Pregnant women are at an increased risk for serious illness from COVID-19. "Compared to nonpregnant women who have the same health and age, a COVID-infected woman is about 1.3 to 1.4 times more likely to end up in the hospital when she's pregnant," says Dr. Regan Theiler, a Mayo Clinic obstetrician.

Should pregnant and breastfeeding women be vaccinated for COVID-19? While there are limited data about current COVID-19 vaccines in pregnant and breastfeeding patients, there are many questions. A Centers for Disease Control and Prevention report states no unexpected pregnancy or infant outcomes have been observed related to COVID-19 vaccination during pregnancy and safety monitoring in pregnant women continues.

In this Q&A, Dr. Theiler answers questions about COVID-19 vaccines for pregnant and breastfeeding women, and women who plan on becoming pregnant:

Watch: Dr. Regan Theiler discusses the COVID-19 vaccine for pregnant women.

Journalists: Broadcast-quality sound bites are available in the downloads at the bottom of the post. Please "Courtesy: Regan Theiler, M.D., Ph.D./OB-GYN/Mayo Clinic."

Should pregnant women be vaccinated for COVID-19?
Since the emergency use authorization was granted, The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine have been firm in recommending that pregnant women have access to COVID-19 vaccines. That is, if women so choose, they should be able to be vaccinated for COVID-19.

Can a fetus get COVID-19 if the mother is vaccinated for COVID-19?Through vaccination for COVID-19, the baby should not be exposed to the virus. It is known that the COVID-19 vaccines are the genetic code for a single protein. It doesn't replicate in a person. It doesn't cause an infection with COVID-19. There's no virus floating around in a woman. Any vaccine that has a live virus that's replicating is not used in pregnant women because of any theoretical risk. It is thought that there is no risk that this would cause an infection in a pregnant woman and cause an infection that goes to the baby.

Are COVID-19 vaccines safe for pregnant women?
Because this is an emergency use authorization, and because any medication or vaccine during its first iteration of trials is never tested in pregnant women, there is no direct evidence of safety in pregnancy. What is known is that there is a lack of theoretical evidence of harm. 

There is no conceivable reason why COVID-19 vaccines should be harmful to pregnant women. None of the components of the vaccines ― the nanoparticles ― are known to be harmful in pregnancy. The best evidence for pregnant women suggests that being vaccinated for COVID-19 is a lot safer than getting COVID-19.

Are COVID-19 vaccines safe for women who are breastfeeding?
There is no indication that COVID-19 vaccines are harmful or damaging to women who are breastfeeding or their infants.

Do COVID-19 vaccines cause infertility?
There's no evidence of COVID-19 vaccines causing infertility. 

There's been a sophisticated anti-vaccine campaign that originated online. The New York Times had a great article about it, going through the levels of disinformation and where it came from. 

It sounds scientific, and it goes something like this. There's a protein in the placenta that has similarities to viruses. And if you have antibodies to viruses that are induced by this vaccine, it will cause you to have a miscarriage and the pregnancy did not implant in your uterus. This is completely made up. It sounds smart. It's based in molecular biology. It's written by a scientist. But it's fundamentally not true. 

If that were true, then women who had COVID-19 ― millions of women now ― would be more likely to have miscarriages and not get pregnant. That's because they would have those same antibodies because it's the identical gene producing the identical kinds of antibodies in the virus infection and in the COVID-19 vaccines. 

OK, so you have the same antibodies; yet, in women who have had COVID-19, there have been other viral infections with even more homology to this protein. No signals are being seen for increased miscarriages or decreased fertility. 

Again, this is a sophisticated scientific-sounding campaign that was purposefully put out on the internet to prevent women especially from getting this vaccine. It's not based in truth, and it's doing significant harm.

Do you have recommendations for women who are pregnant or breastfeeding, or are planning a pregnancy, to avoid getting infected with COVID-19?
Everyone should continue social distancing. Everyone should continue masking. All of those safety measures apply to pregnant women, lactating women and women who are contemplating a pregnancy. 

There are no formal recommendations yet. Knowing how good these COVID-19 vaccines are at preventing infection and how dangerous the infection is in pregnancy, the recommendation is that women stay on their contraception, go through the COVID-19 vaccination series, and then contemplate conception. COVID-19 vaccines are known to be effective.

Mayo Clinic follows the guidelines of the American College of Obstetricians and Gynecologists and Society for Maternal-Fetal Medicine, as well as independent data. 

For more information and all your COVID-19 coverage, go to the Mayo Clinic News Network and mayoclinic.org.

Learn more about: Tracking COVID-19 and COVID-19 trends

The post What pregnant and breastfeeding women should know about COVID-19 vaccine appeared first on Mayo Clinic News Network.

Dr. Kayla Nixon launches her career built on Mayo Clinic Alix School of Medicine foundation.

Dr. Kayla Nixon prepares for the day ahead well before dawn. She is in the operating room, and the third-year resident will be assisting in gynecologic surgeries. She previously reviewed all the files and is recounting each patient in her head. At 8 a.m., Dr. Nixon meets with the other OB-GYN residents for the surgical briefing, where they discuss preliminary surgical plans and meet individually with the consulting physician.

"Gynecologic surgery is very hard technique wise but also so rewarding because the patients are really struggling, and I can help," she says.

OB-GYN is a medical specialty that requires a variety of practices of caring for women through every phase of their lives, such as regular checkups, overseeing pregnancy, delivering babies, menopause management, and gynecologic and oncologic surgery. The specialty often involves lengthy days and an unpredictable schedule. Read the rest of Dr. Nixon's story.

The post Helping Others Heal: A time of transformation appeared first on Mayo Clinic News Network.

Ovarian cancer is estimated to affect more than 22,000 women each year and is the fifth leading cause of cancer deaths among women, according to American Cancer Society.

Unlike other gynecologic cancers, there are no screening tests for ovarian cancer. While some women diagnosed with ovarian cancer have elevated levels of the CA 125 protein, the associated blood test is not accurate enough for ovarian cancer screening, as many noncancerous conditions can increase the CA 125 level.Ovarian cancer is hard to detect in its early stages due to its vague symptoms. Women may experience constipation, bloating, early satiety after eating and back pain.While ovarian cancer tends to occur in post menopausal women, anyone can be at risk. A number of factors, including smoking, endo-metriosis, polycystic ovary disease, and obesity can raise a woman’s risk for the disease.

About 20 percent of all ovarian cancers are caused by a genetic mutation. The genes most likely to increase the risk of ovarian cancer are BRCA1 and  BRCA2. These genes also affect a woman's risk of breast cancer. Genetic mutations that cause Lynch syndrome, an inherited condition associated with colon cancer, also raise a woman’s risk of ovarian cancer.

Watch: New hope for ovarian cancer.

Journalists: The broadcast-quality pkg.(3:33) is in the downloads.

Advances in care

Over the past two decades, there were few options to treat ovarian cancer other than surgery and chemotherapy. And recurrence of the disease was common.

"Ovarian cancer, thankfully, does respond really nicely to surgery and chemotherapy. But unfortunately, in roughly 70 percent of patients, we do see recurrence," says Dr. Andrea Wahner Hendrickson, a Mayo Clinic oncologist.

But thanks to research by Dr. Wahner Hendrickson and her colleagues, patients now have additional — and sometimes more effective — options for treatment, including individualized medical therapy and immunotherapy.

Currently there are more than 1,350 clinical trials for ovarian cancer, including a vaccine trial aimed at preventing recurrence.

Since not all tumors respond to every treatment, Dr. Wahner Hendrickson recommends all ovarian cancer patients undergo genetic testing to see which therapy might work best or them.

"Thanks to the innovations, I think there’s a lot of promise and hope in the treatment of ovarian cancer," says Dr. Wahner Hendrickson.

She encourages women of all ages to see their physician if they experience abnormal signs or symptoms.

The post Ovarian cancer is hard to detect appeared first on Mayo Clinic News Network.

Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video pkg (1:00) is in the downloads. Read the script.

All expectant women hope for a healthy pregnancy, but that’s not always possible. Some develop gestational diabetes.

"Gestational diabetes causes vascular damage and can cause excessive weight gain in neonates," says Dr. Dow. "And about two-thirds of women with gestational diabetes will go on to develop Type 2 diabetes in the following two decades."

Dr. Dow says long-term risks of stroke and heart disease significantly increase in women with gestational diabetes.

"It's not just about blood sugar and managing one’s blood sugar," says Dr. Dow. "It's about all the other cardiovascular risks, including the modifiable ones."

Pregnant women can reduce their risks by maintaining a healthy diet rich in fruit, vegetables, whole grains, lean proteins, and regular exercise.

"One can even start an exercise program during the pregnancy," says Dr. Dow.

Aftercare is just as vital. Dr. Dow says a yearly follow-up after delivery also can reduce health risks.

The post Mayo Clinic Minute: Long-term health risks of gestational diabetes appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. – A new study has found that a condition that threatens the lives of some pregnant women and the fetus may continue to put the mother at risk later in life.

Mayo Clinic researchers found that women with a history of pre-eclampsia are more likely to face atherosclerosis – hardening and narrowing of the arteries – decades after their pregnancy. The findings are published in the September issue of Mayo Clinic Proceedings.

Pre-eclampsia – a condition in pregnant women commonly characterized by high blood pressure – typically shows itself 20 weeks into the pregnancy, and can occur suddenly or develop slowly. The complication poses a concern to the mother and fetus, and affects between 2 and 7 percent of pregnancies.

“We’ve found that pre-eclampsia continues to follow mothers long after the birth of their child,” says Vesna Garovic, M.D., Ph.D., Mayo Clinic Division of Nephrology and Hypertension. “The good news is that we can use these findings to apply earlier interventions for risk factors before cardiovascular disease presents.”

Using health records from the Rochester Epidemiology Project – a collaboration of southern Minnesota and western Wisconsin health care facilities – the research team identified 40 postmenopausal women with histories of pre-eclampsia and 40 women with normotensive – or normal blood pressure – pregnancy histories.

Carotid artery intima-media thickness, or the thickness of the artery walls, was measured in addition to blood tests.  The artery wall thickness of women with a history of pre-eclampsia was significantly greater than those with normotensive pregnancies. These findings were echoed in a study of 10 texts.

“Even without a history of cardiovascular events, women who’ve had pre-eclampsic pregnancies are facing a higher risk of atherosclerosis decades later during their postmenopausal years,” says Dr. Garovic. “This makes pre-eclampsia a pregnancy complication that extends well beyond the pregnancy itself.”

Further study is needed on women with pre-eclampsia histories, according to Dr. Garovic, and that should continue to follow women late into life, where further complications may become apparent.

Other members of the research team are:

• Kent Bailey, Ph.D., Mayo Clinic
• Howard Hodis, M.D., Keck School of Medicine of the University of Southern California
• Muthuvel Jayachandran, Ph.D., Mayo Clinic
• Brian Lahr, Mayo Clinic
• Michelle Mielke Ph.D., Mayo Clinic
• Natasa Milic, M.D., Ph.D., University of Belgrade Medical School
• Virginia Miller, Ph.D., Mayo Clinic
• Tracey Weissgerber, Ph.D., Mayo Clinic
• Wendy White, M.D., Mayo Clinic

###

About Mayo Clinic Proceedings
Mayo Clinic Proceedings is a monthly peer-reviewed medical journal that publishes original articles and reviews dealing with clinical and laboratory medicine, clinical research, basic science research, and clinical epidemiology. Mayo Clinic Proceedings is sponsored by Mayo Foundation for Medical Education and Research as part of its commitment to physician education. It publishes submissions from authors worldwide. The journal has been published for more than 80 years and has a circulation of 130,000. Articles are available at mayoclinicproceedings.org.

About the Rochester Epidemiology Project
The Rochester Epidemiology Project is a collaboration of clinics, hospitals, and other medical and dental care facilities in southern Minnesota and western Wisconsin. Founded by Mayo Clinic and Olmsted Medical Center in 1966 in Olmsted County, Minnesota, the collaboration stretches across 27 counties. Olmsted County Public Health Services is its first public health member. This collaboration and sharing of medical information makes this area of Minnesota and Wisconsin one of the few places where true population-based research can be accomplished. For more information about the Rochester Epidemiology Project, visit the Rochester Epidemiology Project website.

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to clinical practice, education and research, providing expert, comprehensive care to everyone who needs healing. For more information, visit mayoclinic.org/about-mayo-clinic or newsnetwork.mayoclinic.org.

MEDIA CONTACT
Kelly Reller, Mayo Clinic Public Affairs, 507-284-5005, newsbureau@mayo.edu

The post Mothers with history of pre-eclampsia may encounter cardiovascular challenges later in life appeared first on Mayo Clinic News Network.

This story originally appeared on the In the Loop blog.
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In 2012, Mayo Clinic's Center for Innovation and Department of Obstetrics and Gynecology began enrolling volunteers in an experimental program called the OB Nest Project. The program's goal: Reduce the number of prenatal visits for women with uncomplicated pregnancies by giving them equipment and education to monitor their blood pressure and the baby's heartbeat at home. This approach broke new ground in a care system that hadn't seen much change "since the telephone was invented," the Star Tribune reported at the time.

The program's lead obstetrician back then, Roger Harms, M.D., told the newspaper he initially worried patients "might panic" if they "ran into trouble with the equipment, such as the fetal monitor." But it turns out "that didn't happen." In fact, patients loved OB Nest so much that after another successful "trial run" last year, a recent Strib article reports the program will soon become part of Mayo's "routine obstetric service."  Read the rest of the OB Nest article.

The post In the Loop: Prenatal Program Enters Third Trimester appeared first on Mayo Clinic News Network.

Emily Linklater, D.O., Mayo Clinic Health System obstetrician and gynecologist, answers frequently asked questions about intrauterine devices.

What is an IUD?

IUD stands for intrauterine device.  It’s a small device that’s inserted into the uterus by your health care provider for contraception. Many times IUDs are classified as long-acting reversible contraception (LARC).

Who is a candidate for an IUD?

Almost all women are candidates for an IUD, with a few exceptions. It’s a common myth that women who haven’t been pregnant and who are adolescents aren’t candidates. Pregnancy, age and prior vaginal delivery are not required to insert an IUD. An IUD is an excellent option for women who desire a reversible form of birth control, but don’t desire pregnancy at this time. IUDs are 99 percent protective against pregnancy and don’t require daily compliance.

How are IUDs inserted and removed?

After discussing the option with your provider, an IUD can be inserted in the office setting. You may experience some mild cramping from insertion. Overall, the entire procedure takes less than five minutes. Some women choose to take over-the-counter pain medication, such as ibuprofen or acetaminophen before coming to the office. Once inserted, an IUD can be removed on request or at the time of expiration, approximately three-to-10 years later. Removal takes about two-to-three minutes.

What are additional uses for IUDs?

IUDs are used mainly for contraception. However, they can also be useful for emergency contraception, heavy bleeding, anemia, painful periods and occasionally endometriosis.

How do IUDs work?

Currently available IUDs work by preventing sperm from fertilizing ova, although some aspects of the precise mechanism of action are unknown. IUDs are not abortifacients; they don’t interrupt an implanted pregnancy. Pregnancy is prevented by a combination of the ‘foreign body effect’ of the plastic frame and the specific action of the medication (copper or Levonorgestrel) that’s released, which impairs sperm function and implantation, and prevents fertilization.

How effective in preventing pregnancy is the IUD?

It’s a very effective method. Here’s a breakdown of birth control methods and their effective rates:

• Nexplanon, IUDs and bilateral tubal ligation have a failure rate for typical use of less than one in 100 women per year.
• Birth control pills, the patch, the Depo-Provera injection and the ring have a failure rate for typical use of six-to-12 in 100 women per year.
• Natural family planning, the pull out method and condoms have a failure rate for typical use of 18 or more in 100 women per year.

What types of IUDs are available?

• Paragard (Cooper IUD), effective for 10 years, no hormones are released
• Mirena IUD, effective for five years, releases approximately 20 mcg of progestin per day
• Skyla IUD, effective for three years, releases approximately 14 mcg of progestin per day
• Liletta IUD, effective for three years, releases approximately 19 mcg of progestin per day, available as a generic, usually lower cost for those without health insurance coverage

What are the next steps?

For more information, along with more detailed risks and benefits of IUDs, meet with your health care provider.  He or she will review your medical and gynecological history to ensure you’re a candidate for an IUD.

The post Contraception FAQs: Intrauterine Device appeared first on Mayo Clinic News Network.

Does having a cancer biopsy increase the chances your cancer will spread? We’ll explore this topic with cancer surgeon Dr. KMarie Reid Lombardo on the next Mayo Clinic Radio. Also on Mayo Clinic Radio, we’ll talk with OB/GYN specialist Dr. Sean Dowdy about the latest advances in preventing, detecting and treating cervical cancer. Please join us.

Myth or Fact: Having a biopsy of my cancer will cause it to spread.

To listen to the program at 9 a.m. Saturday, January 24, click here.

Follow #MayoClinicRadio and tweet your questions.

Mayo Clinic Radio is available on iHeart Radio.

Mayo Clinic Radio is a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

For a look at future program topics, click here.

To find and listen to archived shows, click here.

The post Mayo Clinic Radio: Cancer biopsies/cervical cancer appeared first on Mayo Clinic News Network.

A Mayo Clinic study has found that patients who had complex gynecologic surgery managed by an enhanced recovery pathway (ERP) had decreased narcotic use, earlier discharge, stable readmission rates, excellent patient satisfaction and cost savings. Patients were eating, drinking and ambulating shortly after surgery.

Mayo Clinic gynecologic surgeon and lead study author Sean Dowdy, M.D., says, “Patients are much happier when we are able to eliminate the use of unproven and unpleasant interventions such as bowel preparations, caloric restriction, sedating medications and the use of surgical drains. We show that patients undergoing the most complex and invasive operations have the most to gain from this recovery pathway.”

The findings are published in the journal Obstetrics & Gynecology. 

Click here for news release

Journalists: Sound bites with Dr. Dowdy are available in the downloads

The post Getting Patients Back To Health Faster with Enhanced Recovery Pathway for Gynecologic Surgery appeared first on Mayo Clinic News Network.

Mayo Clinic on Pregnancy is a trustworthy guide to pregnancy, childbirth and baby’s first three months. It was developed to leverage the medical and lifestyle expertise of Mayo's team of pregnancy experts in obstetrics and gynecology, genetics, nutrition, midwifery, and lactation. Plans are underway to release the app for Android devices later this year.

Roger Harms, M.D., a Mayo Clinic specialist in obstetrics and gynecology, says, “Getting pregnant and becoming a parent are among the most significant experiences in a person's life and can be overwhelming. This app will guide you from conception to delivery, and see you through the first three months with your newborn to give you peace of mind and enhance your sense of wonder throughout the experience.”

Click here for news release.

Journalists: Sound bites with Dr. Harms and b-roll of a patient using the app are available in the downloads

The post Mayo Clinic on Pregnancy App is Now Available on iPhone/iPod appeared first on Mayo Clinic News Network.