Women suffering from uterine factor infertility (UFI) cannot carry a pregnancy because they were born without a uterus, have lost their uterus, or have a uterus that no longer functions. A recently announced research study by the famed Cleveland Clinic will perform uterus transplants in 10 women with UFI, which is breaking new ground in the United States.
The exact incidence of UFI is unknown, but experts estimate that it affects thousands of women of childbearing age worldwide. Transplant may be their only option for pregnancy. In 2014, researchers in Sweden, teaming with the Cleveland Clinic, have performed nine uterus transplants, achieving five pregnancies and four live births.
You can read more about this potentially game-changing study at the Cleveland Clinic web site.
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Four out of 10 women are prescribed antibiotics during pregnancy, and a comprehensive new study shows that the two most often prescribed drugs—azithromycin and clarithromycin—have no adverse outcome on the child’s physical development.
The researchers, from the University of Montreal and its affiliated CHU Sainte-Justine children’s hospital and from the University of Oslo, looked at macrolides, a type of antibiotics that, along with penicillin, are among the most used medications in the general population and in pregnancy. However, there was debate on whether it is the infections or the macrolides used to treat them that put women and their unborn children at greater risk of adverse pregnancy outcomes, including birth defects.
The researchers examined data held in the Quebec Pregnancy Cohort, which contains detailed medical information on hundreds of thousands of pregnancies, in addition to the outcomes for mother and newborn alike. Information on the mother’s use of azithromycin and clarithromycin was compared with the use of penicillin, a well-tolerated antibiotic. A statistical analysis of almost 136,000 pregnancies that met the study’s criteria found no meaningful association with birth defects between the macrolides and penicillin use.
The researchers state that wider studies are needed to confirm the safety of less-often prescribed antibiotics. Be sure to discuss the risks and benefits of any medication use during pregnancy with your physician.
Secondhand smoke is known to be linked to a number of health problems, and here’s another one: cavities in baby teeth.
That’s the conclusion of a study out of Japan, published in the journal BMJ. Researchers analyzed data for 76,920 children born between 2004 and 2010 who were given routine health checkups at 0, 4, 9 and 18 months and at 3 years of age at health care centers in Kobe, Japan. They used questionnaires completed by mothers to assess secondhand smoke exposure from pregnancy to 3 years of age and other lifestyle factors, such as dietary habits and oral care.
Compared with having no smoker in the family, direct exposure to tobacco smoke at 4 months of age was associated with an approximate doubling of the risk of cavities. Even when smokers in the household didn’t come into direct contact with the child, the risk of cavities was higher by a factor of 1.5.
This is an observational study, so no definitive conclusions can be drawn about cause and effect, the authors stress. However, they add that the results “support extending public health and clinical interventions to reduce secondhand smoke.”
A happy patient writes: “I just left the office after my 8-week, 4-day scan, and we are elated to be having twins! Dr. Mann took me when my regular ob/gyn thought it was too early to be looking into infertility. Thank goodness we did, because Dr. Mann diagnosed me with PCOS [polycystic ovary syndrome] and we started our journey from there. It only took us two cycles and one IUI [intrauterine insemination] to conceive these sweet babies.
“Lourdes [the nurse] is amazing. She is very calming and never dismissed anything I asked her. The best part about this office is that they have a blood lab right [there]. This means if you have your blood [sample] taken in the morning, your nurse is calling you before 3 p.m. the same day. I never had to worry about knowing the results of any testing. They call you! I really, really appreciated that.
“Also more about blood work, you will have to do it a lot. So the [available] morning hours between 7 and 8 a.m., [for that] as well as for the monitoring follicle ultrasounds, allowed me to go to the doctor up to four times a week without having to miss a minute of work!
“Dr. Mann is so warm. She gave my diagnosis to me straight and didn’t coddle me, but she was assuring, gave me plenty of hugs, and genuinely smiled when we found out we were pregnant! Her treatment plan was spot on, and my body luckily reacted well to both cycles. I’m going to miss her, but I cannot wait to meet my babies!”
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Most healthy women can skip the fasting and, in fact, would benefit from eating a light meal during labor, suggests research presented at the American Society of Anesthesiologists 2015 annual meeting. Improvements in anesthesia care have made pain control during labor safer, reducing risks related to eating, researchers note.
Women traditionally have been told to avoid eating or drinking during labor because of the danger that they could inhale liquid or food into their lungs, which can cause pneumonia. But advances in anesthesia care mean most healthy women are highly unlikely to have this problem today. Researchers said aspiration today is almost nonexistent, especially in healthy patients. In the United States, there was only one case of aspiration associated with labor and delivery between 2005 and 2013, involving a complicated case of a woman who was obese and had preeclampsia (a precursor to eclampsia, or high blood pressure that can lead to seizures).
The researchers analyzed 385 studies published in 1990 or later and found that the energy and caloric demands of laboring women are similar to those of marathon runners. Without adequate nutrition, women’s bodies begin to use fat as an energy source, increasing the acidity of the blood in the mother and infant, potentially reducing uterine contractions and leading to longer labor and lower health scores in newborns. Additionally, the studies suggest that fasting can cause emotional stress, potentially moving blood away from the uterus and placenta, lengthening labor and contributing to distress of the fetus.
Healthy women who are not at risk for aspiration should ask their medical care providers (including their physician anesthesiologist and obstetrician) if eating a light meal during labor is safe for them. A light meal could include fruit, light soups, toast, light sandwiches (no large slices of meat), juice and water. Most women lose their appetite during very active labor, but can continue to drink fluids such as water and clear juices, researchers said.
Pregnant women have long been frustrated that estimates of when they will actually give birth can be off by as much as two to three weeks. In fact, only 5 percent of women deliver on their exact due dates. There may be a better way, however. A new study suggests that a routine screening test could help narrow that window to seven days from the time of the test.
The research, published BJOG: An International Journal of Obstetrics and Gynaecology, found that measuring cervical length with ultrasound at around 37–39 weeks can give a better sense of whether a mother will deliver soon or not.
Measuring cervical length has been used to find out if a woman has a high chance of premature labor: the shorter the cervix, the more likely labor is imminent. Researchers have also investigated whether it could be used to help predict birth at term as well, but some studies showed poor predictive value while others were more predictive. The current analysis pooled the data from five studies, including 735 women with single-child pregnancies who had babies in the usual head-down position.
The researchers found that when the cervix measured more than 30 millimeters at a woman’s due date, she had a less than a 50 percent chance of delivering within seven days. However, when the cervix measures 10 mm or less, women had more than an 85 percent chance of delivering within seven days.
Cervical length is a good predictor of labor because when a woman’s body prepares for labor, a number of changes start to take place. The cervix begins to soften and changes its usual ice cream-cone shape to a shorter cone, whose top becomes flattened out against the curve of the uterus.
“Women always ask for a better sense of their delivery date in order to help them prepare for work leave, or to make contingency plans for sibling care during labor,” says senior author Vincenzo Berghella, M.D., director of Maternal Fetal Medicine at Thomas Jefferson University Hospital and professor of obstetrics and gynecology at the Sidney Kimmel Medical College at Thomas Jefferson University. “These are plans which help reduce a woman’s anxiety about the onset of labor.”
In 2003, two “mates” from Australia decided to bring the mustache back in popularity, and began what has grown into Movember—the annual movement to raise money and awareness for men’s health issues, including prostate cancer and infertility.
The event went global, and since 2003 it has raised $649 million and funded 832 men’s health projects.
You can help. Start a fundraising team or support one in your community. Learn more at Movember.com.
Some pregnant women take the phrase “eating for two” too far, and it’s well known that gaining too much weight during pregnancy can lead to complications for both mother and baby. But a new study says that excess weight gain may also have a longer-term effect on the child.
The study, published in Pediatrics, found that women who gain too much weight during and after pregnancy thereby increase the risk that their child will be overweight or obese in adolescence. Excessive weight gain during pregnancy may lead to changes in a woman’s body chemistry that make her child more likely to be overweight or obese, the researchers suggest. Weight gain may also reflect the family’s lifestyle and health behaviors, the study authors say.
Data from more than 3,300 Dutch children and their mothers revealed that children born to mothers whose pregnancy weight gain was deemed “excessive” had a 20 percent greater chance of being overweight. When mothers gained too much weight in the year following delivery, their children also had an increased risk of being overweight. And children born to moms who gained too much weight both during and after pregnancy faced more than three times higher odds of ending up overweight at age 14 than did kids with slimmer moms.
Be sure to work with your doctors to control weight gain during pregnancy. Experts believe that women of normal weight should gain an average of 20 to 35 pounds, while overweight women should gain less.
The American Academy of Pediatrics (AAP) has issued new warnings that should become the final word on a somewhat controversial topic: No amount of alcohol is safe to consume while pregnant.
“The only guarantee of having no effects from alcohol is no prenatal alcohol exposure,” said Janet Williams, M.D., a professor of pediatrics at the University of Texas Health Science Center and co-author of the new statement and report from the AAP.
She added that future research most likely will continue to show that “alcohol has subtle yet important lasting effects on academic performance, attention, behavior, cognition, memory, language skills, and visual and motor development.”
Some research over the last few years has failed to identify harm resulting from a small number of drinks per week during pregnancy. These studies, however, “do not conclude that alcohol use is safe,” Williams said. They only show “that in certain study populations under certain conditions, there is or is not sufficient evidence of effect that can be attributable to alcohol exposure.”
According to the report, alcohol use during pregnancy can cause thinking and behavioral problems that last a lifetime. “No amount of alcohol intake should be considered safe,” the report stated, and “there is no safe trimester to drink alcohol.” The report said that all forms of alcohol—beer, wine and liquor—pose similar risks.
Almost half of all women of childbearing age in the United States reported consuming alcohol within the past month, the researchers said, and nearly 8 percent of women continue to consume alcohol during pregnancy.
Don’t be one of them, for your baby’s sake and yours.