Swine flu vaccine safe in pregnancy: study

Swine flu vaccine safe in pregnancy: study
By Alison McCook

The swine flu shot appears to be safe for pregnant women, according to a new government report that tallies health problems occurring after the vaccinations.

During the 2009 and 2010 flu seasons, millions of pregnant women received the vaccine against swine flu, or H1N1 influenza, yet but less than 300 possible complications were reported to a national database.

Researchers estimated that out of one million pregnant women who received the vaccine, 118 experienced a potential side effect from the shot.

These findings support the official recommendation that pregnant women receive the seasonal flu vaccine, which will contain the H1N1 vaccine in the upcoming flu season, said study author Dr. Pedro Moro of the U.S. Centers for Disease Control and Prevention.

"Based on all the information we have available, we definitely think pregnant women should receive the flu shot in the 2011-12 season," Moro told Reuters Health. "The flu shot will protect pregnant women, their unborn babies, and protect the baby after birth."

Compared with women of the same age who aren't pregnant, expecting mothers are more likely to become seriously ill from a flu infection and need hospitalization.

According to the CDC, pregnant women accounted for one in 20 deaths from H1N1 influenza in 2009. By comparison, only one in 100 was pregnant in the population.

The latest findings stem from data submitted to the Vaccine Adverse Event Reporting System (VAERS), a vaccine-safety surveillance system run by the federal government. It allows anyone -- including doctors, vaccine makers and patients -- to report health problems that arise after a vaccination.

The system helps health officials spot new, unusual side effects, although with the caveat that the reported problems are not necessarily caused by vaccination.

Last year, a survey of reports to the VAERS found no unusual complications among pregnant women who've received the vaccine in the past 20 years.

In the latest report, published in the American Journal of Obstetrics and Gynecology, researchers at the CDC and Food and Drug Administration reviewed health problems reported following the swine flu vaccine. Again, they found nothing unusual.

"We found no patterns suggesting a safety concern for the mother or the baby," Moro said in an email.

For every one million women vaccinated during pregnancy, there were 49 reports of miscarriage, and eight reports of stillbirths.

Both of these serious events occur relatively commonly in pregnancy, according to the researchers. Nearly a quarter of pregnant women 34 and older experience miscarriage, while fewer than one in 200 pregnancies result in stillbirth.

"It is important to remember that some health events will happen by chance shortly after vaccination," said Moro. "For example, by chance alone you expect to find reports of miscarriages in pregnant women."

Pregnant women were no more likely to experience less serious complications, such as allergic reactions, following the vaccine than non-pregnant adults either.

Dr. Michael Schatz, who studies vaccine safety during pregnancy but was not involved in the new work, called the findings "reassuring."

"No reasons exist from this report not to continue to follow the CDC recommendations and, pending more information, consider that the benefits of influenza immunizations in pregnant women outweigh the risks," Schatz, of Kaiser Permanente Medical Center, told Reuters Health by email.

Time to Rethink Your Birth Control?

Time to Rethink Your Birth Control?

by Barbara Brody

The Pill (oral contraceptive) is the most popular birth control choice among American women, but a new practice bulletin from the American College of Obstetricians and Gynecologists (ACOG) indicates that we might be picking wrong. Instead, the organization says that long-acting reversible contraceptives (LARCs) such as IUDs and implants are the most effective options, and that they’re safe for almost all women. I asked Jill Rabin, MD, chief of ambulatory care, obstetrics and gynecology, head of urogynecology at Long Island Jewish Medical Center in New Hyde Park, New York, to explain why more women should consider using IUDs and implants.

What are the main benefits of IUDs and implants compared to other types of birth control?

The main plus is that there’s no regular maintenance required (i.e., you don’t have to remember to take a pill every day), so it’s very unlikely that you’d end up with an unwanted pregnancy while using one. But it’s also worth noting that some IUDs (the kind that releases hormones) help to make periods lighter. “For women who suffer from abnormally heavy and prolonged periods, it really creates a big benefit,” says Dr. Rabin.

Why are IUDs and implants currently underused in this country?

In the past, there wasn’t enough education (of doctors and patients) about them. But as the evidence that these methods are very safe and effective has grown, that’s started to change. “I think IUD usage is going to continue to increase as time goes on and more data is accumulated on the safety and efficiency,” says Dr. Rabin.

Is it true that women who haven’t yet had kids can’t use IUDs?

Not at all. Although some doctors have been reluctant to use them in younger women, in part because of the off-chance that they could get an infection that might interfere with their fertility, that outlook is changing because it’s so unlikely. “IUDs may be used in women who have never borne a child as well as in adolescents,” says Dr. Rabin.

Any other myths about long-acting contraceptives?

“Many women are under the impression that the copper IUD is a ten-year commitment and the hormonal IUD a five-year commitment, but that’s misinformation,” says Dr. Rabin. Instead, those numbers refer to the maximum amount of time you can keep either device in before it needs to be replaced. “A patient can choose to stop using the device or change to a different method at any time.”

Have you ever used an IUD or implant? Would you recommend it?

Flu shot during pregnancy can protect baby: US study

Flu shot during pregnancy can protect baby: US study
BY AMY CHUNG

OTTAWA — A new report suggests that pregnant women who are thinking of boycotting the flu shot should think twice.

In the June issue of the American Journal of Obstetrics & Gynecology, a new study sponsored by the Centers for Disease Control and Prevention suggests that getting your flu shot during pregnancy can protect your newborn and reduce the likelihood that your baby will catch the infectious disease.
"It's recommended that all pregnant women receive the influenza vaccine during pregnancy because it is known that pregnant women have increased morbidity and mortality during pregnancy and in the immediate postpartum period if they get the flu," said Dr. Katherine Poehling from the Wake Forest Baptist Medical Center in Winston-Salem, N.C.
Babies in the study were 48 per cent less likely to be hospitalized for the flu if their mothers were vaccinated during pregnancy versus those who were not vaccinated.

Researchers also found that infants less than six months of age have the highest rate of flu hospitalization among all children.

"We know that mothers pass on antibodies to their baby during the latter part of the pregnancy," said Poehling, explaining that babies under six months cannot be immunized.

However, one young mother doesn't think a flu shot will make much difference.

"Our bodies have a natural way of building up our immune system," said Fort McMurray, Alta., banker, Jelena Martinovic, who just gave birth seven months ago.

"I had the flu shot once when it was first introduced and I got the flu that year. Since then, I didn't get the shot and I never had the flu since," the 26-year-old said.

Dr. Susy Hota from the University Health Network in Toronto says there are lots of misconceptions about the flu vaccine during pregnancy because the old vaccine contained a live virus that was used to stimulate the vaccine.

"The current vaccines we have now contains inactivated viruses that cannot be seen in your body," said Hota, adding it's safe for women to get the flu shot at any time during the pregnancy.



"A newborn does not have a fully developed immune system and can develop lots of infections in their first month of life to the first year so it's important if mom gets vaccinated to protect herself and the baby to reduce exposure to influenza," said Hota.

Though recovery from the flu is the most common outcome, there can be some dire effects.


"You can catch bronchitis, pneumonia, middle ear infection, and if you have heart and lung problems, that can be exasperated. The worst case scenario is fetal demise," said Hota
.

IUDs Officially Recommended for Healthy Women, Teens

New guidelines say research shows this form of birth control is safe and effective

By Ellin Holohan, HealthDay News

A female contraceptive device whose reported side effects kept it off the frontline of birth control for years has been formally endorsed for all healthy adult women and adolescents by the American College of Obstetricians and Gynecologists.

The endorsement represents a new chapter in the history ofintrauterine devices (IUDs). The T-shaped pieces of plastic laced with copper or hormones to prevent pregnancy may raise the risk of pelvic inflammatory disease, which can result in serious complications, including infertility, according to the Mayo Clinic.

But many experts say that risk is small, and the new recommendations, published in a Practice Bulletin in the July issue of Obstetrics & Gynecology, replace guidelines issued in January 2005.

At that time, only women who had given birth and were at low risk for sexually transmitted diseases were considered routine candidates for IUDs. However, researchers say other women and adolescents have been using them, despite the lack of official endorsement from the organization until now.

IUDs, once unpopular in the United States, are "safe" and "cost-effective," said Dr. Adam Jacobs, medical director of the family planning division at Mount Sinai Medical Center in New York City.

"What you see now is a rethinking of the idea of how to prevent unintended pregnancy," said Jacobs, calling IUDs the "most cost-effective form" of birth control available.

Jacobs, also an assistant professor of obstetrics and gynecology, said the new guidelines reflect what has been the practice at bigger teaching hospitals for some time. At Mount Sinai, adolescents and adult women have received IUDs for three years, he said.

Another expert agreed that IUDs have been in common use for several years.

"It's really not new," said Dr. Jill Rabin, chief of the ambulatory care division and head of urogynecology at North Shore Long Island Jewish Medical Center in New Hyde Park, N.Y. She noted that a lack of knowledge and access explain the relatively lower use rates for IUDs and implants, and urged doctors to spread the word.

"It is incumbent upon practitioners to help inform and educate our patients about the many benefits, as well as safety, of these methods for the majority of women," said Rabin.

About 6 percent of women using birth control choose IUDs or hormonal implants, another long-acting contraceptive, according to the bulletin. But rates are quickly rising as women learn more about them, according to both Jacobs and Rabin.

"Encouraging the use of long-acting reversible contraceptive methods for appropriate candidates may help lower U.S. unintended pregnancy rates because gaps in use and discontinuation of shorter acting methods are associated with unintended pregnancy rates in high-risk women," according to the Practice Bulletin. No such gaps in use occur with long-acting devices.

IUDs are inserted into the uterus and are available in two types: either a small T-shaped instrument with copper wire threaded around the T, or a T-shaped device with a hormone emission system.

Few birth control methods are risk-free, however, and IUDs are more likely to increase the risk of pelvic inflammatory disease if women have more than one sexual partner, according to the American Pregnancy Association.

IUDs can cause other side effects. These include headache, weight gain, ovarian cysts, mood changes, and pain or irregular bleeding (hormonal IUD) and anemia, heavy bleeding, backache, severe menstrual pain, painful sex and inflammation of the vagina and rash (copper IUD), according to the Mayo Clinic. The side effects often lessen or go away over time, according to the research the guidelines are based on.

In general, IUDs can safely stay in place for up to 10 years, according to the U.S. Food and Drug Administration.

Hormonal implants, matchstick-sized rods that are placed under the skin surface, emit a progestin type hormone for three years. The implants are "the most effective method of reversible contraception," with a failure rate for typical users of 0.05 percent, according to information in the Practice Bulletin. IUDs have a failure rate of less than 1 percent.

IUDs and hormonal implants cost between $400 and $750, not including the doctor's fee, with at least part of the expense covered by most insurance plans, said Jacobs.

In the 1970s, the Dalkon shield, a brand of IUD with a unique design, was taken off the market after being linked to pelvic inflammatory disease and infertility caused by sexually transmitted disease in women using the device, said Jacobs.

Some types of copper IUDs were later linked to pelvic inflammatory disease as well, although some experts say the risk has been overestimated.

There was no similar concern about implants, which have been in use for many years, he said.

"From both a patient standpoint and a social standpoint," IUDs and implants are beneficial because they "keep young women in school" instead of falling into a life of poverty that can follow unintended pregnancies and a lack of education, said Jacobs.

No vitamin D screening in pregnancy: committee

By Alison McCook

Most pregnant women do not need to be screened for vitamin D deficiency, nor given additional supplements, according to an official statement issued by the American College of Obstetricians and Gynecologists.

Vitamin D provided by the mother's body helps build a baby's bones and teeth before it's born. Vitamin D is manufactured in the skin in response to sunlight and occurs naturally in some foods, as well as being added to others such as milk.

Pregnant women do not generally have tests to check their vitamin D levels. But many are asking if they should, or whether they should take supplements, said Dr. George Macones, chair of ACOG's committee on obstetric practice. "And for the most part, the answer is no."

Macones and his colleagues came to that conclusion after reviewing available evidence about the value of screening for low vitamin D levels in every woman who's pregnant - and finding a lack of data to prove a benefit to mother or baby.

Performing an additional blood test that has no benefit would be a waste of healthcare resources, said Macones. "If there isn't a reason to do it, you're just wasting money and time."

The only pregnant women who might benefit from a blood test for vitamin D deficiency - and it's not clear even for them -- are those who are at high risk for the problem in the first place due to certain diseases or other circumstances.

Last November, the Institute of Medicine said the highest amount of vitamin D women could safely take during pregnancy or breastfeeding was 4000 international units (IU) per day. For the average pregnant woman, the Institute recommends 600 IU of vitamin D daily. Most prenatal vitamins contain 400 IU, according to the ACOG report.

In an interview with Reuters Health, Macones explained that women can obtain extra amounts through sunlight and eating fish, as well as through milk and juices that have been specially fortified with vitamin D.

"I have no problem with women deciding to drink some extra fortified milk, or fortified juices," he said. And if a woman asked if she could take a supplement with modest amounts of vitamin D, "I would be okay with that," Macones added. "I just wouldn't routinely recommend it."

Although experts suspect that relatively high levels of vitamin D are safe in pregnancy, there could be some risks to supplements that researchers haven't uncovered yet, Macones said. "We think it's safe, but sometimes unexpected things turn up."

Still, a study last year by researchers in the United States suggested that pregnant women should dramatically increase their intake of vitamin D, in the form of supplements, to as much as 4000 IUs per day. The authors said there is little danger at that level. A review of previous studies published earlier this year concluded that many women have low blood levels of vitamin D early in pregnancy, but it's unclear whether a deficiency stunts fetal growth or causes other pregnancy-related complications.

To date, researchers have not published a randomized controlled study of the effects of vitamin D on pregnancy. That type of trial yields the most reliable results.

Given the lack of conclusive evidence, the ACOG committee did not recommend that pregnant women be screened routinely for vitamin D deficiency and take supplements. Its report appeared online June 20th in ACOG's monthly medical journal, Obstetrics & Gynecology.

Dr. Carol Wagner at the Medical University of South Carolina told Reuters Health that the committee's conclusions are "sound based on the information published," but she and her colleagues recently conducted a randomized controlled study of 350 pregnant women who received either 400, 2000, or 4000 IUs of vitamin D per day. The results, which may be published in a few weeks, showed that 4000 IUs was the "optimal dose" to help pregnant women produce the active, hormonal form of vitamin D, Wagner said.

But does that lower mom's or baby's risk for problems before or after delivery? The answer is clear yet.

For now, as Wagner said in an email, "According to the IOM and the Endocrine Society, up to 4000 IU per day is safe during pregnancy; any dose above that should be taken in consultation with the patient's physician."

SOURCE: bit.ly/kbnKlF Obstetrics & Gynecology, July 2011.

Why Delaying Delivery by Just Two Weeks Boosts Baby's Survival

Why Delaying Delivery by Just Two Weeks Boosts Baby's Survival
By BONNIE ROCHMAN

What if you could make the difference between life and death for your baby, simply by being patient? A new study published in the June issue of Obstetrics & Gynecology shows that mortality rates are halved by waiting until at least 39 weeks rather than 37 weeks to give birth.

The study is the largest to confirm a message that public-health agencies and professional medical groups have been eager to spread: early elective deliveries are a bad idea. “Up until the last several years, we thought term pregnancies between 37 and 41 weeks were the same,” says Alan Fleischman, medical director at the March of Dimes. “This is not the case. It's a biological continuum. The new data makes us pause and realize we ought not intervene unless there's a very good medical reason.”

Researchers at the National Institutes of Health, the March of Dimes and the U.S. Food and Drug Administration collaborated to analyze mortality rates for babies born between 37 and 40 weeks. Forty weeks is an actual full-term pregnancy, but many have considered gestation to weeks 37 to 38 as more or less equivalent; babies born before 37 weeks are classified as pre-term.

Yet the researchers found that babies born at 37 weeks had twice the risk of death as 40-weekers, regardless of race or ethnicity. Using 2006 statistics, the team found that the infant mortality rate was 3.9 per 1,000 babies born at 37 weeks, compared with 1.9 deaths for every 1,000 live births for babies born at 40 weeks. “Mortality is the tip of an iceberg so there are large numbers of babies who don't die but are sick and require neonatal intensive care interventions and hospitalizations that they would not have needed if they were born a few weeks later,” says Fleischman.

Of course, there are situations in which early delivery is essential for medical reasons. But the new research highlights the importance of not scheduling delivery electively before 39 weeks at the earliest, which dovetails with a recommendation from the American College of Obstetricians and Gynecologists. Earlier this year, the March of Dimes called on hospitals to actively combat the surge in early elective deliveries by requiring proof of medical necessity from doctors scheduling such procedures. In explaining the rationale for early delivery, I wrote:

On one hand, it's understandable. Doctors want to be able to better control their schedule, eliminating middle-of-the-night deliveries and ensuring that they — and not one of their partners — delivers a baby since the delivering physician often receives the bulk of reimbursement. ... It's kind of surprising that insurance providers haven't curtailed the practice of early elective deliveries entirely as babies born sooner tend to have more health complications and cost more. Even babies delivered at 37 to 38 weeks can end up costing 10 times as much as a full-term newborn, according to the March of Dimes. One study found that reducing early elective delivies to under 2% could save close to $1 billion in health care each year.

Although not dangerously premature, babies born around the 37-week mark are more likely to have breathing problems and require ventilation. They may have higher bilirubin levels, which contribute to jaundice, or low blood sugar.
Often, those charged with taking care of babies are to blame for too-early deliveries. “There's collusion between mothers and doctors,” says Fleischman. “Sometimes the mother is suggesting early delivery and sometimes it's the doctor.
”

8 Energy Boosters to Beat Menopause Fatigue

Drink lots of water, learn to say no, and pamper yourself now and again — these are just a few simple ways you can fight menopause energy drain and regain your oomph.

By Beth W. Orenstein

Medically reviewed by Lindsey Marcellin, MD, MPH

If you’re like many women, you’ll probably experience bothersome symptoms during menopause — one of which may be fatigue. Fatigue is a common menopause complaint, especially in the early stages of menopause, as your body adjusts to its new chemistry.

But low energy can be also caused by number of other medical conditions, including anemia, coronary artery disease, diabetes, heart failure, hypothyroidism, hyperthyroidism, and kidney or liver disease. If you are fatigued, “you should talk to your doctor just to be sure it’s a menopause symptom,” says Wendy Klein, MD, director of education at the Virginia Commonwealth University Institute for Women’s Health and an associate professor emeritus of internal medicine, obstetrics, and gynecology at VCU School of Medicine.

“Most women don’t need treatment for their menopause symptoms,” Klein says. “The majority of women will have symptoms that are transient. They last two or three years and abate by themselves.”

If you’re dealing with fatigue as you go through menopause, try these eight simple tricks to boost low energy:

1. Exercise daily. You should aim for at least 30 — and preferably 60 — minutes of exercise most days of the week. It may seem incongruous to suggest exercise when you’re feeling weak, but exercise actually boosts your energy, says Staness Jonekos, who co-authored The Menopause Makeover with Dr. Klein. “Exercise is your fountain of youth,” Jonekos says. “It produces those feel-good hormones and gives you the energy you’re looking for when you’re not feeling good.” Some people find it helps to exercise earlier in the day rather than close to bedtime.
2. Cap caffeine and alcohol consumption. Caffeine and alcohol can both affect energy levels and interfere with getting a good night's sleep if you indulge in the evening. They may give you an immediate rush, but when they wear off, they can leave you feeling more drained than before. Nicotine can also have this effect, so if you smoke, quit. You’ll find you have more energy without artificial stimulants.
3. Limit food portions. Being overweight during menopause can cause you to feel sluggish. The best diet is one that is rich in fruits, vegetables, and whole grains and that includes lean sources of protein (poultry, lean meats, and fish) and low- or no-fat dairy products. Limit the amount of fats and sweets you eat. Eating smaller meals more frequently can provide energy throughout the day, Jonekos says. But if you eat more often, be sure you’re not overeating — watch your total calories.
4. Embrace relaxation. How do you unwind? Whether you like to read, take long walks, or meditate, take the time to indulge in your favorite activities. “You’re entitled to pamper yourself and take time for yourself,” Jonekos says. “As a result, you will be more energetic.” Stress and anxiety could be causing your fatigue, and relaxation techniques can be very helpful in learning to overcome them.
   A study published in Menopause: The Journal of the North American Menopause Society shows that stress-reduction therapy may also help with menopause symptoms, decreasing the degree to which women were bothered by hot flashes by 22 percent.
5. Get your Zzz’s. Another menopause symptom is hot flashes or night sweats, which can keep you up at night. Restful sleep is important during menopause so you’re not overly tired during the day. This may require keeping your bedroom cooler than you usually do. Use a ceiling fan and wear lighter bed clothes. Make sure the room is dark and set your body clock by going to bed and waking up around the same time every day — even on weekends.
6. Stay hydrated. “You need to nourish your body with healthy food and water,” Jonekos says. Thirst is your body’s way of telling you that you need more fluid. When you’re dehydrated, your body has to work harder to perform. Dehydration also can cause nausea and difficulty concentrating. Keep a water bottle handy so you can drink when you’re thirsty. Choose water or caffeine-free tea or coffee — not calorie-laden drinks, as weight gain can make you sluggish.
7. Don’t overbook. You may be fatigued because you’re trying to do too much. Learn to say no. Know your limits and what you can and can’t accomplish in a day. Also, if you set reasonable limits, you’ll be less stressed, Jonekos says.
8. Try herbal remedies. Two herbal remedies that have been shown to reduce menopause symptoms that may cause fatigue and anxiety are black cohosh and valerian. Talk to your doctor before taking herbs as teas or supplements as they can interfere with some medications.

“No one recipe fits everyone,” Jonekos says. “But if you’re suffering from fatigue during menopause, you need to take control, and you can by adopting a healthy lifestyle.” Eat right, exercise, get adequate sleep, and learn to relax — you will find you have more energy to enjoy your life.

Gynecology research takes the measure of a man's fertility

Gynecology research takes the measure of a man's fertility
By: W. Gifford-Jones MD

How would you react if your doctor said, "Remove your pants and bend over," then picked up a ruler and measured the distance from the middle of the anus to the base of the scrotum, the anal-genital distance (AGD)? You might decide this doctor is wacky, and quickly find another physician.

Dr. Shanna Swan, professor of obstetrics and gynecology at the University of Rochester, New York, reports an unusual finding in the journal Environmental Health Perspectives. Swan and her colleagues discovered pregnant rats exposed to phthalates, commonly used chemicals suspected of having adverse effects on hormones, produced infertile offspring.

But Swan obviously has a fertile brain. She also noticed the baby rats had a decreased anal-genital distance. It's not a measurement researchers would normally think worthy of study.

But what about human males? Swan's team measured 126 males, most 19 years old. Her study found an average anal-genital distance of 52 millimeters. Men with a shorter AGD were seven times more likely to be sub-fertile with decreased sperm counts, less active sperm, low sperm concentration and an increased number of abnormal sperm. This is not a good recipe for parenthood.

Swan made another surprising finding: nearly one-quarter of these young men had low sperm counts!

What does this discovery mean? Dr. Swan did not inquire whether the mothers of the young men had been exposed to phthalates, nor did she test the volunteers' hormone levels. But her result suggests decreased AGD indicates a lower exposure to testosterone in the womb that may affect full development of the male genital tract. It may also be due to environmental toxins or other unknown factors.

Dr. Sheela Sathyanaryay, assistant professor of pediatrics at the University of Washington, says, "We don't have good ways to predict male fertility unless there are major abnormalities." The AGD simply adds another way to gauge male fertility.

It does give pause for thought for those contemplating marriage. Many couples want to ensure they're in good health before marriage. This usually means each partner agrees to be checked for sexually transmitted disease and other problems.

Most contemplating marriage also want children. This research poses a delicate question. How much will it take for her to say, "Make sure the doctor measures your anal-genital length." She may as well add other requests: "Darling, make sure the doctor checks the length of your legs, your waist circumference and remind him to examine the ear lobe crease."

Dr. Kate Tilling measured the leg length of 12,252 men aged 44 to 65 years of age. Tilling discovered that people with longer legs had less buildup of cholesterol deposits in coronary arteries and those supplying the brain. This increased blood supply decreased the risk of heart attack and stroke.

Dr. Jean-Pierre Despres, professor of human nutrition at Laval University in Quebec City, reports that men with a waistline of over 100 centimeters have an increased risk of heart disease. This fat produces cytokines causing inflammation of blood vessels and increased risk of coronary attack.

In another report, Dr. William Elliott at the University of Chicago examined 1,000 patients suffering from coronary heart disease. He discovered that an easily seen ear lobe crease was associated with increased risk of heart attack. The crease starts where the ear lobe attaches to the head and angles back towards the lower edge of the ear.

Thus, the message for women contemplating marriage is simple. Measurements can make a huge difference in fertility and other medical matters.

That's the long and short of it.

Woman Plans To Donate Womb To Her Daughter

Woman Plans To Donate Womb To Her Daughter
By Amanda Chan

There have been stories in the past of family members donating their organs to their mothers, fathers, brothers and sisters. But now, a British woman is taking things a step further: she plans to donate her womb to her 25-year-old daughter, who was born without reproductive organs.

Eva Ottosson, 56, announced today that she has agreed to the uterus transplant, which would give her daughter, Sara, the opportunity to become pregnant, the BBC reported. The procedure could happen next spring in Sweden.

Sara Ottosson, who lives in Sweden, has Mayer Rokitanksy Kuster Hauser syndrome, and was born without a uterus.

“She needs the womb, and if I’m the best donor for her … well, go on. She needs it more than me. I’ve had two daughters so it’s served me well," Eva toldThe Telegraph.

If the transplant goes well, Sara's eggs will be fertilized with sperm from her boyfriend, andimplanted into her new womb.

Mayer Rokitansky Kuster Hauser syndrome is rare, and only affects one out of about 4,500 women, according to a 2006 study in the Journal of Negative Results in Biomedicine. Women with the syndrome have an absence of their upper vagina and uterus.

The only other womb transplant was conducted in 2000 in Saudi Arabia, according to the BBC, where a womb was transplanted from a 46-year-old to a 26-year-old. But complications prompted the removal of the womb 99 days after the procedure.

Is a used breast pump safe?

Is a used breast pump safe?

Every weekday, a CNNHealth expert doctor answers a viewer question. On Mondays, it's pediatrician Dr. Jennifer Shu.

Asked by Andrea from San Francisco, California

I'm eight months pregnant and plan to breastfeed. I will go back to work after a few months and am thinking about getting a heavy-duty double breast pump, but the new ones are very expensive. Is it safe to buy or rent a used one? I'm worried about the germs that might be inside the pump but can't really afford a new one.

Expert answer

Thanks for your question, and congratulations! Breast pumps are actually regulated by the FDA, and the party line is that personal pumps are designed for single users (kind of like a toothbrush), but hospital-grade ones may be used by multiple women.

Most breast pumps are made up of an "open system" where the breastmilk flows through the breast shields, tubing and collection containers, but milk particles may also come into contact with parts of the machine. Multi-user pumps are "closed systems," in which the milk cannot enter the machine itself, and the tubing and other pieces may simply be changed between users.

If you plan to rent a pump or buy or borrow a used one, it's best to be sure it is the closed-system kind. Although viruses such as HIV cannot survive on surfaces for more than a few hours, there are other germs that can live for several weeks or years, even on dry objects. While it is normal for a baby to be exposed to his own mother's germs, it's important to minimize any unnecessary contact with other viruses or bacteria.

For pricier items such as breast pumps, new parents may opt to put them on a gift registry or see if friends and family members can chip in donations toward the purchase. The pump may also be covered under certain insurance plans or if you have a health savings account or flexible spending account.

Your state health department or local WIC (Women, Infants, and Children) program may provide assistance as well; income eligibility requirements may apply. You could also consider a more affordable single or manual pump, although they are often less efficient than double electric ones.

Good luck!