The gentlebirth.org website is provided courtesy of
Ronnie Falcao, LM MS,
a homebirth midwife in Mountain View, CA
The gentlebirth.org website is provided courtesy of
Ronnie Falcao, LM MS,
a homebirth midwife in Mountain View, CA
|
A Free Film - A wide range of view points ~ A simple message Normalize Birth - watch the trailer then Donate! if you can |
Brief
overview of maternal triglycerides as a risk factor for pre-eclampsia.
Ray JG, Diamond P, Singh G, Bell CM.
BJOG. 2006 Apr;113(4):379-86.
AUTHOR'S CONCLUSIONS: There exists a consistent positive association
between elevated maternal TG and the risk of pre-eclampsia. Given that
maternal hypertriglyceridemia is a common feature of the metabolic syndrome,
interventional studies are needed to determine whether pre-pregnancy weight
reduction and dietary modification can lower the risk of pre-eclampsia.
Poor Pregnancy Outcomes Linked To Increased Uric Acid
Uric
acid is as important as proteinuria in identifying fetal risk in women
with gestational hypertension.
Roberts JM, Bodnar LM, Lain KY, Hubel CA, Markovic N, Ness RB,
Powers RW.
Hypertension. 2005 Dec;46(6):1263-9. Epub 2005 Oct 24.
Women with only hypertension and hyperuricemia have similar or greater
risk as women with only hypertension and proteinuria.
Preeclampsia
as a Maternal-Fetal Conflict by Michel Odent, MD
Regular Consumption
of Cola May Be Linked to Hypertension in Women CME - 11/8/05 [Medscape
registration is free]
Pregnancy
Induced Hypertension – A Case Summary By: Lisa Murray-Doran B.Sc.,
N.D.
Paternal role in pre-eclampsia etiology confirmed - A study of Norwegian birth registry data has confirmed that fetal genes from both the mother and father, as well as maternal genes, contribute to the risk of pre-eclampsia.
Recurrence
of pre-eclampsia across generations: exploring fetal and maternal genetic
components in a population based cohort
Skjaerven R, Vatten LJ, Wilcox AJ, Ronning T, Irgens LM, Lie RT.
BMJ. 2005 Sep 16; [Epub ahead of print]
CONCLUSIONS: Maternal genes and fetal genes from either the mother or
father may trigger pre-eclampsia. The maternal association is stronger
than the fetal association. The familial association predicts more severe
pre-eclampsia.
vitaminshoppe.com has surprisingly good resources about Pregnancy-Induced
Hypertension and Nonproteinuric
PIH
How Should Blood
Pressure Be Measured During Pregnancy? [Medscape registration
is free]. This article has an excellent discussion of the high rate
of misdiagnosis of white-coat hypertension as pre-eclampsia.
Clue to pregnancy
disorder found [10/11/04] Scientists believe they are closer to understanding
why a condition that can threaten pregnancy occurs.
MTLP
or Preeclampsia - Here's a great handout for parents from the
Perinatal Education Associates, Inc. except that they're still using the
OLD definition of PIH as being relative to baseline values, i.e. rise in
diastolic blood pressure of at least 15 mm Hg or in systolic blood pressure
of 30 mm Hg. It should be defined as a sustained blood pressure to
levels of 140 mmHg systolic or 90 mm Hg diastolic.
Circadian
Blood Pressure Variability as a Function of Parity in Normotensive Pregnant
Women [Medscape]
According to ACOG technical bulletin (Number 219 January 1996), hypertension is defined as a sustained blood pressure to levels of 140 mmHg systolic or 90 mm Hg diastolic. The concept of increase in blood pressure of 30 mm Hg systolic or 15 mm Hg diastolic from second trimester values as diagnostic is no longer considered valid.
Report
of the Canadian Hypertension Society Consensus Conference: 1. Definitions,
evaluation and classification of hypertensive disorders in pregnancy.
Helewa ME, Burrows RF, Smith J, Williams K, Brain P, Rabkin SW
CMAJ 1997 Sep 15;157(6):715-25
This is also the definition used by ACOG.
Here's the old information for comparison - OBGYN.net - Definitions of Preeclampsia
Preeclampsia and
Eclampsia Revisited - (12/16/2003) [Medscape registration is free.]
Pregnancy Woe Uncovered: Protein may underlie preeclampsia (March 8, 2003)
" Many of the symptoms of preeclampsia, a major cause of maternal death
and premature birth worldwide, stem from a single protein, researchers
have found. The discovery could lead to new ways of detecting and treating
the disease.
Hypothesis:
Preeclampsia as a Maternal-Fetal Conflict [Medscape registration is
free]
Hormones
Involved in Preeclampsia Shed Light on High Blood Pressure [Medscape
registration is free]
Issue 143 Fruit, vegetables and blood pressure
Summary of Pre-Eclampsia Issues
Stretching
Exercises May Reduce Risk Of Pre-eclampsia During Pregnancy
A comparison of
walking versus stretching exercises to reduce the incidence of preeclampsia:
a randomized clinical trial.
Low
levels of omega-3s associated with preeclampsia
After adjusting for confounders, women with the lowest levels of omega-3
fatty acids were 7.6 times more likely to have had their pregnancies complicated
by preeclampsia as compared with those women with the highest levels of
omega-3 fatty acids (95% CI = 1.4-40.6).
Periconceptual
multivitamin use reduces the risk for preeclampsia, particularly in lean
women - CME
The Role
of Regular Physical Activity in Preeclampsia Prevention [01/04/2005
- Medscape registration is free]
Hypothesis:
Preeclampsia as a Maternal-Fetal Conflict
ABSTRACT: The association of preeclampsia with both high and low birth
weight challenges the current belief that reduced uteroplacental perfusion
is the unique pathophysiologic process in preeclampsia. Preeclampsia is
thus presented from a new perspective, in the framework of maternal/fetal
conflict. Interspecies comparisons encourage us to raise new questions
concerning the potential for conflict among humans. The spectacular brain
growth spurt during the second half of fetal life is a specifically human
trait. A conflict between the demands expressed by the fetus and what the
mother can do without depleting her body leads us to consider first the
needs of the developing brain.
It's possible that an overly acidic system may contribute to the problem.
Acid-alkaline
balance: role in chronic disease and detoxification.
In conclusion, the increasing dietary acid load in the contemporary
diet can lead to a disruption in acid-alkaline homeostasis in various body
compartments and eventually result in chronic disease through repeated
borrowing of the body's alkaline reserves. Adjustment of tissue alkalinity,
particularly within the kidney proximal tubules, can lead to the more effective
excretion of toxins from the body. Metabolic detoxification using a high
vegetable diet in conjunction with supplementation of an effective alkalizing
compound, such as potassium citrate, may shift the body's reserves to become
more alkaline.
Long-term
persistence of the urine calcium-lowering effect of potassium bicarbonate
in postmenopausal women.
Potassium bicarbonate (KBC) potently reduces urine calcium excretion
in adult humans, including patients with hypertension or calcium urolithiasis,
and postmenopausal women.
My recommendation would be to increase fluids as well as protein (110-115
grams
Remember back to basic biology class where the cell membranes are composed
of protein molecules which govern the passage of fluid into and out of
each cell. Blood vessel walls are particularly sensitive to this
lack of protein. As the protein is needed in third trimester for
the needs of the fetus, protein molecules are robbed from wherever they
are most available. Unfortunately, in a protein deficient diet, the likely
source of protein will be the blood vessel walls, leaving them with the
appearance of swiss cheese. The fluid "leaks" out due to the lack
of sufficient protein molecules, dropping the blood pressure inside the
blood vessel and causing edema. The heart senses the drop in pressure
and increases the pressure to compensate. This causes increased pressure
in the kidneys which can further reduce the protein absorption necessary
to the fetus, and feed this vicious cycle. Also causes increased pressure
across the placenta, which lowers the amounts of nutrients available to
the fetus (hence the connection with PIH and IUGR).
So, logically, one would increase dietary protein, and allow sufficient
water to ease the strain on the kidneys and allow protein re-absorption
into the general blood flow. But not to overload the kidneys with
excess fluid, which dulls the appetite.
I have cared for many women with pre-existing PIH, and some with a history
prior pregnancies with full blown pre-eclampsia. With dietary and
fluid adjustments, they all safely delivered at home, and did well, without
any reoccurrence of blood pressure or kidney problems.
Herbal
Allies for Pregnancy by Linda Woolven from Mothering
Magazine - has a section on Preeclampsia.
Maternal
periodontal disease is associated with an increased risk for preeclampsia.
"[A]ctive maternal periodontal disease during pregnancy is associated
with an increased risk for the development of preeclampsia."
It's not at all clear whether this is a causative relationship, but
if I were developing PIH and also noticed increasing gum problems, I'd
certainly want to start treating the gum problems. Increased dental
hygiene could include more diligent brushing, flossing and use of herbal
or chemical oral disinfectants. You could use an echinacea mouthwash
or use tea tree oil on your gumline after brushing. Also, herbal
and vitamin immune support would also seem sensible.
Placental Defect May Cause PIH/Eclampsia
(Reuters) Two studies shown high-stress occupations triple the risk
of pregnancy-induced hypertension, and high levels of personal stress in
pregnant women double the risk of premature birth. Drs. Landsbergis and
Hatch say pregnancy-induced hypertension occurred independently of a number
of factors, including parity, amount of physical work involved in the job
and total hours of paid work. "In particular, was associated with low decision
latitude and low job complexity among women in lower-status jobs," the
Cornell researchers report. In a study conducted by researchers at Aarhus
University in Copenhagen Dr. Morten Hedegaard and others report that: "Women
who had one or more highly stressful life events had a risk of preterm
delivery 1.76 times greater than those without stressful events... was
observed primarily with events experienced between the 16th and 30th week
of gestation." Epidemiology 1996:7:339-345, 346-351.
Another study referred to ( referenced elsewhere in this thread ) showed
( as I recall ) pre-eclampsia to be more common in short duration relationships
than in longer one's in multips also. A number of studies have shown PE
to be more common in multips with new partners than women sticking with
the same partner.
In regards to a recent post that mentioned research published in the
last year about immunological intercourse preventing pre-eclampsia:
I have a copy of a couple of articles about this subject that were published
in Lancet 344: 8 Oct 94 #8928. One is found on page 969, and is titled:
Does immunological intercourse prevent pre-eclampsia?
The other article is page 973 and 975, and is titled: Association of
pregnancy-induced hypertension with duration of sexual cohabitation before
conception.
Lastly, there was an article published in Science news 146: 246, dated
15 Oct 94. This article basically sums up what is in the articles in Lancet.
This article's concluding paragraphs say (and I quote):
"Something in male ejaculate may help protect a woman from pre-eclampsia
- - If she's been repeatedly exposed to it, says David A. Clark of McMaster
University in Hamilton, Ontario. Researchers don't know whether the sperm
itself, the accompanying white cells, or the nourishing liquid called seminal
plasma is responsible for the shielding effect.
Such a concept is not as far-fetched as it may sound. For example, scientist
already know that substances from the father lead to a beneficial immune
response in the mother that helps sustain a healthy placenta. In pre-eclampsia,
blood flow through the placenta in inadequate. -K.A. Fackelmann"
Urinary
podocyte excretion as a marker for preeclampsia.
CONCLUSION: Podocyturia is a highly sensitive and specific marker for
preeclampsia. It may contribute to the development of proteinuria in preeclampsia.
Make sure you check her hemoglobin because if she doesn't have a contracted
hemoglobin then she isn't toxic. There have to be other things in place
before she would have toxemia. I have had clients who had high BP and protein
and swelling and no contracted blood volume so no toxemia. Have her eat
a very high protein diet and see what happens. Usually this will correct
the protein problem.
What are your experiences using deep tendon reflexes in management of
pih?
It's been several years since I did a thorough investigation of this,
in association with a case where an L&D nurse thought the clonus much
more significant than I did. Generalized hyperreflexia can be a normal
result of labor. Because it is a highly non-specific and insensitive finding,
no authoritative case definition of pre-eclampsia uses the presence or
absence of hyperreflexia to contribute to the diagnosis. (I'll append below
the list I've sent here before, with the repeated caution that it was assembled
several years ago and newer versions may have superseded these. I also
have not gone through and niced up the line formatting, non-ASCII characters,
etc. I believe that this is also now on the list's web site.)
IMHO, it is a test that should not be performed, as it does not contribute
information of sufficient quality to base a clinical decision on.
Bed Rest for
Hypertension in Pregnancy Not Backed by Strong Evidence
Preventing Pregnancy Induced Hyptertension (PIH)
"I know PIH far too well... Here's what has worked for me, but others
should research for themselves to see what works.
1. Drink water, drink some more, and drink some more. You'll know the
bathrooms around town like no one else. We're talking 2+ quarts/day.
Also: spend at least 30 mins a day in a pool. Studies have shown that
full body immersion (in a pool, not a tub) for 30+ minutes a day will help
bring the BP down." -Heather McCue
The Role
of Regular Physical Activity in Preeclampsia Prevention [01/04/2005
- Medscape registration is free]
Report
of the Canadian Hypertension Society Consensus Conference: 2. Nonpharmacologic
management and prevention of hypertensive disorders in pregnancy.
Role of Magnesium
Deficiency in Pre-Eclampsia
Theoretically, the most direct way to prevent preeclampsia
would be to consume sea fish that is rich in n-3 polyunsaturates and also
in minerals that are essential nutrients for the brain (eg, iodine, selenium,
and zinc).
Arbor Clinical Nutrition Updates 2002 (Dec);143:1-2 ISSN 1446-5450
It is feasible to increase people’s fruit and vegetable intake with
a relatively simple intervention in a general practice setting.
This will increase antioxidant levels and may reduce blood pressure.
[Editor's Note - some of my clients do well with compressed Wheat Grass
tablets.]
Causes of PIH and Prevention
Yeo S, Davidge S, Ronis DL, Antonakos CL, Hayashi R, O'Leary S.
Hypertens Pregnancy. 2008;27(2):113-30.
Williams MA, Zingheim RW, King IB, Zebelman AM; Omega-3 fatty acids
in maternal erythrocytes and risk of preeclampsia; Epidemiology 1995;6(3):232-237.
Michel Odent, MD
APPPAH Journal : 20 (4). Summer Issue
Minich DM, Bland JS.
Altern Ther Health Med. 2007 Jul-Aug;13(4):62-5.
Frassetto L, Morris RC Jr, Sebastian A.
J Clin Endocrinol Metab. 2005 Feb;90(2):831-4.
Boggess KA, Lieff S, Murtha AP, Moss K, Beck J, Offenbacher S.
Obstet Gynecol 2003 Feb;101(2):227-31
Stress increases pregnancy risks.
The following article cites the critical time when interventions to decrease
stress should be implemented. One positive approach would be the use of
hypnotherapy techniques and/or relaxation techniques, started early on
in pregnancy. One problem is many of these folks aren't interested in these
techniques. Glad to see more research to support the things I've believed
for years.
Underlying Disease
Pre-eclampsia which recurs or which arises in a subsequent pregnancy without
occurring first time round is more commonly associated with underlying
disease - renal, essential hypertension, auto-immune, thrombogenic disorders.
There may be a case for screening these women for auto-immune and thrombogenic
diseases after pregnancy ( > 6 weeks post- partum ), especially if they're
planning another - if positive low-dose aspirin, steroids or heparin may
have a role, not to mention preventive measures for general health.
Semen May Prevent Pre-Eclampsia
Diagnosing Toxemia
Garovic VD, Wagner SJ, Turner ST, Rosenthal DW, Watson WJ, Brost BC,
Rose CH, Gavrilova L, Craigo P, Bailey KR, Achenbach J, Schiffer M, Grande
JP.
Am J Obstet Gynecol. 2007 Apr;196(4):320.e1-7
Treating Toxemia
2. Up your protein to 80 - 100 mg, a day.
3. Calcium... up that as much as possible, combining w/ magnesium.
4. Take baths w/ Epsom salts (the magnesium helps)
5. Visualizations and affirmations (sounds corny, but if you can visualize
your blood pressure going down and your body relaxing, it CAN help)
6. Eat a cucumber each day; as well, bananas help with potassium, too,
so eat one/day.
7. Herbs like Passionflower help relax the circulatory system. Uva
Ursi helps reduce edema, but talk with an herbalist/midwife before consuming.
8. I also take Grape seed extract (w/ some vit E and C) and garlic
capsules and Evening Primrose Oil.
9. Stop wearing a bra. I have no scientific evidence to support this,
but relaxing the chest area from a tight fitting bra can help relax everything.
10. Chiropractics
Moutquin JM, Garner PR, Burrows RF, Rey E, Helewa ME, Lange IR, Rabkin
SW
CMAJ 1997 Oct 1;157(7):907-919
Evening Primrose Oil and Fish Oil to Prevent PIH
Effects
of a combination of evening primrose oil (gamma linolenic acid) and fish
oil (eicosapentaenoic + docahexaenoic acid) versus magnesium, and versus
placebo in preventing pre-eclampsia.
D'Almeida A, Carter JP, Anatol A, Prost C
Women Health 1992;19(2-3):117-131
In the Dec. 1997 issue of Journal Watch/Women's Health, there is a synopsis of a Lancet article on Ketanserin, an antihypertensive drug that also prevents platelet aggregation and its ability to reduce the rate of preeclampsia. In the study of 138 pregnant women with diastolic BP higher than 80 before 20 weeks, some were given ASA and Ketanserin, the rest given ASA and placebo. The rates of preeclampsia were higher with placebo (19% vs 3%). Delivery was significantly earlier with placebo (mean 36.2 vs 37.6 wks) and mean birthweights in babies born between 28-34 weeks was significantly lower with placebo (2791 vs 3074 g). There were 6 perinatal deaths in the placebo group and 1 in the Ketanserin group, but this was nonsignificant (!).
Anyway, I have never heard of this before - does anyone know if this
drug is being used anywhere in the U.S.?
In my state a rise of 30 systolic and/or a rise in diastolic of 30/15
on 2 occasions is an indication for a consult. Of course, I start
on
125 g of protein and 2000 mg of ca++ and 3 qts h2o- probably the same
as you- after the 1st high bp. I've only had one mom not respond,
so the second bp is usually back to nl.
There is an article by Anne Frye in MT#35 called TURNING TOXEMIA AROUND.
Here, Anne says two things in regard to protein in the urine: (1) Minor
degrees of proteinuria frequently occur during pregnancy due to the increased
filtration rate of the kidneys and is not a problem.... (2) Proteinuria
appears as toxemia becomes most severe, not in its early stages, and indicates
the kidneys are being severely stressed. However, as mentioned previously,
the majority of proteinuria cases in pregnancy is related to vaginal discharge,
urinary tract infection, or is benign.
Does anyone out there know anything about cream of tartar taken by the
teaspoonful being a picnoginol source?
I use 2 t cream of tartar with the juice of half a lemon taken 3 days
skip a day repeat to treat high blood pressure. It will drop the pressure
about 20/10 right away.
Nonpharmacologic
Management of Hypertension
As the Guide to Effective Care in Pregnancy reminds us, "Although treatment of hypertension does not strike at the basic disorder, it may still benefit the mother and the fetus. One of the important objectives in severe hypertension in pregnancy is to reduce blood pressure in order to avoid hypertensive encephalopathy and cerebral haemorrhage."
[The
diuretic effect of a bath. Study in healthy pregnant females and patients
with edema and gestosis]
Schnizer W, Mesrogli M, Seichert N, Schops P, Knorr H, Schneider J,
Wassmann M
Zentralbl Gynakol 1989;111(13):864-70
A
comparison of bed rest and immersion for treating the edema of pregnancy.
Katz VL, Ryder RM, Cefalo RC, Carmichael SC, Goolsby R
Obstet Gynecol 1990 Feb;75(2):147-51
Effect
of daily immersion on the edema of pregnancy.
Katz VL, Rozas L, Ryder R, Cefalo RC
Am J Perinatol 1992 Jul;9(4):225-7
Influence
of head-out water immersion on plasma renin activity, aldosterone, vasopressin
and blood pressure in late pregnancy toxaemia.
Kokot F, et al. (Proc Eur Dial Transplant Assoc. 1983)
Renal
responses to immersion and exercise in pregnancy.
Katz VL, et al. (Am J Perinatol. 1990)
[Effect
of exercise in water on maternal blood circulation].
Asai M, et al. (Nippon Sanka Fujinka Gakkai Zasshi. 1994)
Fetal
and uterine responses to immersion and exercise.
Katz VL, et al. (Obstet Gynecol. 1988)
Continuous
measurement of blood pressure, heart rate and left ventricular performance
during and after isometric exercise in head-out water immersion.
Fujisawa H, et al. (Eur J Appl Physiol. 1996)
Interstitial
and intravascular pressures in conscious dogs during head-out water immersion.
Miki K, et al. (Am J Physiol. 1989)
My daughter is 37 weeks pregnant, and having BPs, this week for instance,
136/100, and thereabouts. Generalized edema, 2+ reflexes, trace protein,
no headaches. The midwife said she needs to get into water (pool) up to
her neck and soak twice a day. It really helps the BP after swimming and
floating around in the pool, her BP is 98/62........Of course she is resting
on her side a lots, and not going to work any more. No shopping, just 'makin
a baby'.
Ran across this
weblink through the Perinatal List: it has information regarding the
McMaster's University study on PIH reduction through increased Calcium
intake during pregnancy (recommendation of 1,500 to 2,000 mg. daily). Offhand,
the numbers look good to me.
Problem is, it's a meta-analysis, which means that they took a bunch
of small RCT's, assessed their quality and crunched the numbers therein.
Although meta-analyses can be quite valid, and certainly indicators of
where to look next, they can also be flawed. There's certainly some controversy
about their usefulness (although that's essentially what the Cochrane database
is). In this case, a more recent RCT published in the New England Journal
of Medicine last July which enrolled 4589 women appears to demonstrate
that calcium supplementation does not prevent pre-eclampsia. I haven't
read either work at source, so can't comment further than that. But it
does demonstrate that you have to be careful about what you accept as an
authoritative source. To me, this is one of the fascinating things about
research.
Calcium Supplementation May Reduce the Severity of Preeclampsia CME/CE - Calcium supplementation does not reduce the incidence of preeclampsia but does reduce the severity
World Health Organization randomized trial of calcium supplementation
among low calcium intake pregnant women.
Villar J, Abdel-Aleem H, Merialdi M, Mathai M, Ali MM, Zavaleta N,
Purwar M, Hofmeyr J, Nguyen TN, Campodonico L, Landoulsi S, Carroli G,
Lindheimer M; World Health Organization Calcium Supplementation for the
Prevention of Preeclampsia Trial Group.
Am J Obstet Gynecol. 2006 Mar;194(3):639-49.
CONCLUSION: A 1.5-g calcium/day supplement did not prevent preeclampsia
but did reduce its severity, maternal morbidity, and neonatal mortality,
albeit these were secondary outcomes.
Study Shows Calcium Doesn't Reduce PIH/Eclampsia
I have the perfect "cure" for PIH with almost total compliance...................ready.....................................
...............................................................M I L K
C H O C O L A T E .................CALCIUM AND MAGNESIUM.............................
now about the dose!
The article quotes JAMA -- A new Canadian study analysed 14 calcium trials (1966 to 1994) and finds strong evidence that calcium supplementation "results in an important reduction in blood pressure and pre- eclampsia.. in pregnant women".
Drs. McCarron and Daniel Hatton from OHSU are quoted in an accompanying editorial -- McCarron says that 2000 milligrams of calcium would be closer to our needs than is the government-NIH recommendation of 1500.. and he says the average US woman enters pregnancy consuming only 600 milligrams a day!, prenatals contain only 200 milligrams of calcium.. McCarron is quoted "I tell women that at a bare minimum they need to be getting at least another 1,000 milligrams of calcium from a calcium- carbonate supplement every day during pregnancy".
Now we all 'know" that there are probably better sources of calcium than calcium carbonate[grin].... but the research was DONE with calcium carbonate so it clearly absorbs well enough to show an effect -- It works! If we can recommend something better than we should, but I hate to hear people say "calcium carbonate is worthless" or "calcium carbonate doesn't absorb" or "calcium carbonate is a poor source of calcium".. (and I do hear this pretty often; calcium carbonate has a bad reputation around here[Grin]). There may be better sources, but it must absorb "well enough" because it does work to reduce blood pressure and the incidence of pre-eclampsia.
Questions..... Would anyone with a nutritionist background like to translate
this "2000 milligrams" into servings of milk/dairy/broccoli/whatever? Can
a non-dairy user get enough calcium without supplementation, and if not,
which supplements would you recommend over calcium carbonate (and why?)?
Experts Urge Pregnant Women: Get Your Calcium! This point was supported
in an accompanying editorial written by David A. McCarron, M.D., Co- Director
of the Calcium Information Center, Co-Head of the Division of Nephrology,
Hypertension and Clinical Pharmacology at the University of Oregon Health
Sciences University and an accomplished hypertension researcher in his
own right. "There is a calcium crisis in this country ," said Dr. McCarron.
"The most recent government survey shows that women of child-bearing age
are consuming less than 600 mg of calcium a day, with many getting less
than 400! The pre- natal vitamins most doctors prescribe just don't make
up the difference -- they contain 200, maybe 300 mg of calcium. The bottom
line is that pregnant and lactating women should increase their calcium
intake to recommended levels through dietary means whenever possible, by
including low-fat dairy products (such as milk, cheese, yogurt), certain
dark green vegetables (such as broccoli and kale), and making up the difference
by adding a reliable calcium supplement.
JOURNAL OF AMERICAN MEDICAL ASSOCIATION REPORTS: CALCIUM DURING PREGNANCY COULD SAVE LIVES
A woman's need for meeting the current recommended levels of calcium just took on new urgency. In today's Journal of the American Medical Association (JAMA), scientists from McMaster University (Ontario, Canada ) report that consuming sufficient calcium during pregnancy can reduce the risk of pregnancy-induced hypertension (PIH) and pre- eclampsia, a potentially fatal disorder of high blood pressure and kidney failure. Pregnancy-induced hypertension and pre-eclampsia affect up to one in seven American women and are leading causes of c- sections, pre-term births and low birth-weight babies, making them among the most important issues in pregnancy care.
The most extensive summary of randomized controlled trials in this area to date, McMaster researchers reviewed the data from 14 trials involving nearly 2,500 pregnant women. The compelling results indicate that 1,500 to 2,000 mg daily of calcium supplementation can lower the risk of pregnancy-induced hypertension by 70% and the risk of pre- eclampsia by over 60%!
Experts Urge Pregnant Women: Get Your Calcium! This point was supported in an accompanying editorial written by David A. McCarron, M.D., Co- Director of the Calcium Information Center, Co-Head of the Division of Nephrology, Hypertension and Clinical Pharmacology at the University of Oregon Health Sciences University and an accomplished hypertension researcher in his own right. "There is a calcium crisis in this country ," said Dr. McCarron. "The most recent government survey shows that women of child-bearing age are consuming less than 600 mg of calcium a day, with many getting less than 400! The pre- natal vitamins most doctors prescribe just don't make up the difference -- they contain 200, maybe 300 mg of calcium. The bottom line is that pregnant and lactating women should increase their calcium intake to recommended levels through dietary means whenever possible, by including low-fat dairy products (such as milk, cheese, yogurt), certain dark green vegetables (such as broccoli and kale), and making up the difference by adding a reliable calcium supplement (like TUMS(R)) . This simple, yet significant intervention could save thousands of lives and billions of dollars every year if employed by all women of child-bearing age."
Calcium Information Center To reach a healthcare professional regarding today's news about the importance of calcium during pregnancy, phone the CIC CALCIUM INFORMATION LINE -- 1-800-321-2681. Established in 1991, The Calcium Information Center is a component of the Clinical Nutrition Research Units of the New York Hospital--Cornell Medical Center and Memorial Sloan-Kettering Cancer Center and Oregon Health Sciences University.
To receive a fax of further information on this study, call toll free, 1-800-753-0352, ext. 707, or contact Anne FitzSimons, 212-326-9800.
The study linking high intake of milk during pregnancy to pre-eclampsia
was published in the American Journal of Epidemiology, April 1, 1995.
I was recently told of a study where women on a high protein diet (about
70-80 g I believe) had a significantly smaller incident of pre-eclampsia
than the average ( 0.5% compared to 17%). Does anyone know anything about
this study and if it exists?
Tom Brewer MD has written several books covering this. I suggest reading his book "Metabolic Toxemia of Late Pregnancy: A disease of mal- nutrition" Keats Publishing 1982. I think you still can purchase this through Cascade Birthing Supply PO Box 12203, Salem, Or 97309 phone [503] 443-9942. Other sources of knowledge on this topic are most of the direct entry midwifery community (it has been standard practice for most of us to Rx a 100g protein diet as a preventive for years). In your reading of Brewer please note that he had great success with REVERSING the pre-eclampsia process utilizing increased fluids (gallon of water a day) salting of food to taste and protein. My sources list the toxemia hot line [Tom Brewer MD] as [603] 778 1476 or 66 High Street, Exter, NH 03833 USA
Other documents/presentations: James,Dawn, "New Thoughts About Pre-eclampsia"
presentation 9/15/89 Royal College of Medicine, London Eng. Available thru
President, Pre-eclamptic Toxemia Society, Ty Iago, High Street, LLANBERIS,
Caerarvon, Gwynedd, LL55 4HB, England.
Vitamins may not protect against pre-eclampsia - "Concomitant supplementation with vitamin C and vitamin E does not prevent pre-eclampsia in women at risk, but does increase the rate of babies born with a low birth weight," the team writes. "As such, use of these high-dose antioxidants is not justified in pregnancy." [King's College London, Lancet 2006; Early online publication]
This contradicts a previous study:
Vitamins May Help to Prevent Pre-Eclampsia in High-Risk Women
9/3/99 LONDON (AP) - Women at high risk for toxemia, one of the most dangerous complications of pregnancy, might avoid the condition by taking vitamin C and E pills, new research suggests. But the British scientists who conducted the study - the first to investigate the vitamins' potential to prevent the condition also known as pre-eclampsia - warned pregnant women should not rush to start taking large doses of the vitamins, since the findings are preliminary. Researchers haven't even yet determined if the high doses are safe for the developing fetus. The benefit suggested by the study must be confirmed in large-scale experiments, said lead researcher Lucilla Poston, a professor who runs the fetal health research group at Guy's, King's and St. Thomas' School of Medicine in London.
Women should talk with their care providers about vitamin supplementation!
HerbLore carries a great new product
- Pregnant
Mother's Liver Tonic. So many people have loved our Liver Cleanse caps,
but they're not appropriate for pregnant or nursing mothers! So we added
a Nursing Mother's Liver Tonic for women after birth, and it became clear
that we needed to add another product for pregnant (or wanting to become
pregnant) women. So we give you Pregnant Mother's Liver Tonic, formulated
specifically for pregnant (and wanting to become pregnant) women and their
needs!
According to Susun Weed in her book Wise Woman Herbal for the Childbearing Year Crataegus (Hawthorn Berry) is a strong and relatively safe vasodilator. "[hawthorn] berries work cumulatively and are taken for extended periods for best results. Essential hypertension then, rather than gestational hypertension, is the focus of Hawthorn berry use. The standard preparation is a cold infusion: one ounce of crushed dried berries steeping in two cups of cold water overnight brought quickly to a boil, strained and taken in sips, one cup per day , every day. The tincture dose is 15 drops, two or three times daily."
Here's what Weed recommends for hypertension in order of strength (and probably toxicity):
Weed also mentions nettles and raspberry leaf teas to tone and nourish in general (nettles are especially good for kidneys). And raw beet juice (up to 4 oz daily) or a raw salad of equal parts of one freshly grated raw apple and one grated raw beet. Raw beet is the fastest and most effective way to naturally increase available calcium to the body and it balances the sodium/potassium ratio of your blood. Plus the salad tastes really good, especially with walnuts added -- no dressing required!
She only recommends valerian root for elevated bp IN THE CONTEXT OF BEING IN LABOR (along with hops and skullcap -- she recommends a handful of each valerian root, hops and skullcap in a quart jar, steeped for two hours to temporarily lower bp).
Of course there's also taking an extra b complex vitamin in addition
to your regular prenatal vitamins, high protein, NOT limiting salt, etc.
for preeclampsia.
I have seen a study where EPO was shown to reduce the incidence of PIH. The study was conducted on the Farm, and it was a double-blind, placebo controlled study. I'm so sorry that I don't have the reference for it. Maybe someone else has seen it?
The researchers attributed the decreased incidence of PIH to the essential
fatty acids in EPO, however, instead of to the prostaglandin precursors.
I have personally used the cream of tartar recipe in Susan Weed's book.
Once a day put 2 t of cream of tartar in the juice of half a lemon (reallemon
works too) with a little water. Drink that for three days skip a day and
repeat for three days. It drops my bp about 15/10 after one day.
The Hazards
of Diuretics in Pregnancy - some additional information about the dynamics
of blood volume and blood pressure during pregnancy, and some cautions
about herbal diuretics.
Gemmotherapy (from plant buds) for Hypertension, from Dolisos
English Hawthorne (Crataegus Oxycantha) Young Shoots 1DH: 50 drops
in the morning
European Olive (Olea Europea) Young Shoots 1DH: 50 drops in the afternoon
Black Poplar (Populus Nigra) Buds 1DH: 50 drops in the evening
The acronym stands for: H - hemolysis: breakdown of red cells in vessels
in vasospasm from high blood pressure; EL - elevated liver enzymes, SGOT
and LDH; think liver congestion and symptom of epigastric pain; LP - low
platelets; used up in damaged vascular endothelium; risks for bleeding
and DIC.
HELLP
Syndrome - Here's a great handout for parents from the Perinatal
Education Associates, Inc.
HELLP Syndrome:
Recognition and Perinatal Management from the AAFP
Effects of Mag. Sulfate on Breastfeeding
| About the Midwife Archives / Midwife Archives Disclaimer |