What You Should Know About HPV And Pregnancy

For women who've contracted Human Papillomavirus, the combination of HPV and pregnancy usually results in anxiety. Worries over miscarriages, transferring the virus to the baby, and various other complications are quite typical, However, the good news is, the link between HPV and complications with pregnancy is generally unproven.

HPV and Pregnancy - The Myths

There exists an unproven belief that HPV is correlated with premature births, miscarriages and a host of various other complications with being pregnant. The truth of the matter is, there is no scientific studies to associate the virus with these complications - even during cases when the mother is contaminated with the harmful HPV 16 strain on the virus. When you have HPV, and are either pregnant or would like to be, there isn't any reason to worry about these issues springing up from your infection.

What You Need To Know About HPV and Pregnancy

HPV Transmissions to the Infant

Although unusual, we have seen documented instances of women with HPV passing the virus on to their babies during childbirth. In the most of these extremely rare cases, the baby's immune system clears the virus on its own and presents no health hazards. In some instances, however, it's possible to the infant to become contaminated with the virus in his or her throat - bringing about a probably-critical condition referred to as respiratory papillomatosis.

If the child has respiratory papillomatosis, laser surgery is necessary to take away the resulting warts which develop in the throat before they could lead to difficulties with breathing. In order to avoid subjecting the infant to this particular risk, some doctors advocate caesarean births for females with HPV.

Problems with Genital Warts

Genital warts as well as other symptoms of HPV in women tend to increase more quickly during pregnancy. Such happening is the results of heightened hormonal activity and, in certain women can lead to problems which need the physician to take out the warts prior to giving birth. For example, there has been cases where genital warts have multiplied so quickly, and grown so large, they have partly blocked the mother's birth canal.

As with other issues linked to HPV and pregnancy, problems with excessive wart growth are quite rare and definitely will even clear themselves without treatment in most cases. Because of this, most doctors would prefer to wait as long as possible to see if the infection clears by itself.

Coping With HPV While Pregnant

Apart from problems that may potentially affect your unborn baby, living with HPV while pregnant will show some extra challenges to the pregnant woman. Due to the likelihood of secondary infection which affects the child, a lot of doctors will advise against removing any warts which could form during pregnancy, aside from in situations where too much enlarged genital warts are bleeding or causing other agitation. This may be a departure from the norm for some women, however is just about the trade-offs that must be made where HPV and pregnancy are involved.

This article provides a brief overview of the most common HPV symptoms in women, as well as general information on screening and the HPV vaccine. The material presented is for feneral informational purposes only and should not be considered medical advice. If you believe you have contracted the human papillomavirus, you should contact your general physician or gynecologist and schedule an examination.

The Effects of Diabetes on Pregnancy

Diabetes is present in 2-6% of pregnant women in the United States.

88% of the women have gestational diabetes (GDM). This is a form of diabetes which appears during pregnancy, typically during the second or third trimester.

The prevalence of GDM has increased due to the increased incidence of obesity in the US. It is now seen in 5-7% of all pregnancies.

It is diagnosed by a 75 gram oral glucose tolerance test between 24-32 weeks of pregnancy.

Risk factors for GDM include prior history of GDM, a family history of DM, obesity and increased age.

The remaining 12% of pregnant women with diabetes have pre-existing type 1 or type 2 diabetes.

In all women who become pregnant, increased production of hormones by the placenta, such as human placental lactogen, causes resistance to insulin's action.

Normal women are able to overcome this by increased production of insulin. Their sugars are thus maintained in the normal range.

Women with GDM, as well as pre-existing type 1 DM and type 2 DM, are unable to compensate for pregnancy associated insulin resistance.

In type 1 DM, this is due to absence of insulin production.

In GDM and type 2 DM this is due to pre-pregancy insulin resistance. Many of these women may also have defects in insulin production.

Their inability to compensate for pregnancy related insulin resistance results in blood sugar elevation.

If sugars are increased in women with pre-existing diabetes during the first weeks of pregnancy, there is an increased risk of spontaneous abortions and birth defects.

These risks may be increased 3-6 fold in women with average blood sugar values greater than 200 mg/dl.

If sugars remain elevated throughout their pregnancy, there is an increased risk of large babies and delivery associated injuries. There may also be an increased lifetime risk for obesity and/or diabetes in the child.

Elevated sugars are also associated with an increased risk of high blood pressure and preeclampsia.

High sugar levels in women with GDM are associated with similar risks.

Given the known association of high blood sugar with complications in the newborn and mother, good sugar control is important.

Among women with pre-existing diabetes, every effort should be made to normalize blood sugar before conception.

HA1c levels (a blood test which gives the 2-3 month average blood sugar) should be as close to normal as possible.

Fasting sugars should be in the 70-100 mg/dl range. 1 hour after meal sugars should be <140 mg/dl.

Consultation with a dietitian, endocrinologist, and high risk obstetrician is often recommended.

Once pregnant, typical goals are morning fasting sugars of 70-90 mg/dl and 1 hour after meal sugars <120 mg/dl.

Middle of the night (3-4 AM) and bedtime testing may also be recommended.

70-80% of women with GDM will be able to achieve these goals with changes in their diet and light exercise.

Consultation with a dietician is important.

Typical dietary recommendations include 3 meals per day with a high fiber, low saturated fat, low sweet intake. Snacks are included as needed. Carbohydrate intake should be monitored and reviewed with a dietician as needed.

Light exercise may help reduce insulin resistance, but should only be started after consultation with your medical team. Weight lifting should be avoided.

If sugar goals are not achieved with lifestyle changes, medical therapy is initiated.

In women with pre-existing diabetes, insulin is the most common therapy.

Among women with GDM, treatment with oral diabetes agents such as Glyburide is another option.

Many endocrinologists (myself included) prefer insulin therapy due to lack of long-term safety data, as well as less dosing flexibility, with the oral agents.

Since the degree of resistance to insulin increases as the pregnancy progresses, increasing doses of medications are typically required through the third trimester.

Blood sugars typically return to pre-pregnancy values after delivery.

Sugar control may be erratic in women with type 1 diabetes after delivery.

If nursing is planned, medication regimens should be reviewed with an obstetrician.

Nursing may be recommended given its known health benefits, as well as several reports which suggested a lower incidence of type 1 diabetes in children who were breast fed.

Women with GDM are at a significantly increased risk (up to 50% in some studies) for developing diabetes in the future.

A glucose tolerance test is typically performed 6 weeks after delivery in women with GDM.

Even if the test is normal, efforts should be made to maintain a healthy lifestyle and weight.

If sugar levels are managed carefully in pregnant women with diabetes, the chances for a healthy pregnancy and healthy child are similar to those reported in non-diabetic women.

Future advances in management, as well as earlier diagnosis, should continue to improve the outlook for women with pregnancy and diabetes.

Dr. Michael Dempsey is an endocrinologist with over 20 years of experience caring for people with diabetes. His goal is to improve diabetes control within the parameters of your life. You can learn more about Dr. Dempsey's practice at https://sites.google.com/site/thediabetesdoc/. You can also follow him on his Facebook page for daily updates on diabetes and nutrition at http://www.facebook.com/profile.php?id=100002052992954&ref=tn_tnmn

Pregnancy Heartburn Relief - Tips for Expectant Mothers

Pregnancy is an exciting yet challenging phase for the mom-to-be. Your body grows and changes during the course of your childbearing. All these changes are meant to perfectly and properly accommodate the new life inside you. However, there are other difficulties that pregnant women face when it comes to their health. They are more fragile and at risk for developing diseases which include gestational diabetes and preeclampsia. Pregnant women are very prone to conditions such as nausea, vomiting, and heartburn. As a matter of fact, majority of pregnant women experience heartburn because of several reasons. Because of that, it is very important that you arm yourself with some pregnancy heartburn relief tips and help you get through the nine months with ease.

Why Women Are At Risk for Heartburn?

As mentioned previously, expectant moms-to-be are more at risk to suffer from heartburn. While a majority of people experience it, they do not have heartburn episodes as frequently as pregnant moms. Below are some of the main reasons why women need to look for effective pregnancy heartburn relief methods:

1. Increased hormones - Hormones are very important in the body. They are responsible for several functions. Without them, complications are at all-time high. Pregnant women will usually have an imbalance in their hormonal levels. This makes them weepy and moody all the time. Aside from that, this imbalance usually softens the ligaments in your lower esophageal sphincter and can lead to stomach acid reflux.

2. Pressure in the stomach - As your body and baby grows, the contents of your stomach is usually pushed into your esophagus. This can also cause several heartburn episodes.

Remedies for Heartburn during Pregnancy

Nowadays, there are a lot of medicines that can help you deal with heartburn. However, pregnant women are usually discouraged by physicians to take in over-the-counter drugs because they can pose harm to their unborn child.

If you are looking for pregnancy heartburn relief options that are safe to do, here are some:

1. Stay away from food items that are already known to be heartburn triggers. Citrus fruits and juices, vinegar, spicy food items, and even chocolate are considered as heartburn triggers.

2. A good pregnancy heartburn relief is to say "no" to caffeine. If you are fond of drinking caffeine-rich drinks like coffee or tea, try to stay away from them during the course of your pregnancy. These drinks increase the possibility of acid reflux in your stomach. Same goes with alcohol-based beverages.

3. Eat in moderation. While it is a given fact that you are eating for two, eating several small meals in a day is better than stuffing yourself with food.

Heartburn during pregnancy is a very common problem. By following the above mentioned pregnancy heartburn relief tips, you will be able to get through your childbearing well. Stay safe for you and your unborn child.

If you are pregnant and you always experience heartburn, it is necessary to use only a pregnancy heartburn relief. Go to http://www.severeheartburnrelief.com and know the different heartburn remedies.

Getting Back Pain Relief When You Are Pregnant

More than half of pregnant women would be interested in ways to quickly relieve the pain in their back. Even those who have never suffered from back pain before can suddenly find the pain seemingly unbearable as the body suddenly changes shape and additional stresses are added to the back.

For pregnant women who have a history of back pain, things can be even more grim. Increased incidences of urinary tract infections can also contribute to the pain. On top of all of this, rapidly changing hormones can leave a woman unable to cope with the onset of persistent back pain. No one should look down on a pregnant woman who is seeking quick relief for such pain.

Unfortunately, back pain caused by pregnancy is no excuse for women to indiscriminately pop some pills in their mouth to make the pain go away. Not only are there additional risks involved in taking medications during pregnancy, but taking pain killers has many known and unknown consequences for the unborn baby.

The best medication for relieving back pain during pregnancy is prevention. A professionally directed exercise program before pregnancy can help prepare your body for the rigors of pregnancy. However, if you are already pregnant and experiencing pain in your back, taking short walks may help alleviate some of the pain quickly.

The main thing you need to do is talk about your back pain with your doctor. Find out if it is possible for you to take medications without putting your baby at risk. Better yet, ask your doctor for safer, natural ways to relieve your pain, such as exercises you can do safely.

Your doctor will most likely tell you to avoid wearing tight clothing and high heels, as well as avoid sitting on chairs that promote bad posture. In fact, anything you can do to improve your posture in spite of your now ever-changing center of balance is probably going to help you to get relief. Talk to your doctor about your options right away.

If you suffer from lower back pain, there is relief. Visit BackPainCures.org for more information.

Chances of Getting Pregnant

Could the position of my uterus affect my chances of getting pregnant?

Your uterus lies in the midline of your pelvis. It may be angled slightly toward your abdominal wall (anteverted) or toward your rectum (retroverted). The body of the uterus may also be angled from the plane of the cervix in either an anterior or posterior manner (anteflexion or retroflexion). Picture your forearm and hand as representing the body of your uterus and your cervix. The two parts can be aligned and tilted in a straight line, or you can bend your wrist, creating an angle between "the uterus" and "the cervix." If the uterus is mobile, there are generally no symptoms associated with the position of the uterus.

Most positional differences are anatomic variations that occur from woman to woman. Normally, the uterus is in a position of anteversion. Retroversion of the uterus may be present at birth, may be a consequence of childbirth (due to relaxation of the pelvic ligaments), or may be the result of a disease process in the pelvis.

The orientation of a woman's uterus, as determined at birth, has no relation to fertility in and of itself. In some cases, a sharp backward tilt (retroflexion) of the uterus can cause the cervix to be positioned against the anterior vaginal wall. For some couples, this prevents the cervix from being able to "bathe" in the pool of semen that naturally collects in the posterior vaginal vault after intercourse. This may prevent the sperm from swimming into the cervical canal to reach a released ovum for fertilization.

Additionally, there are certain conditions that may cause a sharp retroflexion of the uterus. These include endometriosis, pelvic inflammatory disease and uterine fibroids. Endometriosis can lead to scarring of the utero-sacral ligaments that may pull the uterus into a fixed retroverted position. As endometriosis can affect fertility, I think you should discuss this with your healthcare provider. Since you have been trying to conceive for the past year, it would be reasonable to undergo additional testing to help evaluate your fertility status. Then you may be able to determine whether or not the position of your uterus is related to a delay in conception.

Pregnancy can occur without penetration into the vagina. Pregnancy can also occur at various times during your cycle, particularly for women who have irregular periods. And yes, some women do experience bleeding at the time of their expected menstruation even though they are pregnant.

Intimacy of this nature can have serious consequences, including pregnancy and the spreading of sexually transmitted diseases (AIDS, herpes, gonorrhea, chlamydia, HPV, etc.). While it is unlikely that you conceived, it is possible. A pregnancy test may be reassuring.

This is a risky behavior that should be avoided. Please use condoms and protect yourself.
Useful materials about pregnancy woman health.

Opioid Maintenance In Pregnancy: Information for Patients and Providers

There are several options for treatment of opioid addiction during pregnancy. The ones of importance include: methadone in pregnancy, Suboxone (buprenorphine/naloxone) in pregnancy, and buprenorphine alone during pregnancy. This is an important topic for mothers who have an opioid addiction and face the choice of whether to continue their opioid maintenance treatment during their gestation or whether to discontinue the medication. As always, only individualized treatment with your own physician can adequately assess your situation and the following are general guidelines.

The current thinking for mothers with an opioid addiction is to continue their maintenance medications. Suboxone carries a Pregnancy Category C indication by the FDA which means that a risk to the fetus can't be ruled out. Since Suboxone is a combination of buprenorphine and naloxone, mothers are many times switched to buprenorphine alone (Brand name Subutex) to decrease exposure to one medication rather than two.

There are a number of risks to discontinuing the methadone, Suboxone, or buprenorphine. The main concern is the risk of the mother going back to using illicit drugs. If this happens, the fetus will be exposed to cycles of the mother getting on and off the drug based on what they can obtain on the streets. The fetus may also get exposed to HIV as drug use and promiscuity are related. The mother is less likely to receive proper healthcare for herself or the fetus, resulting in premature birth, low birthrate children, and the possibility the child will be removed from the home eventually.

It is believed that because of these risks, the majority of opioid dependent mothers should maintained on their medication through pregnancy and after. There there is a 30-40% chance the newborn will undergo an abstinence syndrome at birth, but this is easily managed with proper warning to the treatment team before the birth. Buprenorphine appears to carry a lower risk of neonatal abstinence syndrome compared to methadone. Since there is minimal drug in the breast milk, mothers are allowed to breastfeed.

The American Psychiatric Association sponsors webinars on buprenorphine treatment and the latest update on pregnancy can be viewed here. The webinars are primarily designed for healthcare providers, but have great value in answering questions about Suboxone and Buprenorphine to the person who is taking or is considering taking Suboxone (buprenorphine/naloxone) during pregnancy.

I found this lecture on pregnancy very helpful from a medical perspective. Providers of Suboxone in pregnancy will find the information in the lecture invaluable. The lecture is clear, to the point, and contains updated information on prescribing Suboxone in pregnancy. I think the video could easily be understood by most anyone.

What If One Still Wants To Get Off Their Maintenance medication despite the risks?

Getting off a opioid maintenance regimen is a big deal, let alone to a pregnant mother. It should involve at the very least one physician who can monitor the one's progress. A pregnant female should not rush to get off the medication without professional assistance. I have seen patients alarmed by their pregnancy who get off their medication without a proper discussion. They usually end up wanting to get back on their medication to remain stable.

It is thought that if one is going to wean from the medication, it should be done prior to 32 weeks pregnancy. This will prevent complications of withdrawal (premature baby) prior to the planned delivery date. After delivery, one should consider with their physician, getting back on the maintenance medication as quickly as possible. Preferably immediately.

Opioid Maintenance and Pregnancy: Other Points

    Follow up with your physician every one to two weeks.
    Continue drug counseling during pregnancy.
    It is common to need an increase in the Suboxone, Methadone, or buprenorphine during pregnancy. Expect about a 25% increase in dose.
    Epidural analgesia is effective while on maintenance therapy during pregnancy.
    Nalbuphine and Butorphanol are contraindicated while on maintenance treatment during pregnancy as both can precipitate withdrawal.
    IV and oral narcotics are used to supplement the maintenance dose of methadone, Suboxone, or buprenorphine during labor.
    Breastfeeding is recommended unless HIV positive.
    There appears to be a problem with medication compliance with mothers at about 3 months post partum. Prepare for this possibility.
    There is almost always more of a benefit in having the pregnant mother quit smoking than to get off the methadone, Suboxone, or buprenorphine in pregnancy.

Opioid Maintenance In Pregnancy: Summary

Mothers on opioid maintenance treatment should usually continue their treatment during pregnancy and after delivery. The risk of weaning from maintenance opioid treatment is usually greater than continuing treatment. The mother can best benefit by quitting smoking and receiving proper prenatal monitoring to have the best chance of a good outcome.

Dr. Rich (Richard Senyszyn MD) is a Board Certified Psychiatrist who has an interest in addiction treatment. For more information on Dr.Rich, Suboxone, and finding a doctor who prescribes Suboxone near you: Suboxone Clinics Directory. Dr. Rich also writes on other addiction topics including alcoholism and where to find alcohol treatment at Alcohol Treatment Directory

Will Restorative Yoga Help My Pregnancy Trouble Breathing at Night?

Restorative yoga has many benefits, and it has been beneficial to many infertile women trying to become pregnant. It has also helped many women who have already become pregnant as they look to manage the various symptoms and discomforts associated with their pregnancy. If you feel discomfort, pain, or other symptoms during your pregnancy, it's important to notify your medical doctor first. The cause of your symptoms may be an underlying medical problem demanding the attention of a trained doctor. If your doctor informs you that the symptoms are a normal part of pregnancy, ask about yoga for its various benefits.

Restorative yoga is a type of restful yoga that utilizes props like chairs, walls, blankets, blocks, pillows, etc. to put the body into various poses. As the props do most of the work for you, you are not engaging in a strenuous stretch or pose. There are certain poses that you should avoid, however, such as those that invert you or put you on your stomach. Make sure you inform the instructor that you are pregnant, as he or she will then offer alternative poses for you during the session. Some classes are designed specifically for pregnant women; still inform the instructor of how far along in your pregnancy you are.

This type of yoga has had very positive effects on a lot of people. Many feel more rested and focused following a session. It helps to reduce stress, and is a healthy way to deal with the stressors that we face in our everyday lives. Many also note that they are able to sleep better throughout the night; this means falling asleep faster and sleeping through the night more than they had in the past.

If you are having difficulty breathing at night, this is an example of something you should discuss with your doctor. He or she may even recommend breathing exercises, such as are performed during yoga, to help you. Follow any instructions given to you by your doctor, but inquire about restorative yoga's benefits and whether this exercise may be helpful as you try to improve your breathing at night.

The breathing exercises performed during yoga sessions may be helpful in controlling asthma and various respiratory illnesses, and it may even be beneficial to those who are experiencing anxiety-a common emotional or mental problem during pregnancy. Restorative yoga has been beneficial for those with depression and other emotional disorders as well.

Arianna has assembled more information on restorative yoga for pregnant women. Take a look at your convenience by going to http://www.DomarCenter.com for pain and stress relief and see how it helps during a pregnancy.