Miscarriage, Medicine & Miracles : Everything You Need to Know about Miscarriage
From one of the foremost doctors in the field and a woman who has experienced miscarriage herself comes a comprehensive, encouraging, and accessible guide on both the causes and, more important, the prevention of miscarriage.
Though one in four American women will lose her pregnancy, this heartbreaking experience remains a taboo subject, fraught with myths and misinformation. But with the right prepregnancy evaluation and ongoing care, for many women miscarriage can be prevented.
During forty years of practice, Dr. Bruce Young has treated hundreds of women who experienced the heartbreaking loss of miscarriage and helped them bring babies to term. Now he has teamed up with one of his patients who experienced miscarriages herself, Amy Zavatto, to write this informative, compassionate guide that combines the medical facts with insights from the patient's and doctor's viewpoints. Dr. Young thoroughly explains the basics of pregnancy and miscarriage, and provides in-depth answers to the questions: Why did this happen to me? and What can I do to prevent it next time?
Including case studies of patients who'd experienced recurrent miscarriages, Dr. Young illustrates a variety of reasons for pregnancy loss--from diabetes to genetics, from hormonal deficiencies to autoimmune disorders--explaining why each miscarriage occurred, as well as how to diagnose and in many cases treat the underlying problem.
Providing the most up-to-date information on physical and mental health, nutrition, and technology, Miscarriage, Medicine & Miracles is a proactive tool and comforting resource--from an expert with real-life reasons to give every woman hope for a successful pregnancy.
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April 28, 2008
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Excerpt from Miscarriage, Medicine & Miracles by Bruce Young
Preparing for Pregnancy: Understanding Your Body
NEWLYWEDS DIANA AND GREG STARTED TO THINK ABOUT having children within the first year they tied the knot. Now 25, Diana had been my patient since she was a teenager. At her routine visit six months before, I congratulated her on her recent marriage and her new job as a fund-raiser for the university she'd attended as an undergrad. I suggested that she come in for a pre-pregnancy session and bring along her husband, Greg, an outgoing and friendly newspaper writer, to discuss pregnancy.
When I met Diana ten years ago, her mother had brought her to my office. She was 15 and had been complaining of abdominal pain, which was getting worse and worse. At first, she told me, the pain came and went, although it was sometimes severe, but lately it was nearly continuous and she could not function at all. That day in my office she said the pain was across her lower abdomen and came in waves, but was constant and worse on the right side. It had gotten so bad it was affecting not just her after-school soccer, but her academic work as well. Understandably, both Diana and her mom were anxious about this frightening problem.
I examined Diana and found her abdomen to be very tender. I did a sonogram, which showed me that she had an ovarian cyst, causing a twisted right ovary--immediate surgery was necessary to save her ovary. I performed laparoscopic surgery, removed the cyst, and was able to untwist the ovary and save it, preserving her fertility.
Considered a minimally invasive procedure, laparoscopic surgery is performed by making several small incisions in the abdomen, usually one-half to one centimeter in length. An incision is made through the navel (although the incision may also be made just below the navel, I like to make it through the navel so the scar can't be seen). A thin, long tube called a lap- aroscope is inserted through the incision into the patient. A camera is attached to the outside of the laparoscope, enabling the surgeon to see inside the patient by viewing an image on a TV screen transmitted by the camera. Tiny instruments are then inserted through secondary incisions to perform the surgery.
Now, a decade later, Diana was ready to put that fertility to use. She and Greg were planning pregnancy in about four months, after she finished working on a particularly stressful fund-raiser for the university's capital endowment. I reviewed each of their medical histories and asked about their families to be sure that there were no hereditary problems or increased risk for miscarriage.
I examined Diana again and confirmed that there were no new findings and that she remained physically well. There was no residual scarring from her previous surgery; in fact, there were no visible scars from the laparoscopic surgery. Her fertility was not affected and she was in great shape to get pregnant.
Still, even with a clean bill of health there were some preliminary steps to be taken. I explained genetic screening to the couple and offered them our panel of blood tests for genetic diagnosis, best to be done at this time. I gave them my printed information for pregnant women, which contains answers to the most common questions and recommendations for nutrition and exercise, and describes normal changes in pregnancy. I began Diana on prenatal vitamins to be sure she had high levels in her body before she was pregnant. I explained the normal changes in pregnancy, what to expect, and what was not normal. I answered all the questions she and Greg had. Then I sent Diana for the standard blood tests for prenatal screening.
All Diana's tests were normal. She and Greg followed my advice about stopping the birth control pill and switched to condoms until they were ready to try for pregnancy. Five months later, they conceived. The following nine months were uneventful except at the very end, when labor started. Diana was at work, going over some photos of an event for a news release she'd just finished. She ignored the contractions, approved the final shot for the piece--and then realized she was in the middle of her own newsworthy story.
She quickly called me, Greg, and then a car service. Her water broke as she came through the front door of NYU Medical Center where Greg was waiting. I met them on the elevator, and I whisked her into a delivery room.While Greg was changing to join us, Diana began to push. Three more pushes and I gave Diana and Greg the news they'd been waiting for--an 8 lb 4 oz boy named Stephen.
How Do You Become Pregnant?
I reviewed birth control methods with Diana and Greg. I advised her to stop the birth control pill she'd been using for three months before trying to conceive and switch to condoms or diaphragm to avoid any possible increased risk of miscarriage.