Connective tissue diseases and breast implants

In 1995 a New England Journal of Medicine publication citing a study by harvard Medical School entitled “Silicone breast implants and the risk of connective-tissue diseases and symptoms” concluded that in a large study of over 87,000 women, over a time period from 1976 to 1990, taking into consideration different implant types (including saline, double-lumen and silicone) that there was no association between silicone breast implants and connective tissue diseases.

Silicone breast Disease – American College of Rheumatology statement

According to a statement issued in 1995, there was no demonstrable risk between silicone implants and connective tissue disease OR rheumatic disease. However, other studies have shown that there is a small by statistically significant risk of developing a connective tissue disorder with silicone breast implants.

More about Silicone breast disease:

http://www.bmj.com/content/316/7129/403.extract
http://www.breastimplantanswers.com/expert_ctd.html

Nursing / Breast feeding with silicone implants

Depending on the size of the breast implant it may make it more difficult to breast feed. According to Patricia Lieberman, where she references the Institute of Medicine, any type of breast surgery or breast implant surgery, makes it 3 times more likely that a breast feeding woman will not have enough milk supply. Patricia references another study by Dr. Sarah Strom, in which was consistent with other studies in finding that women with implants are more likely to have problems nursing.

Related pregnancy topics:
list of early pregnancy symptoms
pregnancy breasts

If you are HIV positive you should consult an obstetrician who is an expert in HIV care either prior to becoming pregnant or as early in the pregnancy as possible. He will advise you on the use of medication to reduce the chances of your baby becoming infected with the virus.

• If you are already taking HIV medication prior to pregnancy and are in the first twelve weeks of pregnancy you should talk to your doctor regarding the risks and benefits of continuing the HIV drugs.
• If you are more than three months pregnant and have been taking HIV drugs prior to pregnancy you will probably be advised to continue with the medication.
• If you are diagnosed HIV positive in the first three months of pregnancy the HIV drugs will not normally be commenced until around 14 weeks.

If you have not taken HIV drugs during your pregnancy you can still reduce the risk of your baby being infected by the virus by using HIV medication during labour and birth.

You may be advised to have an elective caesarean section as this reduces the risk of passing the infection onto your baby during birth.

Breastfeeding is not recommended as the HIV virus can be passed to your baby in the breastmilk.

Systemic lupus erythematosus (SLE) is an autoimmune disease. If you suffer from SLE it is important to seek pre-conception advice. Although research indicates that if the disease is in remission pregnancy outcomes are good, SLE can sometimes result in:

• Pre-term labour
• Low-birth weight
• Congenital heart block

If you suffer from SLE you will need to have combined antenatal care with your physician and obstetrician and you should have an early antenatal assessment and ultrasound scan. The frequency of your antenatal check-ups will depend on the severity of your condition. The control and treatment of SLE ranges from simple analgesics such as paracetamol, to stronger medication such as corticosteroids and immunosuppressive drugs.

If you suffer from any complications such as pre-eclampsia or renal problems your labour may be induced early or your obstetrician may recommend an elective caesarean section.

Following delivery of your baby you should rest as much as possible as tiredness and stress can worsen your condition. You will be closely monitored for 24-48 hours after your baby is born and your baby will have a thorough examination by a paediatrician.

If you suffer from a long-term renal problem it is important that you seek pre conception advice before becoming pregnant. A pregnant woman with pre-existing renal disease is considered to be at high risk of developing pre-eclampsia, hypertension, pre-term delivery and her baby may be small-for-dates. The added strain put on renal function during pregnancy may also cause your renal condition to deteriorate.

If you have renal disease your care will be combined by your obstetrician and nephrologist. A hospital delivery is essential. The outcome of your pregnancy will depend on the severity of your renal disease, the stability of your blood pressure and prevention of kidney infections.

The aim of your care in pregnancy is to prevent any deterioration in your kidney function. Therefore, you will need to attend for antenatal visits more often. Renal function tests will be performed at intervals throughout your pregnancy and your blood pressure will be monitored carefully.

You will require admission to hospital if your kidney function deteriorates, your blood pressure increases or if there are any problems with your baby.

If your pregnancy progresses with no complications, your labour may be induced at 38 weeks.

Part of your pregnancy preparation, if you have diabetes, should be to confirm that the hospital that you are going to give birth in has a neonatal intensive care unit. Babies who are born to diabetic mothers may need the special services provided in these units. Women who have diabetes have a tendancy to get more vaginal or urinary tract infections and also may need to make sure they have close monitoring of their blood sugar levels.

As far as possible you will monitor your blood glucose measurements and urinalysis at home but you may need to have blood glucose tests in hospital as well and your insulin requirements adjusted. Special attention will be paid to symptoms such as nausea or vomiting and you may need advice from the dietician on how to maintain an adequate calorie intake. A high-fibre diet is advised because it produces a more constant blood glucose. As your baby grows your carbohydrate intake may need to be increased and your insulin adjusted accordingly. Again, your relationship with your doctor is important and you should rely on them for advice on diabetes during pregnancy.

When you are about to give birth, you may be given an I.V. to supply you with insulin and/or carbohydrates. After your baby is born carbohydrate metabolism returns to normal very quickly and insulin requirements will typically fall sharply. If you are breastfeeding then you may need to keep your carb and insulin levels a little higher. Again, talk to your doctor about this.

Pregnancy can influence diabetes in that pregnancy can increase your body’s need for insulin. The development of diabates during pregnancy is called gestational diabetes. This is different from diabetes as a pre-existing condition before pregnancy. Gestational diabetes is a result of pregnancy.

Excessive food intake results in weight gain, over and above pregnancy related weight gain. The health risks for a baby born to an obese mother include obesity and possible diabetes in the child in later life.