Embrace Providing Hope – Manjula’s Story

Manjula’s story has touched Embrace team tremendously. Having lost her first two babies, her pain is evident, but she is hopeful that with the help of the Embrace Infant Warmer, her third baby will survive.
When Manjula’s third baby was born, she weighed just under two pounds.  Manjula’s husband quietly told us, “My wife gave birth to our first baby at home with the help of village elders; the baby survived only for a couple of hours…we are not sure why she passed away. Our second baby died at birth in the hospital – his kidneys had not developed.”
Five days after being placed in the Embrace Infant Warmer, her baby’s weight had increased to over two and half pounds, a positive indication she was becoming healthy.  Her husband later reported to us, “Our baby has now survived past twenty days, a very good sign.”


Manjula’s story is tragically familiar. Sadly, she was blamed by her community and extended family for the loss of her first two babies, and has been labeled “worthless” as a result.  This is a persistent pattern in many such areas of the world, due to lack of education.  Manjula is silent, and a little apprehensive, but the hope in her eyes is evident as she looks after her little girl.
We are thankful that Embrace was able to help her baby girl survive, and perhaps set Manjula on the path to recover her self confidence.

Thalassaemia in pregnancy Best Practice & Research Clinical Obstetrics & Gynaecology, 02/03/2012

Leung TY et al. – After birth, resumption of iron chelation and bisphosphonates treatment is needed, and counselling on breast feeding and contraception should be given.

• Thalassaemia is the most common monogenetic disease worldwide.
• Antenatal screening is effective and simple, and accurate genetic prenatal diagnosis can be achieved in early gestation.
• Less invasive methods are feasible with ultrasound fetal assessment for alpha–thalassaemia, analysis of circulating fetal nucleic acid in maternal plasma, and pre–implantation genetic diagnosis.
• Women with thalassaemia major and intermedia are at risk of various maternal complications, such as cardiac failure, alloimmunisation, viral infection, thrombosis, endocrine and bone disturbances.
• Therefore, it is prudent to adhere to a standard management plan in this group of pregnant women.
• Close monitoring of the maternal and fetal condition during pregnancy is essential, and various treatments, such as blood transfusion or postpartum prophylaxis for thromboembolism, may be indicated.
• After birth, resumption of iron chelation and bisphosphonates treatment is needed, and counselling on breast feeding and contraception should be given.

Intrauterine exposure to mild analgesics during pregnancy and the occurrence of cryptorchidism and hypospadia in the offspring

Snijder CA et al. – The results suggest that intrauterine exposure to mild analgesics, primarily paracetamol, during the period in pregnancy when male sexual differentiation takes place, increases the risk of cryptorchidism.
Methods

• Associations between maternal exposure to mild analgesics during pregnancy and cryptorchidism or hypospadia in the offspring were studied in 3184 women participating in a large population–based prospective birth cohort study from early pregnancy onwards in the Netherlands (2002–2006), the Generation R Study.
• Cryptorchidism and hypospadia were identified during routine screening assessments performed in child health care centres by trained physicians.
• The use of mild analgesics was assessed in three prenatal questionnaires in pregnancy, resulting in four periods of use, namely, periconception period, first 14 weeks of gestation, 14–22 weeks of gestation and 20–32 weeks of gestation.
• Logistic regression analyses were used to study the associations between maternal exposure to mild analgesics and cryptorchidism and hypospadia.

Results

• The cumulative prevalence over 30 months of follow up was 2.1% for cryptorchidism and 0.7% for hypospadia.
• Use of mild analgesics in the second period of pregnancy (14–22 weeks) increased the risk of congenital cryptorchidism [adjusted odds ratio (OR) 2.12; 95% confidence interval (CI) 1.17–3.83], primarily due to the use of acetaminophen (paracetamol) (adjusted OR 1.89; 95% CI 1.01–3.51).
• Among mothers of cryptorchid sons, 33.8% reported (23 of 68) the use of mild analgesics during pregnancy, compared with 31.8% (7 of 22) of mothers with a boy with hypospadia and 29.9% (926 of 3094) of mothers with healthy boys.