blood test

Amnio bites the dust!!!

Researchers have FINALLY discovered how to detect the extra fetal chromosome 21 in Down Syndrome babies in their mother’s blood. This means that amniocentesis and chorionic villi sampling will no longer be used to detect the genetic disorder, saving countless babies from being miscarried! The miscarriage rate after these invasive tests is about 1%, a significant rate for procedures that are only diagnostic. The only downside I see is that for women who would consider abortion as a viable option for “treating” down syndrome, this may possibly increase the abortion rate. Hopefully we don’t see that happen, but in the meantime we can at least see more babies staying alive after DNA testing.

To read the article, click here.

Something to Think About #28: Rising hCG Levels

From Understanding Diagnostic Tests in the Childbearing Year by Anne Frye, 7th edition:
“It is typically stated that (hCG) levels double every 40-48 hours from implantation through the first 10 weeks. However, the study upon which this information is based included only 20 women (Kader et al., 1987). Barnhart and colleagues (2004) set out to better define normal hCG increases by studying a larger population of 287 women at high risk for miscarriage or ectopic pregnancy due to bleeding in early pregnancy, but who went on to have viable intrauterine pregnancies. In working with this large cohort, Barnhart discovered that the “doubling” rule did not apply and that the normal pattern of rise in hCG levels was much more linear. The average rise over a 24-hour period was 1.5 times, a 50% increase; and after 48 hours it was 2.24 times, a 124% increase. This rise can be considerably more. The slowest normal was 24% in 24 hours and 53% in 48 hours.”

The Monthly Doula Vol 1 Issue 11 May 2009 Prenatal Testing

The Monthly Doula

A newsletter by Birth a Miracle Services

Volume 1 Issue 11 May 2009

Prenatal Testing

Mission Statement: My goal is to educate and inform all parents and future parents of their rights and responsibilities of bearing children and of the truth and wonder of birth. My mission is to inspire them to enjoy their pregnancies and to look forward to bringing their children into the world.

Contents:

Letter from the Editor

In the News

Quote of the Month

Understanding Group B Strep in Pregnancy and Birth

Urine Analysis for Pregnant Women: A Helpful Key to Health and History

Website of the Month

Book of the Month

Online Video of the Month

What is Birth a Miracle Services?

Inspired Birth

Request for Contributions

Subscribing/Unsubscribing

 

Letter From the Editor

The world of science and medicine has advanced so far that although a pregnant woman cannot guarantee having a clean bill of health for either her or her child, both of them have a much better chance of being treated quickly for any complications that arise, and being well-cared for should that happen. Prenatal testing is a method that doctors use to help ensure that a woman remains healthy, as does her unborn child, during pregnancy.

There are many options for prenatal testing, some are considered standard and include blood pressure checks, weight checks, and urine analysis (see article below). Other prenatal tests can help to determine the chances of any baby having genetic abnormalities or other health problems. Yet although it would be ideal to know for sure how to care for your baby when it is born, learning the results of these tests can sometimes have very big consequences, and are not always a piece of cake.

As with everything else I have said, I strongly encourage you to do your research, to learn about whatever intervention your caregiver is recommending you use, and to ask questions if you feel something more should be done. Doctors have a lot of knowledge, but they are human and therefore can’t know everything, and this is your health and your baby that you are caring for.

I hope this newsletter is of good use to you! Please contact me if there is something you would like to contribute or if you have any comments about the articles I have included.

Enjoy!

Naomi Kilbreth, CD

Birth a Miracle Services

36 Greenwood Street

West Paris, ME 04289

(207) 754-8875

Kilbrethfamily@yahoo.com

http://www.birthamiracle.wordpress.com

In the News:

CVS and Amnios may soon be a thing of the past: Scientists are now developing a blood test for the mother that will detect DNA abnormalities in the baby, although they say it may be some time still before the test is ready for wide-spread use. See the full report here: http://www.labtestsonline.org/news/ds_dna081115.html

Another test to add to the list: If a pregnant woman has abnormal thyroid hormone levels, her child will be at a slightly increased risk of having an IQ of less than 85. Some doctors say testing should be reserved for women who are having symptoms of thyroid problems, but it might not be long before this test becomes routine. See the New York Times article here: http://media.aace.com/article_display.cfm?article_id=4894

Some doctors say prenatal screening tests are being touted as diagnostic tests: ABC did a special on the difference between the two, and on a new screening test available to pregnant women that doesn’t carry as high of risks as CVS and Amniocentesis testing. See the full article and video here: http://abclocal.go.com/wls/story?section=news/health&id=6400805

Quote of the Month:

“No method of prenatal testing can guarantee that a baby will be born without birth defects, genetic disease or mental retardation.”

http://babies.sutterhealth.org/during/preg_prenataltests.html

Understanding Group B Strep in Pregnancy and Birth

By Naomi Kilbreth

According to March of Dimes: “Up to 35% of women carry (Group B Strep). If a woman is infected her baby has a one in one-hundred chance of getting infected. Of the babies who are infected, up to 5% die as newborns and up to 30% suffer from serious neurological damage.”

This means that the chances of any baby getting infected with GBS are up to .0035%. A further look shows that the chances of any baby dying from GBS is up to .0001725%, which is up to .05% of babies who have GBS. Also, the chances of any baby having serious neurological problems to do GBS are up to .000135%, which is up to 38% of babies who have GBS. This brings us to the fact that any baby will have chance of up to .0019775% of becoming infected with GBS and live with no serious side effects at all. This is a 57% chance for the baby who has GBS.

Every woman has to make up her mind about whether or not to have the simple swab test taken during her pregnancy. The test will have no lasting impact on the mother in itself. However, if the mother tests positive, it will have a big impact on the baby. First, the doctor may choose to either give the mother intravenous antibiotics during labor, or give the antibiotics intravenously to the baby when he/she is born. They won’t know for sure if the baby is infected, so on the precautionary side they highly suggest giving him/her intravenous antibiotics, either directly or through the mother.

Unfortunately, some doctors don’t make it sound like a choice, and if you aren’t well informed ahead of time, you may feel that “doctor knows best” and decide to go that route without all the information. Intravenous antibiotics have been proven to reduce your baby’s chances of becoming infected, according to some studies, but they also increase the mother’s risk of contracting yeast infections and urinary tract infections plus they often require taking your baby away from you during those first precious moments, even if you had a vaginal birth with no complications. Meaning, if you had a cesarean section, your baby will be taken away from you for at least an hour or two. In some cases, the parent’s worry for their child could have a more negative response in their parenting then the antibiotics the baby may receive. In this situation, it may be in their best interest to allow the normal procedures, in order to reassure them of their child’s safety.

Worst case scenario, even if you do allow antibiotics, your baby will contract the bacteria and may have difficulty breathing, or other symptoms, which if left untreated could result in the baby’s death. I personally know of a baby who was born at home and the parents denied their option of the swab test. Three days after the baby was born, he was having difficulty breathing due to GBS, and was brought to the hospital with the midwife’s oxygen tank. The baby lived, and is now doing just fine, because the parents were paying attention to his body’s signals.

In the case of a “normal” baby, parents should automatically keep an eye on their child’s body signals, so this should not be out of the norm. In fact, for your particular case, it could be the best option. Just remember, that if you, the mother, are infected with GBS, your baby only has a 1% chance of contracting the bacteria, and if he does contract it the bacteria, he has a 57% chance of living with no serious complications at all due to GBS.

“Group B Strep: Infected Mothers are More Likely to Pass Problems to Children” 2009 © Associated Content, All rights reserved.

Editor’s note: Sutter Health is reporting that the risk of a woman contracting GBS may be even smaller, around 1 in 7, and that the risk of infant infection is around 1 per 150, not 1 per 100. http://babies.sutterhealth.org/during/preg_prenataltests.html

Urine Analysis for Pregnant Women: A Helpful Key to Health and History

By Naomi Kilbreth

When you go to the doctor’s for your prenatal checkup, the nurse will weigh you, take a urine sample, check your blood pressure and your pulse, as well as ask you a series of questions. We understand that each of these procedures helps our care providers to understand the state of our health, and helps them to make decisions regarding our care. However, most women do not know how each of these procedures gives information to their doctors and midwives. I believe it is important to stay informed as consumers of health care, and urine analysis, as simple a procedure as it is, plays a significant role in the decisions we are expected to consent to. So here I will present the purpose of this particular procedure.

Surprisingly, your urine is a very good indicator of your health. As your body produces hormones, digests substances, and works to develop your baby, the urine excreted contains varying ingredients depending on what goes into your body and how your body uses the input. For instance, if you do not drink enough water and become dehydrated, your urine will become concentrated. It will appear darker, and smell stronger. On the opposite end, drinking an adequate amount of water will make your urine appear light and have very little smell.

In addition to the color and smell, presence of the following substances are tested for: sediment, protein, glucose, ketones, nitrites, blood, leukocytes, bilirubin, pH, and ascorbic acid. Care providers use each of these substances as indicators of the presence of dehydration, malnutrition, infection, and pregnancy conditions like gestational diabetes and preeclampsia. For the purpose of understanding how you can encourage health, and what questions to ask your care provider should an abnormal situation arise, I will now give you a basic description of each of the above substances and what each of them indicates.

Color. Light yellow urine indicates an adequate intake of water, whereas bright or amber tinted urine indicates too little water intake. If you are taking antibiotics or B vitamins, they can also cause your urine to become darker. A greenish tint to urine is common among those who are taking high doses of vitamins. This is not dangerous, instead it is the body’s way of excreting matter it doesn’t need. The last color you should be aware of is orange. Orange urine may be caused by urobilinogen, the indicator of anemia, jaundice and stress on the liver. Other colors – such as red, brown, or black – while rare, indicate severe problems. If you discover this in your urine at any time, please see your doctor.

Cloudiness/Sediment. Normally, urine should be clear. No matter the color, you should be able to see right through it. If you can’t, it may be because of vaginal mucus that washed into the sample. Other causes include the body eliminating excess nutrients, an alkaline pH level, or in the case of the presence of nitrites, it can also indicate infection of the bladder or kidneys.

Leukocytes. Leukocytes are white blood cells. These are the cells your body uses to fight infection. If your body is fighting any infection, whether from a cold, a yeast infection, or an ingrown toenail, leukocytes will die in the process. The dead are then excreted in the urine and therefore indicate than an infection is being fought. Most infections are marked by both leukocytes and nitrites, except yeast infections which are marked by leukocytes alone. You should know, however, that false positive readings of leukocytes are common in pregnancy, so infection should be confirmed by the testing of nitrites and a bacterial count.

pH. pH is a measure o the acidity or alkalinity of a solution. The measure is based on a scale of 1 (most acidic) to 14 (most alkaline). Normal urine has a measure of 6, and so is considered physiologically neutral. If your urine is acidic (lower than 6) it could be for a number of reasons: your diet is high in protein or cranberries, or you may have uncontrolled diabetes. Alkaline urine (higher than 6) can be caused by the following: recent intake of fruits, veggies and dairy products, a bacterial infection, carbohydrate starvation (also marked by ketones), and taking aspirin.

Protein. In the average person, no protein will be detectable in the urine. Occasionally, a trace can be seen for the following reasons: dehydration, mucus in the urine sample, a urinary tract infection, excessive exercise, hypertension, and standing for long periods of time. The condition that care providers are most concerned about when detecting protein in the urine is Toxemia (beginning with preeclampsia and then eclampsia). Toxemia indicates severe stress on the liver and kidneys due to a contracted blood volume. In most cases, this condition disappears within a week after delivery, but it can cause severe problems (and rarely, death) for both the mother and unborn child. Studies show that adjusting the diet to include more protein may decrease stress on the liver and kidneys. If protein is present in your urine, your care provider will discuss with you the other symptoms of Toxemia.

Glucose. As with protein, the ideal amount of glucose in the urine is none. If you have been eating sweets recently, this can cause a spike of glucose in your urine, but this is of virtually no concern. If, however, glucose continues to spill into your urine, your care provider will recommend a test for gestational diabetes, as glucose in the urine is the primary indicator of this condition. You can help to prevent and treat diabetes by cutting all sweets and simple carbohydrates from your diet as much as possible. If you are showing no other signs of diabetes (such as the presence of ketones in your urine), it may just be the natural reduction of the glucose threshold in pregnancy. In this case, taking nettle leaf infusions or capsules can help strengthen your kidneys.

Nitrites. When your urine is tested for nitrites, they are basically testing it for bacteria. Usually, bacteria is the cause of bladder and kidney infections. Therefore, the presence of nitrites is an indication to test for an infection. The most accurate test results come from first morning urine because nitrites need about four hours to incubate in the bladder before they will show up in a urine analysis. However, urine that has been sitting at room temperature for more than half an hour, urine taken from an “unclean” catch, high vitamin c intake, dehydration, drugs that turn urine red, and digestive disorders are all more likely to lead to a false reading of nitrites. It is important to test for nitrites because often it is the first sign of infection (accompanied by painful or frequent urination), which can eventually lead to severe kidney damage.

Ketones. Ketones are a substance that, if excreted in the urine, indicate that your body is burning fat. This could be for two reasons: One, you had a period of unusually intense exertion within the past 12 hours, or because you and your baby are not getting enough to eat. If this happens on a singular occasion, there is probably no reason to worry, but a repeated reading of ketones warns of an impending miscarriage because essentially your baby is getting hungry. To avoid this situation, do not overwork yourself to the point of excessive fatigue, and try not to skip any meals.

Blood. Even if you can’t see any blood, blood cells can appear in your urine. This can mean different thing, depending on whether it is coming from your vagina or urethra. A clean catch can help to determine its origin. Blood coming from the vagina at the end of pregnancy can indicate that your body is preparing for birth. Blood in the urine may indicate an infection (especially when in combination with nitrites and leukocytes), but results may read positive for the following reasons, though they may or may not be anything to concern yourself about: ingestion of aspirin, high doses of vitamin c, anemia, alkaline urine, heavy smoking, and hypertension. By itself, the presence of blood in the urine analysis is probably nothing to be concerned about, but it can help to confirm other findings.

Bilirubin. Bilirubin is not normally seen in the urine. It is excreted by the liver and only appears when the liver or gallbladder are compromised. If found in the urine, your care provider should recommend further blood tests to ensure that your liver and gallbladder are functioning normally. You should be aware, however, that this particular substance can be difficult to read, so if it comes back positive, do not be concerned until you are given more reason to be. Reasons why the test may be falsely negative include high doses of vitamin c, the presence of nitrites in the sample, exposure to the light or if it is left standing at room temperature for too long. False postive readings may be read if you also have diagnostic dyes or certain drug metabolites in your urine.

Ascorbic acid (vitamin c). Because high doses of vitamin c can interfere with so many of the substances being tested for in the urine analysis, some care providers also test for the presence of vitamin c. If it is detected, it may be advisable to repeat the urine test 10 or more hours after the last vitamin c intake (either nutritional or supplemental), in order to get a more accurate reading of the other substances.

You may be wondering how knowing this information really helps you at all. The reason is that although your care provider has a better understanding of the science behind urine analysis, you have a better understanding about the history of your body. Now that you know what causes the results, you’ll know what to ask if something comes back abnormal. Don’t be afraid to ask questions of your care provider, or to offer information about your lifestyle that may have affected the results. You will receive the best care possible if the two of you work together to get the information you need to make good decisions for you and your baby.

Sources:

“Understanding Diagnostic Tests in the Childbearing Year” 6th edition, by Anne Frye

Spirit-Led Childbirth handout http://www.babybirthandbeyond.com

http://www.webmd.com/a-to-z-guides/urine-test?page=4

2009 © Associated Content, All rights reserved.

Website of the Month:

http://www.mayoclinic.com/health/prenatal-testing/PR00014

Book of the Month:

“Pushed: The Painful Truth about Childbirth and Modern Maternity Care” by Jennifer Block

Online Video of the Month

What is Birth a Miracle Services?

Birth a Miracle Services is the name of the birth doula and childbirth education service that I started in 2002.

A birth doula is a person who offers informational, physical, emotional, spousal, and advocacy support to women through pregnancy, birth, and the early postpartum period. I also offer traditional childbirth preparation classes, birth art classes, and childbirth counseling.

All of this is available to women within an hour of my home in West Paris, Maine for a sliding scale fee. Single, teen, and low-income moms can receive my birth doula support for free.

For more information visit my blog: http://birthamiracle.wordpress.com/

Inspired Birth

I am proud to announce the birth of my first book, Inspired Birth: A Fresh Perspective for Christian Maternity Care Providers. It is an inspirational guide for all Christians who attend women in childbirth, with fresh ideas on how to meet the emotional and physical needs of childbearing women while addressing current challenges to American maternity care. This book is still in the editing process and is not currently available for purchase, but if you know any Christians who are doctors, nurses, midwives, or doulas, please let them know that this book is on the way!

Request for Contributions

Next month’s topic is on how to have an easier, faster, and safer birth. If you have anything you would like to contribute, such as what made your birth experience safe or easier than you expected, please email your thoughts with the subject line “Monthly Doula” to Kilbrethfamily@yahoo.com . Thank you!

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To view previous issues of The Monthly Doula, click this link: http://birthamiracle.wordpress.com/category/the-monthly-doula/