LISTERIOSIS AND PREGNANCY
By Dr. Octavia Cannon
What is listeriosis?
Listeriosis or Listeria is an infection caused by Listeria monocytogenes bacteria. The most common source of infection is contaminated food (deli meats, unpasteurized milk/dairy products, soft cheeses, and pate). Once infected, Listeria lives in the gastro-intestinal tract. Only the monocytogenes species is a cause for concern in humans.
Who is at risk for Listeria?
Listeria occurs in 0.7 per 100,000 people or (2500/year). One-third of the Listeria cases are in pregnant women. Pregnant woman and those with a weakened immune system are 20 times more likely to become infected.
What precautions should be taken to avoid infection?
Listeria is usually killed by pasteurization or cooking. Wash all raw vegetables and separate uncooked food from cooked food. Washing your hands, cutting boards, and knives is important. In addition, pregnant women should avoid soft cheeses (Brie, Camembert, Mexican-style, bleu-veined) unless they are in a fully cooked dish. Food should be stored within 2 hours of serving (1 hour in hot weather). Pregnant woman should also refrain from eating pate, meat spreads, refrigerated smoked seafood, and salads made in the grocery store (ham, chicken, egg, tuna, seafood).
How do I know whether I’ve been infected?
Blood tests can detect Listeria. Symptoms range from none to diarrhea, fever, muscle/joint pain, headache, stiff neck, backache, chills, sensitivity to bright light, and sore throat with swollen glands. Symptoms usually begin 2-8 weeks after eating the contaminated food.
Will this affect my baby if I am pregnant?
It is likely that although you have been infected your baby has not. There is a risk of miscarriage, stillbirth, uterine infection, preterm labor and neonatal death. The complications may occur 2-14 days following maternal infection. Early diagnosis and high doses of antibiotics (Ampicillin/PCN) may prevent infection of the unborn baby. No increased risk for pregnancy loss or birth defects has been reported in women who did not have symptoms of infection. There is no evidence that Listeria is a cause for repeat miscarriages in women. There is a slightly increased risk for meningitis in babies, occurring 2 weeks after delivery; likely due to Listeria in the mother’s birth canal.
How can I know if the baby has been infected/harmed?
The same blood test can be performed on the baby after birth. An ultrasound can be used to check for an enlarged heart, thickened bowel, and increased stomach wall thickness in-utero. There is no evidence that breast milk can pass the infection from mother to baby.
UTERINE FIBROIDS: THERE ARE OPTIONS!!
DR. OCTAVIA M. CANNON
Have you wondered why your menstrual cycle seems to be heavier and more uncomfortable now then when you were 20, 30 or 40 years old? The answer may be uterine fibroids which are non-cancerous tumors located in the smooth muscle of the uterus. Fibroids occur in 20-50% of women and are more common in women of African-American or Latin descent.
Fibroids (also called leiomyomas) are the most common solid pelvic tumors in women. The cause is unknown, but the risk is higher in women who are overweight or who eat diets high in fatty foods. Many women have fibroids yet do not have any symptoms. For women who are experiencing symptoms, the most common are abnormal uterine bleeding, pelvic pressure, and urinary frequency or incontinence. Abnormal uterine bleeding occurs because of the uterus’ inability to contract down due to the location of the fibroid. Pelvic pressure may occur if the fibroids are large or located on top of the uterus. Urinary frequency, urinary incontinence, or constipation occur when fibroids are located near the bladder or bowel.
Women with fibroids are able to conceive and carry a healthy pregnancy to full term. However, they have a higher risk of miscarriage, infertility, preterm labor, pain, bleeding and other labor complications. Therefore, if you have fibroids and desire to become pregnant, consider consulting your gynecologist first. She/He will obtain a thorough medical history, full gynecological examination, diagnostic tests and pelvic ultrasounds and then discuss what options are right for you.
Generally, fibroids only need to be treated if the symptoms you are experiencing are disrupting your lifestyle. There are many surgical treatments for uterine fibroids. Abdominal Myomectomy is a surgical procedure where the fibroids are removed while leaving the uterus intact. Although there is a 10% risk of recurrence, many women find the immediate improvement of their symptoms well worth the postoperative recuperation period, time missed from work, and discomfort experienced while healing. Other surgical options include 1.) Hysterectomy-removal of the fibroids, ovaries and uterus, 2.) Endometrial Ablation-insertion of a balloon-like instrument into the uterus which is heated to destroy the lining of the uterus causing a decrease in menstrual bleeding. 3.) Uterine Artery Embolization-Radiology performed procedure which cuts off the blood supply to the fibroids causing them to shrink. All of these options treat the fibroids and the associated symptoms by removing them or shrinking them.
There are several non-surgical treatment options however they do not treat the fibroids themselves but instead reduce the symptoms associated with them. Such options are: 1.) Birth control pills, Ortho-Evra Patch or Nuvaring, 2.) Hormone-Secreting Intrauterine Device (IUD), and 3.) Injectable medications like Depo-Provera or Depo-Lupron. These hormonal treatments all reduce excessive bleeding without surgical intervention and possible complications.
Lastly, if you are considering trying non-traditional medicine, acupuncture may be the right treatment for you. Studies show that bi-weekly acupuncture treatments over a 3-month period slow the growth of fibroids and decrease abdominal pain. If you are interested in considering acupuncture be sure to confirm that the acupuncturist that you select has experience in the treatment of fibroids.
Thankfully, there are always new treatment options under investigation. If you suspect that you may have fibroids or just want to have a thorough examination before you try to become pregnant, call your gynecologist and make an appointment today!
Dr. Cannon is a Board-Certified obstetrician/gynecologist at Arboretum Obstetrics and Gynecology in South Charlotte.
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