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Pregnancy Risks and Advanced Maternal Age
Medical Genetics, University of South Alabama.
Women approaching or beyond the age of 35 have a greater chance than younger women of having a baby with a chromosome abnormality ...
Pre-Pregnancy Planning
March of Dimes Saving babies, together. All women of childbearing age can take steps even before conception to improve their chances of having a healthy baby. How Can Taking Folic Acid Help? ...
Pregnancy Planning Worksheet designed for a lupus patient
Complete this form, then take it with her for pre-pregnancy discussion with her attending physiogynecologist.
Pre-Pregnancy Planning
Planned Parenthood Federation of America, Inc
Online source for sexual health information.
[*] Planning Pregnancy
Columbia University College of P & S Complete Home Medical Guide ... (17 pages of authoritative "user friendly" text). Physiologically, the optimal years for childbearing are between ages 18 and 35. Women who become pregnant in their early teens or after the age of 35 have an increased risk of pregnancy complications. After age 35, and particularly after 40, there is a greater risk of having a child with a congenital anomaly, such as Down syndrome. ... however, the risk is small and the vast majority of babies are healthy. A woman should if she is above her ideal weight, make every effort to lose weight. Genetic Counseling and Prenatal Testing: Increasingly important part of modern obstetrical care. Extra diagnostic tests are usually recommended for women who will be 35 years ...
Think Ahead
Birth Defects Information ... March of Dimes Saving babies, together ...
[Spanish] Pregъntale a NOAH sobre el embarazo
Planificacion Familiar ... Cuidado Prenatal y Nacimiento ...
Pre-Pregnancy Planning
UCLA Healthcare. Even before conception, a woman's health and substances to which she is exposed can significantly influence the success of a pregnancy and the health of her baby.
Pre-Pregnancy Planning At Cu
Columbia University's Health Education Program ...
Pre-Pregnancy Recommendations
You should stop acne medications, tranquilizers and sleeping pills. Stop using any illegal drugs. Quit smoking cigarettes Now! Decrease your caffeine intake. Decrease your alcohol consumption. Begin taking a multiple vitamin with iron. Take acetaminophen (Tylenol) if you get a fever or have pain. Rubella (German measles) is a serious threat to the health of your unborn baby.
Folic Acid & Pregnancy
Policy Statement from the American College of Medical Genetics ...
B Vitamins Reduce Homocysteine and Heart Disease
The level of homocysteine is dependent on several factors including dietary vitamin B-6, vitamin B-12 and folic acid ...
Ask NOAH About Pregnancy: Fertility, Infertility & Surrogacy
Fertility enhancement ... Male infertility ...
Y-Chromosome Microdeletion and Chromosome Analysis
Approximately 5-10% of men with oligospermia and 10-15% of men with azoospermia carry a chromosome abnormality, most commonly of the sex chromosomes. Most men with Klinefelter syndrome go undetected until trying to conceive children, when an evaluation for infertility is preformed. A chromosome analysis should be routinely offered to all men with infertility before proceeding with ICSI.
Mutation on Y Chromosome Stops Sperm Production
Howard Hughes Medical Institute (HHMI) investigator David Page has found the first mutation on the Y chromosome that prevents sperm production and thus causes male infertility.
Genetics of male infertility
A significant proportion of infertile male with azoospermia and severe oligospermia have a genetic etiology for reproductive failure. Cystic Fibrosis (CF) gene mutation have been detected in men with congenital absence of the vas deferens, but with no other manifestation of CF. Genetic studies revealed that 50-83% of patients with Congenital Bilateral Absence of the Vas Deferens (CBAVD) have at least one known CFTR gene mutation and that approximately 10% have two known CFTR mutations. Renal agenesis was found in 11% of patients with CBAVD and 26% of patients with CUAVD. The most common karyotype abnormality in men with severe male factor infertility is Klinefelter's syndrome, affecting 7-13% of azoospermic men ... deletion of distal end of the long arm of the Y chromosome. This region includes the azoospermia factor (AZF) locus, which contains a gene or genes, required for spermatogensis ... Microdeletions in the Y-chromosome were found in 7% of unselected group of infertile men which suggests that Y-chromosome microdeletions constitute the second most common specific cause of male infertility.
Male Infertility
Male infertility is not the same as impotence, which is the inability to have an erection. Only half of couples who are trying to become pregnant achieve pregnancy easily ... half because of male infertility. Known causes of male infertility include: 1. Genetic or inherited disease 2. Alcohol 3. Physical injury to the testicles 4. Varicose veins in the scrotum 5. Side effects of serious illness such as colitis, hepatitis, uremia, and cancer ...
[*][P] Toxic Exposures & Male Infertility
by Steven M. Schrader, Ph.D.
There is less information on male reproductive toxicology than developmental toxicology. In 1775 the English physician, Percival Pott, reported a high incidence of scrotal cancer in chimney sweeps ... human male reproductive toxicants have been include lead, other pesticides, and organic solvents.
Female Infertility
Infertility is the inability of a sexually active couple, not using any contraception, to conceive during one year, the time in which about 90 percent of couples succeed. Just over half of all infertility is attributable to the female partner.
Pregnancy loss
...Miscarriage is pregnancy loss that occurs before 20 weeks, before the fetus is able to survive outside the womb. Most miscarriages occur in the first trimester or 12 weeks of pregnancy. As many as 50 percent of all pregnancies may end in miscarriage, because many losses occur before a woman realizes she is pregnant....
Adolescent Pregnancy
Adolescent pregnancy in the United States continues to be a complex and perplexing issue for families, health care professionals, educators, government officials, and youth themselves. The percentage of American adolescents who are sexually active has increased significantly in recent years .Currently, 56% of girls and 73% of boys have had sexual intercourse before 18 years of age. There are several predictors of sexual intercourse during the early adolescent years, including early pubertal development, a history of sexual abuse, poverty, the lack of attentive and nurturing parents ...
Teenage Pregnancy Fact Sheet
March of Dimes.
Pregnancy After Age 35
March of Dimes ... Most women over age 35 have healthy pregnancies and healthy babies. However, recent studies suggest that women who postpone childbearing do face some special risks. Since the late 1970s, birth rates for women in their late 30s and 40s have increased dramatically. According to the National Center for Health Statistics, between 1978 and 1997, the birth rate rose 90 percent for women age 35 to 39. Between 1981 and 1997, the rate increased 87 percent for women in their 40s ... How much does age affect fertility? ... have some decrease in fertility ... How do preexisting health problems affect pregnancy? ... At any age, a woman should consult her health care provider before attempting to conceive ... A 1996 Mount Sinai study found that women age 40 and older were almost three times as likely to develop diabetes, and almost twice as likely to develop high blood pressure as women in their 20s ... What is the risk of birth defects in babies of women over 35? ... The risk of bearing a child with certain chromosomal disorders increases as a woman ages ... At age 25, a woman has a 1-in-1250 chance of having a baby with Down syndrome; at age 30, a 1-in-952 chance; at age 35, a 1-in-378 chance; at age 40, a 1-in-106 chance; and at 45, a 1-in-30 chance ... What is the risk of miscarriage as a woman gets older? ... Most miscarriages occur in the first trimester for women of all ages. The rate of miscarriage in older women is significantly greater than that in younger women. Studies estimate that this risk is about 12 to 15 percent of recognized pregnancies for women in their 20s and rises to about 25 percent at age 40 ... Does the risk of pregnancy complications and adverse pregnancy outcomes increase after age 35? ... While women in their late 30s and 40s are very likely to have a healthy baby, they do face more complications along the way ... Do women over 35 have more problems in labor and delivery? ... First-time mothers over 35 are more likely than women in their 20s to have difficulties in labor ... How can a pregnant woman reduce her risks? ... Take a multivitamin containing 400 micrograms of the B vitamin folic acid daily before and early in pregnancy to help prevent certain birth defects of the brain and spinal cord. (This applies to all women of childbearing age.) ... Have a pre-pregnancy medical check-up and obtain early and regular pre-natal care during pregnancy ... Don’t drink alcoholic beverages ... Don’t smoke during pregnancy ...
[**] [P] Maternal Age and Birth Outcomes: Data from New Jersey
by Nancy E. Reichman and Deanna L. Pagnini, Family Planning Perspectives, Volume 29, No. 6, November/December 1997 ... the youngest (younger than 15) and oldest (aged 40 and older) mothers being at higher risk than 25–29-year-olds ... The multivariate analysis also showed that newborn hospitalization costs increased with maternal age among both blacks and whites ... The results indicate that teenagers younger than 15 have the highest risk of delivering a low-birth-weight infant relative to 25-29-year-olds, closely followed by mothers 40 and older ...
[Spanish] Herpes genital
Understanding Gestational Diabetes
Juvenile Diabetes Foundation International
The Diabetes Research Foundation ...
Diabetes
By IRSC ...
American Diabetes Association
The Human Placenta in Diabetic Pregnancy
By Gernot Desoye, Ph.D. ... Diabetes Reviews volume 4, number 1, page 70 ...
CDC's Diabetes & Public Health Resource
Diabetes
CDC's Diabetes Translation Program ... Impact of Diabetes ...
Understanding Gestational Diabetes
A Practical Guide to a Healthy Pregnancy ...
Diabetes Monitor : Planning a pregnancy
If a young woman with diabetes (or previous gestational diabetes) is planning a pregnancy soon, there's a list of things to do. Here's the advice I give my patients ... Tighten up your targets ... Do more blood sugars ... Plan on lots of shots ... Start telephoning ... Talk to a dietitian ...
Guide to Type 1 (Insulin-dependent) Diabetes
Pregnancy and Contraception ...
Gestational Diabetes: Nutrition and Questions
Women with gd are often given a plan as if it is "The Ten commandments" written in stone, and are shocked when they compare their plan with others' and see some of the differences. The similarities generally outweigh the differences ...
Diabetes
Keys to Healthy Pregnancy ... blood glucose ... (macrosomia) ... 43% ... diabetic women ... wary of hypoglycemia ... last trimester ... increase insulin by as much as two or three times. This is normal. Oral diabetes medications can cause birth defects ...
[Spanish] La diabetes durante el embarazo
[Spanish] Intolerancia de Rh
La intolerancia de Rh de los neonatos ocurre cuando existe una falta de compatibilidad entre la sangre de la madre y la de su feto ... La mayorнa de la gente tiene sangre de factor Rh-Positivo ... Esto significa que producen el factor Rh, una proteina hereditaria que se encuentra en la superficie de sus glуbulos rojos. Alrededor del 15 por ciento de los individuos de raza blanca y el 7 por ciento de los de raza afroamericana carecen del factor Rh y son considerados Rh-negativos ...
Antenatal and Neonatal protection of the Infant
by Jacob Sobel, M.D.
Archives of Pediatrics 43:448-465, 1926 ...
[*][P] Prenatal Genetic Diagnosis
American Academy of Pediatrics ...
Prenatal Diagnosis
The Internet Pathology Laboratory Web Path ... Ultrasonography ... Amniocentesis ... Chorionic Villus Sampling (CVS) ... Maternal blood sampling for fetal blood cells ... Maternal serum alpha-fetoprotein (MSAFP) ... Maternal serum beta-HCG ... Maternal serum estriol ... Techniques for Pathologic Examination ...
[Spanish] Ultrasonido
El ultrasonido es una tйcnica que utiliza ondas sonoras para tomar imбgenes del bebй (feto) dentro del ъtero. Debido a que utiliza ondas sonoras en lugar de radiaciones, el ultrasonido es mбs seguro que los rayos X ...
[Spanish] Amniocentesis
March of Dimes Saving babies, together.
Use of age as a threshold for recommending prenatal diagnosis is questioned
Age increases a woman's risk of having a child with a genetic disorder such as Down syndrome. The authors of a recent commentary call for eliminating strict age- or risk-based cutpoints for prenatal diagnosis in favor of the preferences of well-informed women. However, today there are 268 cytogenetic labs that can detect chromosomal abnormalities, and there are 500 board-certified cytogeneticists in the United States ... A woman's risk of giving birth to a child with Down syndrome show that the risk increases substantially among women in their early to mid-30s, but it does not spike suddenly at 35 years of age. In addition, the age 35 cutoff was chosen because that is when the risk that a woman will have a miscarriage after the procedure is about equal to the probability that she is carrying a fetus affected by a chromosomal abnormality ... women's preferences showed that most women (83 percent) would prefer having a procedure-related miscarriage to giving birth to a child with Down syndrome.
SCREENING PREGNANCIES
Pregnancy " Triple Test "
Pregnant women are routinely offered a blood test called a triple test ... This test is also known as: Triple Screen, AFP Plus, Multiple Marker Test, or Prenatal Risk Profile Test ... mainly used to identify pregnancies which may be at increased risk for: Down syndrome, Neural tube defects NTD (spina bifida or anencephaly), Other birth defects. Abnormal results must be confirmed by a diagnostic test (amniocentesis) combined with a high resolution ultrasound performed by an expert in birth defects and laboratory studies of the amniotic fluid and cells including chromosome studies.
Triple Test Q&A
Michigan State University.
WHAT CAN THE TRIPLE TEST TELL ME? ... The Triple Test is a blood test available to any woman who is between 15 and 22 weeks' pregnant. The Triple Test measures alpha fetoprotein (AFP) and two other substances (chorionic gonadotropin and unconjugated estriol) that are made by the developing baby and placenta. All of these substances are normally present in a pregnant woman's blood ... can help to identify women who may be carrying twins, who may be further along in their pregnancy than was thought, who may be at risk of having a premature delivery or a low birth weight baby, or who may be carrying a fetus with certain types of birth defects such as neural tube defects or ventral wall defects. The Triple Test can also help identify women who are not as far along in their pregnancies as was thought, who may not be pregnant, or in a few cases, who may be carrying a baby with Down syndrome ... WHAT ARE NEURAL TUBE DEFECTS? ... Out of 1,000 pregnant women, only one or two will have a baby with a neural tube defect. Neural tube defects occur in two main forms: anencephaly, which is incomplete development of the brain, and spina bifida which is incomplete closure of the spine ... WHAT ARE VENTRAL WALL DEFECTS? ...The Triple Test may also indicate that the fetus has a ventral wall defect, also known as an abdominal wall defect ... If the defect in the abdominal muscle is large, other internal organs such as the liver and bladder may also develop outside the fetal abdomen ... other type of ventral wall defect is gastroschisis in which the intestines and occasionally other organs protrude through the defect ... Gastroschisis is rarely associated with the other malformations ... WHAT IS DOWN SYNDROME? ... WHAT DOES IT MEAN IF MY TRIPLE TEST IS ABNORMAL? ... IF MY TRIPLE TEST IS NORMAL, CAN I BE CERTAIN THAT EVERYTHING IS ALL RIGHT WITH MY BABY? ... WHY SHOULD I HAVE THE TEST? ... WHEN SHOULD I HAVE THE TEST? ... HOW DOES THE TRIPLE TEST DIFFER FROM THE AFP TEST? ... WHO CAN I TALK TO IF I HAVE QUESTIONS ABOUT THE TRIPLE TEST? ... WE CANNOT INTERPRET RESULTS FROM OTHER LABORATORIES ...
What Does the Triple Screen Measure?
March of Dimes.
[Spanish] Examen selectivo de alfafetoproteinas
March of Dimes.
La mayoria de los proveedores de atencion de salud ahora ofrecen rutinariamente a sus pacientes embarazadas un analisis de sangre llamado la prueba de examen selectivo de alfafetoproteinas sericas maternas (MSAFP, maternal serum alpha-fetoprotein screening test). Esta prueba identifica los embarazos en un riesgo mayor de lo promedio de ciertos defectos congenitos graves, como la espina bifida (espina dorsal abierta) y el sindrome de Down (rasgos faciales caracteristicos, retraso mental y posibles defectos del corazon y otros problemas) ... ?Que es la alfafetoproteina?
[German] Triple-Test - Was ist das?
Der Triple-Test ist eine Untersuchung des Blutes der werdenden Mutter. Er wird zwischen der 15. und 20. Schwangerschaftswoche (ublicherweise 16.-17. Schwangerschaftswoche) durchgefuhrt und beinhaltet die Bestimmung von 3 Hormonen im Blut der Mutter: alpha-Fetoprotein (AFP), freies Estriol (E3), beta-Choriongonadotropin (beta-HCG) ...
[French] Le triple test
Qu'est ce que c'est ?
[**] [P] Prenatal Screening and Diagnosis for Down Syndrome Prevention
by Paul Dick, MDCM, FRCPC, Department of Pediatrics, University of Toronto.
In 1979 the Canadian Task Force ... reviewed the evidence for prenatal diagnosis of Down Syndrome (DS) and concluded that there was fair evidence to offer amniocentesis to pregnant women from high-risk groups, including parents with translocation of chromosome 2 1, a family history of DS, or maternal age over 35 years ...
[***] [P] Screening for Down Syndrome
U.S. Preventive Services Task Force
The offering of amniocentesis or chorionic villus sampling (CVS) for chromosome studies is recommended for pregnant women at high risk for Down syndrome ...
Prenatal Screenings
©1999 March of Dimes Birth Defects Foundation ... Amniocentesis ... Chorionic Villus Sampling (CVS) ... Maternal Blood Screening ... Ultrasound ...
Chorionic Villus Sampling and Amniocentesis: Recommendations for Prenatal Counseling (and Limb Deficiencies)
by MMWR 44(RR-9);1-12, 07/21/1995, Richard S. Olney, M.D., M.P.H., et al.
CDC ... Chorionic villus sampling (CVS) and amniocentesis are prenatal diagnostic procedures that are performed to detect fetal abnormalities ... CVS can cause transverse limb deficiencies ... are associated with the timing of CVS ... Use of CVS and Amniocentesis ... Limb deficiencies among infants whose mothers underwent ... Possible mechanisms of CVS-associated limb deficiency ...
Syndromes Detectable in Fetuses
Aicardi's syndrome ... Apert syndrome ... Fetal alcohol syndrome ... Fetal Hydantoin Syndrome ... Fetal Rubella syndrome ... Holt-Oram syndrome ...
Fetal Aneuploidies
45,X/47,XYY mosaicism ... 45,X/47,XY mosaicism ... Monosomy X (Turner) Syndrome ... The ultrasound detection of chromosomal anomalies ...
Fetal Therapy-Ethical Considerations
American Academy of Pediatrics ... Committee on Bioethics ... Decisions by pregnant women concerning fetal diagnostic and therapeutic interventions clearly involve considerations as to what is best for the fetus. These decisions also involve the woman's interest in her own health and freedom from unwanted invasion of her body because all diagnostic and therapeutic interventions on behalf of a fetus necessarily affect the pregnant woman and require her direct participation. Thus, fetal therapy poses a potential conflict between the pregnant woman's own best interests, and her (and others') perception of the best interests of her fetus.
The University of California San Francisco Fetal Treatment Center Fetal Firsts pioneering procedures first practiced at the Fetal Treatment Center at UCSF.
Open fetal surgery ... Urinary catheter for posterior urethral valves ... Congenital diaphragmatic hernia ... Uterine stapling device for fetal surgery ... Fetal endoscopic tracheal clip ... Fetal bladder catheter ...
The University of California San Francisco Fetal Treatment Center Overview
The fetal Treatment Center ... corrective fetal surgery ... 18th through the 30th week ... congenital diaphragmatic hernia, cystic adenomatoid malformations of the lung, urinary tract obstructions, and sacrococcygeal teratoma, and fetal anomalies ...
Overview of Fetal-Placental Abnormalities
Chromosomal Abnormalities ...
[Spanish] Muestra del villus coriуnico (CVS) - їA quiйnes se les ofrece la prueba de CVS?
Image Library
Fetal Anomalies ... Twin-Twin TransfusionSyndrome ... Bilateral Cleft Lib ... Lateral Cleft Lip ... Small Omphalocele ... Large Omphalocele ...
Fetal abnormalities diagnosable by ultrasound:
Achondroplasia ... Acondrogenesis ... Anencephaly (1) ... Beckwith-Weidemann syndrome ...
American Society of Human Genetics Policy Statement for Maternal Serum Alpha-Fetoprotein Screening Programs and Quality Control for Laboratories Performing Maternal Serum & Amniotic Fluid Alpha-Fetoprotein Assays
by Am. J. Hum. Genet. 40:7-82, 1987. MSAFP values are used primarily but not solely to predict occurrence of open neural tube defects in the ferus; their use for prediction of Down syndrome is a new initiative under investigation. The test is a good one, as far as such a test can be, but it is imperfect, because false-negative and false-positive results both occur. In other words, it is not an infallible test ...
Update on MSAFP Policy Statement from The American Society of Human Genetics
by Kenneth L. Garver, Department of Medical Genetics, Western Pennsylvania Hospital, Pittsburg.
Received April 25, 1989 ...
ACMG Position Statement on Multiple Marker Screening in Women 35 and Older
Maternal age (MA) has been an accepted screening method for Down syndrome (DS) for at least 20 years ... This committee recommends that serum analyte screening should be offered to all pregnant women who are less than 35 years unless their history suggests amniocentesis is indicated.
Statement on Guidance for Genetic Counseling in Advanced Paternal Age
American College of Medical Genetics ... There is no clear accepted definition of advanced paternal age. A frequently used criterion is any male, age 40 years or older at the time of conception, as opposed to the current population mean paternal age of 27 years. The risk for genetic defects does not increase dramatically at age 40, but rather increases linearly with age. Some studies have suggested that the risk of genetic defects, specifically, sporadic dominant single-gene mutations, is 4-5 times greater for fathers aged 45 and above than for their 20-25 year old counterparts ...
Statement on Multiple Marker Screening in Pregnant Women
American College of Medical Genetics ... Two years ago a position concerning Multiple Marker (MM) Maternal Serum (MS) screening in women age 35 and older at estimated delivery date was published by the Board of the American College of Medical Genetics. (1) This addendum to the initial statement reviews a) those previous recommendations, b) the selection of age-equivalent risk cut-off levels for MS screening, and c) whether routine MS alpha fetoprotein (MSAFP) screening is appropriate in addition to amniocentesis ...
Breast Cancer and Pregnancy
National Cancer Institute ... Cancer Information Service ... Breast cancer is the most common cancer in pregnant and postpartum women ... About 1 in 3,000 pregnancies ... Cancer are typically detected at a later stage than in a nonpregnant ... To detect breast cancer, pregnant and lactating women should practice self-examination and undergo a breast examination as part of the routine prenatal examination by a doctor ... Staging of breast cancer should be modified to avoid radiation exposure to the fetus ... Nuclear scans cause fetal radiation exposure.
Welcome to the Pregnant with Cancer Support Group
Prevent Blindness in Premature Babies
... Volunteer group formed to provide support and information to individuals and to parents of children who have Retinopathy of Prematurity, or ROP, (formerly called retrolental fibroplasia, or RLF) ...
If you Smoke While You Are Pregnanat
Smoking in Pregnancy
If all pregnant women in the U.S. stopped smoking, there would be an estimated 10% reduction in infant deaths, according to the U.S. Public Health Service ... A recent Danish study reported that women who smoke were about 30% less likely to conceive ... Women who smoke early in pregnancy double their risk of having an ectopic pregnancy ... Smokers are up to 80% more likely to suffer a miscarriage than their non-smoking counterparts ... Smoking nearly doubles a woman's risk of having a low weight baby ... Who weigh less than 5 1/2 pounds at birth ... Smoking during pregnancy may contribute to birth defects ... Increased risk of developing cleft lip and/or cleft palate ...
[*] Alcohol Consumption Among Pregnant and Childbearing-Aged Women -- United States
CDC … MMWR 46(16);346-350 04/25/1997 … This report analyzes and compares data from the 1995 Behavioral Risk Factor Surveillance System (BRFSS) and previously reported 1991 BRFSS data for women aged 18-44 years (3), and presents the prevalence of alcohol consumption among pregnant women … A total of 33,585 women aged 18-44 years were interviewed … 4.7% of women aged 18-44 years reported being pregnant at the time of the interview. Of these, 16.3% reported any drinking during the preceding month, compared with 12.4% in 1991 … The rate of frequent drinking among pregnant women was approximately four times higher in 1995 than in 1991 (3.5% in 1995 and 0.8% in 1991, p less than 0.01) … Among all child bearing-aged women in 1995, 50.6% reported any drinking, and 12.6% reported frequent drinking …
Facts About Alcohol Use During Pregnancy
By The Arc ...
[Spanish] Quй es Perinat?
lista de correo interdisciplinaria de alcance internacional, moderada y creada para profesionales mйdicos pediatras, neonatologos, obstetras, bioquнmicos, farmacйuticos, asistentes sociales, psicуlogos/as, investigadores, enfermeras/os. matronas, parteras u obstйtricas... en fin, todos los que de algъn modo u otro trabajan para y por una mejor salud materno-infantil...
Can the anthrax vaccine be taken by military members who are pregnant?
A simple vitamin
can help prevent birth defects
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