The Stillbirth Summit Introduces the New Pregnancy Buzz Phrase ~ EPV!!!

Bear with me ~ to write about all the researchers and their findings present at the Stillbirth Summit in one sitting would require lots of time and several glasses of wine!!! So, I have decided to introduce you to one researcher per blog and write about what I took away from their lectures in my notes. If you are confused by my interpretation ~ you can Google it, research it & digest it. Take it or leave it; pass it on or delete it. Just know, these men and women will change the face of stillbirth with their passion and fire. They will pull stillbirth from the shadows and place it brightly in the light of day. They will find answers for us; prevention is their intention.

The Stillbirth Summit opened the eyes of all who attended. Dr. Alexander Heazell, MBChB, PhD, MRCOG, Maternal & Fetal Health Research Centre, University of Manchester, UK, delivered the simple yet poignant statement during the first presentation of a colleague, “We understand stillbirth very badly.” There was no pretentiousness. There were no scholarly noses looking down at us. The cards were on the table for everyone to see. Over the next 3 days the researchers would share their passion, frustrations and greatly needed research with us all.

When you listen to Dr. Harvey Kliman, MD, PhD, Director of Reproductive and Placental Unit, Yale University School of Medicine, you come away with one word embedded deeply in your brain: PLACENTA!!! The man is amazing and quick to state, “It is the simple things, tissue etc. which ends up in the pathology lab to be looked at. The information in it tells us why this loss happened.” Kliman is emphatic ~ the placenta is the key to what’s going on in a “loss” investigation and the placenta "must go to pathology."

While all eyes are on the fetus, Kliman explains a small fetus means a small abnormal placenta and “Doctors should know about abnormal placentas. Not knowing anything about the placenta is like driving a car without any gas!!!”

The “small” placenta is one major placental issue. The small placenta does not happen “all of the sudden.” The normal ratio of the fetus to placenta is 6:1. Once it goes beyond 7:1 or 8:1 it crashes. The placentas falling in the 10th to 90th percentiles are optimal. It is the ones which are in the < 10% or > 90% which will pose the problem. The baby and placenta tend to grow at the same rate and ratio up to 36 weeks. But what happens when the placenta is small and cannot supply the growing fetus? Intrauterine Growth Restriction (IUGR) develops. This concern plays a large part in delivering small and low birth weight babies, decreasing amniotic fluid (the amniotic fluid index) within the uterus, and putting your baby at risk for intrauterine death ~ if not detected. The extremes of a lesser ratio or a greater ratio between the baby and placenta indicate the need for diligent monitoring, care and concern.

One sign of a small and insufficient placenta is the onset of decreased fetal movements:

Can your heath care provider know about this beforehand? Yes.

Can something be done about it? Yes.

This can be detected by using standard ultrasound equipment. The measurement is called Estimated Placental Volume (EPV). Or, now there is even an EPV app, http://itunes.apple.com/us/app/epv-calculator/id406708196?mt=8, for your phone. According to Dr. Kliman, EPV should be incorporated in prenatal care and would take all of 15 seconds to do!!! The app costs a mere $29.99!!! So ~ why is Estimated Placental Volume not being calculated by every doctor, midwife and health care member who sees a pregnant woman for her OB appointment? The overriding reason for using this simple and inexpensive device can mean the difference between life and death for your baby. If a small placenta is detected, mom and baby will be monitored closely and a happy healthy outcome is easily achievable as baby can be delivered early if necessary.

According to Kliman, the placenta is part of the fetus and should be checked at a 10 week ultrasound. It should then be checked by ultrasound around 18 weeks. If the placenta is small at this time, there is nothing to do but keep an eye on it. When the placenta is small or large, the need  for closer monitoring is needed. 

Sounds to me ~ Estimated Placental Volume deserves to be the new pregnancy buzz phrase of 2012. If you are pregnant, why not ask to have your baby’s EPV checked the next time you visit your doctor, midwife or health care team? You may ask, “Why?” Quite simply, your baby’s life might just be depending on it…

C’mon Pregnant MOMMIES ~ Enlighten All Your Health Care Team ~ NOW!!!

So, you’re pregnant ~ or not ~ and you have heard about stillbirths but you have also heard the possibility of you or anyone you know actually delivering a baby born still is one in a million or extremely unlikely - RIGHT??? Well, the correct answer to the above statement is actually - WRONG.

A stillbirth occurs once in every 200 births in the USA. There are 30,000 every year in our country according to Dr. Jason Collins, MD of The Pregnancy Institute in New Roads, LA. This equates to about 85 each and every day in our highly medically and extremely technically advanced hospitals and country. Maybe you have seen articles, posts or blogs on stillbirth and quickly flipped the page, clicked to the next entry or exited the post. Maybe you read the information in front of you thinking, "This will never happen to me" and you let the information leave your mind as fast as you let it enter. Well, the time has come for us all ~ parents to be, family & friends, as well as, the medical community - to embrace the information in front of us and demand the resources to extinguish the flame of stillbirth be available to us all.


According to The Lancet's series, STILLBIRTHS, at least 50% of our world’s almost 3 million stillbirths are completely preventable. The statistics used in The Lancet consider a stillborn baby, "the death of a baby at 28 weeks’ gestation or more." What does that mean to us? It means simple interventions may save the life of a precious baby ~ if you are told what to do and what to look out for. At The Star Legacy Foundation we call it empowering and educating parents to be and their health care team.


Dr. Ruth Fretts, OB-GYN and assistant professor at Harvard Medical School in Boston, believes the risk of stillbirth increases late in pregnancy and many could be prevented. "We don't do a very good service to women by not informing them of the risks and giving them options to be evaluating the baby's well being". In the 2010 October/ November Issue, of Fit Pregnancy Magazine, the article “the whole 9 months” section, “Baby likes to move it”, Fretts states, “Most women who notice a decrease in movement will still have a healthy outcome…The biggest concern is when it happens repeatedly.”


The Royal College of Obstetricians and Gynecologist in the United Kingdom, whose stillbirth rates are one of the most dire for a country which is not considered to be one of the 98% low or middle income countries with abysmally high stillbirth rates, just issued a statement on reduced feta movement, "Clinicians should be aware (and should advise women) that although fetal movements tend to plateau at 32 weeks of gestation, there is no reduction in the frequency of fetal movements in the late third trimester."


Dr. Craig Rubens, MD PhD, Co-Founder & Executive Director GAPP states, "Why focus on the last 1/2% of pregnancy during Labor and Deliver to understand why women have adverse outcomes during pregnancy. We need to focus on and study more the 99.5% of pregnancy that's going on currently."


So, what can we do? Although the American College of Obstetricians and Gynecologists support kick counting ~ it is rarely mentioned or explained to pregnant women in the office or during prenatal classes. Don’t take it for granted everyone caring for you and delivering your baby is aware of kick counting and the important role it can play in assuring a happy, healthy and hearty delivery day. Make it your passion to educate all young men and women, moms and dads to be, their doctors, midwives and health care team to the importance of baby's movements from 20 weeks onwards and the importance of daily kick counting from 28 weeks onwards. Visit See Me, Feel Me now. Educate and empower yourself not only on the importance of baby's movements but also on the importance of a 20 & 28 week ultrasound with special attention being paid to the umbilical cord and placenta. Then, pass this vital information on to all so they can become baby's "in utero" advocate as well.


Don't wait until the tragedy of stillbirth strikes ~ and you think to yourself, "Oh yeah, I heard about that somewhere.” Don’t take it for granted your doctor, midwife or health care team is educated to the frequency of stillbirth and the ways to ascertain and address a possibly compromised baby. Write down the link or print out The Lancet series, Stillbirths and your My Kicks Count chart and take them to your appointment!!!

Now you have been told. Now you have the tools. Now spread the word and empower moms, dads, friends, family and the medical community across the globe. Remember ~ a sweet little baby's life will be depending on you...

King Tutankhamen ~ Call Him ~ “DAD”...

It is amazing to me to learn nestled with King Tut in his tomb were two fetuses. One was at least seven months gestation; I guess a 'stillbirth" by today's standards. The second fetus, a tinier more fragile female, was also tucked alongside her dad; I wonder, stillbirth vs. miscarriage?
Were these two little girls the pharaoh's daughters? DNA testing, to confirm true lineage, is the key needed to unlock this vexing scientific question. Although the data is somewhat incomplete, the study suggests one of the infants is truly Tutankhamen's daughter and, most likely, the second infant is as well. Whilst it was believed this King had no heirs to succeed him ~ I guess maybe he “almost” did.


Stillbirth has been around since the beginning of time. The pain and heartache associated with babies who never draw their first breath is as devastating today as it was back in the Golden Age of the Pharaohs. Educating and empowering parents to be, as well as, health care professionals with the tools to end this needless tragedy, is our goal.


Just how precious and irreplaceable is a stillborn baby to grieving parents and family? I guess we only need to look at King Tut ~ as this child king chose to embark on his journey into eternity with his two baby daughters snuggled closely by his side.

QUIET No More ~ JUST Break The Silence..

In October, Pregnant and Infant Loss Awareness Month, we need to remember all babies born sleeping or whom we have carried but never met, or those we have held but could not take home or the ones that came home but didn't stay. If you or someone you know has suffered the loss of a baby, break the silence. Please join us and be the voice for those who will never speak for themselves.

The Congress, by Senate Joint Resolution 314, has designated the month of October, as "Pregnancy and Infant Loss Awareness Month" and authorized and requested the President to issue a proclamation in observance of this month.


NOW, THEREFORE, I RONALD REAGAN, President of the United States of America, do hereby proclaim the month of October as Pregnancy and Infant Loss Awareness Month. I call upon the people of the United States to observe this month with appropriate programs, ceremonies, and activities.

IN WITNESS WHEREOF, I have hereunto set my hand this twenty-fifth day of October in the year of our Lord nineteen hundred and eighty-eight and of the Independence of the United States of America the two hundred and thirteenth.

Ronald Reagan

Former President

United States of America
 
October 15th is the National Pregnancy and Infant Loss Remembrance Day. The resolution to declare October 15 a remembrance day passed the United States House of Representatives on September 28, 2006. In honor of Pregnancy and Infant Loss Remembrance Day, many grieving parents light a candle at 7 p.m. in their respective time zones to create a wave of light around the world in memory of babies lost to pregnancy and infant loss.


"Seeking to forget makes exile all the longer; the secret of redemption lies in remembrance."
                                                 Richard von Weizaecker

READY ~ SET ~ WRITE & ROLL!!!

PLEASE SHARE WITH ALL: From Pat Flynn @ 1st Breath, http://www.1stbreath.org/;

MI Stillbirth / Kick Count Bill passed House & going to Senate. Letters needed to get hearing & vote. Bill could be model for other states!!!

So ~ what to do??? If you or anyone you know has endured the devastating pain and heartache of a stillbirth, please write your personal story and tell why you support HB6091. Strongly advocate for a quick hearing & vote.


Send to: Tom George, Chairman, Health Policy Committee, Room 320, Farnum Bldg. Lansing, MI 48933 ~ OR ~ Email: sentgeorge@senate.michigan.gov

Copy please to: Pat@1stBreath.org

Let's all keep fighting the fight for those unable to speak for themselves...

Hmmm ~ An Abnormality with Baby's 28 Week Ultrasound...

So, you have your 28 week (or thereabouts) ultrasound; there's an abnormality with the cord. What happens next? You"ll have to discuss the possiblities with your OB. Will home fetal heart rate monitoring, frequent ultrasounds or kick counting be the plan? You and your medical team will choose the best approach to keep a daily check on baby. Visit http://www.preginst.com/ to watch home fetal heart rate monitoring in action...

Proactive Measures to Insure a Happy Healthy Delivery

Welcome to "Families Need to Know!" This is an exciting step for The Star Legacy Foundation which is dedicated to stillbirth education and research in forming a Family Advisory Council. We hope to educate families, parents and friends on simple proactive measures available to you to insure the happy safe delivery of your baby. Placental complications and umbilical cord accidents (UCA) are all too prevalent in the USA. UCA account for 30% of the 26,000 stillbirths a year in our country. I hope to provide information and education while guiding you how to be your baby's "en utero" advocate!

This foundation has formed an alliance with Dr. Jason Collins of The Pregnancy Institute in New Roads, LA. We support the Institutes's research and endeavors and hope you will too. We are strong advocates of visualizing the placenta and umbilical cord at your 20 week ultrasound for any abnormality. We also advocate a 28 week ultrasound be mandatory in the doctor's office for visualization of the umbilical cord.

We are also huge proponents of kick counting. We want moms to know their baby's movements well before the 28th week. Moms should know when baby's movements change it is time inform their doctor. When your baby's movements speed up or slow down ~ become involved and let your doctor know!

I look forward to hearing from you, getting to know you and having fun!