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Constipation and Pregnancy

September 2, 2014/in Pregnancy Channel/by coastal

What is it?

Constipation is abdominal pain associated with difficult and infrequent bowel movements accompanied with passage of hard stools. Unfortunately, about half of you reading this post will experience this during your pregnancy.

Causes:

Hormonal Changes: the hormones of pregnancy slow down intestinal motility and gastric emptying. This helps your body absorb more of the food you eat, which is great for the pregnancy/baby, but creates other issues for mom.

Iron Supplements: These can cause nausea, vomiting, diarrhea, and of course constipation. They are best absorbed when taken with Vitamin C, so take your supplements with a glass of orange/apple/mango… juice. They are absorbed poorly when taken with milk, calcium pills/Tums, or antacids. There are different formulations available that may have less constipation; talk to your provider for the supplement that is best for you.
Hypothyroidism: Not often considered, but is associated with constipation too. Have your TSH (thyroid stimulating hormone) level checked by your provider, if it is elevated, you may have early, or true hypothyroidism. Hypothyroidism is also associated with fatigue, weight gain… many symptoms that mimic pregnancy symptoms. It is difficult to assess if you have hypothyroidism clinically; you need to check the labs.
Dehydration: Because pregnancy is associated with slow gastric emptying, and decreased intestinal motility, you need more water in your diet. Soda, offee, tea, caffeine, energy drinks…all are associated with dehydration. Skip these drinks, and stick with water only, and lots of it. You may spend more time in the bathroom having to urinate, but its better than the alternative!
Diet: You are what you eat! You’ve heard this a million times, and it applies during pregnancy as well. Mind over matter! Your baby did not ask you to eat the cheesecake, or the entire pizza, or the dozen donuts on the way to your doctor’s
office! Cravings have a place in your pregnancy, but so does common sense. Your gut is actually filled with bacteria that help you with digestion of your food. What we have to realize is that there is a delicate relationship between the bacteria in your gut, and the food we eat. Preservatives, artificial processed food, high carbohydrate diets….these all
change the ideal environment in your gut, and that causes changes to these bacteria as well. Some diets cause an overgrowth of the bad bacteria, and these lead to abdominal pain, excess gas and bloating, and possibly diarrhea and/or constipation. These symptoms are often associated with irritable bowel syndrome or IBS. For women, changes in your menstrual cycle alone may cause changes in these bacteria and cause the symptoms of IBS.

Lack of Exercise: Your body is the combination of all its moving parts: if you don’t exercise, your muscles become tagnant. Exercise stimulates your bowels too. Pregnancy should be supplemented with at least 30 minutes of exercise daily; consider it your ultimate daily medicine. Lack of exercise during pregnancy can be associated with excessive weight gain, increased fatigue, gestational diabetes, and of course constipation. At least 30 minutes of mild exercise daily is recommended during pregnancy; walking, swimming, jogging…talk to your doctor about the recommendations for pregnancy and what is safest for you.

How if Affects the Baby

Constipation does not affect your baby.

How if Affects the Pregnancy

Constipation can be annoying, and if not treated early, can be quite painful for the mother. Your bowels are constantly moving in a wave, and it moves the contents with these motions. If you have constipation, the waves keep crashing into a “clogged” outlet and this causes pain. Sometimes the pain can be as severe as that experienced with gallstones, or a ruptured appendix, and treatment involves disimpaction (manual removal of stool from the rectum). The key is to be roactive and prevent constipation from becoming that severe. Normal bowel movements include 1-2 times per day, or once every 2-3 days; everybody has a different definition of normal. But if you have increasing time between bowel movements and they are associated with increased straining, abdominal pain, and hard stools, then you need to be more proactive.

Treatment:

Hydration, hydration, hydration, water, water, water. Carry it in your purse, keep it in your car, drink it all the time!

Diet high in fiber: Insider tip: I tell all my patients, eat Raisin Bran for breakfast! If you have a lactose issue, or don’t like milk, use water or Almond milk. This is a great way to prevent the problem from starting. Lots of vegetables, and fruit, and cut down on processed foods: pasta, pizza, bread…donuts.

Exercise Routinely: If you are inactive, your gut will be inactive, but don’t forget #1, drink lots of water during your exercise regimen.

Supplements: If you need iron supplementation, or you find your prenatal vitamin is constipating, then consider a different formulation. If you split your iron dose in 2-3 doses, the side effects of constipation are minimal.

Metamucil: If you find that you are following all of these recommendations, and are still suffering from constipation, talk to your obstetrician about over-the-counter products such as Metamucil (Pregnancy Category B). These may help soften your bowel movements, promote motility, and decrease the incidence of constipation. Do not take laxative pills for constipation without consulting with your obstetrician first. Although these stimulate the gut, they also can cause uterine contractions.

Probiotics: Gut health is extremely important, and more studies confirm this. Eating yogurt daily, and/or taking a probiotic will keep your gut bacteria in good shape.

This blog post is presented to you by VSacharMD.com the worlds first and only cosmetic company that makes safe non-toxic cosmetics that can be used in pregnancy, or by anyone who wants safe cosmetics. Note this post is for entertainment purposes only, and is not meant to be taken in the place of medical advice. Discuss your condition with your obstetrician. Visit us at VSacharMD.com for more posts and information about our products.

Copyright V.Sachar MD 2014. All Rights Reserved.
No part of this may be reproduced without expressed approval from the author.
This blogpost is not to be considered medical advice and is for entertainment purposes only, consult your personal doctor before making any changes to your health care regimen.

Nausea and Vomiting in Pregnancy

August 25, 2014/in Pregnancy Channel/by coastal

What is it?

Up to 75% of pregnant women suffer from nausea and/or vomiting in pregnancy. It is very, very common, and sometimes eferred to as “morning sickness”. This unfortunate side effect of pregnancy probably occurs secondary to a being very sensitive to the hormones of pregnancy. You can have varying severity of disease from mild intermittent nausea, to severe debilitating disease. The onset occurs at about 4-6 wks gestational age, peaks around 12-14, and subsides by about 20 wks.
A severe persistent form of nausea and vomiting of pregnancy occurs in about 1% of women and is called. Hyperemesis Gravidarum. This occurs when you have at least 3 episodes of nausea and vomiting and lose at least 6.5lbs, or 5% of your pre-pregnancy weight.
There are a few maternal conditions that may present with nausea and vomiting as the primary symptom. These include: ovarian torsion, hyperthyroidism, gastroenteritis, intestinal obstruction, kidney infection, molar pregnancy, appendicitis, pancreatitis, hepatitis…your physician will rule these out first before considering a diagnosis of nausea and vomiting of
pregnancy.

How It Affects the Mother

With nausea and vomiting of pregnancy, there are minimal effects on the mother. Loss of work is common, and treatment centers around avoidance of triggers, dietary modifications, and medication.

Triggers include foods that are high in acidity. Vitamin C containing foods such as orange juice, fruit, pizza, spaghetti sauce, caffeine, carbonated drinks, all can trigger acid release in the stomach which can cause acid reflux. These symptoms are worse while lying down, and can cause vomiting. Avoidance of these foods can be helpful as can proton pump inhibitors (PPI) such as Nexium.

Early treatment of symptoms with lifestyle modifications and possibly medications will result in the most success and least amount of work loss. There are however extreme cases of hyperemesis gravidarum in which the mother cannot tolerate anything orally, and needs an IV to get hydration and nutrition. Treatments that are beneficial in treating nausea and vomiting in pregnancy are as follows ginger, Vitamin B6, Diclectin,, Benadryl (diphenydramine), Zofran. Reglan.

There is up to 15% recurrence of nausea and vomiting with subsequent pregnancy.

How It Affects the Fetus
Most cases of nausea and vomiting of pregnancy are not associated with adverse pregnancy outcome. Hyperemesis Gravidarum involving maternal IV for nutrition has been associated with fetal growth restriction and possible adverse fetal outcome.

This blog post is presented to you by VSacharMD.com the worlds first and only cosmetic company that makes safe non-toxic cosmetics that can be used in pregnancy, or by anyone who wants safe cosmetics. Note this post is for entertainment purposes only, and is not meant to be taken in the place of medical advice. Discuss your condition with your obstetrician. Visit us at VSacharMD.com for more posts and information about our products.

Abnormal Pap Smear in Pregnancy

July 28, 2014/in Pregnancy Channel/by coastal

What is an Abnormal Pap Smear?

A Pap smear is a screening test that allows a doctor to look at the cells at the cervix (which is the lower part of the womb) and see if there are precancerous or cancerous cells. This test is usually performed using a speculum. Abnormal Pap smears are now known to be caused by infection with the human papilloma virus (HPV). This is a sexually transmitted virus. There are a number of different strains of HPV, and the strains that are associated with causing cervical cancer have been identified. If one has HPV, most people do not progress to cervical cancer. A similar analogy would be most people who have a cold to not develop pneumonia. Out of most women who get infected with HPV, only a small number of women develop abnormal Pap smears. Out of those, a much smaller number get progressively worse Pap smears that may develop into cervical cancer after 10-15 years. Abnormal

pap smears do not affect the

pregnancy or the baby. Rarely a procedure may be necessary (colposcopy, and/or cervical biopsy) however most procedures can be postponed until after the baby is born. If there is a history of the cervix being excised, frozen (cryotherapy) or a conization procedure then a transvaginal ultrasound is recommended at around 16-20wks to confirm there is no evidence of a short cervix (cervical insufficiency).

Pap smears are graded according to the degree of abnormality. There are three different degrees: Low Grade (LGSIL), High Grade (HGSIL), and Cancer (CIS). The progression from one stage to the other occurs over a number of years. Not all cases progress from one stage to the next; most cases of LGSIL regress to normal over time with no treatment. Management of abnormal Pap smears is dependent upon the patients’ age and degree of abnormality. Colposcopy is performed to rule out the presence of more abnormal cervical cells after an abnormal Pap smear. This procedure is performed using a specific magnifying apparatus, the cervix is carefully examined to ensure there is no evidence of cervical cancer. During this procedure cervical biopsies are often taken. In pregnancy, if necessary colposcopy and biopsies are safe.

LGSIL in a younger patient is managed expectantly with follow up pap smears and colposcopy as opposed to older patients.

Pap smears used to be reviewed by pathologist who based their diagnosis of the abnormal cells in the cervical smear, but with the knowledge that HPV is causative, most pap smears include testing to detect the presence of HPV. Newer tests can detect HPV from a urinalysis; these tests may ultimately replace the Pap smear as a screening test.

How do Abnormal Pap Smears Affect the Pregnancy and Baby?

HPV is not believed to harm the baby, or affect the pregnancy adversely. In rare cases of genital warts (also caused by HPV), a patient may have a large growth of warts called condyloma accuminata. This growth occurs in the vagina, the vuvla, or the rectum. These growths are very delicate, and during vaginal delivery can easily bleed because of the trauma of childbirth. There is a small chance the baby may be exposed to the virus. The baby has a small chance of developing a rare condition called laryngeal papillomatosis.

In some patients, the abnormal Pap smear may progress from LGSIL to HGSIL (slightly abnormal, to very abnormal). Depending upon the age of the patient, and the length of time the the abnormal Pap smear has been present, some patients may undergo a procedure called a LEEP (loop electrosurgical excisional procedure). This procedure is diagnostic, and curative. Using an “electric” knife, the abnormal portion of the cervix is removed. After this procedure usually Pap smears are performed every 4 months for one year to confirm no abnormal cervical cells were left behind. One risk of this procedure is that the amount of cervix removed may impact the ability to carry a baby to term and result in a insufficient (incompetent ) cervix. If you have had this procedure, you will need transvaginal ultrasounds around 16-20 weeks, and if your cervical length is less than 1.5cm, you may benefit from a cervical cerclage.

This procedure is rarely performed during pregnancy. If you are found to be at significant risk for cervical cancer and are pregnant, your doctor will send you to a Gyn-oncologist for their recommendations.
Website: http://www.acog.org/publications/patient_education/bp161.cfm

For more helpful pregnancy hints, instructional pregnancy videos, upcoming podcasts and to get more information about the world’s first non-toxic makeup exclusively for pregnant women, please go to www.VSACHARMD.com.

Chronic Hypertension in Pregnancy

July 20, 2014/in Pregnancy Channel/by coastal

What is it?

Chronic hypertension affects up to 5% of all pregnancies. If you have a blood pressure of 140/90 or greater AND you are before 20 weeks gestational age, then you may have chronic (pre-existing) hypertension. Because most women of childbearing age are young, they often do not go to their doctor for checkups because they feel “healthy”. Pregnancy involves multiple visits to your medical provider, and it may be here that elevated blood pressure is first noted. If you are noted to have elevated blood pressure (greater than 140/90) and you are past 20 weeks gestational age, then your diagnosis is gestational hypertension, or elevated blood pressure during pregnancy. In this case you will be evaluated 12 weeks after you deliver to determine if your hypertension persists; if it does, then you have chronic hypertension, if it resolves then you had transient hypertension.

Risk factors for developing hypertension include obesity, substance abuse, chronic exposure to toxins, advanced maternal age, pre-existing diabetes mellitus, other medical conditions such as lupus, renal disease, and genetics.

If you have chronic hypertension, you are probably on medication. If you are on angiotensin-converting enzyme inhibitors (ACE) or a similar class (ARB) these medications are teratogens associated with congenital malformations in the fetus and are NOT recommended during pregnancy. You should discuss your medications with your obstetric health care provider as early as possible. Classes of antihypertensives that safe in pregnancy include calcium channel blockers, and beta blockers.

Hypertension is a very dangerous disease both during pregnancy and outside of pregnancy. It is called the “silent killer” because the you, the patient don’t feel ill, or sick, however you may have blood pressure that is elevated. The elevated blood pressure causes damage to the placenta (affecting the baby), can injure your kidneys, brain, and your heart.

How it affects the Pregnancy?

I tell my patients that hypertension is like having really big waves on a beach. Eventually, the force of the big waves crashing on the soft sandy beach, will erode the beach. Similarly, elevated blood pressure damages the delicate placenta. If 50-70% of the placenta gets damaged, the placenta cannot function optimally. Accordingly the baby gets less nutrients, and oxygen. Subsequently the baby will stop growing appropriately, and if the placenta gets further damaged, it may eventually lead to fetal demise, or the placenta getting bruised (abruption). In this case there is bleeding inside the placenta, and there can be severe injury to both mother and baby; this is considered a pregnancy emergency.

Hypertension in pregnancy also places the mother at risk for worsening hypertension, pre-eclampsia and eclampsia. Pre-eclampsia is a condition in which the maternal blood pressure rises and this causes adverse maternal reactions in the maternal kidney, liver and brain. If this condition continues to evolve, a small percent of women may develop

a seizure with convulsions (eclampsia). The only way to treat pre-eclampsia and eclampsia is delivery. If pre-eclampsia occurs before 32 wks, there may be a role for expectant management, as the prematurity of fetal delivery places the baby at risk other sequelae of prematurity. When the pregnancy is complicated by a condition that necessitates delivery, women are given injections of Corticosteroids (Betamethasone/ Celestone), 2 injections 24 hours apart. This medication crosses the placenta and accelerates tissue maturity of the fetus therefore protecting the baby from some of the more severe sequelae of delivering prematurely.

Diagnosis and Treatment

The diagnosis of chronic hypertension is based on the finding of elevated blood pressure over 140/90 before 20 weeks gestational age. If elevated blood pressure is noted after 20 weeks gestation, then the diagnosis is called gestational hypertension. When the elevated blood pressure is accompanied by proteinuria, and elevated liver enzymes, the diagnosis is a variant called HELLP syndrome (Hemolysis, Elevated Liver Enzymes, Low Platelets). Generally this condition warrants immediate delivery, but gestational age always plays a role.

If you have this condition before or during pregnancy, your obstetrician will want to establish baseline values of your kidney function, platelet count, and liver tests. The kidney function is assessed by checking your urine for presence of protein. Both the platelet count and liver tests are blood tests.

Hypertension in pregnancy is treated with Beta Blockers, Calcium Channel Blockers, or diuretics. The goal of anti-hypertensive therapy is to keep the blood pressure below 140-150/90-100. In the past Methyldopa was used, however as the safety profile of the other beta blockers, diuretics and calcium channel blockers in pregnancy has been established, methyldopa is out of favor. One beta blocker in particular, atenolol, is NOT recommended in pregnancy as it is associated with growth restriction (impaired fetal growth).

After delivery, you may need to be reassessed by your primary care physician to see which medication is best for your hypertension. Often women with pre-eclampsia, eclampsia, and gestational hypertension may need treatment for up to 6 weeks postpartum. If they need treatment beyond this time period, the diagnosis of chronic hypertension should be considered.

Recently it has been found that women with pre-eclampsia, eclampsia and the disorders of hypertension in pregnancy are at higher risk for cardiovascular events later on in life. Careful followup with your primary care physician, and awareness of your blood pressure values is important to ensure that you do not become a victim to this “silent killer”.

For more helpful pregnancy hints, instructional pregnancy videos, upcoming podcasts and to get more information about the world’s first non-toxic makeup exclusively for pregnant women, please go to www.VSACHARMD.com.

Copyright 2014 V Sachar MD. All Rights Reserved.
No part of this post may be duplicated without expressed consent by author.

Anemia in Pregnancy

July 7, 2014/in Pregnancy Channel/by coastal

What is it?

Anemia is the most common nutritional problem affecting pregnant women. Anemia itself is not a diagnosis, but is a sign of a problem; there are multiple etiologies of anemia. In pregnancy one of the most common causes of anemia is that there is an increase in blood volume but less red blood cells are made. This results in a dilutional anemia; note however, your hemoglobin level should not go below 11. There are nutritional causes or anemia as well: the most common nutritional cause of anemia is iron deficiency. Iron is needed to carry oxygen in the blood, and this oxygen then supports the mom and the baby. Anemia in pregnancy is commonly attributed to the deficiency of iron, folate,and vitamin B12. Iron-deficiency anemia is the most commonly observed pregnancy-related anemia affecting about 15% to 25% of all pregnancies.

However, folic-acid deficiency anemia occurs in only about 1% to 5% pregnancies worldwide. Other common causes of anemia include folate and vitamin B12 deficiency, chronic liver disease, HIV, chronic renal disease etc. Symptoms associated with anemia may be maternal tachycardia, shortness of breath, being constantly tired, palpitations, lightheadedness ..unfortunately, these symptoms are also consistent with the normal symptoms experienced by women in pregnancy.

Some women with an underlying anemia during pregnancy, consume large amounts of nonnutritional substances: ice, chalk, corn starch, soil, matches, sand, hair, soap…and other similar textured substances. This is called Pica. The exact etiology why they eat these substances is unknown, however it makes the anemia more severe. I have had many patients who were sent to me with a diagnos i s of severe anemia (Hemoglobin around 6-7). Upon further questioning, i realized these women had pica,. They were consuming 20-30 large glasses of ice daily. Only after they stopped eating the substance did their hemoglobin levels rise, along with large amounts of iron replacement. In some situations, because the patient was so close to delivery, they needed blood transfusions.

Some anemias are due to a genetic error in the hemoglobin, these are called hemoglobinopathies. Examples include, sickle cell disease, thalassemia…etc. If you have anemia, your physician will order an iron level, folate level, vitamin b12 level, haptoglobin and a hemoglobin electrophoresis. These tests will help determine if you have a nutritional deficiency, or a genetic problem, or a problem with increased red blood cell destruction. This will guide your physician to the etiology of your anemia and best treatment for you.

How it affects Pregnancy & Baby?

In studies, severe anemia is associated with adverse fetal outcome, and possible preterm delivery. In these studies, the hemoglobin level was around 4-6. Note however, if your hemoglobin is below 11, you still should have the appropriate workup, and follow treatment if necessary. A low hemoglobin puts you at risk for medical consequences if you have severe bleeding in pregnancy (hemorrhage) or if you are at risk for hemorrhage (if you undergo a cesarean section). For instance you may need a blood transfusion. Genetic causes of anemia such as thalassemia, or sickle cell disease, may place the baby for risks of inheritance. If you have a genetic cause for your anemia, you should see a genetic counsellor during by your pregnancy to ensure you are aware of all potential risks to your baby.

Treatment

The treatment depends on the etiology of your anemia. This usually involves, iron, or vitamin B12, or folate. Iron supplementation is associated with some side effects, most notably constipation, nausea vomiting, and diarrhea. The most effective way to take iron supplements is with orange juice and food, not with milk.

If your etiology is pica, then stopping the offending action (through diet) will usually help, along with supplements. A followup hemoglobin level about 4-6 weeks after initiating treatment will demonstrate improvement. If the anemia is severe, and you
are going to deliver within 1-2 weeks, you may need a blood transfusion, or intravenous iron. Your practitioner will assess the severity of your anemia with the risk delivery.

Although extremely common in pregnancy, anemia is usually recognized early, and once an accurate etiology is determined, anemia can be treated without adversely affecting the pregnancy.

For more helpful pregnancy hints, instructional pregnancy videos, upcoming podcasts and to get more information about the world’s first non-toxic makeup exclusively for pregnant women, please go to www.VSACHARMD.com.

All Rights Reserved, Copyright 2014
No Part of This Post May Be Reproduced Without Expressed Approval from V Sachar MD

7 Secrets For Pregnancy!

May 22, 2014/in Pregnancy Channel/by coastal

These are 7 great tips for pregnancy written by Dr. V Sachar.Dr. Sachar is a high risk pregnancy specialist, who has created the world’s first cosmetic line devoted toward safe, non-toxic products for pregnancy. Toxin exposure during pregnancy may be associated with the development of adult diseases later in life.These diseases may have origins early in life from toxin exposure even in utero.

1. Continue to exercise!

Continuing to exercise during pregnancy, better prepares you for your delivery, and regular exercise helps keep your weight gain in check. 30 minutes of exercise on most, if not every day of the week is recommended. Keeping your intensity to a level such that you can easily talk while exercising, will not cause any risk to the baby. Note, during pregnancy, low impact exercise, that does not expose you to injury is only recommended (no rollerblading!); always discuss your exercise regimen with your obstetrician.For more information refer here at Acog.

Safe exercise is recommended, skateboarding is NOT!

2. Don’t eat for the baby!

For the longest time, it was believed that you have to gain 35-40lbs for every pregnancy, regardless of your pre-pregnancy weight. What happened though, is that women who were already obese to start with, were becoming morbidly obese because they thought they had to. The World Health Organization and the American Congress of Obstetricians and Gynecologists have recognized this and recently recommended tailoring women’s pregnancy associated weight gain to their pre pregnancy weight.

Make Healthy Choices During Your Pregnancy

For more information refer here at Acog. Always discuss recommended weight gain with your obstetrician.

3. Limit Your Exposure to Toxins!

Air-pollution, second hand smoke, radiation, and even your makeup are sources of fetal toxins. Your makeup may contain parabens, lead, bismuth chloride, phthalates, and other chemicals which may be toxic to your baby, and/or your skin. Parabens are associated with endocrine disruption and future impaired fertility in the baby, and breast cancer in the mother. The surge of hormones and changes in your immune system can make your skin very sensitive to chemicals commonly found in makeup. Makeup you always used, may now cause acne, rashes, and other inflammatory eruptions. Try to use safe cosmetics that are non-toxic during pregnancy. Refer to www.VSACHARMD.com for more information and to purchase the world’s only non-toxic safe makeup created exclusively for pregnant women!

4. Caffeine Can Be Your Friend!

Many women suffer from carpal tunnel syndrome in the second trimester of pregnancy. This causes numbness and tinging in the hands, and can be very uncomfortable. Generalized pregnancy induced edema occurs around the nerves near your writs and causes compression, and numbness. Caffeine is a natural diuretic and can often control this problem. 1-2 cups a day can benefit those suffering from carpal tunnel, as well as alleviate many headaches and migraines in pregnancy! We recommend discussing this with your obstetrician before using caffeine to treat these 2 conditions.

5. Take Your Prenatal Vitamin at Night!

I have had thousands of women complain of nausea in the morning after taking their prenatal vitamin. They did not have morning sickness type of nausea. Personally, I have tried a prenatal pill too, and had severe nausea 1 hour later! To avoid this, take your prenatal vitamin with your dinner. By the time it starts to get dissolved, you will be asleep, and won’t experience all of the side effects.

6. Heartburn in Pregnancy!

Almost everybody experiences heartburn during their pregnancy. The cause is relaxation of the valve between the esophagus and the stomach AND slowed gastric emptying. These are secondary to the hormones of pregnancy, specifically Progesterone. Avoiding some of the triggers may be the easiest way to treat this condition. Caffeine, tea, tomato sauce (pizza, spaghetti), orange juice, big meals…these may all trigger the symptoms of heartburn. This occurs because the acid from the stomach rises into the lower part of the food pipe, and gives a very uncomfortable burning sensation. If avoiding these foods doesn’t help, try over the counter medications such as Tums. This is a simple fix, but doesn’t always work. If you continue to have persistent heartburn, discuss it with your obstetrician, and they can prescribe effective medical treatment. Note, heartburn, also known as gastric reflux is a major cause of nocturnal asthma. For patients with asthma, with worsening symptoms, treatment of your acid reflux may control your symptoms!

7. Varicose Veins!

Pregnancy is a major risk factor for varicose veins. They can range in severity from a cosmetic irritation, to severe pain. They occur as the pregnancy progresses because the pregnant uterus prevents blood from returning from your legs to your pelvis. It is similar to stepping on a hose; the water backs up, and the hose dilates. The hormones of pregnancy also contribute to varicose veins. Unfortunately, these veins aren’t limited to just your legs, and can occur in the vulva, and be very large and disfiguring. Hemorrhoids are another version of varicose veins! Fortunately there are a few solutions. Elevating your legs whenever possible will help eliminate the force of gravity. The most effective however is medical grade support hose. If you are at risk for varicose veins, be proactive; get support TED hose earlier, go prevent their formation, vs after they have formed. 4For those with painful varicose veins in the vulva, there are support hose for this as well. Discuss this with your obstetrician, and they can give you a prescription. They may be a little expensive, but using these will prevent further varicose veins from developing and alleviate some of the discomfort. For hemorrhoids, a stool softener, high fiber, and lots of water will also help.

For more helpful pregnancy hints, instructional pregnancy videos, upcoming podcasts and to get more information about the world’s first non-toxic makeup exclusively for pregnant women, please go to www.VSACHARMD.com.

Note: Before making any medical decisions in your pregnancy, discuss them with your obstetrician. The views in this blog are for information and entertainment only, not to be taken as medical advice.

Herpes Virus Infection in Pregnancy

May 11, 2014/in Pregnancy Channel/by coastal

If someone says the word “Herpes”, everyone cringes. Surprisingly, about 2/3 of you reading this now, may have had HSV 1 (the type that causes cold sores), and about 20% of you may have had the genital type of Herpes (HSV2). Most people who get exposed to herpes are asymptomatic and may not even know they had it. The way we can tell if you have been exposed to this virus before is to measure your immunoglobulins (IGG) against the herpes virus.

Most episodes of HSV during pregnancy are recurrent, and are a very low risk to affect the baby. Transmission occurs through mucous membranes or open or abraded skin. The virus lives in the neurons where it entered near the spine. Recurrent clinical outbreaks occur infrequently, and may involve trauma, UV radiation, change of temperature, pregnancy,stress, immunosuppression or hormonal changes.

Infection presents with papules, pustules, vesicles and ulcers that last 2-6 weeks

The fetus becomes infected by a virus shed from the cervix or lower genital tract. It either invades the uterus during membrane rupture or is transmitted by contact with the fetus during delivery. Neonatal herpes is caused by both herpes simplex types 1 and 2, although herpes simplex type 2 infection predominates. Most infected infants are born to mothers who have no reported infection.

How it affects You/Pregnancy?

The risk of neonatal infection correlates with the presence of HSV in the genital tract, the stage of maternal infection and invasive obstetrical procedures. If the pregnant woman acquires a new infection near the time of delivery the infant has a 30- to 50- fold increased risk of infection due to higher viral load and the lack of protective antibodies. While women with recurrent HSV have less than a 1-percent risk of neonatal infection.

How it affects the mother?

Only 1/3 of newly acquired Herpes infections are symptomatic. The incubation period of 2-10 days followed by eruption that is papular with itching and tingling, which then becomes painful and vesicular. Transient flu-like symptoms are common. Although very rare, life threatening herpes infection may develop in the mother (disseminated disease) with encephalitis, hepatitis and pneumonia may develop. All signs of infection disappear in 2-4 weeks. Many women do not present with the typical lesions, some may have pruritic or abraded areas others may have knife-slit lesions that may sting, or be itchy.

How it affects the baby?

Neonatal transmission occurs during pregnancy in about 5% of cases, during labor and delivery around 85% and after delivery around 10%.

The most concerning HSV infection during pregnancy occurs in those with a primary/first episode infection in early pregnancy. These are associated with an increased risk of preterm labor, IUGR (intrauterine growth retardation), spontaneous abortion or stillbirth. Premature infants account for 2/3 of the cases of neonatal HSV.

Late-pregnancy infection has been associated with preterm labor and delivery. 80% of mothers of infected infants have no reported infection. This often occurs because the mother is unaware that she was infected, or exposed to a partner with HSV. Epidemiologic studies suggest that most sexual transmission of genital herpes occurs when persons shed virus but lack lesions. Both men and women can shed the virus, without visible lesions on their genitals.

Primary/first episode infection during pregnancy is associated with microcephaly and neonatal chorioretinitis; rarely skin lesions. The risk of fetal transmission with HSV primary infection is about 60%. 20% of those with neonatal HSV have long-term neurologic sequelae.

Treatment and Prevention

Specific antiviral medications have been used successfully to attenuate the infection and reduce viral shedding. In those women with a history of prior HSV (recurrent HSV), and recurrent outbreaks, suppressive therapy with daily antiviral treatment has been used successfully to reduce outbreaks, decrease viral shedding, and decrease neonatal HSV.

Antiviral treatment with medication such as Acyclovir appears to be safe in pregnant women.

If women at term with a history of HSV, present with prodromal symptoms of HSV infection such as vulvar burning or itching, and careful examination of the vulva, vagina and cervix should be done to evaluate for the presence of lesions. Cesarean section is indicated for those with only active genital lesions or prodromal symptoms. However even after cesarean section, some infants are born with HSV. Postnatal treatment with antiviral medications are
given for neonatal herpes infection.

This post was presented to you by VSacharMD.com The World’s first and only cosmetic company devoted to safe, non-toxic cosmetics in pregnancy. Toxin exposure in utero is associated with adult diseases as the child grows such as cancer, diabetes, and more.Prevent exposure to toxins by using safe, non-toxic cosmetics.

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