Bird Flu

To date, few people in the world have been infected with avian influenza H5N1, also called bird flu. Research shows most of these people worked closely with birds infected with the disease; they caught it from the birds themselves, not from other people.

At this time, the average American doesn’t have to be concerned with catching bird flu. No special precautions are called for. Health authorities keep a close watch on the disease in birds and humans. Researchers continue to work on a vaccine.

If you want to be cautious, wash your hands with soap and hot water, or use a hand sanitizer, after handling any birds. This is sound advice to help prevent the spread of any type of germs from the bird to you.

Laparoscopy during Pregnancy

As many as 2% of all pregnancies are complicated by a surgical problem. The most common surgical condition during pregnancy is appendicitis. Other surgical emergencies include cholecystitis, intestinal obstruction, ovarian cysts and ovarian torsion.

The second trimester is generally the safest time to perform surgery. Advantages of laparoscopic surgery include small incisions resulting in faster recovery, early return of bowel and gastrointestinal activity, smaller scars, less pain (requiring less pain medicine) and shorter hospitalization.

Laparoscopy may not always be the best choice. As the uterus gets bigger, it may not be possible. However, we can’t give you an exact time or week of pregnancy when laparoscopy can no longer be done. It’s an individual decision in each case.

Cancer and Pregnancy

Pregnancy is a happy time for most women. Occasionally, however, serious problems can occur. Cancer in pregnancy is one serious complication that occurs rarely.

This discussion is included not to scare you but to provide you with information. It is not a pleasant subject to discuss, especially at this time. However, every woman should have this information available.

• to inform you of a serious problem that can occur during pregnancy

• to provide you with a resource to help you form questions for a dialogue with your healthcare provider, if you wish to discuss it

If you’re now pregnant and you have had cancer in the past, tell your healthcare provider as soon as you find out you’re pregnant. He or she may need to make decisions about individualized care for you during pregnancy.

Cancer during Pregnancy. Tremendous changes affect your body during pregnancy. Some researchers believe cancers influenced by increased hormones may increase in frequency during pregnancy. Increased blood flow may increase cancer to other parts of the body. Body changes during pregnancy can make it difficult to find or to diagnose an early cancer.

When cancer occurs during pregnancy, it can be very stressful. The healthcare provider must consider how to treat the cancer, but he or she is also concerned about the developing baby.

How these issues are handled depends on when cancer is discovered. A woman’s concerns may include the following.

• Will the pregnancy have to be terminated so the cancer can be treated?

• Will treatment or medications harm the baby?

• Will the malignancy affect the baby or be passed to the baby?

• Should therapy be delayed until after delivery or after termination of the pregnancy?

Cancer during pregnancy is a rare occurrence; it must be treated on an individual basis. Some cancers found during pregnancy include breast tumors, leukemia, lymphomas, melanomas, bone tumors and cancer of female organs, such as the cervix, uterus and ovaries.

Anticancer drugs stop cell division to help fight the cancer. If taken during the first part of pregnancy, they can affect cell division of the embryo.

Breast Cancer. Breast cancer is uncommon in women younger than 35. Fortunately, it’s a rare complication of pregnancy. However, breast cancer is the most common type of cancer diagnosed during pregnancy. Of all women who have breast cancer, about 2% are pregnant at the time of diagnosis.

During pregnancy, it may be harder to discover breast cancer because of changes in the breasts. Most evidence indicates pregnancy does not increase the rate of growth or spread of a breast cancer.

Studies indicate pregnancy is safe in women with a history of breast cancer if the cancer has been successfully treated. Treatment of breast cancer during pregnancy varies. It may require surgery, chemotherapy and/or radiation. Recent studies indicate chemotherapy for breast cancer during pregnancy may be safe.

A form of breast cancer you should be aware of is inflammatory breast cancer (IBC). Although rare, it can occur during and after pregnancy, and may be mistaken for mastitis, which is inflammation of the breast. Symptoms of inflammatory breast cancer include swelling or pain in the breast, redness, nipple discharge and/or swollen lymph nodes above the collarbone or under the arm. You may feel a lump, although one is not always present.

If you experience any of these symptoms, do not panic! Nearly all of the time it will be a breast infection related to breastfeeding. However, if you’re concerned, contact your healthcare provider. A biopsy is used to diagnose the problem. To learn more about IBC, visit www.ibcsupport.org.

Other Cancers. Cervical cancer is believed to occur about once in every 10,000 pregnancies. However, about 1% of the women who have cancer of the cervix are pregnant when it’s diagnosed. Cancer of the cervix is curable, particularly when found and treated in its early stages.

Malignancies of the vulva, the tissue surrounding the vaginal opening, have also been reported during pregnancy. It is a rare complication.

Hodgkin’s disease (a form of cancer) commonly affects young people. It is now being controlled for long periods with radiation and chemotherapy. The disease occurs in about 1 of every 6000 pregnancies. Pregnancy does not appear to have a negative effect on the course of Hodgkin’s disease.

Pregnant women who have leukemia have demonstrated an increased chance of premature labor or increased bleeding after pregnancy. Leukemia is usually treated with chemotherapy or radiation therapy.

Melanoma is a cancer derived from skin cells that produce melanin (pigment). A malignant melanoma can spread through the body. Pregnancy may cause symptoms or problems to worsen. A melanoma can spread to the placenta and baby.

Bone tumors are rare during pregnancy. However, two types of noncancerous bone tumors can affect pregnancy and delivery. These tumors, endochondromas and benign exostosis, can involve the pelvis; tumors may interfere with labor. The possibility of having a Cesarean delivery is more likely with these tumors.

It may be harder to lose your pregnancy weight after having twins, so stick to the weight goal your healthcare provider gives you. In addition, carrying two babies causes more changes in your body, which may cause you to hold onto the weight you gain during pregnancy.

7. Exercise for Week 32


One exercise you can do during pregnancy may help during labor. Using your diaphragm to breathe is beneficial to you. These are the muscles you will use during labor and delivery. Breath training decreases the amount of energy you need to breathe, and it improves the function of your respiratory muscles. Practice the different breathing exercises below for benefits in the near future (labor and delivery!).

• Breathe in through your nose, and exhale through pursed lips. Making a little whistling sound is OK. Breathe in for 4 seconds, and breathe out for 6 seconds.

• Lie back, propped on some pillows, in a comfortable position. Place your hand on your tummy while breathing. If you breathe using your diaphragm muscles, your hand will move up when you inhale and down when you exhale. If it doesn’t, try using different muscles until you can do it correctly.

• Bend forward to breathe. If you bend slightly forward, you’ll find it’s easier to breathe. If you feel pressure as your baby gets bigger, try this technique. It may offer some relief.

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