Pregnancy, Fertility and Childbirth

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• QWhat is twin-to-twin transfusion syndrome?

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  A Overland Park Regional Medical Center answered

  Twin-to-twin transfusion syndrome (or TTTS) is a condition that arises in 10 percent of monochorionic twin pregnancies (where twins share a single placenta) and occurs when the twins are transfusing their blood from one twin (donor) to the other (recipient). As a result one twin has very little to no fluid around it (oligohydramnios) and the other twin has too much fluid (polyhydramnios).

  In some cases, TTTS can be observed with frequent checks. However, when it progresses to more advanced stages and either of the twins is showing signs of heart failure, TTTS can be fatal for both twins in more than 90 percent of cases. There are minimally invasive procedures that can be performed with little risk to the mom and markedly improved survival for the twins.

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• QWhat are some of the risks of multiple pregnancies?

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  A Dr. Jeanne Morrison, PhD , Family Medicine, answered on behalf of Sigma Nursing

  A woman with a multiple gestation pregnancy is more likely to develop complications during her pregnancy than a woman with a singleton pregnancy. Multiple gestation pregnancies increase the risk to both mother and fetuses:

  Maternal risks:

  • Anemia due to increased fetal demands
  • Pregnancy induced hypertension
  • Preterm labor due to over-distension of the uterus
  • Cesarean delivery
  • Post-partum hemorrhage

  Fetal risks:

  • Stillbirth
  • Preterm birth
  • Congenital anomalies
  • Malpresentation and difficult birth
  • Cord accident
  • Intrauterine growth retardation
• QWhat is pregnancy?

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  A Diana Meeks , Family Medicine, answered on behalf of Sigma Nursing

  Pregnancy is the time between fertilization and birth in which a fertilized egg goes through stages of development inside the mother's body -- first becoming a blastocyst, then an embryo, then a fetus. A normal pregnancy lasts approximately nine months, at which time a baby is ready to be born.

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• QWhat is a molar pregnancy?

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  A Denise Long , Nursing, answered on behalf of Sigma Nursing

  A molar pregnancy, also called gestational trophoblastic disease, is not always a true pregnancy. If there is a fetus, there are usually abnormalities not compatible with life outside the uterus. It involves excess growth of tissues related to pregnancy. It is frequently suspected by the provider when the size of the uterus is larger than expected based on the expected due date, there is dark brown bleeding, and the level of the hormone HCG is elevated. An ultrasound will diagnose the problem with a "snowstorm" pattern seen rather than a normally developing fetus. Surgery is needed to remove the tissue growths. Following surgery, lab work will be needed weekly until the HCG levels drop to normal and then every two weeks for three months, then monthly for 6 - 12 months. Additional tests might be ordered by the provider as well. It is recommended that a woman avoid pregnancy for one year in order to allow accurate follow-up of the HCG hormone.

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• QHow can I find support during pregnancy?

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  A Dr. Jeanne Morrison, PhD , Family Medicine, answered on behalf of Sigma Nursing

  Support during pregnancy can come froma variety of sources. Family, both the partner and extended family such as parents, sibling and aunts are frequent sources of support.  There are also community based resources such as maternal-child services through the health department, church groups and non-profit organizations.  In todays world of social networking there are a growing number of online blogs and support group that can bring people together to provide support and education.
• QWhat happens when an egg is fertilized?

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  A Dr. Darcy N. Bryan, MD , OBGYN (Obstetrics & Gynecology), answered on behalf of Riverside Community Hospital

  

  When a egg is fertilized with a sperm, an embryo is created. In this video, Darcy Bryan, MD, of Riverside Community Hospital, explains the fertilization process.

  

  Find out more about this DVD:

  What Happens When an Egg Is Fertilized?
  Buy DVD

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• QWhat is postpartum hemorrhaging?

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  A Dr. Jeanne Morrison, PhD , Family Medicine, answered on behalf of Sigma Nursing

  Post partum hemorrhage (PPH) is defined as blood loss of 500mL or more after a vaginal birth and 1000 mL or more after a cesarean birth.  Excessive blood loss in the first 24 hours following the birth is classified as an early PPH and beyond 24 hours it is a late PPH. 

  The most common cause of early PPH is uterine atony or failure of the uterus to contract after the birth.  PPH due to uterine atony usually occurs in the first 4-6 hours after birth.  Some factors that increase the risk of uterine atony are: labor induction or augmentation, medication that result in muscle relaxation, chorioamnionitis, a large baby, multiple gestation or a full bladder.  A second cause of PPH in the first 24 hours is trauma to the genital tract, which is the uterus, cervix, vagina, or labia. Trauma to the genital tract can lead to disruption of the soft tissue and tearing of blood vessels

  Late PPH is due to retained placental fragments that delays healing and leads to bleeding from the former placental site.

• QWhat are "Pregnancy Category C" medications?

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  A Dr. Jeanne Morrison, PhD , Family Medicine, answered on behalf of Sigma Nursing

  The FDA has created guidelines for drug companies to follow in regards to labeling medications and their affects on reproduction and pregnancy. According to these guidelines a category C medication is one in which the risk to the pregnancy cannot be ruled out. For medications in this category, adequate, well-controlled human studies are lacking, and animal studies have shown a risk to the fetus or are lacking as well.

  There is a chance of fetal harm if the drug is administered during pregnancy; but the potential benefits may outweigh the potential risk. Many medications pregnant women use fall into this category, therefore the woman and her healthcare provider need to evaluate the benefits of the medication against the possible risk to the fetus.

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• QWhat can I do if I have constipation during pregnancy?

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  A Brigham and Women's Hospital answered

  Constipation is a common complaint for pregnant women. Drinking plenty of fluids, exercising daily, eating raw vegetables and fruits, and eating bran and bran products are good natural remedies. If these don’t work, your doctor may prescribe a mild laxative or stool softener.

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• QWhat is the amniotic sac?

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  A Diana Meeks , Family Medicine, answered on behalf of Sigma Nursing

  The amniotic sac is a thin-walled pair of membranes that contains the fetus and amniotic fluid during pregnancy. The inner membrane, the amnion, contains the amniotic fluid and the fetus. The outer membrane, the chorion, contains the amnion and is part of the placenta. The amniotic sac has a capacity of 4 to 5 L at term. The wall of the sac extends from the margin of the placenta. The intact sac and its fluid provide for the equilibration of hydrostatic pressure within the uterus. During labor, the sac effects the uniform transmission of the force of uterine contractions to the cervix for dilation.