Chronic Health Problems
Q. I am seven weeks pregnant and this is my third pregnancy. My son is 18 months, and I miscarried in July 2003. With all three pregnancies, my eczema has been really bad. Apparently the hormones associated with pregnancy can make it worse. With my son, the eczema was bad, and I was not allowed to use any cortisone creams until after 16 weeks. With this pregnancy, my eczema is so bad that I don't know what to do! My hands are swollen, cracked and bleeding and the itching is out of control! There must be something I can do to be a little more comfortable. Is there anything I can do? I am desperate!
-Anonymous, New York
A. Unfortunately, during pregnancy chronic problems have a tendency to escalate. Those horror-mones can really take a toll on a pregnant woman's body.
It might be wise to see a dermatologist to explore the options available to you during your pregnancy. You may be able to find a specialist in eczema.
You may also want to consider acupuncture, as it doesn't involve the use of drugs. If you go this route, be sure to find an acupuncturist that has experience treating pregnant women.
Q. My husband and I are going to try for pregnancy soon. We visited my gynecologist to ask questions, but I forgot to mention to her that I had an inguinal hernia when I was a child (it runs in my family). When I'm under a lot of stress, the area sometimes aches. Could this affect my pregnancy? Should I talk to my doctor about it before we get pregnant? It's kind of expensive to make another appointment each time I think of a new question, but I don't want to take any chances.
-Anonymous, North Carolina
A. Unfortunately, chronic problems do seem to flare up and intensify during pregnancy. Since an inguinal hernia sometimes happens as a result of the strain of pregnancy, I think your prior condition will become a problem for you. You should talk to your doctor about it now. It may be much easier to have a minor surgery at this point than to address the problem while you’re pregnant. Or, your doctor may just recommend that you keep an eye on it and take extra precautions not to put too much strain on the area during pregnancy. It all depends on the extent of your condition.
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Q. I have chronic eczema and I'm pregnant. My fiancé has never seen my whole body in the light. I tell him that I don't like my body. I have dark marks from the eczema. Do you think he will be upset with me? Should I just show him? He already knows that I have eczema but he doesn't know exactly what my lower body, my belly and my arms looks like. What do I do?
-Anonymous, New York
A. If he is your fiancé and he loves you, you should show him your body. He's bound to see it sooner or later, especially if you plan to have him present for the birth of your baby. Starting off a relationship being honest and open with your thoughts and body will give you the best chance for a strong and loving future together.
You seem to have a negative body image. The good news is that this could change as a result of being pregnant. Some women feel more body positive and sexy as pregnancy progresses. My friend Marsha says she was never more confident in her physical appearance than when she was pregnant. She normally had low self-esteem regarding her looks. She hardly ever wore the negligees that her husband bought her for every anniversary. When she became pregnant, she wore the negligees so often that she stretched out or tore every piece she owned. My guess is that the torn negligee had more to do with her husband's enthusiasm than her expanding girth!
Q. What are fibroid tumors in pregnancy and are they dangerous? My doctor said it was nothing to worry about. Can something be wrong with me or the baby from a fibroid tumor?
A. Most women who have fibroid tumors (a non-cancerous growth in the uterus) during pregnancy have no complications because of them. Only 10 to 30 percent of pregnant women with fibroids end up having some problems. Those problems may include abdominal pain, light vaginal bleeding, stalled labor or the need for a Cesarean section because of a breech birth due to the growth of a fibroid tumor.
Sometimes fibroid tumors become smaller during pregnancy, while other times the tumors may enlarge. Your doctor will most likely keep an eye on your potential problem to ensure the most comfortable and pleasant pregnancy for you and your baby.
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Q. I have a small hernia that does not bother me. Will I need to have it removed before becoming pregnant?
A. You don't have to have your hernia repaired, but I do recommend it. Chronic conditions such as this one do become much more troublesome and painful during pregnancy. It may even escalate to the point of requiring surgery, which is not always the safest option during pregnancy.
You should see your general practitioner for a consultation and to find out if surgery would be covered by your insurance.
My insurance company would not pay for the surgery of my pregnancy-induced herniated navel and muscle separation of the abdomen, because it was not "life threatening." Although my condition is getting better now, it was very painful and uncomfortable during the pregnancy and for the first 14 months after the birth of my second daughter. I hope you have a better insurance plan than I did.
Q. I'm 20 weeks pregnant and previously had two early miscarriages. I have abnormal thrombin function so I'm on blood thinners to help prevent miscarriage due to clotting. I have constant lower back pain that gets worse while I'm lying in bed. I try to sleep on my side and use lots of pillows for support, but it doesn't seem to help. When I get up the pain eases, but by the end of the day I just can't get comfortable in any position. I've read that lower back pain is a sign of premature labor and I'm really worried that this may happen. I occasionally get mild crampy feelings, like the pain I get the day before my period, but this has been going on all through my pregnancy. I also have fibromyalgia and IBS (Irritable Bowel Syndrome). Do I need to worry that my back pain is a bad sign, or could it just be due to the fibromyalgia and IBS getting worse?
-Anonymous, United Kingdom
A. Any pre-existing chronic health problem has the potential to worsen with pregnancy. It's possible that your fibromyalgia and IBS are acting up more than usual.
Then again, what you've described could just be normal symptoms of pregnancy. (See other questions about back pain and labor for more details.) In either case, you should mention your discomfort to your OB/GYN. There may be treatment options available to you to help alleviate the pain.
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Q. I was told at the birth of my last child, who was delivered by Cesarean section, that my uterine wall is thin and my bladder is stuck to the uterus. Can you tell me if this will cause problems in any future pregnancies?
A. It's hard to say if your condition will become a problem with future pregnancies or not. It depends on how thin your uterine wall is, how much surface area of the bladder is stuck to the uterus, if your uterus becomes weaker with each pregnancy, etc. Since you and your doctor are already aware of your condition, you have an advantage. Your doctor will be able to monitor it more closely if you do become pregnant again and head off any potential problems, such as premature labor. But, you most likely will have to deliver via C-section again.
Q. I have had a COPD (Chronic Obstructive Pulmonary Disease) since birth. My symptoms are like bronchitis. I am 23 weeks pregnant with my first child and I have been having much more difficulty breathing. I have been coughing for three months and I am wheezing and easily winded. I have had two rounds of antibiotics and I am using some inhalers, but nothing is helping. I heard once that women with COPD should be careful because the estrogen from pregnancy can make breathing more difficult. Is it likely that this increased estrogen is causing my difficulty breathing?
A. Note: COPD (Chronic Obstructive Pulmonary Disease) is an umbrella term used to describe lung disease associated with airflow obstruction.
The extra estrogen produced during pregnancy does have pro-inflammatory effects, making mucous membranes such as the vaginal walls, nasal passages and lungs more swollen. Therefore, women with COPD have more trouble breathing during pregnancy. Not only is the estrogen going to affect your breathing capacity, but also the growing fetus will, in later months, impede on the space of the lungs.
The only advice I can give you is to try to relax as much as possible for the remainder of your pregnancy. Be very careful not to overexert yourself and do carry your inhaler and emergency information with you everywhere you go.
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Q. I am five weeks pregnant. I've had three miscarriages in the past one and a half years (one at seven weeks, one at 10 weeks and one at six weeks.) I've been diagnosed with Anticardiolipin Antibody Syndrome and a non-functioning pituitary tumor (4mm micradenoma). I am taking progesterone and a low-dose aspirin for this pregnancy. Does having these two conditions mean I will not be able to maintain a pregnancy?
A. Note: Anticardiolipin Syndrome (APS) is characterized by recurrent vein or artery clots, recurrent miscarriage and a reduction of platelets in the blood. APS can be either primary or secondary to other diseases, such as lupus.
Pregnant women who have APS are at increased risk for miscarriage and fetal growth retardation. Your non-functioning pituitary tumor (which produces no hormones that may adversely affect the body) should not affect your pregnancy at all. With close medical attention you might be able to carry a pregnancy to term. If your current pregnancy fails, future pregnancies may not be possible without the intervention of a doctor who specializes in APS.
Q. During pre-menopause a women's estrogen level decreases. When you are extremely overweight, women are thought to have more estrogen and this is why it is difficult to get pregnant and it almost works as a form of birth control. Does this mean that if I am obese, as I get older I will become more fertile? I am 38 and we would like a third child but are having some difficulty getting pregnant.
A. That's an interesting theory, but I don't think you should play the waiting game if you want to become pregnant. There's a possibility that one day your estrogen levels may even out, but who knows for how long. It may be a year, maybe a month, maybe a day. And, who knows when that will happen. Maybe not until you're fifty. If you really want to have another child, I think you should take action now: Go on a diet and start an exercise regimen while you are still relatively young. Not only is it more difficult to become pregnant while being obese, but there are a lot more risks associated with pregnancy for obese women.