by on September 25, 2017

Lupus & Pregnancy: 8 Important Things To Know

Lupus & Pregnancy- 8 Important Things To Know| Dr. Lori Gore-GreenLupus is a chronic inflammatory disease that isn’t discussed nearly as much as it should be.

This condition is a complication whereby an individual’s immune system attacks your organs and tissues. The joints, skin, blood cells, brain, kidneys, lungs, and heart, are touched by inflammation.

Unfortunately, lupus can be challenging to diagnose. The symptoms and signs can be difficult to distinguish, although there’s a distinctive sign of lupus that isn’t found in all cases, which is a facial rash resembling a sprawled-winged butterfly across each cheek.

Lupus can uniquely impact pregnant women. So, if a woman with lupus happens to become pregnant, there are many precautions that she must take, as there are potential risks to both the mother and child. It’s important to speak with one’s physician early and often, but more than that, it’s important to think about medications, it’s important to chat with an obstetrician, and significant to discuss delivery methods during the early stages of pregnancy or even ahead of pregnancy.

According to Doruk Erkan, MD, MPH of the Barbara Volcker Center for Women and Rheumatic Disease, there are ten points to consider to optimize the outcome for who are pregnant while having lupus. Read on for a paraphrasing of eight of those crucial pointers:

  1. Successful pregnancies are possible when one has lupus. Educating oneself and taking professional advice is essential for lupus patients, who are more likely develop complications than non-lupus patients. Rheumatologists and obstetricians experienced in managing high-risk pregnancies are necessary for discussion. Also, consultation with a Neonatal Intensive Care Unit as well as other advanced facilities is essential as a child may require specialized care. It’s also important to lean on the support of family, who may ease impending challenges.
  2. Consider what might be the right time to conceive. Ideally, conception should occur when you’re at peak health, and at least six months after disease activity, particularly that involving kidney disease. Visit with your doctor for blood tests and complete physical examination.
  3. Lupus flares can take place during pregnancy and following delivery. Thankfully, a majority of these flares aren’t life-threatening and can be treated with steroids.
  4. One can identify lupus flares during one’s pregnancy by looking for patchy hair loss, redness across cheeks and the nose, fatigues, body aches, and fever. Pain and swelling in the joints are also generally reported. The retention of fluid usually leads to the swelling of ankles, feet, and hands.
  5. For some patients, complications appear in the form of pre-eclampsia, HELLP syndrome (Hemolysis, Elevated Liver Enzymes, Low Platelets), hypertension, urinary tract infections, diabetes, and renal insufficiency. Frequent urination, headaches, abdominal pain, and blurry vision are additionally experienced. The heightened risk of pregnancy loss should also be acknowledged.
  6. It’s important to note that lupus patients give birth to healthy children, who don’t face an increased risk of mental retardation or congenital disabilities. It’s important to consult your physician about undergoing regular ultrasounds to monitor intrauterine growth retardation (IUGR) and low birth weight.
  7. Discuss any medication with your with your doctor to ensure that it won’t worsen your lupus or cause damage to your child. Consult about steroids, blood thinners, anti-inflammatory drugs, and other medications.
  8. Mothers with lupus can breastfeed, and if they find it to be a challenge, they shouldn’t hesitate to reach out to a trusted health care professional, who will likely advise against breastfeeding if a mother is on azathioprine, cyclosporine, cyclophosphamide, methotrexate, or mycophenolate mofetil.

Beyond the items listed above, lupus patients should also discuss the possibility of vaginal delivery as an option for delivery ahead of giving birth. Broach vital topics on birth control options, child care, and other necessary issues.

Filed Under: Contraception, Dr. Lori Gore-Green Tagged With: , , , , ,
by on June 18, 2016

Zika Virus Affecting 234 Women Nationwide, No Treatment Available

7469978464_6ebe7c0c7c_bThe Zika virus has continued to spread, and the World Health Organization has recommended that women and couples living in Zika-infected areas should refrain from becoming pregnant in order to limit the risk of giving birth to children with a congenital brain disorder –known as microcephaly, provoked by the virus.

Recently, the WHO indicated that the Zika virus will affect millions of reproductive-aged people in 46 nations where the virus has spread. The US Centers for Disease Control and Prevention asked that pregnant women and those trying to conceive not travel to Zika-plagued areas –although such requests frequently ignore certain realities. Approximately 25 percent of Puerto Rico’s 3.5 million population will likely be infected by Zika virus by the year’s end. With that said, scientists have not expected that outbreak will spread to the continental United States.

Zika virus is commonly spread by mosquitoes of the Aedes genus. This can be transmitted by having sex with another person, and mothers can infect infants, who face high rates of microcephaly, which is a disorder characterized by unusually small heads and severe brain damage. Avoiding pregnancy is nearly impossible for certain women living in Zika-infected areas.

In Caribbean and Latin American countries, 58 percent of pregnancies are unattended. These countries also have some of the most restrictive and harshest reproductive health laws. Contraception is far too pricey in these areas, likewise, clinics are too far and many young people avoid contraception because of stigma regarding promiscuity, which all increases the likelihood of childbirth. Additionally, abortion is restricted and banned in many areas. What must also be considered are the number of young women raped each year in Latin America, an estimated 1.6 million.

Unintentionally, women will become present, so it’s up to the government to educate the public and make essential resources available whenever necessary, making it easier for women to avoid pregnancies. According to the New York Times, the Zika virus has not only spread from Brazil into the Carribean, but women and unborn children in the U.S. also face a threat. There are three essential tests used to detect the virus. If a woman tests positive for Zika, there’s no treatment, but doctors will be able to perform several ultrasounds to detect issues in fetal development.

According to the New York Times, there are now 234 pregnant women in the continental U.S. carry the Zika virus. Beyond that, the problem facing health providers is the fact that many who require testing, large numbers of women, many uninsured or low-income immigrants from the Caribbean and Latin America, are not being screened or tested sufficiently.

Beyond that, data isn’t kept on many women who’ve traveled to Zika areas. Conversely, women from higher-income neighborhoods are far more likely to be tested. Risks are mounting as the summer draws nearer and mosquitos carry the virus to Florida and other states along the Gulf of Mexico, where there will most likely be cases of transmission. All reported cases of the virus in the U.S. have been contracted elsewhere –including the three babies born in the U.S. with the disease, and the recent loss of three babies that occurred due to the virus.

The CDC will publish weekly updates, offering pregnancy outcome data:  www.cdc.gov/zika/geo/pregnancy-outcomes.html.

Filed Under: Dr. Lori Gore-Green, Zika Virus Tagged With: , , , ,
by on February 22, 2016

New Prenatal Test Warn Expectant Moms About Risk Factors Just Nine Weeks Into Pregnancy

Pregnancy

With all of the concerns about how various activities and foods will impact the baby, pregnant women have a lot to worry about. While every pregnant woman wishes to have a perfect pregnancy, this is not always possible. And if something does go wrong, it’s best to know as soon as possible. “As soon as possible” has just become a lot sooner thanks to a revolutionary new test called Panorama.

This new prenatal test and can now find abnormalities as early as nine weeks into the pregnancy. Taking this test will take some of the weight off of the shoulders of expecting mothers if there are no abnormalities. If there are some abnormalities, the family will have time to prepare.

So how exactly does it work? Blood is drawn from expectant moms in order to get genetic material from the baby’s placenta. This test can spot defects that can result in Down’s syndrome or other trisomies. It can also find defects that lead to sex chromosome abnormalities and microdeletions, which are the cause of conditions like Angelman and Prader-Willi.

If the results of the test show that there is a high risk for some abnormalities in your baby, there is more that needs to be done. The next step is more testing, such as amniocentesis or the CVS, chorionic villus sampling. If the results show a low risk, the expectant mother may be able to void amniocentesis or other invasive tests.

While it will, of course, be unsettling for an expectant mother to learn that she is high risk, it is ultimately crucial that she find out early, so she can better prepare. If an expectant mother gets back a high-risk result, the mother and her doctor should monitor the pregnancy differently. They will also want to ensure that that the mother is at the best possible location to deliver her baby. This means that she should be near the best specialist and the best NICU possible. This way, her delivery can go as smoothly as possible and the baby can be as healthy as possible.

While the most important aspect of Panorama is, of course, the ability to detect risk factors, it also has a number of other interesting features. For example, parents can detect their baby’s gender early on. It is astounding that a non-invasive surgery that is done with a simple blood test can show this.

One of several cell-free DNA tests on the market, Panorama may give a false positive result. However, out of all prenatal screening tests available, Panorama has the lowest false positive rate for the commonly screened chromosomal abnormalities, trisomies 13, 18 and 21.

Panorama is typically used alongside other routine screening tests such as ultrasounds, and it is typically covered by insurance. With Panorama, expectant mothers who do not have high-risk factors can instead focus on other matters. And those who are at high risk can adjust so that their babies can be as healthy as possible. Panorama is bound to make an incredible difference in the lives of many expectant families.

Speak with your doctor about Panorama and allow your doctor to communicate if this prenatal screening is right for you.

Filed Under: Dr. Lori Gore-Green, Pregnant Tagged With: , , , , ,