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Table of Contents 

Preeclampsia & Hypertension


Birth Day Present


Healthy Living: Stressful Exercise


10-Week Lifestyle Change Program


Red Cross Gala


Office Announcements  


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Robert J. Rubino,

M.D., F.A.C.O.G.
Audrey A. Romero, M.D., F.A.C.O.G.
Lisa Abeshaus,
M.D., F.A.C.O.G.
Jacqueline Saitta, M.D., F.A.C.O.G.

Allan D. Kessel,
M.D ., F.A.C.O.G.
Diana Huang,
M.D., F.A.C.O.G.
Priya R. Patel,
M.D., F.A.C.O.G.,MPH
Meryl Kahan,
M.D., F.A.C.O.G.
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Medical Fact
 "I didn't know that!

In the 1930s, Hans Selye, an endocrinologist, first used the term stress in an organic framework. He used the term in his study with animals which, he concluded, had similar responses to stress as humans, e.g., hypertension, lingering back pain, and chronic abdominal problems.
We hope everyone enjoyed their holidays and are enjoying the buds of Spring plants.

In this issue of our newsletter, we discuss preeclampsia and hypertension in pregnancy. We look at the history of a birth day present and what it all means. In our  Healthy Living section, we feature an article on stress caused by over-exercise as part of Stress Awareness Month.  In addition, we share information on an up-coming 10-Week Lifestyle Change program. We also remind of the upcoming Red Cross "Celebrate Red!" gala. And, you'll find a new interesting "Medical Fact". 

If there is topic you would like covered in our newsletter, please e-mail us at
As always, we will continue to provide topics that are current, informative and important to your good health.  

The Rubino OB/GYN Group
Preeclampsia & Hypertension in Pregnancypreeclampsia
The following article contains content from the ACOG, American College of Obstetricians and Gynecologists

What is hypertension?
High blood pressure also is called  hypertension. Hypertension can lead to health problems. During pregnancy, severe or uncontrolled hypertension can cause complications for you and your baby. Chronic hypertension  is high blood pressure that was present before you became pregnant or that occurs in the first half (before 20 weeks) of your pregnancy.

Gestational hypertension is high blood pressure that first occurs in the second half (after 20 weeks) of pregnancy. Although gestational hypertension usually goes away after childbirth, it may increase the risk of developing hypertension in the future.

What kinds of problems can hypertension cause during pregnancy?
High blood pressure during pregnancy can place extra stress on your heart and kidneys and can increase your risk of heart disease, kidney disease, and stroke. Other possible complications include the following:
  • Fetal growth restriction by decreasing the flow of nutrients to the baby through the placenta.
  • Preeclampsia - This condition is more likely to occur in women with chronic high blood pressure than in women with normal blood pressure.
  • Preterm delivery - If the placenta is not providing enough nutrients and oxygen to your baby, it may be decided that early delivery is better for your baby than allowing the pregnancy to continue.
  • Placental abruption -This condition, in which the placenta prematurely detaches from the wall of the uterus, is a medical emergency that requires immediate treatment.
  • Cesarean delivery -Women with hypertension are more likely to have a cesarean delivery than women with normal blood pressure.

How is chronic hypertension during pregnancy managed?
Your blood pressure will be monitored closely throughout pregnancy. You may need to monitor your blood pressure at home.  Ultrasound exams  may be done throughout pregnancy to track the growth of your baby to determine if you need further testing.

If you have severe hypertension or have health problems related to your hypertension, you may need to start or continue taking blood pressure medication during pregnancy.

A woman has preeclampsia when she has high blood pressure and other signs that her organ systems are not working normally. One of these signs is  proteinuria  (an abnormal amount of protein in the urine). A woman with preeclampsia whose condition is worsening will develop other signs and symptoms known as "severe features." These include a low number of  platelets  in the blood, abnormal kidney or liver function, pain over the upper abdomen, changes in vision, fluid in the lungs, or a severe headache. A very high blood pressure reading also is considered a severe feature.

When does preeclampsia occur?
It usually occurs after 20 weeks of pregnancy, typically in the third trimester. When it occurs before 32 weeks of pregnancy, it is called early-onset preeclampsia. It also can occur in the postpartum period.

What causes preeclampsia?
It is not clear why some women develop preeclampsia, but the risk of developing preeclampsia is increased in women who
  • are pregnant for the first time
  • have had preeclampsia in a previous pregnancy or have a family history of preeclampsia
  • have a history of chronic hypertension, kidney disease, or both
  • are 40 years or older
  • are carrying more than one baby
  • have certain medical conditions such as diabetes mellitus, thrombophilia, or lupus
  • are obese
  • had in vitro fertilization

What are the risks if preeclampsia occurs?
If preeclampsia occurs during pregnancy, your baby may need to be delivered right away, even if he or she is not fully grown. Preterm babies have an increased risk of serious complications. Some preterm complications last a lifetime and require ongoing medical care.

Women who have had preeclampsia-especially those whose babies were born preterm-have an increased risk later in life ofcardiovascular disease  and kidney disease, including heart attack, stroke, and high blood pressure. Having preeclampsia once increases the risk of having it again in a future pregnancy. Preeclampsia also can lead to seizures, a condition calledeclampsia. It also can lead to  HELLP syndrome,   elevated   liver enzymes and   low   platelet count.

What are the signs and symptoms of preeclampsia?
  • Swelling of face or hands
  • A headache that will not go away
  • Seeing spots or changes in eyesight
  • Pain in the upper abdomen or shoulder
  • Nausea and vomiting (in the second half of pregnancy)
  • Sudden weight gain
  • Difficulty breathing

How is mild gestational hypertension or preeclampsia managed?
Management of mild gestational hypertension or preeclampsia without severe features may take place either in a hospital or on an outpatient basis (you can stay at home with close monitoring by your health care provider). You may be asked to keep track of your baby's movements by doing a daily  kick count  and to measure your blood pressure at home. You will need to see your health care provider at least weekly and sometimes twice weekly. Once you reach 37 weeks of pregnancy, it may be recommended that you have your baby.

Preeclampsia with severe features usually is treated in the hospital. If you are at least 34 weeks pregnant, it often is recommended that you have your baby as soon as your condition is stable. If you are less than 34 weeks pregnant and your condition is stable, it may be possible to wait to deliver your baby.  

What steps can I take to help prevent preeclampsia?
If you have hypertension and are planning a pregnancy, see your health care provider for a prepregnancy check-up to find out your blood pressure. If you are overweight, weight loss usually is advised before pregnancy. If you have a medical condition, such as diabetes, it usually is recommended that your condition be well controlled before you become pregnant.

Birth Day Presentpushpresent
A birth day present, or sometimes referred to as a "push" present, is a gift given by the father to a mother upon giving birth to their baby.

There is a long history behind this gift giving - dating back hundreds of years in the United Kingdom and India to kings and queens.

The idea of a gift was to make the mother feel special or "reward" them for their pregnancy and the gift of their child. Men would often buy a small piece of jewelry for the mother to wear as a reminder of the joyous occasion.
Ironically, the birth day present only became more popular in the US recently. Some claim that it was started by jewelers in an effort to sell more merchandise, but much of it seems to stem from viral word of mouth. You don't necessarily have to buy the gifts of the rich and famous - such as Mariah Carey's $12,000 diamond and pink sapphire necklace or Beyoncé's  8-10 carat blue tanzanite ring, estimated at $35,000. Most of the time in the US people give gifts that parents can use for the new baby, both as a practical idea and as a way to celebrate a new human joining the world.
The gesture lets a new mother know she is appreciated and that the father is sympathetic to what they endured during pregnancy and delivery.
I f buying a birth day present, consider something that would be meaningful or that the mother would truly appreciate like a massage, cleaning service, new outfit or meaningful piece of jewelry like a charm bracelet with the baby's name & birth date.
Healthy Living: Stressful Exercisehealthyliving
April is Stress Awareness month. Putting your body under excess stress can be applied in many ways - being overworked, not enough time in the day, household responsibilities and even exercise. If you exercise to the extreme, it could put added stress on your body that could actually have adverse effects.

Cardinal rule of exercise - you have to allow your body to rest and repair. Although this is widely known, many never rest and exercise 7 days a week.

Why Rest Is Important:
  • The body repairs and strengthens itself in-between workouts. Continuous training can actually weaken the strongest athlete.
  • During recovery, the body adapts to the stress of exercise and the real training effect takes place - meaning, this is where you build muscle.
    • Conditioning requires a balance between overload (pushing the muscles) and recovery. Too much overload or too little recovery result in both physical and psychological symptoms.
  • Rest helps maintain a better balance between home, work &  fitness goals.
  • Sleep is key to keeping hormone levels steady which aid in stress and muscle recovery, as well as a stable mood.  Sleep deprivation can also affect aerobic endurance.
  • Too  few rest and recovery days can lead to overtraining syndrome : when you train beyond the body's ability to recover.

Common Warning Signs and Symptoms of Overtraining Syndrome 
  • Washed-out feeling, tired, drained, lack of energy
  • Mild leg soreness, general aches and pains
  • Pain in muscles and joints
  • Sudden drop in performance
  • Insomnia
  • Headaches
  • Decreased immunity (increased number of colds, and sore throats)
  • Decrease in training capacity / intensity
  • Moodiness, irritability or depression
  • Loss of enthusiasm for working out
  • Decreased appetite
  • Increased incidence of injuries
  • A compulsive need to exercise 

Principal of Adaptation & How It Applies To Recovery
When we undergo the stress of physical exercise, our body adapts and becomes more efficient - Principal of Adaptation (also discussed in our  "The Power of Your Heart" blog entry). When you do not properly rest from the stress of physical exercise, your body cannot adapt as easily to the changes.

The body can only tolerate so much stress before it breaks down and risks injury. Doing too much, too quickly will result in muscle damage and have adverse effects (too many days of exercise). Likewise, doing too little, too slowly will not result in improvement (going through the motions).

The other key component of building your fitness level is to vary your workouts between cardio and strength conditioning. All too often, people will focus on one or the other and constantly work the same muscles without rest. Ever try a new class and couldn't move the next morning? Excellent example of muscles you are not training in your normal workout. Varying your workouts allows the muscles you typically use to rest and helps your body adapt to change (improve your fitness level).

It's better to maximize your time at the gym and work hard the days you go, then going through the motions every day and not improving your fitness level. Workout, repair and workout again.

Excerpt from Heels To Laces fitness & nutrition blog.
10-Week Lifestyle Change Programlifestyle
Effortlessly lose the weight & reduce stress.
Introducing a 10-week course focusing on the latest in lifestyle medicine, nutritional science and mindful stress reduction techniques.
This course will empower you to nourish your body and your mind to reach weight and wellness goals.
You will learn:
  • Why the standard american diet is so toxic and so addicting.
  • How to reduce cravings just by adding more fruits, greens, veggies, beans, nuts and seeds.
  • How to biochemically change your body so the weight naturally falls off.
  • Tools to truly nourish yourself while tapping into your body's self healing mechanisms.
  • How to enrich your soul and mind with evidence based techniques deeply rooted in the ancient wisdom of hatha yoga.
Course includes the latest in plant-based eating and nutritional science, menu planning, demos, tastings and mindful stress reduction techniques including breath work, meditation and deep relaxation. You will leave each session relaxed, refreshed and equipped to make the right lifestyle choices.

You will receive a customized plan and complete support to achieve your goals.

Lifestyle change begins with desire. It's fueled by knowledge and ignited with inspiration.  It grows with support. And ends with empowerment.

This program is monitored by Dr. Susan Rubino and facilitated by Sally Younghans, certified wellness coach.

Tuesday's 7:30- 9pm
April 19th-June 21st 
1.5 hour sessions once/week for 10 weeks.
For more information and to register,  click here.
Celebrate Red!RedCross
On Thursday, May 12, 2016, The Red Cross is hosting its annual gala at Mayfair Farms in West Orange, New Jersey for Celebrate Red! The will honor New Jersey heroes who are strengthening the foundation and supporting the growth of Red Cross services in our communities.

Enjoy an evening with friends and colleagues over delicious cocktails and cuisine, live music and dancing, and a fabulous auction - all in the warm, historic setting of Mayfair Farms. For information click here.

Pay Your Bill Onlinepayonlinebills

You can pay your Rubino OB/GYN Group bills online right from the checkbook-pen.jpghomepage of our website. Simply click on the button at the top of the page that says "New! Pay Your Bill Online!".

Options include paying by credit card or  echeck. It is an easy one-time registration to create a password.


For easy reference, the direct link is: Pay My Bill

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The Rubino OB/GYN Group offers vitaMedMD™ in all 4 office locations. VitaMedMD offers patients high quality physician recommended products at an affordable price. Available products include Prenatal One, Menopause Relief and Iron 150.

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