checking the ferritin level in your blood. This particular type of test is more accurate in the measurement of iron stores in your tissues. If the test reveals a low ferritin level (less than 20), it may be indicative that your tissues are being deprived of iron. This can be tiring for the mother and unhealthy for the baby. Mothers who are anemic have a greater chance of delivering premature and/or low birth-weight babies.

On the other hand, the hemoglobin that your doctor measures may suggest you are anemic when, in fact, you are not. Due to the normal increase in fluid volume in your blood during pregnancy, "hemodilution" occurs, possibly showing lower values of hemoglobin than before you were pregnant. In The Pregnancy Book by William Sears, M.D., this is referred to as the "physiological anemia of pregnancy."

According to Sheila Kitzinger in her book The Complete Book of Pregnancy and Childbirth, it is normal for hemoglobin levels to fall during pregnancy. In days gone by, iron was routinely prescribed during pregnancy, but it is now known that can be harmful. Moreso, if a woman's hemoglobin level does NOT fall during pregnancy, she increases her chances of delivering pre-term.

Women who do suffer from anemia during pregnancy are less able to deal with heavy bleeding at the time of birth and are more prone to infection. To compensate for this condition, be sure to incorporate more iron-rich foods, protein, B vitamins (most notably B12), and vitamin C. Additionally, speak with your doctor about taking the folic acid supplement. All of these nutrients are essential to your blood's ability to carry oxygen to all the tissues in your body.

Be sure to discuss all of your symptoms with your doctor so he/she can determine the best course of action to make your pregnancy as comfortable as possible for you.

Source : thebabycorner.com

Placenta Previa

It is the job of the placenta to provide the growing fetus with the necessary nutrients and oxygen. If this organ fails to function properly, the fetus could be deprived of oxygen and become malnourished. If a problem with the placenta is discovered early enough, doctors can work to maintain the health of the baby.

According to Dr. Stefan Semchyshyn, in his book, How to Prevent Miscarriage and Other Crisis of Pregnancy, "in a normal pregnancy, the fertilized ovum should implant on the upper portion of the uterus or womb, which is thicker, stronger, and more muscular than the lower half. However, in cases of placenta previa, the ovum implants on the weaker, lower portion of the womb, causing the placenta to grow over all or part of the cervical canal or cervical os. Complete or central placenta previa refers to a condition in which the cervical canal is completely covered. Partial or low-lying placenta previa means the cervical canal is only partially covered."

When the placenta grows and increases in weight, the weaker part of the uterus cannot offer sufficient support. This can cause the placenta to stretch and thin out, and could possibly tear and bleed.

"Painless bleeding," according to Dr. Semchyshyn, "in either the second or third trimester, is the only symptom of this potentially life-threatening situation for both mother and baby."

To confirm this condition, the patient should be given an ultrasound. If this problem has occurred, the ultrasound will show a bulge over the mouth of the womb. Serious internal bleeding can happen if the cervix is completely covered by the placenta and the mother is allowed to go into labor. Such cases usually call for a cesarean section delivery.

As for treatment for placenta previa, Dr. Semchyshyn notes that it all depends on the stage of the pregnancy in which the woman is in and the exact location of the placenta. If this occurs late in pregnancy, with complete covering of the cervical canal by the placenta, the doctor must decide if the pregnancy should be sustained or if a cesarean section should be performed. If tests show the baby's lungs can fully function outside of the womb, the doctor may proceed to go ahead with the delivery.

If placenta previa is noted in early months, before the baby can survive outside the mother, the doctor has to determine whether he can prolong the pregnancy without posing a risk to the mother. If the doctor feels this can be done safely, the mother will be instructed to bed rest. In addition, certain medication must be given to stop any uterine activity that could prompt premature labor. In these cases, the expectant mother must carefully monitor herself and alert her physician if she suspects any uterine activity.

If the medication helps to control the bleeding, the mother may be able to return to some of her normal activities until the birth of the baby. In some cases of partial previa, the growth of the baby forces the placenta upwards, away from the cervical canal.

Dr. Semchyshyn stresses that while placenta previa is a serious condition, with the aid of proper management, women can have a good chance of delivering a healthy baby.

Source : thebabycorner.com

Pre-eclampsia and Eclampsia

The term pre-eclampsia means a pregnancy disease in which symptoms are hypertension, protein in the urine and swelling. Pre-eclampsia was once known as toxemia. Eclampsia is when hypertension, protein in the urine and swelling (Edema) becomes life-threatening. The symptoms are followed by loss of consciousness, convulsions and possibly coma.

Pre-eclampsia is first diagnosed when the blood pressure rises. Confirmation of pre-eclampsia is when protein is found in the urine. Symptoms include swelling of the hands and face occurring after the 20th week of pregnancy. Often there are no outward symptoms, other than those discovered by the healthcare provider. The swelling often happens once the disease has been diagnosed.

Occasionally one sign first discovered is a sudden weight gain. This is caused by retention of fluid. Weight gain of more than two pounds in a week or six pounds in a month is cause for concern.

The cure for pre-eclampsia/eclampsia is delivery of the baby. But since this is often diagnosed in the early second trimester, delivery isn’t an option, so careful management of the remainder of the pregnancy is imperative. Mild cases of pre-eclampsia can be managed with simple bed rest. Your healthcare provider will determine how much bed rest you need. Severe cases of pre-eclampsia require long-time hospital stays.

If hospital stay is required, the risk of the disease to the mother is compared to the likelihood of the fetus surviving an early delivery. Tests such as amniocentesis are preformed to determine the maturity of the baby’s lungs. If the baby deems mature enough to survive outside the womb, then labor is induced or a cesarean section is preformed to deliver the baby.

In the cases of eclampsia, the severe form of the disease, an emergency cesarean is preformed to save the mother’s life. Every measure is taken to prevent fetal death, however if eclampsia is severe enough that the mother could die, the only route is an emergency cesarean. Magnesium sulfate is given to the mother to prevent seizures or convulsions. In less severe cases, the mother is allowed to carry her baby up to 40 weeks with labor being induced to bring on delivery.

Normally after delivery the blood pressure will fall back into a safe range. However, if the blood pressure doesn’t drop, medication will be given to help bring it down. You will need to see your physician regularly for monitoring.

The risk of a recurrence of pre-eclampsia/eclampsia in subsequent pregnancies depends on how severe the disease was in the first pregnancy. Normally, with mild cases, the disease does not return.

Source : thebabycorner.com

Gestational Diabetes: The Basics of This Not So Sweet Condition

Gestational Diabetes is a complication that occurs in approximately 4% of pregnancies and exemplifies yet another reason to seek and receive quality prenatal care, but it is still considered a very manageable condition. While testing, diagnosis, and treatment is somewhat disputed among medical professionals, gestational diabetes can result in various complications with delivery and if untreated may compromise the health of both mother and baby. For these reasons, the vast majority of obstetricians send their patients for a glucose screening test midway through pregnancy.

What is Gestational Diabetes?

A diabetic condition that occurs at approximately 20 to 24 weeks, gestational diabetes results in women whose pancreas does not produce enough insulin to regulate their blood sugar. The reason a previously non-diabetic woman may experience diabetes during pregnancy is due to the insulin blocking hormones that are produced by the placenta. After delivery of the placenta, the condition essentially goes away. In fact, most women’s blood sugar returns to normal almost immediately after giving birth. However, research has indicated that gestational diabetes may be a precursor for developing the condition later in life. Approximately one half of women who develop gestational diabetes develop the condition permanently within about 15 years.

The Glucose Screening Test

Somewhere around 22 weeks of pregnancy, your obstetrician will order a glucose-screening test. You will likely be asked to refrain from eating for one to two hours prior to your scheduled test time when you will be given a sugary, sickly sweet, liquid to drink. If you’re lucky, you may be offered a variety of flavors from cola to orange, but be prepared, it won’t be a thirst-quenching treat. Some women experience nausea to a level of discomfort, but severe nausea is rare. The test itself is performed by drawing blood and testing the blood sugar level. If your blood sugar level is 120 or higher, a similar, but more in depth, glucose fasting test will likely be required to actually diagnose gestational diabetes. Don’t panic if your initial glucose screening results in a blood sugar level higher than 120 since it is not an automatic indicator that you are or will be developing gestational diabetes, simply that further testing is required to confirm the condition. A good percentage of women test below 120 even with a higher than normal blood sugar level after the first test.

How is it Treated?

Once gestational diabetes is diagnosed, your blood sugar will need to be monitored throughout the remainder of your pregnancy. In many cases, a modified diet with limited intakes of sugar and complex carbohydrates is all that will be necessary to control the condition. This may seem difficult if you happen to be one of those women who crave chocolate, ice cream, butterscotch and the like, but well worth the self-restraint. If diet alone is not enough, it may be necessary to take insulin injections. Moderate and safe exercises may also be recommended. Your health care provider should be comfortable with treating gestational diabetes and will advise you on treatment and control.

What About Baby?

The most common effects of gestational diabetes are larger than normal babies, jaundice and fetal distress. For these reasons, a woman diagnosed with diabetes during pregnancy may be required to obtain more than one ultrasound and multiple stress tests. Ultrasounds can help to determine the growth rate of the baby and can thus prevent a complicated delivery. While the risk of cesarean does increase, preventing complications from attempting to deliver a baby too large to fit through the birth canal is priority. In some cases, it may be necessary to induce labor. Fetal stress tests are also more common and frequent under these conditions.

It is important to remember that this is a controllable condition and that participating in the screening is the first preventative measure you can take to avoid any further complications. While it’s true that if gestational diabetes occurs in one pregnancy, it’s likely to reoccur in subsequent ones, most women go on to have a moderately normal pregnancy and healthy children. Screening for and discussion of gestational diabetes with a qualified health care provider will ease any uncertainties you may have. As a resource to learn more about gestational diabetes visit http://www.nichd.nih.gov/publications/pubs/gest1.htm#2.

Source : thebabycorner.com