Posts Tagged ‘pregnancy’
Tuesday, July 13th, 2010
Stretch Marks During Pregnancy
In the past few weeks, many of you have written me asking if I could focus a few blogs on maintaining beauty during pregnancy. I completely understand. We are deep within the carefree and precious summer months, and while your concerns about how to stay healthy during pregnancy are tremendously important… we women also want to stay beautiful on the outside, while we grow a healthy baby on the inside.
There’s absolutely nothing wrong with wanting to remain attractive so, today, I am writing about stretch marks… one of those pesky skin conditions that may be avoided, or at least minimized, with proper care.
- What Causes Stretch Marks?
Stretch marks are caused by the breakage of skin proteins during the rapid expansion of the skin during pregnancy. Stretch marks can appear on the abdomen, hips, breast, thighs, and underarms.Once formed, stretch marks are permanent. Various skin creams have been developed to try to reduce the appearance of stretch marks once formed. However, prevention should be the main goal since most of the other remedies intended to diminish their appearance do not work.
- What are the important qualities of a good stretch mark cream?
Remedies intended to prevent stretch marks mostly hydrate and moisturize the skin, thus allowing the existing skin proteins to stretch and not tear. However, a better approach is to INCREASE the skin collagen and elastin production giving much more distensibility to the skin.
- Is adding collagen to the ingredients sufficient?
DON’T BE FOOLED!!—when certain products contain collagen in their ingredient list—this is not sufficient. The skin has to manufacture its own collagen and elastin for the product to work!!
- What ingredients should I avoid in choosing a stretch mark cream?
There are several ingredients that should be avoided in pregnancy that are COMMONLY found in many of the popular brands.
- PARABENS—This includes methylparaben and propylparaben.
- RETINOL—Vitamin A has in large doses has been associated with an increased risk of congenital anomalies. In addition, retin-A type products can be very irritating and cause rapid cell turnover so special precautions need to be taken with regard to the sun.
- SODIUM LAURYL SULFATES AND SODIUM LAURETH SULFATE—Can cause dermatitis, skin and eye irritant, reports of toxicity in embryo development in animals
- PHTHALATES—studies have shown that this interferes with the development of the male testes in animals.
- What ingredients are responsible for hydration and moisturization?
The shea butter and various oils are responsible for the moisture and hydration. Unfortunately, most of the stretch mark creams for pregnancy ONLY have these ingredients and this is not sufficient to prevent stretch marks. The oils tend to make the product extremely greasy. Oils are nonabsorbent by the skin since water is a major component of skin cells. The oils tend to sit on the surface layers and stain clothing, especially in a large pregnant belly.In addition, the price points are also very escalated for these relatively inexpensive moisturizing ingredients.
- What other ingredients should I be concerned about?
Alpha-hydroxy acid (AHA) is an ingredient commonly used in many creams. The purpose of this ingredient is to remove old skin and regenerate new skin—basically a mini-peel. This can be very irritating to many women. One must be very careful about going in the sun. AHA treatments are now undergoing scrutiny since there is a question of long term use of doing home chemical type peels. And the possible negative effects in the future.
- What makes the Beauté de Maman products superior?
- The Beauté de Maman product line does not exfoliate skin and does not use acids to peel away skin. We not only use ultra moisturizing and skin softening ingredients but we also have added natural and herbal ingredients that allow the skin to manufacture collagen and elastin (Psium sativum, Bambusa vulgaris, Gardenia Tahitensis, and glucosamine HCL).
- In contrast to other products—we are NOT a messy oil but an absorbant cream that does NOT stain clothes.
- We have no odor.
- We are obstetrician created specifically for pregnant women.
- Products have been pretested on hundreds of pregnant women and are safe for both mother and baby.
- Our pricing is very affordable.
Tags: beaute de maman, collagen, herbal, natural, pregnancy, prevent, safe, stretch marks
Posted in healthy pregnancy | 1 Comment »
Monday, June 14th, 2010
 I’m terribly sorry if anyone is offended by this photo of a horse with a bad set of choppers, but because a whopping 30% of pregnant women get periodontal disease, I simply couldn’t risk losing your attention. As they say, you can lead a horse to water, but you can’t make it brush its teeth.
While periodontal disease may seem like a boring and unglamorous topic for us to be discussing, it’s so important that I even decided to post two articles in a row about proper dental care during pregnancy.
My pregnancy article last week focused on dental changes, good oral hygiene and recommended dental health guidelines. This week’s pregnancy article will concentrate on the specific risks of periodontal disease. It’s not a pretty picture but please read all the way to the end to make sure you understand what you can do to stay out of the 30% and prevent this ugly and damaging syndrome.
What is periodontal disease?
Periodontal disease begins as gingivitis, or inflammation of the soft tissue that supports the teeth. This inflammation is caused by a specific oral bacteria named gram negative anaerobic bacteria. In combination with the elevated hormones during pregnancy that increase blood volume and capillary fragility, these bacteria give rise to redness, increased sensitivity, bleeding and pain. Left untreated, these conditions can predispose a pregnant woman to more serious problems down the road.
Why can periodontal disease lead to more serious problems during pregnancy?
If left untreated, the inflammation previously described can lead to the formation of pockets around the teeth. Within these pockets potential deep infections can occur and as pregnancy progresses, pocket depth has been shown to increase. These pockets are actually the separation of the teeth from the gums and, if left untreated, these teeth can separate from the surrounding supporting structure, named the periodontal ligament and cementum. This separation can eventually lead to the loss of the affected teeth.
What is the incidence of periodontal disease in pregnancy?
Approximately one third of all pregnant women have periodontal disease. Although the disease is measured differently in varying studies it is generally defined as 15 or more tooth sites with greater than 4 mm loss of attachment when probing.
Why is the presence of periodontal disease so important in pregnancy?
Periodontal disease has been associated with preterm delivery (before 37 weeks), low birth weight (less than 2500 grams), poor obstetrical outcomes, pregnancy loss, late miscarriage and preeclampsia, especially in populations comprised of people who have very limited access to dental care. Preterm birth rate has been reported to be 11.2% in women without periodontal disease compared to 28.6% in women with moderate to severe disease (Offenbacher, 2006). Similarly, progression of periodontal disease is also associated with a higher risk of preterm birth (6.4% vs 1.8% by same author). Most studies confirm these findings although some fail to show this association.
How can you explain this association of periodontal disease with poor obstetrical outcome?
- One explanation is that bacteria or infection from the mouth enter the bloodstream and eventually reach the placental membranes causing inflammation and damage resulting in preeclampsia or labor.
- Other explanations behind the results are that the specific bacteria and toxins identified in periodontal disease (Treponema denticola, Campylobacter rectus, Porphyromonas gingivalis to name a few) cause elevations in “inflammatory factors” or cytokines in the maternal blood (tumor necrosis factor-alpha, interleukin-8 (IL-8) and IL-1B) and it is these factors that have been found to increase the substances that stimulate the uterus to contract, such as prostaglandins (PGE-2), which cause the induction of labor.
- Supporting this theory is the finding that blood from pregnant moms who have an increase in antibodies (reactive substances) to some of these bacteria found in the mouth have also been found to have a higher incidence of preterm birth and low birth weight infants. These same elevated antibodies have been found in amniotic fluid and in fetal cord blood samples of infants delivered preterm or of low birth weight.
- Studies have shown that treatment for periodontal disease, through plaque control, scaling, and daily antibacterial rinsing reduced the risk of preterm births. Some studies however, have not been as consistent.
How does periodontal disease relate to other conditions in life?
After pregnancy, chronic exposure to these inflammatory blood substances from bacteria in the mouth may cause a three to four times greater risk later in life to cardiovascular disease, atherosclerosis, stroke, and diabetes compared to the general population. The mechanism is believed to be due to bacteria, toxins and platelets sticking together, along with circulating inflammatory factors which cause clots to form.
Children exposed to these inflammatory factors may also have added risk of cardiovascular disease and diabetes later in life. Other diseases associated with these inflammatory mediators include Crohn’s disease and Alzheimer’s disease as adults.
Summary
Periodontal disease is a curable problem. Treatment may not only help save your teeth, but will support the prevention of perinatal mortality and morbidity. If mothers are educated to realize that there might be a link between preventing periodontal disease and improving the health and well-being of their infant, not to mention their own health, more women will seek preventative dental care during pregnancy. Studies that are more conclusive with controls for socioeconomic status, smoking and study size have yet to be performed. However, even if the associations with these other factors are found not to be a factor in getting the disease, treating periodontal disease in pregnancy is safe and effective and, at the very least, may prevent unpleasant symptoms and appearance. It may also prevent the need for costly treatment and potential tooth loss later in life.
You may want to stick my photo of the gingivitic horse on your refrigerator as a reminder to always take good care of your teeth, especially while you are pregnant. Please share this article with everyone you know who is pregnant or may get pregnant. We have provided some sharing links below.
As I mentioned last week… no one has ever regretted taking good care of their teeth!
Tags: dental care, diseases, gingivitis, mother, oral hygiene, periodontal disease, pregnancy
Posted in disease | No Comments »
Wednesday, June 2nd, 2010
 Last week I wrote about diabetes during pregnancy and how this gestational disorder can predict the development of the full blown disease later in life. A few weeks before this article, I wrote about preeclampsia, another pregnancy specific disease characterized by sudden onset of hypertension, protein in the urine and swelling. I stressed how preeclampsia can be associated with an increased future risk of hypertension and heart disease.
Now that you understand (from these previous blogs) that pregnancy sometimes serves as a “crystal ball” of future diseases in the mother, I want to give you another heads up. This time it’s about thyroid disease.
Thyroid disease is an endocrinological disorder that often manifests itself initially during pregnancy. It is the second most common endocrine disorder for women of childbearing age. In the general population, approximately 4% to 10% of non-pregnant women have sub-clinical hypothyroidism.
What is subclinical hypothyroidism?
The production of thyroid hormone is regulated by the pituitary gland in the brain which secretes thyroid stimulating hormone (TSH). This hormone travels to the thyroid gland and stimulates the production of thyroid hormone. When a patient has increased TSH in conjunction with a thyroid hormone level within the normal range, this is often referred to as “subclinical hypothyroidism.” It is generally considered to be an early stage of hypothyroidism. Overt hypothyroidism develops when a patient develops low thyroid hormone levels along with an elevated TSH level. The stress that pregnancy places on the entire body can cause a an improvement of an existing thyroid condition or cause a “silent” thyroid disease to reach a level at which it needs attention. This is often caused by antibodies developed by the body (auto-antibodies) against the organ. We are immediately concerned about this because women with latent thyroid disease during pregnancy have a higher risk of miscarriage in both the first and second trimester. Minor decreases in maternal thyroid levels have been associated with a lower IQ in the offspring. In addition, an association exists between pre-term delivery and thyroid abnormalities.
What are the changes that occur in pregnancy?
The thyroid gland sometimes increases in size during pregnancy. Iodide levels decrease during pregnancy because of fetal use of iodide. Therefore, it is recommended by the World Health Organization that pregnant women take 200 micrograms per day as a replacement.
The level of thyroid stimulating hormone is generally decreased in the first trimester, which has minimal clinical effects. TSH levels then normalize by second trimester.
How does preeclampsia effect the thyroid gland?
There is new consideration being given to the possibility that vascular damage after preeclampsia may affect the thyroid gland causing subclinical hypothyroidism. It has been proposed that this may be independent of the autoimmune process to which hypothyroidism is usually attributed.
In preeclampsia, the serum concentration of thyroid stimulating hormone is increased. This may cause subclinical hypothyroidism. Studies have shown that TSH levels sometimes increase 2.42 times above baseline in women with preeclampsia. Studies of women with preeclampsia have shown that those women are also more likely than a control group of women who do not have preeclampsia, to develop a raised TSH concentration about 20 years later. This raises the possibility that subclinical hypothyroidism is more common after preeclampsia and that women with a history of preeclampsia may even have an elevated risk of reduced thyroid function as they get older.
These thyroid findings may also contribute to the hypertension and coronary artery disease that has been found to occur in people who have had preeclampsia. Treatment with thyroxine may possibly reduce future cardiovascular risk. It may be advisable to screen women who have had preeclampsia for thyroid function after they deliver, with ongoing follow-ups. Treatment with thyroxine may prove to be beneficial in the prevention of early cardiovascular disease in affected women.
SUMMARY:
Preeclampsia can cause reduced thyroid function during pregnancy and can be an indicator of which women would be more prone to developing reduced thyroid function in later years. Women who have had preeclampsia are advised to be followed by the their physicians after their pregnancy has ended.
Stay healthy, all you mothers out there! Pay attention to what your pregnancy tells you.
Tags: diseases, Hypothyroidism, mother, predictor, Preeclampsia, pregnancy
Posted in disease | 2 Comments »
Monday, October 19th, 2009
 Depression occurs in about 14–23% of all pregnant women. It is essential that we know how to make the diagnoses, when to treat, and the safety profile of the various drugs in managing this disorder. A recent landmark review was published by The American College of Obstetrics and Gynecology and the American Psychiatric Association that reviews the current guidelines.
Should I take an antidepressants if I am thinking of becoming pregnant?
Women with minimal or no symptoms for 6 months prior to conception, should contemplate tapering and discontinuing medication before conception. Behavioral therapy treatments can be used instead of medication.
Women with moderate to severe symptoms on medication should have their psychiatrist continue and optimize their medication prior to conception. The safety profile of the medications used should be carefully evaluated. Newer medications for depression and psychosis should be avoided if safety profile is not available.
Other conditions such as substance abuse, anxiety disorders, and eating disorders should be addressed at the same time.
What is the relationship between maternal depression and pregnancy outcomes?
Results from studies on miscarriage, growth effects, preterm births, and developmental delay with depression and use of antidepressant medication is severely limited due to poor studies and lack of consistency in conclusions. However, there was some evidence of an association of maternal depression and increased irritability, less attentiveness and activity, and fewer facial expressions in the newborn infant.
What is the safety profile of some of the commonly used antidepressant medication?
Tricyclic antidepressants-(Elavil, Norpramin, Pamelor, Aventyl, Anafranil, Tofranil, Evadyne)
Most studies have shown no association between the use of the tricyclic antidepressants and structural malformations. There was an increased association with newborn complications such as jitteriness, irritability, and occasionally convulsions.
Serotonin reuptake inhibitors (examples include Prozac, Celexa, Paxil, and Zoloft)
Some studies have shown a higher risk of cardiac malformations when SSRI’s were used during the first trimester, although the risk is considered very low and does not yet warrant the recommendations that women should not take these drugs. Combinations of different SSRI’s seem to have an even greater risk profile. However, other factors might be contributing to the results including obesity, diabetes, alcohol, and tobacco use. Some studies have shown evidence of rapid breathing, low sugar, temperature instability, irritability, weak cry, lower Apgar scores, and seizures in infants exposed to SSRI’s, especially in late pregnancy. Especially concerning were some reports of persistent pulmonary hypertension and respiratory distress. This can result in right heart failure.
Other antidepressants (Wellbutrin and Zyban, Effexor, Cymbalta, Remeron)
Fewer studies have been done on these agents but no increased risk of congenital anomalies or stillbirths have been found. There was a higher rate of newborn symptoms such as respiratory problems, low Apgar scores,hypoglycemia, and neonatal convulsions compared to women on no medications.
Electroconvulsive therapy
Severe depression that is unresponsive to medication can be treat with electroconvulsive therapy and does not harm the mother or the fetus.
Summary:
In conclusion, treatment of depression in pregnancy is based upon the risk of untreated mental illness in the mother versus risk factors to the fetus with the use of medication. The approach to decision making should be based on multiple factors including the severity of the disease, risk of relapse by stopping medications, response to therapy, social support, and recommendations on the part of the psychiatrist.
Tags: antidepressants and pregnancy, depression, nursing mother, pregnancy
Posted in environment | 1 Comment »
Tuesday, July 28th, 2009
What is Vitamin D?
Vitamin D is a fat-soluble vitamin that plays a central role in calcium and phosphorous metabolism, which is critical for bone formation and maintenance.
Why is Vitamin D important?
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Tags: morning sickness, nausea, pregnancy, vitamin D deficiency
Posted in nausea | 2 Comments »
Wednesday, May 20th, 2009
The debate over circumcision is centuries old. Worldwide, about 25% of males undergo this procedure. In the United States, over 60% of males are circumcised. New evidence has recently emerged that brings forth additional benefits of this procedure, making it more appealing to new parents.
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Tags: Add new tag, healthy baby, obstetrician, pregnancy
Posted in Uncategorized | No Comments »
Saturday, May 2nd, 2009
Being an obstetrician, I have the greatest job in the world. Pregnancy and delivery is undoubtedly one of the supreme highlights in a woman’s life and I have the distinct pleasure of being able to share this moment with my patients on a daily basis.
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Tags: beaute de maman, herbal, natural, obstetrician, pregnancy, Uncategorized
Posted in Uncategorized | 4 Comments »
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