Of the 4 million babies born in the U.S. each year, approximately 12.3 percent of them will be premature and 3.56 percent will occur before 34 weeks. Premature birth is one of the leading causes of severe handicaps and has an annual cost of approximately $26 billion dollars. Although risk factors for preterm labor have been identified, there is still no cure. As stated in a previous blog post, when the cervix becomes weak (a condition called cervical insufficiency), the patient is at risk for second trimester miscarriages and preterm labor. Also, if a patient has a previous history of premature birth then she needs her cervix measured in a future pregnancy. If her cervix is short and measures between 16 mm and 25 mm before 23 weeks, she is at risk for premature labor and delivery. The recommended treatment for a short cervix is either progesterone suppositories or injections. A few months ago, there was profound controversy over an FDA approved injection that would cost approximately $1500.00 if purchased by the manufacturer, K-V Pharmaceuticals. Bending under political pressure, K-V reduced their price to $690.00.
The more options that are available for treatment of premature labor, the greater the chances are of achieving a full term baby. In the past two months, a new study has emerged which describes a progesterone gel that reduced birth rates before 33 weeks by 45 percent and improved newborn outcomes. This is a significant result. Read more »
*This blog post was originally published at Dr. Linda Burke-Galloway*
I can already tell that this pregnancy is different from my first. When I was pregnant with Little Isis, I drank no caffeine and took no over-the-counter medication. I remember having a few headaches and Mr. Isis fighting with me to take a headache pill. I would then proclaim dramatically, “But I can’t! What if it hurts the baby?!”
This morning, now pregnant with my second, I washed down a Zyrtec and two Tylenol with a cup of coffee. The little bugger is going to have to grow up with Little Isis. He might as well start building up his tolerance to exogenous substances at some point. I figure, now that its got a closed neural tube and a beating heart, we might as well begin.
Still, you can’t blame a pregnant woman for being a bit neurotic. The feeling that one is solely responsible for the well-being of a developing creature, combined with often contradictory advice, is enough to make anyone nuts. Most online advice is completely and utterly useless. Take this answer from Russell Turk, M.D. on the popular pregnancy website BabyCenter in response to the common question, “Is it safe to drink diet soda during pregnancy?” He answers:
Diet sodas often contain both caffeine and an artificial sweetener. There are several types of artificial sweeteners you may see on nutrition labels:
Aspartame (NutraSweet): Seems to be okay when consumed in moderation (the amount found in one or two 12-ounce servings of soda per day).
Saccharin (Sweet’n Low): Saccharin was found to cause birth defects in laboratory rats when consumed in very high amounts. Because its safety in smaller amounts is hard to prove, I would advise avoiding it.
Sucralose (Splenda): This relatively new sweetener, a modified form of regular table sugar, appears to be safe. But because it hasn’t been extensively studied, it’s best used in moderation.
It’s generally bad advice and leaves one wondering: “What is moderation? Will one soda hurt my baby? Will two sodas hurt my baby? How about three?” The default answer when we don’t know seems to be to tell women to do things in “moderation.” This places the sole responsibility on her to know what moderation means, and allows her to feel the guilt if something goes wrong. I think that these imprecise answers leave many women feeling helpless and afraid. Read more »
*This blog post was originally published at The Brain Confounds Everything*