There are several known causes of premature birth (such as smoking and drinking, certain medications) but sometimes it happens for no foreseeable reason. A common cause, though, is when the pregnant woman has a short cervix. This is something that a midwife would detect from an examination early in pregnancy, or it can be measured accurately with an ultrasound scan.

Now, a cheap device can reduce the risk of premature births amongst women who are deemed to be at high risk of suffering a premature birth.

The device, created by doctors at the University Hospital, Barcelona, Spain, is a simple ring made out of silicone that is inserted into the cervix early in pregnancy. It dramatically reduces the risk of women going into labour before about 34 weeks.

The efficacy of the device was tested by studying 15,000 women who were all at 20 – 23 weeks’ gestation and who were given a scan to identify those who had short cervixes (shorter than 25mm) and were deemed to be at high risk of premature birth.

Half of the women were given standard care given to all women at high risk of premature delivery and the other half were given the silicone ring. Of the women who were given the ring, 6% went on to have a baby prematurely compared to 27% of the women who were given standard care for high-risk women.

There were found to be no significant side-effects to inserting the ring and most of the women who had been given one would be happy to recommend the procedure to others.
The ring is cheap, easy to insert and remove and is apparently safe. It is not clear when the ring will be widely available in the UK.

The most recent advance has come from research that has tested out a new incubation system for fertilised embryos and may improve the chance of successful conception by more than a quarter.  Previously, fertilised embryos have had to be moved to different pieces of equipment to be worked on at different stages of the IVF process; the new system allows various processes to be conducted on the embryos in a single location, reducing the number of environmental changes that could damage them.

The single unit is sealed and protects the embryos by providing a constant temperature for them.  According to the research, the traditional method of treating the embryos (in different pieces of equipment) led to around 30% of embryos developing to the blastocyst stage, but with the new system 40% of the embryos reach that stage.  The new system also led to more successful pregnancies overall.

The researchers, from Newcastle University, the Newcastle Fertility Centre, Northumbria University and the University Hospital of North Tees, say that the standard procedure of removing embryos from their incubator to check them before implanting them and this can expose them to changes in air quality and temperature which can harm them.  They say the new system reduces this risk by using built-in microscopes and other equipment.

Further research is required to see whether there might have been any other factors that led to these results and not just the incubators, by using a sample of control patients to standardise the variables.

If you are going through IVF treatment at the moment, it is worth discussing this with your consultant, for reassurance that everything that can be done is being done.

An ectopic pregnancy is one in which the fertilised egg grows outside the womb.  Normally, the egg implants in the fallopian tube, but it can also implant in the ovaries, cervix or even the abdominal cavity.

An ectopic pregnancy will normally cause symptoms at an early stage, and some women are told that they have an ectopic pregnancy even before they knew that they were pregnant at all.  Any woman in the early stages of pregnancy who goes to a doctor with bleeding and cramping pains will be assessed and checked for various possible causes of those symptoms, which include miscarriage, ectopic pregnancy and other, non-pregnancy-related illness like appendicitis.

The only way to tell if a woman is having an ectopic pregnancy is to examine her with an ultrasound scan.  It is important that early diagnosis of ectopic pregnancy is made because it can quickly cause serious complications.  If the egg is allowed to grow it can rupture the surrounding tissue (this happens quite quickly within the fallopian tubes) and that can lead to shock and death and certainly removal of the fallopian tube (which could then impact on future conception).

If an ectopic pregnancy is diagnosed early enough to not require removal of any of the reproductive system then there is no reason why future conception and pregnancies should be affected.  However, if parts of the reproductive system have had to be removed (e.g. because of a rupture) then the chances of conceiving may be reduced.  Eggs travel down alternate fallopian tubes each month, so if one is ruptured and removed, an egg will only be able to travel to the womb every other month instead of every month.

It’s not always clear what has caused an ectopic pregnancy, so it may not be possible to prevent the same thing happening with future pregnancies.

This is apparently because they no longer fear pregnancy and so don’t worry so much about using contraception, including barrier methods.

Whilst this lack of protection accounts for much of the risk posed, there are other, physical factors that make it easier for sexually transmitted diseases to be passed on (such as thinner vaginal walls, making it easier for there to be contact between semen and blood). Further, the medications normally prescribed to combat sexually transmitted diseases don’t work as efficiently on women who are of a certain age because their metabolism manages the medication differently.

Dr Coleman said, “There is a knowledge-gap with women knowing what the physiological changes associated with menopause. There is very little research on this subject and society and the government don’t talk about it, but these high risk sexual behaviours need to be addressed because the rate of HIV positive middle aged women is increasing.”

If you are leaving a long-term relationship, remember that just because your new other-half may have also been in a long-term relationship before meeting you, there is still a risk that either of you could be carrying a sexually transmitted disease. Either of your previous partners could have had sex with other people. You are not just sleeping with your partner, you’re sleeping with everyone else they’ve ever slept with, and everyone they’ve slept with and so on. Use a barrier form of contraceptive until you know your partner’s history better, and if in any doubt arrange for you both to be tested (you can do this anonymously at a GUM clinic at your local hospital) if you don’t want to use condoms in the long-term.

We women tend to neglect ourselves, so busy taking care of others or running around after others that we don’t have enough time to look after ourselves. It’s vital that, if we are to keep doing what we do, we make sure that we make time to nurture ourselves, protecting our mental health in the process. After all, if you allow yourself to become overwhelmed, you won’t be able to do what’s important to you, whether that’s working, playing or caring.

Having good mental health is key to having good physical health. But how can you protect and indeed maximise your mental health?

First thing’s first – what you eat will directly affect how your body and mind function. Having a healthy, balanced diet will put you in a good frame of mind – you’ll feel good about yourself, boosting your self-esteem, and your brain will receive all the essential nutrients it needs to function properly. Eating well will give you energy and help to stabilise your mood.

Next, though it might be the very last thing you feel like doing, taking regular exercise will have a positive effect on your mental health. The exercise boosts your levels of endorphins, which make you feel good and can combat anxiety and depression.

Finally, make sure you sleep well. Depression can cause insomnia (either an inability to get to sleep, or an inability to stay asleep), which in turn causes tiredness, which then causes mood swings, irritability and further depression. Breaking that cycle can be hard, but if you are suffering from sleeping difficulties then taking a short course of antidepressants can improve matters if your GP advises. Making sure you sleep well can prevent negative feelings and irritability.

In order to sleep well, you should try to go to bed and wake up at the same time every day – even weekends, avoiding drinking (especially drinks with alcohol or caffeine) an hour before bed, but eat a light snack, preferably containing milk and protein for supper. Relax in a warm bath with a good book (nothing science-fiction: reading sci-fi before bed can lead to vivid, disturbing dreams). See your doctor if you are sleeping well but not feeling refreshed.

Take time to care for yourself, protect your mental well-being and if you can’t do it for yourself then do it for the people you love so that you can continue to care for them.

New research, though, shows that chemotherapy during pregnancy “may not harm the baby”.

The researchers studied seventy children who were in utero when their mothers were undergoing chemotherapy. The children had been in the second and third trimesters of development when the chemotherapy was given.

The children were examined to monitor their health, heart and brain function between the ages of 18 months to 18 years. The results were that their development was comparable to children whose mothers did not undergo chemotherapy. However, those who were born prematurely (perhaps to enable the mother to have further chemotherapy, with their believing that it was better to deliver the baby than to risk further exposure to chemotherapy drugs in the womb) had lower IQ scores.

The results, from the Leuven Cancer Institute and Katholieke Universiteit Leuven in Belgium, have led researchers to advise doctors not to deliver babies early so as to avoid chemotherapy exposure, since the exposure doesn’t seem to have any effect on development (whereas premature delivery does). The researchers also say that there is no need to delay delivering chemotherapy to a patient merely because she is pregnant.

The study will be followed by more research over a greater number of children. The existing study included children whose mothers had received several different types of chemotherapy and/or radiotherapy and there were no difference between the results. The children were mostly born prematurely, with only a third being born at full term.

If you are pregnant and undergoing treatment for cancer, hopefully this research will give you some measure of comfort, that the medicines you are being given to keep you alive won’t harm your baby, and you should discuss with your doctor whether it is indeed necessary to deliver your baby prematurely if that is being considered.

The rate of women with diabetes who went on to have babies with defects that were not caused by chromosomal abnormalities was about 3.8 times higher than that of women without diabetes.

Diabetes in pregnancy has long been known to add to complications (such as miscarriage, still birth and neonatal death) – often because it is associated with obesity – but this is the first evidence that it causes birth defects.
If you have diabetes when pregnant, you will have extra care given to you by your midwife and may have additional tests and scans. But the research says that as soon as it becomes possible to conceive (i.e. any time after puberty) women with diabetes should be given advice on making sure they get proper, specialists care during any future pregnancies, including early scans to detect and manage any deformities.

The study was carried out at Newcastle University, South Tees NHS Trust and Newcastle’s Regional Maternity Survey Office. As the results are based on findings gathered from women who had diabetes prior to conception, it is not known whether developing diabetes during pregnancy (known as gestational diabetes) could have a similar effect on the risk of birth defects.

Guidelines already in place, from the National Institute for Clinical Excellence recommends that women with diabetes should wait until they have a HcA1c of under 6.1% before trying to conceive, and that women with HbA1c of 10% and over should avoid falling pregnant.

So if you’ve fallen off the wagon, diet-wise, and are looking for an alternative, what can you try?

There are several eating plans and diet plans available out there. Going to classes (with companies like Slimming World and Weight Watchers, to name but two) are said to be effective because of the motivation they provide in the form of a weekly weigh-in and support from your ‘consultant’.
But can you follow a good diet at home? How do you go about motivating yourself?

Perhaps the first step is to find a diet that works for you. There are hundreds to choose from, but the basics remain the same: you need to be consuming less energy than you are burning off. If you burn off more (by exercising) then you can eat more.

You could limit the number of calories you consume. The average woman will burn off 2,000 calories per day. If you eat 1,000 – 1,500 per day, you will lose weight, even if you do no exercise. You need to lose 3,500 calories in order to lose one pound of weight. That is, if you burn off 2,000 calories in a day and have only eaten 1,500 that day, your body will have used the other 500 from its stores (i.e. from your fat). Do that for 7 days and you’ll have lost a pound. Add some exercise and you’ll lose the weight quicker.

Or you can try limiting the amount of fat and simple carbohydrates you eat. Limit your white bread (severely) and keep your fat intake to under 10g per day (check the packets for information) and you’ll lose weight.

You’re more likely to stick to your diet if you allow yourself a treat each day – you won’t feel as deprived and bitter. That might be a bar of chocolate in the evening, or an ice cream cone. If you’re due to go for a night out one week, then skip those treats on the other nights of that week and you’ll still lose weight.

Certain circumstances definitely precipitate the need for taking out a life insurance policy. Rather than specifying a specific age for taking out life insurance, it is more important to think about the events going on in our lives. Sometimes, events happen sooner than one thinks or earlier than planned.

One time in life that is an appropriate time to start thinking about getting a life insurance policy would be marriage. When one marries, they no longer are a single person thinking entirely of themselves. As a married couple, they depend upon one another. With a life insurance policy, the surviving spouse will be covered in the event of the other spouse’s death. This can help with certain expenses such as the funeral. Also, as a married couple, people become dependent on two incomes. No longer having that second income could be financially damaging.

Another time in one’s life that would necessitate the new for life insurance would be the birth of one’s first child. Again, you are bringing another person until your life that you must support. Even if a couple already has life insurance, they will probably want to increase their coverage now that there is a child in the home.

If at some point in your life you seek a job that is risky to your life, this would be another time to think about getting life insurance if you do not have it already. Depending upon your industry and employer, you may be required to obtain life insurance as a condition of employment.

If any of these situations apply to you or you have another situation that you think might need life insurance, then contact Endsleigh insurance at www.endsleigh.co.uk for further information.

It seems that the ‘Jade Goody Effect’, seen at its peak in 2008 when her death raised awareness and screening of cervical cancer, is wearing off. When Jade died, there was a huge increase in the number of women attending for routine cervical smear tests. Sadly, that effect has not lasted long and numbers of smear tests are dwindling once again, with approximately one in five women failing to attend for their routine screening tests.

This week is Cervical Cancer Prevention week and experts are trying once again to raise awareness and prompt women to get checked by having regular smear tests.

Cervical cancer is a killer if not detected early. Around a thousand women per year die from the disease out of 2,800 annual new diagnoses. It affects just as many women under 50 as over, and it is the second most common type of cancer amongst women under the age of 35.

As part of Cervical Cancer Prevention Week, charities and the NHS alike are stressing that it is a preventable cancer on the whole. NHS Cancer Screening deputy director Richard Winder said, “A woman can control her risk of developing the disease by being screened regularly. Any abnormalities that might be found can then be treated in order that they do not go on to develop into cancer. Where a cervical cancer is found through screening, it is usually at a very early stage where treatment has a greater chance of success.

“It is essential that women are aware of this when deciding whether or not to be screened. Cervical screening is estimated to save 4,500 lives a year in England alone.”

It’s also possible to prevent the most common cause of the disease by being vaccinated against the Human Papilloma Virus (HPV), which is known to cause about 70% of cases of cervical cancer and is therefore a highly deadly STD. Vaccination is routinely offered the immunisation nationally to under-18s. A new version of the vaccine will also protect against genital warts as of later this year.

Routine smear tests are available to all women aged 25 – 65 years (every 3 years for women age 25 – 49 and every 5 years for women age 50 and over).

A representative, Gemma Byrne, from the charity called ‘The Eve Appeal’ stresses that it is important that women should educate themselves as to the early warning signs of the disease as well as getting the routine screening and vaccinations. “The earlier cervical cancer is diagnosed, the better the outcome will be, so even if women have been vaccinated and had regular screening, none of these is 100 per cent effective so women owe it to themselves to be aware of the early warning signs”

The early warning signs don’t happen in the very early stages of the disease but when they do occur they include unusual bleeding (e.g. after sexual intercourse; between periods; post-menopause), pain in or around the vaginal area during sex; discharge that smells unpleasant; pain or blood during urination; bone pain and weight-loss.

Seeing your GP at the earliest opportunity, and undergoing the screening process might save your life, so make time.