Pregnancy : Health Experts

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in immediate danger, even if she has an ectopic pregnancy, so the prudent approach in situations in which the pregnancy is desired is to simply wait, repeat the hCG levels periodically, every 2-3 days, and perform an ultrasound to look for...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:December 22, 2007
this could be another early pregnancy, it could be an ectopic pregnancy, or ot could be choriocarcinoma arising from your pregnancy in December. I am sorry, but it does sound like you had a very early pregnancy loss - sometimes referred to as a...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:March 16, 2007
Microdeletions of this portion of chromosome 22 are clearly associated with congenital heart defects, especially conotruncal defects, such as Tetralogy of Fallot, that have narrowing of the pulmonary artery and ductus arteriosus and...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:February 7, 2007
then this year on 07/2008 I had another miscarriage I was about 6wks and now I dont know if it was because of my abortion that Iam having miscarriages because I want to get pregnant again Iam very regular in my periods and as soon as I try to get...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:August 12, 2007
Recently, we had a woman diagnosed late in pregnancy with intrahepatic cholestasis of pregnancy, or obstetric cholestasis (OC) Despite reassuring fetal heart rate testing, the baby died. I just logged in and read about the "Inrahpatic Cholestasis...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:January 10, 2007
If the AFP is abnormally high, and there are no apparent abnormalities of the baby to be seen, then that "false positive" result may actually reflect an underlying placental problem (that may not manifest itself as a problem such as fetal growth...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:September 1, 2007
Before I get into details regarding specific abnormalities of the maternal immune system and clotting system that appear to be related to recurrent early pregnancy loss, let me tell you a story about one of those special patients in my life who...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:April 3, 2007
To begin our discussion of actual causes of recurrent early pregnancy loss, lets start with the one that is probably the most commonly touted, though still the least well-understood (and to me the MOST confusing) HORMONAL CAUSES.
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:March 24, 2007
Recurrent Early Pregnancy Loss - 1 - Implantation. 1) Endometriosis/adenomyosis is probably a MUCH mote common cause of recurrent early pregnancy loss than most physicians are aware of. Factors that contribute to recurrent early pregnancy loss...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:March 22, 2007
All the symptoms continued and the sickness and dizziness, hunger etc seemed to get stronger but then going back to the day after the positive pregnancy test i was told to go to hospital to see gynacologyst, when they did a urine test and a blood...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:March 15, 2007
My secound boy was Rh Negative also so he was compatible with me no problems then I had a beautiful little girl and her blood type turned out to be positive she was born perfect but during the night developed awful probelms tryed giving her...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:February 14, 2007
i am 42 and currently 12w1d with twins.baby B "looks" normal.baby A has cystic hygroma.lots of fluid behind the neck, in the abdomen, and all over it's body underneath the skin.doctor said baby A has a 95% chance of dying in utero.i burst into...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:August 22, 2007
Indeed, we have found that one of the primary advantages of first trimester screening and midtrimester screening, coupled with ultrasound, is that we have found ourselves performing far fewer invasive procedures than we have done in the past...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:January 4, 2007
1.in 17th week, 2.In 25th week and 3.was a preterm birth in 24th week - the last one was a twin pregnancy I have this Prothrombin mutation and take Low Molecular Weigh Heparin during pregnancy plus baby aspirin,Progesterone, and Predisone (5mg)...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:August 17, 2007
The risk of the amniocentesis is probably only a tenth the risk of your having a baby with Down syndrome, but with the odds you quoted to me, if you did happen to lose the baby, and the loss was related to the amniocentesis, the odds are that you...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:April 27, 2007
Intrahepatic Cholestasis of Pregnancy - Outcomes and Management. If your itching has completely resolved, it is unlikely that you have true obstetric cholestasis - there are many other causes of itching (and of cholestasis) in pregnancy.
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:January 13, 2007
Recurrent Early Pregnancy Loss - 7 - Immunologic and Hematologic Causes. Indeed, the triad of recurrent pregnancy losses or poor obstetrical outcomes (related to severe preeclampsia, intrauterine growth restriction; fetal deaths, and preterm...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:April 5, 2007
The blighted ovum was very likely to be a chromosomal abnormality as well and trisomy 16 is actuallly one of the more common chromosomal abnormalities that results in early pregnancy losses (those babies rarely get past 8-9 weeks) So, your...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:March 25, 2007
Management of an Rh-Isoimmunized Pregnancy. This is very interesting.I've been concern with my pregnancy (I'm 28 weeks pregnant) This is my second pregnancy and with my first pregnancy my baies blood got mixed with mine and now I'm positive with...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:February 23, 2007
Im 22yrs old and recently found out i was pregant,This will be my 4th pregnancy,my other 3 ended in miscarriages and they were 2 my ex at the time,now with this pregnancy im worried i will miscarry again,i havnt had tests as 2 why i have...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:September 17, 2007
My baby girl had cystic hygromas on both sides of her neck.We went to see our fetal specialist at 17 weeks and he told us that even though the baby looked normal and the chromosome tests came back negative, that cystic hygromas are a signal or...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:January 29, 2008
Concerns Regarding Methotrexate Therapy. The queries below should be of general interest to many women who undergo methotrexate therapy either for ectopic pregnancy or for other medical conditions, such as autoimmune or neoplastic diseases, that...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:October 15, 2007
I am not exactly sure what they found but are adhesions are a growing problem in OB because of the high rate of cesarean sections and REPEAT cesarean sections (and things are NOT going to get any better with time) It is doubtful the adhesions...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:May 10, 2007
First trimester screening for aneuploidy, or as it is commonly referred to as combined first trimester risk assessment, has gained widespread acceptance in other developed nations over the past decade, and is slowly coming into its own here in...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:December 13, 2006
Because of the rising incidence of ectopic pregnancy, the risk (maternal and medical-legal) of not identifying and treating an ectopic pregnancy in a timely fashion, and the widespread acceptance and success of MTX therapy as an alternative to...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:September 11, 2007
There is not a week that goes by in my practice that I do not have to address questions regarding cytomegalovirus (CMV) infections and pregnancy. Anonymous has left a new comment on your post "Cytomegalovirus (CMV):
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:November 18, 2007
Women with single MTHFR polymorphisms do not need special treatment unless they have pregnancy problems that seem to be related to this. If you continue to have miscarriages, prophylactic heparin or lovenox can be started as soon as a pregnancy...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:September 7, 2007
No it does not mean you will be positive again and if you and had no complications related to GBS in the previous pregnancy, and test negative during this pregnancy, you will not even need antibiotics in labor.
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:October 22, 2006
Cervical Dysplasia and Cancer in Pregnancy - 7. This concludes our series on cervical dysplasia and cancer during pregnancy. Cervical dysplasia and cancer in pregnancy. It is my understanding that both women have a very aggressive and somewhat...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:July 22, 2007
Understanding Interpretation of First Trimester Screening Results. Based on the very large number of comments and questions I continue to receive related to the interpretation of the results of combined first trimester screening for aneuploidy.
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:April 22, 2008
from midtrimester on is mostly fetal urine, and CMV is excreted in large amounts from the kidneys following congenital infection, and often for years afterwards, even in 'asymptomatic' cases) However, unless we have confirmatory maternal...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:September 27, 2006
Amniotic Fluid - 4 - Consequences of Decreased Amniotic Fluid. , and in the case of placental insufficiency, decreased fetal oxygenation (ultimately the cause with its own consequences, not the effect, of decreased amniotic fluid) Normally, I...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:May 11, 2008
Trofatter, This posting is timely as I have just received back my results of the first trimester screening and received a positive with a risk of 1:33 for Down's. Many women with your risk in first trimester simply opt to have a careful...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:March 30, 2008
This is not at all unusual in early pregnancy losses, especially if a chromosomal abnormality was present, however, it can also be difficult to differentiate from a condition called "molar pregnancy. I didn't take any drugs during this pregnancy...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:December 18, 2007
Many women carry one dose (heterozygotes) for the MTHFR A1298C and PAI-1 4G polymorphisms and have no trouble at all with pregnancy. association is manifest by totatl number of mutations as well as with PAI-1 mutations.
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:November 5, 2007
The other day, tjtiger left a new comment on my post "MTHFR Mutations and Congenital Heart Defects" Her many questions made her comment worthy of a post of their own and the query related to the possible assocation of MTHFR polymorhisms and...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:October 3, 2007
Anticoagulation during pregnancy has become more widely used to treat, both prophylactically and therapeutically, women who have had problems with thromboembolic complications, unexplained recurrent pregnancy loss, and those who have been...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:April 17, 2008
In fact, if anything, since the drug is now formulated at compounding pharmacies across the nation, and is not under the scrutiny of BIG PHARMA (the product is no longer made by a pharmaceutical company just wasnt worth holding onto over the...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:January 14, 2008
Studies show that women who gain 30 pounds vs 80 pounds during pregnancy do not have significantly different birth weights of their babies. Aim for 25 grams of protein more than pre-pregnancy and the rest of the calories can come from carbs and...
Author:Tara Gidus, MS, RD, CSSD, LD/N
Date:May 9, 2007
Although terminating a pregnancy early is not associated with increased prospects for maternal survival, when late stage cancer is detected early in pregnancy, the woman might consider this option if she wants aggressive therapy but does not want...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:October 9, 2006
Indeed, about 50% of breast cancer cases found during pregnancy already have metastatic disease at the time of diagnosis Since routine mammography is not recommended during pregnancy, breast cancer is usually suspected by detection of a painless...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:October 8, 2006
Her specific question related to the possible role of plasminogen activator inhibitor 1 (PAI 1) activity and polymorphisms in recurrent pregnancy loss. I was told before my fourth loss by my hematologist that PAI 1 levels become elevated very...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:September 30, 2007
Whenever these circumstances arise, it is strongly suggested that the prescribing physician evaluate the need for continuing the drugs, the possibility of reducing doses to the least necessary to control the condition during the pregnancy, or...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:January 27, 2007
If I have had breast cancer treated before a pregnancy, will pregnancy increase the risk of recurrence? Approximately 1 out of every 3000 pregnancies is complicated by breast cancer and, as a growing number of women delay childbearing into their...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:October 8, 2006
Symptoms Accompanying Methotrexate Therapy for Ectopic Pregnancy. Fortunately, with early diagnosis, facilitated by rapid quantitative assays for hCG (human chorionic gonadotropin, the pregnancy hormone measured in most pregnancy tests) and...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:March 8, 2008
With regard to recurrent early pregnancy loss, however, the anticoagulation properties of lovenox and aspirin may be LESS important than their roles in improving trophoblast. We are finding that thyroid conditions, especially when they are...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:January 26, 2008
Your doctors ARE concerned that this was a molar pregnancy, but the odds are that they are having a hard time differentiating 'hydropic degeneration' of an abnormal pregnancy from a true molar pregnancy.
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:December 15, 2007
The readers who sent in the comments below related to recurrent early pregnancy loss (RPL) have what we could consider to be 'borderline' indications for 'treatment' and several questions related to their therapy.
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:December 9, 2007
Cervical Dysplasia and Cancer in Pregnancy - 6. Cervical dysplasia and cancer in pregnancy. All of these procedures have the potential to increase the risk of premature rupture of membranes, premature delivery, intrauterine infection, and even...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:July 18, 2007
Most patients who have recurrent early pregnancy loss are desperate to try anything and everything to achieve a successful pregnancy. To demand an explanation to justify 'treatment' in these settings makes us out to know more than we really do...
Author:Kenneth F. Trofatter, Jr., MD, PhD
Date:April 12, 2007
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