Valerie Gommon Midwife’s Blog

Archive for the ‘obesity’ Category

I’ve just been listening to the latest episode of The Archers where Helen has just had an emergency caesarean section for pre-eclampsia and thought that it would be a useful subject to write about.

I think it is fantastic that the subject has been covered by the radio programme and on the whole they have got it right (wouldn’t expect anything less from The Archers!) but I would like to add a bit more.

Pre-eclampsia is a potentially serious condition of pregnancy that we are still learning about.  For serious pre-eclampsia the only treatment is to deliver the baby (sometimes prematurely), however for most pregnancies the pre-eclampsia can be monitored and the labour may well start normally and spontaneously, or the labour may be induced around your due date and you may well have a normal birth.

Pre-eclampsia is one of the things that your midwife is looking for antenatally and is usually characterised by a collection of symptoms: raised blood pressure, protein in your urine, swelling (oedema), headaches, visual disturbances and upper abdominal (epigastric) pain.

Many women will experience one or more of these symptoms without developing pre-eclampsia, but if you have two or more symptoms or feel concerned you should definitely speak to your midwife urgently.  For example many women will have a headache or some swelling and this is normal during pregnancy – it is usually only when you have several symptoms that pre-eclampsia is suspected and you will then be referred to hospital for further investigations including blood and urine test and monitoring of the baby’s wellbeing.

Women at increased risk of pre-eclampsia include:

  • Those in their first pregnancy
  • Having high blood pressure
  • Having certain blood clotting disorders, diabetes, kidney disease, or an autoimmune disease like lupus
  • Having a close relative (a mother, sister, grandmother, or aunt, for example) who had preeclampsia
  • Being obese (having a body mass index of 30 or more)
  • Carrying two or more babies
  • Being younger than 20 or older than 40

However if you fall into any of these categories you are still more likely NOT to get pre-eclampsia.

There is some evidence (though not mainstream) that pre-eclampsia may be prevented by eating a really healthy diet and by increasing your protein and salt intake.  It may also be beneficial to stop work slightly earlier in your pregnancy and not to overdo things at the end of the pregnancy.

More information on the dietary aspect can be found at https://midwifevalerie.wordpress.com/2009/08/04/dietary-suggestions-for-pregnancy-from-tom-brewer/

I recently attended a professional development course where Dr Anthony Williams, Reader in Child Nutrition and Consultant in neonatal Paediatrics, St George’s Hospital, University of London spoke about the medical benefits of breastfeeding.

We all know “Breast is best” but the facts make interesting reading:

  • The risk of necrotizing entocolitis (a medical condition primarily seen in premature babies, where portions of the bowel undergo necrosis or tissue death) is five times more likely in babies fed formula milk.
  • Breastfed babies also have less diarrhoea and lower respiratory tract infection and have statistically significantly lower hospital admission rates.
  • Exclusive breastfeeding is recommended for six months and this is know to:
  • Reduced gastroenteritis/eczema
  • 50% reduction ottis media (middle ear infections)
  • 20% reduction in allergies (if there is a family history of allergies this reduction is more like 40%)
  • 50% reduction SIDS (Sudden Infant Death Syndrome)
  • Pre-term infants – outcomes appear to be improved if given breastmilk
  • Decreased risk obesity

Maternal effects:

  • 24% reduction in premenopausal breast cancer
  • Small reduction in postmenopausal breast cancer
  • Reduction in some types ovarian cancer
  • Reduced cardiovascular risk
  • Small reduction in: BP/serum cholesterol/BMI/Impaired glucose tolerance

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