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Hematomas During Pregnancy

In the medical world, hema means blood and toma means swelling. A hematoma, then, is an area of the body where blood pools in tissue instead of in the blood vessels where it is supposed to be.  This can be caused by a severe injury that breaks a lot of blood vessels.

During pregnancy, a hematoma can form between the chorion, a membrane surrounding the embryo and the uterine wall. This is called chorionic hematoma and it occurs in about 3 percent of all pregnancies (3 in 100). This condition is the most commonly seen pregnancy-related hematoma and is the most common cause of first trimester bleeding. Hematomas during pregnancy have no known cause. One theory is that the egg might slightly separate from the uterus during development, which can lead to a tear.

There are other places in the womb where hematomas can occur. Most of the time, women don’t realize they are experiencing a problem. Most women have no symptoms of pregnancy-related hematomas. If they do have symptoms, they are likely to notice blood in the vagina and abdominal pain. Later in pregnancy, women may experience premature labor.

Diagnosis of hematomas during pregnancy

Since hematomas often have no symptoms, an ultrasound exam which shows bleeding leads to diagnosis. If you experience vaginal bleeding during your pregnancy, let your doctor know. He or she will likely request ultrasound imaging.

During pregnancy, it is easy to feel like there are so many things that can go wrong with the developing baby and their health. One of the most important things to remember is that there is a wide range of what is normal for women to experience during pregnancy. This can mean physical sensations and even pain, emotional and mood changes, and health-related concerns.

Talk to your doctor about what is normal during pregnancy. If you have a good sense of what the normal range is, you can begin to notice if you are experiencing something that does not seem to fall within that normal range. The doctors at Pacific Women’s Center strive to develop the kinds of relationships that their patients always feel comfortable talking about anything that she may be experiencing.

Treatment of hematomas during pregnancy

Treatment varies and depends on the doctor and the severity of the hematoma and the stage of pregnancy. Refraining from sexual intercourse and bed rest are possibilities. Also, you may be able to continue your normal routine. There is no surgical treatment for hematomas during pregnancy. Blood thinners may be requested. Or, the doctor may have a “wait and see” approach and not prescribe treatment until it truly seems like it is needed.

There is low to medium low to medium risk to the pregnancy with this condition. In most cases, the body absorbs the hematoma and the pregnancy continues on normally.

Doctor and patient consulting on a table about women health. Medical concept. Selective focus at patient's hands.

Severe Morning Sickness – What is Hyperemisis Gravidarum?

Some nausea and vomiting during the earlier stages of pregnancy is common. The discomfort is caused by levels of pregnancy hormones, specifically hCG, (human chorionic gonadotropin, the hormone responsible for helping to build your baby’s placenta) and estrogen in a woman’s body. Both of these increase rapidly during pregnacy. Hyperemisis Gravidarum is known as severe morning sickness. It is nausea and vomiting that goes beyond what is considered a normal level.

It might be Hyperemisis Gravidarum if:

  • You are vomiting multiple times per day
  • Food or liquid comes back up
  • You feel lightheaded
  • You show signs of dehydration (not urinating, dark yellow urine)
  • You’re losing weight
  • You see blood in the vomit
  • You have low blood pressure or a high pulse rate

Hyperemisis Gravidarum occurs in less than one in 200 pregnancies. For those women, severe and continuous nausea and vomiting that becomes debilitating because it interferes with a woman’s ability to eat, drink, sleep, and work. Like most medical conditions, its Latin name describes what it is: The term comes from the Greek hyper-, meaning excessive, and emesis, meaning vomiting. Gravidarum means “pregnant woman.” The grav- part of the word means “heavy,” as in the English word “gravity.”

Severe cases can lead to extreme weight loss, malnutrition in both the mom and baby, and dehydration. Since the baby is affected by the mother’s inability to eat, hospitalization may be needed.

When does Hyperemisis Gravidarum start?

Severe morning sickness usually starts in the first trimester at around week 4 or 5 of pregnancy. Typical morning sickness usually starts around week 6. Hyperemisis Gravidarum can sometimes clear up on its own between weeks 12 and 20. In some cases, though, it can continue throughout a pregnancy.

Severe morning sickness seems to be most common in first-time mothers, very young mothers, and mothers carrying multiple babies. If a woman has had Hyperemisis Gravidarum with a previous pregnancy, she is more likely to have it with subsequent pregnancies. Also, women whose mothers had severe morning sickness are also more likely to have it themselves.

How can you avoid severe morning sickness?

Although it’s a mystery why some women get this and others don’t, there are some things that research tells us contributes to severe morning sickness. Severe emotional stress can be a factor. If you are experiencing an extremely stressful life situation, let your doctor know. Your doctor will be able to make suggestions on how to deal with or possibly improve the situation to remove the stress.

Hormonal imbalances or diseases that cause hormonal imbalance, such as polycystic ovarian syndrome, can increase your risk of severe morning sickness. Vitamin deficiencies or a bacterial stomach infection can also play a role. Looking at a woman’s overall physical and mental health is an important part of diagnosing and treating Hyperemisis Gravidarum.

How can you treat Hyperemisis Gravidarum?

Try traditional treatments for nausea first. This may include eating ginger or drinking ginger tea. Any foods or drinks that are disagreeable to you (make you feel sick) should be avoided. Although with Hyperemisis Gravidarum it can seem like everything makes you feel sick! Drink fluids regularly to avoid becoming dehydrated. There are some prescription medications for anti-nausea that you and your doctor can talk about.

Cropped image of beautiful pregnant woman stroking her tummy and holding a sonogram, on gray background

Pregnancy Back Pain

While some women are lucky enough to not have many problems with nausea or morning sickness during pregnancy, nearly all women experience pregnancy back pain. It’s almost unavoidable, since a woman’s body is changing so much during pregnancy and the growing baby offsets a woman’s center of balance. She holds her body differently, carries bags or car seats differently, and may not be able to get comfortable during daily activities, which can make the pregnancy back pain worse.

Back pain during pregnancy often starts during the late second trimester, when the baby is larger. A few different factors cause pregnancy back pain. Fortunately, there are numerous ways to help deal with and treat pregnancy back pain.

Causes of Pregnancy back pain

Weight gain: As your baby grows and your body responds, your spine must support whatever extra weight you gain. Weight gain is natural and normal during pregnancy. If your doctor says it is ok for you to exercise, getting regular activity and stretching your muscles can help. A healthy weight can help keep your back pain in check.
Posture: You are carrying your body differently during pregnancy. Your doctor can talk with you about how to move your body when going about your daily activities that will put the least amount of strain on your back and help you move most efficiently. Your doctor can recommend stabilization exercises where your body can strengthen certain key muscles that influence back pain.

Changes to your pelvic muscles and ligaments: As your body slowly prepares itself for delivery, the muscles and ligaments relax and change. Massage or other tissue work can help with the pain of pregnancy back pain that is caused by this.

Hormonal changes: During pregnancy, the body makes a hormone called relaxin. This hormone allows the ligaments in the pelvis to relax and loosen in preparation for delivery. Everything is connected to the spine, so this relaxation in combination with increased weight change the shape of the spine and can make it harder for the spine to support the torso and keep your body stable.

Treatments for pregnancy back pain

Luckily, back pain during pregnancy is temporary! It will go away after delivery. Pain relievers should be used carefully during pregnancy and your doctor will need to speak with you about that. You can self-treat pregnancy back pain in ways that are similar to ways that you might treat menstrual cramping.

Hot pads, hot water bottles and cold packs could be used. Paying attention to good posture can help. Healthy, safe exercise can help. Managing your stress in ways that help you feel better can also help. Acupuncture can help. Talk with your doctor about the ways that you can treat your back pain in ways that will not have an affect on your pregnancy.

At our office in Eugene, Oregon, we can educate you on everything you can do to ease your back pain. Our incredible staff of obstetricians at Pacific Women’s Center has years of experience helping women enjoy their pregnancy as much as possible.

Give us a call at 541-342-8616 or Contact Us online today to make an appointment. Pregnancy is an incredible experience and you deserve to feel your best throughout every moment.

Female Doctor Meeting With Patient In Exam Room

Uterine Fibroids and Treatments for Fibroids – Some Have No Symptoms

Fibroids are noncancerous tumors, or overgrowth of uterine muscle, that grow when they should not. Less than 0.1% of uterine fibroids become cancerous, but they generally should be treated because they can cause pain, heavy bleeding and other complications.

Growth of a uterine fibroid

Typically uterine fibroids are simply called fibroids, but they can also be called leiomyomas or myomas. Uterine fibroids may grow inside the uterus or they may grow on its outer surface or within the uterine wall. A woman may have only one, or more than one, and in varying sizes. There is no way to predict how a uterine fibroid will grow.

Sometimes they grow very slowly and remain small for so long that women don’t know they are there. Other times they may grow quickly and become painful over a short period of time. Women who are between the ages of 30 and 40 tend to be most at risk of developing fibroids. Mothers can also pass down fibroids to their daughter through genetic inheritance.

Symptoms of uterine fibroids

If a uterine fibroid is small, a woman may have no symptoms at all. Once a uterine fibroid begins to grow, a woman may experience some or all of the following symptoms:

  • Increase in menstrual cramping and pain
  • Heavier periods
  • Longer periods
  • Vaginal bleeding that’s not menstrual
  • Dull, continuous back ache
  • Pain during sex
  • Pain during urination or difficulty with urination
  • Abdominal cramping that is not menstrual related
  • Feeling of pressure or bloating in the abdomen
  • Miscarriage or possibly infertility

How are uterine fibroids found?

If a woman is having no symptoms, a woman’s doctor may find a uterine fibroid during her annual pelvic exam. If a woman visits her doctor due to symptoms, imaging may be used to assess pelvic and abdominal structures to help in the diagnosis. Typically a pelvic ultrasound is performed but sometimes a CT scan or MRI will be recommended.

Treatments for Fibroids

If a fibroid is small and is not causing symptoms, no treatment may be necessary. A doctor may want to intervene if the symptoms are interfering with a woman’s daily life. Occasionally the doctor may want to be certain that the fibroid is not cancerous.

Hormonal medications such as birth control might help with the pain and bleeding caused by fibroids, but these will not impact the growth of the fibroid. That means the fibroid may keep growing. Other medications are more powerful and can impact the growth of the fibroid and shrink it. These are only used for limited periods of time due to their side effects.

If the problems persist, surgery may be considered. The surgeries do not always remove the uterus, so pregnancy is still an option. The same fibroid does not return after surgical removal. But a new fibroid may grow again at a later time. In the event that the surgical option to keep the uterus does not work, the uterus may be removed in a hysterectomy. This would be a last resort if only all other options have not worked and the woman continues to have problems with treatments for fibroids.

Give us a call at 541-342- 8616 or Contact Us online today to make an appointment. Our doctors want to help you enjoy life to the fullest without pain from uterine fibroids.

Happy mother breast feeding her newborn in room, indoorHappy mother breast feeding her newborn in room, indoor

Lactation Consultant in Eugene

Pacific Women’s Center has a lactation consultant in Eugene who teaches classes right here. Since 2012, we’ve worked with Devorah Bianchi of Loving Arms Lactation to present our ongoing lactation classes.

Breastfeeding does not come automatically easy for every mother. Talking with a lactation consultant in Eugene helps explain some of the problems and solutions that moms might be facing. Or, take a lactation class. A lot of moms do have trouble breastfeeding and can feel like “they can’t do it,” which may make them want to give up breastfeeding. Getting help from a lactation consultant can help moms realize that it does get easier and can be enjoyable and healthy for baby and mom.

When to take a lactation class?

We suggest that expectant mothers take a lactation and breastfeeding class one to two months before their baby is due. We encourage the mothers-to-be to bring along their spouse or partner, or whoever will be involved in the baby’s care and support of the mother. Even though the men can’t breastfeed, they can learn about how important breastfeeding is and how to support the mom while she’s breastfeeding.

Taking the class before the baby is born helps the family to establish a relationship with the lactation consultant before the birth. So if you do need a consultant afterwards, you are already at ease with her. You can also hear first-hand from other moms-to-be what they are worried about or how their pregnancy is going. It’s a great way to connect with others in the community who are experiencing some of the same things you are.

The lactation classes are free, generally held once per month, for Pacific Women’s Center patients. Please contact our office at 541-342-8616 to schedule your attendance or ask your obstetrician at your next appointment. Breastfeeding is a skill that can take time to develop. But with support, like what you will find in a class taught by a lactation consultant, you and your baby will benefit. See you at the class!

Husbands and their pregnant wives at a prenatal class

Childbirth Classes in Eugene

For future moms and dads, the knowledge that nine months into the future a baby will arrive can be a happy and exciting time. It can be a confusing and uncertain time. Pacific Women’s Center offers childbirth classes in Eugene, and these classes are a great way to learn and prepare for the birth.

We hold our childbirth classes in Eugene at Pacific Women’s Center on Coburg Road. Throughout the course of the class, we will explain what your body will experience as your time of pregnancy ends. You will learn to identify the signs of labor. After the class, you should feel confident about knowing when it is time to go to the hospital.

Participants in the childbirth class will get to discuss options for pain relief that might include medications and how they work, relaxation and breathing techniques, how to position your body, and more. This is not a “specific” type of birthing classes for breathing techniques and labor exercises. As in, we don’t teach any specific “method” of labor and delivery. We cover both vaginal and abdominal births in a way that answers your questions and leaves you feeling informed. It is our hope for you to feel relaxed and ready for your exciting adventure.

Two-part Childbirth Classes in Eugene

The childbirth classes in Eugene are in two parts. It allows both mothers- and fathers-to-be to share their hopes and expectations in a supported environment. We encourage discussion and participation. Pacific Women’s Center holds childbirth education classes in Eugene on Monday nights from 6 to 8 pm. Please contact our office 541-342-8616 to schedule an appointment or schedule at the time of your next obstetrical visit. The $20 charge covers four hours of childbirth classes in Eugene at our location, and two participants. We’re excited to see you!

Male doctor sitting with female patient by window, side view

What to Know About Tubal Reversal in Eugene

If you had a tubal ligation, this means that your fallopian tubes were “tied” in some way, whether by blockage (being clamped closed with rings or clips), being tied, or being cut to close them. The idea behind this is that the closure of the tubes stops eggs from traveling from the ovaries into the fallopian tubes. The egg is normally fertilized by sperm in the fallopian tube.

Tubal ligation is considered to be a permanent form of birth control for women. But there is a procedure known as tubal reversal. Gynecology doctors such as those at Pacific Women’s Center can offer tubal reversal in Eugene.

What happens in a tubal reversal?

In a tubal reversal, the fallopian tubes will be re-opened. Depending on the method that was used to close them, they may be untied, reconnected or unblocked. A doctor’s willingness to do this tubal reversal procedure often depends on the reason why the procedure was done in the first place. Also, how old the woman was when it was done. Women who have the procedure thinking that they will never want children do change their minds as they get older. It is possible that this tubal reversal procedure will allow them the opportunity to become pregnant.

The doctor will want to ask you what type of surgery you had to have the tubal ligation. If you have ever been pregnant before and the outcome of that pregnancy is important for the doctor to know. Certain pelvic issues such as endometriosis or fibroids can cause scar tissue. This may be hard to overcome in a tubal reversal. The doctor will also want to review your previous hospital records.

If you have had a tubal ligation and want to become pregnant following a tubal reversal, it would be a good idea to have your partner examined. Ruling out an infertility issue in your partner could be the first step to making sure that you have the ability to get pregnant even if you do have the tubal reversal. Twenty to 40 percent of infertility issues in couples are caused by an issue with the man.

Recovery after a tubal reversal

Tubal reversal is generally a hospital or outpatient procedure. You’ll receive general anesthesia while your doctor uses a laparoscope to look into your pelvic area. If the doctor sees a promising situation for a reversal, he or she will then make a small incision. The incision allows them to access the area where the tubes are blocked and to make the reconnection. After the surgery, you may be allowed to go home, but you will be uncomfortable and will have a recovery period of up to four weeks before you can return to full activity.

The doctors at Pacific Women’s Center in Eugene, Oregon have experience in tubal reversal. Our doctors serve women through the full range of their life changes, from their teenage years to prenatal care, through pregnancy and birth and menopause and beyond. Talk to us, we’re here to help you!

african female sick patient in doctor's office

Menstrual Migraine, or Hormone-associated Headaches

A woman’s menstrual cycle closely relates to hormonal changes taking place in her body at the same time. Unfortunately, the act of the body shedding uterine tissue can be uncomfortable, causing cramping. The hormonal changes can cause menstrual migraines, or hormone-associated headaches too. According to the Association of Reproductive Health Professionals, an estimated 12.6 million women in the US suffer from hormonally induced severe headaches before or during their periods.

Menstrual migraine or hormone-associated migraine affects up to 60 percent of all women who have migraines.

What are menstrual migraines, or hormone-associated headaches?

The hormones estrogen and progesterone regulate a woman’s menstrual cycle. They are also closely associated with mood. Hormone levels that drop or rise suddenly during a cycle can trigger headaches in some women. Women who have levels of estrogen that stay regular seem to have less headaches associated with this.

For most women, hormone levels drop just before a period. This is also when many women report getting menstrual migraines.

Diagnosis of Menstrual Migraine

Doctors will look at how often and when a woman’s headaches occur and how long they last. A doctor will ask questions such as where in the head the pain is located and what its “qualities” are. For example, if it is pulsating or affected by activity. Menstrual migraines are also commonly associated with nausea or sensitivity to light.

Treatment of Menstrual Migraine

Migraines can be difficult to treat because the pain does not always respond to treatments the way that non-migraine headaches do. A combination of over-the-counter and prescription pain relievers is the first thing to try. Supplemental estrogen is a possibility in a migraine condition that is causing estrogen-associated headaches.

For some women, applying ice might work. Your doctor might talk with you about exploring some relaxation techniques, acupuncture or biofeedback techniques. Stopping a migraine before it starts is usually the best approach. Your doctor might talk with you about daily medication that can keep your hormone level regular throughout your cycle.

The doctors at Pacific Women’s Center are experienced in all aspects of a woman’s cycle, including how hormones may affect things in the body other than menstruation and pregnancy. Get in touch with us if you’re experiencing menstrual migraines or estrogen-associated headaches and aren’t sure what your options are.

Hands of doctor examining a pregnant woman

Obstetrics and Pregnancy Care in Eugene

You have some choices for what doctor to choose to help you during your obstetrics and pregnancy care in Eugene. Finding the right doctor to help you is an important part of helping the birth process to go as smoothly as possible.

Write down the qualities you want for your obstetrics and pregnancy care. You might start by asking yourself some basic questions such as whether you want a male or female doctor. Some gynecologists don’t practice obstetrics, so if you’re just choosing a gynecologist for the first time, you might ask yourself how important it is that you be able to go through the whole pregnancy and birth experience with the same care provider. All of the doctors at Pacific Women’s Center in Eugene have experience in obstetrics, gynecology and infertility. (Dr. Betterton is the only one of our doctors at this time who no longer delivers babies.)

At Pacific Women’s Center, our services encompass the whole range of needs of women throughout their lives. Our clinic can provide infertility care, prenatal care, surgical services, contraception, birthing services, classes and more!

Questions to ask yourself about your Eugene OBGYN care:

  • Do you prefer a male or female provider?
  • Should your care provider offer both obstetrics and gynecology?
  • Is your pregnancy and birth at risk for being high-risk? Some ob-gyns have special training in high-risk pregnancies and births.
  • Ask your doctor what his or her views are on pain management during labor. Is it important to you to have a doctor that is pro-natural birth? Are you OK with being offered epidurals and other pain management procedures during labor?
  • Who will deliver you if your doctor is not available?
  • Ask what the doctor’s Caesarean section rate is.
  • Does your doctor offer VBAC, a vaginal birth after caesarean, option?
  • The obstetrician you choose should have hospital rights at the hospital you want to go to when it is time for your birth.

All of these questions are designed to help you find a doctor that you feel comfortable with. Open, honest communication with a doctor that listens to you and respects your views are the hallmark of the care that we strive to provide at Pacific Women’s Center.

Womain complaining to doctor about stomach ache

Sometimes Severe Pain During Periods is Not Normal, it’s Endometriosis

The actresses Julianne Hough and Lena Dunham, along with celebrity fitness trainer Jillian Michaels have all spoken out about their struggles with endometriosis (en-doe-me-tree-Oh-sis). One thing stands out about their stories. It often takes a long time for many women to realize that the severe pain during periods and with intercourse is not typical. “For the longest time, I thought: this is the way my period is,” Julianne Hough told People magazine. “I didn’t want to complain, so I’d just deal with it and ignore it.” The truth is, sometimes severe pain during periods is not normal, it’s endometriosis.

Endometriosis is an overgrowth of uterine tissue outside of the uterus. The tissue that normally grows inside the uterus is called endometrium. The endometrial tissue can grow where it shouldn’t grow. It can grow around ovaries, fallopian tubes, the tissue lining the pelvis. More rarely, it can grow outside the pelvis. Endometriosis affects one in 10 women of reproductive age.

Even though the endometrial tissue grows where it should not be, it still breaks down during each menstrual cycle.  The body tries to shed it through the uterus as normal endometrial tissue would normally be shed.. This can cause severe pain during periods.

Endometriosis and Fertility

Endometriosis can affect fertility. Some women with endometriosis can have trouble becoming pregnant. Working with an experienced fertility doctor in Eugene can help women who want to start a family be proactive and make a plan.

Diagnosis of Endometriosis

The first step in diagnosing endometriosis is a pelvic exam. If the doctor can not feel areas of endometrial tissue growth, she may use ultrasound or surgical laparoscopy. A diagnosis of endometriosis is made if endometrial tissue is found growing anywhere outside the uterus.

Treatment of Endometriosis

Self-care to make you comfortable during the painful periods is important. Try heating pads or warm compresses. It may be safe to take over-the-counter pain medications such as Advil or Aleve at doses your doctor recommends.

Your doctor may suggest hormone therapy or a prescription drug called Lupron that suppresses endometrial tissue growth. This would not be recommended for a woman who is actively trying to become pregnant. Talk to your doctor about your desires for family planning.

Surgery can be an option in severe cases of endometriosis. Discuss risks and benefits of surgery with your doctor. A personalized treatment plan that takes into account your goals will work best for you.