CT Scans of Pregnant Women Increasing

(HealthDay News) -- Although more pregnant women are getting all types of medical imaging, the number of those getting CT scans has more than doubled over 10 years, Brown University researchers report.

CT exams are not routinely done for pregnant women, but, in some cases, it may be the only way to diagnose life-threatening conditions such as bleeding in the brain, blood clots in the lungs or appendicitis. CT scans expose the fetus to higher levels of radiation than other methods, causing concern that CT scans could harm the developing baby.

"At our institution, utilization of radiological imaging in pregnant women increased 107 percent, comparing 1997 to 2006," said lead researcher Dr. Elizabeth Lazarus, an assistant professor of diagnostic imaging and a radiologist at Rhode Island Hospital in Providence. "The rate of increase was highest for computed tomography (CT)."

Lazarus acknowledged that many people worry that the radiation used in these scans might harm the fetus. However, women need not be overly concerned, she added.

"First of all, it should be stated that radiological imaging is safe during pregnancy and is often used to diagnose potentially life-threatening medical problems," Lazarus said. "The risk of direct radiation to the fetus during pregnancy is a very slight increase in childhood malignancy."

The point of the study is to raise awareness about the increase of imaging in pregnant patients and to possibly encourage the development of protocols that minimize radiation exposure, Lazarus said. For example, MRIs and ultrasound do not expose the patient or fetus to ionizing radiation, she noted.

The report is published in the March 17 online edition of Radiology.

For the study, Lazarus' team looked at the trend in pregnant women undergoing CT, fluoroscopy and plain-film X-ray imaging at Rhode Island Hospital and Women and Infants Hospital from 1997 through 2006.

During the period, the number of these tests on pregnant women increased by 10.1 percent a year. The number of CT exams increased by 25.3 percent per year. These exams involve higher amounts of radiation than many other imaging procedures, the researchers noted.

They looked specifically at 5,270 examinations done on 3,285 patients. During the study period, the number of patients imaged each year increased from 237 to 449, and the number of exams increased from 331 to 732. This is an 89 percent increase in patients and a 121 percent increase in examinations. Yet, during the same period, the number of deliveries increased only 7 percent, Lazarus said.

Although the study did not look at the specific causes of increased imaging in these patients, the finding seemed to follow the trend of increased medical imaging in all patient groups, Lazarus said.

"We know from other studies that imaging, particularly MRI and CT, has been increasing in the general population. The increase in the general population has been attributed to multiple causes, including technological progress and the high yield of radiology in the diagnosis and triage of patients. Our data in pregnant patients closely approximates these more general trends," she said.

Dr. Jorge Guerra, a professor of radiology at the University of Miami Miller School of Medicine, agreed that the number of CT scans has increased, as has all imaging, but the radiation exposure to the fetus is minimal.

"The dose of radiation given to the fetus in any one exam is very low," he said. For pregnant women undergoing a CT, the odds that the infant will develop a fatal childhood cancer directly related to the radiation exposure of the exam is one in 2,000, Guerra said.

Guerra noted that limiting radiation exposure is an important goal, and current doses of radiation are significantly lower than the doses used during the period of the study.

"There are ways to cut down on the levels of radiation by changing the parameters of the CT," he said. "Since 2006, we have become so acutely aware that we are changing the parameters in studies that affect children and women of childbearing age. There is no excessive risk to the patient or to the fetus."

More information
For more on medical imaging, visit the Radiological Society of North America.

Ridiculous Pregnancy Advice Examined

By Erica Kain

Does anyone receive more unsolicited advice than a pregnant woman? Now that my pregnancy is obvious to any passer-by, I’m getting it from all sides.
Although it may be well-intentioned, most of the advice I receive from anyone but my doctor sounds like bunk.
Here are five of the more bothersome bits of “wisdom” I have been told—and the truth behind them. View the slideshow.

Health Tip: Dizziness During Pregnancy

(HealthDay News) -- Many women feel dizzy during pregnancy, a condition caused by hormones that help increase blood flow to the baby, but may restrict blood flow to you.
The American Pregnancy Association offers these suggestions to help relieve dizziness during pregnancy:

• Try not to stand up for long periods. When you do have to stand, move your feet frequently to help maintain your circulation.
• When you start to stand up, do so slowly.
• Keep a cool body temperature. Avoid very hot baths or showers.
• Don't go too long without eating.
• Make sure clothing is loose and not so tight that it can reduce blood circulation.
• Ask your doctor about other factors that could cause dizziness. In some women, lying on their back may impede blood flow as the weight of the fetus presses on certain blood vessels.

Facing a Tough Choice: Should I Have Surgery While I’m Pregnant?

By Erica Kain
123rf

Ever since my first child was born, my wrists have been in pain. When my daughter was just three months old, I was diagnosed with de Quervain’s disease, a kind of tendinitis that can be severely aggravated by motherhood. With this, my third pregnancy, the pain has become unbearable, and I’ve just been told that my only option of finding relief is surgery during pregnancy.
Apparently, the wrist actions required for breast-feeding and carrying an infant can be incompatible with a woman’s wrist structure (which seems antievolution), causing tendons in the wrist to swell and become painful to use. Pregnancy can also aggravate tendinitis, and many women experience their first symptoms of Carpal tunnel syndrome while pregnant. Read More

Puking for Nine Months Straight: When Morning Sickness Gets Out of Control

By Erica Kain
Getty Images
Last night was typical of my struggles with hyperemesis gravidarum, aka the morning sickness from hell. At 3 a.m., I dutifully trod into the kitchen to make the baby’s bottle, but by the time we were settled into the rocking chair and she was happily drinking, I had to hurl.
I eyed the garbage can in the corner—could I toss my cookies in there with minimal interruption to my daughter’s meal? Should I take her with me to the bathroom and try to hold her in a gentle, comforting manner while puking up my guts? Or should I just ditch her in the crib with a pacifier and make a break for it? I chose option C. Read More

My Fetus Is Growing, but So Is My Worry

By Erica Kain
Getty Images
Based on today’s ultrasound, we could have a winner here. What a journey this has been—from my initial elation at discovering I was pregnant to a misdiagnosed miscarriage to today’s doctor’s visit. There on the ultrasound screen was a seemingly healthy 9 1/2-week-old fetus frantically waving its little webbed nubby hands at me.
People keep telling me how heroic I am, as though I’ve somehow trumped a potential miscarriage with a healthy baby through the sheer force of hope. But I can tell you that there was no hope involved. It was the opposite of hope. I entered every day of pregnancy with fresh pessimism and dark predictions. Read More

Still Pregnant: My Miscarriage Was Misdiagnosed

By Erica Kain
“What exactly is that?” I asked, propping up on my elbows on the examining table, scrutinizing the ultrasound monitor.
“That is a seven-week-old embryo with a heartbeat,” my doctor said.
“No, wait, is it human?” I asked, gasping for air, staring at the flickering heartbeat pulsing through the little body.
I couldn’t believe it. Two weeks before, I’d been diagnosed with a miscarriage—specifically, a chemical pregnancy. I’d raced to the doctor’s office after experiencing heavy cramping and bleeding, and an ultrasound seemed to confirm my gut feeling that my pregnancy was ending. There wasn’t an embryo where there should have been one. And yet, here I was, two weeks later, finding out that I was still pregnant. Read More

Health Tip: Having a Baby After Age 35

(HealthDay News) -- While many women have successful pregnancies after age 35, certain complications can occur more frequently in women of that age group.

If you're 35 or older, before you try to conceive, consider this information provided by the American Pregnancy Association:

• Make an appointment with your doctor to address your questions and concerns.
• Don't get discouraged if you don't get pregnant right away. On average, it takes women 35 and older one to two years to conceive.
• Get yourself in good physical, emotional and mental health. Avoid alcohol, smoking and caffeine.
• Learn when you are most fertile. Watch for signs that you are ovulating.
• Take an at-home fertility test that screens for fertility elements in both men and women.
• If you haven't been able to conceive after six months of trying, talk to your doctor about the possibility of fertility testing.

Health Tip: Bonding With Your Premature Baby

(HealthDay News) -- Premature babies -- those born earlier than 37 weeks -- are at higher risk of complications and may need to spend time in the hospital's neonatal intensive care until they are healthy enough to go home.

The American Pregnancy Association offers these suggestions to help you bond with your premature newborn:

• Gently touch or stroke your baby as often as possible.
• Try talking, reading or singing to your baby, who is used to the comforting sound of your voice.
• If allowed, change your baby's diaper yourself.
• Take your baby's temperature when it's time.
• Participate in giving your baby the first bath.

Alcohol in Early Pregnancy May Prompt Fetal Cell Death

(HealthDay News) -- Just a few glasses of wine over a short period in early pregnancy may cause fetal problems, suggest researchers from the Medical College of Georgia.

The initial signs of fetal alcohol syndrome, which affects one in 1,000 babies, include facial malformations such as a flat and high upper lip, small eye openings, and a short nose. Researchers are investigating whether these signs can help determine how much alcohol at what point in pregnancy may cause fetal problems.

Supported by a grant from the March of Dimes, Erhard Bieberich, a biochemist in the Medical College of Georgia Schools of Medicine and Graduate Studies, and his colleagues are focusing on how alcohol consumption affects neural crest cells, which help form the upper part of the skull, in mice.

Specifically, the researchers are comparing cell death in mice following different levels of alcohol consumption to the cell death that occurs during normal development.

There is evidence that the equivalent of just a few glasses of wine over an hour in the first few weeks of fetal life can increase cell death.

"It's well known that when you drink, you get a buzz. But a couple of hours later, that initial impact, at least, is gone," said Bieberich in a Medical College of Georgia press release. "But, your fetus may have experienced irreversible damage."

The U.S. Centers for Disease Control and Prevention recommends that pregnant women and sexually active women not using effective birth control refrain from drinking.

More information
The Nemours Foundation has more about fetal alcohol syndrome.

Health Tip: Swelling During Pregnancy

(HealthDay News) - Production of additional fluids and blood during pregnancy sometimes leads to swelling in the woman's face, hands, legs, ankles and feet.

Here are ways to help control swelling during pregnancy, courtesy of the American Pregnancy Association:

• Don't stand for long periods. Sit and rest with your feet elevated.


• Avoid hot temperatures.


• Wear comfortable, flat shoes with stockings that provide support.

• Wear loose-fitting, comfortable clothes.


• Relax in a pool, or swim a few laps.


• Drink plenty of water, and reduce the amount of salt (sodium) in your diet.


• Apply a cold compress to swollen areas.

Sex Ed Can Help Prevent Teen Pregnancy

(HealthDay News) -- Comprehensive sex education may help reduce teen pregnancies without increasing levels of sexual intercourse or sexually transmitted diseases.

So find U.S. researchers who reviewed data from a 2002 national survey of more than 1,700 heterosexual teens, ages 15 to 19.

There is ongoing debate about whether abstinence-only education or comprehensive sex education (including instruction in birth control) is best for students.

Study lead author Pamela Kohler, a program manager at the University of Washington in Seattle, and colleagues found that about 25 percent of teens received abstinence-only education and about two-thirds received comprehensive sex education. About 9 percent -- particularly teens from poor families and those in rural areas -- received no sex education at all.

The researchers found that teens who received comprehensive sex education were 60 percent less likely to get pregnant or to get someone pregnant than those who received no sex education.
Other results -- not statistically significant, however -- suggested that comprehensive sex education, but not abstinence-based sex education, slightly reduced the likelihood of teens having vaginal intercourse. Neither approach seemed to reduce the likelihood of reported cases of sexually transmitted diseases.

The findings, published in the April issue of the Journal of Adolescent Health, support comprehensive sex education, Kohler concluded.

"There was no evidence to suggest that abstinence-only education decreased the likelihood of ever having sex or getting pregnant," she said in a prepared statement.

This study offers "further compelling evidence" about the value of comprehensive sex education and the "ineffectiveness" of the abstinence-only approach, said Don Operario, a sex education expert and professor at Oxford University in England.

More information
The Nemours Foundation has more about teen sexual health.

Health Tip: Massage During Pregnancy

(HealthDay News) - The medical community continues to debate the merits of getting a massage during pregnancy, according to the American Pregnancy Association.

Before you get a massage while you're pregnant, always check with your doctor. The association believes for many pregnant women, massage can offer benefits that include:

• Improved regulation of hormones related to stress and anxiety.
• Reduced swelling of the joints.
• Improvement of nerve pain.
• Better circulation.
• Fewer muscle aches and pains.
• Better sleep.

The association advises that you should always work with a certified prenatal massage therapist, who is attuned to the needs of pregnant women. Of particular concern may be your body's position during the massage. Discuss this with your doctor and massage therapist in advance.

Women with high-risk pregnancies or medical conditions such as preeclampsia should be particularly careful about discussing the risks of massage with their physician.

Health Tip: Caring for a Newborn's Umbilical Cord

(HealthDay News) - Once a newborn's umbilical cord is cut just after birth, the remaining piece needs proper care to prevent infection.

The American Pregnancy Association offers these suggestions:

• Keep the area around the cord clean. Ask your doctor what is recommended -- perhaps cleaning regularly with rubbing alcohol, or just water and a gentle cleanser.


• Make sure the cord area stays dry. Use a newborn diaper with an area cut out to expose the cord. Also, let your baby wear a short t-shirt and a diaper when possible to help air get to the area.


• Don't give your baby a full, submerged bath -- just a sponge bath -- until after the cord has fallen off.


• Never pick or pull at the remaining cord, but let it fall off on its own.