Pre-eclampsia & other complications of pregnancy

waltky

Wise ol' monkey
Feb 6, 2011
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Okolona, KY
New test for pre-eclampsia...
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Pre-eclampsia predicted using test during pregnancy
11 November 2011 - Pre-eclampsia is thought to affect 3-5% of pregnancies
A test carried out during pregnancy could predict which women will develop a potentially fatal condition called pre-eclampsia, scientists say. Presenting their study to the American Society of Nephrology, researchers said the test detected specific kidney cells in patients' urine. Out of 15 women who developed pre-eclampsia, all tested positive for the cells. Experts say a simple, predictive test during pregnancy would be valuable.

Warning sign

Pre-eclampsia is a disorder which appears in the late stages of pregnancy and is characterised by high blood pressure and excess protein in the urine. Researchers at the Mayo Clinic, who presented their work to the annual meeting of the American Society of Nephrology, tested 300 women. Dr Vesna Garovic assessed a test which detects the shedding of kidney cells called podocytes in the urine. The team had previously found podocytes present in patients with pre-eclampsia when they gave birth.

In this study, all the women who went on to develop pre-eclampsia had podocytes in their urine, while none of the 15 who went on to develop high blood pressure or the 44 healthy pregnant women did. Although carried out on small numbers of women, the researchers say the test is highly accurate for predicting pre-eclampsia and could alert doctors early to the problem. Ann Marie Barnard, chief executive of Action on Pre-Eclampsia, said an accurate test would help many women. "A large number of the 1,500 women who call our helpline each year are terrified of becoming pregnant again because they have suffered pre-eclampsia, often with tragic results. Many do decide to go ahead with a new pregnancy anyway.

"Any test which can predict whether they are going to get it again has to be welcomed - while it cannot stop the disease occurring, it would enable services to be more closely focused on them and more alert to signs of the disease developing." And Andrew Shennan, professor of obstetrics at St Thomas Hospital in London, said: "Being able to use a simple accurate test in pregnancy, such as from a urine sample, would be valuable in identifying those women to watch closely. "Current tests are not reliable enough, and further work is needed to confirm these promising findings in larger groups."

BBC News - Pre-eclampsia predicted using test during pregnancy
 
Good pregnancy/drug info hard to find...
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Hard to find good info on drug safety in pregnancy
Mar 12,`13 WASHINGTON (AP) -- Nearly every woman takes a medication at some point during pregnancy. Yet there's disturbingly little easy-to-understand information about which drugs pose a risk to her baby, and what to do about it.
Need some pain relief? In the fine print is the warning that painkillers like Advil aren't for the third trimester. Left unsaid is whether to worry if you took them earlier. An awful cold? Don't panic if you used decongestant pills, but doctors advise a nasal spray in early pregnancy. And don't abandon antidepressants or epilepsy medicines without talking to your doctor first. Some brands are safer during pregnancy than others - and worsening depression or seizures aren't good for a mom-to-be or her baby. "To come off of those medications is often a dangerous thing for the pregnancy itself," warns Dr. Sandra Kweder of the Food and Drug Administration. "They need information on what to expect, how to make those trade-offs."

A new study shows how difficult that information is to come by. Women often turn to the Internet with pregnancy questions. But researchers examined 25 pregnancy-related websites and found no two lists of purportedly safe drugs were identical. Twenty-two products called safe on one site were deemed risky on another. Worse, specialists couldn't find evidence to back up safety claims for 40 percent of the drugs listed, said Cheryl Broussard of the Centers for Disease Control and Prevention, who led the recent study. "The reality is that for most of the medications, it's not that they're safe or not that's the concern. The concern is that we just don't know," she said.

Broussard experienced some of that confusion during her own two pregnancies - when different doctors handed over different lists of what was safe to use. It's a growing dilemma. The CDC says medication use during the first trimester - especially vulnerable for birth defects because fetal organs are forming - has jumped 60 percent in the last three decades. Plus, women increasingly are postponing pregnancy until their 30s, even 40s, more time to develop a chronic health condition before they're expecting.

The CDC is beginning a Treating for Two program to explore how to get better information, and the FDA plans to revamp prescription drug labels with more details on what's known now. But people want an easy answer - use it or don't - and for many drugs, they won't get one anytime soon. "Women agonize over it," said Dr. Christina Chambers of the University of California, San Diego. She helps direct California's pregnancy risk information hotline that advises thousands of worried callers every year.

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Women are the secret oglers: study
Tue, Mar 12, 2013 - It is not men who spend their time secretly ogling women — it is women, according to a revealing new study.
It is also the fairer sex that gives their rivals’ bodies a good visual once-over, found Bristol University researchers, rather than their supposedly Neanderthal partners. Men are more likely to concentrate on a potential mate’s face. The academics came to their conclusions after asking volunteers to examine a range of different images, including stills from nature documentaries, classical and surrealist paintings, and freeze-frames of couples in films.

The researchers found women spent 61 percent of their time looking at the women in the pictures, and only 39 percent on the men. When they looked at the women, their eyes tended to roam around the whole figure, while men concentrated on the face.

Felix Mercer Mos, a computer science PhD student, who led the study, said, “This is counter-intuitive from a sexual perspective if you are thinking about desire, but it’s not surprising if you look at it in terms of sexual competition.” He continued, “The women might be checking out their sexual rivals, and comparing themselves with them.”

http://www.taipeitimes.com/News/lang/archives/2013/03/12/2003556837
 
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Premies suffering from necrotizing enterocolitis may be healed by amniotic fluid...
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Amniotic fluid 'may heal premature baby gut'
24 March 2013 - Amniotic fluid may hold the key to healing a fatal gut disease which affects premature babies, doctors say.
Severe inflammation, called necrotizing enterocolitis, can destroy the gut's tissues and lead to major organ failure. Early animal tests, published in the journal Gut, showed that stem cells inside amniotic fluid could heal some of the damage and increase survival. Further tests are still needed before it is tried in premature babies.

Pregnancy fluid

Babies born too soon are not ready for the world outside the womb and their guts are ill-prepared to deal with food. About one in 10 premature babies in a neonatal intensive care will develop necrotizing enterocolitis. The inflammation can cause tissue death and lead to a hole in the baby's intestines which can result in a serious infection. Breast milk can reduce the risks, but the only major treatment is surgery to remove the diseased tissue. However, 40% of those needing an operation will not survive. "It is quite a problem and we think it is on the increase," said Dr Simon Eaton, from the Institute of Child Health at University College London. He was part of a team investigating the use of stem cells, which are able to become any other type of cell in the body from nerve to bone, taken from the amniotic fluid which surrounds a developing foetus in the womb.

In experiments on laboratory rats, which are programmed to develop fatal necrotizing enterocolitis, injections of stem cells appeared to increase survival times. Dr Eaton told the BBC news website: "We're able to prolong survival by quite a long way. "What appears to be happening is a direct effect on calming inflammation and also stimulating resident stem cells in the gut to be more efficient at repairing the intestines." The study, funded by Great Ormond Street Hospital Children's Charity, showed the intestines were also working better after the treatment.

Cancer risk?

Fellow researcher Dr Paolo De Coppi said: "Stem cells are well known to have anti-inflammatory effects, but this is the first time we have shown that amniotic fluid stem cells can repair damage in the intestines. "Although amniotic fluid stem cells have a more limited capacity to develop into different cell types than those from the embryo, they nevertheless show promise for many parts of the body including the liver, muscle and nervous system." Far more testing would be required to work out if the treatment would work in babies and if it would be safe.

The stem cells would have to be taken from a donor as it would not be practical to store fluid from every birth, just in case. This means there is the risk of rejection. As the stem cells are capable of becoming other types of cells there is also concern that they may pose a cancer risk. However, in the future doctors hope they could harness a drug instead. "It's not the cells, they're delivering something and if we knew what that was then we could deliver that directly," said Dr Eaton.

BBC News - Amniotic fluid 'may heal premature baby gut'
 
Neonatal and post-natal care woefully inadequate in much of the world...
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Report: 3 Million Newborns Die Within First Month
May 07, 2013 - The humanitarian organization Save the Children has released its annual State of the World’s Mothers report. It says despite much progress being made in reducing maternal and child deaths, every year, three million babies die within the first month of life. Many just live a few hours.
Save the Children President and CEO Carolyn Miles said there’s a widespread and mistaken belief that little can be done to save newborn lives in developing countries. As a result, many babies die. “This year’s report we really focused in on newborns. And we found that a baby’s birthday is actually the most dangerous day of their life. More than one million babies are dying the actual day that they’re born.”

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There are several reasons why they’re so at risk that first day. “It’s when they can die of very preventable things. So babies are dying of infection. They’re dying of complications at premature birth and they’re dying of very simple things like not breathing at birth,” she said. Miles said one region of the world stands out as being the worst for newborns. “Sub-Saharan Africa is the place where this is the biggest issue. And if you look at the index that we put together, the bottom 10 in that index are all sub-Saharan African countries. From a percentage standpoint that’s where the most babies are dying.”

Forty percent of first day newborn deaths are in sub-Saharan Africa. Of the 176 countries that are ranked in the Mothers Index, DRC is at the very bottom. Rounding out the bottom 10 are Somalia, Sierra Leone, Mali, Niger, Central African Republic, Gambia, Nigeria, Chad and Ivory Coast.

Miles said, “I think the issue in sub-Saharan Africa is really getting the care that these newborns need to the places where they’re being born. So, a lot of times the health system ends at a district level and there may not be a health post that’s accessible to these women. So, one of the solutions here is getting more frontline health workers out into these communities to help mothers when they’re giving birth.”

More Report: 3 Million Newborns Die Within First Month

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Study: Nutrient Powders Can Prevent Iron-Deficiency in Children
May 08, 2013 - A recently released study says that scaling up micronutrient powders, MNP’s, is the key to preventing iron deficiency anemia in children worldwide. The research was sponsored by the Bill and Melinda Gates Foundation and carried out by the NGO Results for Development Institute in Washington D.C.
Multiple micronutrient powders are tasteless and can be sprinkled on any homemade food, making it easily digestible even for babies. It provides vital vitamins and minerals that children need for growth. Because of their iron content, MNP’s play a critical role in preventing iron deficiency anemia, IDA. Kanika Bahl the managing director at Results for Development Institute, said the report looked in particular at micronutrient powders and called for [their] dramatic global scale- up which can achieve improved nutritional status of tens of millions of children worldwide.

Bahl explained how iron deficiency anemia can contribute to life- long adverse effects: “On average,” she said, “infants with iron deficiency anemia score up to one-third lower on mental development tests than infants with better iron status. To put this in context, over a child’s lifetime, iron deficiency anemia in childhood is associated with a four percent decrease in hourly earnings later in life.” The managing director of Results for Development emphasized that the small one-gram sachet of vitamins and minerals cost only three cents per serving -- and it instantly boosts the child’s intake of vitamins and minerals. But, she said globally, intervention has been slow.

Only a fraction of the 34 million children who need MNP’s receive them. She said the Results for Development Institute recommends the international community mobilize a minimum of $200 million annually to scale up distribution of the nutrient powders. “Two hundred million dollars is equivalent to less than three percent of the global funding provided for HIV control in 2011. We recommend that countries themselves focus with the international community on scaling [up the distribution of the MNPs],” explained Bahl.

She added that she was encouraged by progress being made in African countries. “My team was in Kenya last summer, where it was reported that 69 percent of children are anemic. But, here the national government has worked closely together with civil society and with the local industry to develop a comprehensive national development plans for these powders. And this approach, working in cross sectors is something our report highly recommends,” explained Bahl, who described Zambia as being another country that is doing interesting advances with nutrients.

More Study: Nutrient Powders Can Prevent Iron-Deficiency in Children
 
Does bed rest help prevent prematurity?...
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Study questions if bed rest prevents prematurity
14 May`13 WASHINGTON (AP) — New research is raising fresh concern that an age-old treatment for troubled pregnancies — bed rest — doesn't seem to prevent premature birth, and might even worsen that risk.
Doctors have known for years that there's no good evidence that bed rest offers any benefit for certain pregnancy complications, and it can cause side effects in the mother, not to mention emotional and financial strain. Yet estimates suggest nearly 1 in 5 moms-to-be is told to cut her activity — ranging from quitting work to actually staying in bed all day — at some point during pregnancy.

Now, spurred by the latest study, some specialists are issuing a call for strict studies to finally settle the controversy — and until then, for doctors not to assume that a prescription to take it easy can't hurt. "Bed rest is misperceived as an inexpensive, innocuous, logical recommendation," Dr. Joseph Biggio Jr. of the University of Alabama at Birmingham wrote in the latest issue of Obstetrics & Gynecology, a journal read by thousands of OB-GYNs.

In a separate review of past studies that failed to support bed rest, a trio of obstetricians and ethicists at the University of North Carolina, Chapel Hill, went a step farther: They said it's not ethical to keep prescribing bed rest unless the women are enrolled in a research study, like they are for other unproven treatments.

So why is rest prescribed so often? There aren't a lot of good treatments to prevent prematurity and other problems. "Patients want you to do something, and physicians want to do something," explained Dr. Catherine Spong, a maternal-fetal medicine specialist at the National Institutes of Health who co-authored the latest research.

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Pregnancy Related Deaths Cut In Half...

Maternal mortality falls by almost 50% - UN report
November 12, 2015 - Pregnancy-related deaths have fallen by almost half in the past 25 years, according to a report by United Nations agencies published in The Lancet.
Around 303,000 women died of complications during pregnancy or up to six weeks after giving birth in 2015 - down from 532,000 in 1990. Officials from the World Health Organisation (WHO) said the results showed "huge progress". However, only nine countries hit targets set by the UN. "This report will show that by the end of 2015 maternal mortality will have dropped by 44% from its levels from 1990," said Dr Lale Say, coordinator for reproductive health and research at the WHO.

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Maternal mortality has fallen by almost half since 1990​

But she warned that the progress was "uneven" - with 99% of deaths happening in developing countries. While 39 countries reported "significant progress" in reducing pregnancy-related deaths, only nine countries achieved their targets. "Many countries with high maternal death rates will make little progress, or will fall behind, over the next 15 years if we don't improve the current number of available midwives and other health workers with midwifery skills," said Dr Babatunde Osotimehin, executive director of the UN Population Fund.

Eastern Asia saw the greatest improvement, with maternal mortality falling from approximately 95 to 27 per 100,000 live births. The UN now aims to reduce the global ratio to less than 70 per 100,000 by 2030.

Maternal mortality falls by almost 50% - UN report - BBC News
 
New test for preeclampsia...

Mysterious Pregnancy Complication Diagnosed with Simple Test
February 04, 2016 - Preeclampsia is a mysterious disease, experts say, striking up to 60 percent of pregnant women globally. It is marked by high blood pressure and the presence of protein in the urine.
Untreated, preeclampsia can progress to eclampsia, which can cause seizures and lead to comas. Eclampsia causes 13 percent of maternal deaths around the world. The only treatment is pre-term delivery, but doing so puts the newborn at high risk of death. Premature birth also increases the chances of learning disabilities and cerebral palsy in the baby. The condition can only be diagnosed after a physician assesses all the symptoms. Researchers, however, have developed a simple urine test that can tell doctors in three minutes whether a pregnant woman has developed preeclampsia.

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A new test can tell a doctor in a matter of minutes whether a pregnant woman has preeclampsia.​

How it works

Kara Rood of Ohio State University's Wexner Medical Center in Columbus led the study, in which a drop of the pregnant woman's urine is placed on a piece of paper that contains a red dye called Congo red. The test detects proteins in the urine that have an abnormal shape in women with preeclampsia, according to Rood. "When we discovered this, what we were able to do is look at other diseases that have this misfolded protein, such as Alzheimer's [disease],” Rood said. “Then we were able to add Congo red dye that is a dye that pathologists actually use to diagnose Alzheimer's after somebody has died. And we added that to the urine of pregnant women with preeclampsia, and it actually attaches these proteins in the misfolded, abnormal ones."

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The Congo Red Dot test is a simple clinical tool that allows for accurate, rapid diagnosis of preeclampsia, a new study shows.​

Effectiveness, benefits

The test was 89 percent effective in detecting the condition in a clinical trial of 343 women at Ohio State who were suspected of having preeclampsia. Since early delivery is the only treatment for preeclampsia, Rood said knowing the mother's status could save the life of the baby by extending the pregnancy. "Where preeclampsia is progressive, sometimes you can get a little more time out of the pregnancy if you have the ability to monitor the mom and the baby closely," she said. Rood presented the findings Feb. 4 at a meeting of the Society for Maternal-Fetal Medicine in Atlanta, Georgia. The researchers have partnered with a company to develop the test for general use in the hope of getting it to obstetricians in the next few years.

Mysterious Pregnancy Complication Diagnosed with Simple Test
 
Granny says, "Dat's right pregnant ladies - sleep on yer side...
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Lying Position During Pregnancy Could Increase Stillbirths
November 22, 2016 | WASHINGTON — A new study has found that women who lie on their backs late in their pregnancies could be increasing their risk of stillbirth.
Researchers at the University of Auckland in New Zealand say that when an expectant mother rests in a supine position, her unborn baby's heart rate and activity level change, indicating that the fetus is responding by decreasing the amount of oxygen it takes in.

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Indian gynaecologists conduct ultrasound examinations on pregnant women at a government-run hospital, March 17, 2015. A new study from New Zealand, has found that women who lie on their backs late in their pregnancies could be increasing their risk of stillbirth.​

Investigators studied 29 healthy women in their third trimester of pregnancy. The women were asked to lie in different positions for 30 minutes at a time. The fetal behavior state, a measure of fetal health, was recorded for each position. Researchers found that lying face up late in pregnancy can add stress to the fetus and may reduce the amount of oxygen, possibly contributing to stillbirth.

If a woman has an underlying health conditions, say investigators, that could add to the risk of stillbirth. The findings were published in the Journal of Physiology . Each woman in the study was followed through birth and each baby was born healthy. According to the World Health Organization, more than 18 babies out of 1,000 are stillborn, mostly in low- and moderate-income countries.

Lying Position During Pregnancy Could Increase Stillbirths
 
Uncle Ferd says dat's why womens goes nuts when dey's pregnant...
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Pregnancy alters woman's brain 'for at least two years'
Mon, 19 Dec 2016 - 'Pregnancy brain' exists, but not in the way you might think, scientists say.
Pregnancy reduces grey matter in specific parts of a woman's brain, helping her bond with her baby and prepare for the demands of motherhood. Scans of 25 first-time mums showed these structural brain changes lasted for at least two years after giving birth. European researchers said the scale of brain changes during pregnancy were akin to those seen during adolescence. But they found no evidence of women's memory deteriorating. Many women have said they feel forgetful and emotional during pregnancy and put it down to "pregnancy" or "baby" brain - and, it seems, with good reason.

Hormone surge

Pregnancy is characterised by extreme surges of sex hormones and involves drastic physiological and physical changes in the body, the researchers say. During those nine months, women experience a flood of oestrogen which is greater than for the whole of the rest of their lives. Yet research on the effects of pregnancy on the human brain is scarce. This study, from researchers at the Universitat Autonoma de Barcelona and Leiden University and published in Nature Neuroscience, looked at the brain scans of women before they became pregnant, soon after they gave birth, and two years later, to see how the brain changed. And they compared these women's brains with those of 19 first-time fathers, 17 men without children and 20 women who had never given birth.

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The researchers found "substantial" reductions in the volume of grey matter in the brains of first-time mothers. The grey matter changes occurred in areas of the brain involved in social interactions used for attributing thoughts and feelings to other people - known as "theory-of-mind" tasks. The researchers thought this would give new mothers an advantage in various ways - help them recognise the needs of their child, be more aware of potential social threats and become more attached to their baby. Just by analysing the brain images, computers were able to pick out the women who had been pregnant.

Bonding with baby

In one task, women were shown pictures of their own babies and other babies and their brain activity was monitored. The parts of the brain which lit up when they saw pictures of their own babies closely matched the areas where grey matter had been reduced or "fine-tuned" during pregnancy. The same areas did not light up when pictures of other babies were viewed. Elseline Hoekzema, study author and postdoctoral researcher at the Institute of Psychology at Leiden University in the Netherlands, said: "We can speculate that the volume reductions observed in pregnancy represent a process of specialisation or further maturation of this Theory of Mind network that, in some way, serves an adaptive purpose for pending motherhood."

The study found that pregnant women were all affected in similar ways, regardless of whether they conceived naturally or underwent IVF. And there were no changes in first-time fathers' grey matter in the study when their brains were monitored before and after their partners' pregnancy. The research team also found no major changes in white matter in the brain.

Pregnancy alters woman's brain 'for at least two years' - BBC News
 
Surgery that can help fistula...
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Analysis: The devastating stigma of fistula and the surgery that can help
Jan 4, 2018 - One big challenge of being a foreign correspondent is to make the foreign less foreign, especially on issues that might seem esoteric or irrelevant to an American audience. The challenge was all the greater when we embarked on our report about obstetric fistula, a topic not often seen on television, especially during the dinner hour.
Fistula is a tear in the wall between the vagina and bladder (and sometimes the rectum), caused in most cases by prolonged obstructed labor, leaving the woman incontinent. Women are at especially high risk for fistula in some countries where early marriage is prevalent, their bodies not sufficiently mature for pregnancy. It was once a common occurrence. The site of New York City’s Waldorf Astoria hotel began life in the 1867 as a fistula hospital. Prenatal care and Caesarian sections have made fistulas a rare occurrence in developed countries or most settings where births are aided by a skilled attendant. Yet it continues to be an unfortunate reality for many of the world’s poorest women.

A strong odor accompanies the affliction, making the women feel ostracized and embarassed, often into self-imposed isolation. “I lost all my friends,” says Sarah Omega, 41, featured in our Dec. 27 broadcast report from Kenya. “When you just arrive (in a place) where people are seated, some of them hold their noses because of the bad odor and they start leaving that place one by one.” “I couldn’t go to church,” she adds, a particularly painful consequence for a woman of deep faith, faith that ironically informed her medical predicament in so many different ways.

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Sarah Omega, her husband Kennedy Otieno and their daughter, Jade​

Omega became pregnant as a result of rape by her pastor when she was 19, she says, an assault she kept secret because her abuser threatened dire consequences if she ever reported it. She fled to live with a relative in a distant city. “I was so scared I didn’t want to secure an abortion because of my faith,” she says. “So I kept the pregnancy.” She experienced an excruciating 38 hours of labor, which left her with a stillborn baby boy and a fistula she endured through 12 years of anguished visits to providers who said they were unable to help her, two suicide attempts and eventually a psychiatric commitment to a hospital. Only there, when she met Dr. Hillary Mabeya, was she made aware of an option that’s been readily available for a long time in places where people can afford it; like New York in 1867: surgery.

Obstetrician Mabeya is one of a handful of surgeons performing fistula repairs in Kenya. Quiet and understated, his passion is displayed most vividly in a schedule of some 45 procedures every week, training a number of younger surgeons. Now Sarah Omega is an emissary for the cause — trying to bring women to surgery at the new hospital built for Mabeya in the western Kenyan city of Eldoret. Care is provided at no charge, all supported by the California-based charity, Fistula Foundation. Their campaign, with other local groups, includes public rallies to explain the medical basis for the “curse” visited upon so many women and attack the social stigma they endure in painful solitude.

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