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Pregnancy Can Cause Some Serious Skin Changes

When we think of skin changes in pregnancy, what immediately comes to mind are stretch marks or Striae Gravidarum . Stretch marks occur because of a breakdown of collagen, a substance that holds the skin together and is responsible for its stretching. Teen pregnant patients are more at risk for having stretch marks. Why is that important? Because, according to medical literature, stretch marks can increase the risk of having lacerations (or tears) during birth.

Another fairly common skin condition during pregnant is called Pruritus gravidarum or generalized itching during pregnancy without the presence of a rash. Approximately 14% of pregnant women are affected by this condition and it is associated with twin pregnancies, fertility treatments and diabetes. As stated in my previous blog, itching during pregnancy should not be ignored, especially in the third trimester because it could signify a condition called Cholestasis of Pregnancy that involves an increase in bile or liver enzymes. This condition is also associated with preterm labor.

Hormonal changes of pregnancy that involve estrogen or progesterone can produce Read more »

*This blog post was originally published at Dr. Linda Burke-Galloway*

Pregnant Women: How Sleeping Position Might Affect Baby’s Health

A little knowledge is dangerous; especially when it relates to medicine. A recent article in the British newspaper, Daily Mirror discussed a medical study that attempted to prove there was a link between pregnant women’s sleeping positions and stillbirth. The author is of the opinion that the study was small and biased and therefore “there is a serious need for more research before we’re in a strong position to make ¬any recommendations.” Obviously this author has limited knowledge about the cardiovascular system of a pregnant woman.

Our organs and tissues require oxygen to function. Without it, they essentially die. Blood from the lower part of our body flows back to the heart where it receives oxygen, compliments of a large blood vessel called the Inferior Vena Cava (IVC). The inferior vena cava is a large, thin-walled blood vessel located near the spine. As the pregnant uterus becomes enlarged, it can press against the IVC and reduce the amount of its blood flow. Why is that not good? Because it reduces the circulating blood flow in the body that is commonly known as our cardiac output (CO). When the pregnant uterus squeezes the IVC and reduces cardiac output, a woman might feel dizzy and even faint. Her blood supply of oxygen is reduced and the unborn baby’s is as well. When a pregnant woman in her early or late third trimester feels faint after lying flat on her back, the syndrome is called Supine Hypotensive Disorder. Her blood pressure has dropped because her cardiac output has dropped. The heart can only pump out what comes into it, so less blood into the heart means less blood going out of the heart and the patient feels faint. How is this avoided? Read more »

*This blog post was originally published at Dr. Linda Burke-Galloway*

New Study About Stillbirths Suggests A Possible Screening Test

One of the most dreaded complications in obstetrics is a stillbirth that is defined as the absence of life upon delivery of the baby. There are approximately 3million stillbirths that occur each year globally and one-half million in the U.S. In developing countries, the most common reasons of stillbirths were prolonged labor, pre-eclampsia and infections whereas in the U.S., the most common causes are abnormal genes, abnormal growth (aka growth restriction) and maternal diseases. According to medical studies, unexplained fetal loss is the most common reason for stillbirths that occur after 28 weeks. Risk factors for stillbirth include women who have infections, abnormal chromosomes, genetic disorders and umbilical cord complications. Race and socioeconomics also play a role. Black women have twice the risk of having a stillbirth as Caucasian women. Smoking and advanced maternal age also poses an increased risk.

Until recently, there are no screening tests available to see if a woman was carrying a baby at risk for stillbirth. However, a medical study presented at a conference reported that stillbirths can now be predicted using Read more »

*This blog post was originally published at Dr. Linda Burke-Galloway*

Pregnant Female Prisoners Must Remain In Shackles During C-Section Procedures?

“But for the grace of God go I.” My late aunt drilled that value into my six-year old head and it has never left. An article regarding a New York politician recently caught my attention. When New York State enacted a bill to ban the shackling of pregnant prisoners, a New York State Assemblywoman objected. The article goes on to discuss the case of Jeanna M. Graves, who, in 2002 was arrested on a drug charge and began a three year sentence. Graves was pregnant with twins and while in labor, was handcuffed during her entire C. Section. How utterly ridiculous.

Before a C. Section begins, a patient is usually given either an epidural or spinal anesthesia. On rare occasions, she is put to sleep with general anesthesia if the baby must be delivered emergently. On all accounts, the patient’s legs will either be numb from anesthesia or she will be sleeping. Why then does she need shackles? She’s certainly not in a position to run. Although I addressed this issue last August, it needs to be revisited again. Read more »

*This blog post was originally published at Dr. Linda Burke-Galloway*

Pregnant And Itchy? It Could Be A Dangerous Liver Problem

If a pregnant woman finds herself scratching and itching during the third trimester, these symptoms should not be ignored. Each year, approximately 0.1 to 15% of pregnant women are affected by a liver disorder called Intrahepatic Cholestasis of Pregnancy or (ICP). ICP patients tend to develop symptoms of itchiness of their hands and feet that becomes progressively worse and then spreads all over their body. The itchiness usually worsens at night and if untreated can cause jaundice and several life-threatening complications to the unborn fetus. When a pregnant woman complaints of itchiness (pruritus) all over her body, the first order of business is to determine whether a rash is present. If a rash is absent, ICP should be suspected.

The liver is the largest gland in the body and in addition to filtering harmful substances such as alcohol it is also responsible for processing fats, carbohydrates and proteins. To process fat, the liver makes bile salts. In ICP, bile salts are increased which contributes to the symptoms of itchiness. Affected women will not only be plagued by pruritus but their unborn babies are at risk for stillbirth, preterm labor, fetal distress and abnormal heart rates. South American women and especially those from Chile have a greater risk of developing ICD as do women from South Asia and Sweden. Read more »

*This blog post was originally published at Dr. Linda Burke-Galloway*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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