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Ectopic Pregnancy or Tubal Pregnancy

Ectopic Pregnancy or Tubal Pregnancy

Ectopic Pregnancy or Tubal Pregnancy

Ectopic Pregnancy or Tubal Pregnancy

An “ectopic pregnancy” occurs when the fertilized embryo implants outside of the uterus; most commonly in fallopian tube. When attached to the fallopian tube, this is referred to as a “tubal pregnancy.” Approximately 16%1 of women seeking emergency medical attention due to cramping and/or vaginal bleeding in the first trimester are diagnosed as having an ectopic pregnancy. Overall, ectopic pregnancies are rare, occurring in 1%-2%2 of all pregnancies. As the embryo grows, it can cause the tube to rupture (burst), which can cause major internal bleeding. This can be life threatening3 and/or cause future fertility issues if not discovered early.

Bleeding and cramping are the most common symptoms of an ectopic or tubal pregnancy. Women who are pregnant or may be pregnant should seek immediate medical attention for a possible ectopic pregnancy if they experience any or all of the following symptoms:

  • Cramping pain in the lower abdomen that may worsen with coughing, moving, or bowel strain
  • Sharp, steady pelvic pain
  • Vaginal bleeding
  • Nausea and vomiting
  • Dizziness or weakness
  • Shoulder pain
  • Feeling of pressure in the rectum

Risk factors leading to a greater risk for an ectopic pregnancy include: previous tubal surgery, sterilization, previous ectopic pregnancy, current use of an intrauterine device (IUD), history of pelvic inflammatory disease (PID), infertility for two years or longer, women over the age of 35 years, and smoking.

When a pregnant patient presents with first-trimester bleeding or abdominal pain, physicians should consider ectopic pregnancy as a possible cause. The patient history, physical examination and imaging with transvaginal ultrasound can usually confirm the diagnosis. In some cases, a blood test may also be used to determine diagnosis.2 The ultrasound is performed to check where the embryo implanted, if not found in the uterus. An ultrasound is one of the best methods to determine where the embryo may have implanted and alert if there are other health concerns to be aware of.

Since ectopic pregnancies may be life threatening, they must be treated as an emergency situation and the doctor will determine how best to end the pregnancy, as the embryo cannot be transplanted into the uterus. Many cases of ectopic pregnancy, if caught early enough, can be treated with medicine and not surgery. Early detection may help preserve the fallopian tube for future pregnancy attempts.

In all cases of suspected tubal pregnancies, the Support Circle technician or nurse will immediately refer the woman to the emergency room. If you have questions, Support Circle staff at our three Bay Area clinics are available.

 

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Reference:

  1. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071024/
  2. http://www.aafp.org/afp/2014/0701/p34.html
  3. http://www.acog.org/Patients/FAQs/Ectopic-Pregnancy

 

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Why is my period late?

Why is my period late?

Women who are in their childbearing years sometimes miss a period. While a missed menstrual period is the hallmark of early pregnancy, missing a period can be due to a number of factors and conditions. If you’ve missed a period, try not to stress out. However, you’ll want to rule out pregnancy. You do not have to wait until you miss a period if you suspect you are pregnant. The trained staff at Support Circle can help by administering a free pregnancy test prior to expecting your period. This test is more than 99% accurate and performed by a nurse.

Once you have a negative pregnancy test, you may wish to repeat the test in a few days or your missed period may be due to the following:

  • Stress and anxiety– Stress isn’t good for your body, and it can cause you to have delayed ovulation.
  • Excessive weight loss, or weight gain– Losing a substantial amount of weight, or gaining too much weight too quickly can cause you to experience menstrual problems, like a missed period or a delayed period.
  • Contraceptives– Some women who take certain birth control don’t have regular periods.
  • Breastfeeding– When you breastfeed exclusively, the hormones that are allowing lactation to occur can block ovulation and your regular menstrual cycle.
  • Eating disorders– When you have excessively low body weight this can interfere with hormonal functions, which might stop ovulation.
  • Rigorous Exercise– Women who participate in activities and sports that require them to undergo rigorous training often experience skipped periods or no periods at all.
  • Medication– There are some medications that can disrupt menstrual cycles.
  • Hormonal imbalance– When you have hormonal problems, it can change the levels of hormones that your body requires to support ovulation and the menstruation process.
  • Problems with your thyroid
  • Uterine scarring– If your uterus is scarred from disease or medical procedures, this can prevent the normal buildup and shedding of the uterine lining common to a regular menstrual cycle.
  • Perimenopause – This is the time period before the complete cessation of menstrual periods and, in some women, may begin as early as their mid-thirties.

If you have a late or missed period, we encourage you to visit one of our three Bay Area clinics to have a pregnancy test or to talk to a nurse.

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Zika Virus – Other Common Questions

CDC Zika Virus Information

CDC Zika Virus Information

Zika Virus – Other Common Questions

In an effort to provide our Support Circle clients with information on Zika virus, a virus that has garnered much media attention due to the potential effects on the fetus, we have compiled this list of information directly from the Center for Disease Control (CDC) website.

How is Zika transmitted?

Zika is primarily transmitted through the bite of infected Aedes mosquitoes, the same mosquitoes that spread Chikungunya and dengue. These mosquitoes are aggressive daytime biters and they can also bite at night. Mosquitoes become infected when they bite a person already infected with the virus. Infected mosquitoes can then spread the virus to other people through bites. Men and women with a pregnant partner should use a condom or abstain from intercourse for the duration of the pregnancy. The virus can also be transmitted from a pregnant mother to her fetus during pregnancy or around the time of birth. Spread of the virus through blood transfusion and sexual contact have been reported.

Update July 2016: There is an increased need for women in the U.S. to take precautions to reduce their chances of becoming infected with Zika if pregnant. According to the CDC, there have been over 1,300 reported cases of Zika virus in the United States, including 14 sexually transmitted cases. In U.S. Territories, there have been over 2,900 reported cases of Zika infected people. There have been over 645 cases of pregnant women reported to have Zika in the United States and U.S. Territories.

What are the symptoms of Zika?

About one in five people infected with Zika will get sick. For people who get sick, the illness is usually mild. For this reason, many people might not realize they have been infected. The most common symptoms of Zika virus disease are fever, rash, joint pain, or conjunctivitis (red eyes). Symptoms typically begin two to seven days after being bitten by an infected mosquito. People usually don’t get sick enough to go to the hospital, and they very rarely die of Zika.

Does Zika in pregnant women cause birth defects?

Brazil has been having a significant outbreak of Zika virus since May 2015. Officials in Brazil have also noted an increase in the number of babies with congenital microcephaly (a birth defect in which the size of a baby’s head is smaller than expected for age and sex) during that time. Congenital microcephaly is often a sign of the brain not developing normally during pregnancy. Health authorities in Brazil, with assistance from the Pan American Health Organization, CDC, and other agencies, have been investigating the possible association between Zika virus infection and microcephaly. Additional studies are needed to determine the degree to which Zika might be linked with microcephaly.

More lab testing and other studies are planned to learn more about the risks of Zika virus infection during pregnancy. Because of the possible association between Zika infection and microcephaly, pregnant women should take steps to prevent mosquito bites.

How do I find the most recent CDC updates?

Visit the CDC’s website for more information about the Zika virus: http://www.cdc.gov/zika.

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How to Protect Against Zika Virus

How to protect against Zika virus

In an effort to provide our Support Circle clients with information on Zika virus, a virus that has garnered much media attention due to the potential effects on the fetus, we have compiled this list of most common questions and answers from the Center for Disease Control (CDC).

What is Zika virus?

Zika is a disease caused by Zika virus that is spread to people primarily through the bite of an infected Aedes species mosquito.

Protect against Zika virus

Men with a pregnant partner should use a condom or abstain from sex for the duration of the pregnancy if they have visited, or live in, an area where mosquitos are spreading the Zika virus, which is strongly suspected of causing microcephaly in newborns, the CDC advises.

There is no vaccine or medicine for Zika. The best way to prevent Zika is to prevent mosquito bites. Here’s how:

  • Wear long-sleeved shirts and long pants.
  • Stay in places with air conditioning or that use window and door screens to keep mosquitoes outside.
  • Pregnant and breastfeeding women may use Environmental Protection Agency (EPA)-registered insect repellents(bug spray). Always follow the instructions on the label and reapply every few hours. The effectiveness of non-EPA registered insect repellents is NOT known. An example of a natural product with an EPA registration is oil of lemon eucalyptus.
  • Eliminate mosquito breeding sites, like containers with standing water.

What we know about Zika virus

  • Zika can be spread from a mother to her fetus during pregnancy.
  • Infection during pregnancies may be linked to birth defects in babies.
  • Zika is spread mostly by the bite of an infected Aedes species mosquito.
  • There is no vaccine or medicine for Zika.

What we do not know about Zika virus

  • If there is a safe time during pregnancy to travel to an area infected with Zika virus.
  • If you do travel and are bitten, how likely you are to be infected.
  • If you do travel and are bitten, how likely it is that your baby will have birth defects from the infection.

How worried should I be in the San Francisco Bay Area?

No local mosquito-borne Zika virus disease cases have been reported in the continental U.S., but there have been travel-associated cases in some areas of the US, including California. With the recent outbreaks, the number of Zika cases among travelers visiting or returning to the United States will likely increase. For this reason, men with a pregnant partner should use a condom or abstain from sex for the duration of the pregnancy if they have visited, or live in, an area where mosquitos are spreading the Zika virus.

Update July 2016: There is an increased need for women in the U.S. to take precautions to reduce their chances of becoming infected with Zika if pregnant. According to the CDC, there have been over 1,300 reported cases of Zika virus in the United States, including 14 sexually transmitted cases. In U.S. Territories, there have been over 2,900 reported cases of Zika infected people. There have been over 645 cases of pregnant women reported to have Zika in the United States and U.S. Territories.

How do I find the most recent CDC updates?

Visit the CDC’s website for more information about the Zika virus: http://www.cdc.gov/zika.

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Overcoming Anxiety

Anxiety is common when we experience changes or transitions in our lives. It is often linked to stress, which is one of the many triggers of anxiety. Anxiety can affect us both emotionally and physically. Anxiety symptoms include muscle tension, irritability, feelings of worry, nervousness, or fear, racing thoughts (i.e. your mind going a million miles a minute), and sweating. Anxiety is a normal feeling and response. Although many people believe anxiety is a sign of weakness, those feelings are common for anyone facing an essential transition or crisis.

Anxiety can be managed in several different ways. Practicing deep breathing exercises is one, simple way of managing anxiety symptoms. In times of crisis, our anxiety is triggered and our minds and bodies tend to be on “overload.” Calm breathing is vital because it assists in slowing down your breathing, allowing your body to reach a calm state. It is important to take some time to just sit and breathe. With those living busy lives, it can seem impossible to find the time to relax and breathe. But with the quick exercise described below, you can practice almost anywhere and everywhere!

Before practicing this technique, I recommend you get your mind and body ready. For example, finding a quiet place can be helpful. Sometimes, closing your eyes is helpful as well. The following technique is called “calm breathing” and is taken from http://www.anxietybc.com/sites/default/files/CalmBreathing.pdf

Some simple steps you can practice when you experience anxiety symptoms:

  1. Take a slow breath in through the nose, breathing into your lower belly (for about 4 seconds)
  2. Hold your breath for 1 or 2 seconds
  3. Exhale slowly through the mouth (for about 4 seconds)
  4. Wait a few seconds before taking another breath

Taking 5 minutes to practice this daily can be useful. Once you feel comfortable with this technique, you can increase the time to up to 10 minutes. You can also incorporate mind visuals. For example, while practicing this technique, you can close your eyes and picture something that calms you (e.g. the ocean or a meadow).

While this technique can be helpful, it is advisable to seek professional help should you feel your anxiety symptoms worsen over time or severely affect daily activities such as school and work. Should you feel you are faced with the more pronounced effects of anxiety, I find that having a safe environment to talk about your anxiety and what triggers it is important (e.g. individual psychotherapy). Therapy can provide an environment where you can explore symptoms and how it affects your mind, body, and daily interactions. In therapy, you can discuss further ways to manage your symptoms of anxiety.

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What I love about Support Circle – Board Member

Support Circle Board Member

Nancy Cecconi, Support Circle Board Member

What I love about Support Circle
By Nancy Cecconi, Support Circle Board Member and Former Nurse

I am a member of the Board of Directors of Support Circle. I served as both a volunteer nurse and a staff nurse in the three medical clinics. I believe strongly in the mission of Support Circle and see the need for it in the Bay Area.

The world looks on at an unplanned pregnancy with indifference, and an unspoken, ‘not my problem, so I don’t really care,’ at best. Support Circle is that place that says, ‘I care’ without pressure or judgment, and in full awareness of the woman and her rights, but wants to offer thoughtful, tangible help, at this most difficult time in her life.

What attracted me to the organization is that as an OB nurse, woman, wife, sister, mother, friend, I know the need for this service. What has sustained me is how thoroughly professional and competent they are in offering medical and counseling services.

 

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Pregnancy Options

Pregnancy Options

If you are pregnant, or think you may be pregnant, in an unintended pregnancy, you may have a floodgate of emotions and questions.pregnancy options What do you want to do? Do you want to parent, create an adoption plan, or have an abortion? Each decision carries its own set of unique results and will determine your next steps. Talking to a patient advocate may help you to sort out your thoughts and emotions and to think through each option.

 

Your three pregnancy options include:

Parenting. A decision to carry a pregnancy to term and raise the child. Many women would like to parent but they may have concerns about how to make that happen. You and your partner may choose to parent together, co-parent or you may parent alone. You will have many decisions to make but you do not have to make them all at once or alone. A patient advocate can assist in developing a plan, provide access to community resources and answer your questions.

Adoption. A decision to carry the pregnancy to term and to make an adoption plan involves relinquishing parental rights after the delivery. You may choose the level of involvement you may prefer. These options include: open (usually an on-going relationship), semi-open (usually letters and photos exchanged) and closed (no communication). A patient advocate can explain the different options, answer your questions and help you to develop an adoption plan.

Abortion. A decision to terminate or abort a pregnancy involves the use of either medication or a surgical procedure. Which abortion method depends on how far along the pregnancy has progressed. One of our nurses can answer your questions and provide accurate health information and education about the abortion procedure(s) available to you, including any possible health risks.

According to a recent Public Opinion Strategies survey, the most pressing need of women deciding about an unplanned pregnancy is sorting out their thoughts and feelings. A patient advocate can provide information on your options that will help you in your decision-making process. Whatever you decide should be in line with your beliefs and values. Ultimately, the decision is yours.

Support Circle exists to serve the woman who is unsure of her pregnancy decision by providing time, space, support so that you make the right decision for you. No matter what choice you make about your unintended pregnancy, our options, services and support are free.

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Pregnancy Symptoms

Pregnancy Symptoms

Woman with her monthly menstrual pains clutching her stomach with her hands as she becomes stressed by the ongoing cramps, torso view of her hands and tummy isolated on white

Period late? Think you may be pregnant?

Is your period late? Do you think you may be pregnant? Pregnancy symptoms differ from woman to woman and pregnancy to pregnancy. Understanding the signs and symptoms of pregnancy is important because each symptom may be related to something other than pregnancy. If you think you may be pregnant, treat yourself as if you are until you know otherwise.

Some women experience pregnancy signs or symptoms of pregnancy within a week of conception. For other women, pregnancy symptoms may develop over a few weeks or may not be present at all. Below is a listing of some of the most common pregnancy signs symptoms. If you have been sexually active and are experiencing any of the following symptoms, it is recommended to take a pregnancy test.

Early Symptoms of Pregnancy:

  • Spotting and Cramping – A few days after conception, the fertilized egg travels and attaches itself to the wall of your uterus, causing implantation bleeding, one of the earliest signs of pregnancy. This may occur around six to 12 days after fertilization.
  • Swollen/Tender Breasts – Women’s hormone levels change rapidly after conception, triggering tender, sore, or swollen breasts.
  • Nausea or Morning Sickness – Is one of the most common and popular pregnancy symptoms, but not all women experience it.  Nausea can occur at any time of day and not just in the morning.  The cause of morning sickness or nausea is likely to be hormonal changes.
  • Missed/Delayed Period – Is the most obvious symptom of pregnancy, and the one that prompts most women to visit our free clinic for a pregnancy test. However, a missed period could be caused by other things besides pregnancy.  It may be a symptom of hormonal problems caused by fatigue or stress.  It may also be a side effect of taking oral contraceptives.

Hormonal changes are likely to be the cause of other early pregnancy symptoms including:

  • Difference in menstruation
  • Fatigue/Tiredness
  • Frequent urination
  • Headaches
  • Dizziness
  • Food cravings and aversions
  • Back pain
  • Mood swings

However, these signs and symptoms are not exclusive to pregnancy.  These signs and symptoms could indicate that you are about to get sick.  They could also indicate that your period is coming soon.  In some women, pregnancy can occur without any of the later signs and symptoms of pregnancy.  In addition, there might be other pregnancy symptoms that could happen to you that are not commonly experienced.

If you have missed a period or suspect that you may be pregnant, you might want to get a pregnancy test.  The licensed health professionals at each of our three Bay Area Support Circle Clinics can administer a pregnancy test for you.  Whether your test comes back negative or positive for pregnancy, our health professionals can discuss possible reasons for your symptoms, or pregnancy options, and guide you through next steps.  Support Circle’s confidential services are offered free of charge.

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