New Highly Accurate Blood Test For Downs Syndrome
A new blood test for the mother with accuracy approaching that amniocentesis has been successfully trialled in the United States. VERIFI which can detect fetal DNA in the mother’s circulation has been a resounding success in large U.S. trials. It is much more accurate than nuchal translucency and biochemistry and the test can be done early at 10 weeks.
At present it is available mainly for high risk patients. In time I see it replacing C.V.S. and amniocentesis. The test may have applications in I.V.F. The main draw back at present is its cost and the need to send the mother’s blood test to the U.S.A. Our local laboratory at S.N.P. is arranging for Queensland based versions of the test:- preparations are underway.
IVF and Cancer
A recent study has failed to find any significant correlation between women undergoing IVF treatment and the risks of either breast, endometrial, ovarian or cervical cancer. This continues to be reassuring. There is no significant relationship between IVF and the risk of developing breast, endometrial or ovarian cancers. The risk of developing invasive or pre-invasive cervical cancer was significantly reduced in women undergoing IVF cycles.
Oral Contraceptives, Cancer and Tricycling
A recent statement from R.A.N.Z.C.O.G. indicates that the oral contraceptive does not appear to increase the overall risk of developing cancers. If anything women who have used the pill in the past have some protection from developing cancer.
A study from the United Kingdom has found that women taking the continuous oral contraceptive without placebo (sugar pill) breaks for up to 12 months, are at no higher risk than when taking the pill traditionally. That is three weeks’ worth of hormone tablets followed by one week of sugar tablets. Many women tricycle, i.e. take three months’ worth of active pill tables and then have a break for a week for a period. This has a number of advantages, but some women can develop unpredictable bleeding.
PregnancyAfter Weight Loss Surgery
Women should wait for at least 12 months before conceiving after weight loss surgery. In pregnancy complications such as band slippage and migration may occur, resulting in severe vomiting and abdominal pain. Women who conceive less than 18 months after bariatric surgery, maybe at increased risk of miscarriage. Early consultation between the surgeon, obstetrician and nutritionist is advised with dietary supplementation.
This has been linked to a high risk of osteoporosis and mortality. I advise exercise and calcium in all postmenopausal patients. It is even more important to keep up that gym membership in women who have an early menopause (before 40).
Women Who Have Vaginal Births
These women are three times more likely to have urinary incontinence at more than 10 years after birth than women who deliver by Caesarean section. I advise good bladder habits with an emphasis on pelvic floor exercises.
Foods to Avoid in Pregnancy
Listeria are bacteria that can cause the serious illness, listeriosis, in some people. Eating foods contaminated with Listeria is the most common way of contracting the illness.
Pregnant women, their unborn & newborn babies are at risk of contracting listeriosis. Listeria is not a new micro organism, however changes in the way we store, handle and consume food means that it is now more widely transmitted by food.
Symptoms may include headache, fever, tiredness and aches and pains. Less common symptoms include diarrhoea, nausea and abdominal cramps. Symptoms in pregnant women may be mild, but listeriosis can result in miscarriage, premature birth or, in rare cases, stillbirth.
The best way to avoid Listeria is to eat freshly cooked or freshly prepared food. We recommend not eating foods which have a higher risk of Listeria contamination such as:
- cold meats from delicatessen counters and sandwich bars and packaged, sliced ready-to-eat meats.
- cold cooked ready-to-eat chicken
- pre-prepared or pre-packaged fruit or vegetable salads
- salads from buffets and salad bars
- chilled seafood such as raw oysters, sashimi and sushi, smoked ready-to-eat seafood and cooked ready-to-eat prawns
- soft, semi-soft and surface ripened cheeses such as brie, camembert, ricotta, blue and feta
- refrigerated pate or meat spreads
- soft serve ice cream
- prepare, store and handle food hygienically
- eat only freshly cooked food and well-washed freshly prepared fruit and vegetables
- cook foods thoroughly
- leftovers can be eaten if they are refrigerated promptly and eaten within 24 hours of initial cooking
- reheat foods to ‘steaming’ hot