In a study presented today at the annual meeting of the American Society of Hematology, researchers have found that using heparin and aspirin in early pregnancy does not appear to be beneficial for women with unexplained recurrent miscarriages.

Researchers recruited study participants with a history of at least two miscarriages before the 20th week of pregnancy. The participants were screened to ensure they were clear of uterine malformations, had normal parental karyotypes, had normal fasting homocysteine levels, and had no clear evidence of clotting disorders or other conditions that might explain the recurrent miscarriages. From those participants whose miscarriages remained unexplained, the researchers formed three groups. One group of women received aspirin when they became pregnant again, one group received heparin with heparin, and one group received a placebo. Ultimately, the live birth rates were not different among the groups. There was no improvement in odds of a successful pregnancy for the groups receiving treatment compared to the control group.

The results are certainly disappointing -- it would have been nice if this treatment had turned out to be helpful. Right now, couples with unexplained recurrent miscarriages basically have no choice but to try unproven treatments in the hopes of a benefit or to continue to try with no treatment and hope for the best. Some doctors had begun offering heparin and aspirin as an experimental treatment to women regardless of their blood clotting status, with the idea being that there might be clotting factors that don't show up in the common tests, but this study would seem to indicate that there's no point to using anticoagulant therapy unless you have a clear need for it.

The good news in all this is that even couples with unexplained recurrent miscarriages continue to have good odds of having a successful pregnancy in the future, with or without treatment, and more than half of the study participants had live births within two years in all the treatment groups.

Note that these study results do not pertain to women who have clear evidence of a blood clotting or thrombophilia disorder (such as antiphospholipid syndrome); heparin and/or aspirin is still recommended for these women.

More Information:

• Abstract: Aspirin and Aspirin Combined with Low-Molecular-Weight Heparin in Women with Unexplained Recurrent Miscarriage: a Randomized Controlled Multicenter Trial (ALIFE Study)
• Diagnosing Antiphospholipid Syndrome
• Why Some Women Need Heparin During Pregnancy

Although ectopic pregnancy might sound like something that ought to be easy for a physician to diagnose, the truth is that it really isn't -- at least, not for ectopic pregnancies that have not ruptured. Unless the ectopic pregnancy is visible on ultrasound, which is often not the case, it's difficult to diagnose an ectopic pregnancy based on any single test. When doctors are able to catch ectopic pregnancies before rupture, the diagnosis usually requires collection of info from a pelvic exam, hCG levels, and ultrasound and analysis of all the results together. (More info: How Doctors Diagnose Tubal Pregnancy

That's probably a major reason why around half of all ectopic pregnancies aren't caught until they rupture. According to a recent BBC article, Scottish researchers are attempting to change that. The article describes how researchers at Edinburgh University have discovered that women with ectopic pregnancies tend to have lower levels of a protein called activin B, and the researchers are working on a possible routine blood test that could flag women who might have an ectopic pregnancy.

It will be neat to see where this goes. Right now, ectopic pregnancy is a leading cause of pregnancy-related death in childbearing women. When detected in time, the treatment can be as simple as taking medication, so it would seem that a test with potential to catch these pregnancies early may be able to save lives.

According to a report in ABC News, a new study has shown that about two-thirds of all chickens sold in grocery stores carry potentially dangerous bacteria such as salmonella and campylobacter. Oddly enough, this is an improvement over earlier results that found over 80% of chickens to be contaminated, although some brands still fared worse than others. (Apparently organic "air-chilled" broiler chickens were the safest bet.

The study results are no huge surprise, but I think this offers a good reminder of the importance of cooking your food thoroughly and washing your hands carefully whenever you handle any kind of raw meat. Salmonella in store-bought chicken should not be dangerous if the food is properly cooked before being eaten, as prolonged exposure to heat will kill the bacteria, but it's important to also make sure to wash your hands and any surfaces in your kitchen that were in contact with the meat before it was cooked. Salmonella and other types of food poisoning can be dangerous to pregnant women and unborn babies, and eating or handling improperly cooked meat is a major risk factor for developing these infections.

Related information:

• Food Poisoning and Miscarriage
• Foods to Avoid in Pregnancy

A publication called Star-Telegram has an interesting profile of work done by the palliative care team at the Baylor All Saints Medical Center to help grieving parents of newborns with fatal diagnoses. As the article states, most people don't think of babies when they hear of "palliative care," but for parents who have given birth to babies with incurable diseases, the need for palliative care is a tragic reality.

The article talks specifically about couples who learn of the fatal diagnoses during pregnancy but who choose to continue the pregnancy despite the diagnosis due to religious or philosophical preferences. Neonatalogists at the Baylor All Saints Medical Center realized that these parents would need support as they worked their way through the grief and expanded their palliative care team to meet the need. Now, whenever impending stillbirths or infant deaths are detected in advance, palliative care specialists can be present to support the parents during labor and delivery, make sure the parents are not subjected to unnecessary uncomfortable questions or other circumstances, give a chance to bathe and hold their babies, and assist with funeral arrangements and grief support.

In my opinion, every hospital with a labor and delivery department ought to have such services in place for parents suffering a loss at any stage of pregnancy. With all the horror stories out there about how parents are sometimes treated when they seek pregnancy loss treatment at emergency rooms, it is certainly refreshing to read about a hospital that seems to have the right idea.

According to an article in the BBC, the British group Sands is calling for the British government to take greater action in researching causes of stillbirths and what can be done to prevent them. The group has issued a new report called "Saving Babies' Lives" that asserts many stillbirths to be preventable and decries the fact that stillbirth rates have not dropped much in the past few decades.

There have been several such awareness announcements in the past year, and I know that there's been a push for researchers to learn more about this. More knowledge is needed, given that many stillbirths are never explained and many are believed to be preventable. One would hope that in the rush to reform healthcare in the US that someone would be paying attention to the problem of stillbirths, which, as the article points out, far exceed the numbers even of sudden infant death syndrome.

Here's another of those inspiring stories -- this time from Britain's Mirror.co.uk publication. In the story, new parents Julie and Phil Turnock tell of how they have finally welcomed a baby girl after having five miscarriages and losing a baby who was born premature at 21 weeks. After her third miscarriage, Julie was diagnosed with a blood condition that doctors said was causing the losses, but she continued to have more miscarriages even after being treated. The couple feared they were "destined never to be parents," but they refused to give up hope without trying one more time -- and now they have welcomed their daughter Amy, who was born healthy after an uneventful pregnancy.

I like success stories. When I had three miscarriages in a row, I remember how much it helped to know that other people had been there and come out on the other side with a healthy baby.

If you yourself have a success story you'd like to share about giving birth after one or more miscarriages, share it here to help inspire others. If you're pregnant again but haven't given birth yet, you can share your pregnancy story too.

According to an article in Science Daily, Canada researchers have found an unexpectedly high percentage of pregnant women may be using prescription drugs that are not safe for pregnancy. In the study, 6% of pregnant women in Quebec were using drugs that were known to be harmful to developing babies. Over half of those women electively terminated their pregnancies due to concerns over birth defects, another 6% miscarried, and 8.2% gave birth to a baby with a major birth defect.

This particular study was conducted in Quebec, and it's hard to know what the rates are in other areas -- in the US, for example, there are programs in place to track women using some of the drugs mentioned in the article (such as isoretinoin) to ensure that they are aware of the risks. In some other cases, however, women might be taking medications without being fully aware of the pregnancy risks. This is one reason why it is a good idea to have a preconception visit with a healthcare practitioner if you haven't already, as this gives you an opportunity to review your medical history with your doctor or midwife to look for anything that needs changing before you become pregnant. But given that the majority of pregnancies aren't planned, it's also a good idea to know the safety status of any medications you need to use on a regular basis, whether you're planning a pregnancy or not. If you become pregnant unexpectedly, you should see a doctor as soon as possible to check if you need changes to your treatment plan.

In a recent study reported in JournalWatch, researchers have found that incidence of post-traumatic stress disorder (PTSD) was fairly high in pregnant women who were interviewed in a telephone survey. Over 80% of the women in the study had a history that could potentially have triggered PTSD at some point in their lives, and about 8% had active PTSD. Having had a difficult miscarriage was one of the major risk factors for having active PTSD in pregnancy, along with a history of abuse or difficult experience with an elective abortion.

I do not find these results at all surprising. Past research has found that a small but significant number of women who have a miscarriage can end up developing long-term PTSD, and a larger number may experience PTSD symptoms in the immediate aftermath of the miscarriage. I would bet that even more women probably experience significant anxiety in the next pregnancy after the miscarriage, even if they don't qualify for diagnoses.

What is a good takeaway from this though is the conclusion of the JournalWatch article, which is that help is available for PTSD and other anxiety disorders. That doesn't just mean medication, which many women are naturally hesitant to use in pregnancy, but can also mean counseling referrals or extra supports. Thus, if you think you have signs of PTSD or serious anxiety as a result of your miscarriage, tell your doctor and see what help is available.

More information:

• Signs of Anxiety Disorders in Pregnancy
• Non-Drug Treatment for Anxiety
• About.com Guide to PTSD

I first saw this rumor online a few days ago, but according to an AHN report, Celine Dion's spokesperson has confirmed that the singer may have suffered a miscarriage. The reports are conflicting as to whether it was a miscarriage or a failed IVF procedure, as Calgary Herald reports, where the doctor initially reported a positive pregnancy result "incorrectly" (though that has the sounds of meaning a possible chemical pregnancy).

Dion and her husband have an 8-year-old son but continue to hope for a second child. Celine Dion reportedly had trouble conceiving the first time around also as was forced to turn to IVF for the pregnancy with her son also. I have no personal experience with fertility problems other than recurrent miscarriages, but I can only imagine that losing a pregnancy after you had trouble conceiving must have an extra sting to it. It must also be difficult to deal with these things in the public spotlight. My condolences to the family and I hope they are dealing okay.

So a quick Google search shows me that this is old news, but I found it rather annoying nonetheless. I was just watching TV with my son, who is home sick from preschool today with a fever and headache, and I saw a commercial for Always menstrual pads and saw that they have a slogan of "have a happy period." Judging by info I've read online, apparently this is also printed on the paper you pull off the pads when using them.

I was kind of dumbfounded. Are they for real? I mean, forgetting for a moment that very few women out there consider their period to be something "happy" and fun at any time regardless of circumstances, what about if someone was using the menstrual pads for miscarriage bleeding? I would think seeing "have a happy period" on the pads would be rubbing salt in wounds. I can't imagine who would have thought this would be a good idea. I'm pretty sure this would have angered me if I came across it during a miscarriage. It probably would have bugged me when I was trying to conceive and not pregnant, also, as my period was anything but a "happy" occurrence at those times.

Any thoughts on this slogan? Is this something that would bother you if it were printed on your menstrual pads, or is it no big deal? Post any thoughts here.