GynoFiles

CMV (Cytomegalovirus) is actually the most common perinatal infection women can get in pregnancy. Some studies show that about 4% of all pregnant women will have an infection. Moms mostly do not realize they have had the infection,literally there are no symptoms at all in most cases, but CMV infection from pregnancy can be the cause of several medical complications in the newborn and childhood. CMV is probably the leading cause of deafness that is not due to a genetic cause. If you have an infection, there is not a treatment for CMV. Although antiviral therapies, such as those that we use to treat other herpes viruses (CMV is from the herpesvirus family) . There are not any guidelines that suggest routine testing requirements and in fact experts actually do not recommend routine screening of pregnant patients. Infections with CMV are over 90% harmless in pregnancy, so a good outcome is likely for women who do contract the disease in pregnancy. Certain signs on ultrasound, including th...

Babies are ideal to immunize as their immune system is so powerful they develop immunity to the vaccinated disease, and keep most of that immunity for life. Boosters for vaccines help bridge that protection into old age. However no immunity is perfect, and babies have other susceptibilities and frailties to disease that makes it important for their mothers and their close family and visitors need to have up to date vaccination protection that will help them avoid disease. The Pregnant women should receive influenza vaccination and Tdap during her pregnancy  the  American College of Obstetricians and Gynecologists (ACOG), presents new data to back up this annual opinion published in the September issue of Obstetrics and Gynecology. Tdap should be given between 27 and 36 weeks pregnant. In addition to protecting the baby after birth pregnant women are at increased risk for serious illness from influenza because the immune system changes during pregnancy. These changes app...

We have a global economy and global life, and it's important to be aware of what is going on in the world health wise. Brazilian women have been having babies affected by microcephaly in   For pregnant women this is clearly even more important. If you think you have been exposed we would have to work with state and local public health to get the actual Zika blood testing as it is not a test all labs are set up to do The newest information on CDC testing and precautions can be found here: Zika Virus Update from CDC . 80% of women will not have symptoms. Those women who travel to affected areas of the world should be tested.

In pregnancy we have come to realize the shorter a cervix is, for the given stage of pregnancy, the more at risk the mom is for preterm birth. Oddly we know very little about why some pregnancies are destined to go overdue. first babies, previous late pregnancies, obesity, and genetics are the most commonly associated factors with prolonged pregnancies over 42 weeks. But, it's really not known why a particular pregnancy doesn't deliver by the due date. In a study from Northwestern University School of Medicine, published in Obstetrics and Gynecology September 2015 they studied over 9000 women, having their first baby, and found that the longer the cervix at 18-24 weeks, the more likely the pregnancy was going to be over due. Rates over 4.91 cm at that stage of pregnancy were associated with the latest pregnancies.Routine measurement of the cervix in the second trimester is almost always done now. The screening has been intended to predict who may be at risk for premature deli...

We are getting phone calls regarding the hummus recall and the risk of listeria in pregnancy. The CDC also has found this in ice cream . It is best if you can check the product number you consumed and make a note of the date you consumed the food. Pregnancy itself is a time when a woman's immune system may not be as good. The risk of Listeria monocytogenes listeria is 13 times greater in pregnancy than when a woman is not pregnant. In general the basic recommendation in pregnancy to avoid listeria include avoiding luncheon and deli meats and hot dogs unless heated, make sure all fish have been cooked, avoid pate and uncooked meat spreads, and are told to avoid unpasteurized dairy products that are more likely to have listeria bacteria. Since acquiring the bacteria does not require treatment unless symptomatic we are just urging pregnant patients to be vigilant about their symptoms, and to not be tested or treated unless you are having a fever, fatigue, or body aches. We also wan...

When you are pregnant every part of your body is dramatically effected by the physical changes that accommodate the developing baby. The uterus grows from 70 grams to 1000 grams, most women gain  at least a couple of stone, and your skin starts taking on pigments that may fade but never leave! We notice a our tastes changing, and our smell changing, and generally we ignore what seems minor. But what may seem minor, but often isn't in pregnancy, is the runny nose and altered hearing women report. The changes in the ear, nose and throat are primarily due to changes in the circulatory system, such as the extra fluid in our circulation and the extra fluid our heart pumps. We also have some presumed increased susceptibility to viral infections, as well as some pressure changes from the bulk pressure of the growing uterus. All of these can oddly lead to increased runny nose! This can range from the very minor changes such as an occasional sneeze or drips, ...

Erythema migrans around a prior tick bite In pregnancy women who discover they have a tick bite need to be aware of possible signs and symptoms of lyme disease. Extensive information on Lime disease can be found on the web at the CDC site. Most studies of pregnancy state that pregnant women with or without Lyme disease will have the same outcomes, however some older and retrospective studies have linked Lyme disease with adverse birth outcomes, including cardiac defects. Not all fetal cardiac defects can be detected prior to birth, but many can by either standard ultrasounds or fetal echocardiography (specialized heart ultrasound). If you do get a tick bite, have it properly removed, and observe for symptoms up to 30 days, and check with your birth provider to determine what else she may want you to do.

Once we thought that placentas, amniotic cavities and the breast milk were sterile. But in fact  Texan researchers have shown that being fed by our mother in fetal and infant life also showers us in bacteria and likely viruses as well. Whether this is an inevitable consequence of life on earth or an important symbiotic factor in our long term health remains to be determined, and will be the focus of future research. We h ave now dubbed the genetic make up of the bacteria that live with us our 'second genom e.' The restoration of gut flora is critical in the heath of those with bowel disease that has destroyed their gut bacterial balance, and perhaps restoration of proper fetal flora will be important. Literature like this makes your gyno pause when she thinks about what and if to prescribe antibiotics during pregnancy, but then we have known for a long time to trust our immune systems before indiscriminately prescribing antibiotics.

We have to be more vigilant about testing for Hepatitis C as over 3 million in the US have it, and the majority of those with the condition do not know they have it. Hepatitis C is one of those conditions that can go unnoticed in the early asymptomatic stages. According to the CDC if you are a Baby Boomer, born between 1945 and 1965 you need Hepatitis C testing. Even many people with the potentially fatal, but mostly curable, disease Hepatitis C in pregnancy, do not know they have it. In the new CDC guidelines they mention, that just being tested before may still mean you need special blood tests to see if you have cleared the virus . So ask your gyno which blood tests you need, and how often you should be retested.

Gynos spend about 40% of their patient time in evaluating women for pelvic pain. Women undergo more treatments and surgeries for pelvic pain than any other specific cause. We define acute pain as pain that came on intensely, but then has lasted no more than 3 months. Acute pain in pregnancy may be due to tubal pregnancies, or ruptured cysts, twisting ovaries, pelvic inflammatory disease, or  even due to serious problems that are not specifically related to pregnancy such as appendicitis. It is not wise to wait three months to have the chronic pain of pregnancy be treated, but these conditions require management in hours, or days in order to be treated safely. Ultrasound, pelvic examinations, and blood testing can usually make an accurate diagnosis. Pain in pregnancy that is not accompanied by bleeding may be something as simple as cramping, but it would still be important to see your gyno for evaluation.

Shingles is the nick name of the rash one gets from a varicella-zoster virus. Shingles is more accurately termed varicella zoster infection and is a form of reactivated chicken pox. Chicken pox is a primary varicella infection, which almost always occurs in children. If you have not had chicken pox then you can catch chicken pox from a patient who has shingles. If you have had chicken pox then you are susceptible to get a case of shingles of your own, but you cannot catch it from another with shingles. Being a viral illness it is usually self limiting, and usually the only treatments are for the pain or discomfort of the outbreaks themselves. Antiviral agents are safe, and may shorten the illness and some physicians would use. It is necessary to use antivirals like acyclovir if the patient has a severe rash, some doctors say over 50 lesions. It would be rare for a developing fetus to get chicken pox, but it's even more rare for a developing fetus to be able to get a va...