Check Up: Changing the thinking on cesarean sections

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After a woman has a cesarean section, she is almost sure to deliver future babies by having her abdomen cut open again.

That's why efforts to reduce the overall C-section rate - now one out of every three deliveries - often focus on preventing initial cesareans.

Initial cesareans make up 60 percent of all C-sections, and the expert consensus is that many are not medically necessary.

Consumer Reports, the venerable product-

testing group, this month rates 1,500 of the nation's hospitals on how well they avoid first-time cesareans in low-risk women - women carrying a single, properly positioned, full-term baby.

Consumer Reports drew on public billing records from 22 states from 2009 to 2012 to evaluate hospitals that had at least 100 low-risk deliveries in a two-year period. It found the national average rate for first-time cesareans in low-risk women was about 18 percent - much higher than the 12.6 percent rate in 2000, used as a benchmark.

"Because a hospital's C-section rate can be hard to find, it's likely that most families are unaware of the huge differences in medical practice," Consumer Reports said.

Consumer Reports' data did not include factors that can increase the risk of a C-section, such as obesity, diabetes or high blood pressure.

Still, some geographic areas had "dramatic," inexplicable variations. In Los Angeles, for example, cesarean rates in low-risk women ranged from a high of 55 percent at one hospital, to a low of 15 percent at another center.

The range in the Philadelphia region, including South Jersey, was narrower. At the low end were Jennersville Regional in West Grove (12 percent) and Cooper Health System in Camden (13 percent). At the high end were Pottstown Memorial Medical Center (23 percent) and Lourdes Medical Center of Burlington County in Willingboro (28 percent). Asked about their Consumer Reports rates, several local hospitals cited care of high-risk patients such as those carrying multiple fetuses - even though the Consumer Reports analysis focused on low-risk women.

"Like our peers at other large, urban hospitals, many of our deliveries follow high-risk pregnancies requiring special care and close monitoring, which may result in higher-than-average rates of cesarean deliveries," e-mailed Penn Medicine, which last year had 8,885 births at the Hospital of the University of Pennsylvania (16 percent rate in Consumer Reports) and Pennsylvania Hospital (22 percent).

Why do so many women with no clear need for a surgical delivery wind up having one?

http://articles.philly.com/2014-05-18/news/49928281_1_consumer-reports-c-section-cesareans

Post C Section Recovery

Did you know, the amount of Caesarean deliveries in the USA continues to rise every year since 1996?  But the number of women with a prior Caesarean delivery, attempting a natural labour decreased. At the Gynecology Emergent Care Center we have an OB GYN in Long Beach, CA (http://www.gyn-emergentcare.com/gynecologists-services-long-beach) that is happy to answer any questions about Caesarean delivery you may have. Body changes and self care are usually a main concern.  If you are planning to have a c section, you should know that many body changes occur after the procedure.

For more information click here:

http://www.gyn-emergentcare.com/the-latest/item/90-great-insight-on-post-c-section-health-enhancement

Pseudocyesis: When You Think You're Pregnant, Have Pregnancy Symptoms, But Aren't Pregnant

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A man in Canada recently found out that his girlfriend showed all signs of pregnancy, but wasn't actually pregnant with quintuplets like they thought.  She did experiences lactation and signs of stomach swelling, according to news reports.

CTV reported that the girlfriend may have had a condition called pseudocyesis, or false or phantom pregnancy; she is currently being psychiatrically evaluated.

People with pseudocyesis think that they are pregnant and even exhibit physical symptoms of pregnancy -- but they are not actually pregnant at all. It's currently included in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in the "Not Elsewhere Classified" section, under Somatic Symptom Disorders. However, it's been around for many years -- a 1941 article in the New England Journal of Medicine, for instance, described is as "an affliction of queen and commoner with reverberations in many fields from domestic to theological."

WebMD reports that anywhere from one to six cases of every 22,000 live birthsinvolves pseudocyesis.

According to the DSM-5, pseudocyesis is defined as "a false belief of being pregnant that is associated with objective signs and reported symptoms of pregnancy, which may include abdominal enlargement, reduced menstrual flow, amenorrhea, subjective sensation of fetal movement, nausea, breast engorgement and secretions, and labor pains at the expected date of delivery."

A 2013 article in the journal Reproductive Biology and Endocrinology noted that currently, most cases of pseudocyesis occur in undeveloped countries, where a woman might receive medical care later in the pregnancy than a woman would in developed countries (where visits to the obstetrician often take place in the first trimester).

The same article also evaluated published studies on pseudocyesis, and identified 10 women with the condition to deduce commonalities between them. The researchers found "that pseudocyetic women share many endocrine traits with PCOS [polycystic ovary syndrome] and major depressive disorder, although these traits are more akin to PCOS than to major depressive disorder," they wrote in the study.

read more here:

http://www.huffingtonpost.com/2014/03/26/pseudocyesis-false-phantom-pregnancy_n_5037887.html

A Gynecologist in Long Beach, CA Explains the Causes and Symptoms of Endometriosis

Lakewood OBGYN

Which Medicines Are Safe for Pregnant Women?

The GYN Emergent Care Center is a Long Beach OBGYN Clinic.  Click here to visit our website.  This means that we are experienced with keeping pregnant women healthy.  We want all women who are expecting to understand the importance of being careful when consuming over the counter medicines (OTC).  This is why we recently compiled a list of these medicines that are safe for your convenience.  

Remember, when pregnant you are consuming food and medicine for you AND your child.  What you consume passes through your bloodstream and may affect the health of your fetus.  This is the exact reason all OBGYN doctors tell their pregnant patients to stop smoking cigarettes, doing drugs, or consuming alcohol.  Even coffee can affect your baby, so it is best to stay away from it.  If you want to read our list of safe medicines for pregnant women please visit out website here:

http://www.gyn-emergentcare.com/the-latest/item/85-find-out-which-medicines-are-safe-for-you-to-take-during-pregnancy

Responding to Critics, Gynecology Board Reverses Ban on Treating Male Patients

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Parents should use a tiny smear of fluoride toothpaste to brush baby teeth twice daily as soon as they erupt, instead of waiting until children are older, according to new guidelines by the American Dental Association.

That advice overturns the A.D.A.’s decades-old recommendation to start using a pea-size amount at 24 months. Once children are 3 to 6 years old, then the amount should be increased to a pea-size dollop, the updated guidelines say.

To fight the rising number of cavities in the very young, the dental group now advises getting a jump-start on prevention. However, they emphasize only the tiniest amount of fluoride toothpaste should be used to minimize the risk of mild discoloration, white spots or streaking of the teeth, a condition called fluorosis that is caused by ingesting fluoride toothpaste at a young age.

“We want to minimize the amount of fluoride consumption to reduce the risk of fluorosis while simultaneously adding a preventive tool for kids 2 and under that we haven’t recommended previously,” said Dr. Jonathan Shenkin, a spokesman for the A.D.A. and a pediatric dentist in Augusta, Me. Only a tiny amount of toothpaste should be smeared on the brush since some youngsters are likely to ingest some of the fluoride, he said.

The change comes after a systematic review of 17 studies published in The Journal of the American Dental Association this month. It concluded that scientific evidence, though limited in children under age 6 and more robust in older children, demonstrated that fluoride toothpaste is effective in controlling tooth decay, and that “the appropriate amount” should be used “by all children regardless of age.”

An early start is crucial, Dr. Shenkin said, because children with dental decay are at greater risk of developing cavities as adults. “By starting earlier, we can effectively reduce a lifetime of disease for a lot of kids.”

Dr. Man Wai Ng, the dentist in chief at Boston Children’s Hospital, applauded the new recommendation and said, “It’s a great thing for parents to know: ‘Use a tiny amount of fluoride, and brush two times a day to counter the effects of frequent snacking.’”

Most of the children she sees with tooth decay are using “a training toothpaste without fluoride,” she said.

http://www.nytimes.com/2014/01/31/health/responding-to-critics-gynecology-board-reverses-ban-on-treating-male-patients.html

Women who catch a cold during pregnancy are more likely to have a baby with asthma, study claims

Check out this article a gynecologist in Long Beach CA from GYN Emergent Care Cener found:

Women who catch a cold during pregnancy are more likely to give birth to an asthmatic child, a new study has revealed.

Researchers say women who are pregnant may want to take extra precautions around those who are sniffling and sneezing this winter. 

The more colds and viral infections a woman has during pregnancy, the higher the risk of her baby having asthma, according to the study published in the journal Annals of Allergy, Asthma and Immunology.

Researchers found a mother’s infections and bacterial exposure during pregnancy affect the baby's environment in the womb, increasing a baby’s risk of developing allergies and asthma in childhood.

Allergist Dr Mitch Grayson, Annals deputy editor and fellow of the American College of Allergy, Asthma and Immunology, said: ‘In addition, these same children that had early exposure to allergens, such as house dust and pet hair, had increased odds of becoming sensitised by age five.

‘When dust mites from the mother and child’s mattresses were examined, children with high dust mite exposure, yet low bacteria exposure, were more likely to be allergic to dust mites than those with low mite exposure and high bacteria exposure.’

Researchers studied 513 pregnant women in Germany, and their 526 children. 

Questionnaires were completed during pregnancy, when the children were three and 12 months old, and every year up to five-years-old. 

Of the families, 61 per cent had a parent with asthma, hay fever or atopic dermatitis.

According to the ACAAI, asthma and allergy can be hereditary.

Read more: http://www.dailymail.co.uk/health/article-2551053/Women-catch-cold-pregnancy-likely-baby-asthma-study-claims.html#ixzz2sTHRyH3o

A Long Beach Obstetrics & Gynecology Medical Group Talks About Menopause

Long Beach OBGYN Medical Center 855-376-2496 

Prenatal Appointment Importance

As a pregnant women, it is important to look out for your health as well as your baby's health.  After all, your health during pregnancy can affect your child at birth and for the rest of their life.  Staying consistent with your prenatal visits to a physician is important.  A physician can help you determine any risk factors and take over wellness exams for you and your unborn child.  

To read more about this topic please visit this gynecologist in Long Beach, CA's blog.  Here is the link:

http://www.gyn-emergentcare.com/the-latest/item/58-an-gynecologist-explains-the-importance-of-routine-prenatal-visits