Experts are warning women not to take Vitamin E supplements during pregnancy because it may harm the unborn child.Prof Stuart Campbell, the obstetrician who pioneered 3D scans of foetuses "walking in the womb", called for the Government to place a health warning on the vitamin, after trials revealed that it doubled the rate of stillbirths, led to low birth weight and increased health complications in the newborn.Another specialist, Prof Andy Shennan, of St Thomas' Hospital in London, who carried out research into the role of vitamins E and C in pre-eclampsia, said pregnant women were "self-medicating" with high doses of the vitamin in the mistaken belief that it did them good.Concern over vitamin E, particularly in large doses, comes as record numbers of Britons, including pregnant women, turn to vitamins thinking they will protect their health. The vitamin market in Britain is worth an estimated £362 million a year and their use in pregnancy is soaring because of Goverment advice to take vitamin D for strong bones and folic acid (a B vitamin) to prevent spina bifida.
Research has previously suggested that vitamin E, an antioxidant, has a protective effect against miscarriage and pre-eclampsia (a serious complication of pregnancy), particularly when taken with high doses of vitamin C.But two recent studies in London and Australia, published in The Lancet and the New England Journal of Medicine, suggest that the reverse may be true.Prof Campbell believes that vitamin E can interfere with the ability of the mother's immune system to avoid attacking the baby as an "invader". He also thinks that the vitamin could disrupt the functions of the placenta, depriving babies of nutrients, and argues that children born to women who have taken high doses of vitamin E may have an increased risk of asthma and eczema.He said: "The evidence suggests vitamin E may be harmful in pregnancy and it's therefore wise to avoid it."Concerns were raised when experts at St Thomas' Hospital in London conducted a trial on 2,500 women at risk of pre-eclampsia.The women took high doses of vitamins E and C from 14 weeks until they gave birth.
Those who took 400 international units of vitamin E daily - about 250mg - and 1,000mg of vitamin C developed pre-eclampsia earlier and had a more severe form of the illness. The European Union's recommended daily amount for vitamin E is 20mg but the official "safe" level is 540mg a day - about 800 international units.A total of 19 babies were stillborn in the study, compared with just seven in women who took a placebo - a statistically significant rate of one per cent versus 0.5 per cent. On average, the birth-weight of babies whose mothers took the vitamins was 60g less than in the placebo group.Prof Shennan said: "Vitamins are deemed to be innocent and good and there is no doubt that pregnant women are out there, self-medicating with these high doses. One women came to me and she was taking 5g of vitamin E a day. I told her to stop."Our trial was looking to see if there was a benefit for a specific condition, pre-eclampsia, and that turned out not to be the case."A Department of Health spokesman said its experts on the Scientific Advisory Committee on Nutrition were not considering the safety of vitamin E in pregnancy.
"The only vitamin supplements recommended by the Department of Health during pregnancy are folic acid and vitamin D," the spokesman said. "We advise against vitamin A supplements during pregnancy. We keep all evidence on other vitamin supplementation under review."Dr Anne Walker, from the Health Supplements Information Service, said: "A multivitamin specifically designed for pregnancy is a good idea, but high doses of vitamin E are not suitable. But, because of problems with insufficiency in pregnancy, particularly for folic acid, it would be wrong to put people off vitamins."What Are the Warning Signs of a Miscarriage? Vaginal bleeding during pregnancy may be the first warning sign of a miscarriage. However, about 20% of women have vaginal bleeding during the first 12 weeks of pregnancy, and less than half of them miscarry. And, 75% of women who have had three or four miscarriages will go on to have a successful pregnancy. If you are pregnant and bleeding vaginally, your health care provider will probably use an ultrasound to help assess whether your pregnancy is healthy.
An ultrasound can help determine whether there is a fetal heartbeat and whether the amniotic sac that surrounds the fetus is normal. It can also tell whether the placenta is separating. An ultrasound will also help determine whether the pregnancy is ectopic (occurring outside the uterus, such as in one of the fallopian tubes) or whether you may have spontaneously aborted one fetus in a twins or triplets pregnancy. A blood test can determine whether pregnancy hormones are being produced. A complete blood count (CBC) may be done to determine the degree of blood loss, and several other tests may be done to rule out potential infection. Your health care provider may also perform a pelvic exam, looking for signs of miscarriage, including changes to the cervix and ruptured membranes. Your blood type will also be checked. If you are Rh negative and have miscarried, an injection of rho (D) immune globulin will be given to help prevent problems associated with incompatible blood types in future pregnancies.
Because chromosomal abnormalities of the embryo are identified in more than half of miscarriages occurring in the first 13 weeks, doctors don't usually recommend special testing to look for a cause. The chances are excellent that the next pregnancy will be healthy. After three or more miscarriages, consider consulting an OB/GYN who specializes in or has extensive experience with miscarriage. Testing for clotting and bleeding disorders may be performed. Special hormone tests and exams looking for connective tissue disorders in the mother may also be given. You and your partner should also discuss undergoing genetic testing with your health care provider. An X-ray or ultrasound of your reproductive organs may be recommended to look for structural differences that may have played a role in your miscarriages. What Are the Treatments for Miscarriage? If your health care provider determines that you are at risk for a miscarriage, he or she may recommend that you stay in bed, restrict activity, and abstain from sexual intercourse until the signs are gone.
Some health care providers recommend this kind of bed rest, although there is no scientific evidence that it will prevent a miscarriage. It can also lead to increased risk for other health issues. More often than not, little can be done to stop a miscarriage. Treatment of a miscarriage, once it has begun, depends on your symptoms. The primary goal of treatment during and after a miscarriage is to prevent hemorrhaging and infection. If vaginal bleeding fills more than one super sanitary pad in an hour for 2 hours in a row, you should contact your health care provider. Heavier bleeding and cramping often indicate that a miscarriage is progressing. In most cases, a woman's body expels all of the pregnancy-related tissue. The earlier you are in the pregnancy, the more likely that your body will complete the miscarriage on its own. If all pregnancy-related tissue wasn't expelled, a condition known as an incomplete miscarriage, you may need treatment to stop the bleeding and prevent infection.
The most common procedure is a dilation and curettage (D&C), which involves the widening of the cervix and scraping of the uterine lining, called the endometrium. Sometimes suction is used along with scraping. This procedure can be uncomfortable, so it is most often done under general anesthesia. Another option is to take medication (misoprostol), which will help your body expel the tissue. Talk to your health care provider to determine the best treatment for you. You may be given antibiotics or other medications afterward to minimize bleeding. Any additional vaginal bleeding should be monitored closely. You should also find out whether you are Rh negative. If you are, you probably will need a shot of Rh immune globulin vaccine to prevent problems in future pregnancies. Call Your Doctor About Miscarriage If: You have a fever or chills. Septic (infected) abortions are rare in cases of miscarriage, but a fever or chills may indicate infection. Any remaining pregnancy-related tissue must be removed, and you should take antibiotics to prevent serious illness.
Recovering Emotionally After Miscarriage It's common to feel sad after losing a pregnancy. Many couples feel the grief of losing a child. This is normal, so allow yourself time to grieve. Consider joining a support group where you can talk about your experience and feelings with others who have had a miscarriage. Family and friends may want to be comforting, but they may feel like they don't know how best to respond. If you can, let them know that you need their support, tell them what they can do, and rely on their help. Miscarriage can be a physical and emotional challenge for you and your partner. The stress in a relationship can be high. Some people may be tempted to blame themselves or their partner for the miscarriage -- even though it's highly unlikely that either of them did anything to cause the miscarriage or could have done anything to prevent it. Keep in mind that there is a good chance that you will give birth to a healthy baby in the future. Only about 20% of women who have had a miscarriage have another miscarriage the next time they become pregnant.