Posts Tagged ‘prevent’

The Importance of the First Prenatal Visit

Tuesday, November 9th, 2010
OB/GYN Prenatal Visit

Come in to see your OB/GYN as soon as you think you're pregnant. Honestly, there is nothing more important for getting you and your baby off to a great start!

You just found out you’re pregnant! You rush to call your husband, then your mother, email your Aunt Annie and text your BFF. Excitement, celebration, hugging and kissing!

But before the excitement cools, there’s still one more person that wants to hear your good news… your OB/GYN.

Don’t delay. Here’s why.

The purpose of prenatal care is to optimize the chances of a healthy baby while ensuring the physical and emotional health of the mother. In order to best accomplish this, it is essential that there is early initiation of the first prenatal visit. Reports from Center for Disease Control have shown that delayed or no entry into prenatal care can result in a higher rate of complications with resultant severe maternal morbidity and or mortality. In addition, for the baby, studies have shown a direct association between early comprehensive prenatal care and increased birth weights.

What are some of the important reasons for having an early prenatal visit?

  • Establish more accurate dating
  • Counsel and educate patients about diet and exercise
  • Obtain a detailed medical history and physical so medical conditions both current and from previous pregnancies can be detected and managed early in the pregnancy
  • Discussions about avoidance of dangerous medications and harmful habits such as smoking, drinking, and the use of drugs
  • Detect early signs and symptoms of miscarriage or possible ectopic pregnancy

Unfortunately, recent studies have shown a trend that women are delaying the scheduling of their first prenatal appointments.

Several reasons why pregnant women delay early care:

  • Mothers sometimes avoid scheduling early appointments due to non-recognition of the pregnancy
    Over the counter pregnancy tests are extremely accurate so make sure you know the signs of early pregnancy. It’s very easy to ignore these signs but it’s very important that you are seen before the fetus begins developing.
  • Difficult work schedules
    Inform your employer that you are pregnant. Perhaps they can help rearrange your work schedule to find time for your very important prenatal visits.
  • Financial considerations
    Ask the physician’s billing department if the practice offers terms for newly pregnant families. Make sure you understand your insurance policy and if not, call your carrier and have them go over your options in detail.
  • Difficulty in the doctor’s office accommodating the new pregnant mother
    If the receptionist can not accommodate an early appointment, make sure the doctor knows you believe you are pregnant. Your doctor may have some slots available for a newly pregnant woman. If you can’t get an appointment with the doctor, ask if they have a physician’s assistance, midwife or a nurse practitioner to initiate your prenatal care. Alternatively, some practices now have Group Prenatal Care for low risk patients and multiple people can be seen together for the preliminary visit. This can be fun, a great way to meet other pregnant women and you can obtain the early, very important information and advice you need.

It has been found that over one quarter of all first prenatal visits are occurring after 8 weeks gestation when all the organ systems have already developed in the fetus and toxins or certain medical conditions have already taken their toll.

If you’re not yet convinced:

In a recent article, Sept 2010 in the American Journal of Obstetrics and Gynecology by Arnold Cohen, a suggestion was made to have a mini-triage system established for all pregnant patients who called the office for a first prenatal appointment by a competent and skilled health care provider. By asking certain key questions that pertain to dating the pregnancy, and known risk factors such as medical illness, medications, and previous pregnancy complications, it can be decided which patients take precedence and require very early initial prenatal appointments and which patients are more routine and can be delayed. In this way, more time and effort can be expended to improve prenatal care to those who most need it. Too often the questions currently being asked revolve solely around patient insurance issues and hospital coverage.

Summary:

In a country that spends 35% of all US infant spending on prematurity and also ranks at the bottom of the developed countries in the world on infant mortality, I think it is very reasonable to try and identify high risk pregnancies very early in the game in the hopes of preventing adverse outcomes through education and careful, frequent monitoring by a qualified health professional right at the very beginning of the pregnancy. In this way, we might be able to see an improvement in prematurity, adverse maternal outcomes, congenital anomalies, and low birth weight infants in the future.

Don’t Let the Marks On Your Body Define You!

Tuesday, July 13th, 2010

Stretch Marks During Pregnancy

In the past

Stretch Marks or Ferocious Tiger Stripes?

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 embarking on the holiday season, 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.

  1. 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.
  2. 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.
  3. 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!!
  4. 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.
  5. What ingredients are responsible for hydration and moisturization?
    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.
  6. 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.
  7. What makes the Beauté de Maman products superior?