preterm labor

Mamas on Bedrest: A Step Closer to “Curing” Pre-Eclampsia!

October 20th, 2014

IMG_3750 1x13Mamas, Exciting News!!

Researchers at the Center for Perinatal Research at the Nationwide Children’s Hospital in Ohio have identified a Urine test that detects proteins in pregnant mamas’ urine that indicate pre-eclampsia. Pre-Eclampsia is one of the most common reasons mamas are prescribed bed rest, and one of the leading causes of preterm labor, prematurity and even death in mamas globally. This new finding is significant because this current research shows that pre-eclampsia, more specifically the proteins found in the urine of pregnant women with pre-eclampsia, are also associated with diseases of neurodegenerative diseases of aging such as Parkinson’s Disease, Mad Cow Disease and Alzheimers Disease.

Dr. Irina Buhimschi, director of the Center for Perinatal Research at Nationwide Children’s Hospital in Ohio and lead author of the paper. While Dr. Buhimschi admits that this is definitely a huge breakthrough in pre-eclampsia research, she admits that physicians and researchers are still no closer to knowing why some women develop pre-eclampsia and why others don’t. Pre-eclampsia is still responsible for some 75,000 deaths annually, mostly in poorer, developing nations. The proteins noted in mamas’ urine are now easily identified with a simple and inexpensive urine test called the Congo Red Dot Test. This simple test merely requires that clinicians place a small amount of urine on a test paper and if a large red dot develops, they know that the urine contains proteins indicative of pre-eclampsia.While we have reported on the Congo Red Dot test previously, a simple test like the Congo Red Dot test could really be a breakthough in treatment in these areas and significantly lower maternal mortality.

Brenda Torigiani's feet at 7 months.Pre-Eclampsia is diagnosed when a mama has high blood pressure and protein in the urine. Mamas will also often experience facial and extremity swelling. Left untreated, pre-eclampsia leads to dizziness, visual changes, seizures, stroke, swelling and weight gain, organ (kidney) failure and death. Pre-Eclampsia is a leading cause of preterm delivery, yet once the baby and placenta are delivered, mama’s symptoms resolve.

The connection between pre-eclampsia and other neurodegenerative diseases such as Alzheimers has yet to be determined. Additionally, no one yet knows if women who develop pre-eclampsia are at greater risk for developing Alzheimers or Parkinson’s Diseases or have some sort of protection. These questions will definitely have to be answered in subsequent research. In the meantime, having a low technology, easy to perform and inexpensive test to screen for pre-eclampsia may well reduce the maternal mortality associated with it tremendously worldwide. Even here in the US, this low lost, low tech test, performed early, may enable obstetricians to begin treating women early with antihypertensive medications and ward off the more serious signs and symptoms of pre-eclampsia. The next step-or perhaps leap-is that perhaps them mamas who have pre-eclampsia may not need to be placed on bed rest-so long as their blood pressures are stabilized on medications, they are no longer spilling proteins into their urine and they are not having any signs of seizure, stroke or organ failure. Finally, combining these findings with the Pluristem Technology, and yes, we may in fact be on the way to eradicating pre-eclampsia!!

Reference: MacLean’s Digital Magazine

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Mamas on Bedrest: Pessaries as a treatment for Cervical Insufficiency

September 29th, 2014

Hello Mamas!

In today’s video blog, I am discussing the use of pessaries for the treatment of cervical insufficiency. In answering a question from Mama on Bedrest Rose from our Facebook Community, I share the background on pessaries (typically used for treatment of bladder prolapse and urinary incontinence), how some Obstetricians are using them for cervical insufficiency and what the current research says about efficacy. THIS IS IN NO WAY A RECOMMENDATION FOR YOU TO GET A PESSARY!! If you think that you may be a candidate for a pessary, you may want to share this video with and talk with your healthcare provider.

References:

Uptodate – A medical reference website.

Mamas on Bedrest: The World Is Watching-and Questioning Bedrest

September 8th, 2014

Bedrest is in the news again! This time via Great Britain, in the online  News Report “The Daily Mail”.

Citing research presented at the 2014 Society for Maternal Fetal Medicine annual conference held February 3-8, 2014, The Daily Mail reports,

“Bed rest during pregnancy could harm your baby: ‘Putting your feet up increases risk of blood clots, diabetes, depression and having a smaller newborn,’ warn experts”

This is not news. As seen in our book, “From Mamas to Mamas: The Essential Guide to Surviving Bedrest”, many physicians, researchers, writers and pundits have questioned the bed rest prescription. THERE IS NO EVIDENCE THAT IT IS EFFECTIVE and THERE IS EVIDENCE BEDREST CAUSES HARM TO MAMAS AND BABIES. As such, there is an increasing demand to stop the practice.

I want to be very clear here. There are instances and situations in which bed rest is ABSOLUTELY the right thing to do. When a woman presents in preterm labor with high blood pressure, spotting or amniotic fluid leaking, in the acute period until she is stable, medical care and yes, bed rest, are indicated. What is being questioned is the extended periods of inactivity-lasting weeks to months. In these cases, when there isn’t any acute medical intervention being done, obstetricians and researchers are questioning placing a woman on bed rest “just in case”.

Co-author of the cited study Anthony Sciscione, of the Delaware Centre for Maternal and Fetal Medicine, said: ‘There is no evidence bed rest improves outcomes.”

But there is evidence that bed rest can be harmful for mamas and babies.  Here are health complications associated with prolonged inactivity as a result of bed rest:

 

Muscle and bone loss. This ‘deconditioning’ can start after only a few days and there is a lack of information on its effect on pregnant women. (See our resources on this!)

Increases the risk of developing blood clots in the legs – and raises the chance that clots will move to the lungs, which can be fatal. Such clots are more common among pregnant women, so limiting physical activity may compound these risks.

Increases a woman’s risk of gestational diabetes. The Society said that being admitted to hospital for problems during pregnancy has been associated with a higher chance of this condition. It pointed to studies which have shown that patients who are put on bed rest when not pregnant tend to develop high blood sugar levels, a key risk factor for diabetes.

Increases the risk of anxiety and depression, perhaps because of the forced inactivity. (Also think lonliness and isolation)

Loss of income due to inability to work and has been linked to having a baby with a lower birth weight.

 

But we all know this and I have written extensively on this subject in this blog. And thankfully folks are listening. I realize that many mamas are attached to the notion that bed rest saved their baby’s life and I am not here to discount that. What I am here to report, and what I am hoping for, is that rather than simply putting a woman on bed rest and with that prescription increasing her risk for other health problems, I (and many others) advocate for finding solutions to the complications that result in the bedrest prescription. It’s exciting to see Pluristem doing stem cell research as a way to cure PreEclampsia. It is encouraging to see the March of Dimes pouring funds into research to investigate and treat preterm labor and preterm births. And who knows? Perhaps the March of Dimes Research is onto something noting that low maternal blood levels of vitamin D are associated with preterm labor and preterm birth.

Do not be dismayed, Mamas. There is research going on and more and more mama and babies are surviving pregnancy complications every day. While bed rest is still a major part of high risk pregnancy treatment here in the United States, it is nice to see that new treatments are on the horizon.  For me, when I was having my children (namely my daughter), I was offered bed rest as a treatment. I most certainly hope that when my now 12 year old daughter is having her children, if she has complications as I did while pregnant with her, there will be more effective, evidences based and non debilitating treatments available for her and her baby than there were for me while I struggled to carry her.

Want to know more about the origins of bed rest, it’s role in obstetrics and what’s on the horizon as treatment for high risk pregnancies? Subscribe to our blog (the little orange button on the upper right hand corner of this webpage) and also check out our extensive archives. There is a plethora of information for mamas and those who love and are caring for them in our post. For mamas wanting more tips on how to survive bed rest, Download our ebook guide, “From Mamas to Mamas: The Essential Guide to Surviving Bedrest” Available exclusively on Amazon.com.