December 29, 2010
Filed under: Baby health — Alan @ 8:35 am
A multiple pregnancy is a risky pregnancy for both the mother and the children. The pregnant women themselves have a threefold increased mortality rate. Hyperemesis gravidarum frequently occurs in early pregnancy, and the occurrence of gestosis is seen later in pregnancy. The preterm delivery rate is significantly increased.
In late pregnancy there is retardation of the growth of the fetuses – occurring in twin pregnancies from the 34th-35th weeks of pregnancy, and for triplets starting from the 28th week. Fourteen-day check-ups are recommended to determine the different growth of individual fetuses up to the 28th week, followed by 7-day check-ups.
In a multiple pregnancy, the following complications occur more frequently:
Increased water retention, especially in the legs,
Impairment of maternal abdominal organs due to the large uterus (e.g., urinary or bowel problems),
Pregnancy-hypertension (hypertension), due to pre-eclampsia,
Varicose veins (varices),
Anaemia,
Upstream placenta (placenta previa) and placental abruption,
Impaired function of the placenta (placental insufficiency) with the growth of the child,
Shortened cervix and premature opening of the cervix (cervical insufficiency),
Blood transfers between the multiples (Twin-to-twin transfusion syndrome TTTS), which means that one of the twins receives more blood than the other. Usually in this case a microsurgical closure of the vessel formation is necessary,
Excessive amniotic fluid formation (polyhydramnios),
Wrapped umbilical cords.
A more severe effect, especially with pregnancies of triplets and greater multiples, is the possibility of selective feticide, i.e., the prenatal reduction of multiple pregnancies. Here, there is a medical indication that at least one of the unborn children is killed, either because it is disabled or because there is a need to increase the survival and development opportunities of the other fetuses.
As a rule, prenatal examinations precede the decision for selective feticide. Such examinations will study whether a child may have an illness or disability that could facilitate the choice of the child to be killed. In the absence of such evidence, the youngest child is usually selected and either killed by lethal injection or by stopping the supply to its vessels. The risk that all of the children will ultimately be lost by a miscarriage that is caused by the operation averages 15 percent.
December 21, 2010
Filed under: Baby health — Alan @ 10:32 pm
Health centres may be with birthing rooms and will have different procedures and protocols of care during delivery. Among the most frequently used to monitor the mother and baby are:
Auscultation: the monitoring of the fetal heart rate (FHR) using a stethoscope or ultrasound. In some schools it is customary to print the control of the heartbeat of the fetus, and others are outlined in a pantograph for the childbirth care staff. Listening to the FHR is recommended intermittently for 60 seconds at least every 15 minutes in the stage of labour, and every five minutes over the period of delivery. Intermittent auscultation should be discontinued and replaced by continuous monitoring when changes occur in the FCF or upon the advance of delivery.
Uterine dynamics: the control of uterine contractions can be done mechanically, using a manometer, and occasionally with an intrauterine pressure catheter that provides more accurate readings of uterine contractions and fetal heartbeat.
Vital signs such as pulse, blood pressure and respiratory rate of the mother should be controlled during labour. All these values are recorded in a pantograph that lasts the duration of labour.
The vaginal examination is the most accepted method to assess the progress of labour. The number of contacts must be limited to those strictly necessary. These are usually experienced by women as a source of anxiety, and an invasion of their privacy and intimacy. Whenever possible, it should be done by the same midwife as it is a measure with a component of subjectivity.
Clinical surveillance of the evolution of labour can prevent, detect and manage the development of complications that can lead to damage, sometimes irreversible or fatal, to mother or newborn infant. The study of fetal heart rate is the method most currently used to ascertain the state of oxygenation of the fetus.
The monitoring of fetal heart rate (FHR) during labour can be performed intermittently by Pinard stethoscope or by using ultrasound (Doppler) in low-risk women with a normal evolution of labour.
December 15, 2010
Filed under: Baby health — Alan @ 10:31 pm
In the first three months of pregnancy there is a relatively large increased risk of suffering a miscarriage. An estimated quarter of all pregnancies end in the first 12 weeks. Only 25% of all fertilized eggs end with the birth of a living child. The majority are implanted into the uterus without the woman noticing it.
The miscarriage is regarded as a delayed menstrual period. A consciously perceived miscarriage can be a very traumatic experience for a woman. To address any disappointments and the social pressures, it is widely accepted to wait for 12 weeks before the official announcement of the pregnancy.
In contrast to the early and spontaneous abortions, an abortion is deliberately aborting the pregnancy. As for medical reasons, it will be considered due to a health risk to pregnant women or a serious mental disability of the foetus.
Abortions for medical reasons, however, are quite rare.. Although in most cases, the psychological burden of the birth of a severely disabled child, gives rise to the risk of the health of the woman.
Other impairments
Before, during or after pregnancy can lead to further deteriorations. See:
Infertility
Pregnancy outside the uterus (ectopic pregnancy)
Stretch marks in the fabric
Laceration in childbirth
Post-partum depression
Postnatal Depression
December 14, 2010
Filed under: Uncategorized — Alan @ 10:28 pm
The uterus is a female sexual organ, in which the fertilized egg matures before birth. All female mammals have a uterus. Processes occurring within the uterus are described by the adjective ‘in utero’.
The shape of the uterus of the woman resembles an upside-down pear and at the upper end of the uterus is the fundus of the uterus, the fallopian tubes (tubes). Next to the uterine fundus it is divided into a body (corpus uteri), an isthmus and the cervix (cervix uteri), which is divided into the peg of the vagina, cervix, and the outstanding portion overlying supra-vaginal.
In a woman who has not had a baby, it is, on average, about 7cm long. The normal situation is the so-called ante version, which means the womb is inclined from the vagina to the front. The degree of inclination is dependent on the filling of the bladder and rectum.
In addition, the uterus has a bend between the body and neck, which is called ante flexion. For an enlarged uterus (e.g. by prolonged confinement in a supine position, during pregnancy), a bending backward (retro flexion) may occur. A back tilt of the stretched uterus is called retroversion, in combination with a bend backwards.
Neighbouring institutions of the uterus are the bladder in front of it, the underlying bowel to the front and ovaries to the side. The side of the uterus are the pelvic vessels, below the pelvic floor. The connective tissue supporting structures of the uterus consist of several bands called the parametrium.
The blood supply of the upper part of the institution is on the abdominal aorta, outgoing ovarian artery, the lower part of the internal iliac artery and the outgoing uterine artery.
Layer
The uterus, like all the hollow organs, are made up of three layers. Outside lies the perimetrium, a smooth glossy coating of the serosa. The main part of the wall forms a layer of smooth muscle, the myometrium. The liner is a mucous membrane, which is called the endometrium.
The inner cavity is called the cavum uteri. The endometrium is controlled in the monthly cycle. If fertilization does not take place, then occurs primate menstrual bleeding (menstruation).
Non-human primates also show cyclical changes in the endometrium during the sexual cycle. There is no menstruation it with them, however. For a successful fertilization and implantation of the fertilized ovum (zygote), it continues to grow and makes the uterine lining to supply the growing embryo, safe. After the birth in primates, the endometrium to the placenta is expelled as the afterbirth.
Change in size during pregnancy
The uterus rises developmentally. The prepubertal uterus is relatively small. After puberty in humans in are 50 – 10 inches tall and expands greatly during pregnancy from the top and sides. It reaches by the end of pregnancy, up to the ribs. After delivery, it shrinks back. After menopause, it is smaller again.
December 11, 2010
Filed under: Baby health — Alan @ 4:26 am
Recent studies suggest that pregnant women who talk on their cell phones for long periods of time every day may be putting their children at risk for emotional or behavioural problems by the age of seven. A report published in the Journal of Epidemiology and Community Health indicates that the risk of such problems is 50% greater in children who were exposed to the radiation from cell phones in the womb and in early childhood than in those who were not exposed at all, or minimally.
There is also a 20% greater risk of behavioural problems in children who began using a cell phone before age seven, according to this study, which focused on about 28,000 children aged seven and their mothers. The women were asked to supply specific information about various aspects of their lifestyles, including cell phone usage, during and after their pregnancies. The children’s behaviour was analyzed at approximately seven years of age and the results overall showed an increase of between 10% and 80% in the incidence of behavioural problems, depending on the amount of exposure by mothers and children.
Research in other countries has yielded similar results over the past three or four years, and health officials in Europe and the U.S. are concerned about the public health issue involving cell phones. Most of them stress that this research is not conclusive, and that more is required to establish a causal effect on children’s behaviour. However, many are advising that warnings should be issued on the subject.
Though no research has been published on human brain structure relative to this phenomenon, a Canadian study published recently showed that pregnant rats exposed to similar radiation revealed a change in brain structure in the offspring.
December 4, 2010
Filed under: Baby health — Alan @ 5:05 am
Neonatal care in Wales is far below the standards published by the assembly government in 2008, according to Bliss, a special care baby charity organization. In the sixth annual Bliss Welsh baby report they called ‘Still A Long Way To Go’, the agency gave its findings on progress that has been made in the amount and quality of care for the most vulnerable babies. Apparently there has been very little since recommendations were made in 2005.
In many cases, premature babies and babies that are seriously ill cannot get the treatment they need because of staffing shortages and lack of facilities. The Bliss report noted that four out of six units answering questions about staffing said they did not have enough funded nursing positions to meet the minimum standard. Eight out of nine surveyed said the lack of staff meant that often they were unable to provide special care even to babies born in their own hospital, and had to close their doors to babies needing care that were born elsewhere.
Ideally the ratio of qualified nursing staff to babies needing special care should be one-to-one, but with current staffing levels it’s not even close. This also leads to babies being transported to other facilities, often far from their birthplace and even out of Wales, and the strain on both babies and parents can be tremendous. To add to the problem, there is a lack of dedicated transport for getting the babies to and from medical facilities. A 12-hour service is being set up, but is still not fully operational, and even then will not be up to the 24-hour standard set in Scotland and England.
Again ideally, neonatal care units should be working at about 80% capacity, to allow for unexpected emergencies and to allow the staff to provide optimum care at all times. According to the Bliss report, four out of seven units surveyed responded that they work well over the recommended ratio of capability to demand.
