When Your Placenta is in the Wrong Spot

During a normal pregnancy, your placenta will start low and slowly make its way up towards a richer blood supply. The placenta is the organ that connects your growing baby with your blood supply for the transfer of nutrients and waste removal. When your placenta moves up, it also makes way for your baby to leave the birth canal...
Pregnancy: Blogs

The Placenta Is Different in Boys or Girls

Certain medical conditions are more likely if the fetus is a boy or a girl. For example, this study showed that preeclampsia, diabetes, polyhydramnios, abruptio placentae, and preterm birth are more likely in boy fetuses. Up to now, nobody knew exactly why. This publication is among the first to show that the placenta...

Tocolytic Therapy for Preterm Delivery

This is a great review from the British Medical Journal of tocolytic therapy, treatment to stop preterm labor. It reviews what works and what does not. There are two tocolytics that seem to have the highest success rate: prostaglandin inhibitors (eg indomethacin, ketorolac)  performed best closely followed by calcium channel...
Postpartum: Blogs

Cesarean Scar Defect (CSD)

A cesarean scar defect (CSD), is also known as a "deficient uterine scar" or "scar dehiscence" following a Cesarean delivery. A CSD involves the myometrial defect at the site of a previous Cesarean delivery scar.  The incidence of cesarean section scar defect reportedly rangesbetween 1 in 20 to 1 in 2 women with prior cesarean...

Celebrities and Hidden Infertility

Celebrities are in the spotlight every waking moment, but they somehow seem to find enough alone time to get pregnant and hide that pregnancy for three to four months, in some cases. Behind many of the 40-year-old first-time Hollywood moms is a deep, dark secret that leaves many women angry, frustrated and resentful. Hollywood...
Recently, there have been new definitions for infertility published in Fertility & Sterility: Broadened definition of infertility Infertility: A disease characterized by the failure to establish a clinical pregnancy after 12 months of regular, unprotected sexual intercourse or due to an impairment of a...
What is Naegele's rule? Your due date, the calulated day when the baby is due, is the most important information you should know. Not because the baby will be born exactly on that day, only 5% of all babies are born on their due date, and 80% are born within 2 weeks before and after the due date. Your due date is important...

Vaccination During Pregnancy

Vaccines are given to pregnant women to protect the mother and the baby against serious infectious diseases. When you get vaccinated, you are protecting yourself. And you are also sharing some early protection with the baby too. Both the Centers for Disease Control (CDC) and the American Congress of Obstetrics and Gynecology (...
Pregnancy: Blogs

Low Asprin for Preventing Preeclampsia

Preeclampsia is one of the most deadly medical problems affecting pregnant women. Preeclampsia complicates up to 10% of pregnancies worldwide and contributes to both maternal and infant morbidity and mortality as well as accounting for about 1 in 7 preterm births in the United States. Below are the most recent recommendations...
Question: I have a perfect 6-month-old daughter and we will start TTC next month. I will be 37 in August and would LOVE to have twins. I have been eating a diet to increase chances for twins (as well as male) My questions are: 1. Many say to wait until as close to ovulation to conceive male so we were going to try that. However...
The best (and only) correct website to calculate your fertile days is babymed.com. Scientifically proven. Researchers analyzed more than 50 popular websites and smartphone apps that offer to predict a woman's "fertility window," or the days during a woman's menstrual cycle when she can become pregnant.They found that the...

Isoretinoin Accutane and Pregnancy - Not a good mix

Do not use Accutane when trying to get pregnant and during pregnancy! According to the Canadian Medical Association in response to a recent study that said Canadian women are not heeding pregnancy warnings about the use of isotretinoin, a potent but effective drug that treats severe acne. The drug, originally marketed under the...
A recent study from Canada finds an elevated risk for diabetes when a person has both depression and metabolic syndrome; the diabetes risk is higher when the two disorders are combined than when only one or the other disorder is present. A second study, from Europe, finds similarly elevated risk for diabetes and other...
One of my pregnant patients recently asked me if she should keep her heart rate no higher than 140 beats per minute when exercising?  Answer:There is presently no scientific basis and no official recommendation to keep the heart rate during pregnancy below certain levels. Physical activity during pregnancy has benefits beyond...
The US Preventive Services Task Force issued an updated recommendation for screening all adults for depression. The last update, in 2009, did not recommend screening all adults over 18 but the 2016 update does. Depression in anyone 15 and older is one of the leading causes of disability in the US. Screening Recommended for...
Pregnancy: Blogs

Zika Virus Guidelines for Pregnant Women

The Centers for Disease Control (CDC) has published GUIDELINES AND A TRAVEL ADVISORY FOR PREGNANT WOMEN as well as TRAVEL HEALTH NOTICES concerning the Zika virus. Also read about COUNTRIES WITH THE ZIKA VIRUS. 1. All pregnant women who traveled to an affected country should see their doctor. 2. All pregnant women who traveled...

Women With PCOS May Have Children with Autism

This Swedish study suggests that children of mothers with PCOS polycystic ovary syndrome have an increased risk of developing ASD autism spectrum disorder, regardless of sex.  [bmed_ad_r] The authors of this study a matched case-control study nested within the total population of Sweden (children aged 4–17 who were born in...
Nutrition

How To Eat Safe Food

There are always many opportunities to gather and share food, if it's during the holidays or in between. Whether you eat in someone's home, at work, or at a restaurant, it's important to get educated and be careful about what you eat. Food poisoning is a frequent occurrence and each year millions of people in the United States...
Question: I am 37-years-old and have not had a period for 2 years. What could it be? Dr.Amos answers: There are several reasons why a woman does not get her period (amenorrhea). The first reason is pregnancy, in which case the pregnancy test would be positive. Or breastfeeding. If there is no pregnancy, then other reasons...
Pregnancy: Blogs

Misperceptions are common about Miscarriage

This study published online in May in the Obstetrics & Gynecology journal called "A National Survey on Public Perceptions of Miscarriage" asked about perceptions about miscarriage. Not surprisingly, most who answered the questionnaire have many misconceptions about miscarriage. Respondents to the survey erroneously believed...
Pregnancy: Blogs

Travel During Pregnancy. A Good Idea?

CNN reported on a baby that was born 8 weeks early in Hong Kong.  The mother apparently cannot pay the hospital expenses and the hospital withheld the baby's birth certificate. Her insurance won't pay for the baby either, likely because the hospital is outside the United States, so she is responsible to pay expenses herself....
Pregnancy: Blogs

Pregnancy News May 14th, 2015

Drum Circle For Homebirth? In a Craigslist ad, a drum circle is requested for a home birth. According to Wikipedia, "a drum circle is any group of people playing (usually) hand-drums and percussion in a circle."  Considering that home births have been associated with an increase in neonatal deaths, one wonders whether a drum...
Study Shows Babies Born as early as 22 weeks Can Survive With Resuscitation Until now, 24 weeks of the pregnancy was considered the absolute cut-off for viability, for the potential of a premature neborn baby to survive. But now this long-time understanding of how babies survive is being challenged. A new studies shows that...
So you just missed your period but the home pregnancy test is negative? You are sure that you are not pregnant? Think again. Maybe it's a false negative pregnancy test which means the test is negative when in fact you are pregnant. Studies have shown that women with a high BMI, women who are overweight, have lower hCG pregnancy...

Pregnancy & Fertility News April 27, 2015

World Health Organization Publishes Folate Recommendations for Women In the United States, women consume folic acid from three sources: enriched cereal grain products (i.e., fortified foods), ready-to-eat cereals, and supplements. Neural tube defects increase with folic acid deficiency. In 1996  the U.S. Food and Drug...

IVF In-Vitro Fertilization Calculator Can Help Predict IVF

In-vitro fertilization or IVF is a procedure where eggs are fertilized outside the body and implanted into the uterus.  There are many clinics that perform this procedure but success rates can be confusing because they depend on many factors including a woman's age, height, weight, prior pregnancies, reasons for infertility,...

Pregnancy & Fertility News April 23, 2015

Induction of labor after 39 weeks may have benefits The authors studied randomized controlled studies of labor inductions between 39w0d and 40w6d and found that induction of labor at full term in uncomplicated singleton gestations was not associated with increased risk of cesarean delivery and has overall similar outcomes...

Pregnancy & Fertility News April 15th, 2015

Cesarean Section Should Only Be Performed When Medically Necessary Cesarean section may be necessary when vaginal delivery might pose a risk to the mother or baby – for example due to prolonged labor, fetal distress, or because the baby is presenting in an abnormal position. Cesarean section is valuable in saving the lives of...
Here are the most common misconceptions and myths I often we hear: 1. 'I am 35 years old and there is no need to worry about getting pregnant until much later on." No matter how you look at it, from a biologic point of view the best time to get pregnant and havea baby is well before the age of 35. At birth, a woman...

Pregnancy & Fertility News April 9th, 2015

How did the Dutch Get So Tall? The Dutch are the teallest in the world. This study proposes that natural selection in addition to good environmental conditions may help explain why the Dutch are so tall. Read more HERE.... Breast Milk Purchased Over The Internet includes Cow Milk This study found that 10% of supposedly human...

Pregnancy & Fertility News March 30th, 2015

Lebanon seizes 550 kilogram of radioactive sanitary napkins This is from the "I can't believe it's true" news. And it's not an early April fools joke. Read more HERE.... Why are more baby boys born than baby girls? At the time of conception the ratio between girls:boys is about equal but over the pregnancy, more girls die than...

Pregnancy & Fertility News March 26th

Proactive Induction of Labor improves Neonatal Outcomes In this Danish study the authors show that inducing labor before the pregnancy has become postdate, inducing labor no more than 10 days after the due date, reduces neonatal asphyxia, stillbirths, neonatal mortality, and macrosomia. So much for homebirths where labor cannot...

Australian College Of Ob-Gyn (RANZOG) Is Against Homebirth

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), which considers itself an authority on childbirth safety, recently came out with a statement that differs from the one published by the British or the American organizations of Ob-Gyns. RANZOG concluded that home birth is associated with...

Ethical Challenges: Creating And Selling Embryos

In this review article in the American Journal of Obstetrics and Gynecology, the authors Dr. Klitzman and Dr. Sauer review the ethical challenges associated with creating and selling embryos. They mention questions regarding the rights of the unborn children and their ability to know their biological parents. Companies that...

Pregnancy News March 20th, 2015

Kim Kardashian Has a False Positive Pregnancy Test A false positive pregnancy test happens when your pregnancy test is positive but you are not pregnant. Read more HERE.... Breastfeeding is associated with more intelligence In this study of  3493 participants the durations of total breastfeeding and predominant breastfeeding (...
Pregnancy: Blogs

Pregnancy & Fertility News March 16, 2015

Home Births In The United States Are not Low Risk The authors conclude that at least 30% of midwife-attended planned home births are not low risk and not within clinical criteria set by ACOG and AAP, and 65.7% of planned home births in the United States are attended by non-AMCB certified midwives, even though both AAP and ACOG...
Pregnancy: Blogs

Pregnancy & Fertility News March 9th, 2015

Antidepressant Use During Pregnancy and Asthma in the Offspring Antidepressant use during pregnancy generally did not increase the risk of asthma. Only use of older antidepressants was associated with an increased risk of asthma. Read here more.... Clinical applications of preimplantation genetic testing. Preimplantation...

Restless Genital Syndrome (RGS)

Restless genital syndrome (RGS) is a condition which mainly affects women (though also occasionally in men) that is characterized by an unpleasant sensation involving the genital area and pelvis. A woman with RGS experiences sudden, continuous and uncontrolled arousal in her genital region but she does not have a desire or...

Omega 3 Fatty Acids While Pregnant

What are Omega-3 Fatty Acids? Omega-3 fatty acids chemicals that are essential for the development of important body functions. Most omega-3 acids are consumed in the diet but they can also be added to the diet with supplements. During pregnancy, getting enough omega-3 fatty acids is crucial because these fatty acids are...

Prevention of Travelers' Diarrhea

Take two Pepto Bismol chewable tablets whose active ingredient is bismuth subsalicylate (BSS) 4-times a day to prevent travelers' diarrhea. Studies have shown tthat it can reduce the incidence of travelers diarrhea by approximately 50%. BSS should be avoided by travelers with aspirin allergy renal insufficiency gout  those...

Iron Deficiency during Pregnancy

According to the World Health Organization, the prevalence of anemia in pregnancy varies considerably because of differences in socioeconomic conditions, lifestyles and health-seeking behaviors across different cultures. Anemia affects nearly ¼ of all pregnant women in the developed world. Here is the low-down on iron...

High Blood Pressure in Pregnancy May Predict Stroke Risk

Heart disease tends to run in my family and most of the women usually suffer from high blood pressure and heart murmurs. Since we already know this, we try to avoid lifestyles that could exacerbate these conditions and make them worse. However, what about the women who don’t know they might suffer from medical conditions until...

Follow the Mediterranean Diet and Improve Your Fertility

It's a fact: If you watch your weight and closely follow a Mediterranean-style diet high in vegetables, vegetable oils, fish and beans then you may increase your chance of becoming pregnant. One in 3 cases of female infertility is due to weight issues, either being overweight or underweight. Both weight issues cause shifts in...
Childbirth

Is Water Birth a Good Idea?

According to Wikipedia, a water birth refers to childbirth, usually human, that occurs in water. There are some misunderstandings as to what exactly a waterbirth refers to, as it may refer to: Women laboring in water during the early part of labor, then push and deliver outside the water ("early water labor") Women laboring in...
  There is no question that drinking milk in pregnancy improves the growth of the developing fetus. But what about future growth? Does it affect the height of adults too? A new study published online Sept. 4, 2013 in The European Journal of Clinical Nutrition shows that the amount of milk a pregnant woman drinks is not only...

Prenatal Testing for Down Syndrome

Like most moms-to-be, you want assurances about your and the baby’s health and you want to have the right tests done to ensure you get the information you need. That's where prenatal testing comes in. Seeing your doctor during pregnancy involves many things, but more importantly, it includes a whole list of tests to check on...

Effect of Timing of Umbilical Cord Clamping

It seems unthinkable to deliberately deprive a newborn baby of 30% to 40% of its blood supply but some delivery experts suggest we do exactly that when the umbilical cord is severed within a minute of its birth. A recently published report indicating a wait of just another minute or two delivers immediate benefits to the baby...

Birthzillas, Birthing Plans and Homebirths

I found this interesting article describing the author's feelings about controlling pregnant women, birthing plans, homebirth, and birth experience here. The authors describes "birthzillas" as women for whom it's all about the birth experience and not the baby. Or, as someone else describes it, throwing the baby out with the...

Preeclampsia in First and Subsequent Pregnancies

Pre-eclampsia has been defined as a disease of first pregnancies. The association between primiparity and pre-eclampsia is so widely accepted that it is at the core of several pathophysiological theories. For example, it has been proposed that pre-eclampsia is the consequence of a maternal immune reaction against paternal...

Typical patient questions about lifestyle

Many of my patients ask me about lifestyle issues and pregnancy, especially about exercise, alcohol, caffeine, and artrificial sweeteners. Here are my straight-forward answers: Exercise When there are no other medical contraindications, I would recommend in pregnancy regular moderate exercise but try to avoid more strenuous,  ...

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