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February 4, 2010, 7:41 AM CT

Sutures cause fewer complications than staples

Sutures cause fewer complications than staples
In a study to be presented today at the Society for Maternal-Fetal Medicine's (SMFM) annual meeting, The Pregnancy Meeting , in Chicago, scientists will present findings that there were less complications for women, after having a cesarean delivery, if sutures were used instead of staples to close the wound.

When Suzanne Basha, M.D. began her career as an obstetrician/gynecologist, she was surprised to find nothing in the literature that provided evidence about which method was better to close a wound after a cesarean.

"It seemed to me that I was seeing more patients return with complications after a cesarean birth when staples were used instead of sutures but I couldn't find any studies that supported a recommendation for the use of either method," Basha said.

Basha and her colleagues at the Lehigh Valley Health Network in Allentown, Pa., conducted a study of 425 patients who were randomized. Women undergoing cesarean delivery in labor as well as scheduled cesarean delivery were eligible. Surgical and postpartum care was otherwise at the discretion of the provider. Wound complication data was complete for 98% of subjects (219 suture and 197 staples) and included wound separation, wound infection, antibiotic use, need for a wound-related doctor visit, and readmission. Data were collected via telephone interview two to four weeks postoperatively by a single investigator.........

Posted by: Emily      Read more         Source


February 4, 2010, 7:39 AM CT

Genes and premature labor

Genes and premature labor
New evidence that genetics play a significant role in some premature births may help explain why a woman can do everything right and still give birth too soon.

Research presented today at the 30th Annual Society for Maternal-Fetal Medicine (SMFM) meeting ― The Pregnancy Meeting ― showed that the genes of both the mother and the fetus can make them susceptible to an inflammatory response that increases the risk of preterm labor and birth.

Silent, undetected infections and inflammation are major risk factors for preterm labor and birth, says SMFM member Roberto Romero, MD, Chief of the Perinatology Research Branch at the National Institute of Child Health and Human Development. One of every three preterm births occurs to a mother who has an infection in her uterus, but has no symptoms.

Dr. Romero led a team of physicians and researchers studying a large number of genes involved in the control of labor that could help explain the complex process that triggers preterm birth. They found DNA variants in genes involved in fighting infection in the pregnant woman and the fetus. Eventhough these variants increased the risk of preterm labor and birth, they have been preserved by evolution because they are needed to fight infection, Dr. Romero said.........

Posted by: Emily      Read more         Source


February 4, 2010, 7:33 AM CT

Treating depression during pregnancy with acupuncture

Treating depression during pregnancy with acupuncture
In a study to be presented today at the Society for Maternal-Fetal Medicine's (SMFM) annual meeting, The Pregnancy Meeting , in Chicago, scientists will unveil findings that show that acupuncture appears to be an effective therapy for depression during pregnancy.

"Depression during pregnancy is an issue of concern because it has negative effects on both the mother and the baby as well as the rest of the family," said Dr. Schnyer, one of the study's authors.

About 10% of pregnant women meet criteria for major depression and almost 20% have increased symptoms of depression during pregnancy. The rates of depression in pregnant women are comparable to rates seen among similarly aged non-pregnant women and among women during the postpartum period, but there are far fewer therapy studies of depression during pregnancy than during the postpartum period.

Dealing with depression is difficult for pregnant women because the use of anti-depressants poses concerns to the developing fetus and women are reluctant to take medications during pregnancy.

In the study, an evaluator-blinded randomized trial, 150 participants who met the Diagnostic & Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria for Major Depressive Disorder were randomized to receive either acupuncture specific for depression (SPEC, n=52) or one of two active controls: control acupuncture (CTRL, n=49) or massage (MSSG, n=49). Treatments lasted eight weeks (12 sessions). Junior acupuncturists masked to therapy assignment needled participants at points prescribed by senior acupuncturists. Massage therapists and patients were not blinded. The primary outcome was the Hamilton Rating Scale for Depression, administered by blinded raters at baseline and after four and eight weeks of therapy. Data were analyzed using mixed effects models and by intent-to-treat.........

Posted by: JoAnn      Read more         Source


February 3, 2010, 7:59 AM CT

Women should be allowed to eat, drink during labor

Women should be allowed to eat, drink during labor
The traditional practice of restricting food and fluids during labour does not provide any benefits, finds a new review co-authored by a Queen's University Associate Professor.

"Based on our review, there is no convincing and existing evidence to support restriction of fluids, and perhaps food, for women during labour. Women should be able to choose for themselves," says Dr. Joan Tranmer of the Queen's School of Nursing.

Practitioners have been concerned about eating and drinking during labour since the 1940s. The restriction is thought to prevent Mendelson's syndrome (named after work by Dr. Carl Mendelson), a rare, but sometimes fatal, condition caused by regurgitation of acidic stomach contents into the lungs when a general anaesthetic is given.

"With medical advances over the past 60 years, including the increase use of epidural anesthesia, we thought it was time to question the widespread ban on food and drink now that we are in the 2000s," says Professor Tranmer. "The use of general anesthesia during C-sections is low. And even when used, the techniques have improved since the 1940s, so the risk of maternal death or illness is very, very low" .

There is tremendous variation in the practice of fluid and food restriction across birth settings (home births versus hospitals).........

Posted by: Emily      Read more         Source


January 26, 2010, 8:50 AM CT

Antidepressants and lactation difficulties

Antidepressants and lactation difficulties
As per a newly released study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM), women taking usually used forms of antidepressant drugs may experience delayed lactation after giving birth and may need additional support to achieve their breastfeeding goals.

Breastfeeding benefits both infants and mothers in a number of ways as breast milk is easy to digest and contains antibodies that can protect infants from bacterial and viral infections. The World Health Organization recommends that infants should be exclusively breastfed for the first six months of life. This newly released study shows that certain common antidepressant drugs appears to be associated with a common difficulty experienced by new mothers known as delayed secretory activation, defined as a delay in the initiation of full milk secretion.

"The breasts are serotonin-regulated glands, meaning the breasts' ability to secrete milk at the right time is closely correlation to the body's production and regulation of the hormone serotonin," said Nelson Horseman, PhD, of the University of Cincinnati and co-author of the study. "Common antidepressant drugs like fluoxetine, sertraline and paroxetine are known as selective serotonin reuptake inhibitor (SSRI) drugs and while they can affect mood, emotion and sleep they may also impact serotonin regulation in the breast, placing new mothers at greater risk of a delay in the establishment of a full milk supply".........

Posted by: JoAnn      Read more         Source


January 6, 2010, 8:10 AM CT

Increasing sonogram use in pregnant women

Increasing sonogram use in pregnant women
Current use of prenatal ultrasounds in women with singleton pregnancies is 55% greater than in 1996, even in low-risk pregnancies. More than one-third (37%) of pregnant women now receive 3 or more ultrasound tests in the second and third trimesters of a given pregnancy, found an article http://www.cmaj.ca/embargo/cmaj090979.pdf in CMAJ (Canadian Medical Association Journal) www.cmaj.ca. The increase in the use of multiple ultrasound scans per pregnancy has been more pronounced in low-risk than high-risk pregnancies, suggesting a need to review current practices.

Current guidelines recommend two ultrasounds in an uncomplicated pregnancy one in the first trimester and one in the second to screen for fetal and genetic anomalies.

The study included almost 1.4 million singleton pregnancies between 1996 and 2006 in Ontario, Canada's most populous province. It included both low-risk and high-risk pregnancies, the latter defined by the presence of a maternal comorbidity, need for genetics counselling or a previous complicated pregnancy. The study accounted for the recent introduction of first trimester nuchal translucency scanning.

The authors observed that almost 1 in 5 of all pregnant women including those at low-risk of complications now receive 4 or more ultrasounds in the second and third trimesters.........

Posted by: Emily      Read more         Source


December 1, 2009, 8:14 AM CT

Glucose intolerance in pregnancy

Glucose intolerance in pregnancy
Women who have gestational glucose intolerance (a condition less severe than gestational diabetes) exhibit multiple cardiovascular risk factors as early as three months after birth, as per a newly released study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM).

Scientists in this study sought to evaluate the relationship between gestational glucose intolerance and postpartum risk of metabolic syndrome (defined as the clustering of several cardiometabolic risk factors including obesity, high blood pressure and low HDL cholesterol). Metabolic syndrome, like gestational diabetes itself, is linked to increased risk of developing type 2 diabetes and cardiovascular disease.

Scientists followed 487 women who underwent oral glucose tolerance testing during pregnancy. Each subject was classified as either having normal glucose tolerance, gestational glucose intolerance or gestational diabetes. At three months postpartum, scientists reviewed each subject's cardiometabolic characteristics, such as blood pressure, weight, waist measurement and lipid levels.

Findings support that even mild glucose intolerance during pregnancy predicts an increased likelihood of the metabolic syndrome at 3 months postpartum. The presence of cardiovascular risk factors as early as three months postpartum indicates that these risk factors appears to be longstanding and contribute to the long-term risk of cardiovascular disease in this patient population.........

Posted by: Emily      Read more         Source


November 13, 2009, 8:16 AM CT

Exercising up to the end of pregnancy

Exercising up to the end of pregnancy
Contrary to more conservative customs, exercising up to the end of pregnancy has no harmful effect on the weight or size of the foetus. This is what has been indicated in a study carried out by scientists of the Universidad Politcnica de Madrid (Polytechnic University of Madrid), which also shows the positive relationship between the weight of sedentary mothers before pregnancy and the body size of their babies. The conclusions appear in the International Journal of Obesity

"Partaking in low-level physical activity has beneficial effects on materno-foetal health". These findings have recently been reported in the International Journal of Obesity and highlight the benefits for the health of the baby and the mother when a physically-active lifestyle is maintained throughout pregnancy.

"An exercise regime carried out during the second and third trimester of pregnancy does not harm the health of the foetus", Jonatan R. Ruiz, researcher at the Karolinska Institute, Sweden, and principal author of this study, who has coordinated a team from the Polytechnic University of Madrid in collaboration with the Swedish centre, explains to SINC.

160 healthy women between the ages of 25 and 35 participated in the study, all of whom had sedentary habits and no risk of premature birth. Of this group of women, half followed an exercise regime under the supervision of experts in Physical Activity and Sports Science in collaboration with the Gynaecology and Obstetrics Unit of Hospital Severo Ochoa in Madrid.........

Posted by: Emily      Read more         Source


November 11, 2009, 8:18 AM CT

Healthy Babies by the Numbers

Healthy Babies by the Numbers
When a fetus is smaller than expected for the number of weeks of pregnancy, due to associated problems like a poorly developed heart, health concerns as severe as brain damage can result.

The condition, known as Intra-uterine growth restriction (IUGR), prompts doctors to use ultrasound to track a baby's health and determine the best time for delivery. But these measurements are often incomplete, and obstetricians have had to rely on educated guesses about the strength of a fetus's circulatory system.

Now, thanks to new research from Tel Aviv University, IUGR babies will have a better chance for a healthy life.

Prof. Ofer Barnea of TAU's Department of Biomedical Engineering, in collaboration with Prof. Jacob Bar from the Wolfson Medical Center, couples mathematical models with information about a baby's physiology inside the womb. Combining ultrasound with powerful algorithms based on real-life data, pediatricians get critical data on the development of the fetal circulatory system, so they can determine when the baby is strong enough to survive on its own.

"Babies with IUGR experience stress and growth restrictions inside the womb," says Prof. Barnea. "Doctors need to assess their growth, but currently have to rely on partial data from ultrasound systems. If they leave the baby inside too long, she may suffer from brain damage. Conversely, we need to be sure her heart is strong enough to survive outside the womb".........

Posted by: Emily      Read more         Source


November 5, 2009, 8:22 AM CT

Women with asthma may benefit from oral contraceptives

Women with asthma may benefit from oral contraceptives
New research shows that during natural menstrual cycles, women with asthma who were not taking oral contraceptives (OC) had lower exhaled nitric oxide levels (eNO), a marker of airway inflammation linked to asthma, than women who were taking OC.

Scientists from McMaster University in Hamilton, ON, Canada, studied 17 women with asthma during their menstrual cycles. Results showed that individuals not using oral contraceptives (OC) had higher mean eNO levels than women using OC.

Furthermore, among women not using oral contraceptives, an increase in estrogen levels was linked to a decrease in eNO, while an increase in progesterone was significantly linked to an increase in eNO. Scientists speculate that OC may have a potential role in the management of premenopausal women with asthma.........

Posted by: JoAnn      Read more         Source



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Did you know?
The addition of testosterone to hormone therapy in women after menopause enhances their sexual function. However, it may also reduce HDL cholesterol (the "good" cholesterol) in women, according to a systematic review of current evidence."If the reduction in HDL had been associated with an increase in triglycerides [fatty acids] or LDL cholesterol it would be of great concern," said Dr. Susan Davis, professor of medicine at Monash University, Melbourne, Australia, and study co-author "However, as an isolated finding the significance is difficult to interpret." She added, "Testosterone has not been found to alter other coronary heart disease risk factors.".

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