Posts Tagged ‘fetus’
James N. Martin, Jr, MD
By James N. Martin, Jr, MD President, The American Congress of Obstetricians and Gynecologists
Up to seven percent of pregnant women will develop preeclampsia, a serious pregnancy-related condition that can affect the placenta, liver, kidneys, blood, brain, and other organs. It is a leading cause of maternal and infant sickness and death in the US.
While the cause of preeclampsia is unknown, high blood pressure is a main contributing factor. normally, blood pressure changes throughout the course of the day—for example, it increases when you exercise and slows when you’re at rest. but when it stays elevated, it can strain the heart and blood vessels, increasing the risk of heart attack and stroke and damage to the kidneys, brain, and eyes. During pregnancy, high blood pressure can also restrict the flow of blood, oxygen, and nutrients to the fetus.
Some women have ongoing (chronic) high blood pressure before they get pregnant. Others may develop high blood pressure during pregnancy, usually after the 20th week of gestation. Women who have chronic or gestational high blood pressure, are pregnant for the first time, have had preeclampsia in a previous pregnancy, are 35 years or older, are carrying more than one fetus, have certain medical conditions such as diabetes or kidney disease, are obese, are African American, or have certain immune disorders such as lupus or blood diseases are at increased risk of developing preeclampsia.
Other symptoms of preeclampsia include increased amounts of protein in the urine, headaches, visual problems, and swelling of the hands and face. Severe preeclampsia may be accompanied by lung, liver, kidney, or clotting complications and seizures (eclampsia).
If you have chronic high blood pressure, it’s important to make efforts to lower blood pressure before pregnancy by losing weight and taking medication as prescribed. Regular prenatal care during pregnancy can help detect preeclampsia early in all pregnant women. at each prenatal visit, a woman’s weight and blood pressure are taken along with a urine sample to monitor any changes. you may be checked more often if your blood pressure is high.
The gestational age of the fetus, the severity of the mother’s preeclampsia, and risks to mother and fetus will be assessed to guide the decision on when to deliver. some women will be monitored to see if the situation improves, or—if the risk to the fetus is greater in the womb than in a special nursery—delivery may be necessary. Women with slightly increased blood pressure who are not near the end of pregnancy may be prescribed bed rest at home or in the hospital.
For more information, the ACOG Patient Education Pamphlet “High Blood Pressure During Pregnancy” is available at acog.org/publications/
This entry was posted on Tuesday, September 27th, 2011 at 8:00 am and is filed under Medicine. you can follow any responses to this entry through the RSS 2.0 feed.
If you are pregnant, you will be offered prenatal screening tests to check for spina bifida and other birth defects. these tests are not perfect. Even if the results are negative, there is still a small chance that spina bifida is present, and many mothers who have positive blood tests have normal babies. Speak with your doctor about prenatal testing, its risks and how you might handle the results. Prenatal testing is a personal choice.
Following are methods used to check for spina bifida during pregnancy:
- Blood tests. the primary test used to check for myelomeningocele is the maternal serum alpha-fetoprotein (MSAFP) test. in this procedure, your doctor draws a blood sample to be sent to a laboratory, where it’s tested for alpha fetoprotein (AFP), a protein that’s produced by the fetus. It’s normal for a small amount of AFP to cross the placenta and enter the mother’s bloodstream, but abnormally high levels of AFP may indicate that the fetus has a neural tube defect. Varying levels of AFP can be caused by factors including a miscalculation in fetal age or multiple fetuses. if this occurs, your doctor may order a follow-up blood test for confirmation. if the results are still high, you will need further evaluation, including an ultrasound examination.
- Ultrasound. many obstetricians use ultrasonography to screen for spina bifida. if blood tests indicate high AFP levels, your doctor will suggest an ultrasound exam to determine why. Ultrasound exams bounce high-frequency sound waves off tissues in your body to form black and white images on a small video monitor. the information these images provide can help establish whether there is more than one fetus and can help confirm gestational age – factors that can alter AFP levels. An advanced ultrasound can also detect signs of spina bifida, such as an open spine or particular features in your baby’s brain that may indicate spina bifida. Ultrasound today is quite effective in detecting spina bifida and assessing its severity. this procedure is safe for both mother and baby.
- Amniocentesis. if a blood test shows high levels of AFP in your blood and the ultrasound is normal, your doctor may offer an amniocentesis. during an amniocentesis, your doctor uses a needle to remove samples of fluid from the amniotic sac that surrounds the fetus. the analysis indicates the level of AFP present in the amniotic fluid. A small amount of AFP is normally found in amniotic fluid, however the amniotic fluid contains an elevated amount of AFP when an open neural tube defect is present because the skin surrounding the baby’s spine is gone and AFP leaks into the amniotic sac. A second test can be done on the same sample to confirm that a neural tube defect is present. however, an amniocentesis cannot indicate the severity of spina bifida. this test does have a risk to the developing fetus – about one in 200 to one in 500 pregnant women miscarries after an amniocentesis.