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Nausea in pregnancy is very common, affecting more than 50% of pregnant women. Though commonly called ‘Morning Sickness’, the symptoms can occur at any time of the day. Nausea of pregnancy usually improves by 14-16 weeks, but can continue throughout the pregnancy for some women. Nausea in pregnancy is usually not harmful to your developing baby, but may become more problematic when associated with consistent vomiting and weight loss.
The cause of Nausea in Pregnancy is not well understood. It may be caused by the elevated hormone levels of pregnancy and their effect on slowing overall gut motility. The GI tract is normally constantly moving food and stomach acid from the stomach, though the GI tract. The effect of slower gut motility can result in a feeling a nausea after eating a large (your standard sized) meal, where food isn’t moving out of the stomach at the same rate. With slower gut motility, stomach acids aren’t moving out of the area at a normal rate either, potentially also causing a feeling nausea when we go 3-4 hours without eating.
When considering a woman’s contraceptive options, IUDs bear discussion. Some women have familiarity with IUD use, others have “heard of them”, but don’t have a real concept of how they’re used or how they work. An IUD (Intra-Uterine-Device) is a contraceptive device placed inside the uterus, in an in-office procedure, that generally takes less than 5 minutes for your doctor to insert. Pregnancy prevention occurs by a ‘foreign body’ inflammatory reaction that occurs based on the metal or plastic frame (T-shaped, about the size of an open paperclip) and by the local effect of the medication released by the IUD (either copper or progesterone.) This ‘inflammatory reaction’ likely creates a toxic environment for sperm (spermicidal), as well, likely inhibits implantation.
In the process of labor your baby’s normal fetal heart rate patterns assure us of the well-being of the baby, and it’s tolerance of the process of labor. During labor, the baby’s heart rate is monitored most commonly by a device called the Electronic Fetal Monitor. Many of you may be familiar with the device with the 2 Velcro straps wrapped across your belly. One of the circular sensors of the monitor laid across your abdomen picks up the fetal heart rate, while the other sensor measures the frequency of your contractions.
While we don’t intend for labor to be a ‘stressful’ condition for you or your baby, the reality is that the arduous process of labor can be a stress to both of you. While in labor, we monitor our Moms with vital signs, oxygen status, often IV hydration, and pain management when requested. Monitoring of the baby’s status during labor happens by our interpretation of the baby’s fetal heart rate patterns, using the Electronic Fetal Monitor. The monitor uses Doppler ultrasound wave forms (no radiation exposure) to record the fetal heart rate pattern, and is considered completely safe, posing no risk to your baby.
Understandably, for many persons, a new diagnosis of genital herpes may lead to feelings of shock, shame, guilt or embarrassment. Often times, patients are unaware of how common this virus is among the general population. Some studies have shown up to 1 in 5 of sexually active people have been infected with the Herpes virus, whether they’re aware of it or not.
Genital herpes is a treatable condition. Aside from being sexually transmitted, much of the negative stigma around this infection seems to come from the fact that you don’t ‘get rid of’ it, and that recurrences can happen. Herpes is a viral infection (like HPV,) and though the symptoms (a cold sore in the case of oral herpes, or a genital sore in the case of genital herpes) can be treated, the virus itself remains present in our blood stream indefinitely. Even in its dormant state (no symptoms present,) the virus remains detectable by blood test, and can lead to partner-to-partner spread of infection (from asymptomatic shedding of the virus) when no detectable ‘sore’ is present. Gonorrhea and chlamydia, different from the Herpes virus and HPV, are bacteria or bacterial-like infections that are cured with treatment, with no detectable bacteria remaining after adequate therapy (unless the individual is ‘re-infected’.)
Though a diagnosis of genital herpes can be an embarrassing nuisance, it’s actually a newborn baby who’s at the most serious risks from a genital herpes infection. A newborn baby infected with genital herpes is at risk for multi-organ infection, that can be fatal if left untreated. If you are pregnant, with a known history of genital herpes, it’s important to let your healthcare providers know that information. Certain measures (anti-viral medications in the last month of your pregnancy, and performing a Cesarean section if active lesions are present at the time of labor) should be taken, to decrease the risk of spread of infection to your newborn baby.
You may be worried about first visit to the gynecologist. Don’t worry, this is normal, and with a little preparation it can be an empowering and educational experience. Let your doctor know that you are nervous and we can be more effective at walking you through the process. The American Congress of Obstetrician and Gynecologists recommends young women make their first visit to the gynecologist between ages 13-15. Your doctor will want to ask you questions regarding your medical and surgical history, menstruation history, sexual history, exposures to alcohol or tobacco, and review vaccinations you’ve received or may be due for. If these topics seem too personal, or you are uncomfortable discussing them, remember your conversation with the doctor is confidential. It may be helpful to go to the appointment with a parent or friend, but be sure some of the time is spent with you and the doctor in private, so you can voice concerns or questions that might be awkward to discuss around others. You may want to write questions down before-hand, as this is an opportunity for you to gain knowledge regarding your health and well-being.mind well-informed.
Heavy menstrual flow is a common occurrence affecting 10-35% of women, and a common reason for visits to the gynecologist. Though the causes for heavy menstrual periods (menorrhagia) vary, the Novasure endometrial ablation procedure is an excellent treatment option for many women, when child-bearing is completed.
As an Ob/Gyn physician with greater than 10 years of experience performing the Novasure procedure (and with hundreds of satisfied patients having selected the procedure), I thought it may be helpful to discuss common questions from patients considering the procedure as their treatment of choice. Here are my answers to 5 common patient questions regarding the Novasure procedure:
1. How is the procedure performed?/What can I expect from my menstrual flow after the procedure…lighter periods or no period?
The procedure is considered minimally invasive, performed through the vaginal aspect without surgical incisions. The Novasure wand (containing a triangular mesh) is inserted within the uterus, where a short (less than 2 minute) cauterization of the uterine lining occurs. The procedure may be performed in an outpatient surgical setting (with anesthesia) or possibly in your doctor’s office. You should expect to be back to normal activities within a day or so.
Several research studies on the results of the Novasure procedure note over 90-95% patient satisfaction with the procedure. Expected results range from notably lighter menstrual periods (for most patients)…to skipped/or absent menstrual flows (up to 40% of patients.) It’s not possible to predict for patient’s what result they will get, but when questioned overall, most patients are (very) satisfied with the results achieved.
Suzanne Hall, MD, FACOG
50%-90% of pregnant women experience symptoms of ‘morning sickness’ in the early months of pregnancy. These symptoms can range from mild intolerance to certain odors or food, to more significant, daily nausea and vomiting (N/V). Studies suggest that up to 25% of pregnant women experience nausea, 50% experience both nausea and vomiting, leaving only 25% of pregnant women unaffected. In those affected, the symptoms usually manifest by the 9th week of pregnancy.
Much is written and discussed about home/medical remedies for morning sickness, but much less is written/discussed about the (possible) causes for nausea and vomiting in pregnancy (NVP). Though the cause of NVP has not been proven, it has been postulated that NVP is an innate mechanism, presenting as a ‘protection’ for the developing fetus (an inherent ‘aversion’ to substances that could be harmful to the fetus.) Leading medical theories consider the adverse reaction of the ‘hormones of pregnancy’ as potentially causative (in the absence of other intestinal or medical problems that could present with N/V.)
Who really likes going to see the Gynecologist? For some women, it probably ranks right up there with getting a tooth drilled at the dentist, or like nails to a chalkboard. But let’s face it, the gynecologic exam/Pap smear is a necessary part of preventative Women’s Health screening. Whether it’s your first visit, or you’re seeing the Ob/Gyn you’ve known for years, here are a few tips that may help to make your visit go more smoothly…
Prepare your questions/concerns
Make a list of your concerns/questions, include your medical history, medications, allergies, ect…
In that the average patient-physician interaction is 10-20 minutes, it’s helpful when your list of problems/concerns is concise. Know your medical/surgical history, medication allergies, and list your current medications. Think about (or write down) your problem list/symptoms, when they began/worsened, what aggravates/or improve the symptoms, and from a gynecologic perspective, if they’re cycling with your menstrual period. Understand that if your list of questions/concerns is long, we may have to address some of them at a subsequent visit.