Pregnancy, Fertility and Childbirth

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    A Obstetrics, answered on behalf of
    In humans, singleton (one-baby) pregnancy lasts, on average, 40 weeks, or 280 days from the first day of the last menstrual period, which this is how doctors determine the estimated due date. By comparison, elephants can be pregnant for up to two years.

    Until recently, anyone between 37 to 42 weeks of pregnancy was considered “term” and safe to deliver. This conventional wisdom existed because it was believed that the outcomes for both the baby and the mother during this interval of time were uniform and good, or safe with few risks. However, a large amount of research has now shown this is not uniform during these five weeks, and  risks can exist from both a maternal and neonatal standpoint. As a result, in 2012, a group of professional societies convened and redefined what exactly “term” means, and provided recommendations regarding delivering for medically indicated and non-medically indicated circumstances. In addition, national initiatives now exist to decrease complications to babies and the mothers when delivery occurs too early without a medical reason.

    In defining term pregnancy, it is now recommended to use the following: Early term is between 37 weeks through the 38th week, full term is 39 weeks through the 40th week, late term is 41 weeks up to the 42nd week and post term is greater than 42 weeks. The American Congress of Obstetricians and Gynecologists, The Society for Maternal Fetal Medicine, and many neonatal and pediatric societies support these definitions as well.

    These definitions are important because research shows that adverse neonatal outcomes, especially regarding respiratory issues, is the lowest among uncomplicated pregnancies delivered between 39 weeks of gestation and through the 40th week. Lung development continues into early childhood, and elective early term deliveries increase the incidence of respiratory distress syndrome, ventilator use, infections such as pneumonia, respiratory failure, NICU admissions, low blood sugar, decreased APGAR scores and possibly infant mortality. Unless one enters labor naturally, or a medical reason exists for early term delivery, elective delivery prior to 39 weeks is discouraged.
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    A answered
    Locking or locked twins is a rare condition in which during birth a fetus in a breech (feet-first) position becomes locked at the chin with his twin fetus who is in a vertex (head-first) position. Locked twins occur in about 1 in every 1,000 twin births and one in every 90,000 births overall. Locked twins can be identified on an ultrasound examination at the beginning of labor. In most cases, a Caesarean section will be recommended for delivering the babies.
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    Call your doctor immediately if you experience these symptoms of an ectopic pregnancy (a condition in which a fertilized egg grows outside of the uterus, usually in a fallopian tube):
    • abnormal vaginal bleeding
    • abdominal or pelvic pain
    • shoulder pain (may signal blood build-up in the diaphragm from a ruptured fallopian tube)
    • feeling faint or dizzy (may be a sign of blood loss)
    Ectopic pregnancy is a serious medical condition. Your doctor can do an ultrasound exam and blood tests to diagnose the ectopic pregnancy. Medications or possibly surgery can be used to treat an ectopic pregnancy. Once you have had one ectopic pregnancy you are at increased risk of having another one. However, many women who have had ectopic pregnancies go on to have normal pregnancies and births.
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    A , Family Medicine, answered
    Varicose veins are a common complaint during pregnancy. If and when you develop varicose veins may depend on which pregnancy it is sometimes. For women in their second, third or fourth pregnancies, they may see varicose veins earlier, while women in their first pregnancies may see them later in second trimester. Some pregnant women may never have varicose veins.
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    A , Family Medicine, answered
    Several things can cause trouble sleeping. One is increased urinary frequency because the baby is pushing on the bladder as it grows, and also as the body grows and is stretching, there can be stretching of tendons and ligaments that are uncomfortable. Leg cramps can keep women up at night, and vivid dreams may be a possibility as well that can keep them awake.
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    A OBGYN (Obstetrics & Gynecology), answered on behalf of
    What Steps Do Women Go Through before IVF?
    Before going through IVF, a woman can have her OB/GYN perform a number of tests and take her history, says Stephen Montoya, MD, an OB/GYN at Sunrise Hospital. In this video he describes this process.
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    A OBGYN (Obstetrics & Gynecology), answered on behalf of
    Vaccines help keep pregnant women and their growing families healthy, and are necessary for the protection of your children and those in the community from vaccine-preventable diseases. In addition to boosting your immunity during pregnancy, you should be cautious about travel to areas known to be common locations for vaccine-preventable diseases. Talk to your doctor about any planned international travel and work together on a care plan if the trip is unavoidable.
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    A OBGYN (Obstetrics & Gynecology), answered on behalf of
    Among all the health questions that arise during pregnancy, one of the biggest is: what medicines and vaccines are safe during this time?

    The most important vaccine during pregnancy is for influenza. The “flu shot” is given annually to combat the anticipated strains of flu circulating in that given year, and it is of paramount importance for pregnant women to receive the inactivated flu vaccine. Contracting the flu during pregnancy puts you at serious risk for complications and hospitalization, and symptoms can be detrimental to the pregnancy.

    You should also get the Tdap vaccine for tetanus, diphtheria and acellular pertussis during each pregnancy. Ideally, this will be administered between weeks 27 and 36 of your pregnancy during your third trimester.

    Some of a woman’s immunity to disease is passed along to their baby during pregnancy, protecting them from some diseases during the first few months of life, before the baby’s 2-month checkup when initial vaccines are routinely administered.

    In addition to boosting your immunity during pregnancy, you should be cautious about travel to areas known to be common locations for vaccine-preventable diseases. Talk to your doctor about any planned international travel and work together on a care plan if the trip is unavoidable.

    This content originally appeared on the HCA Virginia Physicians blog. 
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    A Physical Medicine & Rehabilitation, answered on behalf of
    Certain hormones produced in pregnancy may increase your risk for back pain. For example, the hormones estrogen and relaxin allow your pelvis to widen to accommodate your growing baby. Those hormones work on the ligaments in the sacroiliac joint, which connects your spine to your pelvis, causing them to stretch. That stretching can cause back pain. If you are having back pain, talk to your doctor about the best way for you to manage it during your pregnancy.
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    New parents may feel crowded by relatives and friends who want to be in the delivery room. Besides making a private affair feel congested, too many people can put a strain on the doctors and nurses who are there to ensure a safe delivery. Don’t hesitate to decline these requests; instead, invite them for a private visit at home.