Dr. Onyeije’s Maternal-Fetal Medicine Blog

Baby Brought Back to Life by Mother’s Love

TAGS: None

An Australian mother has told how her touch brought her 'dead' baby back to life.

Doctors gave tiny Jamie Ogg no chance of survival when he was born prematurely at 27 weeks weighing just 2lb. His twin sister Emily had survived but after battling for 20 minutes to get him to breathe Jamie was declared dead. He was then handed to his mother Kate so she and her partner David could grieve and say their goodbyes.

But after two hours of being spoken to, touched cuddled and held by his mother he miraculously began showing signs of life. Then after being given breast milk on his mother's finger, he began breathing regularly.

Kate, who gave birth after a three-hour labour in March, has spoken of how vital 'skin-on-skin' care can be for a sick baby, or 'kangaroo touch' as it is known in Australia. 'Skin-on-skin' care is when the child is laid on the mother.

Normally, premature babies are sent to intensive care and she was only given her son to hold because he was thought to have died.

Telling how the drama unfolded at a hospital in Sydney, she said: "The doctor asked me after the birth had we chosen a name for our son. I said, 'Jamie', and he turned around with my son already wrapped up and said, 'We've lost Jamie, he didn't make it, sorry.' It was the worse feeling I've ever felt. I unwrapped Jamie from his blanket. He was very limp. His little arms and legs were just falling down away from his body. I took my gown off and arranged him on my chest with his head over my arm and just held him. He wasn't moving at all and we just started talking to him. We told him what his name was and that he had a sister. We told him the things we wanted to do with him throughout his life."

"Jamie occasionally gasped for air, which doctors said was a reflex action. After just five minutes I felt him move as if he were startled, then he started gasping more and more regularly. I thought, 'Oh my God, what's going on?' A short time later he opened his eyes. It was a miracle.

"I told my mum, who was there, that he was still alive. Then he held out his hand and grabbed my finger. He opened his eyes and moved his head from side to side."

"She said they passed on a message to their doctor insisting Jamie was showing signs of life, but he sent back a midwife with the reply that they were just natural reflexes and that there was no possible way he could still be alive."

Kate then said to her husband, "What if he lives?" She added: "I was like, 'We could be the luckiest parents in the world.'"

"I gave Jamie some breast milk on my finger, he took it and started regular breathing."

"At that point the doctor came back. He got a stethoscope, listened to Jamie's chest and just kept shaking his head. He said, 'I don't believe it, I don't believe it.'"

David, speaking to the Australian TV show Today Tonight, said: "Luckily, I've got a very strong, very smart wife. She instinctively did what she did. If she hadn't have done that, then Jamie probably wouldn't be here."

The doctor who delivered Jamie refused to be interviewed for the TV show.

Source

Daily coffee fine for pregnant women

TAGS: None

Pregnant women need no longer give up their morning cup of coffee.

A research review by the American College of Obstetricians and Gynecologists has found that moderate caffeine consumption probably won't increase the risk of a miscarriage or premature birth.

Until recently, studies have had conflicting findings about the effect of moderate caffeine consumption on pregnancy complications but a college committee has reviewed the evidence.

"I think it's time to comfortably say that it's OK to have a cup of coffee during pregnancy," Dr. William Barth, the chair of the College committee, told Reuters Health.

The College's Committee on Obstetric Practice said that 200 milligrams of caffeine a day -- about the amount in a 12-ounce cup of coffee -- doesn't significantly contribute to miscarriages or premature births.

That definition of "moderate caffeine consumption" would also include drinking about four eight-ounce cups of tea or more than five 12-ounce cans of soda a day, or eating six or seven dark chocolate bars.

The committee said the evidence was not clear on whether consuming more than 200 mg of caffeine a day might increase pregnancy risks.

The group considered two recent studies, each of which followed more than 1,000 pregnant women.

One study, led by Dr. David Savitz of The Mount Sinai Medical Center in New York, found no increased rate of miscarriage for women who consumed low, moderate, or high levels of caffeine at different points in their pregnancy.

In the other, Dr. De-Kun Li and his colleagues at Kaiser Permanente's Division of Research in Oakland found a higher risk of miscarriage in women who consumed more than 200 mg of caffeine per day, but no extra risk at lower levels.

The committee also pointed to two other studies that found that a mother's moderate caffeine intake did not make it any more likely she would deliver a baby prematurely.

Research has shown that caffeine is able to cross the placenta, which led to worries that it could cause miscarriage or premature birth.

In the United States, about 16 per cent of all pregnancies end in miscarriage and about 12 per cent of babies are born prematurely.

Source

Meet the UK’s Most Premature Baby to Survive

TAGS: None

Amelia Hope Burden was born before the 24-week legal limit for abortion when her mother was just 23 weeks and two days pregnant, the Daily Mail reported.

She was born weighing only 1lb 2oz ten days before her brother Arthur arrived at 1lb 4oz.

He was born in July after Amanda Staplehurst had been pregnant for 24 weeks.

She went to hospital complaining of stomach cramps only to be told that she was in labor.

Amelia Hope showed little sign of life but doctors were able to revive her.

Under law they are not obliged to do so unless they feel it is in the child’s best interest.

Miss Staplehurst, 30, from Bournemouth, told the Daily Mail: “Doctors said she had just a 10 per cent of chance of survival and we never thought she’d pull through.

“Then having delivered Amelia Hope, it was totally bizarre that for ten days I remained pregnant with Arthur. The doctors have told us they’ve never come across a case like it.”

The babies are being kept in incubators but are putting on weight and said to be developing well.

The twins’ survival will give weight to the campaign to have the abortion limit lowered.

Some campaigners would like to see it reduced to 20 weeks.

David Cameron, the Prime Minister, voted for a cut earlier this year and has said that an upper limit of 20 or 22 weeks would be “sensible”.

The previous British record for surviving premature twins was 24 weeks, the paper reported.

Source

Teenagers ‘risk premature babies’

TAGS: None

Pregnant teenagers are more likely to give birth prematurely and have a small baby than women in their 20s, says an Irish research team.

Fourteen to 17-year-olds were also more likely to give birth early if they were having a second child, a study of more than 50,000 women in England found.

The findings, reported in BMC Pregnancy and Childbirth, highlighted the importance of routine medical checks.

The team said more studies were needed to find out why the young were at risk.

The study included all women aged between 14 and 29 who had given birth in north-west England over a two-year period.

In all, 3,600 of those were aged between 14 and 17, the researchers said.

More than a third of them came from the most socially deprived areas.

The study also found teenage mothers were also more likely to be underweight.

Those aged under 17 were 21% more likely to have a premature baby with their first pregnancy and 93% more likely to have their second baby early.

There was also a link with younger mothers and having a baby with a low birth weight.

Researcher Dr Ali Khashan, from University College Cork, in the Republic of Ireland, said it might be that the risk of premature birth in the young teenagers was related to "biological immaturity".

"It is also possible that the increased risk of poor pregnancy outcome in the second teenage pregnancy is related to numerous complicating factors such as greater social deprivation and less prenatal care," he added.

Source

Fertility treatment tied to risk of cerebral palsy

TAGS: None

A new study confirms that children conceived via infertility treatment may have a higher-than-average risk of cerebral palsy -- explained largely by their higher rates of multiple births and preterm delivery.

The study, of nearly 590,000 children born in Denmark between 1995 and 2003, found that those conceived through assisted reproduction were about twice as likely to be diagnosed with cerebral palsy as children who were conceived naturally.

The findings, reported in the journal Human Reproduction, confirm those from a number of past studies. They also suggest that the increased risk of cerebral palsy can be largely attributed to the heightened odds of twin or higher-order births, as well as preterm delivery, with assisted reproduction.

However, the absolute risk of having a baby with cerebral palsy is still quite low for couples undergoing infertility treatment.

In the U.S. and Europe, it's estimated that two or three of every 1,000 babies are affected by the disorder. So even with a relatively increased risk, the vast majority of children born via assisted reproduction techniques will not have cerebral palsy.

Still, researchers say their findings offer an argument for implanting women with only one embryo at a time, in order to cut the odds of multiple births and preterm delivery.

Cerebral palsy refers to a group of conditions, usually present at birth, that permanently impair movement, balance and posture. The impairments range from mild -- some children have only relatively minor problems with movement -- to more severe, with some children being unable to walk or having additional impairments, such as mental retardation or vision and hearing problems.

The precise cause of cerebral palsy is unknown, but it is believed to involve a disruption in normal fetal brain development. Premature and low-birthweight infants are known to have a higher risk than full-term, normal-weight babies.

For the new study, researchers led by Dr. Dorte Hvidtjorn, of the University of Aarhus in Denmark, examined national data on all 588,967 children born in the country between 1995 and 2003. That included 33,139 children conceived via in-vitro fertilization (IVF) or with the help of fertility drugs to stimulate the ovaries to produce eggs.

Overall, 0.2 percent of all children were diagnosed with cerebral palsy. The risk was more than doubled among children in the IVF group, and 55 percent higher among those conceived using fertility drugs, compared with children conceived naturally.

When the researchers factored in the effects of multiple births and preterm delivery, the link between fertility treatment and cerebral palsy disappeared -- indicating that those two factors are likely responsible for the connection.

In fact, the researchers found no increased risk of cerebral palsy among singletons born via IVF.

Source

Preterm Births Rarely Discussed With Doctors

TAGS: None

Even though one in eight babies in the United States are born preterm each year, most new or expectant mothers and their doctors don't discuss preterm birth, a new survey shows.

Conducted by the March of Dimes and BabyCenter, the poll included more than 1,000 participants, including new or expectant mothers, mothers who've experienced preterm birth and their obstetricians/gynecologists.

Despite the fact that prior preterm birth is a major risk factor for delivering another baby prematurely, nearly 40 percent of women who had a previous preterm delivery were not informed of this by their doctors.

"If you've had a preterm birth, talk to your doctor because the greatest risk factor for having a preterm baby is if you've already had had one," said Dr. Alan Fleischman, March of Dimes medical director. "Our survey found that a lot of moms don't feel informed about preterm birth's risk factors and potential consequences."

"Early prenatal care, including reviewing medical history and lifestyle habits, is an opportunity to give babies a better chance of a healthy, full-term birth," said Fleischman. "Therefore, having that conversation about preterm birth should take place early enough so the mom-to-be can address any modifiable risk factors, and treat any health conditions that may put her or her baby at increased risk."

The survey also found that more than two-thirds of new and expectant mothers did not know the correct definition of preterm birth (less than 37 weeks of completed weeks of gestation), and one-third weren't able to pinpoint risk factors associated with preterm birth.

Among the other findings:

  • Only 15 percent of mothers who had experienced preterm birth discussed preterm delivery with their doctor before the second trimester, and nearly 40 percent didn't know they were at risk for a subsequent preterm birth.
  • Less than half of new or expectant mothers said they felt very informed about symptoms of preterm labor, and even fewer felt very informed about lifelong consequences.
  • Among obstetricians/gynecologists, most cited the lack of preterm birth prevention options as a challenge in broaching the topic of preterm delivery with patients, and more than half cited concern about causing undue fear or worry.

Learn more about premature labor here.

Source

Too little weight gain risky in twin pregnancy

TAGS: None

Women pregnant with twins should be sure to gain the recommended amount of weight, according to a new study, which shows that gaining less weight than recommended during a twin pregnancy ups the risk of early birth and low weight babies.

"A woman should gain about a pound a week; less than that, and we had smaller babies and more pre-term births," Dr. Nathan Fox of Maternal-Fetal Medicine Associates of New York City told Reuters Health.

Fox and his partners wanted to know if the twin pregnancy weight gain guidelines updated by the Institute of Medicine in 2009 made a difference in pregnancy outcomes.

These recommendations suggest a range of weight gain depending on a woman's weight at the start of her twin pregnancy. A normal weight woman should gain 37 to 54 pounds; an overweight woman, 31 to 50 pounds; and an obese woman, 25 to 42 pounds.

In looking at 281 mostly normal weight women pregnant with twins, Fox and colleagues found that women who gained the recommended amount of weight did much better in regards to the pregnancy outcomes.

Women who gained less than the recommended amount of weight were more likely to give birth early (before 32 weeks of pregnancy) than women who gained the correct amount of weight (14 percent versus 5 percent). They were also more likely to give birth to smaller babies.

Unlike in singleton pregnancies, gaining enough weight in twin pregnancies can be Herculean task. "It's often not easy," Fox said. "We send our patients to nutritionists and have them on high calorie diets a lot to have them gain the right amount of weight. It's not easy for many (women)."

About 3 in every 100 pregnancies is a twin pregnancy, the investigators note, and preterm births occur about 60 percent of the time, making the issue of correct weight gain even more important.

The strong link between inadequate weight gain in twin pregnancies and increased rates of pre-term birth "has not been conclusively demonstrated previously," the investigators point out in the journal Obstetrics & Gynecology.

Their findings, they say, shed light on the importance on what "could be a correctable cause of prematurity in twins," they conclude.

Source

Flame Retardant May Up Risk of Thyroid Problems in Pregnancy

TAGS: None

Exposure to flame-retardant chemicals may reduce a pregnant woman's levels of certain thyroid hormones that play a critical role in fetal brain development, a new study shows.

Polybrominated diphenyl ether (PBDE) flame retardants are used in a large number of consumer products, including cars, electronics and home furnishings. PBDEs are found in the blood of most Americans, according to data collected by the U.S. Centers for Disease Control and Prevention.

In the new study, published online June 21 and in an upcoming print issue of the journal Environmental Health Perspectives, researchers from the University of California, Berkeley, measured thyroid hormone levels in 270 women, most of them Mexican-American, and found that those with higher PBDE levels had lower levels of thyroid-stimulating hormone.

Women with the highest levels of the flame retardant in their blood were more likely to have subclinical hyperthyroidism, which is defined as below-normal levels of thyroid-stimulating hormone with normal levels of the thyroid hormone thyroxine (T4), the researchers found.

"Women with low [thyroid-stimulating hormone] may be above their natural set-point for the T4 thyroid hormone, which means that their thyroids may not be functioning normally," study author Jonathan Chevrier, of the Center for Children's Environmental Health Research at University of California, Berkeley, said in a news release from the journal's publisher.

"Elevated T4 in pregnancy has been associated with increased risks of miscarriage, premature birth and intrauterine growth retardation," study co-author Brenda Eskenazi added.

"A mother's thyroid hormones affect her developing baby throughout her pregnancy, and they are essential for fetal brain development," Eskenazi, director of the Center for Children's Environmental Health Research, stated in the news release.

Source

Father involvement in pregnancy could reduce infant mortality

TAGS: None

Studies have shown fathers who are active in their children's upbringing can significantly benefit their children's early development, academic achievement and well being. Now, a new study by University of South Florida researchers suggests that a father's involvement before his child is born may play an important role in preventing death during the first year of life - particularly if the infant is black.

The USF team sought to evaluate whether the absence of fathers during pregnancy contributes to racial and ethnic disparities in infant survival and health. Their findings were recently reported online in the Journal of Community Health.

"Our study suggests that lack of paternal involvement during pregnancy is an important and potentially modifiable risk factor for infant mortality," concluded the study's lead author Amina Alio, PhD, research assistant professor of community and family health at the USF College of Public Health. "A significant proportion of infant deaths could be prevented if fathers were to become more involved."

The researchers examined the records of all births in Florida from 1998 to 2005 – more than 1.39 million live births. Father involvement was defined by the presence of the father's name on the infant's birth certificate. While this measure does not assess the extent or quality of a father's involvement during pregnancy, other studies have established a link between paternal information on a birth record and prenatal paternal involvement.

Among the study's findings:

  • Infants with absent fathers were more likely to be born with lower birth weights, to be preterm and small for gestational age.
  • Regardless of race or ethnicity, the neonatal death rate of father-absent infants was nearly four times that of their counterparts with involved fathers.
  • The risk of poor birth outcomes was highest for infants born to black women whose babies' fathers were absent during their pregnancies. Even after adjusting for socioeconomic differences, these babies were seven times more likely to die in infancy than babies born to Hispanic and white women in the same situation.
  • Obstetric complications contributing to premature births, such as anemia, chronic high blood pressure, eclampsia and placental abruption, were more prevalent among women whose babies' fathers were absent during pregnancy.
  • Expectant mothers in the father-absent group tended to be younger, more educated, more likely to never have given birth, more likely to be black, and had a higher percentage of risk factors like smoking and inadequate prenatal care than mothers in the father-involved group.

Paternal support may decrease the mother's emotional stress, which has been linked to poor pregnancy outcomes, or promote healthy prenatal behavior, Dr. Alio suggested. For instance, some studies, including USF's, indicate that pregnant women with absent partners are more likely to report smoking during pregnancy and get inadequate prenatal care. Barriers to expectant fathers' involvement in the lives of their pregnant partners, including issues like unemployment, relationship status, and participation in prenatal visits, must be examined to increase the role of men during pregnancy, she said.

Improving the involvement of expectant fathers holds promise for reducing costly medical treatments for the complications of premature births as well as reducing infant mortality rates, particularly in black communities, Dr. Alio said. "When fathers are involved, children thrive in school and in their development. So, it should be no surprise that when fathers are present in the lives of pregnant mothers, babies fare much better."

Source

Slightly early births linked to autism, dyslexia

TAGS: None

Babies born just 1 or 2 weeks before their 40-week gestation due date are more likely to develop learning difficulties such as autism or dyslexia, according to a British study published on Tuesday.

The findings show that even babies born at 39 weeks -- the point at which many women who choose to have a Cesarean section delivery -- have an increased risk of a developing a learning disability compared with babies born a week later at 40 weeks.

Scientists in Scotland, analyzing the birth history of more than 400,000 schoolchildren, found that while babies born at 40 weeks have a 4 percent risk of learning difficulties, those born at 37 to 39 weeks of gestation have a 5.1 percent risk.

It is already known that a baby born prematurely -- for example at 24 weeks of gestation -- is more likely to have learning difficulties. But the risks for babies born in the 24 to 40 week range had not previously been studied.

Around a third of babies are born between 37 and 39 weeks of gestation, either by cesarean section or natural vaginal delivery.

Pell, whose study was published in the Public Library of Science Medicine journal, stressed that cesarean sections were not the only factor behind early-term births, since some women go into labor naturally before 40 weeks of gestation.

But she said doctors and women should consider the risks of learning difficulties when thinking about a cesarean.

Source

© 2009 Dr. Onyeije’s Maternal-Fetal Medicine Blog. All Rights Reserved.

This blog is powered by Wordpress and Magatheme by Bryan Helmig.