When women come to me for ultrasounds, they are often surprised to hear that they have a small, perhaps walnut-sized fibroid. The hormones of pregnancy encourage fibroids to grow, so what was too small to notice before pregnancy might become visible on an ultrasound during pregnancy.

If you have fibroids during your pregnancy, there are some things to consider. Fibroid tumors can be a problem if:

The tumor is so big that it compresses the baby, which is rare.

It’s under the placenta and restricts blood flow to the placenta, which is not common.

It is large (the size of a softball or grapefruit) and located low enough in the uterus that it is blocking the birth canal, which is also not common.

Sometimes, what is thought to be a fibroid is really a localized contraction of the muscle that goes away by itself. When having an ultrasound, you should be sure that the scan goes on for a few minutes to see whether the muscle contraction resolves itself or whether what’s seen on the scan is a true fibroid.

Sometimes fibroids cause pain if the tumor grows faster than its blood supply. The treatment is pain medication, including Tylenol, codeine or Demerol. Of course, never take aspirin, Motrin, ibuprofen or other related medications when you’re pregnant, even though they are what we usually use outside of pregnancy for this kind of pain.

If you have had surgery to remove a fibroid tumor, it’s important for your doctor to know how it was done. If the tumor was on a stalk and simply cut, the fibroid is generally not an issue in the pregnancy or delivery. However, if the muscle of the uterus was cut, then you will need to be delivered by Caesarean section because there is a risk of the uterus rupturing in labor.

Fibroids rarely cause infertility, although the surgery to remove them can leave scars on the pelvis that can interfere with normal conception.

What’s the bottom line? If you know that you have fibroids, they may grow, but usually are not a major problem in pregnancy. If you need surgery for fibroids, have it done before you get pregnant. Surgery for most fibroids is not a good idea during pregnancy, and due to the high volume of blood flow to the pregnant uterus, we also don’t like to take them out during Caesarean sections.

ULTRASOUND

Commonly known and most often used in women even when not pregnant, this sonography bounces sound waves creating an image and projects the image unto a screen. It is like a X-ray, in that you can see inside the body, yet without the radiation and associated risks. An ultrasound technician will slide a monitor, kind of a mouse like transducer or speaker around the patient’s abdomen and may be insert into the vagina as a probe. This device is smeared with a gel and used as a sound conductor. Remember if it is a male ultrasound technician, a female assistant will be present when the vaginal probe is used.

Almost instantly, a proto-baby – or important parts – head, heart, and limbs appear animatedly on a nearby computer monitor. This test is used to help date pregnancies, to detect multiple fetuses, to watch development and placental location- to see if there are any problems developing. Often times near the due date, it is used to detect the exact position of the fetus. Ultrasound can be done at anytime during a pregnancy, but like any other tests it has its risks and should not be abused. This non-invasive technology is also used as a guide for invasive procedures such as Amniocentesis.

AMNIOCENTESIS

This study is the removal of a small amount of amniotic fluid from the uterus with a needle which is inserted through the abdomen. The physician’s hand and needle are under Ultrasound guidance. This allows for hundreds of chromosomal and genetic abnormalities to be recognized. Thus inherited disorders can be recognized before birth. The lab analysis of fluid collected also includes search for organisms, such as bacteria and viruses. Amniocentesis also reveals information on lung maturity, Rh. isoimmunization. Results can reveal with 98.9% to 99.9% accuracy such conditions as Downs Syndrome, Spina Bifida, Sickle Cell disease and Cystic Fibrosis. including neural defects This is not a routine test and more than 3/4′s of all amino tests that are performed are done because of maternal age as it relates to Downs Syndrome. There is a higher then average incidence of Down Syndrome in women that are 35 or older. This is usually performed when indicated, in the second trimester ( between 15 and 18 weeks) of the pregnancy. Test results require 10 to 14 days of lab work for a final reading.

MATERNAL-SERUM-ALPHA-FETOPROTEIN (MSAFP)

MFAFP is a blood screening test to establish the level of Alpha-fetal protein (AFP) in the mothers blood. This is produced initially by the yolk sac and then by the fetus’s liver, peaking at 14-18 weeks of gestation. If levels are higher than normal in the mother’s blood it can indicate that the baby has a neural deficit such as Spina Bifida, congenital kidney disorder, a cyst on the testicle or an esophageal malformation. Really low levels can mean Downs Syndrome or other chromosomal defects. This is a test widely recommended and even mandated by law in California and New York. A mother’s blood sample is usually collected between 16 and 18 weeks for this test. If you feel that this test needs to be done, discuss it with your physician.

CHORIONIC VILLUS SAMPLING (CVS)

This test is not frequently performed as it involves removing cells from what will become the placenta. It collects fluid from the outer membrane that encloses the fetus. This is the chorion. Performed to screen for evidence of abnormalities that are revealed by an amniocentesis. It is done earlier between the weeks 9 and 12 in a pregnancy in at risk mothers. The results are determined quicker than an amniocentesis. Cells are taken from the outer membrane that encloses the fetus either by a tube inserted into the vagina or they can be taken through the abdomen wall.

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What are some ways we can deal with the heat and still nurture our little one’s need for closeness?

Lighten up

Babies need very little covering when it is beastly hot, so remove some clothing. A simple cotton T-shirt or onesie and diaper are usually all that’s needed, and when it’s really hot, even a naked body on a waterproof pad is fine. If the baby will be exposed to air conditioning, simply adjust the clothing to what you are comfortable wearing.

Shed layers of blanket, too. Using cotton receiving blankets rather than fuzzy ones can help alleviate the misery of the heat. There’s need to wrap baby, but you can use the blanket to absorb some of the sweat created when you are holding the nursling close to you. A cotton diaper used under the breast to absorb dripped milk and sweat can also make you more comfortable!

Quench your thirst

First, Mom needs to drink enough to satisfy her thirst. Water (and lots of it) is best, followed by unsweetened fruit juices. Second, the baby really doesn’t need any water at all, as long as he’s nursing. This runs contrary to much popular advice — especially that of our own moms who were taught, erroneously, that babies need water. In fact, breastmilk has a very high water content. And as long as your baby is nursing well he should be fine.

To be on the safe side, remember and watch for the signs of dehydration: lethargy, wetting fewer diapers than normal (this varies with the age of the baby) and/or a sunken fontanel. These can indicate the need for increased nursing, and perhaps a phone call or visit to the pediatrician.

Stay out of the sun

It’s said that only mad dogs and Englishmen go out in the midday sun — no mention of nursing babies and their mamas. In fact, babies are VERY sensitive to the sun, and can burn and overheat easily. Since sunscreen is not recommended for babies under 6 months of age, be sure to avoid the sun as much as possible, and keep a cotton hat on your baby’s very delicate head.
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Seek the cool

A cool damp cloth can be a great thing to have nearby when nursing during a heat wave. Wiping your baby’s and your own wrists, ankles, and neck can be very soothing, as well as cooling.

If your house is not air conditioned, take advantage of the air conditioning in public places. A library, movie theater, or mall may be a good place to spend a couple of relaxing hours and give both you and baby a much needed break from the heat.

Keep cool!

It is possible to have symptoms of a yeast infection, yet the underlying problem is not a yeast infection. The reason for this is due to yeast infection symptoms being similar to other problems. For this reason, a doctor should be consulted to get to the root of the problem.

The major symptom of yeast infections is itching of the vagina or vulva (the outer portion of the female genitalia). Soreness, pain during urination and intercourse, a burning sensation and discharge from the vagina can be caused by yeast infections. When discharge occurs, it displays no color and looks somewhat like cottage cheese — white with a heavy texture and appearance.

Yeast infections are recurrent in a few women — about 7 percent. Yeast infections are considered as recurring if a woman gets hit with four or more yeast infections within a year that are not associated with antibiotic ingestion. When yeast infections keep occurring, it could be a symptom of another problem.

Anti fungal medications are used in the treatment of yeast infections. A few are applied topically, which means on the surface. Applications of topical medications are used on and inside the vagina. Anti-fungal treatments can also be taken orally.

More than one category of medication may be required if an infection is triggered by mixed categories of yeast microbes. Clotrimazole (Lotrimin), butoconazole (Femstat 3), miconazole (Monistat) and terconazole (Terazol 3) are some of the common topical anti fungals creams. The common oral drug of choice for a yeast infection is Diflucan or fluconazole. Physicians are more likely to prescribe topical treatments over oral treatments for yeast infections. The oral drug cannot be used if you are pregnant or breast feeding, and may lead to side effects such as headache, nausea and stomach pain. Topical medications are not very liable to cause any type of side effects.

You can treat a yeast infection with over the counter treatments. Nevertheless, if symptoms persist, you should go see a doctor to ensure that you have no problems other than the yeast infection. Bacterial vaginosis, chlamydia and gonorrhea are some of the conditions with similar symptoms as a yeast infection.

Buy Diflucan at online pharmacy

Where is Diflucan sold with no prescription necessary?

A prescription medicine, Fluconazole is available in 50 mg, 100 mg, 150 mg and 200 mg tablets. It can be purchased by prescription only in tabular form for oral use, but the online pharmacy will accept Fluconazole orders sans prescription. You can purchase Diflucan from them online to save money, avoiding the usual store markup.

Can I use my Credit Card to pay for my order from Diflucan?

Pharmacies will take credit cards like Visa and MasterCard, online checks (ACH), EuroDebit and wire transfers.

Is it against the law to purchase Diflucan?

Indeed, it is not illegal. You attest that you are purchasing the Diflucan tablets just for personal use with no intention of reselling them. All medications are acceptable for use in numerous countries. Generic Fluconazole should have no problem passing through any customs house, American included. If you encountered trouble with customs, report it to the pharmacy and they will duplicate your Fluconazole order without further charge.

What if this is the first time I’m buying Diflucan online?

Order Fluconazole online. After weighing the prices against those of your local pharmacy you will have no doubt that any pharmacy can retail inferior generic Diflucan at a lower rate.