Tuesday, January 27, 2009

Crowded Off the News by the Birth of Octuplets

I boasted to my students today that I would be interviewed by Reuters TV concerning President Obama's Green Jobs plans. I had even created a list of cogent points that I spent 15 minutes in class today talking about. But, as usual, my opportunity past. The birth of octuplets is certainly bigger news than anything I have to say and the camera man who would have interviewed me is still at the California hospital nearby covering this story.

I've also had to live with the cosmic injustice that the new Senator from New York is younger than me
http://www.nytimes.com/2009/01/26/nyregion/26gillibrand.html?hp. I was happy to read that she is UCLA Law School Graduate.

Now back to that pack of new diaper wearers.

Q&A: The Incredible Birth of Octuplets
Jeanna Bryner
Senior Writer
2 hrs 47 mins ago

The birth of eight babies at a California hospital yesterday is a gestational feat that has happened only one other time in the United States, doctors said.

The event required a team of 46 to carry out the Caesarean section at Kaiser Permanente Medical Center. As of this writing, Mom and all eight babies - six boys and two girls - were said to be doing fine, despite being 9 weeks premature.

This birth of octuplets raises a slew of questions surrounding multiple births:

How could a woman conceive octuplets?

"It would be very unlikely that this would be natural," said James Airoldi, maternal fetal medicine specialist and director of Obstetrics at St. Luke's Hospital and Health Network in Bethlehem, Pa. "It's very likely this was the result of some form of ovarian stimulation with the use of fertility drugs." This method would cause the ovaries to produce more follicles (each of which releases an egg) than normal.

"In vitro fertilization won't get you this [octuplets], because most doctors who do in vitro fertilization will only put two or three embryos back," Airoldi said, adding that even if a doctor inserted three embryos back into a woman's uterus and one of these split to produce twins, you'd only get four embryos.

"There's no doctor who would've put seven or eight embryos back in. That would be totally irresponsible of any doctor," he said.

The likely cause: so-called ovarian stimulation and fertility drugs, which cause a woman to produce more eggs than normal.

Do multiple babies share the same placenta?

Only identical twins, which would come from the same egg that splits, could share the same placenta, a pancake-shaped organ that attaches to the inside of the uterus and is connected to the fetus by the umbilical cord. The placenta delivers nutrients and oxygen from the mother's blood to the fetal blood, while transferring the baby's waste in the other direction.

The other babies, which come from separate eggs, would each pull nutrients from a separate placenta.

Does a mom carrying octuplets need to eat more?

"We recommend 300 extra calories per baby," Airoldi said, adding though that with eight babies, the extra calorie intake would not be feasible (multiply 300 by 8 ... 2,400 extra calories).

"They can't because their bellies are so big. So usually it amounts to trying to eat small frequent meals and trying to keep your calories up to at least 3,000 calories per day," he added.

Does carrying octuplets put more stress on a woman's body?

A resounding yes. "These babies are the most efficient parasites in the world," Airoldi told LiveScience. "They are taking every ounce of iron to build their red blood cells and every ounce of calcium to build their bones. So if mom isn't supplemented, mom is going to end up with nothing in the bank."

Have multiple births increased in the United States?

"Absolutely," Airoldi said. "I'll see 25 patients a day and at least five of them will be multiple gestation."

Over the past two decades, multiple births in the United States have skyrocketed, with the number of twins born between 1980 and 2003 increasing by more than 65 percent and the number of higher-order multiples (triplets or more) jumping four-fold during that time, according to the National Center for Health Statistics. Today, more than 3 percent of all babies born in the United States are multiples, with most being twins.

Why? The fact that more women are getting pregnant at older ages and the use of fertility drugs and other artificial fertility methods, according to Airoldi.

For older women, "their ovaries are trying to get that one last party in, that one last shot at conceiving so they have this overshoot phenomenon where they may release two eggs at once, trying really hard to desperately conceive before they go kaput," Airoldi said.

"Older women that conceive are at higher risk of multiples," he said. "And we are seeing women conceiving at later ages. And we also see higher rates in fertility medication used to conceive."