These questions and answers are going to be written here every day when Dr Petrikovsky gets a question to be answered by one of his patiens. We decided to put them here, because all of the questions which are being asked are unique to the person who is asking them, and just in case you have a similar question, you can find the answer. Also, sometimes, a question by someone else can trigger you to ask your question. We would like to post your question, and of course your identity will be kept nameless.
Questions and answers with Dr Petrikovsky
Q - My sister has breast implants. She is getting married and considering pregnancy. Please comment.
A – Silicone breast implants have not been found to result in higher rates of birth defects. Breastfeeding is safe through breasts that have silicone implants. While some doctors feel that feeding babies through silicone enhanced breasts may increase gastrointestinal ailments in the babies, this has not been proven.
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Q - My cleaning lady came from Honduras , she just told me she is pregnant. Can she continue working for me?
A – Many home cleaning and polishing products contain petroleum distillates, benzenes, chlorinated hydrocarbons, and ammonia. All of these can be dangerous to pregnant women. It is far better to clean with vinegar or lemon juice, or use cleaners such as chlorine-free Bon Ami and steel wool.
Exposure to chlorine products such as household bleach or swimming in chlorinated swimming pools have not been shown to harm the baby
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Q - What about caffeine and pregnancy I usually drink 4-5 cups of coffee every day?
A – Caffeine is found in coffee and tea. An average cup of brewed coffee has about 100 milligrams of caffeine, a cup of instant coffee about 50 milligrams of caffeine, and a cup of black tea about 40 milligrams. Caffeine is added to many soft drinks such as Coca-Cola, Pepsi-Cola, Dr. Pepper, Tab, and Mountain Dew. An average cola drink has 30-45 milligrams of caffeine per serving. Ingesting more than three cups of coffee a day has been shown to increase the incidence of miscarriages.
Pregnant women should moderate their intake of caffeine, whether from coffee, tea, or caffeinated soft drinks.
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Q - What is fish consumption, lead and pregnancy?
A - Some fish have high lead levels. Predators and fatty fish such as tuna, shark, swordfish, whitefish, mackerel, and bluefish often have high levels of lead, mercury, and/or PCB’s. Several states have advised pregnant women not to eat more than seven ounces of tuna each week, because it contains lead. The Environmental Protection Agency has a website ( www.epa.gov ) that lists all state warnings about contaminated fish.
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Q - I think I am pregnant. What do I do with my allergies:
A - First of all, do a pregnancy test and if it is positive, see your doctor or midwife.
The following are generally considered to be safe for pregnant women to take: allergy and cold medications, such as chlorpheniramine and diphenhydramine, which are antihistamines; decongestants such as pseudoepherdrine and Claritin have no known dangerous effects during pregnancy.
If you have a stuffy nose, normal saline nose drops is the safest remedy. Expectorants (guaifenesin) and cough suppressants (dextrmethorphan) are considered safe for short-term use in therapeutic doses. Allergy shots can be continued if necessary, but women should let the doctor know they are pregnant.
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Listeria and Pregnancy
In 1998 other doctors and myself published a manuscript “various faces of listeria” The results of our telephone interviews revealed that the majority of physicians failed to warn patients about the risks of Listeria and discuss dietary precautions with them. At a minimum, physicians should advise pregnant patients to stay away from unpasteurized dairy products and soft cheeses (mozzarella, feta, brie, Mexican soft cheese and others). We recommend that physicians include the pamphlet on Listeria in pregnancy in the prenatal packages they distribute to prospective mothers.
Early signs of Listeriosis are fever, chills, muscle aches, diarrhea and upset stomach. At first you may feel as if you have the flu.
Pregnant women are at high risk for getting sick from Listeria, harmful bacteria found in many foods. Listeriosis can cause miscarriage, premature delivery, serious sickness, or death of a newborn baby. If you are pregnant, you need to know what foods are safe to eat.
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Q - What can I do to keep my food safe?
A - Listeria can grow in the refrigerator: The refrigerator should be 40 degrees Fahrenheit or lower, and the freezer 0 degrees Fahrenheit or lower.
Clean up all spills in your refrigerator right away-especially juices from hot dog packages or raw meat or chicken/turkey.
Clean the inside walls and shelves of your refrigerator with hot water and liquid soap.
Use precooked or ready-to-eat food as soon as you can.
Wash your hands after you touch hot dogs, raw meat, chicken, turkey, or seafood or their juices.
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Q - Recent report in the Chicago Tribune addressed the issue of high mercury content in canned tuna. Does it change your recommendation for fish consumption for pregnant women?
A - I read the Chicago Tribune’s report which states that canned tuna presents a far greater health hazard to American consumers then what the federal government and the tuna industry have led people to believe.
“The government, for example, has stated repeatedly that canned light tuna is low in mercury and a nutritious choice for pregnant mothers and children.” It continues that “because mercury passes easily through the placenta and can harm the developing central nervous system, fetuses and small children are most vulnerable to its effects. A recent government study 410,000 babies born each ear in the United States are at risk for mercury poisoning because of high levels in their mother’s body.”
Last year, the FDA and EPA jointly warned pregnant women, nursing mothers, women of childbearing age and young children not to eat more than 12 ounces of fish a week, including no more than 6 ounces of canned albacore tuna.
In conclusion the newspaper put together suggested weekly limits:
Here are the amounts of various fish a 161-pound person can eat per week before being exposed to potentially unsafe amounts of mercury. A typical serving is 6 ounces.
Swordfish Albacore
1.3 oz. (about ¼ serving) 6.0 oz. (1 serving)
Orange roughy Skipjack (canned light tuna)
3.2 oz. (about ½ serving) 16.4 oz (about 2 ¾ servings)
Walleye Salmon
3.5 oz. (about ½ serving) 60.1 oz. (about 10 servings)
Yellowfin (tuna steak)
5.2 oz. (more than ¾ serving)
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Q - My wife is 7-8 weeks pregnant she is not eating well, because of nausea and occasional vomiting. Can it hurt our baby?
A - The baby should be perfectly fine. Famous research done immediately after the 2 nd World War (Dutch Famine Study) clearly demonstrated that women who had been on severe dietary restrictions during early pregnancy had normal offspring. It’s very common for pregnant women in the 1 st trimester not to eat well due to nausea. Many of my patients can not tolerate certain types of food even the smell of it.
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BIRTH CONTROL PILLS
Q - I was taking birth-control pills to regulate my menstrual period. However, I did not get regular periods and upon my doctor’s advice continued to take pills. Finally, I discovered I am 6 weeks pregnant. What should I do?
A - Some women take birth control pills or medroxyprogesterone (Provera) before realizing that they are pregnant. It was once feared that these medications caused fetal heart defects, but that has not been borne out.
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Q - . “Science” section of the New York Times addressed the topic on the time of the year when most babies are born in America.
A - I am quoting from the New York Times (January 10, 2006). July and August recently traded first and second place among the most common birth months, according to the National Center and Health Statistics. In 2002, there were about 359,000 births in August and 358,000 in July. In 2003, there were 364,226 births in July and 360,103 in August. The totals for the rest of the months of 2003 varied only moderately, from 307,248 in February, with just 28 days, to 359,644 in September. A much stronger trend can be found for days of the week: Sundays averaged just 7,563 births in 2003; Monday climbed to 11,733; Tuesdays surged to 13,001; Wednesdays, 12.598; Thursdays, 12,514; Fridays, 12,396; and Saturdays fell back to 8,605.
My personal statistics are much more modest: On Sunday I’ve delivered twins, nobody on Monday and Tuesday, premature baby on Wednesday, one on Thursday and took a break on the weekend.
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Multifetal Pregnancy
Q - Dr. Petrikovsky, you have been recently interviewed by Newsday staff writer Curtis Taylor (Health & Science Section, Newsday, Friday, September 23, 2006 , www.newsday.com ) regarding multifetal pregnancies. What is your personal experience with twins and triplets
A - Dr. Vintzelious and I put together our of the first review articles on multiple births. During my tenure at North Shore Hospital , where I served as a Maternal-Fetal Medicine Chief I have managed many hundreds of twins and triplets with good results.
Q - Are all twins and triplets high risk?
A - Yes, they require additional attention, counseling, and numerous ultrasound examinations, etc.
Q - What are the risks?
A - Prematurity is the most significant risk factor. Patients should be familiar with signs and symptoms of preterm labor.
Q - How do you deliver mothers with multifetal pregnancies?
A - Most mothers with twins may deliver vaginally, triplets and quadruplets by cesarean section.
Q - Some doctors routinely perform cerclages (cervical stitch) for multifetal pregnancies. What is your opinion?
A - I am aware of such an approach, I do not do it r out inely. However, if uterine cervix becoming shorter as seen during obstetrical sonogram, cerclage may be needed.
Q - What’s your final message to parents of multifetal pregnancies?
A - Find a right doctor with extensive experience and expect a good out come. Most twins and may triplets in experienced hands do as well as single pregnancies.