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Shaping up to get pregnant

Is there a chance of me giving birth to a deformed child after my first childbirth?

Congenital malformation can be defined as a baby with abnormal physical shapes or functions at the time of birth. Major malformations such as harelip or congenital heart disease require surgery. Generally, major malformations are found in about 3% of all newborns. But minor malformation that doesn’t require surgery or treatment is found in up to 40% of all new borns. The information regarding malformation in a baby leaves clues for the next baby you carry. However, many of them get pregnant without making proper evaluation on the previous case, and the problem may recur.
For example, if your first baby is born with neural tube defects, the odds of you delivering your second child with the same problem are about 2%. If two of your babies are born with the same neural tube defects, the third baby has a 6 to 10% chance of having it. Some reports say that taking folic acid of 4 mg every day for 3 months before pregnancy decreases the recurrence rate by up to 70%. Still, there still are cases in which some mothers get pregnant again after six weeks into pregnancy without taking any folic acid even when her baby was born with myelomeningocele, which are neural tube defects. It is a good thing if her fetus has no peculiar symptoms, but it’s unfortunate if it does.

If you have to get an abortion as your unborn is diagnosed to have malformation or a uterine fetal death occurs because of it, the cause of malformation must be examined by autopsy including a hereditary screening for the detection of chromosome abnormality. Or you can keep the fetal tissues safely to have them checked out later but before you get pregnant again.

I wonder why stillbirth occurs. Is there a chance of recurrence?

It is not common, but I do witness from time to time during prenatal examinations that a fetus inside the uterus of a woman after 20 weeks of gestation doesn’t show heartbeats. It is natural for the mother, her family and her doctor to wonder about the cause and that is the right thing to do to gain more information to make her next pregnancy successful. Stillbirth can be defined as a case where there are no signs of life at the point of birth or after birth. Generally, more than half of all stillbirths occur before 28 weeks of gestation and more than 80% of the cases take place before 40 weeks of gestation.

Known causes include chromosome abnormality, malformation, infection by viruses or bacteria, problems in the placenta such as placental abruption, umbilical cord complications and amnionitis. Causes attributed to the mother’s body include diabetes, hypertension, septicemia, and colic. About a fourth of it have unknown causess. Nevertheless, it is known that the cause of more than 90% of the cases can be figured out through autopsy and chromosome analysis. These analyses and tests are known to provide 30% more information required for evaluating the possible recurrence rate. Psychologically, mothers who experience a stillbirth are prone to depression. Even if they experienced it in their early trimester, about a third of them suffer from depression. Therefore, they should be closely observed for posterior symptoms and her family should be more attentive to her needs.

Generally, stillbirth has a recurrence rate of up to 8%. But the specific rates vary by the cause. If it is caused by chromosome abnormality, the rate comes at 1%, while it shoots up to 50% if it has something to do with the Digeorge syndrome. The rate drops to almost zero if it was caused by umbilical cord complications.

Generally, stillbirth has a recurrence rate of up to 8%. But the specific rates vary by the cause. If it is caused by chromosome abnormality, the rate comes at 1%, while it shoots up to 50% if it has something to do with the Digeorge syndrome. The rate drops to almost zero if it was caused by umbilical cord complications.

Digeorge syndrome occurs in one out of every 4,000 newborns and is a hereditary disease that induces congenital heart disease, facial deformity, immune disorder and blood disorder. It is known to be caused by minute defects in the 22nd chromosome.

I gave birth prematurely. Is there a chance it might happen again?

Generally, premature birth refers to the birth of a baby who is less than 37 weeks of gestational age. Clinically, however, childbirth at less than 34 weeks increases the chances of death or cerebral palsy. The cause of premature birth is known to stem from the placenta previa, placental abruption, amniotic infection, incompetence of cervix uteri, uterine malformation, or immune disorders such as antiphospholipid antibody syndrome.

Premature birth can also be induced by toxins stemming from the bacteria in the legion where the mother has gum disease or cavity, or if the mother suffers from bacterial vaginosis. Bacterial vaginosis is known to be inflicted by incorrectly washing out the inside of the vagina with water or vaginal sanitizer.

Lactobacillus is a normal virus that resides inside the vagina and generates lacto acid to maintain a level of acidity at Ph 4 (for comparison, human blood is alkalescent at Ph 7.4). But an incorrect method of washing the vagina with water or vaginal sanitizer reduces the level of acidity, letting in abnormal viruses into the vagina to replace normal bacterial strains. These strains spread across the uterus and abdominal cavity to play a key role in inducing premature birth, infertility or ectopic pregnancy. If you want to maintain the vaginal area clean, simply wash the external area, not the internal, with soapy water or clean water.

The rate of recurrent premature birth is known to come at 15% for the second child. If you experience premature birth two consecutive times, the rate increases to nearly 30% for the third. Therefore, expert counseling is required before pregnancy to find out exactly what caused it and how to deal with it.

Can hereditary diseases be prevented through genetic counseling before pregnancy?

It is always best to receive genetic counseling not during pregnancy but before it. It will make you less nervous when you are not yet pregnant and you have more time to take the genetic test.  If the test results show anything worrying, you can do something about it to reduce the risks that your unborn baby might face and make up your mind about what to do according to the prenatal diagnosis.

Therefore, genetic counseling before pregnancy can give you more options to choose from in regard to your pregnancy.
If some of your family members have genetic disorders but you don’t have a history of delivering a deformed child, a prospective method can be considered. If you do, a retrospective method should be adopted. The areas the couple and their doctor should focus on are the occurrence of hereditary disease in the family, possibility of recurrence, and information from a preimplantation genetic diagnosis.