Family & Pregnancy

Irregular Periods: Risk Factor for Ovarian Cancer?

Women with irregular menstrual cycles may have more than double the risk of ovarian cancer compared to women who have regular monthly periods, new research suggests.

This finding suggests that women with irregular periods — including those with a condition called polycystic ovarian syndrome — might be a group that could benefit from early screening for ovarian cancer, said the study’s lead author, Barbara Cohn. She is director of child health and development studies at the Public Health Institute in Berkeley, Calif.

“Ninety percent of women who get ovarian cancer don’t have risk factors for it. Our study findings help to narrow the search,” said Cohn.

“If we can confirm what we have here and can learn more about the mechanism behind ovarian cancer, then we might be able to do something as simple as recommend birth control pills for women with irregular periods, provided they have no other risk factors against birth control pill use,” said Cohn.

However, the study design wasn’t able to show that irregular periods caused ovarian cancer or an increased risk, only that there was an association between the two.

The American Cancer Society estimates that nearly 22,000 American women will be diagnosed with ovarian cancer in 2014, and more than 14,000 will die from the disease. One reason ovarian cancer remains so deadly is there are no reliable early detection tools for it. When found, it’s often in the later stages when treatment is less effective.

Some research has suggested that women who ovulate less frequently may have some protection against ovarian cancer. For example, women who take birth control pills, which prevent ovulation, have a lower risk of ovarian cancer. The new study sought to see if women who naturally have irregular periods, and perhaps ovulate less frequently, had a lower rate of ovarian cancer.

The study included more than 14,000 women who were part of the Kaiser Permanente Health Plan in Alameda, Calif., between 1959 and 1967. The researchers followed the women’s health over the next 50 years or until death. All had at least one child, and none used fertility drugs to conceive, according to the study.

An irregular menstrual cycle was defined as longer than 35 days even if it was regular, a cycle that was unpredictable from month to month (and the woman wasn’t in perimenopause when unpredictable cycles are normal), or if a woman didn’t ovulate, Cohn said. The women were around age 26 when they reported having irregular periods.

Although none of the women was diagnosed with polycystic ovary syndrome when the study began because the disease wasn’t really recognized at the time, it’s likely that at least some of them had the hormonal disorder, Cohn said.

Polycystic ovarian syndrome is a common cause of irregular periods, but it’s possible that other abnormalities associated with the disorder might also explain the study findings, she said.

During the study, 103 women developed ovarian cancer, 20 of whom had irregular periods, said Cohn. And 65 died of ovarian cancer, 17 with irregular menstrual cycles. The average age of ovarian cancer death was about 69.

Women with irregular periods had a 2.4 times higher risk of ovarian cancer death than women who had normal cycles, the researchers concluded. In addition, women who had a first-degree relative (mother, sister or daughter) with ovarian cancer, a known risk factor for the disease, had almost three times the risk of death from ovarian cancer, said Cohn.

A lot of biological factors increase a person’s risk of ovarian cancer, said Dr. David Fishman, director of the Mount Sinai Ovarian Cancer Risk Assessment Program in New York City.

“This study’s findings are an interesting observation, but it’s not cause and effect, and I don’t want women to be afraid,” Fishman said. “Menstrual irregularities are very common, and most women with menstrual irregularities won’t have ovarian cancer.”

For women who have menstrual irregularities, this study reinforces the benefit of birth control pills to reduce the risk of ovarian cancer, Fishman added.

Any woman who is concerned should talk to her doctor, he said. Her physician can let her know if she’s at an increased risk of developing ovarian cancer. The study findings were scheduled for presentation Wednesday at the American Association for Cancer Research annual meeting in San Diego.

Research presented at medical meetings should be viewed as preliminary until published in a peer-reviewed journal.

Source; webmd

Labour in tub OK but childbirth in water unproven

Sitting in a tub of warm water can relieve a mom-to-be’s pain during the early stages of labour, but actually giving birth under water has no proven benefit and may be risky, say recommendations for U.S. obstetricians.

There’s no count of how many babies in the U.S. are delivered in water, but it is increasingly common for hospitals to offer birthing pools or tubs to help pregnant women relax during labour.

In a report released Thursday, a distinction is made between the two uses, saying that early on immersion may be helpful, as long as some basic precautions are taken.

But there has been little scientific study of underwater delivery, along with a handful of reports over the past decade or so of near-drownings and other risks to the infant, said the joint opinion from the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics.

Although complications appear to be rare, the report urges that underwater deliveries be performed only in research studies to settle the questions.

“Labouring in water is not the same as delivering under water,” said co-author Dr. Jeffrey Ecker of Harvard University, adding that he’s cared for numerous women comforted by immersion during labour.

As for delivery, “We want people to do more research,” added ACOG committee member Dr. Aaron Caughey of Oregon Health & Science University.

In fact, midwives at Caughey’s hospital perform several dozen underwater deliveries a year and are collecting data on how mothers and babies fare, said Cathy Emeis, a certified nurse-midwife at the Oregon university. She cautioned that the numbers are small but so far don’t show increased risks.

Pregnant women interested in a water birth at the Oregon facility are required to take a special class and sign a consent form, Emeis said.

“We always acknowledge to our patients that there is not a lot of high-quality evidence that shows there’s a benefit to birthing under water,” she said.

Thursday’s recommendations aren’t binding. Birthing in warm water, which proponents say simulates the uterine environment, has been an option for several decades, although more women use it for early labour than delivery, said Tina Johnson of the American College of Nurse-Midwives.

“I don’t know that this statement will necessarily change women’s desire for that option,” said Johnson, whose organization is drafting its own guidelines.

The Canadian Association of Midwives told CBC News it is standard practice for midwives in Canada to offer underwater deliveries.

“In our experience and our understanding of the research to date, there’s no major concern around the safety of water birth for healthy, normal pregnancies and healthy, normal labour and birth,” Elizabeth Brandeis of the Ontario Association of Midwives said in an interview.

“The majority of women I work with gravitate towards water at some point during their labours.” Brandeis called the U.S. appeal for more research “a laudable impulse.”

The U.S. report recommends that hospitals or birth centres choose low-risk candidates for immersion during labour, keep tubs clean, monitor women appropriately and be able to move them out of the water quickly if a problem occurs.

It says potential risks of underwater delivery include infection, difficulty regulating the baby’s body temperature and respiratory distress if the baby inhales water.

Source: cbc

Baby born after growing in mother’s abdomen — not uterus

NR

A pregnant woman with a stomach ache turned out to have a serious pregnancy complication that was missed during her previous ultrasound exams: The woman’s 32-week-old fetus was growing within her abdomen, outside her uterus, according to a new report of her case.

When doctors examined the woman further and discovered the abdominal pregnancy, they quickly operated on the woman’s abdomen and found her live fetus floating in her abdominal cavity, without its nourishing amniotic sac. The healthy baby girl was delivered and sent home with her 22-year-old mother in good condition, researchers in Tanzania said.

Abdominal pregnancies are rare, and when they do happen, they can go unnoticed even if ultrasounds are used, because the pregnancy can appear normal in an ultrasound examination, the researchers wrote in the report, published Feb. 25 in the journal BioMed Central. An abdominal pregnancy that goes unnoticed can threaten the mother’s life and cause massive bleeding. [14 Oddest Medical Case Reports]

“I’ve seen maybe four or five abdominal pregnancies over the course of 25 years,” said Dr. Jill Rabin, chief of ambulatory care, obstetrics and gynecology at Long Island Jewish Medical Center in New Hyde Park, N.Y., who wasn’t involved with the case.

“Many times, these pregnancies are not diagnosed until the labor,” Rabin said. “The woman is going through labor, the cervix is dilated and you are wondering, ‘Why is the patient having contractions and nothing is happening?'”

Abdominal pregnancy is a rare form of ectopic pregnancy, occurring in about 1 out of every 10,000 pregnancies, according to some estimates. In an abdominal pregnancy, an embryo usually first implants in one of the fallopian tubes (instead of the uterus), and then moves backward within the body, toward the ovaries. From there, it implants for the second time — this time, in the abdomen.

Diagnosing an abdominal pregnancy is difficult, Rabin said. “It’s very rare, but you have to keep it in your mind when examining a pregnant woman who has abdominal pain.”

Other symptoms include painful fetal movements, and gastrointestinal problems. Also, if it’s too easy to feel the baby, or see it with an ultrasound, that might be a sign that the baby is outside the uterus, Rabin said.

If doctors find that a fetus is growing outside the uterus, they make an incision in the pregnant woman’s abdomen, to deliver the baby. The placenta is often left to be absorbed by the body, because removing the placenta can cause severe bleeding. “The patient has to be followed very, very closely to be sure that the placenta is reabsorbed; it takes a couple of months,” Rabin said.

Most of the babies that Rabin has seen in abdominal pregnancies were healthy, she told Live Science.

“The placenta is attached to something vascular, so the baby is getting fed from the mother’s blood supply, just not in the way that we would like, so many of these babies are very small,” Rabin said.

If an abdominal pregnancy is detected in the first trimester, doctors usually remove the embryo. However, most cases are not diagnosed until later on in the pregnancy. “If it’s diagnosed in the second trimester, you watch the mother very carefully, but every case is different,” Rabin said.

Source: Huffington post

Light drinking ‘is preterm risk’

Even moderate drinking during the earliest months of pregnancy may be damaging, say researchers in Leeds. Their study is the latest in a long debate over whether it is safe to drink at all during pregnancy.

The findings, published in the Journal of Epidemiology and Community Health, suggest the chances of premature birth increased. The NHS recommends people avoid alcohol during pregnancy or when trying to conceive.

But says if people choose to drink, then they should not have more than two units of alcohol (about one pint) twice a week.

Heavy drinking in pregnancy is known to be damaging as it can affect the baby’s development. But there is far more debate about drinking at the upper limit of the NHS guidelines.

Around seven in every 100 births in the UK is premature. The study on 1,264 women in Leeds showed drinking more than the two units limit doubled the risk of premature birth, but even drinking at the limit increased the risk.

Camilla Nykjaer, one of the researchers at the University of Leeds. “This is a very sensitive issue, we don’t want women who are pregnant now to panic, the individual risk is actually low.

“They shouldn’t drink, they should stop drinking if they have been drinking during the pregnancy.”

However, a study of more than 11,000 five-year-olds, conducted by University College London, showed drinking one or two units of alcohol a week during pregnancy did not raise the risk of developmental problems in the child.

Prof Yvonne Kelly who conducted that research told the BBC: “Heavy drinking is really very, very bad, but at low levels, in the work we’ve done we haven’t found any negative effects in childhood.

“It’s a massively charged area, getting the tone of this right is quite difficult.

“The guidelines are there, women are sentient beings and can choose – it’s hugely politically charged all of this, I guess people will make their own judgements.”

Dr Patrick O’Brien, a spokesperson for the Royal College of Obstetricians and Gynaecologists, said: “While the safest approach would be to choose not to drink at all, small amounts of alcohol, not more than one to two units once or twice a week, have not been shown to be harmful after 12 weeks of pregnancy.

“Pregnant women should always consult their midwives or doctors if they have any concerns about their alcohol intake.”

Source: BBC news

Birth control pills — effectiveness, side-effects and health risks

Contraceptive pills

Every day, over 100 million women all over the world pop an emergency oral contraceptive pill. Oral contraceptive pills are no doubt an effective way to birth control in sexually active married women. But, such widespread use of birth control pills is definitely alarming because most women using them are unaware about its mechanism of action and its safety aspect. In this article, we highlight important aspects about birth control pills that every woman should know.

How does a birth control pill work?

A woman is said to become pregnant when the ovaries release an egg (through reproductive hormonal regulation) that gets fertilised by the male sperm. This fertilised egg then gets attached or implanted to the uterus, where it is nourished over the period of nine months to develop into a baby.

Oral contraceptive pills are designed such that they disrupt the normal hormonal cycle in women and create an artificial hormonal environment that does not allow you to conceive by interfering with contraception and implantation. Most birth control pills that are available today are a combination of oestrogen and progesterone (female reproductive hormones). These pills:

  • Block the release of egg from the ovaries
  • Make the entry of the sperm difficult by thickening the cervical mucus
  • Affect the sperm motility so that it does not reach the egg to fertilise it.

When should you take the pill?

Most birth control pills have clear instructions regarding dosage and use on their leaflet. Some pills are to be taken on specific days of the menstrual cycle. Emergency contraceptive pills are usually required to be taken within 72 hours of unprotected sex. But not all brands of birth control pills can be used for emergency contraception. Further, the number of pills required to be taken in a dose differs for each brand.

What are the side-effects?

Birth control pills can cause minor side-effects which can appear immediately or any time after taking them. Every woman taking birth control pills will experience different side-effects including:

  1. Nausea
  2. Headache
  3. Weight gain
  4. Digestive problems- diarrhoea or constipation
  5. Vomiting
  6. Stomach cramps
  7. Changes in menstrual cycle
  8. Mood changes

These side-effects do not last for a long time. But there are some rare side-effects which need immediate medical attention:

  1. Severe headache
  2. Dizziness
  3. Sever stomach pain
  4. Swelling of hand and feet
  5. Unusual bleeding
  6. Heaviness in the chest
  7. Dark coloured urine
  8. Skin rash
  9. Speech problems
  10. Potential health risks of birth control pills

Several studies have linked the use of birth control pills with increased risk of breast cancer and cervical cancer. A study by Danish researchers suggested that oral contraceptive pills may increase the risk of heart attack and stroke in women. The risk is largely dependent on the dose of oestrogen used in the pill. There are several registered cases where women have suffered from blood clotting (deep vein thrombosis) after having a contraceptive pill.

Source: Health India

New contraceptive ring aims to protect against both pregnancy and HIV

IntraVaginalRingNorthwestern

For decades, the condom has been the only form of contraceptive widely used to prevent both unplanned pregnancies and the transmission of HIV.

Now, researchers at Northwestern University have come up with a new option: An intravaginal ring that helps prevent pregnancy while simultaneously releasing low doses of an antiretroviral drug that reduces a woman’s risk of contracting both HIV and genital herpes.

Patrick Kiser, an associate professor of biomedical engineering and obstetrics and gynecology at Northwestern, devised the ring with the hopes that it would offer women more control over both disease and pregnancy prevention.

“The field of HIV prevention is really moving towards these long-acting drug delivery systems that require less user intervention, which is great because sex is episodic and exposure to [HIV] is episodic,” Kiser told FoxNews.com. “And because you don’t know when you’re going to be exposed, or even necessarily when you’re going to have sex, it’s better to…have protective measures on board at all time.”

Kiser and his team at Northwestern spent five years developing the two-inch ring, which releases doses of the contraceptive levonorgestrel and the common antiretroviral HIV medication tenofovir after being inserted in the vagina. Similarly to the NuvaRing, women can insert the device on their own. Women can then leave the ring in for up to 90 days, removing it briefly for cleaning if necessary.

Creating a device capable of releasing the proper doses of both the contraceptive and antiretroviral drugs posed a unique obstacle to researchers.

“The dose of contraceptive is very low – 10 micrograms per day, whereas with the antiviral drug we’re delivering is about 10 milligrams a day,” Kiser said. “That’s a thousand times different in terms of the amount being delivered for each drug and that was a real engineering challenge to develop a device that could achieve those extreme ranges of drug delivery.”

Eventually, they created a ring composed of three types of plastic tubing capable of releasing the appropriate doses of each medication contained within the device.

The medications used in the device both have a proven history of being both safe and effective. Levonorgestrel, which thickens a woman’s cervical mucus to prevent sperm from reaching the uterus, is widely used in popular forms of birth control like Mirena.

Source; Fox news

Nutritional do’s and don”ts for pregnant women!

You’ve just received the good news that a little one is on the way! Congratulations, you’re pregnant!

Pregnancy is beautiful, magical and even empowering! Whether you are elated or in a wee bit of shock, remember pregnancy is an immense physical, psychological and emotional experience whatever the circumstances surrounding it.

Once it sinks in that you are on your way to motherhood you may find yourself thinking, what”s next? Expect a lot of changes in your lifestyle which include some dietary modifications because your growing baby is absorbing everything you”re eating.
You will be snowed under with advice from family, friends and yes, even complete strangers about what foods are safe and what aren’t during pregnancy, enough to confuse anyone.

First and foremost you’ll need protein and calcium for your baby’s tissues and bones, extra folic acid to protect against neural tube birth defects and iron to help red blood cells carry oxygen to your baby. Although it is imperative that you discuss your diet with your doctor, we at MedGuru give you some dos and don’ts that will help get you started!

Foods to eat during pregnancy:-
Whole grains
Try incorporate whole grains that are fortified with folic acid and iron into your daily diet. Eat oatmeal during breakfast, whole-grain bread at lunch and brown rice for dinner.

Leafy greens, fruits
Increase intake of green veggies broccoli and spinach, food items like muesli and fruits like Blueberries, raspberries, and blackberries which are a good source of iron that a woman”s body needs to produce all the blood needed to supply nutrition to the placenta.

Eggs
Apart from being rich in protein, eggs provide amino acids, vitamins and minerals, including choline, which is good for baby”s brain development. Refrain from eating under-cooked or raw eggs as they may be tainted with bacteria.

Sea food
Fish, touted for omega-3 fatty acids that help the baby”s brain development and eyes is a good meal choice during pregnancy. It is absolutely safe to consume up to 12 ounces of low-mercury fish, such as salmon per week. Try it grilled, broiled, or as a salad.

Low-fat yogurt
Low-fat yogurt is rich in calcium, high in protein and it sans the added sugar of flavored yogurts. Blend it with fruit into smoothies or sprinkle it with nuts or muesli for a tasty crunchy snack.

Foods to avoid during pregnancy:-
Liver or liver-containing products such as liver pâté, liver sausage or haggis should be eaten only occasionally as they contain large amounts of vitamin A which may cause damage to the embryo.

Avoid drinking too much of coffee, tea and colas as caffeine based beverages may affect the growth of baby.

Skip unpasteurized cheeses, blue-veined cheeses like brie or camembert to avert the possible risk of transmission of infectious diseases such as Listeria. However, varieties such as cheddar and mozzarella can help in meeting your calcium requirements.

Source: med guru

Diet during pregnancy linked to preterm birth

A new study on diet and pregnancy suggests that what you eat when you are expecting is as important as what you don’t.

Women who ate plenty of fruits and vegetables and who tried to drink water instead of soft drinks were less likely to have premature babies than women who ate more “Western” diets, a big study in Norway has shown.

It wasn’t that women who ate pizza, tacos and sweets were more likely than average to have premature babies, the researchers found. It was that healthier eating lowered the risk by about 15 percent.

Dr Linda Englund-Ögge of Sweden’s Sahlgrenska Academy and colleagues studied a big database of 66,000 Norwegian women who are taking part in a larger study. One of the things they did was fill out a food diary while pregnant.

Englund-Ogge’s team classified their diets into three broad types: a “prudent” diet with plenty of fruits and vegetables and not too much junk food; a “traditional” Nordic diet with boiled potatoes, fish and gravy; and a more typical modern “Western” diet with processed white flour, sweets and snacks.

“Our results indicate that increasing the intake of foods associated with a prudent dietary pattern is more important than totally excluding processed food, fast food, junk food, and snacks,” they wrote in their report, published in the British Medical Journal.

It makes sense, says Dr, Walter Willett, a nutrition expert at the Harvard School of Public Health who was not involved in the study. “It does fit with what we have learned about diet and pregnancy,” he told NBC News.

“Dietary pattern has been linked to a lower risk of diabetes. It has been linked to a lower risk of hypertension.” And high blood sugar and high blood pressure are both big risks in pregnancy that in turn contribute to the risk of pre-term birth.“Those are things that impair development of the fetus,” Willett said.

The U.S. infant mortality rate is higher than in most other developed countries at 6.14 infant deaths per 1,000 births. The average for the Organization for Economic Cooperation and Development, which groups developed countries, is around 4 per 100,000

Source: NBC news

Male hormones play an important role in female fertility

Several fertility clinics across the country are beginning to administer testosterone, either through a patch or a gel on the skin, to increase the number of eggs produced by certain women undergoing in vitro fertilization (IVF). Women are also purchasing the over-the-counter supplement DHEA, which is converted by the body into testosterone, to boost their chances of pregnancy with IVF.

A few clinical trials support the use of testosterone given through the skin, while others have shown no benefit of DHEA – also used in attempts to slow aging and enhance muscle mass – in increasing pregnancy and birth rates in women who don’t respond well to IVF therapy. Lacking a large and convincing body of data on the topic, the jury is still out as to whether male hormones such as testosterone improve female fertility.

A new study suggests that male hormones, also called androgens, help drive the development of follicles – structures that contain and ultimately release an egg that can be fertilized by a man’s sperm. Published in the Proceedings of the National Academy of Sciences, the research also details how male hormones boost the production of follicles in mice. Authors believe the study provides potential biological targets to enhance fertility in women with diminished ovarian reserve, who produce few or no follicles in response to IVF drugs designed to boost follicle development.

“There is a raging debate in the reproductive endocrinology field about what male hormones are doing in female fertility,” said Stephen R. Hammes, M.D., Ph.D.,senior study author and professor of Endocrinology at the University of Rochester School of Medicine and Dentistry. “Our study doesn’t solve the controversy, but, along with some earlier seminal studies from other groups, it does tell us that we can’t dismiss male hormones. They might actually be doing something useful.”

Using multiple animal models and cell experiments, Hammes and lead study author Aritro Sen, Ph.D., research assistant professor of Endocrinology at the medical school found that male hormones promote follicle development in two ways. First, they prevent follicles from dying at an early stage. They do this by ramping up a molecule that stops cells from self destructing, a process called apoptosis. Hammes and Sen speculate that if a woman doesn’t have enough androgens (male hormones), more of her follicles may be dying and fewer progressing to a mature stage when they produce and release an egg.

Using multiple animal models and cell experiments, Hammes and lead study author Aritro Sen, Ph.D., research assistant professor of Endocrinology at the medical school found that male hormones promote follicle development in two ways.

First, they prevent follicles from dying at an early stage. They do this by ramping up a molecule that stops cells from self destructing, a process called apoptosis. Hammes and Sen speculate that if a woman doesn’t have enough androgens (male hormones), more of her follicles may be dying and fewer progressing to a mature stage when they produce and release an egg.

Second, androgens make ovarian cells more sensitive to follicle-stimulating hormone or FSH, which promotes follicle growth. They do this by creating more FSH receptors – molecules on the surface of ovarian cells that jumpstart the follicle making process in response to the hormone.

When the team administered small doses of androgens to mice that were taking the equivalent of medications given to women undergoing IVF therapy, they developed more mature, egg-containing follicles than mice that didn’t receive androgens.

The androgen-treated female mice also released larger numbers of eggs with ovulation.

The study has been published in the Proceedings of the National Academy of Sciences.

Source: Medical express

Is a normal delivery possible after a C-section?

I got married on November 2011 and conceived on December 2011. My first pregnancy took a toll on me. Though I consider myself a strong person but went weak on my knees when I had to counter labour pains. Though my doctor assured a normal delivery, but I requested for a C-section amidst labour. Today my baby is 18 months old. I have a gut feeling that I might be pregnant again. Though I am not planning for any kids at the moment and ain’t sure if my concerns are true. But just in case I get pregnant again can I opt for a normal delivery now. Is it possible?

If you even have the slightest doubt that you could be pregnant get a home pregnancy test done and be sure. A normal delivery after a C-section is called a VBAC or vaginal birth after C-section. In most cases a normal delivery after a C-section is possible though it comes with some risks attached to it.

In a normal delivery after a C-section, the scar may tear open leading to uncontrolled bleeding at the site of previous C-section, during labour. Though it might not be the case always. If you opt for VBAC talk to your doctor about it. If you are planning for a VBAC, be sure that you take good care of yourself well in advance. Apart from regular exercises take care that you are doing enough to strengthen your core and back. With a history of C-section, putting too much pressure on your core is not advisable. Try alternative methods like side obliques or stretches. Hire a trainer if you can.

Remember during VBAC you would need a lot of monitoring during your labour to ensure that both you and your baby are safe. If your abdominal muscles are not strong enough to go through the strains of labour it can tear open at the site of operation. But if you are monitored constantly such an incidence can be avoided if at all it happens. If your doctor senses any trouble during the labour you might be taken for an emergency C-section too. But many doctors also support VBAC and would help you during your pregnancy to prepare for the same. So talk to your doctor and find out one who supports your decision. But before all that get checked if you are pregnant.

Source: the health site