![[Breech variations]](../images/Pregnancy_variations-breech-_various_breech_presentations.jpg)
Your baby turns a lot during the pregnancy. Up until 35-36 weeks, you should not worry too much if your baby is breech. About 3 out of 100 babies are breech. Between 18 and 22 weeks of pregnancy, 24% of babies are breech. Between 28 and 30 weeks of pregnancy 8% are breech. Once you are 35 weeks, and if your baby has been breech all along, then you need to begin thinking of ways to turn a breech. Discuss this with your care giver. There are many ways to help turn a breech, you and your midwife can talk about them.
![[prolapsed cord]](../images/Pregnancy_variations-c-section-_prolapsed_cord.jpg)
![[C-section reasons]](../images/Pregnancy_variations-c-section-_reasons_for_a_c-section.jpg)
On March 29 a statement was issued from the National Institute of Health regarding so-called maternal request cesareans. The following is part of a statement from the International Cesarean Awareness Network, Inc. (ICAN) which can be found @ http://www.ican-online.org
"The united States already lags far behind other industrialized countries in maternal-child health outcomes. Opening the door to more unnecessary cesarean surgeries will cause additional poor outcomes in otherwise healthy mothers and babies and will take a toll on an already overburdened medical system. A new report by the World Health Organization published in the Lancet identifies complications from cesarean surgery and anesthesia as the leading causes of maternal death in developed countries, including the United States."The United States percent is 26.1% which is a increase of 7% over 2001, Indiana is 24.9%, Michigan is 24.9%, Iowa is 24.*%, Ohio is 23.4%. The lowest states are New Mexico and Utah at 19.1 %.
http://www.ican-online.org/resources/statistics.php| Year | Primary | Overall | VBAC Rates |
| 2003 | 19.1 | 27.6 | 10.6 |
| 2002 | 18.0 | 26.1 | 12.6 |
| 2001 | 16.8 | 24.4 | 16.4 |
| 2000 | 16.0 | 22.9 | 20.7 |
| 1970 | 4.2 | 5.5 | 2.2 |
One of the reasons that the change has occurred is the fear of uterine rupture. The following is from ICAN and may be copied and distributed with retained copyright. International Cesarean Awareness Network, Inc. All rights reserved.
A 10-year population-based study of uterine rupture![[Turning a breech baby]](../images/Turning_a_breech.jpg)
While many breech babies spontaneously turn to head first, or vertex, you may want to try some of the following.
Do three times to four times a day for 10-15 minutes each time. You should do this before you eat a meal, so you do not become sick from lying in the position. Try to pick times of the day when the baby is most active. Place a few pillows under your hips, so that your hips are raised much higher than your shoulders. They should be about 12 inches or more raised. Keep your knees bent. Relax as much as you can and focus on your baby.
Prop one end of an ironing board or another board that is at least 12 inches wide, on the seat of a chair or the couch. The other end should be on the floor. You then lay down with your head at the lowest end, and your feet up at the other end. Keep your knees bent, and you can have a pillow under your head also for comfort.
When your head is lower, gravity encourages the baby's head to float down towards your fundus, which is the top of your tummy, then flex its chin and will begin to turn. Pressure will begin to build on the back of the baby's head, and then the baby will begin to turn. First the baby will turn to a transverse, and finally head down (vertex). a helpful web site for breech is: breechbabies.com
Or your care giver may choose to turn the baby.The baby in this position is lying sideways, meaning the head is to your side and so are the feet. This may occur in a mother that has lax abdominal and uterine muscles.
![[A transverse baby]](../images/Transverse_lie.jpg)
This baby is trying to come down head first, but with its back to the mothers back. So baby's face is out towards your tummy. This position does not allow the baby as much room to deliver, because of how the baby flexes its head to its chin. This position use to be one of the main reasons that women were given c-sections. Baby's can be delivered vaginally this way, but often your labor is much longer and harder, being felt in the back called 'back labor'. The baby comes out 'star gazing' or 'Sunny side up'. Many baby's turn before they are born. When I worked in the hospital, is was common for women to have the section. Now many are not, you are encouraged to do things to help get the baby to turn. I call these babies star gazers, because they are trying to come out face up, not face down, towards the mothers spine. They can be delivered in most cases, but it far better to do things to get your baby to turn. You midwife can give you all kinds of suggestions. If you are delivering in a hospital, you should have a doula to help you. They will give suggestions to assist you.
![[Posterior]](../images/Pregnancy_variations-posterior.jpg)
You can still have the baby. When I use to work in the hospital as a nurse, due to being posterior, many babies were born by c-section. This is NOT a good reason for a c-section. There are just too many ways to work with a posterior baby to get him/her to turn. If the baby does not turn, there is a reason. Work with your midwife, remember that birth is normal. You are able to deliver this baby. Trust birth. Trust yourself
This is when the baby is not coming down at the correct angle, such as tipping its head towards the shoulder. Your labor will have more discomfort deep in the left side of your pelvis, usually just below the hop joint. You need to move and flex your pelvis.
this is when a hand or arm is trying to come at the same time the head is. Meaning, the baby has its arm or hand up at the head. Progress is usually slower, and the woman may feel pain on the side where the hand is. This presenting hand may also cause the water to break earlier. If the arm is wrapped around the body, (try to reach your right arm up around you neck and face to reach your back left shoulder, this is what we mean here). The woman will feel pain in her sacrum during the contraction. This is from the babies elbow being forced against the sacrum.
This is when the babies anterior shoulder become lodged under the mothers pubic bone. The impacted shoulders, along with the squeezing of the birth canal against the chest can cause the venous return from the head to be impaired which can result with intracranial bleeding, brain damage, and death.
Signs to look for:There are good reasons for a c-section and not so good reasons. This country, the great U.S. is not first for the best outcomes with healthy moms and babies. There are other countries that do a better job, and those countries are not always 1'st world countries. The difference is they use midwives for ALL normal births, and OB's are ONLY used for the problem deliveries. That means at the birth"there is never at anytime a doctor in the room." -(Marsden Wagner MD, former head of the World Health Organization)
Here in the U.S. the c-section rate is about 25-35% in most hospitals. Some may be lower, but many are actually higher.
These are not good reasons to be induced: Your care giver is going out of town. You are due so why not? You are a week over due. You are just tired of being pregnant. You want your baby to be born on a certain day, and not another. Your labor is slow. Your husband has the day off. You have a baby sitter today. ( I have heard them all!)
Good reasons to be induced: You are 2 weeks or more over due. You are having other health problems and it is healthier for baby to be out here now, and better for your health. Your water has broken (for sure) and your labor has not started after failed attempts of natural ways to get it going.
Augmenting is when you are in labor, and it is not going fast enough or has stopped. In the hospital: they will usually start a pitocinIV drip, ( a man made version of the hormone that causes you to have contractions). At home you may be asked to do nipple stimulation. This causes your body to produce more of a hormone that makes your have contractions. Yes, it works!
Before you have any procedure done, you need to ask questions "Is this really necessary?" "Is there any thing else that we can do first?"
A blood test should be done in this case.
Some women experience itching in late pregnancy. This can be caused by Cholestasis. It is a common liver disease that only occurs in pregnancy. The flow of bile in the gallbladder is affected by the high amounts of pregnancy hormones. The gallbladder holds bile that is produced in the liver. The function of bile is to aid in the digestion of fats. When the flow of bile is slowed down or stopped, it causes a build up of bile acids in the liver which can spill into the bloodstream.
It is diagnosed by blood test after a history is taken. Elevated maternal levels of bile can stress the baby's liver. The developing baby relies on the mothers liver to remove bile acids from the blood.
Dandelion root and Milk thistle are natural substances that are helpful to remove the toxins. Cold baths and ice water slows down the flow of blood in the body by decreasing the temperature.
After you eat your glucose level is elevated. Glucose levels are controlled by insulin and glucagon. Before you eat, the level is low. Once you have eaten, and the glucose level rises, your insulin is secreted. This makes the glucose go into the cells to be metabolized to glycogen, amino acids, and fatty acids. By testing this, it will give your care giver a guide to your body's handling your glucose level. If it is elevated or abnormal , your care giver might talk with you about doing a 3 hour glucose tolerance test. It will give him/her more information about how your body is handling and processing glucose.
A epis. can hurt, and even if it does not, the stick with the needle to numb you does. When you are pushing you don't want to feel this pain, along with the normal pains you are feeling. The medical community says that is does not hurt much if they do it while you are pushing, no numbing then, but it does hurt! You feel it! Pain is pain! You need to ask, 'do I really need that done?' The decision that you need one should be made seconds before it is done, not weeks and months before the infants birth. My first baby the decision was made before the birth, with my first visit to the doctor. I was told that all first time mothers received one, and I thought I had to go along with this decision. No one told me about my rights. YOU DO HAVE A SAY!
It is the spouses job to remind the doctor that you do not want to be cut. If you don't want to be cut and or tear, let me tell you how to prevent tearing...
I had a 4th degree tear with my third baby, (although the records show they only charted it as a 3rd degree, they had verbally stated it was a 4th) Tearing is measured by how bad it is, 1st not being so bad, 2nd, 3rd and finally a 4th, which extends into the muscles. So I had the worst one that you can have. It was mostly MY fault. I am not trying to place any guilt onto any mothers out there, but the fact is I was NOT in control of my pushing! I pushed very hard, holding my breath for a long time, and pushed her down the birth canal fast and out fast. She was my smallest baby and I never should have torn. Had I been in control, with my breathing and pushing, I would not have torn. this is when a doula would help a lot . DONA.org
I hear moms talk about this all of the time, 'I pushed 5 times, or I pushed 10 times'. so what? so what if you only pushed 5 times and ended up like I did? That is nothing to brag about. The mom who pushed 30 times may not have torn at all. she is less sore, with no tear, because she pushed slow. This allowed her tissues to stretch. Her bowels work better, and easier after the delivery, and she can walk and sit with out being sore. Who would you rather be like?
Group B Streptococcus (GBS) is a bacteria found in the lower intestine and in the vaginal of healthy women. (It is also found in other healthy adults). It is a bacterium that causes illness in newborns, pregnant women, the elderly, and adults with other illnesses, such as diabetes or liver disease. GBS causes sepsis (blood infection) and meningitis (infection of the fluid and lining surrounding the brain) in newborns. Approximately 8,000 babies get GBS each year, and about 300 of these die.
It is not the kind that causes strep throat, that is from group A-strep. It is also not a sexually transmitted disease.
When you have Group B Strep, you are said to be colonized, and are not contagious. Group B Strep is a normal part of the commonly found bacteria in the human body, and usually does not cause a problem. You can carry it in your bowel, vagina, bladder or throat.
With newborn babies, GBS is a common cause of sepsis (infection of the blood) and meningitis (infection of the fluid and lining surrounding the brain) and can cause pneumonia. If a baby has this, and survives, he can have long-term medical, hearing or vision problems, and other physical and learning disabilities such as cerebral palsy. Your baby can become colonized with GBS if the mother is colonized with GBS in the rectum or vagina, and this occurs before or at the birth.
A baby can come in contact with it before or during birth if the mother carries GBS. About 1-2% infants that are colonized with GBS develop signs and symptoms of GBS Disease. Some get early onset GBS which occurs in the first week of life, but most are apparent within a few hours after the birth. If the water is broken in a mother with GBS for longer than 18 hours the risk to the infant is greater. If the baby is premature the risk is greater. There is also evidence that the GBS may cross the membranes prior to delivery. GBS can cause pre-term delivery, still births, or miscarriages, but is not the only cause of these things.
GBS is tested by taking a swab from your vagina and rectum. This culture is then processed in a lab. This is done from 35-37 weeks of your pregnancy. (recommended by the Center for Disease Control, CDC) . If you are positive, it means that you have GBS, you are colonized, it does not mean that you and your baby will become sick. You are then given antibiotics during the labor. If you have a positive culture from your urine, then that is treated at the time of diagnosis, not waited until labor begins. It is stated that the antibiotics prevent the spread of GBS from the mother to the baby.
It is NOT recommended that colonized women take oral antibiotics prior to labor beginning. It is recommended that you have IV antibiotics when labor begins. If you are delivering at home or a birth center, and are unable to have IV antibiotics, then it is recommended that you have IM antibiotics.
There are those (including physicians, OB's, and midwives) that think to be tested at 35-37 weeks does not prove that your test would be the same results during labor. They say that you may have a negative result now and a positive result later, or visa versa. Others disagree. Either way, you need to become an informed consumer to make the choice that is best for you.
Chlorhexidine vaginal flushings versus systemic ampicillin in the prevention of vertical transmission of neonatal group B streptococcus, at term. Facchinetti F, Piccinini F, Mordini S, volpe A. Department of Gynecology, Obstetrics and Pediatric Sciences, University of Modwna and Reggio Emilia, Italy
Objective: To investigate the efficacy of intrapartum vaginal flushings with chlorehexidine compared with ampicillin in preventing group B streptococcus transmission to neonates.
METHODS: This was a randomized controlled study, including singleton pregnancies delivering vaginally. Rupture of membranes, when present, must not have occurred more than 6 hours previously. Women with any gestational complication, with a newborn previously affected by group B streptococcus sepsis or whose cervical dilation was greater than 5 cm were excluded. A total of 244 group B streptococcus-colonized mothers at term (screened at 36-38 weeks) were randomized to receive either 140 ml chlorhexidine 0.2% by vaginal flushings every 6 hours or ampicillin 2 g intravenously every 6 h until delivery. Neonatal swabs were taken at birth, at three different sites (nose, ear and gastric juice).
RESULTS: A total of 108 women were treated with ampicillin and 109 with chlorhexidine. Their ages and gestational weeks at delivery were similar in the two groups. Nulliparous women were equally distributed between the two groups (ampicillin, 87%; chlorhexidine, 89%). Clinical data such as birth weight (ampicillin 3,365 +/- 390 g; chlorhexidine, 3440 +/- 0.6; chlorhexidine, 9.6 +/- 1.1) were similar for the two groups, as was the rate of neonatal group B streptococcus colonization (chlorhexidine, 15.6%; ampicillin, 12%). Escherichia coli, on the other hand, was significantly more prevalent in the ampicillin (7.4%) than in the chlorhexidine group (1.8%, p < 0.05). Six neonates were transferred to the neonatal intensive care unit, including tow cases of early-onset sepsis (one in each group).
CONCLUSIONS: In this carefully screened target population, intrapartum vaginal flushings with chlorhexidine in colonized mothers display the same efficacy as ampicillin in preventing vertical transmission of group B streptococcus. Moreover, the rate of neonatal E. coli colonization was reduced by chlorhexidine.
BMJ 1997 Jul 26;3 15(7102):216-9; discussion 220 comment in : BMJ Jul 26; 315(7102):199-200. Effect of cleansing the birth canal with antiseptic solution on maternal and newborn morbidity and morality in Malawi: clinical trial. Taha TE, Biggar RJ, Broadhead RL, Mtimavalye LA, Justesen AB, Liomba GN, Chiphangwi JD, Miotti PG. Department of Epidemiology, School of Hygiene and Public Health, Johns Hopkins University, Baltimore MD 21205, USA. OBJECTIVE: To determine if cleansing the birth canal with an antiseptic at delivery reduces infections in mothers and babies postnatally. DESIGN: Clinical trail; two months of no intervention were followed by three months of intervention and a final month of no intervention. SETTING: Queen Elizabeth Central Hospital (tertiary care urban hospital), Blantyre, Malawi. SUBJECTS: A total of 6965 women giving birth in a six month period and their 7160 babies. INTERVENTION: Manual wipe of the maternal birth canal with a 0.25% chlohexidine solution at every vaginal examination before delivery. Babies born during the intervention were also wiped with chlorhexidine. MAIN OUTCOME MEASURES: Effects of the intervention on neonatal and maternal morbidity and mortality. RESULTS: 3635 women giving birth to 3743 babies were enrolled in the intervention phase and 3330 women giving birth to 3417 babies were enrolled in the non-intervention phase. There were no adverse reactions related to the intervention among the mothers or their children. Among infants born in the intervention phase, overall neonatal admissions were reduced (634/3743 (16.9%) v 661/3417 (19.3%), P< 0.01), as were admissions for neonatal sepsis (7.8 v 17.9 per 1000 live births, P < 0.0002), overall neonatal morality (28.6 v 36.9 per 1000 live births, P < 0.06), and mortality due to infectious causes (2.4 v 7.3 per 1000 live births, P <0.005). Among mothers receiving the intervention, admissions related to delivery were reduced (29.4 v 40.2 per 1000 deliveries, P < 0.02), as were admissions due to postpartum infections (1.7 v 5.1 per 1000 deliveries, P=0.02) and duration of hospitalization (Wilcoxon P =0.008). CONCLUSIONS: Cleansing the birth canal with chlorhexidine reduced early neonatal and maternal postpartum infectious problems. The safety, simplicity, and low cost of the procedure suggest that it should be considered as standard care to lower infant and maternal morbidity and mortality.
Lancet 1992 Jul 11;340(8811):65-9. Comment in : Lancet. 1992 Sep 26;340(8822):791; discussion 791-2. Lancet. 1992 Sep 26:340(8822):792. Prevention of excess neonatal morbidity associated with group B streptococci by vaginal chlorhexidine disinfection during labor. The Swedish Chlorhexidine Study Group. Bacteriological Laboratory, Stockholm, Sweded. Streptococcus agalactiae transmitted to infants from the vagina during birth is an important cause of invasive neonatal infection. We have done a prospective, randomized, double-blind, placebo-controlled, multi-centre study of chlorhexidine prophylaxis to prevent neonatal disease due to vaginal transmission of S. agalactiae. On arrival in the delivery room, swabs were taken for culture from the vaginas of 4483 women who were expecting a full-term single birth. Vaginal flushing was then done with either 60ml chlorhexidine diacetate (2g/l) (2238 women) or saline placebo (2245) and this procedure was repeated every 6 h until delivery. The rate of admission of babies to special-care neonatal units within 48 h of delivery was the primary end point. For babies born to placebo- treated women, maternal carriage of S. agalactiae was associated with a significant increase in the rate of admission compared with non-colonized mothers 95.4 vs 2.4%; RR 2.31, 95% CI 1.39-3.86; p = 0.002). Chlorhexidine reduced the admission rate for infants born of carrier mothers to 2.8% (RR 1.95, 95% CI 0.94-4.03), and for infants born to all mothers to 2.0% (RR 1.48, 95% CI 1.01-2.16; p n 0.04). Maternal S. agalactiae colonization is associated with excess early neonatal morbidity, apparently related to aspiration of the organism, that can be reduced with chlorhexidine disinfection of the vagina during labor.
INDUCTIONS are when you start the labor, when you 'get the labor going' and augmenting is when your labor is already begun on its own, and has slowed to the point that they try to get it going again. Artificial inductions of labor have become commonplace in the United States. Approximately one in five births is begun artificially and this number continues to rise. Inductions are performed for both necessary medical reasons and unnecessary non-medical reasons (also known as an "elective induction"). Inductions have, directly and indirectly, contributed to many of the climbing cesarean rates and numbers of premature births in the country.
Good reasons to be induced: You are 2 weeks or more over due. You are having other health problems and it is healthier for baby to be out here now, and better for your health. Your water has broken (for sure) and your labor has not started after failed attempts of natural ways to get it going.
Inductions are done by the medical community by IV pitocin which is a medicine, a man made type of the hormone that your body produces naturally. A IV is started then you are strapped to a monitor, the baby's heart is monitored for about a half an hour to see how the baby is doing. Then the medicine is added to the IV solution, you need to stay on the monitor as the medicine can cause fetal distress. They will continue to increase the amount of medicine you get as the watch to be sure the baby is tolerating this ok. If at any time the baby does not tolerate this, they can stop the medicine.
Augmenting is when you are in labor, and it is not going fast enough or has stopped. In the hospital: they will usually start a pitocin IV drip, ( a man made version of the hormone that causes you to have contractions). At home you may be asked to do nipple stimulation. This causes your body to produce more of a hormone that makes your have contractions. Yes, it works!
"Stripping of the membranes" --separating the amniotic sac from the lower uterine walls/cervix--has also been used to induce labor, though it is a fairly uncomfortable/painful procedure. There are the risks of inadvertently rupturing the membranes and/or leading to an infection. Success for this route is hit or miss--often with the "misses" leading to patterns of frequent contractions which are strong enough to keep you awake, but not strong enough to launch you into labor. However, if induction is imminent and cannot be avoided, a recent study has shown that "Membrane sweeping at initiation of labor induction increased the spontaneous vaginal delivery rate, reduced oxytocic drug use, shortened induction to delivery interval, and improved patient satisfaction." (Obstetrics and Gynecology March 2006)
Cytotec is a pill that is NOT made for use for birth, but has been used for inducing. The drug manufacture does not suggest its use for this. Doctors and some midwives continue to use it for this, but they are taking your life into their hands. Many will use it, and do just fine. But the one that has a uterus rupture, and does not make it to the OR in time, may die. IT SHOULD NEVER BE GIVEN AT HOME or birth center, EVER. It is placed in side your vagina up by the cervix. It causes contractions, and they come on and you can go very quickly. This type of contraction, can cause your uterus to rupture. The pill can NOT be removed once inserted and dissolved. So there is no way to get it out, or stop its action like you can do with pitocin. The only thing that I feel that this pill is good for is to treat a post partum hemorrhage, when it will be inserted rectally.
This is when the baby had a bowel movement inside the uterus. This can become a problem if it is very thick. The baby can aspirate some into it's lungs before or at the birth. Sometimes the baby will be suctioned well prior to the delivery of the body, as I have you pant to prevent pushing the baby out too fast, and also suctioned well after the birth. The latest sutdies show that although we may suction a baby well, it actually may not do any good, and infact cause more harm. Your care provider will decide at the birth what is the best thing to do. One way to possibly help is to have a water birth. As the baby's head is delivered, the mouth is washed out with the tubs water, thus may decrease the chance of aspiration of meconium into the lungs that may be in the mouth. Remember that the baby may have already aspirated prior to the birth, so this does not mean that the baby may not have problems. Can you avoid this from happening to the baby? Well, there is some belief that if you try to avoid stress in your life, it will reduce stress to the baby and thus less of a chance for this to happen. Also over due babies may be more likely to have a bowel movement prior to the birth.
Pregnancy Induced Hypertension is present when a pregnant woman's blood pressure rises above 140/90 on two or more occasions, at least six hours apart. PIH occurs in the second half of pregnancy (usually after 20 weeks of gestation) in women who previously had normal blood pressure. It disappears following delivery.
Pre-eclampsia is similar but more severe and is also associated with proteinuria.
Eclampsia is serious and can result in convulsions.
There is Gestational hypertension (high blood pressure only), preeclampsia (high blood pressure, protein in the urine and swelling) and eclampsia (high blood pressure, protein in the urine, swelling and convulsions or seizures)
The heart, kidneys, liver and brain can be affected by PIH.High blood pressure, water retention(swelling) and protein in the urine.
Headaches, blurred vision, inability to tolerate bright light, fatigue, nausea/vomiting, urinating small amounts, pain in the upper right abdomen, shortness of breath, and tendency to bruise easily.
Your blood pressure is an important measure of your health. The stystolic number (the one on top or reported first) measures the pressure in your arteries when the heart contracts. (this measure the heart 'at work'). The diastolic (or bottom number, or the second number reported) measures pressure in the arteries when our heart relaxes. (your hearts measurement at rest)
PIH can occur at any time, but most often after the 20th week of pregnancy. If this occurs the placenta will not have enough blood flow which means the baby does not recieve enough oxygen and nutrients. This can cause the baby's growth ot slow. With 'mild' PIH, your B/P will rise slightly. You must work to keep it under control. Sometimes even though you do everything correct, you still may have trouble.
Diet is very important and the following link will give you a diet to follow that helps you. www.blueribbonbaby.org
Whilst cardiac output appears to decrease as preeclampsia worsens, generalized vasoconstriction occurs which affects much of the physiological activity of the tissues within the body. Capillary permeability increases and the fluid which escapes contributes to the edema within the tissues. The presence of excess fluid within the cells impedes oxygenation and tissue hypoxia occurs which may cause tissue necrosis of the vital organs.
In the kidney vasospasm of the afferent arterioles results in a decreased renal blood flow which produces hypoxia and edema of the endothelial cells of the glomerular basement membrane as the condition worsens. Permeability increases and serum albumin filters through into the urine. This alters the plasma osmotic pressure resulting in tissue fluid retention producing generalized edema.
The circulating plasma volume is reduced resulting in haemoconcentration.
Disseminated intravascular coagulation (DIC) results and as the process progresses fibrin and platelet deposits occur in many organs including the brain and liver.
The uterus is also affected, particularly the vessels supplying the placental bed. Vasoconstriction and DIC reduce the uterine blood flow and vascular lesions occur in the placental bed.
Placental abruption can be the result. Reduction in blood flow to the choriodecidual spaces diminishes the oxygen which diffuses through the cells of the syncytiotrophoblast and cytotrophoblast into the fetal circulation within the placenta. The result is that the placental tissue becomes ischemic, the capillaries in the chorionic villi thrombose and infarctions occur. Hormonal output is impaired with reduced placental function. This has serious implications for the survival of the fetus. In their research into Doppler umbilical and uterine flow wave forms in severe pregnancy hypertension, Trudinger and Cook (1989) concluded that an abnormal Doppler flow velocity wave form correlated with adverse fetal outcome. They also suggested that the associated placental lesion may precede the maternal hypertension.
The liver is affected in severe cases where intracapsular hemorrhages and necrosis occur. Edema of the liver cells produces epigastric pain and impaired liver function may result in jaundice.
The brain becomes edematous and this, in conjunction with DIC, can produce thrombosis and necrosis of the blood vessel walls resulting in cerebrovascular accident. DIC was identified in 12 women out of 27 who died as a result of pre-eclampsia or eclampsia in the triennium 1985-87 (DH et al 1991). Sheehan identified that cerebral venous thrombosis could account for eclampsia occurring in the postpartum period (cited in MacGillivray 1983).
The lungs become congested with fluid in severe cases; oxygenation is impaired and cyanosis occurs.
This is when the placenta separates from the uterine lining. This can occur at any time, but is more common in the third trimester. After the 20th week only about 1% of women will experience this. The placenta provides your baby with rich oxygenated blood, and without this, the baby will die.
Signs and Symptoms:This is when you need bed rest. You will be monitored close. If the bleeding does not stop, then they will attempt to deliver the baby. Possibly by c-section.
Bed rest and close monitoring is prescribed. In some cases transfusions and other emergency treatment may be needed as well.
Prompt medical action, including transfusions and immediate delivery is needed.
This is when the placenta covers the opening of the cervix inside of the uterus. It can cover it slightly, which means that you can still deliver the baby vaginally. If the opening is covered too much, or completely, then you would have to have a C-section. The baby can not come thru the placenta, the baby would die. One way that this is diagnosed is there may be some bleeding in your pregnancy. This can occur at any time, but most often occurs later in the pregnancy. If this is suspected you can have a ultra sound to confirm if you have placenta previa.
If at any time you begin to have contractions or any sign of labor prior to 37 weeks, you need to contact your midwife right away! Although many moms deliver babies prior to 37 weeks, that do just fine, some do not. Some babies born before 37 weeks will have problems with their respiratory system, meaning they may require help with ventilation.
This can reseal, but you are now at risk for infection since it has ruptured. Also there is a 30% chance that your baby can die. The baby's lungs are not mature as they need to by. The baby can have Respiratory Distress Syndrome. There is more of a chance for the cord to prolapse. This would require a C-section. You need to call your midwife right away!
The bag of waters act as a shock absorber to the baby, allows the baby to move easier, prevents the cord from becoming compressed or prolapsing, and helps to regulate the babys temperature.
When your water bag breaks early, you now have a chance for infection to become introduced to the uterus and to the baby. I have my clients take extra zinc, and vit C. Both are important and required for strengthening the membranes. You do not wait to take them when a problem occurs, you begin to take them prior to a problem. I have you take 15-25 mg of Zinc, and 500mg to 3000mg of Vit C. daily. If you do not go into labor on your own, you will need to talk with your midwife or Doctor to make a decision what you should be doing.
The tipped uterus is back toward the back of the pelvis. This occurs for different reasons, but may be from scarring from adhesions as a result of endometriosis, or fibroids. Giving birth can cause this if the ligaments that hold the uterus stretch. You may have pain with menstruation or sexual intercourse. You may also experience back pain and some incontinence of your urine, UTI, and fertility problems.
You can treat this with out seeing a doctor (who would recommend surgery) by trying the knee chest exercise. This may help, but not if it is caused by fibroids or endometriosis. Then you may have to go the medical route, of surgery to fix the problem.
This is from a parasite which is found in the feces of cats. It can cause a rare, but serious blood infection.
You should not be handling your cats litter. Also handling of raw meat, not cleaning your counters well or other areas where raw meat has been, or eating undercooked meat are other ways to get this. Diagnosis is made with a blood test. Treatment is with antibiotics for several months.
Urinary Tract Infection (UTI) is a bacterial inflammation of the urinary tract. When you are pregnant you are at more of a risk for this. This is due to the fact that the uterus is sitting on the top of the bladder, and as it grows (the uterus), its increasing weight can block the drainage of urine from the bladder, and cause a infection.
Treatment is with either 'medical' or natural antibiotics. You should not allow the infection to go on without treatment as it can cause you to go into premature labor. Talk to your midwife if you are experiencing this.
