My sister, Michelle-Ann Iking's 3% chance of conceiving naturally was a success! Here's her story:
(My apologies as I've been overwhelmed with personal matters. I've only managed to get to my desk. So finally got around posting this).
This is the story behind my sister's pregnancy struggle and how she shared her journey over her Facebook page.
Because some may have not caught her LIVE session chat with me (https://www.facebook.com/daphneiking/videos/687743128744960/) , or read her lengthy post (as it's a private page);
she's allowed me to copy and paste it over my wall, in case you need to know more about her thought process on how AND why she focused on the 3% success probability. Read on.
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Posted 10th May 2020.
FB Credit: Michelle-Ann Iking
A week ago today I celebrated becoming a mother to our second, long awaited child.
Please forgive this mother's LONG (self-indulgent) post, journalling what this significant milestone has meant for her personally, for her own fallible memory's sake as well as maybe to share one day with her son.
If all you were wondering was whether I had delivered and if mum and bub are OK, please be assured the whole KkLM family are thriving tremendously, and continue scrolling right along your Newsfeed 😁.
OUR 3% MIRACLE
All babies are miracles... and none more so than our precious Kiaen Aaryan (pronounced KEY-n AR-yen), whose name derives from Sanskrit origins meaning:
Grace of God
Spiritual
Kind
Benevolent
...words espousing the gratitude Kishore and I feel for Kiaen's arrival as our "3% miracle".
He was conceived, naturally, after 3 years of Kishore and I hoping, praying and 'endeavoring'... and only couples for whom the objective switches from pure recreation to (elusive) procreation will understand how this is less fun than it sounds ...
3 years during which time we had consensus from 3 different doctors that we, particularly I (with my advancing age etc etc) had only a 3% chance of natural conception and that our best hope for a sibling for our firstborn, Lara Anoushka, was via IVF.
Lara herself was an 'intervention baby', being one of the 20% of babies successfully conceived through the less intrusive IUI process, after a year and a half of trying naturally and already being told then my age was a debilitating factor.
We had tried another round of IUI for her sibling in 2017 when Lara was a year old. And that time we fell into the ranks of the 80% of would-be parents for whom it would be an exercise in futility... who would go home, comfort each other as best they could, while individually masking their own personal disappointment... hoping for the best, 'the next time around'...
So the improbability ratio of 97% against natural conception of our second baby, as concurred by the combined opinion of 3 medical professionals, was a very real, very daunting figure for us to have to mentally deal with.
Deep, DEEP, down in my heart however, though I had many a day of doubt... I kept a core kernel of faith that somehow, I would again experience the privilege of pregnancy, and again, have a chance at childbirth.
And so, the optimist in me would tell myself, "Well, there have to be people who fall in the 3% bucket... why shouldn't WE be part of the 3%?"
Those who know me well, understand my belief in the Law of Attraction, the philosophy of focusing your mind only on what you want to attract, not on what you don't want, and so even as Kishore and I prepared to go into significant personal debt to attempt IVF in the 2nd half of 2019, I marshalled a last ditch effort to hone in on that 3% chance of natural conception... through research coming across fertility supplements that I ordered from the US and sent to a friend in Singapore to redirect to me because the supplier would not deliver to Malaysia.
I made us as a couple take the supplements in the 3 month 'priming period' in the lead up to the IVF procedure - preconditioning our bodies for optimum results, if you will.
At the same time, I had invested in a sophisticated fertility monitor, with probes and digital sensors for daily tracking of saliva and other unmentionable fluid samples, designed to pinpoint with chemical accuracy my state of fertility on any given day.
(UPDATE: For those interested - I obtained the supplements and Ovacue Fertility Monitor from https://www.fairhavenhealth.com/. Though I had my supplies delivered to a friend in Singapore, and redirected to me here since the US site does not deliver to Malaysia, there are local distributors for these products, you will just have to research the trustworthiness of the vendors yourself...)
I had set an intention - in the 3 months of pre-IVF priming, I would consume what seemed like a pharmacy's worth of supplements, and track fertility religiously... in hopes that somehow, within the 3 month priming period, we would conceive naturally and potentially save ourselves a down payment on a new property... and this was just a projection on financial costs of IVF, not even considering the physical, emotional and mental toll it involves, with no guarantee of a baby at the end of it all...
It was a continuation of an intention embedded even with my first pregnancy, where all the big ticket baby items were consciously purchased for use by a future sibling, in gender neutral colours, in hopes that sibling would be a brother "for a balanced pair", though of course any healthy child would be a welcome blessing.
It was a very conscious determination to always skew my thoughts in service of what the end objective was. For example, when 3+year old Lara would innocently express impatience at not yet having a sibling, at one point suggesting that since we were "taking too long to give her a baby brother/sister", perhaps we should just "go buy a baby from a shop", instead of getting defensive or berating the baby that she herself was, we enlisted Lara's help to pray for her sibling... so in any place of worship, or sacred ground of any kind that we passed thereon, Lara would stop, close her eyes, bow her small head and place her tiny hands together in prayer, reciting earnestly, "Please God, please give me a baby brother or baby sister."
After months and months of watching Lara do this, in the constancy of her childlike chant, Kishore started feeling the pressure of possibly disappointing Lara if her prayer was not answered. Whereas for me, Lara's recitation of her simple wish became like a strengthening mantra, our collective intention imbued with greater power with each repetition, and the goal of a sibling kept very much in the forefront of our minds (hence our calling Lara our 'project manager' in this endeavour).
And somehow in the 2nd month of that 3 month period, a positive + sign appeared on one of the home pregnancy tests I had grown accustomed to taking - my version of the lottery tickets others keep buying in hopes of hitting the jackpot, with all the cyclical anticipation and more often than not, disappointment, that entails...
This time however I was not disappointed.
With God's Grace, (hence 'Kiaen', a variation of 'Kiaan' which means 'Grace of God'), my focus on our joining the ranks of the 3% had materialised.
It seems poetic then, that Kiaen chose to make his appearance on the 3rd May, ironically the same date that his paternal great-grandfather departed this world for the next... such that in the combined words of Kishore and his father Kai Vello Suppiah,
"The 1st generation Suppiah left on 3rd May and the 4th generation Suppiah arrived on 3rd May after 41yrs...
One leaves, another comes, the legacy lives on..."
***
KIAEN AARYAN SUPPIAH'S BIRTH STORY
On Sunday 3rd May, I was 40 weeks and 5 days pregnant.
The baby was, in my mind, very UN-fashionably late past his due date of 29th April, so as much as I had willed and 'manifested' the privilege of pregnancy, to say I was keen to be done with it all was an understatement.
In the weeks leading to up to my full term, I had experienced increasingly intense Braxton-Hicks 'practice contractions' - annoying for me for the discomfort involved, stressful for Kishore who was on tenterhooks with the false alarms, on constant alert for when we would actually need to leave home for the hospital.
Having become a Hypnobirthing student and advocate from my first pregnancy with Lara, and thus being equipped with
(1) a lack of fear about childbirth in general and
(2) a basic understanding of how all the sensations I would experience fit into the big picture of my body bringing our baby closer to us,
I was less stressed - content to wait for the baby to be "fully cooked" and come out whenever he was ready... though I wouldn't have minded at all if the cooking time ended sooner, rather than later.
With Lara, I had been somewhat 'forced' into an induced labour, even though she was not yet due, and that had resulted in a 5 DAY LABOUR, a Birth Story for another post, so I was not inclined to chemically induce labour, even though I was assured that for second time mothers, it would be 'much faster and easier'...
That morning, I had a hunch *maybe* that day was the day, because in contrast to previous weeks' sensations of tightening, pressure and even spasms that were concentrated in the front of my abdomen and occasionally shot through my sides and legs, I felt period - like cramping in my lower back which I had not felt before throughout the pregnancy.
It was about 8am in the morning then, and my 'surges' were still relatively mild ('surges' being Hypnobirthing - speak for 'contractions', designed to frame them with the more positive connotations needed to counteract common language in which childbirth is presented as something that is unequivocally painful and traumatic, instead of the miraculous, powerful and natural phenomenon it actually is).
I recall (masochistically?) entertaining the thought of opting NOT to have an epidural JUST TO SEE WHAT IT WOULD BE LIKE...
I figured this would be the last time I would be pregnant and so it would be my 'last chance' to experience 'drug free labour' which, apart from the health benefits for baby and mother, might be *interesting* in a way that people who are curious about what getting a tattoo and skydiving and bungee jumping are like, might find these *interesting*...even knowing there will be pain and risk involved...
Since I have tried tattoos and skydiving (unfortunately not being able to squeeze in bungee-jumping while my life was purely my own to risk at no dependents' possible detriment) a similar curiousity about a no-epidural labour was on my mind...
In the absence of other signs of the onset of labour (like 'bloody show' or my waters breaking), I wanted to wait until the surges were coming every few minutes before we actually left the house for the hospital, not wanting to be one of those couples who rushed in too early and had interminable waits for the next stage in unfamiliar, clinical surroundings and/or were made to go home in an anti-climatic manner.
I was even calm enough through my surges to have the presence of mind to wash and blowdry my hair, knowing if I did deliver soon I would not be allowed this luxury for a while.
Around 9am I asked Kishore to prep for Lara and himself to be dressed and breakfasted so we could head to hospital soon, while I sent messages to family members on both sides informing them 'today might be the day.'
My mother, who had briefly served as a midwife before going back into general nursing and then becoming a nursing tutor, prophetically stated that if what I was experiencing was true labour, "the baby would be out by noon".
The pace in which my surges grew closer together was surprisingly quicker than I expected; and while I asked Lara to "Hurry up with breakfast" with only a tad more urgency than we normally tell her to do, little Missy being prone to dilly-dallying at meals, I probably freaked Kishore out when about 930am onwards, I had to instinctively get on my hands and knees a couple of times, eyes closed, trying to practice the Hypnobirthing breathing techniques I had revised to help along the process of my body birthing our child into the world.
I recall him saying a bit frantically as I knelt at our front door, doubled over as he waited for Lara to complete something or other, "Lara hurry up! Can't you see Mama is in so much pain and you are taking your own sweet time??!!"
SIDETRACK: Just the night before, Lara and I had watched a TV show in which a woman gave birth with the usual histrionics accompanying pop culture depictions of labour.
Lara watched the scene, transfixed.
I told her, simply and matter-of-factly, "That's what Mama has to do to get baby brother out Lara, and that's what I had to do for you also."
In most of interactions with my daughter, I have sought to equip her to face life's situations with calmness, truthful common sense, and ideally a minimum of drama.
Those who know the dramatic diva that Lara can be will know that this is a work-in-progress, but her response to me that night showed me some of my 'teachings' were sinking in:
She looked at me unfazed, "But Mama," she said. "You won't cry and scream like that lady, right? You will be BRAVE and stay calm, right?"
#nopressure.
So as we prepped to leave for the hospital I did indeed attempt to be that role model of calm for her, asking her only for her help in keeping very quiet,
"Because Mama needs to focus on bringing baby brother out and she needs quiet to concentrate...".
As we left the house at 10.11am, I texted Kishore's sister Geetha to please prep to pick up Lara from the hospital, and was grateful Kishore had the foresight to ask our gynae to prepare a letter for Geetha to show any police roadblocks between my in-laws' home in Subang Jaya and the hospital in Bangsar, this all happening under the Movement Control Order (MCO).
To Lara's credit, in the journey over to the hospital, she - probably sensing the gravity of the situation, sat very quietly in her seat at the back, and the silence was punctuated only by my occasional deep intakes of breath and some variation of my Ohmmm-like moans when the sensations were at their height.
By the time we got to Pantai Hospital at around 10.30am, my surges were strong enough I requested a wheelchair to assist me in getting to the labour ward, as I did not trust my own legs to support me... and Kishore would have to wait until Geetha had arrived to take Lara back to my in-laws' house before he himself could go up.
I slumped in the wheelchair and was wheeled up to the labour room with my eyes closed the whole time, trying to handle my surges.
I didn't even look up to see the attendant who pushed me... but did make the effort to thank him sincerely when he handed me over, with what seemed like a palpable sense of relief on his part, to the labour ward nurses.
The nurse attending me at Pantai was calm, steady and efficient. I answered some questions and changed into my labour gown while waiting for Kishore to come up, all the while managing the increasingly intense surges with my rusty Hypnobirthing breathing techniques.
By the time Kishore joined me at around 11am (I know these timings based on the timestamps of the 'WhatsApp live feed' of messages Kishore sent to his family), I was asking the nurse on duty, "How soon can I get an epidural??" thinking what crazy woman thought she could do this without drugs???!!!
The nurse checked my cervix dilation, I saw her bloodied glove indicating my mucous plug had dislodged, and she told me, "Well you are already at 7cm (which, for the uninitiated, is 70% of the way to the 10cm dilation needed for birthing), you are really doing well, if you made it this far without any drugs, if can you try and manage without it... I suspect within 2 hours or less you will deliver your baby and since it will take about that time for the anaesthesiologist to be called, epidural to be administered and kick in... it might all be for nothing... but of course the decision is completely up to you... "
So there I was, super torn, should I risk the sensations becoming worse... or risk the epidural becoming a waste?? And of course I was trying to decide this as my labour surges were coming at me stronger and stronger...
I was in such a dilemma...because as a 'recovering approval junkie' there was also a silly element of approval-seeking involved, ("The nurse thinks I can do this without drugs... maybe I CAN do this without drugs... Yay me!") mixed with that element of curiosity I mentioned earlier ("What if I actually CAN do this without drugs... plenty of other women have done it all over the world since time immemorial.. no big deal, how bad can it be...??") so then I thought I would use the financial aspect to be the 'tiebreaker' in my decision making...
I asked the nurse how much an epidural would cost and when she replied "Around MYR1.5k", I still remember Kishore's incredulous face as I asked the question, i.e."Seriously babe, you are gonna think about money right now? If you need the epidural TAKE IT, don't worry about the money!!!"... and while we are not rich by any stretch of the imagination, thankfully RM1.5k is not a quantum that made me swing towards a decision to "better save the money"...
So in the end, I guess my curiosity won out, and I turned down the epidural "just to see what it would be like and if I had it in me" (in addition of course to avoiding the side effects of any drugs introduced into my and the baby's body).
My labour occuring in the time of coronavirus, it was protocol for me to have a COVID19 test done, so the medical staff could apply the necessary precautions. I had heard from a friend Sharon Ruba that the test procedure was uncomfortable, so when the nurse came with the test kit as I was starting another surge, I asked, "Please can I just finish this surge before I do the test?" as I really didn't think I could multitask tackling multiple uncomfortable sensations in one go.
The COVID19 test involved what felt like a looong, skinny cotton bud being inserted into one nostril... I definitely felt more than a tickle as it went in and up, being told to take deep breaths by the nurse. Then she asked me to "Try to swallow" and I felt it go into my nasal cavities where I didn't think anything could go any further, but was proven wrong when she asked me to swallow again and the swab was probed even deeper. Then she warned me there would be some slight discomfort as she prepared to collect a sample... but at that point all I could think about was:
(i) I really don't have much of a choice
(ii) please let this be over before my next surge kicks in
(iii) if all the people breaking the MCO rules knew what it feels like to do this test maybe they won't put themselves at risk of the need to perform one...
In full disclosure as I was transferred into the actual delivery room at some point after 11am, another nurse offered me 'laughing gas' to ostensibly take some of the edge off... I took the self-operated breathing nozzle passed to me but don't recall it making any difference to my sensations..so didn't use it much as it seemed pretty pointless.
I recall some measure of relief when I heard my gynae Dr. Paul entering the room, greeting Kishore and me, and telling us it was going well and it wouldn't be long now and he would see us again shortly.
From my previous labour with Lara I knew the midwives pretty much take you 90% of the way through the labour and when the Dr is called in you are really at the home stretch, so was very relieved to hear his voice though knowing he would leave and come back later meant it wasn't quite over yet.
I do remember realising when I had crossed the Thinning and Opening Phase of labour to the Birthing Phase, by the change in sensations... it is still amazing to me that as the Hypnobirthing book mentioned, having this knowledge I was instinctively able to switch breathing techniques for the next stage of labour .
Was my opting against epidural the right choice for me?
Overall? Yes.
Don't get me wrong.
I *almost* regretted the decision several times during active labour... especially when I felt my body being taken over by an overwhelming compulsion to push that did not seem conscious and was accompanied by involuntary gutteral moans where I literally just thought to myself, "I surrender, God do with me what you will..." (super dramatic I know but VERY real at the time...).
I think I experienced 3-4 such natural explusive reflexes (?), rhythmically pushing the baby down the birth path, one of which was accompanied by what felt like a swoosh of water coming out of a hose with a diameter the size of a golf ball... this was when I realised my water had finally broken...
The nurses kept instructing me to do different things, to keep breathing, to move to my side, then to move to the middle, to raise my feet... and when I didn't comply, Kishore (who was with me throughout both my labours) tried to help them by repeating the instructions prefaced with "Sayang..." but I basically ignored all the intructions because I felt I had no capacity to direct any part of my body to do anything and someone else would have to physically manoeuvre that body part themselves.
When I heard Dr. Paul's voice again and the flurry of commotion surrounding his presence, I knew the time was close... and when I heard the nurse say to Kishore, "Sir, these are your gloves, for when you cut the baby's cord", it was music to my ears...
I'm very, VERY grateful Kiaen slid out after maybe the 4th of those involuntary pushes... the wave of RELIEF when he came out so quickly... it still boggles my mind that my mother was essentially right and as his birth time was 12.02pm, it was *only* about 1.5 hours between our arrival at the hospital and his arrival into the world.
Kiaen was placed on my chest for skin to skin bonding and remained there for a considerable time.
For our short stay in the hospital he would be with us in my maternity ward number C327... another trivially serendipitous sign for me because he was born on the 3rd (May) and our wedding anniversary is 27th (July).
I was discharged the following day 4th May at about 5.30pm, after I got an all clear on COVID19 and a paediatric surgeon did a small procedure on Kiaen to address a tongue-tie that would affect his breastfeeding latch... making the entire duration of our stay about 31 hours.
I have taken the time and effort to record all this down so that whenever life's challenges threaten to get me down I can remind myself, "Ignore the 97% failure probability, focus on the 3% success probability".
Also that the human condition is miraculous and it is such a privilege to experience it.
To our son Kiaen Aaryan, thank you for coming into our lives and choosing us as your parents.
Even though Papa and I are both zombies trying to settle into a night time feeding routine with you, I look forward to spending not only all future Mother's Days, but every day, with you and your Akka...
And last but not least, to my husband Kishore...without whom none of this would be possible - we did it sayang, I love you ❤️
Photo credit: Stayhome session with Samantha Yong Photography (http://samanthayong.com/)
同時也有5部Youtube影片,追蹤數超過2萬的網紅Anh Minh,也在其Youtube影片中提到,Pregnancy hormones are messing with my emotions. I usually ignore all the negative things in my life but my mind needed to go off and blow some steam....
multiple pregnancy 在 威廉氏後人 - 李毅評醫師 Facebook 八卦
< 母親節的困難抉擇 - 三胞胎問題:安胎 vs. 減胎 >
各位好
小弟 威廉氏後人 – 李毅評醫師
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這是一位在我這裡進行試管療程的患者
由於胚胎品質不理想
且備孕時間較長 (超過五年)
療程中也只收集到三顆胚胎,
因此我選擇了給這位36歲的患者三顆全部植入
1顆D5 (4BB)、2顆D6 (3CC、3CC)
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原先懷孕5週的時候
超音波追蹤到2個胚囊
結果到了7週的時候,
出現了3個心跳!
-
母親節前夕
面對這突如其來的驚喜 (或驚嚇?)
隨之而來的
是對未來的無比憂心。
-
面對三胞胎的困局
減胎成雙胞胎 或者 三個都保留
這是一個極為困難的抉擇。
-
儘管如此
我還是要再次強調
根據美國婦產科醫學會的建議
三胞胎減成雙胞胎,或者維持三胞胎生產
都是合理的 (reasonable)。
.
沒有誰對誰錯,
也沒有非怎麼樣不可。
這只是一個”選擇” (option)
.
“Fetal reduction to twins or a singleton is an option, but continuing the triplet pregnancy is also reasonable.”
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今天先撇開嬰幼兒的教育、家庭經濟、照顧人力、心力交瘁等難題
假設家裡經濟寬裕、照顧人手充足、社區托嬰托幼資源健全的情況下
三胞胎的懷孕與生產又會有什麼樣的困難與風險呢?
-
人類自然發生的三胞胎雖然不常見
但其實也都見於典籍當中
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相傳春秋時代
越王勾踐除了臥薪嘗膽之外
也獎勵國人早結婚、多生多育。
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左傳作者左丘明,寫的另一本大作:《國語》
中記載:
勾踐之地,曰:
女子十七不嫁,其父母有罪;丈夫二十不取,其父母有罪
生丈夫,二壺酒,一犬;生女子,二壺酒,一豚
生三人,公與之母。 生二人,公與之餼 (ㄒㄧˋ、米粟);
《國語、卷二十、越語、勾踐滅吳》
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就是說呢
越王勾踐因為被吳王夫差擊敗之後
越國人丁短少
因而採納了賢相范蠡、文種的建議
鼓勵結婚、獎勵生育。
-
女生17歲、男生20歲沒結婚的,父母有罪。
生兒子,政府送兩壺酒、一隻狗
生女兒,政府送兩壺酒、一隻豬。
生雙胞胎的,政府發奶粉
生三胞胎的,政府出保母。
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這裡所寫的:”生二人”、”生三人”
依照古代的多生多育的社會情況
生”二人”、”三人”指的並不是第二胎、或第三胎
指的是雙胞胎、三胞胎。
-
也就是說
在大約西元前400年的時候
三胞胎就已經是當時社會上出現的情況了。
-
當然啦,
三胞胎的發生率並不高
自然界的發生率約萬分之三
自從有了人工生殖的技術之後
三胞胎的發生率提升至千分之一左右。
-
三胞胎最大的問題
來自於人的身體、子宮容量有其上限
通常一個人的子宮
裝到4000公克開始
就會以為自己的小孩夠大了
就會開始宮縮。
-
因此
根據統計
單胞胎的平均出生週數為39週。
雙胞胎的平均出生週數為35週。
三胞胎的平均出生週數為32週。
-
無論我們如何努力安胎
三胞胎大約的平均出生週數很可能落在32週左右
出生體重大約1800g左右。
-
當然啦,
隨著新生兒加護病房照顧品質的不斷提升
32週、體重超過1500克以上的早產兒
目前幾乎所有這樣的早產兒
都能夠沒有併發症的存活
且未來發育良好
-
而且,
對於同樣的出生週數的早產兒來說
32週的單胞胎早產兒
跟32週三胞胎早產兒的死亡率與併發症比例是一樣的。
-
然而,
不可否認的是
懷三胞胎的孕婦
還是有比一般單胞胎更高的極低體重早產(<1500g)的風險
37% 的三胞胎會發生<1500g 的早產情況
三胞胎也有著較高的新生兒死亡風險:
單胞vs雙胞vs三胞:5/1000 vs 24/1000 vs 61/1000
.
而長期併發症的比例
雙胞胎是單胞胎的1.3倍左右
三胞胎是單胞胎的1.8倍左右
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除了小孩子的部分不同之外
三胞胎的孕婦也面臨著比單胞胎孕婦更大的身體衝擊
.
體重平均會上升25kg
.
子癲前症發生率為10%左右
較一般單胞胎孕婦的發生率高2倍左右。
屬於子癲前高風險,
需最晚於16週以前,
就要開始服用阿斯匹靈做預防
.
唐氏症的篩檢原則跟單胞胎一樣
初唐或羊穿都適用,
但nipt無法使用。
.
妊娠糖尿病的發生率是12.8%,
較一般單胞胎孕婦的發生率高3倍左右。
.
預防性的使用子宮頸環紮手術、黃體素、臥床等安胎方式
並沒有任何證據顯示有效。
因此不建議子宮頸長度超過2.5cm的產婦使用
-
另外
剖腹產率為85%以上,
僅極少數三胞胎產婦能順利完成陰道生產
-
所以
三胞胎並不是不行
但面臨的生活上困難與醫學上的風險
是必須納入考量的。
-
那如果選擇減成雙胞胎的話又是怎麼樣呢?
-
首先
有53%的三胞胎,
會自然發生胎兒無心跳萎縮
而自行減胎成雙胞胎。
原因很多,可能因為高齡、胚胎異常、胎盤早期出血等等
-
由於這樣胚胎的自行流產通常發生在10週以前,
因此
減胎手術大約會安排在妊娠13週左右進行。
-
減胎前,
於妊娠11~12週左右
應該先接受初唐或絨毛膜採樣的檢查
如果有外觀不正常、生長遲緩、羊水不足、頸部透明帶較厚或其他結構異常的胎兒,
會優先減去那個不正常的胎兒
.
若胎兒的健康狀況都差不多,
則會選擇最容易進行手術的胎兒,
也就是最靠近肚皮的那一個,
-
當然,
必須再次強調的是
孩子的性別
絕對不是選擇哪個減胎的考量因素。
-
減胎手術方式和羊膜穿刺很類似
就是透過超音波的導引
將針具刺進要進行減胎的胎兒身上
再注射藥物使其心跳停止。
-
減胎手術的風險與羊膜穿刺類似
出血或感染的風險並不高
機率小於1/1,000,
-
最主要的風險來自於減胎後的”全部流產”。
一般羊膜穿刺的流產風險約為3/1,000,
雙胞胎減胎的流產風險約為2/100,
三胞胎減胎的流產風險約為5/100。
-
關於減胎手術的相關詳細說明
歡迎google:”減胎 + 李毅評”
可以找到2018年,我的專訪文章
“多胞胎減胎.成就手足的健康”
發表於:Mombaby 媽媽寶寶懷孕生活網
-
參考資料:
1. 左丘明、國語、卷二十、越語、勾踐滅吳
2. Spontaneous reduction of multiple pregnancy: incidence and effect on outcome. Am J Obstet Gynecol. 2002;186(1):77.
3. Triplet births: trends and outcomes, 1971-94. Vital Health Stat 21. 1997;
4. Institute of Medicine. Weight gain during pregnancy: Reexaming the guidelines. The National Academies Press; Washington, DC 2009.
5. Preterm delivery in triplet pregnancies. Matern Fetal Neonatal Med. 2017;30(21):2596. Epub 2017 Feb 8
6. Is routine prophylactic cervical cerclage associated with significant prolongation of triplet gestation? J Matern Fetal Neonatal Med. 2006;19(9):575.
7. 媽媽寶寶第378期,2018年8月號。
-
“我完全可以理解,照顧三個孩子的媽有多辛苦,更何況是同時一次三個!!”
-
~ 威廉氏後人 - 李毅評醫師 ~
臉書蒐尋 : 威廉氏後人 - 李毅評醫師
粉絲專頁 : https://www.facebook.com/mrwilliams999
網誌連結 : https://mrwilliams999.blogspot.tw
-
multiple pregnancy 在 李木生醫師 Facebook 八卦
2019的新型冠狀病毒 (武漢肺炎病毒) 已經發生超過8 個月了,最近出生小嬰兒的孕期也已幾乎全部發生於此新型冠狀病毒流行的時代裡。 在這個新的時代,我們偏好在家吃外送,看網路電視 而比較少出門。身為婦產科醫師的我,也一直在了解它對於產婦的影響。有兩點想與大家分享。
首先,懷孕中感染並不會增加武漢肺炎的死亡率。但感染新型冠狀病毒的媽媽可能會經由胎盤垂直感染給小孩。所以孕婦戴口罩,勤洗手與社交距離的重要性再跟大家提醒。很幸運的,目前在台灣我們並沒有這樣的個案出現。
第二點是我覺得比較少人討論到的:維他命D缺乏。在台灣30歲的婦女普遍有三分之一都有維他命D的缺乏。維他命D由食物吸收,但必須靠肝,腎與(陽光照射)皮膚活化(註)。所以在這個大家因為疫情都比較少出門曬太陽的大環境裡,我覺得維他命D缺乏的比例會更高。
維他命D幫助鈣質的吸收,對於骨骼與肌肉的健康有很大的幫助。對於孕婦它甚至可能減少孕期糖尿病或子癲癇症 的風險。但至於有些報告指出維他命D缺乏可能是武漢肺炎死亡率的危險因子,英國國家衛生機構NICE 已經釋疑,認為維他命D缺乏與武漢肺炎死亡率並無因果關聯。
(註) 維他命D3是目前比較被廣泛使用的口服維他命,因其不需要經由身體活化。
==============================
謝謝熱心讀者的詢問,這是本篇文章所採用的醫學文獻。
懷孕與武漢肺炎的死亡率關聯
Ellington S, Strid P, Tong VT, et al. Characteristics of Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status — United States, January 22–June 7, 2020. MMWR Morb Mortal Wkly Rep 2020;69:769–775.
2019的新型冠狀病毒由胎盤垂直感染的證據
Vivanti, A.J., Vauloup-Fellous, C., Prevot, S. et al. Transplacental transmission of SARS-CoV-2 infection. Nat Commun 11, 3572 (2020). https://doi.org/10.1038/s41467-020-17436-6
維他命D 降低子癲癇症與孕期糖尿病風險的證據
Palacios C, Kostiuk LK, Peña-Rosas JP. Vitamin D supplementation for women during
pregnancy. Cochrane Database of Systematic Reviews 2019, Issue 7. Art. No.: CD008873.
DOI: 10.1002/14651858.CD008873.pub4
台灣北部人口維他命D缺乏的證據
Lee MJ, Hsu HJ, Wu IW, Sun CY, Ting MK, Lee CC. Vitamin D deficiency in northern Taiwan: a community-based cohort study. BMC Public Health. 2019;19(1):337. Published 2019 Mar 22. doi:10.1186/s12889-019-6657-9
英國國家衛生機構 (國家臨床卓越協會, National Institute of Clincal Excellence, NICE) 對於維他命D與武漢肺炎關聯的看法
https://www.nice.org.uk/advice/es28/chapter/Key-messages Accessed August 23rd, 2020
===============================
It has been more than 8 months since the start of the global pandemic of COVID-19. We are now seeing the ripple reflected in the way we live, even in Taiwan. People prefer to stay home now: they order delivery food instead of going to restaurants, and watch video streaming at home instead of going out. As an obstetrician and gynaecologist, I wondered about its effect on women.
First of all, pregnancy does not increase mortality of SARS-CoV2 virus infection. But it can transmit from mother to child via their placental connection. The virus has recently been found in the placenta of a mother and newborn with COVID-19: proving vertical transmission other than routes such as breastfeeding and/or air droplet transmission. So it is worth reiterating the importance of masking at public spaces and hand hygiene for pregnant women. Luckily, in Taiwan thus far, there has not yet been any cases of vertical transmission.
The second point is less well discussed but may well affect more women. And that is Vitamin D deficiency, which is already common in Taiwan pre-COVID-19 era. Its prevalence is about one third in 30 year-olds. In the COVID-19 era, I suspect the prevalence will increase even further because people prefer staying home. Vitamin D deficiency has also been found to be more common in patients who succumb to COVID-19, although it merely reflects the association between vitamin D deficiency and multiple-comorbidities rather than a causal relationship. However, we already know that vitamin D deficiency in pregnancy can be related to a number of birth-related complications such as gestational diabetes and pre-eclampsia. So it is worthwhile testing for vitamin D levels at the beginning of pregnancy. Vitamin D3 is widely used as a supplement in patients with deficiency, because it does not require activation by sunlight.
multiple pregnancy 在 Anh Minh Youtube 的評價
Pregnancy hormones are messing with my emotions. I usually ignore all the negative things in my life but my mind needed to go off and blow some steam. It's a weird feeling to have since I'm not normally like this but I guess that's what happens when your hormones are not in check! My emotions are multiple by a lot so I have to find a way to figure it out. Hopefully I'll have full control of it in time.
STAY CONNECTED.....
YOUTUBE: https://www.youtube.com/anhminhnet
EMAIL: anhminh@anhminh.net
FACEBOOK: https://www.facebook.com/anhminhfan
INSTAGRAM: https://instagram.com/anhminhledoan
SNAPCHAT ?: anhminhnet
TWITTER: https://twitter.com/anhminhnet
multiple pregnancy 在 瘦妮Sonnie Koenig Youtube 的評價
我最愛的妝前乳和粉底液的組合實測來囉!
Please thumbs up if you like it =D
如果你喜歡這視頻的話,請不要客氣地幫我按一個讚唷 =D
**影片中提到的東西 Items I mentioned in the video**
1. Smashbox Primer Water
http://amzn.to/2y6xDd5 (DE)
http://amzn.to/2wjryFE (UK)
2. Clio Kill Cover Pro Artist Liquid Concealer 珂莉奧專業藝術遮瑕液
http://amzn.to/2yq0a9C (DE)
http://amzn.to/2y6Uwgw (UK)
3. Becca Backlight Priming Filter
http://amzn.to/2kI2lmI (US)
http://amzn.to/2exTa6d (DE)
http://amzn.to/2wwy7p8 (UK)
4. Clinique Superbalanced Silk Makeup SPF15
http://amzn.to/2xBYjxs (US)
http://amzn.to/2wwA6cY (DE)
http://amzn.to/2esPQG1 (UK)
5 Becca Cosmetics Aqua Luminous Perfecting Foundation Fair
http://amzn.to/2y5YPbH (UK)
http://amzn.to/2yrBxcu (DE)
6. NYX Butter Gloss Creme Brulee
http://amzn.to/2xw9sEl (UK)
http://amzn.to/2hxfDxz (DE)
7. e.l.f. Moisturizing Lipstick Ravishing Rose
http://amzn.to/2wjE47Q (UK)
http://amzn.to/2xzuteE (DE)
8. LANEIGE Two Tone Shadow Bar 蘭芝超放電絲絨雙色眼影
https://goo.gl/15PPn2 (TW)
9. NARS The Multiple Maui
http://amzn.to/2y7MQL0 (DE)
**給大家的參考**
『我的膚質 My Skin Type』混合性內油外乾痘痘肌
Combination & Acne
『我的唇性 My Lip Type』唇紋明顯、唇色較深、唇乾
Dark & Dry
♛ Find My Vlog Series Here 生活影音記錄影片播放列在這兒
https://goo.gl/BKv074
♛ Find My Pregnancy Diary Here 懷孕日記系列播放列在這兒
https://goo.gl/Ua1sFv
♛ Watch other planning related videos here 手帳本影片播放列在這
https://goo.gl/vdmCJS
♛ Check out my blog!
http://sonniekoenig.com/
♛ Like me on Facebook! 來臉書找我!
Germany+Taiwan 德國嬌妻瘦妮的異國趣
http://www.facebook.com/sonniekoenig
Sonnie Koenig 瘦妮玩美生活實驗室
http://www.facebook.com/sonniekoenig2
♛ Instagram:
@sonniekoenig (手帳本以外分享 Sharing everything except planner related stuff.)
@pimpmyplannerco (手帳本相關分享 It's all about planners and stationery.)
♛ Join me on Snapchat @ sonniekoenig
♛ Follow me on twitter!
https://twitter.com/SonnieKoenig
♛ Pinterest: @sonniekoenig
♛ Google+: sonniekoenig
Sound effects: iLife
Disclaimer: It's not sponsored. I bought everything myself! It's my honest opinions!
聲明:這不是業配視頻,全部都是我自己買的!分享內容也是我真實的感想!
multiple pregnancy 在 瘦妮Sonnie Koenig Youtube 的評價
好久沒有跟錄這樣的影片了,想跟大家分享的東西太多、加上很多話,所以影片有點兒太長啦 XD 希望大家還喜歡囉!
Please thumbs up if you like it =D
如果你喜歡這視頻的話,請不要客氣地幫我按一個讚唷 =D
影片中提到的產品 The products I mentioned in the video:
1. 蜜妮新頂級深層卸粧棉
https://goo.gl/OR6EmO (TW)
2. 倍優胺基酸保濕洗卸慕斯
3. Dentek Floss Picks Complete Clean Fresh Mint 牙線棒
http://amzn.to/2f8BdXr (DE)
4. Egyptian Magic All Purpose Skin Cream
http://amzn.to/2f8Br0M (DE)
https://goo.gl/u6QDi5 (TW)
5. Wuta kamille Handcreme + Glyzerin
http://amzn.to/1UvG8na (DE)
6. Weleda Schwangerschafts-Pflegeöl, 100ml 薇莉達孕婦撫紋按摩油
http://amzn.to/2f8CxcJ (DE)
https://goo.gl/FCVg16 (TW)
7. 理膚寶水安得利極效防曬乳 La Roche Posay ANTHELIOS XL CREAM
https://goo.gl/U5A17o (TW)
http://amzn.to/1EJfLTC (DE)
http://amzn.to/1FryFJt (US)
8. Smashbox Photo Finish Oil Free Foundation Primer Pore Minimizing
http://amzn.to/1g46ZDP (DE)
http://amzn.to/1Frzi5Y (US)
9. L'Oreal Paris Nude Magique CC Cream (Anti-Redness)
http://amzn.to/2f1CbqQ (DE)
10. Maybelline New York Fit Me Concealer (10 Light)
http://amzn.to/2f1KQcD (DE)
https://goo.gl/o8mE7l (TW)
11. Tarte Amazonian Clay 12-Hour Full Coverage Foundation SPF 15 Fair light
http://amzn.to/1Kz8x7d (DE)
http://amzn.to/1FrA56X (US)
12. Nars The Multiple - Maui
http://amzn.to/1OoJt0f (DE)
http://amzn.to/1ISfVTz (US)
13. Clio Kill Brow Tatoo-lasting Gel Pencil 1Natural Brown
珂莉奧刺青凝膠不斷電持色眉膠筆01深棕
https://goo.gl/suO3yX (TW)
14. Clio sharp, so simple pencil liner 超流線抗暈眼線膠筆 02棕
15. Panasonic EH-NA56 國際牌吹風機
http://amzn.to/2f1KVNN (DE)
https://goo.gl/MmaJvj (TW) 新款 EH-NA57
16. Michael Kors 皮夾(我找不到一模一樣的產品連結)
17. Erin Condren Life Planner
Click on this link, you'll receive $10 off your first purchase of Erin
Condren Life Planner. 點這連結可以得到10塊美金的折價唷!
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18. Pilot FriXion Ball Knock Retractable Gel Ink Pen - 0.5 mm 摩擦筆
http://amzn.to/1FrFAm9 (DE)
http://amzn.to/1K0ajMx (US)
♛ Watch other planning related videos here 手帳本影片播放列在這
https://goo.gl/vdmCJS
♛ Find My Vlog Series Here 生活影音記錄影片播放列在這兒
https://goo.gl/BKv074
♛ Find My Pregnancy Diary Here 懷孕日記系列播放列在這兒
https://goo.gl/Ua1sFv
♛ Check out my blog!
http://sonniekoenig.com/
♛ Like me on Facebook! 來臉書找我!
Germany+Taiwan 德國嬌妻瘦妮的異國趣
http://www.facebook.com/sonniekoenig
瘦妮黃臉婆。Germany+Taiwan 德國台灣之愛玩美生活
http://www.facebook.com/sonniekoenig2
♛ Instagram:
@sonniekoenig (手帳本以外分享 Sharing everything except planner related stuff.)
@pimpmyplannerco (手帳本相關分享 It's all about planners and stationery.)
♛ Join me on Snapchat @ sonniekoenig
♛ Follow me on twitter!
https://twitter.com/SonnieKoenig
♛ Pinterest: @sonniekoenig
♛ Google+: sonniekoenig
Sound effects: iLife
Disclaimer: It's not sponsored. I bought everything myself! It's my honest opinions!
聲明:這不是業配視頻,全部都是我自己買的!分享內容也是我真實的感想!
multiple pregnancy 在 Multiple pregnancy: having more than one baby - RCOG 的相關結果
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multiple pregnancy 在 Multiple Pregnancy and Birth: Twins, Triplets, and High Order ... 的相關結果
Twin pregnancies occasionally progress to 40 weeks but almost always deliver early. As the number of fetuses increases, the expected duration of the pregnancy ... ... <看更多>
multiple pregnancy 在 Multiple Pregnancy | ACOG 的相關結果
If more than one egg is released during the menstrual cycle and each egg is fertilized by a sperm, more than one embryo may implant and grow in the uterus. ... <看更多>