ULTRASOUND EVALUATION OF CONGENITAL CERVIAL TERATOMA AND THERAPEUTIC MANAGEMENT (EX.

UTERO INTRAPARTUM TREATMENT)

The ultrasound evaluation of the fetal neck has a high importance as a key point of the airway and digestive tract. We report the case of a fetus diagnosed with a cervical teratoma by ultrasound, which generated a compressive effect on airway, requiring a surgical approach EXIT (ex utero intrapartum treatment) to ensure the extrauterine viability. The ultrasound evaluation of the fetal neck is increasingly important, because it has a high impact on fetal adaptation to extrauterine life. The presence of masses in this location can cause obstructive problems at airway, producing complications during the course of pregnancy, as the development of polyhydramnios. But the biggest problem is after delivery, with the appearance of acute neonatal asphyxia with newborn death, if you do not carry out invasive techniques for resolution. One of these approaches is the realization of EXIT surgery, a technique designed to allow partial fetal delivery by cesarean section, with establishment of a secure airway, using intubation, bronchoscopy, or tracheostomy, while fetal oxygenation is maintained by the uteroplacental circulation.

Reference: Case Reports in Obstetrics and Gynecology, Volume 2012 (2012), Article ID 597489, 4 pages, doi:10.1155/2012/597489

REACTION ULTRASOUND EVALUATION OF CONGENITAL CERVIAL TERATOMA AND THERAPEUTIC MANAGEMENT (EX.UTERO INTRAPARTUM TREATMENT)

The EXIT approach is an appropriate tool in the congenital airway obstruction management, because it allows the fetal adaptation into extrauterine life. This procedure requires a multidisciplinary participation, it involves many professionals from different specialties, with a preoperative detailed planning. The detailed followup during the pregnancy is very important, you must be always conscious of the maternal-fetal wellbeing during the process. At the same time, the ultrasound and MRI evaluation give to you the diagnosis and management option of congenital cervical pathology, as the case presented. Our therapeutic decision was based on the information obtained by ultrasonic monitoring.

WORKING AFTER EIGHT MONTHS OF PREGNANCY IS AS SMOKING, STUDY FINDS Working after eight months of pregnancy is as harmful for babies as smoking, according to a new study. Women who worked after they were eight months pregnant had babies on average around 230g (0.5lb) lighter than those who stopped work between six and eight months. The University of Essex research which drew on data from three major studies, two in the UK and one in the US found the effect of continuing to work during the late stages of pregnancy was equal to that of smoking while pregnant. Babies whose mothers worked or smoked throughout pregnancy grew more slowly in the womb. Past research has shown babies with low birth weights are at higher risk of poor health and slow development, and may suffer from a variety of problems later in life. Stopping work early in pregnancy was particularly beneficial for women with lower levels of education, the study found suggesting that the effect of working during pregnancy was possibly more marked for those doing physically demanding work. The birth weight of babies born to mothers under the age of 24 was not affected by them continuing to work, but in older mothers the effect was more significant. The researchers identified 1,339 children whose mothers were part of the British Household Panel Survey, which was conducted between 1991 and 2005, and for whom data was available. A further sample of 17,483 women who gave birth in 2000 or 2001 and who took part in the Millennium Cohort Study was also examined and showed similar results, along with 12,166 from the National Survey of Family Growth, relating to births in the US between the early 1970s and 1995. The research, conducted by three economists, Francesconi, Emilia Del Bono and John Ermisch, is published in the July edition of the Journal of Labour Economics, published by the University of Chicago. Reference: http://www.guardian.co.uk/lifeandstyle/2012/jul/28/working-eight-monthspregnancy-smoking Date Retrieved: January 25, 2013 Time Retrieved: 8:11 am

REACTION WORKING AFTER EIGHT MONTHS OF PREGNANCY IS AS SMOKING, STUDY FINDS Generally, if you exercised throughout your pregnancy and had a normal vaginal delivery, you can safely do light exercisewalking, modified push-ups, and stretchingwithin days of giving birth. But if you weren't active during your pregnancy, or tapered off your fitness routine as the weeks went on, check with your doctor or midwife before you begin exercising. Although some women develop a gap in their abdominal muscles as their belly expands during pregnancy and labor, a condition called diastasis recti. It takes four to eight weeks after giving birth for this gap to close. So I guess, working after the delivery of the baby is alright, but just don't overdo it for the first few months after giving birth. Since you just gave birth, your body needs time to heal, and you need time to adjust to your new roleand bond with your baby.

PRENANCY INCREASES HEART ATTACK RISK CHICAGO Heart attacks are often linked to high blood pressure, diabetes and smoking. But a new study suggests pregnancy can also increase the risk. There are significant hormonal changes that occur during pregnancy that affect the coronary arteries, said study author Dr. Uri Elkayam, professor of medicine, cardiology, and obstetrics and gynecology at the University of Southern California. Heart attacks are usually triggered by atherosclerosis a build-up of plaque that narrows the arteries and makes it harder for blood to flow. But only a third of heart attacks that occur during pregnancy are caused by atherosclerosis, Elkayam said. Rather the vast majority are caused by a tear of one of the three layers that make up a blood vessel known as a dissection. Seventy percent of spontaneous coronary dissections occur in women and 30 percent of those occur during pregnancy or immediately after, according to Dr. Sharonne Hayes, a cardiologist at the Mayo Clinic in Rochester, Minn. who was not involved in the study. We have known for decades that young women with heart attack have higher mortality than men at the same age and also have very different cardiovascular disease risk factors, she said. Elkayam found that performing a coronary angiogram, in which you inflate a balloon and place a stent, in 5 percent of the patients made things worse In patients who are stable, we advise to evaluate the patient non-invasively, and only the high risk patient should undergo a cardiac catherization, he said. A heart attack occurring in a young, previously healthy young woman is very unusual, with a reported incidence of 1/16,000. Elkayam emphasized that women should not be afraid to become pregnant because the incidence of a heart attack is very small.

Reference: Ike S. Okwuosa, MD, ABC News, Mar 25, 2012 3:27pm

REACTION PRENANCY INCREASES HEART ATTACK RISK I dont believe pregnancy has anything to do with Heart attacks. ABC News sensational headline falsely promotes the services of Planned Parenthood. Bungee jumping can promote a heart attack, so can flying in a plane for long periods without moving. Life in of itself has inherent risk. The title of the article should of been from this statement, Elkayam emphasized that Women should not be afraid to become pregnant because the incidence of a heart attack is very small. I believe that it is the food that woman eat before, during and after pregnancy. Think about it! How many woman that eat healthy and exercise normally, do you see have heart attacks ever in their life and have had up to at least 5 children. Come on this is just another scare from scientists and the government to try to control the population. GOD gave women the bodies to reproduce! It is up to us women to keep ourselves healthy to prevent heart disease and other problems.

POSSIBLE LINK BETWEEN FLU DURING PREGNANCY & AUTISM IS ANOTHER REASON TO GET YOUR FLU SHOT If you have been going back and forth over whether or not you should get a flu shot during your pregnancy, then a new Danish study may convince you to roll up your sleeve without hesitation once and for all. A new study has found a potential link between kids whose moms had the flu while pregnant and autism. Research showed that moms who had the flu during pregnancy have a slightly higher risk of their child being diagnosed with infantile autism before the age of 3. And as for why having the flu could possibly make your child more likely to have autism? Researchers say that when a mother's immune system is affected by the flu, it can potentially have an effect on the baby's brain development. Ok, so you've probably stopped reading at this point and are rushing to the phone to call your doctor and schedule your flu shot, right? Because you'd think if there was enough of a concern for researchers to conduct this study, it must be something they are pretty worried about. Interestingly enough, the doctor in charge of the study stressed that 99 percent of moms who had the flu DO NOT have autistic children -- that's how small the possible link is -- and she doesn't think this is anything pregnant women should worry about or panic over. Whew. That's a relief. But wait a minute -- does that mean pregnant women should get the flu shot, or not? Based on this new research, I'd say it can't hurt to go ahead and have one, regardless of how tiny the link between the flu and autism may be. If nothing else, getting the shot will give you one less thing to worry about and stress over, which is a break that every expectant mom definitely needs. Have you had your flu shot yet?

REACTION AUTISM LINKED TO FLU DURING PREGNANCY, STUDY FINDS Flu shots are not "full of mercury" They have less significantly than a single serving of fish, and it's in a form that has been PROVEN to be completely benign to the human body. And saying that healthy living can lessen your chances of getting a virus is the same as the people a century ago saying that moral living can keep you from getting sick. A virus is a virus. If you don't have the immunity, then exposures over the threshold will make you get sick. But I know, you FEEL, and that's far more important than double-blind scientific study. Silly me, trusting facts instead of inflamatory rhetoric. Yes lets go get a flu shot full of mercury and countless other potentially harmful chemicals that have NOT been tested on pregnant women for the less than 1% chance that getting the flu will harm our unborn child. That is less than 1% chance of harm IF you get the flu. Practice healthy habits, eat healthy and you will greatly decrease your chances of getting the flu too without the possible harmful side effects of the chemicals in the vaccine.

NO RISKS SEEN WITH FLU SHOT IN EARLY PREGNANCY Adding to evidence that the flu shot is safe for pregnant women, a new study finds no link between the vaccine and the risk of serious birth defects. The study, of nearly 9,000 pregnant women who got the flu shot, found that about 2 percent had a baby with a major birth defect, such as a malformation in the heart or a cleft lip. That was identical to the rate among almost 77,000 pregnant women who did not get the vaccine. What's more, researchers found, women who got vaccinated were less likely to suffer a stillbirth (a pregnancy loss after the 20th week): 0.3 percent did, versus 0.6 percent of unvaccinated women. Their newborns also had a lower death rate: 0.2 percent died soon after birth, compared with 0.4 percent of babies born to unvaccinated moms. It's not clear if the flu vaccine deserves the credit. But Dr. Jeanne S. Sheffield, the lead researcher on the work, said it's possible the vaccine helped by preventing severe cases of the flu. "Can we say for sure that it's the vaccine? No," said Sheffield, a professor of obstetrics and gynecology at the University of Texas Southwestern Medical Center in Dallas. But, she added, these findings suggest that the flu shot is at least safe, and possibly has a benefit against stillbirth. Sheffield and her colleagues report the findings in the journal Obstetrics & Gynecology. The Centers for Disease Control and Prevention (CDC) and other groups recommend that all pregnant women get a seasonal flu shot. That's because pregnant women are more likely than other women their age to get a severe case of the flu or have complications, such as pneumonia. The flu is also thought to raise the risk of preterm delivery and fetal distress.

Still, Sheffield said, many women and doctors alike still have concerns about flu vaccine safety during pregnancy - especially the first trimester, which is when birth defects form and when most miscarriages happen. But in this study, the researchers found that vaccination during the first trimester came with no increased risk of birth defects. Despite recommendations to get the flu shot, most pregnant women do not. In the U.S., only between 10 percent and one-quarter of women have been vaccinated each flu season over the last couple decades, Sheffield's team notes. Based on studies, that seems largely due to safety worries. On the other hand, Sheffield said "it's amazing" how many women are unaware that the flu itself is considered a risk during pregnancy. "The flu is a problem in pregnancy," she said. "But we have a vaccine to prevent it. And it's considered safe and effective in any trimester." A CDC study published last year found "no unusual patterns" of pregnancy complications or newborn health problems among U.S. women who received the flu shot between 1990 and 2009. Based on cases reported to the CDC's Vaccine Adverse Event Reporting System, the rate of miscarriage was 1.9 per one million vaccinated pregnant women.

Reference: http://www.foxnews.com/health/2012/08/28/no-risks-seen-with-flu-shot-in-earlypregnancy/#ixzz2IwkCMYu6 Date Retrieved: January 25, 2013 Time Retrieved: 9:31am

REACTION NO RISKS SEEN WITH FLU SHOT IN EARLY PREGNANCY

Seriously? In the past moths I have read some articles saying that if you are fat you'll have a kid with autism, if you vaccinate, if you use you cell phone, if you use microwave, all we needed for those paranoid mom is another thing, the truth is that no one knows for sure, so let's stop guessing, for the sake of millions of new moms who are pressured enough from the media. There are moms who didn't get a flu shot when theyre pregnant yet still ended up with an autistic child. Ive asked a common friend who has an autistic child, she says that watching his son and seeing firsthand how it has affected his sons life and how his son acts, she personally believe that there is no ONE thing that causes it. Have any of you ever heard that there are no two Autistics that are the same? It's because no two act or react identically to anything. That is part of the reason why it is so hard to diagnose in the first place. A lot of the possible symptoms could be something else. It's not like there is a blood test that can be done to show it. I also believe it has been around for longer than what they have been diagnosing it for, they just didn't have a name for it and they didn't care. Up until recently (historically speaking) people with any kind of mental illness where put in mental institutions and forgotten. Those people where simply labeled "retarded" and left to rot. I never had a flu shot and I never will, and considering that the number of autistic kids is on the rise, it makes more sense that flu shot increases the risk considering that 20 years ago no one was getting flu shots!

In Partial Fulfilment of the Requirement for NCM 102 First Semester AY 2012 2013

Submitted By: Jarin, Mary Joy M. BSN 2A

Submitted to: Cerina Joy Alarca R.N., M.A.N

January 25, 2013