TYPES OF LOSS I wanted to include a section on this site about all the different types of loss just to include a little bit of info about each individual loss and some helpful links to sites about that loss so that people can find out more about it and perhaps find comfort and support from the sites and information I can give. CONTENT WILL COVER ALL TYPES OF LOSS ANENCHEPHALY PERINATAL LOSS PREMATURE LABOUR LOSS MISCARRIAGE TRISOMY 18 AND 13 BIRTH DEFECTS HYPOLPASTIC LEFT HEART LOSS DIAPHRAGMATIC HERNIA LOSS SIDS LOSS (SUDDEN INFANT DEATH SYNDROME) NEO NATAL LOSS STILLBIRTH. STILLBIRTH Statistics
Stillbirth is common. It may affect anyone. There is no way to predict when stillbirth will happen or who will experience it. Stillbirth occurs in families of all races, religions, and income levels. Each year in the United States about 25,000 babies, or 68 babies every day, are born still. This is about 1 stillbirth in every 115 births. Something as common as this will, at some point, directly or indirectly touch the lives of many people. A friend, a relative, or you, yourself, may experience stillbirth.
Why?
One of the most common questions following a stillbirth is, "Why did my baby die?" Answering this question is not always easy or possible. Extensive and careful examination of the baby and placenta is needed following delivery. This includes an internal autopsy and several other studies. Often these evaluations will provide helpful information and eventually bring peace of mind. With extensive evaluation, a cause for stillbirth can be identified in 40%-50% of all stillbirths. Even when a cause is not specifically identified, at least potential high risks for recurrence may be ruled out. Parents who experience stillbirth will be asked to consider extensive evaluations for their baby. Many will want everything done to try to discover why their baby died. Others may think that such assessment violates their baby. The decision should be theirs. They will need to choose what is best for them.
Causes
Information about cause can be very important for parents and families. It may help parents in planning future pregnancies by providing insight to the frequently asked question, "Will stillbirth happen again?" The information may also help parents and families to deal emotionally with their loss. Knowledge, in general, can be empowering, and it may provide a sense of comfort by helping to alleviate uncertainty or guilt.
Identifiable causes of stillbirth generally fall into one of three different categories: birth defects in the baby, problems with the placenta or umbilical cord, or maternal illnesses or conditions which may sometimes affect pregnancy.
Birth defects are common but often overlooked causes for stillbirth. About one-fourth of babies who are stillborn have one or more birth defects that are responsible for their death.
The placenta and umbilical cord are the baby’s "lifeline" for oxygen and nutrients. Problems in either one may completely cut off or severely interfere with the needed flow of blood, oxygen, and nutrients to the baby. Although commonly pointed to as the likely cause for the death of a baby, problems with the placenta or umbilical cord actually account for only a moderate number of stillbirths.
Although uncommon, maternal conditions may be responsible for stillbirth. Certain illnesses in the mother, such as diabetes or hypertension, and their treatments, sometimes cause stillbirths. An increased risk for stillbirth is also associated with the use of certain recreational drugs, particularly cocaine.
In addition, there are many other rare causes of stillbirth.
How to Cope
In the natural course of life events, babies are least of all expected to die. The loss of a baby through stillbirth can be overwhelming and devastating for parents as well as for family members and friends. Although such feelings are surprising to some, the stillbirth of a baby is a great loss, as great as that of an older child or any loved one.
When stillbirth occurs, parents who were anxiously awaiting a baby suddenly are not. It is natural for them to grieve deeply for the baby who has died and for the hopes, dreams, and wishes that will never be. They may feel a strong sense of sadness, or anger, or bitterness at the unfairness of this tragedy. There is usually nothing anyone did to cause, or could have done to prevent, a stillbirth. Yet, parents especially may feel guilt and blame themselves for the death of their baby. Parents may also experience feelings of loneliness and longing, helplessness, or, because of the intensity of their emotions, confusion.
These emotions are real and a normal part of grieving. Grieving is a process of making meaning out of the loss and of life without their baby. Grieving is not easy. It is long, unpredictable, and requires a lot of energy. Parents and family members need time to grieve since grieving is necessary to work through pain toward healing.
INFORMATION FROM :EMPTYCRADLES.COM/STILLBIRTH.
I WILL BE INCLUDING MY OWN INFORMATION ABOUT STUFF AND ALSO A LITTLE FROM SITES I WANT TO TAKE TIME TO EXTEND MY SYMPATHIES THAT YOU ARE VISITNG SITES LIKE THESE AND THAT YOUR CHILD HAS DIED BUT I HOPE YOU CAN FIND SOME COMFORT AND SUPPORT.
SIDS
(OTHERWISE KNOWN AS SUDDEN INFANT DEATH SYNDROME)
- SIDS claims the lives of almost 3,000 infants in the U.S. each year - that's nearly 9 babies every day.
- SIDS deaths occur unexpectedly and quickly to apparently healthy infants, usually during periods of sleep.
- Most SIDS victims are between two and four months of age.
- SIDS occurs in families of all races and socioeconomic levels.
- SIDS can not be predicted or prevented.
- SIDS is NOT caused by suffocation, choking, immunizations or vaccinations. It is not contagious, nor is it a result of neglected illness or child abuse.
- SIDS can, and does, claim any baby, in spite of parents doing everything right.
Sudden Infant Death Syndrome (SIDS) is one of the leading causes of death among infants one month through one year of age in the United States. The National Institute of Child Health and Human Development (NICHD) defines SIDS as the sudden death of an infant under one year of age which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene and review of the clinical history. SIDS is therefore a diagnosis of exclusion, affixed only once all known and possible causes of death have been ruled out.The Impact of SIDS
The sudden, unexpected death of an infant to Sudden Infant Death Syndrome (SIDS) is a tragic loss. Death happens suddenly, and the family often has no time to prepare. The infant may recently have been given a clean bill of health from the pediatrician.
The death of an infant from SIDS disrupts the natural order and is a traumatic event that affects the family for the rest of their lives. The sudden, unexpected death of an infant threatens parents' safety and security and forces them to confront their own mortality. The lack of a discernible cause, the suddenness of the tragedy and the involvement of the legal system make a SIDS death especially difficult, leaving a great sense of loss and a need for understanding. The impact of SIDS is extensive and affects a myriad of people from parents, siblings, and grandparents to extended family, friends, babysitters, and co-workers. Families are directly helped through information and support services to alleviate their guilt and aid in understanding this devastating syndrome.
Parents often complain of physical symptoms such as aches, tightness in the throat, loss of appetite, insomnia, and feelings of loneliness and isolation. They are often fearful of "going crazy" as they continue to hear the baby cry at night or wake to care for an infant who is no longer there.
The lack of a definitive cause of death, even after autopsy, does little to alleviate any feelings of guilt the parents may have about their responsibility for the death. They often blame themselves. The "if onlys" plague parents who wonder if there was something in the baby's behavior or health they may have missed. A generally uninformed public, including family members and health care professionals, can add to the grief and guilt of the family by voicing incorrect assumptions. Parents have been accused of neglecting or abusing their child because of mistaken information. They need to know that they did not cause, nor could they have prevented, the death. It is not their fault.
Six step to reduce the risk of sudden infant death syndrome
Please contact us for further information on how you can help reduce the risk of SIDS. 1. Put your healthy baby on its back to sleep - If your baby has problems breathing or spits up a lot after feeding, ask your doctor about how your baby should sleep. 2. No smoking near the baby - Do not smoke during pregnancy and do not let others smoke near your baby.
3. Do not let your baby get too hot - Dress your baby in as much or as little as you would wear. Do not wrap your baby in lots of blankets or clothes. If your baby is sweating, has damp hair, or a heat rash, he or she may be too hot. A baby that has a fever, is breathing fast, or is not able to rest, may also be too hot.
4. Put your baby to sleep on a firm mattress - Do not let the baby sleep on soft things, like cushions, pillows, blankets, the couch, sheepskins, foam pads, or waterbeds.
5. Take good care of yourself and your baby - When pregnant, see your doctor often and do not use drugs or alcohol. Talk with your baby's doctor about changes in your baby and how your baby acts. 6. If possible, breast feed your baby - Breast feeding has been shown to be good for your baby.
ALL THIS INFO WAS FROM THE CJ FOUNDATION FOR SIDS
CLICK HERE TO BE TAKEN TO MY FRIEND DONNA'S SITE HER BEAUTIFUL LITTLE GIRL AISLINN CELESTE McCOMSEY WAS TAKEN BY SIDS HERE IS THE SITE: http://aislinnmccomsey.bravehost.com
Its a lovely sit there is also info about SIDS on there.
ANENCHEPHALY
Anencephaly:
Is known as a neural tube defect. One of the most common occurring in about 1 out of every 1000 pregnancies. It is the failure of the neural tube to close properly resulting in the absence of the major portion of the brain and the top part of the skull.
Neural Tube: .
The neural tube is a narrow sheath (see picture) that folds and closes between the 3rd and 4th wks of pregnancy (roughly 21 to 28 days after conception) to form the brain and spinal cord. When the cephalic or head end of the tube fails to close properly, it results in the absence of the major portion of the brain, skull and at times scalp. Infants are born without a fore-brain (the thinking and coordinating area)and are usually blind, deaf, unconcious and are unable to feel pain. Infants may exhibit reflex actions, such as respiration and responses to touch and sound. ( I truly believe that even though my daughter may have been deaf, that her soul...her spirit was not and that she was able to hear and feel my love for her)
Diagnosis:
Diagnosis is usually made by the AFP (alpha-fetoprotein) test at 16 to 18 wks and then confirmed by follow up level 2 ultrasound. Normally, a detectable and predictable amount of this protein crosses the placenta and enters the bloodstream.The alpha-fetoprotein test detects amounts of this protein, which is produced by the unborn babies liver, and measures the amount in the mother's blood. But if the fetus has an abnormal opening in its spine (spina bifida) or head (anencephaly), or an abdominal wall defect, more alpha-fetoprotein may leak out which will cause the AFP test to be elevated. Some cases of anencephaly have been diagnosed, via ultrasound, as early as 10 1/2 wks . It has been shown that a transvaginal ultrasound is better at diagnosing anencephaly before 16 wks than the standard abdominal ultrasound.
At Risk:
Women taking anticonvulsant medication.
Women with undiagnosed or uncontrolled diabetes.
Women with Malabsorption problems.
Any woman with a family history of neural tube defects.
Causes:
1) Folic acid defiency ( Which can be caused by poor or inadequate diet,smoking, alcohol use, psorasis,& birth-control pill use)
2) Undiagnosed diabetes
3) Hypervitaminosis A
4) High temperatures of 102 degress or higher for more than 5 hours. (Hot tub use is discouraged when pregnant)
6) Anticonvulsant medication, especially Valporic acid (valporate)
7) Environmental/chemical exposure
8) Rare genetic cause ( Genetics have long been considered likely because of the increased risk of having a 2nd child with anencephaly, but scientists still remain uncertain about the evidence to prove or disprove this theory. Some genetic disorders such as waardenburg syndrome and certain ethnic groups seem to have a higher incidence of anencephaly.)
Treatment:
There is no cure for anencephaly.
Prognosis:
Most infants with anencephaly will be born still. A small percentage(30-33%) will be born alive and will live for a few moments to a few days. A rare few have lived for several months.
Possible Complications:Polyhydraminos (increased amniotic fluid) is caused by the poor swallowing reflex of the baby. With increased amniotic fluid there is an increased chance of placental abruption if the water breaks and comes out too fast. Generally, though, because there is no top part of the head pressing down, the water does not break on its own. There is also an increased chance of uterine rupture especially if there is a previous uterine scar. Amniocentesis has been performed to remove some of the excess fluid in some cases, but generally the polyhydraminos is just monitored through invasive procedures such as ultrasound and fundal measurements. (In all the women I have talked to who have had polyhydraminos, there was one who had placental abruption, but she feels that is was the direct result of poor management by her Dr. during labor.)
Prevention:
Taking 4 to 5 miligrams of folic acid daily for 2 to 3 months before conception and until at least the 3rd month of pregnancy is recommended for all woman at risk of having a child with a neural tube defect.(Woman who have had a previous baby with anencephaly are 10 to 15 times more likely than average to have a second NTD pregnancy.Folic acid is thought to be able to prevent 70% of NTDS.)Normal recommended daily dosage for all woman of child bearing ages is 400 micrograms (0.4 miligrams).Taking more than 1 miligram of folic acid daily is not recommended for all woman, because folic acid can mask the symptoms of pernicious anemia (a B-12 deficiency) and makes diagnosis difficult.(To learn more about folic acid Click Here.
Folic Acid:
Folic acid is a necessary element needed for correct neural tube development. It is part of the B-Complex Vitamins and is also called folate or folacin. It is present in many leafy, green vegetables, orange juice, dried beans, and peas. It is difficult to get enough folic acid by diet alone. In fact, in order to get 4 mgs of folic acid daily, you would need to drink 80 glasses of orange juice or have 100 servings of broccoli. In the United States, we now fortify many of our grain products, such as bread to help prevent neural tube defects. Folic Acid can significantly reduce the risk of having a baby with a neural tube defect,but does not totally eliminate the possibility.
Research:
The National Institute of Neurological Disorders and Stroke (NINDS) "conducts and supports a wide range of studies that explore the complex mechanisms of normal brain development. Knowledge gained from fundamental studies provides the foundation for understanding how this process can go awry and, thus, offers hope for new means to treat and prevent congenital brain disorders including neural tube defects such as anencephaly."
The March of Dimes started a Folic Acid Awareness campaign in Dec. of '98'. The Foundation has pledged to reduce the incidence of neural tube defects by at least 30% by the year 2001 through its new, multi-year Folic Acid Campaign. The Campaign will reach women through community action, health professional education, and mass media. Everyone is welcome to join this important campaign. (There may be more organizations conducting research that I am unaware of yet.)
Organ Donation:
Organ donation has caused an ethical debate when it comes to infants with anencephaly due to the difficulty in determing brain death since these infants usually have a rudimentary brain stem. Loma Linda University has conducted studies on organ donation using anencephaic organ donors. You can find more information on this at Brenda Winner's Ten Perfect Fingers site (in memory of her first-born daughter, Jarren) at http://home.earthlink.net/~mbwinner/tpf_home.html .
ALL THIS INFORMATION WAS FROM A SITE CALLED JESSICAS JOURNEY HERE IS THE ADDRESS FOR MORE INFORMATION:http://www.geocities.com/hotsprings/spa/4346/
PLEASE BEAR WITH ME AS I WILL BE ADDING TONS MORE FOR EACH SECTION OF LOSS I JUST WANTED TO PUT A LITTLE BIT UP JUST NOW SO THAT I COULD GET THE PAGE STARTED.
DIAPHRAGMATIC HERNIA
Diaphragmatic hernia
Definition
A diaphragmatic hernia is an abnormal opening in the diaphragm, occurring before birth, that allows part of the abdominal organs to migrate into the chest cavity.
Alternative Names
Hernia - diaphragmatic; Congenital hernia of the diaphragm Causes
A diaphragmatic hernia is caused by the improper fusion of structures during fetal development. The abdominal organs such as the stomach, small intestine, spleen, part of the liver, and the kidney appear in the chest cavity. The lung tissue on the affected side is thus not allowed to completely develop. Respiratory distress usually develops shortly after the baby is born, because of ineffective movement of the diaphragm and crowding of the lung tissue, which causes collapse. The reason why this occurs is not known.
Congenital diaphragmatic hernia is seen in 1/2200 to 1/5000 live births with the vast majority (80 to 90%) occurring on the left side. There is a 2% recurrence rate in first degree relatives of a patient with the disease.
Symptoms
- severe breathing difficulty
- bluish coloration of the skin due to lack of oxygen
- fast breathing (tachypnea) asymmetry of the chest wall
- fast heart rate (tachycardia)
Exams and Tests
The pregnant mother may have shown signs of polyhydramnios (excessive amounts of amniotic fluid). Fetal ultrasound may show abdominal contents in the chest cavity.
Examination of the infant shows:
- chest movements asymmetric with breathing
- breath sounds absent on the affected side
- bowel sounds heard in the chest
- concave abdomen that feels less full on examination by touch (palpation)
A chest X-ray may show abdominal organs in chest cavity. Treatment
A diaphragmatic hernia is a surgical emergency. The abdominal organs must be replaced into the abdominal cavity, and the opening in the diaphragm repaired. Support of the respiratory system is necessary immediately after birth until the infant recovers from surgery. Some infants are placed on ECMO (extracorporeal membrane oxygenation) which is a heart/lung bypass machine which gives the lungs a chance to recover and expand after surgery.
If a diaphragmatic hernia is diagnosed early in gestation (~24 to 28 weeks), fetal surgery may be an option to be considered.
Outlook (Prognosis)
Congenital diaphragmatic hernia is a very serious disorder. The lung tissue may be underdeveloped on the affected side, and the outcome depends upon the development of the lung tissue. With advances in neonatal and surgical care, survival is now greater than 80%. A poor prognosis, however, is associated with polyhydramnios, presence of the fetal stomach in the chest, and an early presentation (i.e., distress in the first few hours of life). Infants who survive may have long-term complications including persistent pulmonary hypertension (PPHN), recurrent lung infections, and gastrointestinal problems.
Possible Complications
- pulmonary (lung) infections
- other congenital anomalies may be present
The diaphragm is a thin dome-shaped muscle which separates the thoracic cavity (lungs and heart) from the abdominal cavity (intestines, stomach, liver, etc.). It is involved in respiration, drawing downward in the chest on inhalation, and pushing upward in exhalation.
AS YOU WILL REMEMBER I ALSO HAVE A SECTION SPECIALLY ON THE SITE ABOUT THIS ALSO KNOWN AS CDH FOR SHORT (AS THIS IS WHAT MY BABIES DIED OF)
The chest cavity includes the heart and lungs. The abdominal cavity includes the liver, the stomach, and the small and large intestines. The two regions are separated by the diaphragm, the large dome-shaPE.
THIS IS A DIAGRAM OF A NORMAL BABY WHP DOES NOT HAVE CDH
An abnormal opening in the diaphragm that allows part of the abdominal organs to migrate into the chest cavity, occurring before birth.
AND THIS IS A PICTURE OF A BABY WHO DOES HAVE CDH
ALL OF THE ABOVE INFROMATION CAME FROM A SITE CALLED ATO Z OF LIFESPAN
THIS IS A SITE ALL ABOUT CDH ITS VERY IMFORMATIVE AND A GOOD SITE FOR INFORMATION ON THE CONDITON:www.cherubs-cdh.org/
CONGENITAL DIAPHRAGMATIC HERNIA
What is Congenital Diaphragmatic Hernia?
Your baby has a problem called "Congenital Diaphragmatic Hernia" or CDH. Congenital means "born with" and a hernia is a problem where something goes through a hole it is not supposed to. The hole is in your baby's diaphragm. The diaphragm is a muscle that helps us to breathe and keeps the organs in the abdomen from going into the chest cavity. This is a picture of how things are normally:
When your baby was very small (early in the pregnancy), there was a hole in the diaphragm. This is normal, but the hole usually closes by the end of the third month of pregnancy. In your baby's case, the hole stayed open. This allowed some of the intestines to go into the chest cavity. Since the intestines were in the chest cavity and not where they were supposed to be, the lungs could not grow in the normal space that they need (they had to share the space with the intestines). This means that the lungs are smaller than they should be. The intestines can also push on the other lung and keep it from growing fully and can sometimes keep the heart from growing normally. This is a picture of how things look in a baby with a left-sided diaphragmatic hernia:
How is Congenital Diaphragmatic Hernia treated?
Many times, the lungs of babies with CDH are so small that they have a very hard time breathing after they are born. Most of them need to be placed on a mechanical ventilator or breathing machine. They sometimes even need to be placed on temporary heart/lung bypass (called ECMO) if they have severe problems. The hole in the diaphragm is fixed after the baby is stable. This may range from a few hours to a few weeks after delivery. The surgery may be finished at one time or the baby may need more than one operation. After the operation, most babies are still in the intensive care unit for a while as their lungs get better. Some babies may need help feeding for a while with a tube for feeding. A few babies need another operation to help with feeding or other problems. Many babies with CDH do fine after leaving the hospital, but some have problems that need to be followed. All babies with CDH need regular follow up after going home from the hospital. This is especially important in the first few years after birth.
I JUST WANTED TO INCLUDE SOME MORE INFORMATION FROM ANOTHER SOURCE AS THERE IS QUIET A LOT OF INFO AND SOME MORE STUFF THAT THE OHTER DIDNT INCLUDE. HYPOPLASTIC LEFT HEART SYNDROME Hypoplastic Left Heart Syndrome (HLHS) is a condition in which the left side of the heart is underdeveloped. Usually, the left ventricle, the left atrium, the mitral valve and the aorta are affected. It is called a syndrome because it can encompass several different variations and varying degrees of development of these parts of the heart.
To understand HLHS, it is helpful to understand how a normal baby's heart works. The heart is comprised of four chambers: the upper chambers are called the left and right atria, and the lower chambers are called the left and right ventricles.
Very simply, in a healthy heart blood flows from the right atrium to the right ventricle where it is then pumped through the pulmonary artery to the lungs to be oxygenated. Blood then flows back to the heart via the left atrium to the left ventricle, which pumps this oxygenated blood through the aorta out to the body. This is how the body's organs and tissue receive oxygen, which is vital. When a baby has HLHS, the left side of the heart is underdeveloped so it cannot sufficiently pump the oxygenated blood out to the body.
Babies with HLHS do not have problems while in the womb - it is only after birth that the heart fails to work properly. This is because all babies receive oxygen from the placenta while in the womb, so blood does not need to go to the lungs. In addition, there is an opening between the pulmonary artery and the aorta, called the patent ductus arteriosus (PDA) that is present in all babies. It allows the blood to go from the right ventricle out to the body, bypassing the left side of the heart.
The PDA usually closes a few days after birth, separating the left and right sides of the heart. It is at this time that babies with undetected HLHS will exhibit problems as they experience a lack of blood flow to the body. They may look blue, have trouble eating, and breathe rapidly. If left untreated, this heart defect is fatal - usually within the first few days or weeks of life.
Once HLHS has been diagnosed, a drug called prostaglandin is given to keep the PDA open until surgery is performed. There are two surgical options for treating HLHS: a Heart Transplant or the 3-Stage Surgical Procedure, the first stage of which is called the Norwood procedure. Hypoplastic left heart
Definition
Hypoplastic left heart describes the underdevelopment of the left side of the heart (left ventricle, aortic valve, and aorta). The condition is congenital (present at birth).
Alternative Names
Hypoplastic left heart syndrome; HLHS Causes
Hypoplastic left heart is a rare type of congenital heart disease. The problem develops before birth when there is inadequate growth of the left ventricle and associated structures (aortic and mitral valves that guard the exit and entrance of the ventricle and the aorta which is the blood vessel that carries oxygenated blood from the left ventricle to the entire body).
In patients with this condition, the left side of the heart is unable to maintain blood circulation for the body. As a result, the right side of the heart must maintain the circulation for both the lungs and the body. This extra workload eventually causes the heart to fail.
The only possibility of survival is a connection between the right and the left side of the heart through which blood may pass. This is called a shunt. Babies are normally born with two of these connections (the foramen ovale and the ductus arteriosus), which spontaneously close a few days after birth.
If these structures are allowed to close in a baby with hypoplastic left heart syndrome, however, the patient will quickly die because no blood will be pumped to the body.
There is no known cause of hypoplastic left heart syndrome. Up to 40% of patients with this condition have other birth defects.
Symptoms
Initially, a newborn with hypoplastic left heart may appear normal. Symptoms usually occur in the first few hours of life, although it may take up to a few days to develop symptoms. These symptoms may include:
- Lethargy
- Poor suckling and feeding
- Shortness of breath
- Rapid breathing
- Cold extremities
- Enlarged liver
- Poor pulse
- Pounding heart
- Bluish or poor skin color
- Sudden death
In healthy newborns, bluish color occurs in hands and feet as a response to cold (this reaction is called peripheral cyanosis). However, a bluish color observed in the chest or abdomen, lips, and tongue is abnormal (called central cyanosis) because it reflects lack of adequate levels of oxygen in the blood. This is secondary to the heart malformation and circulatory malfunction. Central cyanosis often increases with crying.
Exams and Tests
A physical examination usually reveals a blue, critically ill patient who may show signs of congestive heart failure, liver enlargement, rapid breathing, and lethargy. Additionally, the pulse at various locations (wrist, groin, and others) is usually very weak.
Tests:
- An ECG shows enlargement of the right ventricle of the heart.
- An x-ray of the chest shows heart enlargement.
- An echocardiogram for the definitive diagnosis shows the tiny left ventricle
- A cardiac catheterization may be necessary in some cases to complement the echocardiogram.
Treatment
Once the diagnosis of hypoplastic left heart is made, a nunber of things are done. First, the patient is put on a ventilator to assist with breathing if necessary. A medicine called prostaglandin E1 is started to prevent a shunt called the ductus arteriosus from closing. Intravenous fluids are started and medicine to help the heart beat stronger is often begun.
These measures are only supportive; they do not solve the problem. The next step is surgery.
There are two surgical approaches to hypoplastic left heart syndrome. One is to do a heart transplant early in life. This means that a small donor heart, which is very rare, must be available. It also means that the patient will have to take a number of medicines to prevent rejection of the new heart.
The other option is a series of operations done over the first 3 years of life; this option is called the Norwood procedure. Stage I of the Norwood procedure is done within the first few days of life and consists of attaching the functioning right ventricle to the aorta (vessel that delivers blood to the body).
Because the lungs must still receive blood, a surgically created conduit (tunnel) is created to attach the a large artery in the chest to the pulmonary arteries (the vessels that lead to the lungs). This conduit is called a Blalock-Taussig (BT) shunt.
In the stage II operation, called the Glenn or Hemi-Fontan procedure, the superior vena cava (the vessel that removes deoxygenated blood from the head and arms) is attached to the pulmonary arteries and the BT shunt is removed.
During stage III, called the Fontan procedure, the inferior vena cava (the vessel that returns deoxyganted blood from the lower half of the body) is also attached to the pulmonary arteries. This is usually performed between the ages of 2-3 years. After the third stage the patient is no longer blue (cyanotic).
The Norwood procedure is relatively new, but outcomes have been good so far. While it is possible that these patients' hearts eventually will fail and they will need a heart transplant, it is much easier to transplant an older patient than an infant.
Outlook (Prognosis)
If left untreated, hypoplastic left heart syndrome is fatal. Survival rates for the staged repair continue to rise as surgical technique and postoperative management improve. Survival after the first stage is more than 75%.
It is important to note that the size and function of the right ventricle are important determinants of outcome after surgery.
Possible Complications
If untreated, heart failure continues to worsen and will result in death.
Prevention
There is no known prevention for hypoplastic left heart syndrome. As with many congenital diseases, the causes of hypoplastic left heart syndrome are uncertain and have not been linked to any maternal diseases or behavior
ABOVE INFORMATION WAS TAKEN FROM LIFESPAN A TO Z
MISSCARRIAGE
Spontaneous abortion (SAB) or miscarriage is the term used for a pregnancy that ends on it's own, within the first 20 weeks of gestation. Often the medical name spontaneous abortion (SAB) gives many women a negative feeling, so throughout this information we will refer to any type of spontaneous abortion or pregnancy loss under 20 weeks as miscarriage.
Miscarriage is the most common type of pregnancy loss, according to the American College of Obstetricians and Gynecologists(ACOG). Studies reveal that anywhere from 10- 25% of all clinically recognized pregnancies will end in miscarriage. Estimations of chemical pregnancies or unrecognized pregnancies that are lost can be as high as 50-75%, but many of these are unknown since they often happen before a woman has missed a period or is aware she is pregnant.
Most miscarriages occur during the first 13 weeks of pregnancy. Pregnancy can be such an exciting time, but with the great number of recognized miscarriages that occur, it is beneficial to be informed on miscarriage, in the unfortunate event that you find yourself or someone you know faced with one.
There can be many confusing terms and moments that accompany a miscarriage. There are different types of miscarriage, different treatments for each and different statistics for what you chances are of having one. The following information gives a broad overview of some of the confusing parts of miscarriage. This information is to help equip you with knowledge so that you might not feel so alone or lost if you face a possible miscarriage situation. As with most complications with pregnancy, remember that the best person you can usually talk with and ask questions of, is your health care provider.
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Why do miscarriages occur?
The reason for miscarriage is varied and most often, the cause can not be identified. During the first trimester, the most common cause of miscarriage is chromosomal abnormality-meaning that something is not correct with the baby's chromosomes. Most chromosomal abnormalities are the cause of a faulty egg or sperm cell or due to a problem at the time that the zygote went through the division process. Other causes for miscarriage include (but are not limited to):
- Hormonal problems, infections or health problems in the mother
- Lifestyle (i.e. smoking, drug use, malnutrition, excessive caffeine and exposure to radiation or toxic substances)
- Implantation of the egg into the uterine lining does not occur properly
- Maternal Age
- Maternal trauma
Factors that are not proven to cause miscarriage are sex, working outside the home (unless in a harmful environment) or moderate exercise.
What are the chances of having a Miscarriage?
For women in childbearing years, the chances of having miscarriage can range from 10-25%, and in most healthy women the average is about 15-20% chance.
- An increase in maternal age changes the chances of miscarriage
- Women under the age of 35 yrs old have about a 15% chance of miscarriage
- Women aged 35-45 yrs old have a 20-35% chance of miscarriage
- Women over the age of 45yrs old can have up to a 50% chance of miscarriage
- A woman who has had a previous miscarriage has a 25% chance of having another (only a slightly elevated risk than for someone who has not had a previous miscarriage)
What are the Warning signs of Miscarriage:
If you experience any or all of these symptoms, it is very important to contact your doctor or get to a medical facility as soon as possible:
- Mild to severe back pain (often worse than normal menstrual cramps)
- Weight loss
- White-pink mucus
- True contractions (very painful happening every 5-20 minutes)
- Frequent bowel movements
- Brown or bright red bleeding or spotting with or without cramps (20-30% of all pregnancies can experience some bleeding in early pregnancy, with about 50% of those resulting in normal pregnancies)
- Tissue with clot like material passing from the vagina
- Nausea
- Decrease in signs of pregnancy or loss of breast tenderness
The different types of Miscarriage:
Miscarriage is often a process and not a single event. There are many different stages or types of miscarriage. There is also a lot of information to learn about healthy fetal development so that you might get a better idea of what is going on with your pregnancy. Understanding early fetal development and first trimester development can aide you in knowing what things your health care provider is looking for when there is concern of a miscarriage occurring.
Most of the time all types of miscarriage are just called Miscarriage, but you may hear your health care provider refer to other terms or names of miscarriage such as:
Threatened Miscarriage: Some degree of early pregnancy uterine bleeding accompanied by cramping or lower backache. The cervix remains closed. This bleeding is often the result of implantation.
Inevitable or Incomplete Miscarriage: Abdominal or back pain accompanied by bleeding with an open cervix. Miscarriage is inevitable when there is a dilation or effacement of the cervix and/or there is rupture of the membranes. Bleeding and cramps may persist if the miscarriage is not complete.
Complete Miscarriage: A completed miscarriage is when the embryo or products of conception have emptied out of the uterus. Bleeding should subside quickly, as should any pain or cramping. A completed miscarriage can be confirmed by an ultrasound or by having a surgical curettage performed.
Missed Miscarriage: Women can experience a miscarriage with out knowing it. A missed miscarriage is when embryonic death has occurred but there it not any expulsion of the uterus. It is not known why this occurs. Signs of this would be a loss of pregnancy symptoms and the absence of fetal heart tones found on an ultrasound. (THIS IS THE MISCARRIAGE THAT I HAD WITH MY MIDDLE BABY ) Usually this type of miscarriage is discovered around 13 weeks.
Recurrent Miscarriage (RM): Defined as 3 or more consecutive first trimester miscarriages. This can affect 1% of couples trying to conceive.
Blighted Ovum: Also called an anembryonic pregnancy. A fertilized egg implants into the uterine wall, but fetal development never begins. Often there is a gestational sac with or without a yolk sac, but there is an absence of fetal growth.
Ectopic Pregnancy: A fertilized egg implants itself in places other than the uterus, most commonly the fallopian tube. Treatment is needed immediately to stop the development of the implanted egg. If not treated rapidly, this could end in serious maternal complications.
Molar Pregnancy: The result of a genetic error during the fertilization process that leads to growth of abnormal tissue within the uterus. Molar pregnancies rarely involve a developing embryo, but often entail the most common symptoms of pregnancy including a missed period, positive pregnancy test and severe nausea.
Treatment of Miscarriage:
The main goal of treatment during or after a miscarriage is to prevent hemorrhaging and/or infection. The earlier you are in the pregnancy, the more likely that your body will expel all the fetal tissue by itself, and will not require further medical procedures. If the body does not expel all the tissue, the most common procedure performed to stop bleeding and prevent infection is a dilation and curettage, known as a D&C. Drugs may be prescribed to help control bleeding after the D& C is performed. Bleeding should be monitored closely once you are at home and if you notice an increase in bleeding or the onset of chills or fever, it is best to call your physician immediately.
Prevention of Miscarriage:
Since the cause for most miscarriages is due to chromosomal abnormalities, there is not much that can be done to prevent them. One vital step is to get as healthy as you can before conceiving to provide a healthy atmosphere for conception to occur.
- Exercise regularly
- Eat healthy
- Manage stress
- Keep weight in healthy limits
- Take folic acid daily
- Do not smoke
Once you find out that you are pregnant, again the goal is to be as healthy as possible, to provide a healthful environment for your baby to grow in:
- Keep your abdomen safe
- Do not smoke or be around smoke
- Do not drink alcohol
- Check with your doctor before taking any over-the-counter medications
- Limit or eliminate caffeine
- Avoid environmental hazards such as radiation, infectious disease and x-rays
- Avoid contact sports or activities that have risk of injury
Emotional Treatment:
Unfortunately, miscarriage is not prejudice in whom it touches. It can affect any couple or family. Often women are left with unanswered questions regarding their physical recovery, their emotional recovery and trying to conceive again. It is very important that women try to keep the lines of communication open with family, friends and health care providers during this time.
please call back as i will be adding more types of pregnancy loss and also more to each section.
Statistics
Stillbirth is common. It may affect anyone. There is no way to predict when stillbirth will happen or who will experience it. Stillbirth occurs in families of all races, religions, and income levels. Each year in the United States about 25,000 babies, or 68 babies every day, are born still. This is about 1 stillbirth in every 115 births. Something as common as this will, at some point, directly or indirectly touch the lives of many people. A friend, a relative, or you, yourself, may experience stillbirth.
Why?
One of the most common questions following a stillbirth is, "Why did my baby die?" Answering this question is not always easy or possible. Extensive and careful examination of the baby and placenta is needed following delivery. This includes an internal autopsy and several other studies. Often these evaluations will provide helpful information and eventually bring peace of mind. With extensive evaluation, a cause for stillbirth can be identified in 40%-50% of all stillbirths. Even when a cause is not specifically identified, at least potential high risks for recurrence may be ruled out. Parents who experience stillbirth will be asked to consider extensive evaluations for their baby. Many will want everything done to try to discover why their baby died. Others may think that such assessment violates their baby. The decision should be theirs. They will need to choose what is best for them.
Causes
Information about cause can be very important for parents and families. It may help parents in planning future pregnancies by providing insight to the frequently asked question, "Will stillbirth happen again?" The information may also help parents and families to deal emotionally with their loss. Knowledge, in general, can be empowering, and it may provide a sense of comfort by helping to alleviate uncertainty or guilt.
Identifiable causes of stillbirth generally fall into one of three different categories: birth defects in the baby, problems with the placenta or umbilical cord, or maternal illnesses or conditions which may sometimes affect pregnancy.
Birth defects are common but often overlooked causes for stillbirth. About one-fourth of babies who are stillborn have one or more birth defects that are responsible for their death.
The placenta and umbilical cord are the baby’s "lifeline" for oxygen and nutrients. Problems in either one may completely cut off or severely interfere with the needed flow of blood, oxygen, and nutrients to the baby. Although commonly pointed to as the likely cause for the death of a baby, problems with the placenta or umbilical cord actually account for only a moderate number of stillbirths.
Although uncommon, maternal conditions may be responsible for stillbirth. Certain illnesses in the mother, such as diabetes or hypertension, and their treatments, sometimes cause stillbirths. An increased risk for stillbirth is also associated with the use of certain recreational drugs, particularly cocaine.
In addition, there are many other rare causes of stillbirth.
How to Cope
In the natural course of life events, babies are least of all expected to die. The loss of a baby through stillbirth can be overwhelming and devastating for parents as well as for family members and friends. Although such feelings are surprising to some, the stillbirth of a baby is a great loss, as great as that of an older child or any loved one.
When stillbirth occurs, parents who were anxiously awaiting a baby suddenly are not. It is natural for them to grieve deeply for the baby who has died and for the hopes, dreams, and wishes that will never be. They may feel a strong sense of sadness, or anger, or bitterness at the unfairness of this tragedy. There is usually nothing anyone did to cause, or could have done to prevent, a stillbirth. Yet, parents especially may feel guilt and blame themselves for the death of their baby. Parents may also experience feelings of loneliness and longing, helplessness, or, because of the intensity of their emotions, confusion.
These emotions are real and a normal part of grieving. Grieving is a process of making meaning out of the loss and of life without their baby. Grieving is not easy. It is long, unpredictable, and requires a lot of energy. Parents and family members need time to grieve since grieving is necessary to work through pain toward healing.
INFORMATION FROM :EMPTYCRADLES.COM/STILLBIRTH.
I WILL BE INCLUDING MY OWN INFORMATION ABOUT STUFF AND ALSO A LITTLE FROM SITES I WANT TO TAKE TIME TO EXTEND MY SYMPATHIES THAT YOU ARE VISITNG SITES LIKE THESE AND THAT YOUR CHILD HAS DIED BUT I HOPE YOU CAN FIND SOME COMFORT AND SUPPORT.
SIDS
(OTHERWISE KNOWN AS SUDDEN INFANT DEATH SYNDROME)
- SIDS claims the lives of almost 3,000 infants in the U.S. each year - that's nearly 9 babies every day.
- SIDS deaths occur unexpectedly and quickly to apparently healthy infants, usually during periods of sleep.
- Most SIDS victims are between two and four months of age.
- SIDS occurs in families of all races and socioeconomic levels.
- SIDS can not be predicted or prevented.
- SIDS is NOT caused by suffocation, choking, immunizations or vaccinations. It is not contagious, nor is it a result of neglected illness or child abuse.
- SIDS can, and does, claim any baby, in spite of parents doing everything right.
Sudden Infant Death Syndrome (SIDS) is one of the leading causes of death among infants one month through one year of age in the United States. The National Institute of Child Health and Human Development (NICHD) defines SIDS as the sudden death of an infant under one year of age which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene and review of the clinical history. SIDS is therefore a diagnosis of exclusion, affixed only once all known and possible causes of death have been ruled out.The Impact of SIDS
The sudden, unexpected death of an infant to Sudden Infant Death Syndrome (SIDS) is a tragic loss. Death happens suddenly, and the family often has no time to prepare. The infant may recently have been given a clean bill of health from the pediatrician.
The death of an infant from SIDS disrupts the natural order and is a traumatic event that affects the family for the rest of their lives. The sudden, unexpected death of an infant threatens parents' safety and security and forces them to confront their own mortality. The lack of a discernible cause, the suddenness of the tragedy and the involvement of the legal system make a SIDS death especially difficult, leaving a great sense of loss and a need for understanding. The impact of SIDS is extensive and affects a myriad of people from parents, siblings, and grandparents to extended family, friends, babysitters, and co-workers. Families are directly helped through information and support services to alleviate their guilt and aid in understanding this devastating syndrome.
Parents often complain of physical symptoms such as aches, tightness in the throat, loss of appetite, insomnia, and feelings of loneliness and isolation. They are often fearful of "going crazy" as they continue to hear the baby cry at night or wake to care for an infant who is no longer there.
The lack of a definitive cause of death, even after autopsy, does little to alleviate any feelings of guilt the parents may have about their responsibility for the death. They often blame themselves. The "if onlys" plague parents who wonder if there was something in the baby's behavior or health they may have missed. A generally uninformed public, including family members and health care professionals, can add to the grief and guilt of the family by voicing incorrect assumptions. Parents have been accused of neglecting or abusing their child because of mistaken information. They need to know that they did not cause, nor could they have prevented, the death. It is not their fault.
Six step to reduce the risk of sudden infant death syndrome
| Please contact us for further information on how you can help reduce the risk of SIDS. |
| 1. Put your healthy baby on its back to sleep - If your baby has problems breathing or spits up a lot after feeding, ask your doctor about how your baby should sleep. 2. No smoking near the baby - Do not smoke during pregnancy and do not let others smoke near your baby. 3. Do not let your baby get too hot - Dress your baby in as much or as little as you would wear. Do not wrap your baby in lots of blankets or clothes. If your baby is sweating, has damp hair, or a heat rash, he or she may be too hot. A baby that has a fever, is breathing fast, or is not able to rest, may also be too hot. 4. Put your baby to sleep on a firm mattress - Do not let the baby sleep on soft things, like cushions, pillows, blankets, the couch, sheepskins, foam pads, or waterbeds. |
| 5. Take good care of yourself and your baby - When pregnant, see your doctor often and do not use drugs or alcohol. Talk with your baby's doctor about changes in your baby and how your baby acts. 6. If possible, breast feed your baby - Breast feeding has been shown to be good for your baby. ALL THIS INFO WAS FROM THE CJ FOUNDATION FOR SIDS CLICK HERE TO BE TAKEN TO MY FRIEND DONNA'S SITE HER BEAUTIFUL LITTLE GIRL AISLINN CELESTE McCOMSEY WAS TAKEN BY SIDS HERE IS THE SITE: http://aislinnmccom ANENCHEPHALY Anencephaly: Neural Tube: . Diagnosis: At Risk: Causes: Treatment: Prognosis: Possible Complications:Polyhydraminos (increased amniotic fluid) is caused by the poor swallowing reflex of the baby. With increased amniotic fluid there is an increased chance of placental abruption if the water breaks and comes out too fast. Generally, though, because there is no top part of the head pressing down, the water does not break on its own. There is also an increased chance of uterine rupture especially if there is a previous uterine scar. Amniocentesis has been performed to remove some of the excess fluid in some cases, but generally the polyhydraminos is just monitored through invasive procedures such as ultrasound and fundal measurements. (In all the women I have talked to who have had polyhydraminos, there was one who had placental abruption, but she feels that is was the direct result of poor management by her Dr. during labor.) Prevention: Folic Acid: Research: Organ Donation: |
ALL THIS INFORMATION WAS FROM A SITE CALLED JESSICAS JOURNEY HERE IS THE ADDRESS FOR MORE INFORMATION:http://www.geocities.com/hotsprings/spa/4346/
PLEASE BEAR WITH ME AS I WILL BE ADDING TONS MORE FOR EACH SECTION OF LOSS I JUST WANTED TO PUT A LITTLE BIT UP JUST NOW SO THAT I COULD GET THE PAGE STARTED.
DIAPHRAGMATIC HERNIA
Diaphragmatic hernia
Definition
A diaphragmatic hernia is an abnormal opening in the diaphragm, occurring before birth, that allows part of the abdominal organs to migrate into the chest cavity.
Alternative Names
Causes
A diaphragmatic hernia is caused by the improper fusion of structures during fetal development. The abdominal organs such as the stomach, small intestine, spleen, part of the liver, and the kidney appear in the chest cavity. The lung tissue on the affected side is thus not allowed to completely develop. Respiratory distress usually develops shortly after the baby is born, because of ineffective movement of the diaphragm and crowding of the lung tissue, which causes collapse. The reason why this occurs is not known.
Congenital diaphragmatic hernia is seen in 1/2200 to 1/5000 live births with the vast majority (80 to 90%) occurring on the left side. There is a 2% recurrence rate in first degree relatives of a patient with the disease.
Symptoms
- severe breathing difficulty
- bluish coloration of the skin due to lack of oxygen
- fast breathing (tachypnea) asymmetry of the chest wall
- fast heart rate (tachycardia)
Exams and Tests
The pregnant mother may have shown signs of polyhydramnios (excessive amounts of amniotic fluid). Fetal ultrasound may show abdominal contents in the chest cavity.
Examination of the infant shows:
- chest movements asymmetric with breathing
- breath sounds absent on the affected side
- bowel sounds heard in the chest
- concave abdomen that feels less full on examination by touch (palpation)
Treatment
A diaphragmatic hernia is a surgical emergency. The abdominal organs must be replaced into the abdominal cavity, and the opening in the diaphragm repaired. Support of the respiratory system is necessary immediately after birth until the infant recovers from surgery. Some infants are placed on ECMO (extracorporeal membrane oxygenation) which is a heart/lung bypass machine which gives the lungs a chance to recover and expand after surgery.
If a diaphragmatic hernia is diagnosed early in gestation (~24 to 28 weeks), fetal surgery may be an option to be considered.
Outlook (Prognosis)
Congenital diaphragmatic hernia is a very serious disorder. The lung tissue may be underdeveloped on the affected side, and the outcome depends upon the development of the lung tissue. With advances in neonatal and surgical care, survival is now greater than 80%. A poor prognosis, however, is associated with polyhydramnios, presence of the fetal stomach in the chest, and an early presentation (i.e., distress in the first few hours of life). Infants who survive may have long-term complications including persistent pulmonary hypertension (PPHN), recurrent lung infections, and gastrointestinal problems.
Possible Complications
- pulmonary (lung) infections
- other congenital anomalies may be present
The diaphragm is a thin dome-shaped muscle which separates the thoracic cavity (lungs and heart) from the abdominal cavity (intestines, stomach, liver, etc.). It is involved in respiration, drawing downward in the chest on inhalation, and pushing upward in exhalation.
AS YOU WILL REMEMBER I ALSO HAVE A SECTION SPECIALLY ON THE SITE ABOUT THIS ALSO KNOWN AS CDH FOR SHORT (AS THIS IS WHAT MY BABIES DIED OF)
The chest cavity includes the heart and lungs. The abdominal cavity includes the liver, the stomach, and the small and large intestines. The two regions are separated by the diaphragm, the large dome-shaPE.
THIS IS A DIAGRAM OF A NORMAL BABY WHP DOES NOT HAVE CDH
An abnormal opening in the diaphragm that allows part of the abdominal organs to migrate into the chest cavity, occurring before birth.
AND THIS IS A PICTURE OF A BABY WHO DOES HAVE CDH
ALL OF THE ABOVE INFROMATION CAME FROM A SITE CALLED ATO Z OF LIFESPAN
THIS IS A SITE ALL ABOUT CDH ITS VERY IMFORMATIVE AND A GOOD SITE FOR INFORMATION ON THE CONDITON:www.cherubs-cdh.org/
| CONGENITAL DIAPHRAGMATIC HERNIA What is Congenital Diaphragmatic Hernia? Your baby has a problem called "Congenital Diaphragmatic Hernia" or CDH. Congenital means "born with" and a hernia is a problem where something goes through a hole it is not supposed to. The hole is in your baby's diaphragm. The diaphragm is a muscle that helps us to breathe and keeps the organs in the abdomen from going into the chest cavity. This is a picture of how things are normally:
When your baby was very small (early in the pregnancy), there was a hole in the diaphragm. This is normal, but the hole usually closes by the end of the third month of pregnancy. In your baby's case, the hole stayed open. This allowed some of the intestines to go into the chest cavity. Since the intestines were in the chest cavity and not where they were supposed to be, the lungs could not grow in the normal space that they need (they had to share the space with the intestines). This means that the lungs are smaller than they should be. The intestines can also push on the other lung and keep it from growing fully and can sometimes keep the heart from growing normally. This is a picture of how things look in a baby with a left-sided diaphragmatic hernia:
How is Congenital Diaphragmatic Hernia treated? Many times, the lungs of babies with CDH are so small that they have a very hard time breathing after they are born. Most of them need to be placed on a mechanical ventilator or breathing machine. They sometimes even need to be placed on temporary heart/lung bypass (called ECMO) if they have severe problems. The hole in the diaphragm is fixed after the baby is stable. This may range from a few hours to a few weeks after delivery. The surgery may be finished at one time or the baby may need more than one operation. After the operation, most babies are still in the intensive care unit for a while as their lungs get better. Some babies may need help feeding for a while with a tube for feeding. A few babies need another operation to help with feeding or other problems. Many babies with CDH do fine after leaving the hospital, but some have problems that need to be followed. All babies with CDH need regular follow up after going home from the hospital. This is especially important in the first few years after birth. |
Hypoplastic left heart
Definition
Hypoplastic left heart describes the underdevelopment of the left side of the heart (left ventricle, aortic valve, and aorta). The condition is congenital (present at birth).
Alternative Names
Causes
Hypoplastic left heart is a rare type of congenital heart disease. The problem develops before birth when there is inadequate growth of the left ventricle and associated structures (aortic and mitral valves that guard the exit and entrance of the ventricle and the aorta which is the blood vessel that carries oxygenated blood from the left ventricle to the entire body).
In patients with this condition, the left side of the heart is unable to maintain blood circulation for the body. As a result, the right side of the heart must maintain the circulation for both the lungs and the body. This extra workload eventually causes the heart to fail.
The only possibility of survival is a connection between the right and the left side of the heart through which blood may pass. This is called a shunt. Babies are normally born with two of these connections (the foramen ovale and the ductus arteriosus), which spontaneously close a few days after birth.
If these structures are allowed to close in a baby with hypoplastic left heart syndrome, however, the patient will quickly die because no blood will be pumped to the body.
There is no known cause of hypoplastic left heart syndrome. Up to 40% of patients with this condition have other birth defects.
Symptoms
Initially, a newborn with hypoplastic left heart may appear normal. Symptoms usually occur in the first few hours of life, although it may take up to a few days to develop symptoms. These symptoms may include:
- Lethargy
- Poor suckling and feeding
- Shortness of breath
- Rapid breathing
- Cold extremities
- Enlarged liver
- Poor pulse
- Pounding heart
- Bluish or poor skin color
- Sudden death
However, a bluish color observed in the chest or abdomen, lips, and tongue is abnormal (called central cyanosis) because it reflects lack of adequate levels of oxygen in the blood. This is secondary to the heart malformation and circulatory malfunction. Central cyanosis often increases with crying.
Exams and Tests
A physical examination usually reveals a blue, critically ill patient who may show signs of congestive heart failure, liver enlargement, rapid breathing, and lethargy. Additionally, the pulse at various locations (wrist, groin, and others) is usually very weak.
Tests:
- An ECG shows enlargement of the right ventricle of the heart.
- An x-ray of the chest shows heart enlargement.
- An echocardiogram for the definitive diagnosis shows the tiny left ventricle
- A cardiac catheterization may be necessary in some cases to complement the echocardiogram.
Treatment
Once the diagnosis of hypoplastic left heart is made, a nunber of things are done. First, the patient is put on a ventilator to assist with breathing if necessary. A medicine called prostaglandin E1 is started to prevent a shunt called the ductus arteriosus from closing. Intravenous fluids are started and medicine to help the heart beat stronger is often begun.
These measures are only supportive; they do not solve the problem. The next step is surgery.
There are two surgical approaches to hypoplastic left heart syndrome. One is to do a heart transplant early in life. This means that a small donor heart, which is very rare, must be available. It also means that the patient will have to take a number of medicines to prevent rejection of the new heart.
The other option is a series of operations done over the first 3 years of life; this option is called the Norwood procedure. Stage I of the Norwood procedure is done within the first few days of life and consists of attaching the functioning right ventricle to the aorta (vessel that delivers blood to the body).
Because the lungs must still receive blood, a surgically created conduit (tunnel) is created to attach the a large artery in the chest to the pulmonary arteries (the vessels that lead to the lungs). This conduit is called a Blalock-Taussig (BT) shunt.
In the stage II operation, called the Glenn or Hemi-Fontan procedure, the superior vena cava (the vessel that removes deoxygenated blood from the head and arms) is attached to the pulmonary arteries and the BT shunt is removed.
During stage III, called the Fontan procedure, the inferior vena cava (the vessel that returns deoxyganted blood from the lower half of the body) is also attached to the pulmonary arteries. This is usually performed between the ages of 2-3 years. After the third stage the patient is no longer blue (cyanotic).
The Norwood procedure is relatively new, but outcomes have been good so far. While it is possible that these patients' hearts eventually will fail and they will need a heart transplant, it is much easier to transplant an older patient than an infant.
Outlook (Prognosis)
If left untreated, hypoplastic left heart syndrome is fatal. Survival rates for the staged repair continue to rise as surgical technique and postoperative management improve. Survival after the first stage is more than 75%.
It is important to note that the size and function of the right ventricle are important determinants of outcome after surgery.
Possible Complications
If untreated, heart failure continues to worsen and will result in death.
Prevention
There is no known prevention for hypoplastic left heart syndrome. As with many congenital diseases, the causes of hypoplastic left heart syndrome are uncertain and have not been linked to any maternal diseases or behavior
ABOVE INFORMATION WAS TAKEN FROM LIFESPAN A TO Z
MISSCARRIAGE
Spontaneous abortion (SAB) or miscarriage is the term used for a pregnancy that ends on it's own, within the first 20 weeks of gestation. Often the medical name spontaneous abortion (SAB) gives many women a negative feeling, so throughout this information we will refer to any type of spontaneous abortion or pregnancy loss under 20 weeks as miscarriage.
Miscarriage is the most common type of pregnancy loss, according to the American College of Obstetricians and Gynecologists(ACOG). Studies reveal that anywhere from 10- 25% of all clinically recognized pregnancies will end in miscarriage. Estimations of chemical pregnancies or unrecognized pregnancies that are lost can be as high as 50-75%, but many of these are unknown since they often happen before a woman has missed a period or is aware she is pregnant.
Most miscarriages occur during the first 13 weeks of pregnancy. Pregnancy can be such an exciting time, but with the great number of recognized miscarriages that occur, it is beneficial to be informed on miscarriage, in the unfortunate event that you find yourself or someone you know faced with one.
There can be many confusing terms and moments that accompany a miscarriage. There are different types of miscarriage, different treatments for each and different statistics for what you chances are of having one. The following information gives a broad overview of some of the confusing parts of miscarriage. This information is to help equip you with knowledge so that you might not feel so alone or lost if you face a possible miscarriage situation. As with most complications with pregnancy, remember that the best person you can usually talk with and ask questions of, is your health care provider.
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Why do miscarriages occur?
The reason for miscarriage is varied and most often, the cause can not be identified. During the first trimester, the most common cause of miscarriage is chromosomal abnormality-meaning that something is not correct with the baby's chromosomes. Most chromosomal abnormalities are the cause of a faulty egg or sperm cell or due to a problem at the time that the zygote went through the division process. Other causes for miscarriage include (but are not limited to):
- Hormonal problems, infections or health problems in the mother
- Lifestyle (i.e. smoking, drug use, malnutrition, excessive caffeine and exposure to radiation or toxic substances)
- Implantation of the egg into the uterine lining does not occur properly
- Maternal Age
- Maternal trauma
Factors that are not proven to cause miscarriage are sex, working outside the home (unless in a harmful environment) or moderate exercise.
What are the chances of having a Miscarriage?
For women in childbearing years, the chances of having miscarriage can range from 10-25%, and in most healthy women the average is about 15-20% chance.
- An increase in maternal age changes the chances of miscarriage
- Women under the age of 35 yrs old have about a 15% chance of miscarriage
- Women aged 35-45 yrs old have a 20-35% chance of miscarriage
- Women over the age of 45yrs old can have up to a 50% chance of miscarriage
- A woman who has had a previous miscarriage has a 25% chance of having another (only a slightly elevated risk than for someone who has not had a previous miscarriage)
What are the Warning signs of Miscarriage:
If you experience any or all of these symptoms, it is very important to contact your doctor or get to a medical facility as soon as possible:
- Mild to severe back pain (often worse than normal menstrual cramps)
- Weight loss
- White-pink mucus
- True contractions (very painful happening every 5-20 minutes)
- Frequent bowel movements
- Brown or bright red bleeding or spotting with or without cramps (20-30% of all pregnancies can experience some bleeding in early pregnancy, with about 50% of those resulting in normal pregnancies)
- Tissue with clot like material passing from the vagina
- Nausea
- Decrease in signs of pregnancy or loss of breast tenderness
The different types of Miscarriage:
Miscarriage is often a process and not a single event. There are many different stages or types of miscarriage. There is also a lot of information to learn about healthy fetal development so that you might get a better idea of what is going on with your pregnancy. Understanding early fetal development and first trimester development can aide you in knowing what things your health care provider is looking for when there is concern of a miscarriage occurring.
Most of the time all types of miscarriage are just called Miscarriage, but you may hear your health care provider refer to other terms or names of miscarriage such as:
Threatened Miscarriage: Some degree of early pregnancy uterine bleeding accompanied by cramping or lower backache. The cervix remains closed. This bleeding is often the result of implantation.
Inevitable or Incomplete Miscarriage: Abdominal or back pain accompanied by bleeding with an open cervix. Miscarriage is inevitable when there is a dilation or effacement of the cervix and/or there is rupture of the membranes. Bleeding and cramps may persist if the miscarriage is not complete.
Complete Miscarriage: A completed miscarriage is when the embryo or products of conception have emptied out of the uterus. Bleeding should subside quickly, as should any pain or cramping. A completed miscarriage can be confirmed by an ultrasound or by having a surgical curettage performed.
Missed Miscarriage: Women can experience a miscarriage with out knowing it. A missed miscarriage is when embryonic death has occurred but there it not any expulsion of the uterus. It is not known why this occurs. Signs of this would be a loss of pregnancy symptoms and the absence of fetal heart tones found on an ultrasound. (THIS IS THE MISCARRIAGE THAT I HAD WITH MY MIDDLE BABY ) Usually this type of miscarriage is discovered around 13 weeks.
Recurrent Miscarriage (RM): Defined as 3 or more consecutive first trimester miscarriages. This can affect 1% of couples trying to conceive.
Blighted Ovum: Also called an anembryonic pregnancy. A fertilized egg implants into the uterine wall, but fetal development never begins. Often there is a gestational sac with or without a yolk sac, but there is an absence of fetal growth.
Ectopic Pregnancy: A fertilized egg implants itself in places other than the uterus, most commonly the fallopian tube. Treatment is needed immediately to stop the development of the implanted egg. If not treated rapidly, this could end in serious maternal complications.
Molar Pregnancy: The result of a genetic error during the fertilization process that leads to growth of abnormal tissue within the uterus. Molar pregnancies rarely involve a developing embryo, but often entail the most common symptoms of pregnancy including a missed period, positive pregnancy test and severe nausea.
Treatment of Miscarriage:
The main goal of treatment during or after a miscarriage is to prevent hemorrhaging and/or infection. The earlier you are in the pregnancy, the more likely that your body will expel all the fetal tissue by itself, and will not require further medical procedures. If the body does not expel all the tissue, the most common procedure performed to stop bleeding and prevent infection is a dilation and curettage, known as a D&C. Drugs may be prescribed to help control bleeding after the D& C is performed. Bleeding should be monitored closely once you are at home and if you notice an increase in bleeding or the onset of chills or fever, it is best to call your physician immediately.
Prevention of Miscarriage:
Since the cause for most miscarriages is due to chromosomal abnormalities, there is not much that can be done to prevent them. One vital step is to get as healthy as you can before conceiving to provide a healthy atmosphere for conception to occur.
- Exercise regularly
- Eat healthy
- Manage stress
- Keep weight in healthy limits
- Take folic acid daily
- Do not smoke
Once you find out that you are pregnant, again the goal is to be as healthy as possible, to provide a healthful environment for your baby to grow in:
- Keep your abdomen safe
- Do not smoke or be around smoke
- Do not drink alcohol
- Check with your doctor before taking any over-the-counter medications
- Limit or eliminate caffeine
- Avoid environmental hazards such as radiation, infectious disease and x-rays
- Avoid contact sports or activities that have risk of injury
Emotional Treatment:
Unfortunately, miscarriage is not prejudice in whom it touches. It can affect any couple or family. Often women are left with unanswered questions regarding their physical recovery, their emotional recovery and trying to conceive again. It is very important that women try to keep the lines of communication open with family, friends and health care providers during this time.
please call back as i will be adding more types of pregnancy loss and also more to each section.
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