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20111202

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20111027

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20110708

Premature Birth – Causes And Treatment

Premature Birth – Causes And Treatment

A full term pregnancy is desirable for delivering a happy, healthy baby. However, some babies have to be delivered earlier which can lead to physical and developmental issues.  This is known as a premature birth.

One definition of premature birth is a baby that is born before 37 weeks of gestation. During each week of pregnancy, the baby matures in a different way. Each of the baby's body systems takes one step further towards completion. The lungs are the last organ to develop, just in time to breathe the air of the world outside the womb.

When a baby is born early, for any reason, each week the baby misses developing in the womb can lower the chances of developing fully, or even of survival.  Babies born prematurely often have lower birth weights and are more fragile when they enter the world. There is an increased incidence of breathing issues from underdeveloped lungs, possible problems with sight, even blindness, as well as the inability to regulate body temperature.

Causes of Premature Birth

Women can go into premature or pre-term labor for no apparent reason at all. It can be a mystery, something totally out of our control.

There are, however, cases where a quantifiable cause for the premature birth is found. Here are a few examples:

·         Placental problems (previa, abruption)
·         Infections in the uterus
·         Preeclampsia or eclampsia
·         Incompetent cervix
·         Previous preterm births

Infections are a danger to both the mother and the baby. It is difficult to treat an infection during pregnancy because of the effect the drugs may have on the baby. Infections and/or the drugs used to fight infections can lead to premature breaking of the waters and increase infection rate for the baby. The loss of amniotic fluid can also lead to premature delivery.

When there are problems with the placenta, this can cause hypoxia (lack of oxygen) for the baby. Without proper oxygenation, there can be developmental problems and the possibility of miscarriage.

Possible Treatment

Certain conditions can be diagnosed early enough that steps can be taken to prolong pregnancy as long as possible. An incompetent cervix, for example, can be closed with a procedure called a cervical cerclage. The cervix is sutured closed so that it won’t open under pressure from the growing fetus. It is also not uncommon for the mother to remain on complete bed rest to bring the pregnancy to term.

When a woman has a history of premature births, doctors can take extra precautions to help ensure that it doesn’t happen again if at all possible. This could mean more frequent visits to the doctor and additional ultrasounds.

Doctors want to avoid premature births at all cost. When there is a danger to baby, mother, or both, early delivery may be the only option, but you and your doctor will take all options into consideration for the safe delivery of your baby.

** Disclaimer: Please note that every effort has been made to include accurate information, but further research and the advice of a physician is highly recommended before taking any recommendations or ideas on child birth listed on this site.

Fetal Distress – Causes And Treatment

Fetal Distress – The Causes And Treatment

Two words that strike fear in every mother's heart – fetal distress.  Rather than sit in fear, let's learn some basic facts about fetal distress and how it is treated.

Fetal distress describes any time that the baby is failing to thrive inside the womb or during labor and delivery. Something has changed and has caused the developing fetus to have difficulties.

Indications of Fetal Distress

One of the conditions that mothers are keenly aware of is a reduction in fetal activity. After a certain length of time, the baby will start to move around within the amniotic sac. It is an exciting time for the expectant parents as the movement of the baby is felt for the first time.

Each time you go to the doctor, you will listen for the baby’s heartbeat. You will also be asked by your doctor about the baby’s movement. If any decreased movement is noticed, this could signal that the baby is in distress. The doctor will investigate immediately to see what the cause may be.

Incidents of fetal distress may occur during the time of labor. The baby’s heartbeat is monitored during labor. A decreased heart rate after a strong contraction could be the result of fetal distress. One cause may be that the umbilical cord is wound around the baby’s neck, reducing or cutting off proper blood supply to the baby.

Meconium is the baby’s first feces. This may occur in the womb if the baby is experiencing some sort of stress such as a prolapsed umbilical cord or a breech position. Meconium aspiration is possible under these conditions. This causes breathing problems that have to be handled immediately upon delivery.

Multiple births can lead to fetal distress. More than one fetus in the womb increases the chance that one or more babies may have some sort of distress during delivery. 

Treatment

When a baby is in distress, everyone in the delivery room acts quickly. Time is of the essence to safely delivery the baby. The first and most desirable course of treatment is delivering the baby immediately. For a baby who is experiencing distress before full term, that can mean a premature birth. Drugs given to speed the development of the lungs will often give the distressed baby a  greater chance of survival outside the womb.

When multiple birth babies show signs of fetal distress, cesarean section is a viable solution. Delivering multiple babies who are distressed by a vaginal birth is risky as the medical team may not reach all the babies fast enough or the umbilical cords could be prolapsed. With cesarean delivery, multiple babies can be delivered with the least amount of added stress.

Fetal distress is serious, but can often be monitored with a successful outcome.  Sometimes labor is induced with early delivery being the best option.  You and your doctor will work closely and quickly together to give your little one a good, healthy start in the world.

** Disclaimer: Please note that every effort has been made to include accurate information, but further research and the advice of a physician is highly recommended before taking any recommendations or ideas on child birth listed on this site.

Breech Positions

What Is A Breech Position?

During labor and delivery, the most desirable position for the birthing process is head down. That doesn’t always happen. The baby can end up in breech position, without the head down, when entering the birth canal.

When you are pregnant, it is common to feel your baby move around, upside down, sideways, all over. Sometimes you can even make out the head or foot poking at odd angles against your abdomen. It's cute to watch, but once the delivery gets near, your little one should settle down with its head nicely situated down toward the birth canal.

Breech Positions

In the weeks immediately before labor, the baby gets ready for delivery. The baby will change position so that he or she can pass through the birth canal. The “head down” position is the way your baby wants to be before delivery day. With the head first, the doctor will be able to clear the airway and nasal passages immediately upon delivery.

The term “breech” is used to describe the baby’s position when he or she is not turned head down for delivery. What are the reasons for a breech presentation of a baby? There can be several:

·         Premature birth
·         Multiple births
·         Lack of amniotic fluid
·         Placental previa

There are three different classifications of breech positioning:

1.    Frank breech – The baby’s buttocks is positioned to be delivered first. The baby is curled up tight, in half, with the feet near the head.

2.    Complete breech – This position is similar to the Franck breech, but the knees are bent and possibly crossed at the ankles. The feet are in front of the buttocks which are still positioned to be delivered first.

3.    Footling breech – In this position, the first body part to be delivered will be the right or the left foot. One of the legs has positioned itself in the birth canal and the head is up.

What to do?

An ultrasound alerts your doctor that the baby is in the breech position. If it is confirmed that the baby has not moved into the head down position as you approach full term (at least 37 weeks), the doctor has several options:

1.    Abdominal positioning – This is best accomplished as early as possible. The doctor will attempt to gently turn the baby using abdominal manipulation from the outside. The baby’s heart rate will be closely monitored during the technique for any signs of distress.

2.    Chiropractic positioning – In this instance, a chiropractor that is experienced with breech birth and pregnancy can use subtle techniques to help the baby turn on its own.

Discovering that your baby is in a breech position does not mean that you will necessarily have a difficult labor or a cesarean section. Your doctor will use different methods before labor to correct the breech and will continue to monitor your baby's position during labor in order to deliver your baby safely to your waiting arms.

** Disclaimer: Please note that every effort has been made to include accurate information, but further research and the advice of a physician is highly recommended before taking any recommendations or ideas on child birth listed on this site.

The Debate Over An Episiotomy – Is It Necessary?

The Debate Over An Episiotomy – Is It Necessary?

Childbirth is painful – there's no getting away from that.  There are several pain issues to deal with before, during, and after delivery.  One of the most debated procedures during delivery is the episiotomy.  This incision is often described as the “unkindest cut of all.”  It can often make recovery more painful than believed is necessary.  What is it and is it necessary at all?  Let's look at the debate and you be the judge.

What is an Episiotomy?

Vaginal delivery is the natural form of birth. During this birthing process, when a mother pushes, she bears down so that she can move her baby through the vagina, or birth canal, and out into the world. The process can lead to possible stretching of the vaginal muscles, hemorrhoids, and weakness in the pelvic floor muscles.

In an effort to decrease the amount of pressure needed to push the baby through the birth canal, doctors may perform an episiotomy. This is an incision into the tissues of the perineum, the small area between the vaginal opening and the anal opening. The incision is believed to make birth easier with less stretching and damage.

If the mother is using natural, drug free, childbirth techniques, a local anesthetic is injected in the tissues of the perineum. A scalpel is used to incise the tissue. Once the baby is delivered, the area is sutured up.

There are different degrees of episiotomy performed depending on how large the child is or how difficult the labor. Usually the area is only cut halfway between the vagina and the anus with minimal skin layers incised. This is considered a second degree episiotomy. A fourth degree cut completely incises the skin layers.

What Now?

Who is right and who is wrong about the necessity of an episiotomy? Women who have had an episiotomy may disagree with the reasoning behind performing this procedure. Post-delivery, the episiotomy wound is difficult to deal with for many reasons.  Simply urinating becomes a frightfully painful event, not to mention a bowel movement.  Any straining or pushing during the healing process becomes unbearable.  The wound stings, burns, and is often too sore to comfortably sit without some sort of 'donut.'

There is no clear scientific evidence that supports having an episiotomy over not having one.  Many women who have delivered babies with big heads or shoulders have recovered without any adverse effects and given birth quite successfully again. The vagina is made to stretch for the birth of a baby, so the reasoning behind an episiotomy is questioned by mothers as well as the medical profession.  So, the debate continues.  Let's look at some possible side effects of having an episiotomy:

·         Infections
·         Uncomfortable or painful scar tissue
·         Painful intercourse afterwards
·         Longer recovery from delivery


So, is an episiotomy the “unkindest cut of all?”   Discuss this procedure like you would any other with your doctor.  An episiotomy should not be done as a matter of course, rather it should be approached as any other surgical procedure – with knowledge and caution.


** Disclaimer: Please note that every effort has been made to include accurate information, but further research and the advice of a physician is highly recommended before taking any recommendations or ideas on child birth listed on this site.

Cesarean Delivery – Why Is It Sometimes Necessary

Cesarean Delivery – Why Is It Sometimes Necessary

The good old days weren't always so good.  Women who had difficulties delivering their babies often were subjected to dangerous methods to resolve the problem, if even possible. Difficult and dangerous births were delivered vaginally often with terrible results.  Now, we have medical advances that allow for the safe delivery of babies using what's called a Cesarean Section.

Why a Cesarean Delivery?

Cesarean sections are done for a variety of reasons. These reasons have to do with the health of the baby and the mother. The doctor makes the decision when and if a c-section will need to be performed based on monitoring the mother and baby.

What are the indications for a cesarean? Traditionally, a baby is delivered by c-section when the monitor or other indicator shows a life-threatening complication. The baby may have to be delivered quickly to save its life.  In these cases, a cesarean is normally the best course.

Another reason a cesarean section may be performed is the size of the pelvis. Some women have small birth canals and large babies. When the head will not safely pass, the only option is a c-section. This means fewer traumas to both the baby and the mother. Also, when the natural softening and spreading of the pelvis during the labor stages doesn't occur, a cesarean section is used to extricate the baby before complications can arise.

How is a cesarean section performed?

A cesarean section delivery is a major operation. As such, it is not performed in the birthing suite but in an operating room under aseptic conditions. Doctors and hospital staff wear sterile gowns and gloves so they won’t introduce any infections into the mother’s body.

The mother is kept awake for the procedure. She will be given medication to relax her. There will also be a spinal or epidural anesthesia to block pain from the areas below her waist much the same as an epidural for vaginal delivery. An antiseptic like betadine is used to clean the belly.

A scalpel is used to make the abdominal incision. A horizontal cut low on the abdomen is preferred by the doctor and mother for two reasons; the incision is made in line with the muscles instead of across them making for better healing, and the incision is hidden after surgery for swimsuit season. If a vertical incision needs to be made, it is made from navel to pubic bone. All the layers of tissue are incised. The doctor enters the amniotic sac, taking special care of the baby, and the baby is lifted out head first. After that, the routines of cutting the umbilical cord and delivering the placenta are the same as a vaginal birth.

The mother may see her baby above the drape sheet as the doctor works on the sutures.  Recovery after a cesarean delivery can be a month or more, including a prolonged hospital stay.  Again, a cesarean is major surgery and is treated as such in the hospital as well as with the after care.

Talk to your doctor about the possibilities of a cesarean delivery.  If a cesarean becomes necessary, you will want to know the facts about the procedure before you are wheeled into the operating room.

** Disclaimer: Please note that every effort has been made to include accurate information, but further research and the advice of a physician is highly recommended before taking any recommendations or ideas on child birth listed on this site.