Caring For Pregnant Women With Autoimmune Diseases

Pregnant woman are at high risk of severe disease/complications if they do not have immunity to chickenpox (Department of Health – Victoria, 2007). If

The right of every human to a standard of living that ensures health and wellbeing independently of race, religion, geographic location, social status, and political views , is often viewed as a way of guaranteeing individual dignity and development (United Nations).

In general, if medication is required, the lowest dose possible should be used and combination drug therapies and first trimester exposures should be avoided (“Teratogens/Prenatal”, 2008).

Afton is a 31yo, primigravida, who is currently 23 weeks 6 days. She has type 2 diabetes but her A1C coming into pregnancy was just under 6. A recent A1C in June was 6.1. She is currently on insulin with Levemir and NovoLog. She also has chronic HTN and takes labetalol. She is on a baby aspirin for preeclampsia prevention. She has been following in our perinatal diabetes program and we have made some adjustments. Because of her type 2 diabetes she is here today for a fetal ECHO.

Modern medicine continues to bring new technology to its patients and is steering in the direction of “Science Fiction” in some areas. Every individual has to decide if prenatal testing “works” for them, if the result is worth the risk of induced stress, miscarriage and/or fetal limb abnormalities. Psalm 127:3 in the Bible says, “Behold, children are a gift of the LORD, The fruit of the womb is a

458). Not to mention the concern involving “fetal injury, control and convenience” (Ramachandrappa & Jain, 2009, para. 7). Obstetric-based or maternal-based reasons need to be discussed honestly between the patient and physician carefully.

Jaclyn is 23 years old single African American mother who has her four year old son enroll at Berean Head Start Centers, one of the programs under the umbrella of Total Community Action, INC of New Orleans. One of the requirements is that families who have children enroll at any of the Head Start or Early Start Programs parents are to meet with the Social Worker or the Family Service Worker to complete a Partnership Agreement. The Partnership Agreement is to help families set reachable goals in an attempt to enrich their future and provide a better quality of life for them and their children. Jaclyn came into the center to update her partnership agreement; during this interview we learn that she had been to the doctor that morning, when the she was told by her doctor that she is four months pregnant with her second child. Jaclyn “stated she is not ready to have another baby at this time”, however her son always asks her when he is going to have a brother or sister to play with. Jaclyn also revealed she has gained excessive weight and have been diagnosed with hypertension, “Jaclyn stated she is experiencing bad headache during the day when she is working, and she is not sure how long she will able to work with these bad headache”. Recently Jaclyn’s mother has been bringing her grandson to school. I inquired about Jaclyn; “she stated Jaclyn is in on bed rest, with complication in her pregnancy”.

The health burden of the sickness is also a tertiary outcome. The rate of severity of symptoms ranges from life threatening to mild sickness. For perceived maternal sickness: questions will be asked to determine women’s perceptions of any symptom or sickness during the antenatal, delivery, and the postnatal period for their most recent (index) pregnancy will be

Have you ever heard of the disorder spina bifida? Well, if you have not, you should learn many interesting facts about this particular defect. Spina bifida is the most common neural birth disorder; affecting a little over 1,500 babies every year, in the United States alone. There are three stages of spina bifida, spina bifida occulta, Meningocele, and Myelomeningocele. The last stage, ‘Myelomeningocele’, is the worst stage of spina bifida.

When a woman is a single mother raising one or more children with autism, they are constantly stressed and overwhelmed even though they love their children. But, when a female goes to the doctor’s office, currently pregnant, and is told that her offspring has a higher risk of developing autism due to the environmental factors or medications around her lifestyle, it is shocking and heartbreaking to a woman. The medications in current vaccines for children are extremely harmful to children and exede the normal guidelines for the amount of medications able to be given (Wakefield). It is not even the vaccine itself, but also the specific components of certain medicines that lead to prenatal and postnatal complications.

As Page (2000) states, in providing woman centred care, it is important to understand the woman together with her values, worries and hopes for her pregnancy. In Jill’s case, it was important for the midwife and student to approach her as a pregnant woman and not as woman with diabetes who

Being pregnant for the first time has made me aware of a phenomenon that I am convinced only a pregnant woman can truly understand. I call it “the open-season-on-pregnant-women syndrome,” for lack of a better name. Early in my pregnancy, my older sister warned me that having a baby is not the private affair I had always assumed it would be. Despite millions of years of babies, the idea of a new life is still fascinating enough to make even strangers want to share in the excitement and responsibility. To put it simply, the pregnant woman, and her fetus, are public domain.

MMF is now a first-line agent for the treatment of lupus nephritis, transplantation and NMO [37,41,42]. Although, its teratogenicity causes a typical clinical syndrome in the fetus, including hypoplastic nails, shortened fifth fingers, diaphragmatic hernia, microtia, micrognathia, cleft lip and palate and congenital heart defects [43]. Thus, it is strongly recommended against using this drug as a first-line agent in women in reproductive age. Switching from MMF to safer immunosuppressive drugs such as azathioprine, ciclosporin and tacrolimus at least 3 months before conception seems more reasonable [35].

Use of certain medications such as the use of anti-seizure medication (topiramate or valproic acid) in the first trimester or methotrexate (cancer/arthritis/psoriasis treating drug)

Relative contraindications include: bleeding disorders, vascular disease, diabetes, taking blood thinners, compromised immune system, pregnancy in the first trimester, TDN