PRE-NATAL GENETIC TESTING

Two to three percent of babies have some type of birth defect. Down syndrome is the most common chromosomal abnormality to cause mental retardation. Genetic screening and diagnostic tests can help you find out if your baby is at risk.

Genetic Screening
There are two types of prenatal testing used to detect chromosomal abnormalities: screening and diagnostic. “Screening tests do not indicate that disease is either present or absent, but tell us whether the chance of disease is higher or lower than otherwise expected for an individual patient,” says board-certified Ob/Gyn Steven C. Goldberg, M.D., FACOG. “The purpose of genetic screening is to assist a pregnant woman in evaluating the need to have additional diagnostic testing.” Physicians test to find possible genetic diseases in unborn babies and to find out if people are carrying a gene for a disease their children may inherit. “Screening tests are non-invasive and pose no threat to a woman’s pregnancy,” says Dr. Goldberg.

Types of screening tests include:

Ultrasound
Between 11 – 14 weeks, a nuchal translucency ultrasound (NT) can determine a woman’s risk of having a baby with Down syndrome and also detect fetal cardiac abnormalities. This screening measures the fluid under the skin at the back of the baby’s neck. All babies have some fluid, but in many babies with Down syndrome, the nuchal translucency is increased. Done alone, this test picks up about 75 percent of babies with Down syndrome, and when combined with a maternal blood test, the detection rate improves to about 90 percent and also detects other potential abnormalities.

Maternal Serum Screen
(double screen, triple screen or quadruple screen)
Between 15 and 18 weeks, MSS screening looks for “markers” for Down syndrome in the mother’s blood. A double screen looks for two markers; a triple screen looks for three, a quadruple screen for four. The double test detects about 59 percent of Down syndrome babies, and the quadruple about 75 percent. MSS testing doesn’t actually show if a baby has a chromosomal problem, but instead gives an estimate of risk. Only two or three out of every 100 women who have an abnormal MSS will have a child with birth defects. These tests can also indicate the possibility of abnormalities such as spina bifida.

Diagnostic Testing
“Diagnostic testing, such as amniocentesis or placental biopsy, are offered to pregnant women whose screenings indicate a higher risk of having a baby with some type of abnormality,” says Dr. Goldberg. “These tests are more invasive and may bring a slight risk to the pregnancy, but they will determine whether the condition you are screened for is actually present.”

A woman can then evaluate her options for her pregnancy and parents can optimize plans for the baby’s birth and care at the time of delivery. “An advantage to knowing in advance is to have time to plan and get prepared,” says Dr. Goldberg. “Once you know your risks, it might help to speak with a genetic counselor or a maternal-fetal specialist to help you decide the best course of action for you and your family,” concludes Dr. Goldberg.

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On May 3rd, 2013, posted in: News by

BREAST AWARENESS AND SELF EXAM

Early detection of breast cancer through routine exams saves potentially thousands of lives each year by improving the chance of a cure, says Ob/Gyn Eumena M. Divino, MD, FACOG.

The American Cancer Society believes there is enough compelling data to indicate that breast self exam is effective in helping women stay aware of any changes that may be cause for concern. The ACS now recommends a new technique to improve breast awareness.

“The major difference between this new recommendation and the traditional one is that it is done lying down,” says Dr. Divino, “not standing up as women have been instructed to do for years.” Experts say it is easier to feel breast tissue this way, as it spreads more evenly and is at its thinnest.

“The more women are familiar with how their breasts feel and appear, the more quickly they can notice changes that would indicate the need for further testing by their doctor,” Dr. Divino says.

Dr. Divino urges women to have a breast exam as part of their annual check-up and to have regular mammograms. “But check yourself every month. If you don’t do a regular breast self exam, get started now and schedule a mammogram at The Women’s Center at Raritan Bay Medical Center, recognized as a Pink Ribbon™ facility in recognition of its superior imaging capabilities for early breast cancer detection and the advancement of women’s health.”

To schedule an appointment for an annual check-up, call 732.316.4951,

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On May 3rd, 2013, posted in: News by

Choosing A Birth Control Option

Hate the idea of hormones? Want more spontaneity with sex? Would you like to have children, but not now? Are you a mother who has decided her family is large enough?

“Each woman’s contraceptive needs are unique,” says ob/gyn Steven C. Goldberg, M.D., FACOG, “and options can vary. For example,
someone who is healthy and a non-smoker can safely use birth control pills throughout her entire reproductive life. Someone who smokes – which increases the risk for blood clots – or has other medical conditions, may not be a good candidate at any age.” Fortunately, there are many choices and a woman’s ob/gyn can recommend the safest alternative for her.

The pill is one of the leading methods of birth control, but longacting, reversible contraceptives are gaining new popularity. These include intrauterine devices, or IUDs, and hormonal arm implants.

“Many women like these long-term methods,” says Dr. Goldberg. “They are a good choice if you don’t remember to take your pill every day or just like the convenience.” Birth control patches and the vaginal ring also offer long-term contraception.

A condom acts as a barrier against both pregnancy and sexually transmitted infections, or STIs. The diaphragm is also a barrier, but some women are allergic to spermicide, and the diaphragm is not as effective as other forms of birth control.

Women who have either finished having children or have decided not to have them can c h o o s e p e rma n e n t contraception, including tubal ligation or other noninvasive methods, which require no surgery. A vasectomy is an excellent option for couples.

Emergency contraception is designed to prevent pregnancy after unprotected sex by inhibiting ovulation and disrupting the production of key cells needed to conceive. It is also recommended when a condom breaks. Emergency contraception works best if taken up to 24 hours after intercourse, although it lowers pregnancy risk if taken within 120 hours. It will not work if you are already pregnant.

“Women who don’t want to become pregnant should take precautions against conception until they enter menopause,” says Dr.
Goldberg.

“The U.S. has one of the highest rates of teen pregnancy,” says Dr. Goldberg, “and half of all pregnancies are unplanned, so we know that contraception is being underutilized. Whether I am seeing a teen for the first time or a married woman in for her annual check-up, I always ask if the patient is sexually active and what form of birth control is she using or would like to use.”

All women, especially teens, need to understand not only how to prevent pregnancy, but also how to protect their health from STIs. “Talk with your doctor to determine a safe method of birth control,” concludes Dr. Goldberg, “and if you are going to be sexually active, understand that a condom is the most effective way to protect against the majority of STIs.”

To schedule an appointment to learn more about birth control options, call 732-316-4951.

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On January 17th, 2013, posted in: News by

New Year — New Attitude!

Do you have a positive attitude? Do others think you do? Staying positive can be challenging, especially when life is out of balance at home or at work. Sometimes it takes a consistent effort to stay upbeat when you are struggling with difficult situations.

According to Frank Paluzzi, MA, LPC, a licensed professional counselor at Bay Behavioral Health, “Things can’t always improve overnight, but keeping a positive attitude is possible when you set realistic expectations for yourself. Giving yourself small goals and achieving them can be self-motivating.”

“Don’t hesitate to get the help you need,” says Paluzzi. “People do care, so don’t be afraid to talk with family and friends, co-workers, and professional counselors.” If you have a set-back, Paluzzi recommends that you acknowledge it and get back on track. “Getting a new attitude and keeping it is a marathon, not a sprint,” he observes, concluding, “There’s a whole new year ahead. Take the time you need to accomplish whatever goal you set and you will achieve your dream of living a happy life.”

To make an appointment with the healthcare professionals at Bay Behavioral Health, call 732-360-0287.

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On January 17th, 2013, posted in: News by

GESTATIONAL DIABETES: Are You + Your Baby at Risk?

During pregnancy – usually around the 24th week – many women develop gestational diabetes. The American Diabetes Association estimates that gestational diabetes affects 18% of pregnancies.

“A diagnosis of gestational diabetes doesn’t mean you had diabetes before you conceived, or that you will have diabetes after giving birth,” says board-certified ob/ gyn Steven R. Berkman, M.D., FACOG, FACS. “It is concerning, however, because gestational diabetes causes high blood sugar that can affect your pregnancy and your baby’s health.”

When to See a Doctor

Seek pre-pregnancy health counseling when you first think about becoming pregnant, says Dr. Berkman. “Your doctor will evaluate your risk of gestational diabetes as part of your overall childbearing wellness plan. Once you become pregnant, your doctor will address gestational diabetes as part of your prenatal care and perform a screening test about mid-way through your pregnancy. During the last three months of pregnancy, your doctor will carefully monitor your blood sugar level and your baby’s health.”   

For most women, gestational diabetes doesn’t cause noticeable signs or symptoms and blood sugar usually returns to normal soon after delivery. But if you’ve had gestational diabetes, you’re at an increased risk for future type 2 diabetes and complications may arise during pregnancy, including high blood pressure, preeclampsia and eclampsia. 

Are You At Risk?

Any woman can develop gestational diabetes, but some women are at greater risk, including:

• Women over the age of 25

• Women with a family or personal health history of diabetes

• Women with excess weight, with a body mass index (BMI) of 30 or higher

• Women of black, Hispanic, American Indian or Asian Heritage

Any pregnancy complication is concerning, but there’s good news, says Dr. Berkman. “Expectant moms can help control gestational diabetes by maintaining a healthy weight and eating a healthy diet during pregnancy, exercising and, if necessary, using medication. Taking good care of yourself can ensure a healthy pregnancy for you and a healthy start for your baby.”

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On December 6th, 2012, posted in: News by

Bone Up On Healthy Bones

“When you think about staying healthy, you may think about making lifestyle changes to prevent conditions like cancer or heart disease. Keeping bones healthy may not be at the top of your list but it should be”, says ob/gyn Eumena M. Divino, MD, FACOG, and here’s why …

Roughly 10 million Americans have osteoporosis and another 34 million are at risk, according to the National Osteoporosis Foundation. Osteoporosis causes bones to become weak and brittle — so brittle that a fall or even mild stresses like bending over or coughing can cause a fracture. Bone is living tissue, which is constantly being absorbed and replaced. Osteoporosis occurs when the creation of new bone doesn’t keep up with the removal of old bone.

Osteoporosis-related fractures most commonly occur in the hip, wrist or spine. Some people lose height and become shorter. Broken bones can cause severe pain that does not go away and can keep you from getting around easily and doing the things you enjoy. This can make people – especially older adults – feel isolated and depressed. It can also lead to other health problems.

Who’s at Risk for Osteoporosis?

Osteoporosis affects men and women of all races. But white and Asian women — especially those past menopause — are at highest risk. Osteoporosis can affect people of all ages but is far more common in older adults. A recent study by the Cleveland Clinic Foundation found that there is a strong hereditary factor for osteoporosis from mothers to daughters. It’s never too soon to focus on building healthy bones. Eighty-five percent of adult bone mass is acquired in girls by age 18 and in boys by age 20.  

You can’t feel yourself getting osteoporosis, but a simple, painless bone mineral density scan can tell if you have osteoporosis. Medications, dietary supplements and weightbearing exercise can help strengthen your bones. “Get at least 1,000 milligrams of calcium a day from low-fat dairy and take a multi with vitamin D, which helps the body absorb calcium,” Dr. Divino says. “At the gym, hit the free weights along with the treadmill. Bones get stronger in response to force, and strength-training can target areas like the shoulders, spine, and wrists,” she says.

“Whatever your age,” says Dr. Divino, “the habits you adopt now can affect your bone health for the rest of your life. Now is the time to take action.”

To schedule a bone density scan at Raritan Bay Medical Center, please call 732-324-5270

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On December 6th, 2012, posted in: News by