OB Reports

Obstetrics related news - Powered By EZDoctor

Vaginal Health Mistakes


  • Playing Down Heavy Periods

Girlfriends may have warned that your periods could become heavier as you get older — but that’s not always true. “As menopause approaches, your periods may come closer together or farther apart, but they shouldn’t necessarily be heavier,” says Suzanne Kavic, MD, associate professor of obstetrics and gynecology at Loyola University Chicago Stritch School of Medicine. If your periods do become heavier, or if they’re coming way more often (like every two weeks), or you’re bleeding in between periods or after sex, let your doctor know. Heavy bleeding can be a sign of fibroids (benign uterine tumors), anemia, a hormonal issue like polycystic ovarian syndrome, or more rarely, cervical, uterine, or ovarian cancer.

 

  • Treating the Wrong Infection

“As soon as they experience any itching and discharge, most women assume it’s a yeast infection and apply an over-the-counter anti-fungal cream, but that’s not always the cause,” says Mary Peterson, MD, director of the Midlife Health Center at the University of Pittsburgh Medical Center’s Magee-Women’s Hospital. Although yeast infections are common — nearly 75 percent of women have at least one in their lifetime — they are only one of three common vaginal infections. Bacterial vaginosis (BV), caused by an overgrowth of the bacteria in the vagina, and trichomoniasis (trich), a sexually transmitted infection, are the other two. Both vaginosis and trich can cause symptoms similar to those of yeast infections, which is why it’s so important to make sure it’s really a yeast infection. If left untreated, BV can cause pelvic inflammatory disease, and both BV and trich can make you more susceptible to sexually transmitted diseases. “If you’ve had lots of yeast infections and this seems to be exactly the same, you can probably get away with treating yourself,” Dr. Peterson says. However, if symptoms are slightly different or you’re just not sure, check with your doctor. Yeast infections, vaginosis, and trich are all easily treated. An over-the-counter or prescription anti-fungal cream or prescription pill will treat yeast; prescription antibiotics are needed for BV or trich.

 

  • Applying Talcum Powder

Patting on talcum powder (or any powders, including some baby powders, that list talc among their ingredients) to feel fresher isn’t just a harmless hygiene measure. The habit can raise your risk of invasive ovarian cancer by about 30 percent, according to new research presented at the 2011 annual meeting of the American Association for Cancer Research. Frequent, long-term use doubled or even tripled the risk. The study authors speculate that the powder could spread to the genital tract and create an inflammatory reaction. Peterson’s advice: Don’t use it. “There are other ways to keep dry,” she says. If you’re prone to sweating down there, Peterson recommends wearing cotton underwear and changing them often, avoiding tight-fitting pants, and going commando at night (to give the area a chance to breathe).

 

  • Forgetting About Kegel Exercises

Maybe you attempted Kegel exercises during or after pregnancy to tighten things up, but not doing them regularly can set you up for urinary incontinence later in life. If you had incontinence then, it’s more likely to strike again when you’re older, says Peterson. According to a University of Washington survey, urinary incontinence affects more than 40 percent of women in their forties and almost half of all women over age 50. The problem occurs when the muscles in the pelvic area become weaker (due to such issues as pregnancy, childbirth, menopause, or excessive weight), which can lead to urine leaks when you exercise, cough, or laugh. Kegels strengthen those weak muscles and prevent or improve symptoms. Need a refresher? Imagine you’re going to the bathroom, then squeeze as though you’re trying to stop the flow. Aim to do three sets of 12 to 15 a day.

 

  • Not Using Birth Control

If you’ve skipped a period or two and have what seem to be hot flashes, you may think you can no longer get pregnant because you’re starting to enter menopause. But you’re wrong. “As long as you’re having periods of any kind, no matter how irregular they are, there is always a chance of becoming pregnant,” Peterson says. In fact, an analysis by the Pew Research Center found that in 2008, 14 percent of births were to women age 35 and older (compared to 10 percent of births to teen moms). More than half of all pregnancies in women over age 40 are unintended, according to the Guttmacher Institute, a sexual and reproductive health research organization. So don’t toss out birth control unless you’re okay with getting pregnant. “You’re not safe until it’s been at least a year since your last menstrual period,” says Peterson.

 

  • Skipping Barrier Contraceptives

Adults over age 40 are less likely to use condoms than younger people, according to the National Survey of Sexual Health and Behavior (NSSHB), which evaluated sexual health information collected from almost 6,000 people between the ages of 14 and 94 — and the unsafe habit is affecting their health. In 2009, people between age 50 and 64 accounted for 15 percent of all new HIV diagnoses. Diseases such as chlamydia and syphilis are also on the rise among people over 40, according to the latest U.S. government data. Even if you use hormonal birth control, or you’re past menopause and have no chance of getting pregnant, it’s still a good idea to use condoms every time you have sex “unless you’re in a mutually monogamous relationship and you and your partner have both been tested for sexually transmitted infections,” says Peterson.

 

  • Putting Sex on the Back Burner

According to data published last year in the Journal of Sexual Medicine, 30 percent of women in their forties and 50 percent of women in their fifties say they hadn't had vaginal sexual intercourse in the previous year. And — surprisingly — such a dry spell could affect their health down there. “When estrogen levels drop after menopause, the tissues of the vagina tend to flatten and become thinner, which can cause painful sex, as well as itching, dryness, burning, and discomfort,” says Machelle Seibel, MD, professor of obstetrics and gynecology at the University of Massachusetts Medical School in Worcester. But having sex regularly can help prevent symptoms by keeping the vagina moisturized and improving elasticity. If you experience vaginal dryness during intercourse, a good lubricant can make things more comfortable. For women who aren’t sexually active, consider self-stimulation with a vibrator and non-hormonal vaginal moisturizers, like Replens, or vaginal estrogen creams, rings, or pills.

 

  • Wearing a Panty Liner Too Often

If your periods are irregular or you’re dealing with incontinence, you may wear a panty liner frequently to avoid embarrassing situations. But this can set you up for infections and irritation. “The plastic backing on the panty liner prevents air from flowing through and retains heat and sweat, and wearing the same one for too long can lead to bacterial or fungal infections,” Peterson says. Plus, the constant rubbing may cause vulvar irritation. Having a change of underwear, keeping tampons or pads on hand for unexpected periods, and managing incontinence with Kegels, lifestyle changes, or medication may reduce your reliance on panty liners. When you do use them, change your panty liner at least every four hours.

 

  • Not Seeing Your Doctor Enough

According to the most recent guidelines from the American College of Obstetricians and Gynecologists, women 30 and older who have had three consecutive, negative (meaning normal) Pap tests need only get Paps every three years. But that doesn’t mean you can skip your annual checkup. Your gynecologist still needs to see you once a year — and the clinical breast exam and bimanual pelvic exam she’ll perform can help detect serious health issues like cancer, ovarian cysts, and fibroids. It’s also a great opportunity to get advice on anything from hot flashes to birth control to your sex drive.

Make sure you make an appointment to see your doctor through ezdoctor.com. You can search for doctors and filter by specialty, name and insurance plan. Before booking your appointment, make sure you get an EZDoctor Report. EZDoctor Reports contain important information about doctors such as; malpractice claims, criminal offenses, and board actions. Go to ezdoctor.com now to get started.


Original and full article: everyday health.com 

Yoga in Pregnancy | Benefits


Set aside your ego and honor where your body is at today. Practice loving compassion for yourself and baby. Prenatal yoga is one of the best things that you can do for yourself, as well as your growing baby.

It's important that you find the right yoga practice for you. Whether it be going to a yoga studio, finding a DVD, or developing your own practice at home. Listen to your body and do what feels right to you. Some of the benefits of practicing yoga during pregnancy include:

1. Develops stamina and strength As baby grows within our body, more energy and strength is needed to be able to carry the weight.  Yoga poses strengthen our hips, back, arms and shoulders. 

2. Balance Our balance is challenged physically as the fetus grows within our body. Emotionally we are drained due to the increases in progesterone and estrogen. As we try to focus on holding and breathing through each yoga pose, we are able to fine tune our balance, physically and emotionally.

3. Relieves tension of lower back, hips, chest, upper back, neck and shoulders As baby grows, more stress is put upon these specific muscle groups in our bodies.  We tend to have more of a lordotic/lower back curve due to the increased size of our bellies. Our hips get tighter due to the added pressure of baby’s weight in our bellies. As our breasts increase in size, our upper back and chest have more tension, along with our neck and shoulders.

4. Calms the nervous system Through deep breathing, the nervous system goes into parasympathetic mode, which is responsible for relaxation.  When our bodies are in that mode, our digestions operate properly, we tend to sleep better, and our immune system is at its optimal.

5.  Preparation for Labor You are working with conscious breathing during each yoga pose, which may sometimes be challenging. This transfers into the time of labor, allowing one to practice being “comfortable with the uncomfortable” through our breathwork.  As you inhale, you acknowledge the tension that is felt.  As you deeply exhale, you let go of it more and more with each breath.

6.  Connection with baby A prenatal yoga practice allows us to slow down and focus attention on what is going on within our bodies. Through working with our breath and doing each pose, you become more aware of what is going on within.

7. Increases circulation Circulation is enhanced within our joints and our muscles are elongated during practice.  Upon circulation of the blood within our bodies, swelling is decreased and our immunity is enhanced, creating a healthy environment for a thriving baby.

8. Breath-work practice This is a good tool for labor during contractions.  If we are consciously breathing, our blood pressure and heart rate is regulated keeping us in parasympathetic/relaxation mode.  Calm mama equals calm baby. 

9. Sense of community/sisterhood It can be very comforting to be with a group of women who understand what we are going through.

10. Nurturing time This time allows us to stop and slow down from our busy days.  Through the practice of yoga, you are setting intention in taking care of not only yourself, but of baby.

Article Source: fitpregnancy.com

12 Types of Birth Control


Combination pill

What it's called: Estrostep Fe, LoEstrin 1/20, Ortho-Novum 7/7/7, Ortho Tri-Cyclen Lo, Yasmin, Yaz.

What it does: This birth control mainstay is still 99% effective against pregnancy when taken around the same time every day. It's also known for easing hot flashes and restoring regular periods.

Who should avoid it: Smokers and those 35 or older. The estrogen may cause dangerous blood clots. If you suffer from migraines, you should also pass because it may trigger the painful headaches.

Progestin-only pill

What it's called: Micronor, Nora-BE, Nor-QD, Ovrette.

What it does: Known as the mini pill, progestin-only meds don't contain estrogen. They're safer for smokers, diabetics, and heart disease patients, as well as those at risk for blood clots. They also won't reduce the milk supply for women who are breast-feeding.

Who should avoid it: If you have trouble remembering to take your pill at the same time every day, progestin-only pills might not be your best bet. They need to be taken at exactly the same time every day; if you're more than three hours late, plan on using a backup method.

Extended-cycle pill

What it's called: Lybrel, Seasonale, Seasonique.

What it does: These pills prevent pregnancy and allow you to have a period only every three months. (Note: Lybrel stops your period for a year, but you must take a pill every day, year-round.)

Who should avoid it: There's no evidence proving it's dangerous not to have periods, but there is still no long-term research to show that it is safe.

Vaginal ring

What it's called: NuvaRing.

What it does: The ring is made of flexible plastic and delivers estrogen and progestin, just like the combination pill. You place the ring in your vagina for three weeks, and then remove it for one week so that you have a regular period.

Who should avoid it: Women who smoke, or have blood clots or certain cancers, should not use the NuvaRing.

Diaphragm

What it's called: Milex Wide Seal, Ortho All-Flex, Semina, SILCS.

What it does: Made of rubber and shaped like a dome, a diaphragm prevents sperm from fertilizing an egg. It covers the cervix and must always be used with a spermicide. Women must be fitted for a diaphragm in their doctor's office.

Who should avoid it: If your weight tends to fluctuate by more than 10 pounds at a time, the diaphragm may not work. If you gain or lose weight, you'll need to be refitted. Prone to bladder infections? You might want to consider another option. If you've had toxic shock syndrome, you shouldn't use a diaphragm.

IUD

What it's called: Mirena, ParaGard.

What it does: ParaGard is a surgically implanted copper device that prevents sperm from reaching the egg. Mirena, also surgically implanted, works by releasing hormones. Intrauterine devices (IUDs) are more than 99% effective and good for 10 years.

Who should avoid it: Some doctors recommend the device only for women who have given birth. When the device is implanted, your uterus is expanded, and this might cause pain in women who have not had children. If you're planning on having children in a year or two, look at other options. The IUD can be removed, but the high cost—up to $500—might not be worth it for short-term use.

Female condom

What it's called: Femy, Protectiv, Reality.

What it does: The female condom is made of polyurethane, or soft plastic, and protects against STDs. It is inserted deep into the vagina, over the cervix, much like a diaphragm. Unlike the male condom, the female condom can be put into place up to eight hours before sex.

Who should avoid it: Male condoms offer more protection—both against STDs and pregnancy—than female condoms, so if you and your male partner aren't in a long-term, monogamous relationship, female condoms are not a perfect substitute.

Male condom

What it's called: Durex, LifeStyles, Trojan.

What it does: Male condoms protect against pregnancy and STDs, including HIV. Worn properly, condoms prevent sperm from entering the uterus. Go with latex or polyurethane condoms; lambskins do not shield you against all STDs.

Who should avoid it: If your mate is allergic to latex or polyurethane, you'll have to find another option. And if you tend to use a lubricant that contains oil, such as hand lotion or baby oil, you'll need to switch to an oil-free option like K-Y Jelly, which, unlike oil-based lubricants, doesn't degrade latex.

Patch

What it's called: Ortho Evra.

What it does: You can place the hormone-releasing patch on your arm, buttock, or abdomen, and rest easy for one week.

Who should avoid it: If you're particularly at risk for blood clots, you might want to find a different method. The patch delivers 60% more estrogen than a low-dose pill, so you're at an increased risk for dangerous blood clots.

Implant

What it's called: Implanon, Norplant.

What it does: About the size of a matchstick, the implant is placed under the skin on your upper arm. Implants last for three years and can cost up to $800. They are nearly 100% effective.

Who should avoid it: Implanon may not work as well for women taking St. John's wort, or women who are overweight.

Sterilization

What it's called: Essure, tubal ligation, vasectomy.

What it does: Women can undergo either tubal ligation, a surgical procedure that blocks the fallopian tubes from carrying eggs to the uterus, or tubal implants (Essure), a nonsurgical technique in which a small coil is inserted into the fallopian tubes. The sterilization process is less risky for men: A vasectomy is a minor surgery in which the tubes that carry sperm from the testicles are cut.

Who should avoid it: If you plan to have children, sterilization is not an option—it's not designed to be reversible.

Emergency contraception

What it's called: Copper T IUD, Next Choice, Plan B, Plan B One-Step.

What it does: Emergency contraception is a backup for regular birth control. Plan B contains a higher dose of the same synthetic hormones found in the combination pill. It works best if taken within 72 hours of unprotected sex, but may work up to five days later. There's also the copper T IUD, which a doctor can insert into your uterus five to seven days after unprotected sex.

Who should avoid it: Plan B, known as the morning-after pill, is available over-the-counter at most pharmacies, but only to women 18 years and older. Minors need a prescription. Copper T IUDs can be very expensive—up to $500. Plus, they last for up to 10 years, so if you hope to get pregnant in the future, this isn't for you.

Source: health.com

EZDoctor and April Partner to Offer Virtual Doctor Visits to International Travelers


EZDoctor, the leader in healthcare transparency and April, a global travel insurance provider have recently partnered to offer telemedicine services to patients traveling abroad that are in need of medical assistance.

The alliance between EZDoctor and April, allows patients to remotely consult with a U.S. board certified physician while traveling abroad.

With EZDoctor's support, April will be connecting their travelers from around the world with doctors anytime, anywhere needing only a webcam enabled device and a reliable internet connection.

These virtual physician consultations are not intended to treat emergency medical conditions/situations. Patients will receive primary care services, treatment for common ailments like the flu, allergies, rashes etc. and educational and informative medical advice from a trained and thoroughly screened professional.

EZDoctor and April are working together to improve the doctor-patient experience by providing on demand consultations and with doctors readily available to treat patients 24 hours a day, 7 days a week. To serve the needs of April's global travelers patients are connected with U.S. physicians within 15 minutes and can currently request doctors that are fluent in English, Spanish, French, or Portuguese.

According to the American Telemedicine Association, approximately 10 million patients benefited from using telemedicine last year. The telemedicine industry is developing quickly and becoming more prominent in societies around the world. EZDoctor and April are two leaders expanding quality telemedicine services worldwide.

"We're very excited about this partnership, we believe patients should have access to a board certified physician anywhere and anytime. As telemedicine continues to be a rapidly growing component of healthcare in the United States, we want to provide patients an accessible way to treat their healthcare needs when they are away from home," said David Marsidi, EZDoctor's founder and CEO.

"April & EZDoctor are both convenient, progressive thought leaders in the way we prioritize the patient's needs and that is what we want to deliver through this new service by offering a fast, easy, reliable and secure doctor consultations," continued Marsidi. "Together we will deliver the world-class healthcare service that patients deserve."        

EZDoctor and April patients will:

  • Have access to telemedicine services 24/7.
  • Resolve unexpected medical problems when traveling.
  • Receive virtual physicians consultations from any location worldwide.
  • Connect with a physician within 15 minutes of their request.
  • Have better outcomes because of timelier access to a physician.
  • Reduce unnecessary admissions, save time and money.
  • Receive primary care services on the go.

About EZDoctor
EZDoctor, healthcare technology business located in Florida, provides healthcare services nationwide. As an advocate for healthcare information transparency, EZDoctor developed a Carfax type of report but for doctors called EZDoctor Reports, to help patients make better decisions when it comes to choosing a doctor. With their rapid growth in the healthcare technology industry and over 1.5M+ doctor profiles, EZDoctor has radically transformed the industry by connecting healthcare consumers with the best doctors and equipping them with accurate information to make an informed healthcare decision.

About April
April has been a leading brand providing quality Travel and other Specialty Insurance programs providing services in Europe, Latin America and the U.S.
April offers comprehensive travel insurance & assistance plans covering multiple trips for frequent travelers. 

Quick Tips for Choosing a Doctor

When you choose a primary care doctor for yourself or a loved one, make sure to choose a doctor you can trust. A primary care doctor can help you make important decisions, like which screening tests and shots to get, treat many health problems, refer you to a specialist when you need more help with a specific health issue.

Here are some things you should know before selecting a physician

  • Listens to your opinions and concerns
  • Encourages you to ask questions
  • Explains things in ways you can understand

When you and your doctor work together as a team, you’ll get better health care. Try the following tips to find a doctor who’s right for you.

Research your doctor.

If you have health insurance, you may need to choose a doctor in their network. Some insurance plans may let you choose a doctor outside the network if you pay more of the cost.

What you should know about your doctor:

  • Contact information, Locations and Gender. 
  • License Information. It is important to know if your doctor is licensed to provide the care that you need.
  • Education. To learn more about your physician’s background EZDoctor Reports contain information regarding where they studied, graduation date, board certifications, as well as their internship, residency and fellowship. This will help you make an educated decision regarding your doctor’s training and ability.
  • Hospital Affiliations/Privileges.  Its common practice for a doctor to have their office in one location and perform treatment in a separate location. For example, you could go to a doctor’s office for a consultation regarding your knee and that doctor might provide treatment and/or surgery at a hospital that he is affiliated with or has privileges. By having this information before hand, it can help you in deciding whether this doctor would be the most convenient for you.
  • Procedure Pricing Information. When taking care of any health concern, one of the main things we consider is the cost associated with any procedures that might be necessary. An EZDoctor report will display an average charge for procedures performed by the physician you are reviewing.
  • Patient Referral Summary.  Primary care physicians, when needed, refer patients to a specialist. Especially when they face a diagnosis that is beyond their Scope of Practice. With an EZDoctor report you will see the  physicians referral pattern.
  • Pricing/Prescribing Habits. Is your  doctor more likely to prescribe a name brand versus a generic drug? Despite your preference, by seeing a breakdown of the most common prescriptions a physician orders you can get a clear view of his prescribing tendencies and average price per prescription.
  • Disciplinary Actions. Finding out if a physician has been sanctioned or not by a state medical board can be very useful when it comes to selecting a doctor to visit. Equally important is to know  what those infractions were related to.
  • Criminal Offenses. While federal criminal records are not available to the public, EZDoctor reports include state government records that indicate whether a physician has ever been charged or convicted of a crime. Allowing you to have this information prior to any consultation and/or treatment.
  • Malpractice Claims. You have the right to know if your physician has been involved in any incidents regarding his medical care. From surgical and medication errors to misdiagnoses, EZDoctor will provide the information you need.
  • Patient Reviews. It’s always good to know what other patients are saying about a physician. EZDoctor reports collect patient reviews from multiple sources.

Other important questions to ask about the doctor:

  • Is the doctor taking new patients?
  • Is the doctor part of a group practice? Who are the other doctors?
  • Who will see you if your doctor isn’t available?
  • Which hospital does the doctor use?
  • If you have a medical condition, does the doctor have experience treating it?
  • What languages does the doctor speak? 

You can find all the information you need on a physician by obtaining an EZDoctor Report. Go to ezdoctor.com now to get started! 

Source: healthfinder.gov

Ease Morning Sickness


The term “morning sickness” is misleading, as this can occur in the morning, afternoon, evening or middle of the night. Although it is inevitable and unavoidable, here are 24 ways to ease morning sickness.

1. Avoid Morning Sickness Nausea Triggers

The most common offenders you should eliminate to ease morning sickness include body odors, stale or leftover food in the fridge, coffee, gasoline, solvent fumes, garbage, scented cosmetics and toiletries, and pungent aromas of cooking foods.

2. Make “Designer” Days

Compare your good and bad days. As much as humanly possible, design your day to avoid the known triggers that set off morning sickness. If wet dog smells or litter box stench gets to you, let someone else get them out of your way. WARNING! During pregnancy, avoid cat feces because they may contain toxoplasmosis bacteria, which can cause serious damage to the baby.

3. Eat Before Your Feet Hit the Floor

If you start the morning off sick, you are likely to stay sick all day. Set a tray of easy-to-digest favorites at your bedside to ease morning sickness. When you need to use the bathroom in the middle of the night, treat your stomach to a nibble or two while you’re up. Continue to munch all morning, carrying your nibble tray around with you; if necessary—yes, even in the car and by your desk at work.

4. Ease Into Your Day

If you don’t have to awaken at a set time, don’t. Ask your mate to get up quietly without disturbing you, and slowly wake up in your own time.

5. Graze to Your Stomach’s Content to Ease Morning Sickness

Low blood sugar can trigger morning sickness nausea, and it may occur when you wake up or anytime you go hours without food. Grazing on nutritious mini-meals throughout the day keeps your stomach satisfied and your blood sugar steady.

6. Nibble, Nibble and Nibble on Stomach-Friendly Foods

Because high-fat, spicy and some high-fiber foods are harder to digest, consume easily digestible foods to ease morning sickness, such as liquids, smoothies, yogurts and low-fat, high-carb foods. Avoid hard-to-digest fatty foods and fried foods when experiencing morning sickness, such as premium ice cream, french fries and fried chicken.

7. Eat Nutrient-Dense Foods

Include California avocados, kidney beans, cheese, fish, nut butter, whole-grain pasta, brown rice, tofu and turkey. If peanut butter is too strong, try almond or cashew butter, and spread it thinly on crackers, bread, apple slices or celery sticks.

8. Avoid Dehydration by Eating Foods that Stimulate Thirst

Remember the three P’s (pickles, potato chips and pretzels) to avoid letting your saliva hit an empty stomach. An empty stomach is hypersensitive to saliva, and nausea will soon follow. Ease morning sickness by lining your stomach with milk, yogurt or ice cream before eating a saliva-stimulating food such as salty foods, or dry foods such as crackers. Try peppermint candies or gum to help with nausea, but not on an empty stomach. Also chew gum containing sugar to avoid chemical sweeteners, and eat foods with a high water content to ease dehydration that aggravates nausea. You should include melons, grapes, frozen fruit bars, lettuce, apples, pears, celery and rhubarb.

9. Take Prenatals with your Biggest Meal

Vitamins can be a big trigger of nausea and morning sickness — unless they are taken with a large meal.

10. Eat High-Energy Foods

Complex carbohydrates act as time-release energy capsules, slowly releasing energy into your bloodstream and helping to keep your appetite satisfied. The main food group represented here is grains (rice, corn, wheat, oats, millet, barley), found in breads, cereals, pastas and crackers.

11. Stick to Feel-Better Favorites that Ease Morning Sickness

Make a list of foods that help you ease morning sickness. While this list may change, it can help you avoid food triggers that make you ill.

12. Make Yourself Eat

No matter whether you feel like it or not—eat something. If you don’t eat, you will get an acid-filled stomach and low blood sugar.

13. Get Out and See the World

Visit friends, go to a movie, rest in a hammock, take a walk at lunchtime or go to a park with friends. Any change of scenery may provide a stomach-settling distraction to morning sickness.

14. Drive, Don’t Ride

Some women find that by doing the driving instead of riding, they have less of a morning sickness problem. This explains why the helmsman on a boat is the least likely to get seasick.

15. Delegate, Delegate, Delegate

Ease morning sickness by delegating tasks to “Mr. Mom” or to older kids. Post a list of “These things bother mom…These things make mom feel better.” Let your spouse mop the floor, cook easier meals, and if the entire family has to eat cheese, crackers and carrots for a few meals, they will survive.

16. Plan Ahead

If you know what makes you miserable, arrange for detours around the things that trigger nausea. Follow this checklist:

If cooking odors bother you, consider cooking and freezing foods on days you feel well.

Buy more convenience foods.

If you are invited to another home for dinner, offer to bring a dish you know you’ll be able to eat.

Carry your reliable edibles with you. When a hunger surge hits, the nausea is sure to follow if you don’t have a tried-and-true tidbit handy.

17. Ease Morning Sickness by Reducing Stress

Prenatal researchers feel it’s better for a baby in utero to be spared a steady barrage of stress hormones—and stress can increase your nausea cycle. Learning to reduce stress now is good practice for maintaining serenity as a new mother. Remind yourself that what your baby needs most is a happy, rested mother, both before and after birth.

18. Try Acupuncture

Both Eastern and Western medical practitioners describe a pressure point about two inches above the crease on the inner aspect of the wrist. If this pressure point is stimulated, it may relieve nausea and vomiting associated with pregnancy. With other conditions similar to morning sickness, such as seasickness, Sea Bands® can be worn around one or both wrists. Each band contains a button to press on the vomiting-sensitive pressure point. These bands have been proven effective by research studies and are available without prescription at pharmacies and marine stores.

19. Dress Comfortably

Wearing loose clothing can help ease morning sickness. Many mothers find that anything pressing on their abdomen, waist or neck is irritating and nausea triggering.

20. Position Yourself for Comfort

Heartburn is another common part of the morning sickness package. This burning feeling, caused by reflux of stomach acids into the lower esophagus, occurs more frequently during pregnancy when hormones, again, relax the stomach walls. For heartburn, keep upright or lie on your right side after eating. Lying on your back is more likely to aggravate heartburn.

21. Sleep it Off

It’s fortunate that the extreme need for sleep coincides with the morning sickness phase, so you will want to ensure that sleep goes on as long as possible.

22. Have One Last Meal Before Bed

Before going to bed, eat a meal or snack, preferably fruit and long-acting complex carbohydrates (grains and bland pasta) to ease morning sickness. These foods slowly release energy into your bloodstream throughout the night, but are unlikely to keep you awake. Add to these natural antacid foods—milk, ice cream and yogurt— to neutralize upsetting stomach acids as you drift off to sleep. Also consider taking chewable calcium tablets, which act as antacids, before retiring or upon awakening.

23. Eat Anyway!

While it’s not uncommon for women to feel that nothing tastes good, not eating can actually aggravate the cycle of morning sickness nausea.

24. Be Positive to Ease Morning Sickness

Lastly, choose who you share your misery with. Mothers who have been there and felt morning sickness will understand; others won’t. When you’re having a day you can’t keep anything down, keep your eyes on the prize—the precious baby-to-be!

    

Uterine Fibroids: Everything You Need To Know


Fibroids (leiomyomata uteri) are the most common benign tumors of the uterus. They usually come in a variety of shapes and sizes, as well as numbers, in the uterus. Very rarely do they turn to cancer – the exact incidence being less than 1% in a patient’s lifetime. Women who are at risk usually have a family history, are Black or Hispanic, and may have an elevated Body Mass Index (BMI). As a matter of fact, because we are seeing more women with an increase in BMI, Caucasian women are presenting with fibroids more frequently as well. While there is still a lot to understand about the development of fibroids, they grow for two reasons: hormones, in particular estrogen, and blood supply.

Fibroids can be located in different parts of the uterus. There are some fibroids that are located underneath the surface of the uterus, which are called subserosal; these generally do not cause bleeding but can cause pressure. There are those that are embedded in the muscle of the uterus, which are called intramural. Finally, there are those fibroids that affect the lining of the uterus, which are called submucosal, and these are the ones that usually present with excessive bleeding.

Symptoms and Tests

The most common symptoms of fibroids are heavy bleeding, pressure, increased frequency in urination and pelvic pain. Although most fibroids do not usually cause pain, if they outgrow their blood supply, it can cause pain due to degeneration (which means tissue breakdown). Fibroids are usually diagnosed with a pelvic exam and a pelvic sonogram. Transvaginal sonography is very good at detailing whether a fibroid is affecting the uterine lining or not.

Treatment

While the leading cause of hysterectomies is fibroids, there are many more conservative treatments that are available now. Birth control pills are one of these treatments; not only can they suppress bleeding, but they can also suppress the hormones that can control the growth of the fibroid. Decreasing weight also decreases the amount of exogenous estrogens that can control the growth as well. Uterine artery embolization can cut off the blood supply to the uterus, thus controlling growth and bleeding. In the case of submucosal fibroids, they can be resected hysteroscopically by going into the uterus and removing the fibroid through the vagina. Another procedure called a myomectomy just removes the fibroids, thus conserving the uterus. Lastly, you can also just watch them: If they don’t bother you, don’t bother them. Specific treatment modalities should be discussed with your physician to see what works best for you.

Types of Fibroids

All uterine fibroids are made of abnormal uterine muscle cells growing in a tight bundle or mass.

Uterine fibroids are sometimes classified by where they grow in the uterus:

  • Myometrial (intramural) fibroids are in the muscular wall of the uterus.
  • Submucosal fibroids grow just under the interior surface of the uterus, and may protrude into the uterus.
  • Subserosal fibroids grow on the outside wall of the uterus.
  • Pedunculated fibroids usually grow outside of the uterus, attached to the uterus by a base or stalk.

Uterine fibroids can range in size, from microscopic to several inches across and weighing tens of pounds.

Symptoms of Uterine Fibroids

Most often, uterine fibroids cause no symptoms at all -- so most women don’t realize they have them. When women do experience symptoms from uterine fibroids, they can include:

  • Prolonged menstrual periods (7 days or longer)
  • Heavy bleeding during periods
  • Bloating or fullness in the belly or pelvis
  • Pain in the lower belly or pelvis
  • Constipation
  • Pain with intercourse

Some experts believe that some uterine fibroids can occasionally interfere with fertility and pregnancy. Although it's rare, a uterine fibroid projecting into the uterus might either block an embryo from implanting there, or cause problems with the pregnancy later.

Effects on Pregnancy

One of the most common concerns that I am asked about in my clinical practice is whether the patient can become pregnant with a fibroid. Again, location is key. Depending on where it is, whether it affects the cavity where the baby grows or blocks the fallopian tube for fertilization, treatment will be dictated by these factors. If those issues are not present, women can become pregnant and have a normal pregnancy. All these issues should be discussed with your physician prior to pregnancy to determine your specific needs. Fibroids will grow during pregnancy, often experiencing the greatest growth during the first trimester.

Conclusion

Although intimidating at first, fibroids are not as scary as they sound. Not everyone must have them removed, and a solid relationship with your physician will help guide you as to the best treatment.

If you are ever in doubt, seek a second opinion. If your physician does not perform minimally invasive procedures, there are many specialists that do.

 

Source: DoctorOz, WebMD

Antidepressants: Safe during pregnancy?


Taking antidepressants during pregnancy might pose health risks for your baby — but stopping might pose risks for you. Get the facts about antidepressants and pregnancy.

Antidepressants are a primary treatment option for most types of depression. Antidepressants can help relieve your symptoms and keep you feeling your best — but there's more to the story when you're pregnant or thinking about getting pregnant. Here's what you need to know about antidepressants and pregnancy.

How does pregnancy affect depression?

Pregnancy hormones were once thought to protect women from depression, but researchers now say this isn't true. In addition, pregnancy can trigger a range of emotions that make it more difficult to cope with depression.

Is treatment important during pregnancy?

Depression treatment during pregnancy is essential.

If you have untreated depression, you might not seek optimal prenatal care, eat the healthy foods your baby needs or have the energy to care for yourself. You also might turn to smoking or drinking alcohol. The result could be premature birth, low birth weight or other problems for the baby — and an increased risk of postpartum depression for you, as well as difficulty bonding with the baby.

Are antidepressants an option during pregnancy?

A decision to use antidepressants during pregnancy is based on the balance between risks and benefits. Overall, the risk of birth defects and other problems for babies of mothers who take antidepressants during pregnancy is very low. Still, few medications have been proved safe without question during pregnancy, and some types of antidepressants have been associated with health problems in babies.

Which antidepressants are considered OK during pregnancy?

Generally, these antidepressants are an option during pregnancy:

  • Certain selective serotonin reuptake inhibitors (SSRIs). SSRIs are generally considered an option during pregnancy, including citalopram (Celexa), fluoxetine (Prozac) and sertraline (Zoloft).
  •  Serotonin and norepinephrine reuptake inhibitors (SNRIs). SNRIs are also considered an option during pregnancy, including duloxetine (Cymbalta) and venlafaxine (Effexor XR).
  • Bupropion (Wellbutrin). This medication is used for both depression and smoking cessation. Although bupropion isn't generally considered a first line treatment for depression during pregnancy, it might be an option for women who haven't responded to other medications or those who want to use it for smoking cessation as well.
  • Tricyclic antidepressants. This class of medications includes amitriptyline and nortriptyline (Pamelor). Although tricyclic antidepressants aren't generally considered a first line or second line treatment, they might be an option for women who haven't responded to other medications.

Some research associates use of citalopram, fluoxetine and sertraline with a rare but serious newborn lung problem (persistent pulmonary hypertension of the newborn) when taken during the last half of pregnancy.

Other rare birth defects have been suggested as a possible risk in some studies, but not others. Still, the overall risks remain extremely low.

Which antidepressants should be avoided during pregnancy?

The SSRI paroxetine (Paxil) is generally discouraged during pregnancy. Some research suggests that Paroxetine may be associated with a small increase in fetal heart defects.

In addition, monoamine oxidase inhibitors (MAOIs) — including phenelzine (Nardil) and tranylcypromine (Parnate) — are generally discouraged during pregnancy. MAOIs might limit fetal growth.

Are there any other risks for the baby?

If you take antidepressants throughout pregnancy or during the last trimester, your baby might experience temporary discontinuation symptoms — such as jitters or irritability — at birth. However, tapering dosages near the end of pregnancy isn't generally recommended. It's not thought to minimize newborn withdrawal symptoms. In addition, it might pose challenges for you as you enter the postpartum period — a time of increased risk of mood and anxiety problems.

Should I switch medications?

The decision to continue or change your antidepressant medication is up to you and your health care provider. Concerns about potential risks must be weighed against the possibility that a drug substitution could fail and cause a depression relapse.

What happens if I stop taking antidepressants during pregnancy?

If you stop taking antidepressants during pregnancy, you risk a depression relapse. In addition, stopping an SSRI abruptly might cause various signs and symptoms, including:

  • Nausea and vomiting
  • Chills
  • Fatigue
  • Anxiety
  • Irritability

What's the bottom line?

If you have depression and are pregnant or thinking about getting pregnant, consult your health care provider. Sometimes mild to moderate depression can be managed with psychotherapy, including counseling or other therapies. If your depression is moderate to severe or you have a recent history of depression, the risk of relapse might be greater than the risks associated with antidepressants.

Deciding how to treat depression during pregnancy isn't easy. The risks and benefits of taking medication during pregnancy must be weighed carefully. Work with your health care provider to make an informed choice that gives you — and your baby — the best chance for long-term health.

Postpartum Hemorrhage


Is it normal to bleed a lot after delivery?

All women lose some blood as the placenta separates from the uterus and immediately afterward. And women who have C-sections generally lose more than those who give birth vaginally. But because the amount of blood in your body increases by almost 50 percent during your pregnancy, your body is well prepared to deal with this expected blood loss.

Normal bleeding just after childbirth is primarily from open blood vessels in the uterus, where the placenta was attached. (If you had an episiotomy or tear during birth, you may also bleed from that site until it's stitched up.)

As the placenta begins to separate, these vessels bleed into the uterus. After the placenta is delivered, the uterus usually continues to contract, closing off these blood vessels.

Your healthcare practitioner may massage your uterus and give you a synthetic form of the hormone oxytocin (Pitocin) to help the uterus contract. Breastfeeding, which prompts your body to release oxytocin naturally, can also aid in the process.

Unfortunately, some women bleed too much after birth and require special treatment. This excessive blood loss is called a postpartum hemorrhage (PPH) and it happens in up to 6 percent of births.

It's most likely to occur while the placenta is separating or soon after. If it happens within 24 hours after giving birth, it's considered an early PPH (also called an immediate or primary PPH). If it happens in the days or weeks after delivery, it's called a late (or delayed or secondary) PPH.

What else might cause a PPH?

Occasionally, cervical lacerations, deep tears in your vagina or perineum, or even a large episiotomy may be the source of a postpartum hemorrhage. A ruptured or inverted uterus may cause profuse bleeding, but these are relatively rare occurrences.

Finally, a systemic blood clotting disorder may cause a hemorrhage. (A clotting disorder may be an inherited condition or it may develop during pregnancy as a result of certain complications, such as severe preeclampsia or HELLP syndrome or a placental abruption.) And a hemorrhage itself can cause clotting problems, leading to even heavier bleeding.

What's the treatment for PPH?

There are a number of steps that your medical team will take right away if you begin to bleed excessively. Since uterine atony (loss of tone) is the most common cause of PPH, your caregiver will massage your uterus to help it contract while you get intravenous oxytocin. (If you don't already have an IV, the nurse will start one immediately.) You will also be catheterized to make sure your bladder is empty since a full bladder makes it more difficult for your uterus to contract.

If your placenta hasn't come out yet, your practitioner will attempt to deliver it, which in some cases requires her to reach up inside your uterus and remove it manually. You'll receive some pain medication before the procedure, and if you're in a birthing room you'll be moved to an operating room.

If you start bleeding – or continue to bleed – from your uterus after the placenta is out, you'll receive other medications in addition to oxytocin while your caregiver continues to massage your uterus. In most cases, the medication works very quickly and the uterus contracts, stopping the bleeding.

If need be, your practitioner will insert a hand inside your vagina and place her other hand on your belly, and compress your uterus between her two hands. This measure in combination with medication is usually enough to stem the tide.

If you continue to bleed, you'll be transferred to the operating room and given pain medication to keep you comfortable. The doctor will carefully check to make sure that there are no lacerations that appear to be the primary source of your bleeding. She will also "explore" your uterus (via your vagina) to check for fragments of the placenta that may remain. In some cases, you'll need a procedure called dilation and curettage (D&C) to remove them.

If your bleeding is extensive and doesn't stop or your vital signs aren't stable, you'll get a blood transfusion. This is necessary only in rare cases. Even more rarely, you'll need abdominal surgery and possibly a hysterectomy to stop a hemorrhage.

Regardless of the cause of the hemorrhage, your blood pressure and pulse will be taken frequently to help your caregiver gauge how your body is coping with the blood loss. (This is done right after birth anyway to help determine the amount of postpartum blood loss.) An abnormally low blood pressure or high pulse will provide your caregiver with valuable information.

You'll also have blood tests to check for anemia and, if necessary, to see whether your blood is clotting normally.

What's the recovery like?

You'll continue to receive IV fluids and medication after the bleeding is controlled to help your uterus stay contracted, and you'll be watched very closely for further bleeding and to see how you're doing in general. You may feel weak and lightheaded. Don't try to get out of bed on your own.

Your recovery will depend in part on how much blood you lost and what your "reserves" were to begin with – that is, how much your blood volume had increased during pregnancy and whether or not you were anemic to begin with.

You'll probably develop anemia from the blood loss and will have to take it easy when you get home from the hospital. You'll need to get plenty of rest, fluids, and nutritious food. Your doctor will likely prescribe prenatal vitamins with folic acid, as well as additional iron supplements.

 

Source: Babycenter

TDAP Vaccine: What You Need to Know.


Why get vaccinated?

Tetanus, diphtheria, and pertussis are very serious diseases. Tdap vaccine can protect us from these diseases.  And, Tdap vaccine given to pregnant women can protect newborn babies against pertussis.

TETANUS (Lockjaw) is rare in the United States today. It causes painful muscle tightening and stiffness, usually all over the body.

  • It can lead to tightening of muscles in the head and neck so you can’t open your mouth, swallow, or sometimes even breathe. Tetanus kills about 1 out of 10 people who are infected even after receiving the best medical care.

DIPHTHERIA is also rare in the United States today. It can cause a thick coating to form in the back of the throat.

  • It can lead to breathing problems, heart failure, paralysis, and death.

PERTUSSIS (Whooping Cough) causes severe coughing spells, which can cause difficulty breathing, vomiting, and disturbed sleep.

  • It can also lead to weight loss, incontinence, and rib fractures. Up to 2 in 100 adolescents and 5 in 100 adults with pertussis are hospitalized or have complications, which could include pneumonia or death.

These diseases are caused by bacteria. Diphtheria and pertussis are spread from person to person through secretions from coughing or sneezing. Tetanus enters the body through cuts, scratches, or wounds.

Before vaccines, as many as 200,000 cases of diphtheria, 200,000 cases of pertussis, and hundreds of cases of tetanus, were reported in the United States each year. Since vaccination began, reports of cases for tetanus and diphtheria have dropped by about 99% and for pertussis by about 80%.

Tdap vaccine

Tdap vaccine can protect adolescents and adults from tetanus, diphtheria, and pertussis. One dose of Tdap is routinely given at age 11 or 12.  People who did not get Tdap at that age should get it as soon as possible.

Tdap is especially important for health care professionals and anyone having close contact with a baby younger than 12 months. 

Pregnant women should get a dose of Tdap during every pregnancy, to protect the newborn from pertussis.  Infants are most at risk for severe, life-threatening complications from pertussis.

Another vaccine, called Td, protects against tetanus and diphtheria, but not pertussis. A Td booster should be given every 10 years. Tdap may be given as one of these boosters if you have never gotten Tdap before.  Tdap may also be given after a severe cut or burn to prevent tetanus infection.

Your doctor or the person giving you the vaccine can give you more information.

Tdap may safely be given at the same time as other vaccines.

Do not get this vaccination if you are: 

  • A person who has ever had a life-threatening allergic reaction after a previous dose of any diphtheria, tetanus or pertussis containing vaccine, OR has a severe allergy to any part of this vaccine, should not get Tdap vaccine. Tell the person giving the vaccine about any severe allergies.
  • Anyone who had coma or long repeated seizures within 7 days after a childhood dose of DTP or DTaP, or a previous dose of Tdap, should not get Tdap, unless a cause other than the vaccine was found.  They can still get Td.
  • Talk to your doctor if you: 
    • have seizures or another nervous system problem
    • had severe pain or swelling after any vaccine containing diphtheria, tetanus or pertussis,
    • ever had a condition called Guillain Barré Syndrome (GBS)
    • aren't feeling well on the day the shot is scheduled.

Risks

With any medicine, including vaccines, there is a chance of side effects. These are usually mild and go away on their own. Serious reactions are also possible but are rare.

Most people who get Tdap vaccine do not have any problems with it. Mild problems following Tdap:

  • Pain where the shot was given (about 3 in 4 adolescents or 2 in 3 adults)
  • Redness or swelling where the shot was given (about 1 person in 5)
  • Mild fever of at least 100.4°F (up to about 1 in 25 adolescents or 1 in 100 adults)
  • Headache (about 3 or 4 people in 10)
  • Tiredness (about 1 person in 3 or 4)
  • Nausea, vomiting, diarrhea, stomach ache (up to 1 in 4 adolescents or 1 in 10 adults)
  • Chills, sore joints (about 1 person in 10)
  • Body aches (about 1 person in 3 or 4)
  • Rash, swollen glands (uncommon)

Moderate problems following Tdap (Interfered with activities, but did not require medical attention):

  • Pain where the shot was given (up to 1 in 5 or 6)
  • Redness or swelling where the shot was given (up to about 1 in 16 adolescents or 1 in 12 adults)
  • Fever over 102°F (about 1 in 100 adolescents or 1 in 250 adults)
  • Headache (about 1 in 7 adolescents or 1 in 10 adults)
  • Nausea, vomiting, diarrhea, stomach ache (up to 1 or 3 people in 100)
  • Swelling of the entire arm where the shot was given (up to about 1 in 500).

Severe problems following Tdap (Unable to perform usual activities; required medical attention):

  • Swelling, severe pain, bleeding, and redness in the arm where the shot was given (rare).

Problems that could happen after any vaccine:

  • People sometimes faint after a medical procedure, including vaccination. Sitting or lying down for about 15 minutes can help prevent fainting, and injuries caused by a fall. Tell your doctor if you feel dizzy, or have vision changes or ringing in the ears.
  • Some people get severe pain in the shoulder and have difficulty moving the arm where a shot was given. This happens very rarely.
  • Any medication can cause a severe allergic reaction. Such reactions from a vaccine are very rare, estimated at fewer than 1 in a million doses, and would happen within a few minutes to a few hours after the vaccination.

As with any medicine, there is a very remote chance of a vaccine causing a serious injury or death.

The safety of vaccines is always being monitored. For more information, visit the Vaccine Safety site. 

SOURCE: cdc.gov