BayWellness — Fall 2015
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Bringing you wider access to the best physicians.

I’m Pregnant. Could I Be At Risk Of Gestational Diabetes?
Gestational diabetes mellitus (GDM), or high blood sugar during pregnancy, used to be relatively rare, occurring in about 3 percent to 4 percent of pregnancies. “But in recent years, the rate has doubled,” says Dr. Borislava Burt-Libo. “Now up to 6 percent to 8 percent of moms-to-be are diagnosed with this prenatal complication.”

In women with GDM, excess glucose (blood sugar) passes from the mother’s bloodstream through the placenta.

Maternal complications of gestational diabetes include a higher risk of gestational hypertension or preeclampsia (a serious high blood pressure condition that can be fatal), cesarean delivery and increased risk of developing diabetes later in life. Up to 50% of women with GDM can develop diabetes in the years following pregnancy, even as many as 20-30 years later. Women of certain ethnicities may develop diabetes sooner. Particularly at risk are women of Latin-American descent.

Possible complications to the fetus are macrosomia (large for gestational age infant), difficulty with delivery that may result in birth trauma, difficulty maintaining normal sugar levels after birth and elevated bilirubin levels leading to jaundice. There is some data that these offspring may themselves be at risk of developing diabetes later in life.

Risk factors for developing gestational diabetes include advanced maternal age (over 35), being overweight, sedentary lifestyle and genetic predisposition (Hispanic, African American, Native American, Asian and Pacific Islander ethnicities have shown an increased prevalence of gestational diabetes).

“Your doctor will screen for gestational diabetes between the 24th and 28th weeks of pregnancy, sooner if you are at risk,” says Dr. Burt-Libo. “Gestational diabetes can be controlled with diet, exercise and medication.”

What Can I Do To Ensure The Health Of My Future Baby?
“Mothers who do not receive prenatal care are at a higher risk of having babies with low birth weight and serious medical complications – including birth defects – than those born to mothers who do receive pre-natal care,” says Dr. Eumena Divino.

Good pre-conception care helps ensure that you and your baby will have a healthy pregnancy and future good health: don’t smoke; limit alcohol; exercise and eat a folic acid-rich diet including green, leafy vegetables, oranges and orange juice, cantaloupe and bananas, milk, grains and organ meats.

Folic acid is a B vitamin that helps the body form healthy new cells. “Women who don’t get enough folic acid during pregnancy are more likely to have a baby with serious defects of the brain or spinal cord,” says Dr. Divino. “These defects occur during the first 28 days of pregnancy, usually before a woman even knows she’s pregnant.”

If you are planning to become pregnant, take a pre-natal vitamin with 400 to 800 mg of folic acid every day.

Should My Son Or Daughter Have The Hpv Vaccine?
The human papillomavirus (HPV) is associated with cervical, vaginal, vulvar, penile, anal, and oropharyngeal cancers and genital warts.

“Both the Centers for Disease Control and Prevention and the American College of Obstetricians and Gynecologists recommend routine HPV vaccine for girls and boys,” says Dr. Steven R. Berkman.

Despite the benefits of HPV vaccines, only approximately one third of girls in the recommended age group have received all three vaccines. Compared with other vaccines recommended in the same age bracket, HPV vaccination rates in the United States are unacceptably low.

“It is crucial that obstetrician–gynecologists educate parents and patients on the benefits and safety of HPV vaccination,” says Dr. Berkman. Despite cervical cytology screening in the United States, each year cervical cancer is diagnosed in more than 12,000 women and nearly 4,000 die from the disease. Additionally, nearly 2.8 million abnormal Pap test results are identified annually.

“We can protect the next generation of young women against cancer if we can get better immunization rates, in both boys and girls,” says Dr. Berkman. “HPV vaccines offer the best protection to girls and boys who receive the vaccine and have time to develop an immune response before being sexually active. That’s why HPV vaccination is recommended for preteen girls and boys at age 11 or 12 years,” says Dr. Berkman.

Is An Annual Pap Test Really That Important?
Cervical cancer, which is caused by HPV (human papillomavirus) starts in the cervix, the narrow opening into the uterus from the vagina. Fortunately for most women with HPV, the virus clears on its own. Only when HPV persists could cancer develop, and this could take many years. This is why the recommendation for yearly Pap tests has been relaxed and the interval between Pap tests has been increased.

However, more than 12,000 U.S. women will be diagnosed with cervical cancer this year. “Cervical cancer is the second most common type of cancer for women, but because it develops over time, it is also one of the most preventable types of cancer,” says Dr. Steven C. Goldberg.

Fortunately, deaths from cervical cancer in the US continue to decline primarily due to the widespread use of the Pap test to detect cervical abnormalities and allow for early treatment. Most women who have abnormal cervical cell changes that progress to cervical cancer have never had a Pap test or have not had one in the previous three to five years.

Cancer of the cervix tends to occur during midlife, usually between the ages of 35 and 55. It rarely affects women under age 20, and approximately 20 percent of diagnoses are made in women older than 65. “For this reason, it is important for women to continue cervical cancer screening until at least the age of 70,” says Dr. Goldberg. “Some women need to continue screening longer.”

Pre-cancerous conditions are completely curable when followed up and treated properly. The 5-year survival rate for cancer that has spread to the inside of the cervix walls but not outside the cervix area is 92 percent. “The 5-year survival rate falls steadily as the cancer spreads into other areas, making it even more important for women to schedule an annual Pap test,” concludes Dr. Goldberg.

Second Location Now Open In Old Bridge

Now women in Central Jersey have a convenient new destination to access their healthcare needs, bringing the best board-certified physicians closer to home.

Bay Obstetrics & Gynecology in Iselin is staffed by Drs. Eumena Divino, Borislava Burt-Libo, Steven R. Berkman, and Steven Goldberg. In addition, Drs. Berkman and Goldberg have relocated their South Amboy practice to Old Bridge in the Medical Arts building at 3 Hospital Plaza, suite # 314.

All of The Bay physicians are board-certified and provide comprehensive healthcare for women of all ages.