Placenta previa, the implantation of the placenta at least partially covering the cervix, occurs in about one in 200 pregnancies. There are actually three types of previa.
Complete previa where the cervical os, the mouth of the uterus, is completely covered. Partial previa where just a portion of the cervix is covered by the placenta. And the marginal previa that extends just to the edge of the cervix. Diagnosing a previa is usually made when there is painless bleeding during the third trimester. If you are bleeding it is unwise to do a vaginal exam until an ultrasound has ruled out a placenta previa. However, there is a 10% false positive diagnosis rate, usually because of the bladder being over full. There is also a 7% false negative rate, typically caused from missing the previa that is located behind the baby's head. Other reasons to suspect a previa would sometimes be premature contractions, abnormal lie (breech, transverse, etc.), or the uterus measuring larger than you should according to dates. During second trimester ultrasounds, done in some places on a routine basis, will show that there are many more previas diagnosed at this stage. Typically at 16 weeks the placenta takes up 25-50% of the surface area. Also the third trimester brings a growth of this lower uterine segment, that out flanks the growth of the placenta. For these reasons, while 5% of pregnancies are diagnosed with complete previa in second trimester ultrasounds will see 90% of them resolved by term and while 45% of pregnancies are diagnosed with marginal previas will see 95% resolved at term. A follow up ultrasound will be done, and as noted above the vast majority of previas are not seen. True placenta previa at term is very serious. Complications for the baby include:
Problems for the baby, secondary to acute blood loss
Intrauterine growth restriction (IUGR) due to poor placental perfusion
Increased incidence of congenital anomalies
Risks for the mother include:
Life-threatening hemorrhage
Cesarean delivery
Increased risk of postpartum hemorrhage
Increased risk placenta accreta (Placenta accreta is where the placenta attaches directly to the uterine muscle.)
Placenta previa, once diagnosed, will usually mean bed rest for the mother, frequently in the hospital. Depending on the gestational age steroid shots may be given to help mature the baby's lungs. If the bleeding cannot be controlled immediate cesarean delivery is usually done, regardless of the length of the pregnancy. Some marginal previas can be delivered without cesarean surgery, the other types of placenta previa preclude vaginal delivery.
An ectopic pregnancy occurs when the fertilized egg attaches itself in a place other than inside the uterus. Almost all ectopic pregnancies occur in a fallopian tube, and are thus sometimes called tubal pregnancies. The fallopian tubes are not designed to hold a growing embryo; the fertilized egg in a tubal pregnancy cannot develop normally and must be treated. An ectopic pregnancy happens in 1 out of 60 pregnancies.
What causes an ectopic pregnancy?
Ectopic pregnancies are caused by one or more of the following:
An infection or inflammation of the fallopian tube can cause it to become partially or entirely blocked.
Scar tissue left behind from a previous infection or an operation on the tube may also impede the egg's movement.
Previous surgery in the pelvic area or on the tubes can cause adhesions.
An abnormality in the tube's shape can be caused by abnormal growths or a birth defect.
Who is at risk for having an ectopic pregnancy?
Women who are more at risk for having an ectopic pregnancy include the following:
Are 35-44 years of age
Have had a previous ectopic pregnancy
Have had pelvic or abdominal surgery
Have Pelvic Inflammatory Disease (PID)
Have had several induced abortions
Women who get pregnant after having a tubal ligation or while an IUD is in place
What are the symptoms of an ectopic pregnancy?
Although you may experience typical signs and symptoms of pregnancy, the following symptoms may be used to help recognize a potential ectopic pregnancy:
Sharp or stabbing pain that may come and go and vary in intensity. The pain may be in the pelvis, abdomen or even the shoulder and neck (due to blood from a ruptured ectopic pregnancy gathering up under the diaphragm).
Vaginal bleeding, heavier or lighter than your normal period
Gastrointestinal symptoms
Weakness, dizziness, or fainting
It is important for you to seek emergency care if you are experiencing sharp pain or have bleeding.
How is an ectopic pregnancy diagnosed?
Ectopic pregnancies are diagnosed by your physician, who will probably first perform a pelvic exam to locate pain, tenderness or a mass in the abdomen. Your physician will also use an ultrasound to determine whether the uterus contains a developing fetus.
The measurement of hCG levels is also important. An hCG level that is lower than what would be expected is one reason to suspect an ectopic pregnancy. Low levels of progesterone may also indicate that a pregnancy is abnormal.
Your physician may do a culdocentesis, which is a procedure that involves inserting a needle into the space at the very top of the vagina, behind the uterus and in front of the rectum. The presence of blood in this area may indicate bleeding from a ruptured fallopian tube.
How is an ectopic pregnancy treated?
An ectopic pregnancy may be treated in any of the following ways:
Methotrexate may be given, which allows the body to absorb the pregnancy tissue and may save the fallopian tube, depending on how far the pregnancy has developed.
If the tube has become stretched or it has ruptured and started bleeding, all or part of the fallopian tube may have to be removed. Bleeding needs to be stopped promptly, and emergency surgery is needed.
Laparoscopic surgery under general anesthesia may be performed. This procedure involves a surgeon using a laparoscope to remove the ectopic pregnancy and repair or remove the affected fallopian tube. If the ectopic pregnancy cannot be removed by a laparoscope procedure, then another surgical procedure called a laparotomy may be done.
What about my future?
Your hCG level will need to be rechecked on a regular basis until it reaches zero if you did not have your entire fallopian tube removed. An hCG level that remains high could indicate that the ectopic tissue was not entirely removed, which would require surgery or medical management with methotrexate.
The chances of having a successful pregnancy after an ectopic pregnancy may be lower than normal, but this will depend on why the pregnancy was ectopic and your medical history. If the fallopian tubes have been left in place, you have approximately a 60% chance of having a successful pregnancy in the future.
It's actually a misnomer. Morning sickness can strike at anytime of the day or night, sometimes all day and all night.
I recently read a book from the early 1990s that said morning sickness was now a thing of the past. I bet you'd have trouble explaining that to those of us who routinely wind up hanging our heads over the toilet.
In any case about 50% of all pregnant women will experience some form of nausea and vomiting during pregnancy. Trying to eat a healthy diet can become very difficult when you've also got to deal with problems like food aversions, a sensitive sniffer, and a growling, churning stomach. Here are some ideas to help you get along your days and nights, and hopefully feel a little bit better.
Eat something high in protein before going to bed. Helps your blood sugar stay more level.
Two crackers before your head leaves the pillow is old but wise advice.
Have sips of ice water as the urge to purge strikes. Many women say that this helps them keep meals down as well.
Flat Sprite® is supposedly great at keeping the stomach from churning.
Avoid foods and smells that seem to trigger nausea. Sometimes this will be nearly every food or every smell.
Ginger, teas, cookies, even the spice can be helpful in preventing nausea.
Acupressure bands can be worn like bracelets and can curb nausea while you wear them. But be forewarned as one mom says, stand next to a bucket when you take them off!
Smaller frequent meals can also help keep an ailing belly at bay.
Peppermint, either smelling it in aromatherapy form or sipping the tea can help curb nausea. It's also known to help with sagging energy levels.
Try peanut butter or other protein snack before rising from your bed.
A teaspoon of cider vinegar in a cup of warm water has been said to be effective.
Take a deep breath. It might be mind over matter sometimes.
Comfort foods! Eat what you can, if it stays down it is probably a good thing. Slowly add more foods to your diet as possible.
Sleep to avoid nausea. Hey, don't knock it until you've tried it.
One mom swears by cold veggies soaking in water to help relieve the churning feeling.
When possible avoid hunger, it can also make your stomach upset.
During early pregnancy, the main thing you will be concerned about is the next nine-months, interspersed with happiness and various symptoms that have to be dealt with. Apart from the usual nausea, heartburn, edema and backache, there are certain other complications that are likely to crop up. These can be minor and easily treated through medication or they can turn out to be risky for mother and baby. What are the pregnancy types to watch out for, during these months?
One condition to watch out for is an ectopic pregnancy. An ectopic or tubal pregnancy is an abnormal condition that occurs when the fertilized egg implants itself outside the uterus, probably in the fallopian tube. Suppose you have had a miscarriage earlier, you might need an ultrasound during early pregnancy to check for an ectopic pregnancy. As far as symptoms are concerned, they show during the sixth week of pregnancy. If spotted in time, you can be treated and save the pregnancy through medication or surgery.
Pregnancy is a totally natural state - but that does not mean it is easy! Another serious pregnancy problem is a lupus pregnancy, resulting in blood clotting problems and the risk of pre term delivery. Lupus has to do with your immune system as well and can affect vital organs. For most women with lupus, a successful pregnancy can happen. Understanding the problem can help find solutions. If you suffer from lupus, you will need to be in constant touch with a rheumatologist and obstetrician during the pregnancy. Preferably, do not risk pregnancy unless your disease has been in remission for at least six months since the medication you take can harm your fetus, resulting in damage and stillbirth.
Whether it is the first or second pregnancy, your body will probably behave differently through each pregnancy. You will naturally be quite excited though a bit worried about the new pregnancy with the unspoken fear of the possibility of something going wrong. More so - if you have experienced complications in your earlier pregnancy. The early pregnancy days can be full of discomfort, and your body undergoes major changes to adjust to the next 9 months. During a second pregnancy, you are more likely to be at ease since you've already been through the experience once. But you might want to know whether this will be different from the first and how. Usually second pregnancy symptoms show quicker than the first.
Twin pregnancies, on the other hand are considered risky. There is a possibility of complications for both you and the babies. But there are many women who just sail through twin pregnancies. Considering that since pregnancy involves a risk for every woman, an additional fetus just makes it riskier. Ensure that you keep all your doctor's appointments and take good care of your health, weight and diet.
The risks associated with teen pregnancy which is on the rise today are much more than with healthy adult women. Probably the main reason is that the teenage girl herself is not fully grown up yet, causing complications during the entire pregnancy unless precautions are taken. There is the likelihood of premature deliveries, and babies with low birth weight. Pregnant teenagers must enroll in prenatal care during early pregnancy stages.
No matter what the pregnancy type, it is wise to be aware of what to watch out for throughout your pregnancy - so that remedial action can be initiated.
Most articles about morning sickness cover all the various ways to try and prevent you from actually being sick. While this is always preferable, in the real world it's not always possible.
Many pregnant women will experience morning sickness is pregnancy, most of them will experience it in early pregnancy, though a few will have it in the third trimester. The unlucky ones experience both. While it can strike at any point during the day, it may cause the most problems if you're feeling ill during work time.
You may only experience the feeling of nausea, but not vomiting, or you might have both. Either way it's a good idea to plan ahead. One of the first things to think about is how you're going to safely get to and from work. You might consider public transportation or even car pooling if you're feeling nauseated or dizzy. Both of these can interfere with your ability to drive. This may not always be possible. In that case be sure to have your car prepared. A big glass of ice water can sometimes help, as well as driving with the window down or with the cool air on your face. Worst case scenario, have a couple of plastic grocery bags (without holes!) tucked near by. You can also pull over to a safe spot until the wave of nausea or vomiting passes.
Once you arrive at work you can freshen up if you've been ill on your way in. Some women find that eating as soon as they get up makes the ride to work more bearable. Deep breathing can also help delay these feelings for a few minutes.
At your desk you might want to plan the route to the nearest bathroom, or again keep those plastic grocery bags handy. Even a waste basket can be good, and usually there are plenty around. If you're lucky enough to have your own office, you can quietly shut the door. If you work in a cubicle try to borrow a private enclosed space or head to the employee lounge or restroom. Cool rags around your throat and on your forehead may also help.
You might even want to try and enlist some help from your office mates. They might be able to cover for you while you step away from your desk. The down side to this is if you wanted to keep the good news a surprise for awhile longer, this might make it harder to achieve. So be sure you place your trust in someone who can keep your secret until you're ready to share.
To freshen up after a bout with nausea or vomiting you can try a pocket toothbrush. If toothpaste is something that is making you nauseated you can try using children's tooth paste with different flavors, or a really soft bristled toothbrush. One mom told me that resorting to baking soda and salt as toothpaste really helped her get through those first few weeks. Another breath freshening technique is to use mints or even the square sheets of gelatin that are impregnated with mouth wash that melt quickly.
Hopefully you won't ever need this information. And here's to hoping it passes quickly if you do!
Would you be surprised to learn that you're carrying twins? Here's what you need to know about taking care of yourself and your babies. Would you be shocked to learn that you're carrying twins or triplets? It happens to about three percent of pregnant women. And that number is growing.
What's causing the twin pregnancy trend?
Many women are delaying having children to well into their 30s and beyond when age-related hormonal changes may cause more than one egg to be released at a time. This increases the chances of conceiving nonidentical or fraternal twins.
Because of decreased fertility in older women they are more likely to use reproductive technologies such as in vitro fertilization to conceive. Since these procedures involve implanting more than one fertilized egg in the uterus, they're more likely to result in twins or other multiples.
How twins are made
Fraternal twins, the most common kind occur when two separate eggs are fertilized by two different sperm. Each twin has his or her own placenta and amniotic sac. The twins can be two girls, two boys or a boy and a girl. Genetically, they're no more alike than any other siblings. Identical twins occur when a single fertilized egg splits and develops into two fetuses. Identical twins may share a placenta, but each baby usually has a separate amniotic sac. Genetically, the two babies are identical. They'll be the same sex and look exactly alike. Triplets and other higher order multiples can be identical, fraternal or a combination of both. But these births are rare.
Making the diagnosis
With modern medicine, multiple births are diagnosed long before delivery. The first clue is often a uterus that's larger than normal or more than one fetal heartbeat. Certain blood tests may suggest twins or other multiples as well. A suspected twin pregnancy is often confirmed with an ultrasound. During this exam, sound waves are used to create images of your uterus and baby or babies. Sometimes a seemingly normal twin pregnancy is later found to have only one baby. Such an episode can be heartbreaking, frustrating and confusing and experts aren't sure why it happens.
What twin pregnancy means for mom
Taking good care of yourself is the best way to take care of your babies. Here's what to expect.
More side effects. Carrying multiples may intensify common pregnancy complaints, such as nausea, vomiting, heartburn, insomnia and fatigue. Abdominal pain, shortness of breath and pressure on the pubic bone are common as well.
More frequent checkups and ultrasound exams. You'll see your health care provider often to track your babies' growth and development, monitor your health and watch for signs of preterm labor. This may mean every-other-week visits during the second trimester and once-a-week visits during the third trimester.
More emphasis on certain nutrients. You'll need more folic acid, calcium, iron, protein and other essential nutrients. If you're already eating healthfully, keep it up, and be sure to take a daily prenatal vitamin. Your health care provider may recommend an iron supplement as well.
More weight gain. Gaining the right amount of weight can support your babies' health and make it easier to shed the extra pounds after delivery. For twins, the recommendation is often 35 to 45 pounds. This may take up to 2,700 calories a day. Work with your health care provider to determine what's right for you.
More precautions. Your health care provider may ask you to limit some of your activities such as work, travel and exercise as your pregnancy progresses.
Consider complications
Healthy multiples are born every day. But it's important to be aware of possible complications. For example:
Preterm labor. Most pregnancies last 38 to 42 weeks. For a twin pregnancy, 37 to 39 weeks is optimal. Preterm labor refers to contractions that begin to open the cervix before week 37. Sometimes preterm labor can be stopped with fluids, rest or medication.
Preterm birth. If preterm labor can't be stopped, your babies may be born too early the most common problem for multiples. You may be given injections of a steroid medication to speed your babies' lung development. Even then, the smallest preemies may fight to survive. Complications may include low birth weight, breathing and digestive difficulties, underdeveloped organs, learning disabilities and developmental problems.
High blood pressure. Mothers of multiples are more likely to develop high blood pressure during pregnancy. By reducing blood flow to the uterus, this condition known as preeclampsia may deprive the babies of oxygen and nutrients.
Twin-twin transfusion. With identical twins, it's possible for a blood vessel in the placenta to connect the babies' circulatory systems causing one baby to receive too much blood and the other too little. Often, babies in this situation are delivered as soon as the benefits of early birth outweigh the potential problems of prematurity.
Caesarean birth. About 50 percent of women carrying twins deliver their babies by C-section especially if the babies aren't in a head-down position. C-sections are considered safer for triplets and higher order multiples.
Bleeding after delivery. The risk of excessive bleeding after delivery increases with a larger placenta or multiple placentas. Your health care provider will be prepared to help with medications or other interventions if needed.
Caring for multiples
Healthy multiples have the same needs as other newborns. You, however, may need more rest and support than you imagined. Take time to enjoy your babies and ask friends, loved ones and others for help.
Pregnancy symptoms differ from woman to woman and pregnancy to pregnancy; however, one of the most significant pregnancy symptoms is a delayed or missed menstrual cycle. Understanding the signs and symptoms of pregnancy is important because each symptom may be related to something other than pregnancy. Some women experience signs or symptoms of pregnancy within a week of conception. For other women, pregnancy symptoms may develop over a few weeks or may not be present at all. Below is a listing of some of the most common pregnancy signs symptoms. If you have been sexually active and experiencing any of the following symptoms it is important to take a pregnancy test.
Implantation Bleeding:
Implantation bleeding can be one of the earliest pregnancy symptoms. About 6-12 days after conception, the embryo implants itself into the uterine wall. Some women will experience spotting as well as some cramping.
Other Explanations: Actual menstruation, altered menstruation, changes in birth control pill, infection, or abrasion from intercourse.
Delay/Difference in Menstruation:
A delayed or missed menstruation is the most common pregnancy symptom leading a woman to test for pregnancy. When you become pregnant, your next period should be missed. Many women can bleed while they are pregnant, but typically the bleeding will be shorter or lighter than a normal period.
Other Explanations: Excessive weight gain/loss, fatigue, hormonal problems, tension, stress, ceasing to take the birth control pill, or breast-feeding.
Swollen/Tender Breasts:
Swollen or tender breasts is a pregnancy symptom which may begin as early as 1-2 weeks after conception. Women may notice changes in their breasts; they may be tender to the touch, sore, or swollen.
Other Explanations: Hormonal imbalance, birth control pills, impending menstruation (PMS) can also cause your breasts to be swollen or tender.
Fatigue/Tiredness:
Feeling fatigued or more tired is a pregnancy symptom which can also start as early as the first week after conception.
Other Explanations: Stress, exhaustion, depression, common cold or flu, or other illnesses can also leave you feeling tired or fatigued.
Nausea/Morning Sickness:
This well-known pregnancy symptom will often show up between 2-8 weeks after conception. Some women are fortunate to not deal with morning sickness at all, while others will feel nauseous throughout most of their pregnancy.
Other Explanations: Food poisoning, stress, or other stomach disorders can also cause you to feel queasy.
Backaches:
Lower backaches may be a symptom that occurs early in pregnancy; however, it is common to experience a dull backache throughout an entire pregnancy.
Other Explanations: Impending menstruation, stress, other back problems, and physical or mental strains.
Headaches:
The sudden rise of hormones in your body can cause you to have headaches early in pregnancy.
Other Explanations: Dehydration, caffeine withdrawal, impending menstruation, eye strain, or other ailments can be the source of frequent or chronic headaches.
Frequent Urination:
Around 6-8 weeks after conception, you may find yourself making a few extra trips to the bathroom.
Other Explanations: Urinary tract infection, diabetes, increasing liquid intake, or taking excessive diuretics.
Darkening of Areolas:
If you are pregnant, the skin around your nipples may get darker.
Other Explanations: Hormonal imbalance unrelated to pregnancy or may be a leftover effect from a previous pregnancy.
Food Cravings:
While you may not have a strong desire to eat pickles and ice cream, many women will feel cravings for certain foods when they are pregnant. This can last throughout your entire pregnancy.
Other Explanations: Poor diet, lack of a certain nutrient, stress, depression, or impending menstruation.
Thinking you might be pregnant and wondering what the most common signs of pregnancy are. Well, we got them for you. We've included all the common symptoms as well as some the less common ones. Examine the symptoms to your heart's content, but remember your doctor is the only one who can confirm pregnancy.
COMMON SIGNS OF PREGNANCY:
No menstrual period
Although this is not proof positive, absence of your menstrual cycle is a good indicator of pregnancy.
Fatigue and sleepiness
For many women, fatigue is the first symptom of pregnancy. If you suddenly find yourself needing an afternoon nap, you could be pregnant.
Breast changes
Along with fatigue, breast changes are possibly the earliest sign of pregnancy. Breast changes include fullness, tenderness, sensitivity to touch, change in size, and darkening of the areola.
Nausea and vomiting
Nausea and vomiting, also known as morning sickness, is another symptom of pregnancy. Not all women experience morning sickness and morning sickness may not occur until two to four weeks after a missed period. Generally, morning sickness resolves or improves in the second trimester.
Frequent urination
Once you become pregnant, your blood volume increases and your kidneys increase in size. These factors can lead to an increase in urination.
Fullness, bloating, achiness in the abdominal area
Believe it or not for many women the symptoms of pregnancy mimic the symptoms of PMS. If you are experiencing PMS symptoms, don't rule out the possibility of pregnancy. Some women will also complain of diarrhea or constipation in pregnancy
Mood swings and irritability
Hormonal changes combined with fatigue may cause mood swings and irritability. If you find yourself incredibly crabby this could be a sign of pregnancy. Keep in mind, however, that crabbiness is also a sign of PMS.
Other common signs of pregnancy include an increase in vaginal secretions, aversion to certain foods or smells, weight gain, and constipation.
LESS COMMON SIGNS OF PREGNANCY:
Implantation bleeding
An estimated twenty percent of women will experience bleeding when the fertilized egg implants into the uterus. Implantation bleeding is typically light in color and amount and generally occurs six to ten days past ovulation.
Headaches
For women that suffer from headaches, pregnancy usually decreases the frequency of headaches. For some, however, there will be a marked increase in the amount of headaches during pregnancy.
Placenta previa, the implantation of the placenta at least partially covering the cervix, occurs in about one in 200 pregnancies. There are actually three types of previa.
