Health Scan: Male fetuses<i> are</i> more trouble

A fetus being a male "is an independent risk factor" for preterm delivery and preterm rupture of membranes.

By JUDY SIEGEL-ITZKOVICH
fetus 88 (photo credit: )
fetus 88
(photo credit: )
It isn't an "old wives' tale" that carrying a male fetus is more "troublesome" than carrying a female fetus, according to research encompassing over 66,000 women who gave birth at the Rabin Medical Center (RMC) in Petah Tikva between 1995 and 2006. Prof. Marek Glezerman, Dr. Yariv Yogev and Dr. Nir Melamed of the medical center's Helen Schneider Hospital for Women and Tel Aviv University's Sackler Faculty of Medicine found in the retrospective study that a fetus being a male "is an independent risk factor" for preterm delivery, preterm rupture of membranes, delivery by vacuum and forceps or cesarean section; at the same time, female fetuses are at increased risk for breech presentation (legs first) and intrauterine growth restriction. The study will be presented at the founding conference of the Israel Society for Gender Medicine, which will be held at Rabin Medical Center at the end of this month. Over 34,000 (51.8 percent) delivered boys and 32,000 (48.2%) delivered girls. The demographic and obstetric characteristics of the women with a male fetus and those with a female fetus were similar. The rate of pre-term delivery (as early as 29 weeks) was higher for male fetuses and was attributed to an increased incidence of spontaneous preterm labor and preterm, premature rupture of membranes. Women carrying male fetuses were at increased risk for operative vaginal delivery, gestational diabetes, abnormal fetal heart rate and failed vaginal delivery and cesarean delivery. Female fetuses were more likely to experience restricted fetal growth, while males were at increased risk for being too big. The doctors admitted that they did not have a clear understanding of the mechanisms by which fetal gender interacts with pregnancy outcome. But they said the broad and long-term study could help in the future to understand the mechanisms involved in premature birth and factors that influence fetal growth in the uterus. Glezerman, who heads the Helen Schneider Women's Hospital, said the study of early differences between the sexes shows that medicine should regard males and females as different in their characteristics. "Further investigation of the mechanisms responsible for this association may contribute to our understanding of the pathophysiology of pregnancy complications such as preterm delivery and fetal growth restriction," the team concluded. AIRBAGS FOR MOTORCYCLES? Airbags are mandatory inside newer vehicles, but how about airbags for motorcycle drivers? A media report from the UK described tests by a stuntman on a motorcycle equipped with a jacket made of airbags that inflate when the rider crashes or falls. The researchers concluded that in their country alone, dozens of motorcyclists' lives could be saved every year if airbag jackets were made compulsory. Although motorcyclists make up just one percent of road users there, they account for 20% of fatalities. One type of jacket is attached to the bike by a lead that detaches when the rider has come off suddenly, the BBC reported. The pressure triggers a small gas canister that inflates the jacket in less than one fifth of a second. A UK physician who is also a motorcycle rider said: There's no question that the jackets protect the biker's vital organs, neck and spine over and above the level that a normal jacket would do. An accident victim said he needed two major operations, couldn't walk for six months and still felt the after-effects two years later. "I've got a plate in the front of my pelvis with six bolts in it. I've got two nine-centimeter bolts going through my pelvis into my spine." Told about this technology, Michal Klein of the Beterem organization (Israel Center for Child Safety and Health), comments that airbag technology used in cars shows a lot of promise While the design described in the BBC article "sounds promising, new road safety technologies will need to be thoroughly tested prior to any type of legislation or even safety recommendation. A Harvard professor who is on sabbatical at the Hebrew University of Jerusalem related that he is slowly recovering in the orthopedics ward of Hadassah University Medical Center from a bad motorcycle crash that shattered his left knee and lower leg. He had rented a lighter-than-usual motorcycle to travel from Petah Tikva to Jerusalem and went into a skid. He said an airbag jacket would surely have reduced his injuries. Prof. Elihu Richter, an accident prevention expert in Jerusalem, said that if tough motorcyclists complained that such jackets would be too hot in an Israeli summer, "freezer packs (or some modification) could be added to mitigate the heat." Another expert in road safety, Dr. Jakov Adler, added he thought the airbag jacket could be very effective and prevent serious body injuries. The problem is that in Israel, such a law would not be passed in our Knesset because of motorcycle lobbyists in the Knesset. SURVIVAL BOOST The monoclonal antibody drug Rutiximab (commercially known as Mabtera) has been shown to reduce mortality by an amazing 40 percent in follicular lymphoma patients; 400 new cases are diagnosed each year. This was proven in research at the Rabin Medical Center-Beilinson Campus that was published recently in the prestigious Journal of the [US] National Cancer Institute. The meta-analysis of a number of previous controlled studies included Mabtera treatment on 985 patients who were followed up for three years. Dr. Liat Vital of the Davidoff Cancer Center on the Petah Tikva campus said most patients with this kind of blood cancer have relapses. If this immunological treatment is given following chemotherapy, she added, survival rates soar. Prof. Ofer Sperling, head of the hematology department there, said such patients should receive Mabtera for two years after a relapse of the lymphoma and that it should become standard treatment for all cases. The Rabin Medical Center research, he continued, will help lengthen the survival of many patients around the world.