Preeclampsia and Eclampsia

What are preeclampsia and eclampsia?
Preeclampsia is a syndrome marked by a sudden increase in the blood pressure of a pregnant woman after the 20th week of pregnancy. It can affect the mother’s kidney, liver, and brain. If left untreated, the condition can be fatal for the mother and/or the baby and can lead to long-term health problems.

Eclampsia is a more severe form of preeclampsia that can cause seizures and coma in the mother.
What are the symptoms of preeclampsia?
Possible signs of preeclampsia include:

* High blood pressure
* Too much protein in the urine
* Swelling in a woman’s face and hands (a woman’s feet might swell too, but swollen feet are common during pregnancy and may not signal a problem)
* Systemic problems, such as headache, blurred vision, and abdominal pain

What is the treatment for preeclampsia?
The only cure for preeclampsia is delivering the fetus.

If preeclampsia develops, the health care provider may develop a plan to try to prolong the pregnancy to give the fetus more time to grow and mature. At the same time, the health care provider will closely watch the health of the mother for signs that the fetus needs to be delivered right away, even prematurely, if necessary. If the preeclampsia is severe enough and the fetus is not delivered, the mother could die. Health care providers will take steps to prevent the condition from being fatal for mother and baby.

If you have questions about preeclampsia and delivery, talk to your health care provider.
What are the risk factors for preeclampsia?
There is no proven way to prevent preeclampsia. But some women are more likely to develop it, including:

* Women who have high blood pressure before becoming pregnant
* Women who had high blood pressure or preeclampsia in previous pregnancies
* Women who are obese
* Women younger than age 20 or older than age 40
* Women who are pregnant with more than one baby
* Women with certain health conditions, such as diabetes or kidney disease

Know more on Preterm Labor and Birth

What are preterm labor and birth?
Preterm labor (also called premature labor) is labor that begins before 37 weeks of pregnancy. Because the fetus is not fully grown at this time, it may not be able to survive outside the womb. Health care providers will often take steps to try to stop labor if it occurs before this time.

A baby born before 37 weeks of pregnancy is considered a preterm birth (or premature birth).
Who is at risk for preterm labor and birth?
Health care providers currently have no way of knowing which women will experience preterm labor or deliver their babies preterm. But there are factors that place a woman at higher risk for preterm labor or birth:

* Certain infections, such as bacterial vaginosis and trichomoniasis
* Shortened cervix
* Previously given birth preterm

What are the challenges to a baby born preterm?
Premature infants may face a number of health challenges, including:

* Low birth weight
* Breathing problems because of underdeveloped lungs
* Underdeveloped organs or organ systems
* Greater risk for life-threatening infections
* Greater risk for a serious lung condition, known as respiratory distress syndrome
* Greater risk for cerebral palsy (CP)
* Greater risk for learning and developmental disabilities

What methods are used to prevent preterm delivery?
Research supported by the NICHD found that treating high-risk pregnant women (those who have previously had a spontaneous preterm baby) with a certain type of progesterone reduces the risk of another preterm delivery. The treatment worked among all ethnic groups in the study and improved outcomes for the babies. Efforts to find out whether the treatment works for other at-risk women, such as those having twins and triplets, are ongoing.

Bed rest and medications that relax the muscles in the uterus are also commonly used to try to stop preterm labor.

All About Migraine

What is Migraine?

The pain of a migraine headache is often described as an intense pulsing or throbbing pain in one area of the head. It is often accompanied by extreme sensitivity to light and sound, nausea, and vomiting. Migraine is three times more common in women than in men. Some individuals can predict the onset of a migraine because it is preceded by an "aura," visual disturbances that appear as flashing lights, zig-zag lines or a temporary loss of vision. People with migraine tend to have recurring attacks triggered by a lack of food or sleep, exposure to light, or hormonal irregularities (only in women). Anxiety, stress, or relaxation after stress can also be triggers. For many years, scientists believed that migraines were linked to the dilation and constriction of blood vessels in the head. Investigators now believe that migraine is caused by inherited abnormalities in genes that control the activities of certain cell populations in the brain.
Is there any treatment?

There are two ways to approach the treatment of migraine headache with drugs: prevent the attacks, or relieve the symptoms during the attacks. Many people with migraine use both approaches by taking medications originally developed for epilepsy and depression to prevent future attacks, and treating attacks when they happen with drugs called triptans that relieve pain and restore function. Hormone therapy may help some women whose migraines seem to be linked to their menstrual cycle. Stress management strategies, such as exercise, relaxation, biofeedback, and other therapies designed to help limit discomfort, may also reduce the occurrence and severity of migraine attacks.
What is the prognosis?

Taking a combination of drugs to prevent and treat migraine attacks when they happen helps most people with migraine to limit the disabling effects of these headaches. Women whose migraine attacks occur in association with their menstrual cycle are likely to have fewer attacks and milder symptoms after menopause.
What research is being done?

Researchers believe that migraine is the result of fundamental neurological abnormalities caused by genetic mutations at work in the brain. Investigations of the more rare, familial subtypes of migraine are yielding information about specific genes and what they do, or don't do, to cause the pain of migraine headache. Understanding the cascade of biological events that happen in the brain to cause a migraine, and the mechanisms that underlie these events, will give researchers opportunities to develop and test drugs that could prevent or interrupt a migraine attack.

All About PCOS

What is PCOS?

Polycystic ovary syndrome (PCOS) is a hormone imbalance that can cause irregular periods, unwanted hair growth, and acne. PCOS begins during the teenage years and can be mild or severe.

What are the signs of PCOS?

Young women with PCOS commonly have one or more signs. Some of the most common signs include:

* irregular periods – periods that come every few months, not at all, or too often
* extra hair on your face or other parts of your body, called “hirsutism” (her-suit-is-em)
* acne
* weight gain and/or trouble losing weight
* patches of dark skin on the back of your neck and other areas, called “acanthosis nigricans” (a-can-tho-sis ni-gri-cans)

Could I have PCOS?
If you have some or all of the above signs, you might have PCOS. There may be other reasons why you might have one or more of these signs. Only your doctor can tell for sure. If you do have PCOS, you'll want to know what causes it and how to treat it. Check out this quiz to help you find out if you might have PCOS.

What causes PCOS?

No one knows the exact cause of PCOS. Still, we do know that PCOS results from an imbalance in the hormones in your brain and your ovaries. Hormones are natural body chemicals that affect or control other parts of your body. Many girls with PCOS also have too much insulin. Insulin is a hormone that helps turn food into energy. It may be that the ovaries react to this extra insulin by making too much testosterone, which is also a hormone. This can lead to acne, excess body hair, weight gain, and irregular periods.

1. The pituitary (pi-tu-i-tary) gland in your brain makes the luteinizing (lu-tin-iz-ing) hormone and the follicle (fall-ih-call)-stimulating hormone (LH and FSH).
2. After getting the signal from the LH and FSH hormones, the ovaries make estrogen (es-tro-gen) and progesterone (pro-ges-ter-one), the female sex hormones. All normal ovaries also make a little bit of the androgen testosterone (an-dro-gen teh-stass-tuh-rone), the male sex hormone.
3. The pancreas (pang-cre-us) is an organ that makes the hormone insulin. High levels of insulin can also cause the ovaries to make more of the testosterone hormone.

Why are my periods so irregular?

Having PCOS means that your ovaries are not getting the right hormonal signals from your pituitary gland. Without these signals, you will not ovulate (make eggs). Your period may be irregular or you may not have a period at all.

Let’s review a regular menstrual cycle.

* The menstrual cycle starts when the brain sends LH and FSH to the ovaries. A big surge of LH is the signal that tells the ovaries to ovulate, or release a ripe egg.
* The egg travels down the fallopian tube and into the uterus. Progesterone from the ovary tells the lining of the uterus to thicken.
* If the egg isn't fertilized, the lining of the uterus is shed. This shedding is your menstrual cycle or period.
* After the menstrual period, the cycle begins all over again.




The diagram on top shows a normal menstrual cycle. The diagram on the bottom shows a PCOS cycle where the menstrual cycle stops just before ovulation. As a result, girls with PCOS may ovulate occasionally or not at all. Their periods may be too close together or, more often, too far apart. Some girls may not get a period at all.

Now, let's look at what happens during a menstrual cycle with PCOS.

* With PCOS, LH levels are often high when the menstrual cycle starts. The levels of LH are also higher than FSH levels.
* Because the LH levels are already quite high, the surge that sets off the chain reaction causing ovulation does not happen. Without this LH surge, ovulation does not occur and periods are irregular.

What types of tests will my doctor do to diagnose PCOS?

Your doctor will ask you a lot of questions about your menstrual cycle and your general health and then do a complete physical examination. You most likely will need to have a blood test to check your hormone levels, as well as your blood sugar and cholesterol levels. Your doctor may also want you to have an ultrasound test of your uterus and ovaries. An ultrasound creates images so the doctor can see what's happening inside your body.
Does PCOS mean I have cysts on my ovaries?

The term "polycystic ovaries" means that there are lots of tiny cysts, or bumps, inside of the ovaries. Some young women with PCOS have these cysts; many others do not. Even if you do have them, they are not harmful and do not need to be removed.
Why do I get acne and/or extra hair on my body?

Acne and extra hair on your face and body can happen if your body is making too much testosterone. All women make testosterone, but if you have PCOS, your ovaries make a little bit more testosterone than they are supposed to. Skin cells and hair follicles are extremely sensitive to the slight increases in testosterone found in young women with PCOS.
Why do I have patches of dark skin?

Many adolescents with PCOS have higher levels of insulin in their blood. Higher levels of insulin can sometimes cause patches of darkened skin on the back of your neck, under your arms, and in your groin area (inside upper thighs).
Will PCOS affect my ability to have children some day?

Women with PCOS have a normal uterus and healthy eggs. Many women with PCOS have trouble getting pregnant, but some women have no trouble at all. If you are concerned about your fertility (ability to get pregnant) in the future, talk to your doctor about all the new options available, including medications to lower your insulin levels and to help you ovulate each month.
Does PCOS put me at risk for other conditions?

If you have PCOS, you may be at higher risk for other health problems. Women with PCOS often have low levels of the hormone progesterone. Progesterone causes the endometrium to shed each month as your period. If you don't have enough progesterone, the endometrium becomes thick, which can cause heavy or irregular bleeding. In time, this can lead to endometrial hyperplasia or cancer for some women. Women with PCOS are also at higher risk for diabetes, high cholesterol, high blood pressure, and heart disease. Getting your PCOS symptoms under control at an early age may help to reduce this risk.

What can I do about having PCOS?

While you can't cure PCOS, you can treat it. A healthy lifestyle is very important, including healthy eating and daily exercise. There are excellent long-term medications to help you manage irregular periods, hair growth, and acne. Ask your doctor about the various options, including hormone treatment and insulin-sensitizing medications. For more information on healthy eating and daily exercise if you have PCOS, read this Healthy Lifestyle Guide.

What is the treatment for PCOS?

The most common form of treatment for PCOS is the birth control pill. Birth control pills contain hormone medicine. Your doctor may prescribe birth control pills because they contain the hormones that your body needs to treat your PCOS. By taking the birth control pill either continuously or in cycles you can:

* correct the hormone imbalance
* lower the level of testosterone which will improve acne and lessen hair growth
* regulate your menstrual periods
* lower the risk of endometrial cancer (which is higher in young women who don’t ovulate regularly)

Is there any other medicine to treat PCOS?
Metformin is a medicine that helps the body lower the insulin level. It is especially helpful in girls who have high levels of insulin or have pre-diabetes or diabetes. If you have PCOS, your doctor may also ask you to take an oral glucose tolerance test which measures your body's ability to use glucose. This will help your doctor find out if you are more likely to get diabetes. You will need to have your kidney and liver function checked before taking metformin. It is important to discuss with your doctor whether this medicine is right for you. Sometimes girls are treated with both metformin and birth control pills at the same time. If you are getting ready to have a glucose tolerance test, read this guide to help you prepare for the test and understand what the results might mean.

Ask your doctor about treating hair growth
Only you and your doctor can decide which treatment is right for you. Options may include bleaching, waxing, depilatories, spironolactone (spi-ro-no-lac-tone) which is an anti-hair growth medication, electrolysis, and laser treatment.

Ask your doctor about treatment for acne
There are various ways to treat acne, including the birth control pill, topical creams, oral antibiotics, and other medications.

Ask your doctor about a weight loss plan
If you are overweight, losing weight may reduce some of the symptoms of PCOS. Talk to your doctor or nutritionist about healthy ways to lose weight and increase your exercise. Following a nutrition plan that helps manage insulin levels may help girls with PCOS manage their weight too. It also keeps your heart healthy and lowers your risk of developing diabetes.

* Choose nutritious, high-fiber carbohydrates instead of sugary carbohydrates.
* Balance carbohydrates with protein and healthy fats.
* Eat small meals and snacks throughout the day instead of large meals.
* Exercise regularly to help manage insulin levels and your weight.

What if I have worries about having PCOS?

If you have been told you have PCOS, you may feel frustrated or sad. You may also feel relieved that at last there is an explanation and treatment for the problems you have been having with keeping a healthy weight, having excess body hair, acne, or irregular periods. Having a diagnosis without an easy cure can be difficult. However, it is important for girls with PCOS to know they are not alone. Finding a doctor who knows a lot about PCOS and who you feel comfortable talking to is very important. Keeping a positive attitude and working on a healthy lifestyle even when results seem to take a long time is very important too! Many girls with PCOS tell us that talking with a counselor about their concerns can be very helpful. Other girls recommend Internet chats.

What else do I need to know?

It is important to follow-up regularly with your doctor and make sure you take all the medications prescribed to regulate your periods and lessen your chance of getting diabetes and other problems. Because you have a slightly higher chance of developing diabetes, your doctor may suggest that you have your blood sugar tested once a year or have a glucose challenge test every few years. Quitting smoking (or never starting) will also improve your overall health.

Symptoms of stomach cancer

In most cases symptoms of stomach cancer are not easy to find out. As the cancer grows to a stage, the most common symptoms are:
uneasiness in the stomach area
Feeling full or overstuffed after a small meal
sickness and vomiting
Weight loss

Studies have found the following risk factors for stomach cancer:

Age: Most people with this disease are 72 or older.

Sex: Men are more likely than women to develop stomach cancer.

Race: Stomach cancer is more common in Asian, Pacific Islander, Hispanic, and African Americans than in non-Hispanic white Americans.

Diet: Studies suggest that people who eat a diet high in foods that are smoked, salted, or pickled may be at increased risk for stomach cancer. On the other hand, eating fresh fruits and vegetables may protect against this disease.

Helicobacter pylori infection: H. pylori is a type of bacteria that commonly lives in the stomach. H. pylori infection increases the risk of stomach inflammation and stomach ulcers. It also increases the risk of stomach cancer, but only a small number of infected people develop stomach cancer.

How is cancer linked to overweight?

Cancer occurs when cells in one part of the body, such as the colon, grow abnormally or out of control. The cancerous cells sometimes spread to other parts of the body, such as the liver. Cancer is the second leading cause of death in the United States.

How is it linked to overweight?

Being overweight may increase the risk of developing several types of cancer, including cancers of the colon, esophagus, and kidney. Overweight is also linked with uterine and postmenopausal breast cancer in women. Gaining weight during adult life increases the risk for several of these cancers, even if the weight gain does not result in overweight or obesity.

It is not known exactly how being overweight increases cancer risk. It may be that fat cells release hormones that affect cell growth, leading to cancer. Also, eating or physical activity habits that may lead to being overweight may also contribute to cancer risk.

What can weight loss do?

Avoiding weight gain may prevent a rise in cancer risk. Healthy eating and physical activity habits may lower cancer risk. Weight loss may also lower your risk, although studies have been inconclusive.

Neck Pain

Neck pain may begin in any of the structures in the neck. These include muscles and nerves as well as spinal vertebrae and the cushioning disks in between. Neck pain may also come from regions near the neck, like the shoulder, jaw, head, and upper arms.

When your neck is sore, you may have difficulty moving it, especially to one side. Many people describe this as having a stiff neck.

If neck pain involves nerves (for example, significant muscle spasm pinching on a nerve or a slipped disk pressing on a nerve), you may feel numbness, tingling, or weakness in your arm, hand, or elsewhere.

Causes

A common cause of neck pain is muscle strain or tension. Usually, everyday activities are to blame. Such activities include bending over a desk for hours, having poor posture while watching TV or reading, placing your computer monitor too high or too low, sleeping in an uncomfortable position, or twisting and turning the neck in a jarring manner while exercising.

Traumatic accidents or falls can cause severe neck injuries like vertebral fractures, whiplash, blood vessel injury, and even paralysis.

Other causes include:

* Other medical conditions, such as fibromyalgia
* Cervical arthritis or spondylosis
* Ruptured disk
* Small fractures to the spine from osteoporosis
* Spinal stenosis (narrowing of the spinal canal)
* Infection of the spine (osteomyelitis, diskitis, abscess)
* Cancer that involves the spine

Home Care

For minor, common causes of neck pain:

* Take over-the-counter pain relievers such as ibuprofen (Advil, Motrin IB) or acetaminophen (Tylenol).
* Apply heat or ice to the painful area. One good method is to use ice for the first 48 - 72 hours, then use heat after that. Heat may be applied with hot showers, hot compresses, or a heating pad. Be careful not to fall asleep with a heating pad on.
* Stop normal physical activity for the first few days. This helps calm your symptoms and reduce inflammation.
* Perform slow range-of-motion exercises -- up and down, side to side, and from ear to ear -- to gently stretch the neck muscles.
* Have a partner gently massage the sore or painful areas.
* Try sleeping on a firm mattress without a pillow or with a special neck pillow.
* Use a soft neck collar for a short period of time to relieve discomfort.

You may want to reduce your activity only for the first couple of days. Then slowly resume your usual activities. Do not perform activities that involve heavy lifting or twisting of your back or neck for the first 6 weeks after the pain begins. After 2 - 3 weeks, slowly resume exercise. A physical therapist can help you decide when to begin stretching and strengthening exercises and how to do them.

Avoid the following exercises during your initial recovery, unless your doctor or physical therapist says it is okay:

* Jogging
* Football
* Golf
* Ballet
* Weight lifting
* Leg lifts when lying on your stomach
* Sit-ups with straight legs (rather than bent knees)

When to Contact a Medical Professional

Seek immediate medical help if you have a fever and headache, and your neck is so stiff that you cannot touch your chin to your chest. This may be meningitis. Call your local emergency number (such as 911) or get to a hospital.

Call your health care provider if:

* Symptoms do not go away in 1 week with self care
* You have numbness, tingling, or weakness in your arm or hand
* Your neck pain was caused by a fall, blow, or injury -- if you cannot move your arm or hand, have someone call 911
* You have swollen glands or a lump in your neck
* Your pain does not go away with regular doses of over-the-counter pain medication
* You have difficulty swallowing or breathing along with the neck pain
* You have pain that gets worse when you lie down or wakes you up at night
* You have such severe pain that you cannot get comfortable
* You lose control over urine or stool (incontinence)