::mystero net::

اذاعه شبكه ومنتديات المايسترو- بث مباشر-متاح للجميع

noreply@blogger.com (mystero) — Sun, 28 Dec 2008 22:00:00 +0000

بث مباشر وحى لاذاعه المايسترو

mystero fm

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Who Else Wants To Make Money With Adsense?

noreply@blogger.com (mystero) — Wed, 03 Dec 2008 19:55:00 +0000

Fact number 1: Kids in high school are making thousands of dollars every month with Adsense.
Fact number 2: Housewives, retirees, mom and dads, who are just staying at home and have never made a dime on the internet have created full-time incomes by simply placing Adsense ads on their web site or blog.

These are just some of the â€œsuper Adsense earnersâ€. You may have already heard about their story for they are among the few who are on their way to making millions worth of cash just by promoting Adsense sites.

Anyone, any age and gender can become money generating Adsense publishers as long as they what it takes. How does one go about this Internet advertising?

Writing articles for Adsense is the way to do it. Using the right keywords in your articles and having Google ads on a certain site has become the most profitable way of marketing that anybody can get into. No experience and level of education needed. If you are not using this strategy, or may not be aware of it in the first place, chances are you may be losing thousands of dollars worth of extra income and still do not know it yet.

This is one of the many reasons why writing original quality content articles is now the latest in marketing buzz. Content and links. When combined together becomes a really powerful tool to a successful web site and richer individuals. Many internet marketing professionals are already aware of the value of an original quality content and how using keywords can drive targeted traffic into their sites from the search engines.

So why donâ€™t all these web site owners write and submit their own articles if that is what is important?

The simple and understandable answer is that it takes time to write articles, submit them and get targeted traffic to their websites. That is why they get the services of those who can spares sometime to write the articles that would cater to their site purpose but still turn out as a good quality and unique piece of work.

To get into the Adsense marketing business and start earning some good cash, ask yourself. Did you enjoy writing when you were in school? If you answer yes to this question, you already have an initial advantage over most internet marketing business owners that wants to make money online and doing it at home.

With the boom in the Adsense market comes the need for sites to want fresh, quality and original keyword rich content. This way, web site owners can have a steady supply of articles with the proper keywords that they relate to their site contents. The result of this is seen in the sites page rank when indexed by the search engines. Which, in turn, gets moreAdsense ads to show above, below or next to the article on their website with targeted traffic.

What do people have to do?

Write quality and original content, keyword or phrase rich articles with links to your website in the resource box. Then build a website or web page with targeted keyword or phrase rich original content for the targeted traffic that originates from the articles you wrote. Finally, you will have a Google Adsense ads that are targeted to your keyword or phrase rich original content site where visitors will get to visit when they come looking for information.

A win-win situation if you think more about it. A favor for persons looking for quality content and information. For the persons writing the original content articles. And the person with the quality original content rich website. Of course, the search engines and its advertisers are getting targeted traffic and sales but so what? As long as you are getting something in your favor, it does not really matter what the others are getting for themselves.

So who else wants to start earning money with Adsense. You. Everyone. Anybody. Internet marketing has many opportunities wide open for this people. Writing articles and using Adsense for your kind of internet marketing strategy is one sure way of getting a piece of that action and cash.

Better not be left behind the many making millions already.

John Ugoshowa. You are welcome to use this article on your website or
in your ezines
as long as you have a link back to href="http://www.quickregister.net/partners/">http://www.quickregister.net/partners/
For more information on Google Adsense see the Internet section of Quickregister.net Free Search Engine Submission Service
at: href="http://www.quickregister.net/partners/">http://www.quickregister.net/partners/

Quantum of Solace is Huge; Secret Beatles Track

noreply@blogger.com (mystero) — Mon, 17 Nov 2008 20:50:00 +0000

The new James Bond movie, Quantum of Solace, brought in $70.4 million on its opening weekend, shattering "the previous best opening in the Bond franchise Die Another Day, which bowed in 2002 with $47.1 million," and almost doubling Casino Royale's opening, reports The Weekend Gross. So how's the movie? Brent's Blog writes that "Daniel Craig earned his pay, doing many of his own stunts, which frankly made my palms sweat" and would like to see Alicia Keys as the next Bond girl. Blog Critics says the film is "Better than it appears at first glance, and well worth the price of admission, this is action-packed and thrill-soaked. Oh yes, don't forget to spy the homage to Goldfinger." To haters, Coosa Creek Cinema says, "Lighten up! It's only a Bond film! What do you want? Tarkovsky?" But Cinema Verdict says Quantum of Solace isn't like other Bond films, it's a sequel and requires a thorough knowledge of everything that happened in Casino Royale."

Popnography, however, thinks "they bring you up to speed quickly on the vengeance plotline" and, more importantly, "Craig takes his shirt off twice and the man wears the hell out of some khaki pants, better than any Banana Republic model. I know some fans don't like their Bond so fashionably accessible, but I liked going out the next day and buying myself a pair of pants that successfully frame my package as well as his did." Risky Biz Blog says it's a good folm, it's just not a true Bond film. .

Elsewhere in entertainment, Paul McCartney is hoping to release a previously unheard Beatles song, "'Carnival of Light,' a 14-minute experimental track the band recorded in 1967 for an electronic music festival but never released," writes Rock On The Streets. Minor Matters says the song was "thought to be too adventurous when it was first performed." How should the song be released? Well, Shark Guys says there will be "legal challenges a la passage of the US bailout bill: approval from the widows Lennon, Harrison as well as Ringo Starr, even if his artistic contribution to the Beatles is comparable to those transients Picasso painted during his 'Blue Period'." But once that's done, Electric Roulette says the format of the release is simple: "Give it away as a free download and press it onto a 12 inch. Easy. Don't muck about trying to turn it into something more. The Beatle estate has got more than enough money. Let us have somethin' fer nuthin' fer once."

My favorite muscle

noreply@blogger.com (mystero) — Sun, 16 Nov 2008 22:10:00 +0000

Each day I receive a "Word a Day" e-mail from the Wordsmith. Last week I was delighted to get a message related to my favorite muscle. Here is an excerpt from the e-mail:
sartorial (sar-TOR-ee-uhl) adjectiveRelated to a tailor or tailored clothes.[From Late Latin sartor, tailor.]Today's word has a cousin, sartorius, a long narrow muscle in the leg, the longest muscle in humans. What would tailored clothes have in common with a muscle of the leg? Sartorius is so named since it is concerned with producing the cross-legged position of tailors at work.If you have the opportunity to dissect a cadaver, you can't miss the sartorius. The longest muscle in the human body, the slender sartorius wraps like a python across the thigh and knee, attached at one end to a large protuberance on the hip bone (the anterior superior iliac spine, or ASIS for short) and to the tibia just below the knee at the other end.In spite of its impressive appearance, the sartorius hasn't become a household term like the more familiar "quads," "hamstrings," "biceps," and "lats." Perhaps this is because the muscle normally is buried under a layer of fatty connective tissue, and rarely stands out like the massive quadriceps next to it. Here is an extraordinary exception:

See the long skinny muscle just below the contest number on his left hip? That's the sartorius. While other people are admiring Aaron Maddron's biceps or lats, I'm thinking, "Now that's a nice sartorius!"To be honest, I had no idea that tailors assumed a characteristic position with their legs until I learned about the sartorius. Tailors don't have a monopoly on this position. Anytime you sit cross-legged with your left outer ankle resting on your right knee (or vice versa), you're doing it too.From an anatomical perspective, describing the actions required to cross your legs is more complicated than you might guess, so bear with me. Imagine yourself standing, face and palms facing forward, feet together, elbows and knees straight. Anatomists call this the "anatomical position." Now (1) bend your left knee; (2) lift your left knee so that your thigh makes a right angle with your trunk; (3) move that knee outward; then (4) rotate the left thigh so that your foot swings towards your right knee. Each of those actions - knee flexion, hip flexion, hip abduction, and hip external rotation - happens when you activate the sartorius on the left side. Now all you have to do is flex your right knee and hip, find a chair to sit on before you lose your balance, make sure your left leg is resting on the right knee, and you've assumed the tailor's position.So, could you cross your legs without a sartorius? Yes, because every action assigned to the sartorius is also performed by other muscles. And it's relatively weak. Given its small diameter, the sartorius doesn't generate much force compared to its neighbors in the thigh. Perhaps its most important function is protection. In the anatomy lab, pulling the sartorius to one side reveals two major blood vessels on their way to and from the calf - the femoral artery and femoral vein. Covering those vessels with a muscle presumably offers better protection than mere skin, fat, and connective tissue.

noreply@blogger.com (mystero) — Sun, 16 Nov 2008 22:07:00 +0000

Cy, short for Cyclopes, a kitten born with only one eye and no nose, is shown in this photo provided by its owner in Redmond, Oregon, on Wednesday, Dec. 28, 2005. The kitten, a ragdoll breed, which died after living for one day, was one of two in the litter. Its sibling was born normal and healthy. (AP Photo/Traci Allen)
OK, so this entry isn't about human anatomy, but the condition called cyclopia can occur in humans, too. Cyclopia is a variety of holoprosencephaly, a congenital malformation of the forebrain and parts of the skull and face. Fortunately (for them), babies with cyclopia don't survive for long. IMO the most astonishing congenital anomaly is cephalopagus (or janiceps) conjoined twins, in which the twins have a single skull with two faces looking in opposite directions (like the Roman God Janus). Although the faces may look normal, each face is actually composed of two fused half-faces, one from each twin! A few years ago I stumbled across a janiceps specimen in an old embryology collection in our anatomy department. Given that the incidence is something like 1 in 3,000,000 births (according to a recent case report), these specimens must be extraordinarily rare. I plan to photograph it before I leave this summer (update: here are the photographs).Here's an article written by the AP in response to the initial skepticism about the one-eyed kitty photo: One-Eyed Cat Had Medical Condition. I'm not sure how long the article is going to remain online so I'll keep a copy in my (offline) archives.

Muscles to smile, muscles to frown

noreply@blogger.com (mystero) — Sun, 16 Nov 2008 22:05:00 +0000

A long time ago I heard the adage that it takes something like 43 muscles to frown but only 17 muscles to smile, ergo, we should just smile because it's easier. It wasn't until my first anatomy class in college that I realized these numbers couldn't possibly be right. As far as I can tell, there are only about 36 named muscles of facial expression, and they're not all involved in smiling and frowning. Here they are in alphabetical order (a "2" in parentheses means the muscle is bilateral, "1" means it's unpaired):Auricularis anterior (2)Auricularis posterior (2)Auricularis superior (2)Buccinator (2)Corrugator supercilii (2)Depressor anguli oris (2)Depressor labii inferioris (2)Depressor septi nasi (1)Frontalis (1)Levator anguli oris (2)Levator labii superioris (2)Levator labii superioris alaeque nasi (2)Mentalis (1)Nasalis (2)Orbicularis oculi (2)Orbicularis oris (1)Platysma (1)Procerus (1)Risorius (2)Zygomaticus major (2)Zygomaticus minor (2)So which ones are responsible for smiling and/or frowning? I could hazard a guess, but I'll defer to Dr. David Song, a plastic surgeon and Associate Professor at the University of Chicago Hospitals, who was interviewed for a Straight Dope article: Does it take fewer muscles to smile than it does to frown? Counting only the muscles that make significant contributions, he concludes that smiling takes one more muscle than frowning (12 vs. 11). That doesn't necessarily mean that smiling is harder to do. Maybe it is, maybe it isn't. I suppose you could compare the masses of "smiling muscles" vs. "frowning muscles" to get a rough estimate of energy consumption (assuming the muscles all consume energy at the same rate per unit mass). In the meantime, check out Happiness Is Only Grin Deep at the always enlightening and entertaining Urban Legend Reference Pages.

Referred pain

noreply@blogger.com (mystero) — Sun, 16 Nov 2008 21:58:00 +0000

If you woke up with a pain in your shoulder, you'd probably think something was wrong with your shoulder, right? Maybe you slept on it the wrong way, maybe you're a weekend warrior who threw the football a few too many times. In most cases, your hunch is probably right. Pain in the shoulder usually indicates an injury or disease that affects a structure in your shoulder, such as, say, your subacromial bursa or a rotator cuff tendon. Makes sense, doesn't it?But you might be way off. Sometimes the brain gets confused, making you think that one part of the body hurts, when in fact another part of the body, far removed from the pain, is the real source of trouble. This curious (and clinically important) phenomenon is known as referred pain. For example, it's unlikely but possible that your shoulder pain is a sign of something insidious happening in your liver, gall bladder, stomach, spleen, lungs, or pericardial sac (the connective tissue bag containing the heart). Yup - conditions as diverse as liver abscesses, gallstones, gastric ulcers, splenic rupture, pneumonia, and pericarditis can all cause shoulder pain. What's up with that?Neuroscientists still don't know precisely which anatomical connections are responsible for referred pain, but the prevailing explanation seems to work pretty well. In a nutshell, referred pain happens when nerve fibers from regions of high sensory input (such as the skin) and nerve fibers from regions of normally low sensory input (such as the internal organs) happen to converge on the same levels of the spinal cord. The best known example is pain experienced during a heart attack. Nerves from damaged heart tissue convey pain signals to spinal cord levels T1-T4 on the left side, which happen to be the same levels that receive sensation from the left side of the chest and part of the left arm. The brain isn't used to receiving such strong signals from the heart, so it interprets them as pain in the chest and left arm.So what about that shoulder pain? All of organs listed above bump up against the diaphragm, the thin, dome-shaped muscle that moves up and down with every breath. The diaphragm is innervated by two phrenic nerves (left and right), which emerge from spinal cord levels C3, C4, and C5 (medical students remember these spinal cord levels using the mnemonic, "C3, 4, 5 keeps the diaphragm alive"). The phrenic nerves carry both motor and sensory impulses, so they make the diaphragm move and they convey sensation from the diaphragm to the central nervous system.Most of the time there isn't any sensation to convey from the diaphragm, at least at the conscious level. But if a nearby organ gets sick, it may irritate the diaphragm, and the sensory fibers of one of the phrenic nerves are flooded with pain signals that travel to the spinal cord (at C3-C5). It turns out that C3 and C4 don't just keep the diaphragm alive; neurons at these two spinal cord levels also receive sensation from the shoulders (via the supraclavicular nerves). So when pain neurons at C3 and C4 sound the alarm, the brain assumes (quite reasonably) that the shoulder is to blame. Usually that's a good assumption, but sometimes it's wrong.

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Illustration showing sites of referred pain from abdominal organs. From Moore and Dalley's Clinically Oriented Anatomy. Please note that I added the "tighty whities" with Photoshop (hey, this is a family friendly site).

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Another example that seems bizarre until you know the anatomy is disease in the stomach causing pain between the shoulder blades. Recently a classmate told me that one of her former professors complained to his doctor about pain in his upper back that wouldn't go away. It turns out that the professor had gastric cancer, a relatively aggressive and often incurable disease unless it's caught early. Unfortunately it wasn't caught early enough and it ended up taking his life. Maybe the outcome would have been different if the doctor had remembered that some of the nerve fibers to the stomach (specifically, visceral afferents that travel in the greater splanchnic nerve) convey pain signals to the same spinal cord levels (especially T5 and T6) that receive pain signals from the skin between the shoulder blades. This variety of referred pain is rare, but it happens often enough to be mentioned in anatomy textbooks.Not all cases of referred pain are that easy to explain. Take the appendix, for instance. That wormy little appendage of the colon is located in the right lower quadrant of the abdomen, nowhere near the diaphragm. Typically people with appendicitis feel diffuse pain or discomfort around the umbilicus (belly button), or sharp pain in the right lower quadrant if the appendix is geting ready to burst. But occasionally the pain refers to the right shoulder. Why? I have no idea. I can't come up with a plausible anatomical explanation. It happened to one of my classmates when he was a kid, so I'm confident that web sites like this one aren't just making up stuff!

High Risk Pregnancy

noreply@blogger.com (mystero) — Sun, 16 Nov 2008 21:46:00 +0000

Introduction
Pregnancy is a state of dynamic, physiologic adaptations. While pregnancy is a normal, natural, and healthy process, in some women pre-existing medical problems or findings during the pregnancy can change the risks to the mother and to the fetus, and in the way that the pregnancy progresses. This description of high risk pregnancy describes some of the pre-existing medical conditions and diagnoses during pregnancy that affect the way that a pregnancy is managed. Exercise, nutrition, and healthy habits are just as important in a high risk pregnancy as they are in a normal pregnancy. Women with high risk pregnancies are able to enjoy their pregnancies, and plan for their babies just like women with normal pregnancies.
Common tools used for managing a high risk pregnancy Women with high risk pregnancies may be referred for consultation with a maternal-fetal medicine specialist, (perinatologist.) A perinatologist is an obstetrician who has had advanced training in how to care for women with complications during pregnancy. Sometimes the perinatologist will be the primary obstetric provider, and at other times, may co-manage the pregnancy with the primary obstetric provider. If there is a co-management plan, communication between the two providers will usually be by phone calls and letters. As the pregnancy advances, a recommendation will be made as to whether you should delivery your baby in your community hospital, or deliver the baby at a referral hospital. There are three levels of baby nurseries, and if your baby will be sick at birth or premature, you should consider delivering at a hospital with a Level 3 Intensive Care Unit. A Level 2 Intensive Care Unit takes care of preterm babies, about 32 weeks or older, and a Level 1 Baby Nursery takes care of full term babies who are not significantly ill. If you happen to deliver at a Level 1 hospital, and your baby is sick, the baby may need to be transported to a higher level of care at another hospital. If this is the case, you should check to see if you can also be transferred to that hospital if you still need to be hospitalized, so you can be near your baby. If you have a pre-existing medical condition, your doctor will develop a plan for the management of your pregnancy that takes two key questions into account:
How will the medical condition affect the pregnancy?
How will the pregnancy affect the medical condition? If you have a complication that arises during pregnancy, your doctor will determine how this development will change the way that the rest of your pregnancy will be managed. In some cases, your doctor may recommend more intensive monitoring for you or your fetus in order to assess well-being. Monitoring may include blood pressure checks, laboratory tests, or physical exams. Commonly used techniques for monitoring the fetus include ultrasound pictures of the fetus, monitoring of the fetus’s heart rate, and occasionally, magnetic resonance imaging or MRI pictures of the fetus. Ultrasound of the fetus Sometimes, intervention or treatment may be needed during the pregnancy. This may consist of medications for the mother, testing such as amniocentesis to determine if a fetus has a genetic condition, or even sampling of the blood in the umbilical cord to determine the baby’s blood count. If there is a concern that the baby may need to be delivered early, a steroid called betamethasone (two injections 24 hours apart) or dexamethasone (pills or injections) may be given to you to help decrease the likelihood of complications to the baby. If you need to take medications, a useful phone number to have to check out the safety of the medication during pregnancy and breastfeeding is: 1-800-532-3749 ( University of California at San Diego). The goal of your obstetric practitioner’s care is to safeguard the well-being of you and your baby so that you can have the safest and most uncomplicated pregnancy, labor and delivery, and postpartum course.
Medical complications in pregnancy
Obesity Obesity is a significant problem in the United States. The Centers for Disease Control estimate that over 50% of American women of reproductive age are overweight (Body Mass Index of 25-29.9), and 30% are obese (Body Mass Index over 30). (Click here to calculate your BMI: http://www.nhlbisupport.com/bmi/) During pregnancy, the recommended weight gain for women who are overweight is 15-25 pounds, and for obese women, it is less than 15 pounds. A nutritionist is often available through the obstetric practice to talk with pregnant women about how to best approach these weight targets. Early in pregnancy, obesity[PR1] increases the risk of miscarriage and birth defects. Later in pregnancy, obesity increases the risk of high blood pressure in pregnancy (preeclampsia), elevated blood sugars in pregnancy (gestational diabetes), preterm delivery, and stillbirth. For the fetus, there is an increased risk of growing too big, which can lead to increased complications at the time of birth, after birth, and later in the child’s life. At the time of delivery, there is an increased risk of cesarean delivery and complications resulting from surgery. [PR2] A healthy diet, exercise, and appropriate weight gain during pregnancy are the best approach to decrease the likelihood of pregnancy complications due to obesity. Pregnancy is a great time to make lifestyle changes and adopt healthy habits that will benefit you and your baby during and after the pregnancy. Breastfeeding is recommended, both for the benefits to the baby and to the mother. For more information on nutrition during pregnancy: American College of Obstetrics and Gynecology http://www.acog.org/publications/patient_education/bp001.cfmUSDA Food pyramid for pregnancy and breastfeeding: http://mypyramid.gov/mypyramidmoms/index.html
High blood pressure in pregnancy Hypertension is the most common medical disorder during pregnancy. Most women diagnosed with high blood pressure in pregnancy have high blood pressure only during pregnancy.
Chronic hypertension Women diagnosed with high blood pressure (> or equal to140/90 mm Hg) prior to pregnancy are at increased risk for developing high blood pressure and protein in their urine during pregnancy (preeclampsia), as well as early separation of the placenta from the uterus (abruption), early delivery, and a small baby (intra-uterine growth restriction). In addition, having high blood pressure increases health risks to the mother, just as they do for people who are not pregnant. There are a number of medications that can be used to control blood pressure safely during pregnancy. However, some of the medications commonly used outside of pregnancy are not recommended for women who are trying to conceive or during pregnancy, so women with high blood pressure should talk to their doctors if they are planning to have a baby. The category of medications to avoid is “ACE inhibitors.” Other medications, such as hydrocholothiazide, methyldopa, beta-blockers, and calcium channel blockers are commonly used during pregnancy. In addition, long term high blood pressure can lead to damage to a woman’s eyes, heart, and kidneys, so the doctor may want to evaluate these organs before a woman is pregnant or at the first prenatal visit. Pregnancy puts increased demands on the body, and in some women with severe hypertension, the risk of complications to the mother and the fetus can be high. Being seen early and frequently will help your obstetric practitioner have the information needed to make your pregnancy as safe as possible. Diet and exercise are an important part of the management of high blood pressure. Laboratory tests and frequent blood pressure checks will be used to see how the mother is doing; ultrasound or fetal testing may be used to monitor how the fetus is growing and assuring that the placenta is working well. If there are no complications to the pregnancy, women with chronic hypertension usually have their labors induced at 39 or 40 weeks (40 weeks represents your due date). If medications are needed to control the blood pressures after delivery, there are medications that are safe for breastfeeding. Just as with other healthy women, breastfeeding is recommended for women with chronic hypertension.
Gestational Hypertension and Preeclampsia Gestational hypertension refers to an elevation in blood pressure of 140/90 mm Hg or greater, after 20 weeks gestation. It is more common in women having their first baby, women who have had high blood pressure in pregnancy before, and women carrying twins or triplets. About 30% of women who develop high blood pressure in pregnancy will also have protein in the urine; this combination hypertension and protein in the urine is called preeclampsia. The reason that preeclampsia develops is not known. If preeclampsia develops, additional complications can occur such as seizures, and kidney or liver complications. Most of the time, high blood pressure in pregnancy develops after 37 weeks. If the blood pressures are very high (>160/110 mm Hg), the risk of complications increases. For women who develop gestational hypertension or preeclampsia early in their pregnancies, the risk of having a small baby or the placenta separating too early (abruption) is increased. These pregnancies require more intensive monitoring of the mother and the fetus; in some cases, this requires that the mother be hospitalized. Preeclampsia is cured by the delivery of the baby and the placenta. Since there are risks for the mother associated with preeclampsia including seizure, stroke, liver damage, and kidney damage, it is always safer for the mother for the baby to be delivered. However, if preeclampsia is diagnosed early in the pregnancy, the risk to the baby of being born early must be balanced against the risk to the mother of continuing the pregnancy. If the pregnancy is continued after preeclampsia has been diagnosed, the mother and fetus are monitored closely with laboratory tests, ultrasound, and fetal heart rate testing and hospitalization may be indicated. If symptoms or effects on the mother’s organs develop (pain in the right side of the abdomen, changes in vision, severe headache, seizure), then delivery of the baby is the best plan for both mother and baby. One of the risks of preeclampsia is a seizure (eclampsia). A seizure may be the first symptom a woman has of preeclampsia. Magnesium sulfate, a medication given intravenously, decreases the likelihood of seizures. Depending on the severity of the preeclampsia or hypertension, women may be given this medication during labor and for the first day after delivery to decrease the likelihood of a seizure. Most women who develop high blood pressure during pregnancy will have normal blood pressure after delivery. Sometimes, women will require medications to lower the blood pressure for a short time after delivery. Women with a history of preeclampsia have an increased risk of developing high blood pressure associated with pregnancy in their next pregnancy. Just as with other healthy women, breastfeeding is recommended for women with hypertension. For more information on High Blood Pressure and Pregnancy: American College of Obstetricians and Gynecologists http://www.acog.org/publications/patient_education/bp034.cfm American Heart Association http://www.americanheart.org/presenter.jhtml?identifier=3028465 March of Dimes- Hypertension http://www.marchofdimes.com/pnhec/188_1054.asp Up-To-Date Patient Information http://patients.uptodate.com/topic.asp?file=pregnan/4563 National Institute of Child health and Human Development http://www.nichd.nih.gov/health/topics/Preeclampsia_and_Eclampsia.cfm For more information on medications for high blood pressure in pregnancy: American Heart Association http://www.americanheart.org/presenter.jhtml?identifier=3028464
Diabetes Diabetes is a disease in which the body is not able to control the level of glucose (sugar) in the blood, leading to elevated blood sugar levels. Since glucose crosses the placenta and the fetus receives its nutrients from the mother, if the blood sugar of the mother is high, the fetus will receive extra sugar as well. Depending on whether blood sugar is high prior to pregnancy (pre-existing diabetes) or is diagnosed during pregnancy (gestational diabetes), it has different effects on how the fetus forms and grows. Women with gestational diabetes or pre-existing diabetes have increased risks of high blood pressure associated with pregnancy (preeclampsia), early delivery, and cesarean delivery.
Pre-Existing Diabetes Women who have diabetes before they are pregnant should see their doctor before they decide to conceive. Long term diabetes can damage women’s eyes, kidneys, heart, and blood vessels. Pregnancy can put increased stress on these organs, and depending on how severe the diabetes is, doctors may have recommendations for when a pregnancy would be safest. For all women with diabetes, getting the blood sugar as close to the normal range as possible before getting pregnant is very important. If the blood sugar is high at the time that the fetus is forming (weeks 5-8), this can lead to a higher risk of miscarriage and birth defects. Women who have well-controlled blood sugars before conception can decrease their likelihood of birth defects and miscarriage. One way of checking for overall glucose control is a blood test called a Hemoglobin A1C. This test gives an estimate of the average blood glucose level after the past several months. As pregnancy progresses, there is a risk that the fetus may grow to be bigger than expected, or smaller than expected, depending on the effect of elevated blood sugars on the fetus and the placenta. In addition, the placenta may begin to work less effectively due to the effects of elevated blood sugars. There is also an increased risk of stillbirth. Women with pre-existing diabetes may have extra ultrasounds and monitoring of the baby’s fluid and heartbeat to make sure the baby is growing as expected and the placenta is working well.
Gestational Diabetes Gestational diabetes refers to elevated blood sugars diagnosed for the first time during pregnancy. The placenta produces hormones that make the body resistant to the action of insulin, the hormone responsible for lowering blood sugar. This effect is seen most in the third trimester, so for most women, a screening test is performed for gestational diabetes in the beginning of the third trimester. If the screening test is elevated, usually a three hour glucose tolerance test is done after a fasting blood sugar is drawn. If two out of the four values are elevated, gestational diabetes is diagnosed, and the woman is referred to a specialist in diabetes. Elevated blood sugars in the third trimester can cause the baby to grow larger, which can lead to complications at the time of delivery.
Blood Sugar Control For all women with diabetes, keeping the blood sugars in a normal range decreases the likelihood of problems during the pregnancy. Management of diabetes in pregnancy involves controlling the blood sugar with a combination of diet, exercise, and treatment with insulin or pills, if needed. Blood sugars will need to be checked frequently for monitoring. Women with diabetes before pregnancy will likely be on medication from the start of pregnancy. Because of the action of the hormones of the placenta, the amount of insulin that is needed usually increases as the pregnancy progresses. For women with gestational diabetes, insulin is used when blood sugars cannot be controlled with diet and exercise alone.
Effects on the baby After birth, babies born to mothers with gestational or pre-existing diabetes need to be monitored for low sugars and other changes brought about by exposure to elevated blood sugars and elevated insulin levels during pregnancy. Sometimes, these complications mean that the baby has to stay in the hospital for a longer time after delivery. Babies born to women with high blood sugars during pregnancy are at increased risk for becoming overweight or developing diabetes when they get older. Breastfeeding is good for moms with diabetes and for babies born to moms with diabetes.
Postpartum For women with pre-existing diabetes, insulin requirements will decrease quickly after delivery. Women with gestational diabetes usually do not need insulin after delivery, but they do need to have their sugar checked at about 6 weeks postpartum to be sure that the glucose levels are normal after pregnancy. Women who have had gestational diabetes are at higher risk of developing gestational diabetes in a later pregnancy or diabetes later in life; weight loss and exercise can help to decrease the risk of diabetes. For more information on Diabetes and Pregnancy: Centers for Disease Control http://www.cdc.gov/ncbddd/bd/diabetespregnancy.htm March of Dimes http://www.marchofdimes.com/pnhec/188_1025.asp For more information on pregnancy in women with pre-existing diabetes: Up-To-Date Patient Resources http://patients.uptodate.com/topic.asp?file=pregnan/5061 For more information on Gestational Diabetes: American Diabetes Association http://diabetes.org/gestational-diabetes.jsp National Institute of Child health and Human Development http://www.nichd.nih.gov/health/topics/Gestational_Diabetes.cfm For more information of postpartum ways to decrease the risk of diabetes later in life National Diabetes Education Program http://www.ndep.nih.gov/campaigns/SmallSteps/SmallSteps_nevertooearly.htm
Thyroid disease The thyroid gland makes and stores hormones that help regulate body temperature, heart rate, blood pressure, and metabolism. Pregnancy causes short term changes in thyroid hormones. The mother also provides the thyroid hormone necessary for the developing fetus until 12 weeks, when the fetal thyroid begins to work.
Hypothyroidism Symptoms of low thyroid, or hypothyroidism, include fatigue, muscle cramps, constipation, and cold intolerance. Women who have a low thyroid hormone level that is not corrected are at increased risk for miscarriage, high blood pressure brought on by pregnancy (preeclampsia), and early separation of the placenta (abruption). However, treatment of low thyroid hormones decreases the likelihood of these problems. Low thyroid hormone is treated with thyroid replacement taken as a pill. The doctor will monitor the levels of the hormone TSH (Thyroid Stimulating Hormone) in order to make sure the right dose of thyroid medication is being given. Because of the changes in the thyroid during pregnancy, the amount of thyroid medication that a woman needs may increase during her pregnancy. The amount of replacement usually returns to normal after delivery.
Hyperthyroidism Symptoms of increased thyroid hormones, or hyperthyroidism, include nervousness, excessive sweating, weight loss, or tremor. The most common cause of hyperthyroidism is Graves Disease, in which an antibody stimulates the thyroid. Women with Graves’ disease have an increased risk of having a small baby, delivering early, and having high blood pressure associated with pregnancy (preeclampsia). Treatment of increased thyroid hormone levels decreases the likelihood of these problems. Increased thyroid hormone levels are usually treated with a medication called propylthiouracil (PTU). Hormone levels are monitored until they reach a normal level. In women with Graves’ Disease, the antibody is present in the blood even when the thyroid level is normal. These antibodies can cross the placenta and may lead to short- term thyroid problems in the baby after it is born.
Postpartum For women with low thyroid hormone levels, the dose of replacement usually returns to the level of thyroid hormone used before the pregnancy started. Levothyroxine, the most commonly used thyroid replacement medication, is found in breast milk, but the levels are so low, it will not affect the baby. People with hyperthyroidism who are not pregnant are usually offered more permanent treatment options after the pregnancy. Just as with other healthy women, breastfeeding is recommended in women with thyroid disease. About 10% of women will develop transient thyroid problems after pregnancy; this is called postpartum thyroiditis. Women with postpartum thyroiditis usually have a period where the thyroid hormone is high, followed by a period when the thyroid hormone is low. They may require thyroid replacement for 6 to 12 months. About a third of women with postpartum thyroiditis continue to need thyroid replacement after 12 months. For more information on thyroid disease in pregnancy: March of Dimes http://www.marchofdimes.com/pnhec/188_8923.aspAmerican Thyroid Association http://www.thyroid.org/patients/patient_brochures/pregnancy.htmlEndocrine Society/Hormone Foundation- Hyperthyroid http://www.hormone.org/pdf/hyperthyroid_women.pdfEndocrine Society/Hormone Foundation- Hypothyroid http://www.hormone.org/pdf/hypothyroid_women.pdf
Respiratory Disease Asthma is a chronic irritation or inflammation of the airways in the lungs that leads to narrowing of the airways. Because of the hormonal effects of pregnancy and the effect of the growing uterus, many women may report feeling short of breath at rest or with exercise during pregnancy. Asthma refers to more persistent symptoms of chest tightness, cough, and shortness of breath. Women with asthma have an increased likelihood of needing to be in the hospital during the pregnancy as well as postpartum, and may also have an increased likelihood of developing an increase in blood pressure during pregnancy (preeclampsia), having a small baby, and delivering early. Specific therapy targeted for asthma decreases the likelihood of these complications. Medications used to treat asthma in pregnancy commonly include beta- agonists like albuterol, and inhaled steroids, which are safe in pregnancy. In more severe cases, steroids by mouth or other medications may be added. The severity of the asthma can be measured by pulmonary function tests, which are done by the doctor, or by peak flow meter readings, which are done by the patient. In addition to medical treatment, avoiding asthma triggers like dust and irritants is helpful. Only small amounts of the medications used to treat asthma are excreted in the breast milk. The only exception is theophylline, which can cause neonatal effects. Just as with other healthy women, breastfeeding is recommended. For more information on Asthma and Pregnancy: Up-To-Date Patient Information http://patients.uptodate.com/topic.asp?file=pregnan/2993
Depression and Other Mood Disorders Many women have experienced depression or other psychiatric disorders either before, during, or after their pregnancies. Pregnancy can worsen mood disorders and for many women the supposed “glow” of pregnancy will not counter-balance their emotional pain. The most common pregnancy mood disorders - depression and anxiety - are usually treated with medication and/or therapy. Planning a pregnancy should involve evaluation of mood concerns, medication history, and a decision regarding continuing medication that has been treating a psychiatric condition. The most commonly prescribed anti-depression medications (SSRIs) can be associated with a slightly increased risk of birth defects. However, the overwhelming majority of women on these medications have healthy babies. Deciding to go off of medication during the conception period, as well as the first trimester, can be made in order to decrease the risk of negative fetal exposure. Women who decide to do this can also choose to resume the medication in the second trimester. Since conception may take up to a year, it is also an option for women to go off their medication with the first positive pregnancy test. Since 60% of women who discontinue their depression medication are likely to relapse, it is wise to have a therapist involved during this process and to strongly consider stabilizing moods by resuming medication. In fact, many women choose to continue their medication throughout the pregnancy since many experts in this field believe that untreated anxiety and depression can negatively affect a developing fetus. Postpartum exacerbation of depression is very common - research estimates this likelihood at 10%. It is therefore important that evaluation and treatment resources for new mothers be accessible. Untreated postpartum depression can have negative effects not only for the suffering mother, but for her infant. When a new mother is depressed, her ability to positively attach to her infant can be severely compromised. Research has shown that children of depressed mothers are slower than other children in achieving cognitive milestones and have an increased risk of other behavioral and psychiatric problems as they grow older. Anxiety disorders can co-exist with depression or occur without depression. These disorders can express themselves in panic attacks or obsessive-compulsive behaviors - during and/or after pregnancy. It is important to consider medication and/or therapy. Bipolar disorder and schizophrenia are also treatable during pregnancy. Women are best served when psychiatrists are involved in the medication planning for these, as they are serious disorders. As in the case of depression and anxiety, it is always best to find a way to help women achieve emotional stability during both their pregnancies and postpartum course. For more information about depression and other psychiatric disorders in pregnancy: www.nimh.nih.gov www.nmha.org www.nami.org www.ndmda.org www.depressionafterdelivery.com www.postpartum.net www.womensmentalhealth.org
Autoimmune Disease Autoimmune diseases such as systemic lupus erythematosus, rheumatoid arthritis, and scleroderma result from the immune system attacking the body instead of defending it. Autoimmune disorders may get better, get worse, or stay the same in pregnancy. Systemic Lupus Erythematosus (SLE) is a chronic inflammatory disease that can affect the skin, joints, kidneys, lungs, brain, liver, and other organs. Most women with SLE have intermittent periods of improving and worsening symptoms, even when they are not pregnant. It is not clear if women with SLE have a higher risk of a flare (worsening symptoms) during pregnancy. Women with SLE who have kidney problems as a result are at risk for worsening kidney function during pregnancy; sometimes this is permanent. Overall, the best way to increase the likelihood of a successful pregnancy is to make sure that lupus symptoms are well controlled prior to pregnancy. While there are many medications used to treat lupus that are safe during pregnancy, some are not (like cyclophosphamide, methotrexate, aspirin, ibuprofen); seeing a doctor prior to becoming pregnant will allow them to make sure that all the drugs being used will be safe in pregnancy. Some women with lupus have antibodies that increase their chance of having a blood clot; depending on the history, they may need to be treated with blood thinners during pregnancy. If a woman has SSA or SSB antibodies, her fetus is at a small risk for developing a slow heart rate (heart block), which is a serious condition. Women with lupus need to be carefully monitored during pregnancy as they have an increased risk of pregnancy loss, high blood pressure associated with pregnancy (preeclampsia), delivering early, and having a small baby (IUGR). In addition, some babies born to women with lupus can develop “neonatal lupus,” which can affect the baby’s heart or skin. Finally, women can develop lupus flares during pregnancy which can be difficult to identify and treat. Some women may also have a flare of lupus symptoms after they deliver. Rheumatoid arthritis (RA) is a chronic inflammatory condition of the joints. Many patients with RA improve during pregnancy, although most also have increasing and decreasing symptoms throughout pregnancy. Women with RA may be at higher risk for miscarriage, but do not seem to be at increased risk for other pregnancy complications. While there are many medications used to treat RA that are safe during pregnancy, some are not (like methotrexate, aspirin, ibuprofen); seeing a doctor prior to becoming pregnant will allow them to make sure that all the drugs being used will be safe in pregnancy. Systemic Sclerosis or Scleroderma is an autoimmune disorder that can affect the blood vessels, heart, lungs, kidneys, and other internal organs. Pregnancy can be very dangerous in women with scleroderma if their heart, lungs, or kidneys have been severely damaged. During pregnancy, women with scleroderma are at increased risk for pregnancy loss, high blood pressure associated with pregnancy (preeclampsia), delivering early, and having a small baby (IUGR). For more information on autoimmune diseases and pregnancy: American College of Rheumatology http://www.rheumatology.org/public/factsheets/pregnancy.aspFor more information on Lupus and pregnancy: Lupus Foundation http://www.lupus.org/webmodules/webarticlesnet/templates/new_aboutindividualized.aspx?articleid=314&zoneid=18 Up-To-Date Patient Information http://patients.uptodate.com/topic.asp?file=arth_rhe/8273For more information on rheumatoid arthritis and pregnancy: Up-To-Date Patient Information http://patients.uptodate.com/topic.asp?file=arth_rhe/9738For more information on scleroderma: National Institute of Arthritis and Musculoskeletal and Skin Diseases http://www.niams.nih.gov/Health_Info/Scleroderma/default.asp
Venous Thromboembolism Pregnancy increases the likelihood of blood clots due to the effect of pregnancy on the clotting system, the increased blood volume, and increased pooling of the blood in the legs (venous stasis). Women with a prior history of a deep venous thrombosis or a pulmonary embolism, women with a genetic susceptibility to clotting, and women with a mechanical heart valve should receive blood thinners during pregnancy to decrease the likelihood of blood clots. Blood thinners are usually safe in pregnancy (warfarin can be associated with birth defects if given during the first trimester of pregnancy however, and many obstetricians only use heparin or Lovenox by injection during the pregnancy). There is the usual 10% risk of bleeding that also occurs when a patient is on blood thinners. When it is time for delivery, blood thinners must be briefly stopped in order to allow the safe use of epidural anesthesia, if desired. After delivery, treatment usually is continued for 6 weeks as the risk of thromboembolism continues in the postpartum period. Breastfeeding is compatible with the use of Lovenox and heparin: some pediatricians prefer that mothers on warfarin not breastfeed, but other pediatricians are comfortable with it. Women on bedrest and women undergoing cesarean delivery are at increased risk of venous thromboembolism. Depending on the situation, these women may receive nonmedical therapies (leg massagers) or medications to decrease the likelihood of blood clot. Thromboembolism may be difficult to diagnose during pregnancy as symptoms may be vague and some of the lab tests used in nonpregnant women are not accurate during pregnancy. Ultrasound of the legs or CT scan of the chest are the studies that are usually done to diagnose deep venous thrombosis or pulmonary embolism. More rarely, MRI may be useful. Once venous thromboembolism is diagnosed, treatment with blood thinners should be started. If this is the first time a woman has had a venous thromboembolism, she is usually treated at least until 6-12 weeks postpartum. As with non-pregnant women, a first episode of venous thromboembolism is usually treated with 6 months of anticoagulation, so depending on the time that the clot is diagnosed, medications may be continued for more than three months postpartum.
Cardiac Disease During pregnancy, the volume of blood and the number of blood cells in the body increases to meet the needs of the growing baby. For women who have a problem with their heart, the extra workload for the heart that this creates can cause complications during the pregnancy. Risks associated with maternal cardiac disease and pregnancy include growth problems for the baby, early delivery, and danger to the mother’s health. In addition, if the heart problem that the mother has is a birth defect, then the baby is at increased risk for having a heart birth defect as well. A specialized ultrasound of the baby’s heart (fetal echocardiogram) is done at around 16 weeks to check for this. Because of the potential risks of pregnancy to the health of a woman with a heart condition, when possible, pregnancy should be planned after discussion with the woman’s heart doctor (cardiologist). A dedicated ultrasound of the mother’s heart (echocardiogram) may be helpful to see how the heart is functioning at baseline. Based on the type of heart problem and the way that the heart is functioning, the cardiologist and perinatologist can get a better idea of the risks of pregnancy to the mother’s health. There are some heart conditions like Eisenmenger’s Syndrome and pulmonary hypertension in which there is a high chance that pregnancy can be fatal for the mother because the heart is not able to handle the extra workload. Some women will have repairs of their heart valves or heart structure before pregnancy. The maternal and fetal risks for these women also depend on how the heart is working before pregnancy. In addition, for women who have a mechanical heart valve, it is important that they are on blood thinners during pregnancy. Finally, women with certain problems with the valves of the heart or women who have had valve surgery may need to be given antibiotics during labor and delivery to prevent infection of the heart (endocarditis). During pregnancy, the growth of the fetus and how the mother’s heart is functioning will be monitored closely. In some cases, if the heart is not functioning well at the end of the pregnancy, the baby may need to be delivered early. Some women with heart problems are able to push to deliver their babies; others need to have an assisted delivery, in which the doctor uses forceps or a vacuum to help deliver the baby, and the mother is asked not to push. After the delivery, the mother must be watched carefully, as she is at risk during that time as well. Breastfeeding is good for the mother and the baby. For more information on Heart Disease and Pregnancy: American Heart Association http://www.americanheart.org/presenter.jhtml?identifier=4688

Kidney Disease Pregnancy leads to an increase in the workload of the kidneys, which can lead to complications in women who have kidney disease before pregnancy. Though there are increased pregnancy complications in women with renal disease, most women can have happy, successful pregnancies. Complications of renal disease for the mother include development of preeclampsia, worsening of kidney function, low blood count (anemia), early delivery, and cesarean delivery. For the baby, complications include being born small and the complications related to being born early. The most important predictor of pregnancy complications in women with kidney disease are the level of kidney function before pregnancy (usually estimated by the creatinine level in the blood along with the analysis of a collection of all urine for 24 hours for total protein and for creatinine clearance), and whether or not there is high blood pressure prior to pregnancy. If the kidney disease is severe and associated with high blood pressure, there is a risk that the stress of the pregnancy will cause the kidney function to get worse, potentially leading to permanent kidney failure (which can be treated with either dialysis or kidney transplant). During pregnancy and labor and delivery, the mother and the baby need to be monitored closely for signs or symptoms of the problems that can arise. Most women with kidney disease will be followed by a kidney doctor (nephrologist) as well as an obstetrician and/or perinatologist during pregnancy. For more information on kidney disease and pregnancy National Kidney Foundation http://www.kidney.org/ATOZ/atozItem.cfm?id=104
Obstetric Complications
Twins or more (Multi-fetal Gestation) Multi-fetal gestation occurs when there are two or more babies in the uterus together. Twins are the most common; triplets and quadruplets occur more rarely. Multi-fetal gestation occurs more commonly when assisted reproductive technology (e.g., IVF) is used. Multi-fetal gestations have many risks including increased risk of early delivery (at least 50% of the babies deliver prematurely, three weeks or more before the due date), high blood pressure, cesarean delivery, fetal growth restriction, birth defects, and postpartum bleeding. Women with multi-fetal pregnancies are also more likely to be hospitalized during the pregnancy. Early and regular prenatal care is important to reduce the risk of complications. Many women have uncomplicated twin pregnancies. Based on how they develop, there are a number of different kinds of twin pregnancies. Dichorionic diamniotic twins may form from the development of two separate embryos or from the very early division of a single embryo. Dichorionic diamniotic twins each have their own placenta and amniotic sac. Monochorionic diamniotic twins result from splitting of one embryo a little later in pregnancy and share a placenta, but each has an individual amniotic sac. Because of the shared placenta, there is a risk of a complication called twin to twin transfusion syndrome (TTTS) in 15% of monochorionic diamniotic twins. This results when one twin receives more blood flow from the placenta than the other. Over time, this can be unhealthy for both the twins: one gets too much blood flow and the other twin gets too little blood flow. Without treatment, this can result in serious compromise or even death of one or both twins. However, there is treatment for this condition that is fairly successful (reduction of amniotic fluid by amniocentesis in the sac of the twin with too much amniotic fluid, and/or laser surgery of the placenta). Monochorionic monoamniotic twins result from even later division of a single embryo, and both twins are in the same sac in this case. Because they share the same sac, monochorionic monoamniotic twins are at high risk of getting their umbilical cords tangled. This can lead to injury or death of one or both twins. Often women with monoamniotic twins are hospitalized at 28 weeks with continuous fetal monitoring, and cesarean delivery is performed about 6 to 8 weeks before the due date. Performing an early ultrasound at about 12 to 14 weeks from the last menstrual period is the easiest way to determine which kind of twin pregnancy is present. During pregnancy, mothers with multiples need to increase their caloric intake over that of a singleton pregnancy as well as their iron and folate supplementation. [PR3] Ultrasounds and monitoring of the babies’ heart beats are performed to see how they are growing and to check for symptoms of the specific complications that they may be at risk for during the pregnancy. Mothers are monitored closely for signs or symptoms of pregnancy-induced hypertension or preterm labor. If the monitoring remains reassuring, twins are usually delivered at 38-39 weeks. However, 50% of twins are born at less than 37 weeks, and triplets even earlier. Depending on the position, number, and size of the babies, vaginal delivery may be an option. In other cases, cesarean delivery may be recommended. Breastfeeding is possible and encouraged. For more information on Twins: National Institutes of Health http://www.nlm.nih.gov/medlineplus/twinstripletsmultiplebirths.htmlAmerican College of Obstetrics and Gynecology http://www.acog.org/publications/patient_education/bp092.cfmAmerican Society for Reproductive Medicine- Patient Information http://www.asrm.org/Patients/patientbooklets/multiples.pdf

Preterm Labor A preterm delivery is a delivery that occurs between 20 and 37 weeks of gestation. Preterm birth is the biggest cause of neonatal complications. About 75% of preterm deliveries result from women going into spontaneous labor or breaking their water. The other 25% occur in women with a complication during their pregnancy that results in a need to deliver the baby early (like preeclampsia or diabetes). Preterm labor can be defined as persistent contractions associated with opening of the cervix, the entrance to the uterus. Preterm labor seems to result either from infection or inflammation, bleeding during pregnancy, the uterus being overfilled (with extra fluid, twins, or triplets), or the activation of the normal mechanisms of labor too early in pregnancy. Preterm labor is more likely in women with a prior preterm delivery, women who smoke, women with low or high weight gain in pregnancy, women with vaginal bleeding during pregnancy, and women with twins or triplets. When a woman is diagnosed with preterm labor, the main goals are to try and delay the delivery of the baby for long enough to give betamethasone or dexamethasone to the mother (optimally to have at least 48 hours from the first dose to the delivery, if delivery is imminent). These steroids decrease the likelihood of complications in babies that are born early, and allow time for the mother to be taken to a hospital where they have the doctors and facilities necessary to take care of a baby that is born early. Early detection of preterm labor is difficult because many of the symptoms, such as contractions, pelvic pressure, or vaginal discharge, also occur in normal pregnancies. Evaluating the cervix with ultrasound to detect early dilation or thinning out and testing for chemicals released prior to delivery (fetal fibronectin) are two ways to identify women at risk for preterm labor and to make the diagnosis of preterm labor in women who present with symptoms. The cervix can be examined with ultrasound. This exam is usually done with an ultrasound probe (a transducer that looks like a wand) that is inserted in the vagina in order to get the most accurate measurement possible. There are many characteristics of the cervix can be examined, but the closed length of the cervix is the most helpful measurement. A cervix that is greater than 3 cm. long is normal. A normal cervical length is reassuring, and decreases the likelihood of preterm delivery. Fetal fibronectin is a protein that helps to attach the fetus’s amniotic sac to the uterus. If fetal fibronectin is present in the back part of the vagina, it is worrisome (about a 1 in 5 chance that the baby will be born in the next two weeks.) If the fetal fibronectin is not present (negative), then there is a 98% chance that the baby will not be born in the next two weeks. Once a woman is diagnosed with preterm labor, she may be admitted to the hospital, and be given medication to try and decrease contractions, as well as a steroid shot or pills to help decrease the complications for the baby if the delivery is early. She may also be given antibiotics to decrease the likelihood of infection with Group B streptococcus if the baby is born early. If the contractions go away and the woman does not deliver, she may be able to go home. Women with preterm labor are often told to reduce their activity level. Many women who are diagnosed with preterm labor will remain pregnant for some time after the diagnosis; some will even go to or beyond their due date. For women who have a history of preterm delivery, progesterone (one of the hormones of pregnancy), can be given to reduce the likelihood of preterm delivery during the current pregnancy. Progesterone is usually given as a weekly injection, starting after 16 weeks and continuing until 36 weeks. For more information on preterm labor: March of Dimes http://www.marchofdimes.com/pnhec/188_1080.aspNational Institute of Child health and Human Development http://www.nichd.nih.gov/health/topics/Preterm_Labor_and_Birth.cfmUp-To-Date Patient Information http://patients.uptodate.com/topic.asp?file=pregnan/6340Sidelines- a support network for women with premature births http://www.sidelines.org
Preterm Premature Rupture of Membranes Preterm premature rupture of membranes (PPROM) refers to the water breaking before 37 weeks. More than half of women who break their water early will deliver within 7 days. The complications associated with PPROM include infection, separation of the placenta (abruption), and compression of the fetus’s umbilical cord. The earlier that PPROM occurs, the greater the risk of complications for the baby. For women who break their water after 34 weeks, the risks of continuing the pregnancy usually outweigh the benefits, and delivery is usually recommended. For women who break their water between 24 and 34 weeks, the complications associated with early delivery are high enough that if the mom and baby appear to be healthy, the pregnancy will be continued, usually in the hospital with the mother on bedrest. Since the membranes surrounding the baby are the barrier to the outside world, the main risk of continuing a pregnancy with PPROM is developing an infection that can make the mother and baby sick. PPROM is usually diagnosed based on history, physical exam, and ultrasound. Once PPROM has been diagnosed, if there are no signs of labor or infection, antibiotics may be started to try and increase the length of time between when the water breaks and when the delivery occurs. Steroids such as betamethasone or dexamethasone are usually given to the mother to decrease the likelihood of complications if the baby is born early. The mother and baby are monitored carefully to look for signs of infection, separation of the placenta (abruption), or fetal distress (low heart rate of the fetus on the monitor or periodic dips in the heart rate). Sometimes an amniocentesis is performed to test the fluid around the baby for infection and./or lung maturity. Because of the risk to the baby and the mother, most women with PPROM remain in the hospital from the time that they are diagnosed until they deliver.
Cervical Insufficiency Cervical insufficiency refers to the opening of the cervix in the absence of any contractions. This usually happens in the late second trimester or the early third trimester of pregnancy (16 to 22 weeks from the last menstrual period). Risk factors for cervical insufficiency include a history of surgery on the cervix or abnormal formation of the cervix. Another term used for this condition is cervical incompetence. Women who have a history of pregnancy loss in the second trimester or preterm delivery consistent with cervical insufficiency may be monitored with ultrasound measurements of the cervix during the pregnancy, or they may be offered a cerclage. A cerclage is a stitch that is placed in the cervix to try and prevent it from dilating early. When a cerclage is placed due to a history of cervical insufficiency, the surgery is usually performed at 13-14 weeks of pregnancy. If a woman is monitored with cervical ultrasound, a cerclage may be performed when cervical shortening is noted. The risks of cerclage include bleeding, infection, rupture of the membranes, and pregnancy loss. These risks are increased when the cerclage is placed later in pregnancy, or if the cervix is dilated at the time of the surgery. For more information on cervical insufficiency: March of Dimes http://www.marchofdimes.com/pnhec/188_20201.asp
Intrauterine Growth Restriction (IUGR) Growth restriction occurs when a fetus is not able to grow to its genetically determined potential size. This occurs when the fetus is not able to get the nutrients and oxygen that it needs, due to decreased levels of oxygen and nutrients in the mother’s blood, or due to problems with the placenta that keep the nutrients in the mother’s blood from being transferred to the baby. Problems with the placenta can result from medical problems in the mother such as high blood pressure, diabetes, autoimmune disease, smoking, and problems leading to increased blood clots. Problems with the baby’s genes (chromosomal anomalies) or the way that the placenta formed (velamentous cord insertion) can lead to growth restriction as well. Intrauterine growth restriction leads to increased risks for the baby, both before, during, and after birth. It is difficult to determine what a fetus’s genetically determined growth potential would be, so intrauterine growth restriction is diagnosed by ultrasound estimate of the baby’s weight. Small for gestational age (SGA) is defined as babies who are in less than the 10th percentile for their gestational age. However, it is important to remember that some of these babies may be genetically destined to be small, and so are entirely normal, and not at increased risk for complications. Since obstetric practitioners can’t easily determine which fetuses are meant to be small and which ones are not, all fetuses who are estimated to be small are monitored for potential complications. Follow-up ultrasounds to see how the baby is growing, measuring the blood flow in the umbilical cord, monitoring the fluid around the baby, monitoring the fetal heart rate as well as determining how the baby is moving are all ways to monitor how the baby is doing. The decision to deliver a baby with growth restriction depends on the gestational age of the baby, the presence of other complications in the mother or baby, and the indicators of how the baby is doing. Once there is evidence that the risk to the baby of staying in the womb is greater than the risk of delivery, delivery is indicated. After delivery, the baby will be evaluated by the pediatrician to see if there are any signs that the baby was not getting all the nutrients that it needed during the pregnancy. Breastfeeding is important for both the mother and the baby.
Placental Abruption Placental abruption is defined as premature separation of the placenta from the uterus. Abruption increases the risk of preterm delivery as well as risk of injury to the mother and baby. Risk factors for abruption include smoking, high blood pressure, preeclampsia, preterm premature rupture of the membranes, trauma, and drug use. The symptoms of abruption are usually vaginal bleeding and abdominal pain. Abruption is diagnosed based on history, symptoms, and physical exam. Ultrasound may be used to assess the well being of the fetus and look for a separation of the placenta. If an abruption is seen, the likelihood that there is an abruption is very high, but ultrasound will not detect more than half of abruptions. A blood test to see if there are fetal blood cells in the maternal circulation is sometimes checked as well. This test (Kleihauer-Betke) can confirm the diagnosis when it is positive, but does not rule out the diagnosis when it is negative. Management of a woman with an abruption depends on the gestational age and the well-being of the mother and the fetus. If an abruption occurs early in pregnancy and the mother and baby are stable, the pregnancy may be continued. Steroids such as betamethasone or dexamethasone are given to decrease the likelihood of complications if the baby is born early. If there is evidence that bleeding is leading to distress in the mother or the baby, then delivery is indicated. Blood in the uterus stimulates contractions, so some women with abruptions will go into labor on their own. For more information on abruption: March of Dimes http://www.marchofdimes.com/pnhec/188_1135.asp
Placenta Previa Placenta previa refers to a placenta that is over the opening to the uterus, the cervix. The reason why the placenta implants over the cervix is not clear. Placenta previa is associated with bleeding during pregnancy and at the time of delivery, a need for blood transfusion, an increased risk of hysterectomy, and an increased likelihood of early delivery. Women with a placenta previa must be delivered by cesarean as the placenta is blocking the opening to the birth canal. Placenta previa is usually diagnosed on ultrasound. Many women who are thought to have a placenta previa in early pregnancy will not have a placenta previa later in pregnancy. The primary symptom of placenta previa is painless bleeding, although some women do have painful contractions with bleeding. Women with bleeding from a placenta previa will be admitted if the bleeding is significant enough to cause the mother or fetus to be in distress, or if it occurs after 24 weeks. During the admission, the woman is monitored to make sure that the bleeding stops, and given steroids such as betamethasone or dexamethasone to decrease the likelihood of complications if the baby is born early. If the bleeding stops, a woman may be able to go home if she lives close to a hospital and has someone available to take her to the hospital if bleeding occurs. Women who have multiple episodes of bleeding or ongoing bleeding may remain in the hospital. Because there is always a risk of bleeding with placenta previa, most women are delivered by 36-37 weeks, when the likelihood of complications from prematurity is low. Women with a placenta previa are at increased risk for having a placenta that is abnormally adherent to the uterus (placenta accreta). More rarely, the placenta may invade the muscular layer of the uterus or push through the uterus entirely (placenta increta or percreta, respectively). Placenta accreta can sometimes be diagnosed by ultrasound and MRI. Women who have had cesarean deliveries in the past are at increased risk for placenta accreta. Placenta accreta is associated with high blood loss at the time of delivery, the need for blood transfusion, an increase in surgical complications, and need for cesarean hysterectomy (removal of the uterus at the time of cesarean delivery.) If the hospital has an interventional radiology unit, sometimes catheters can be placed into the femoral arteries of the mother, and manipulated into the pelvic vessels with the infusion of coils or pledgets to decrease the bleeding so that hysterectomy might be avoided. Vasa previa refers to the situation where fetal vessels run over the cervix, unprotected by the umbilical cord. When the water breaks, these vessels are at risk for rupturing also, resulting in bleeding from the baby. Since the baby has only a small amount of blood, this bleeding can result in compromise to the baby or even death. Vasa previa is sometimes diagnosed by ultrasound. Women with vasa previa are delivered by cesarean delivery to avoid the water breaking and damaging the fetal vessels usually before 37 weeks of gestation. For more information on placenta previa or accreta: March of Dimes- Placenta Previa http://www.marchofdimes.com/pnhec/188_1132.aspMarch of Dimes- Placenta Accreta http://www.marchofdimes.com/pnhec/188_1128.asp
Rh Alloimmunization Alloimmunization refers to a process when there is a specific difference in Rhesus (Rh) factor[PR4] between the mother (Rh negative) and the fetus (Rh positive): the mother’s immune system can then attack the fetus’s red blood cells, causing the fetus to have a low blood count (anemia). During the course of a normal pregnancy, there is a small amount of mixing of the fetus’s blood and the mother’s blood. If the baby is Rh positive and the mom is Rh negative, when the fetus’s blood is in the mother’s circulation, the immune system recognizes something new, and gets ready to respond to it by making antibodies. The next time that a woman is pregnant, if the baby is Rh positive, the antibodies that were made attach themselves to the fetal red blood cells, which causes them to be removed from the circulation and destroyed. Depending on how much of the antibody the mother makes, the fetus may become very anemic, which can make the baby sick both before and after it is born. Luckily, there is a way to prevent the mother’s body from making these antibodies. All women who are Rh negative should have a shot called Rhogam if they have bleeding during pregnancy, an amniocentesis, an abortion, a miscarriage, or a version (turning the position of the baby around from head up to head down). Rhogam is also routinely given to women at between 28 to 32 weeks in their pregnancy for the very tiny chance that this sensitization might occur during the current pregnancy. At delivery, the baby’s blood type is determined, and if the baby is Rh positive, the mother should receive a Rhogam shot before leaving the hospital. All women get a blood type with Rh factor and antibody screen at the beginning of the pregnancy. If a woman is found to have a certain antibody that has the capability of causing problems to the fetus during the pregnancy, the father’s blood type may be determined. If he has the same blood type as the mother, the baby will have the same blood type as well, and so will not be affected by the antibody. If the mother and father have different blood types, an amniocentesis can be performed to determine the blood type of the baby. If the blood type of the baby is different from the mom, then the baby could be affected by the antibodies. The antibody level correlates with the likelihood of the baby being affected, so the antibody test will be checked every month. If the antibody is high enough, then the baby needs to be tested to see if anemia has developed. Originally, testing to see whether the baby was anemic was done by amniocentesis, but now an ultrasound can be done that estimates how anemic the baby is by measuring the speed that the blood is traveling in one of the main blood vessels in the brain (middle cerebral artery dopplers). If the speed is high, the likelihood of anemia is high. The next step is to test the blood count of the fetus directly by putting a needle in the fetus’s umbilical cord and testing the baby’s blood count. If the blood count is low, the baby can be given a blood transfusion while the needle is still inside the uterus. The transfusion may have to be performed several times over the next few weeks to keep the baby from becoming anemic. If a woman has had a pregnancy where her baby was anemic, the likelihood of complications in the next pregnancy is increased. For more information about Rh factor and pregnancy: American College of Obstetricians and Gynecologists http://www.acog.org/publications/patient_education/bp027.cfmNational Institute of Health http://www.nlm.nih.gov/medlineplus/ency/presentations/100217_1.htm
Birth Defects Birth defects are abnormalities in the way that the baby formed, that are present when the baby is born. Birth defects can be caused by a problem with the genes, a problem with the number of chromosomes (e.g., Down Syndrome), an exposure to an infection or a chemical during pregnancy, or an unknown cause. Some birth defects can be diagnosed during pregnancy, while others can only be seen after the baby is born. There are screening tests to determine the risk of chromosomal abnormalities (Quad Screen and First Trimester Nuchal Translucency and Blood Screening). Many babies with chromosomal abnormalities have birth defects, but not all babies with birth defects have chromosomal abnormalities. Some birth defects are diagnosed by ultrasound. Ultrasound may be able to see a problem with the baby’s heart (problems with the heart valves or blood vessels of the heart), spinal cord (spina bifida or neural tube defects), or abdominal wall (gastroschisis or omphalocele). Once a birth defect is diagnosed, mothers are often referred to a hospital where they have experience taking care of babies with birth defects. Depending on the specific problem, the doctors may recommend delivery at a hospital with specialists in taking care of newborns (neonatologists) and pediatric surgeons. In some cases, there may be a treatment or surgery that can be performed while the fetus is in the uterus to help the fetus develop more normally. For more information on birth defects, fetal therapy and genetic testing: UCSF Fetal Treatment Center http://fetus.ucsfmedicalcenter.orgNational Institute of Child Health and Human Development http://www.nichd.nih.gov/womenshealth/research/pregbirth/birthdefects.cfmMarch of Dimes http://www.marchofdimes.com/pnhec/4439.asp
Infection in Pregnancy
Urinary Tract Infections Urinary tract infections are the most common infection in pregnant women. Because of the changes to the body during pregnancy, pregnant women are at high risk of developing bladder and kidney infections. Some pregnant women have bacteria in the urine without having symptoms of a bladder infection; if this is not treated, the likelihood of developing a kidney infection is increased. The symptoms of kidney infection include fever, chills, and pain in the abdomen and back. A kidney infection can be life threatening for the mother and can increase the risk of early delivery of the baby, so most women with kidney infections are admitted to the hospital. After a woman has had a kidney infection in pregnancy, antibiotics are continued at a low dose for the rest of the pregnancy to prevent another kidney infection.
Infections that are especially concerning during pregnancy There are a number of infections that women can get during pregnancy that may be transmitted to the fetus and cause birth defects or stillbirth. These infections include toxoplasmosis, rubella, cytomegalovirus, parvovirus, listeria, and herpes simplex virus. Toxoplasmosis is an infection that is transmitted to people by eating inadequately cooked meat or having contact with cat feces. The risks to the mother are minimal, but depending on the time of the infection, the baby may have problems with hearing or developmental delay. The best way to prevent toxoplasmosis infection is to avoid eating undercooked meat, to wash hands and kitchen surfaces thoroughly after contact with raw meat, and to avoid contact with cat feces (e.g. wear gloves while gardening). Most people are vaccinated against rubella, and all pregnant women are tested to see if they are immune, or protected from this infection. Cytomegalovirus (CMV) is a virus that is transmitted from person to person by contact with bodily fluids. Women who work with young children (such as women working at a daycare center) are at increased risk of infection. Women who get CMV for the first time during pregnancy have the highest risk of passing the infection to the fetus. About 50% of women have been exposed to CMV; people who have been exposed before can still pass the infection to the fetus, but the effects are not usually as severe. Cytomegalovirus infection in the baby can lead to hearing loss, developmental delay, and eye problems. Depending on the time in the pregnancy when the infection happens, amniocentesis may be used to help determine if the baby is infected, but no test before birth can tell for sure what the effects on the baby will be. The best way to avoid cytomegalovirus infection is to practice good handwashing and safe sex. Parvovirus (Fifth disease) is a viral infection spread from person to person. Children with parvovirus may have a characteristic “slapped cheek” rash. The symptoms in the mother may include a rash and joint pain. Sometimes there no symptoms at all and transmission is by exposure to an infected person. If the fetus is infected, there is a chance that the fetus will become anemic (low blood count). This can lead to stillbirth. If a woman is exposed to parvovirus for the first time during pregnancy and develops the infection herself, then the fetus will be monitored with ultrasound to see if there is evidence of anemia. If anemia develops, sometimes it can be treated by giving a transfusion into the umbilical cord. If there is no anemia, there are no other effects of the infection. The best way to avoid parvovirus infection is to wash your hands frequently and avoid contact with children who are sick. Listeria is an uncommon infection that is transmitted by eating unpasteurized dairy products or deli meats. The main symptoms in the mother are fever and malaise, like the flu. If the fetus is infected, it can lead to stillbirth. The best way to prevent listeria infection is to avoid eating foods that could contain the bacteria: hot dogs, deli meats (unless reheated to steaming), soft cheeses like brie, feta, camembert, and queso fresco, pate, meat spreads, smoked salmon, or unpasteurized milk. Herpes is a virus that causes cold sores and genital herpes infection. Symptoms of genital infection include pain and burning, usually in the presence of tiny blisters. Because of the immune system changes during pregnancy, if a woman is infected with herpes for the first time during pregnancy, the infection can become more serious, leading to effects on the mother’s liver and brain. If the baby is infected during pregnancy, the infection can have effects on the brain or lead to death. Most of the time, if a baby becomes infected, it is during delivery, through an infected birth canal. For women who know that they have herpes, medication (acyclovir) can be given during the last month of pregnancy to decrease the likelihood of infection at the time of delivery. Any women with symptoms of herpes infection at the time of delivery will have an exam of the vagina and vulva; if there are herpes sores present, a cesarean delivery may be recommended to decrease the likelihood of the baby getting infected.
Human Immunodeficiency Virus (HIV) All pregnant women are offered testing for human immodeficiency virus (HIV) during pregnancy. For women with HIV who are not treated with any anti-HIV medications during pregnancy or labor and delivery, there is about a 25% risk of giving the infection to the baby during delivery, and an additional risk of infection during breastfeeding. The best way to reduce the likelihood of transmission to the baby is to treat the mother’s HIV during pregnancy. Women with HIV should see a doctor before conception to make sure that they are on medications that are safe in pregnancy, and to assure that the level of infection (viral load) is as low as possible. Additional anti-HIV medications will be given during labor and delivery to decrease the likelihood of transmission to the baby. For women with a low viral load, the risk of transmission is the same with vaginal delivery or cesarean delivery. For women with a higher viral load, a cesarean delivery before labor decreases the likelihood that the baby will be infected. The baby will be given anti-HIV medications after delivery to further reduce the risk of infection. With all of these measures, the risk of transmission to the baby can be reduced to less than 2%. Because of the risk of transmission of HIV, women with HIV should not breastfeed. http://www.nlm.nih.gov/medlineplus/aidsandpregnancy.html For more information about infections in pregnancy: National Institutes of Healthhttp://www.nlm.nih.gov/medlineplus/infectionsandpregnancy.htmlFor more information about toxoplasmosis and pregnancy: Centers for Disease Control http://www.cdc.gov/toxoplasmosis/pregnant.htmlFor more information on cytomegalovirus and pregnancy: Centers for Disease Control http://www.cdc.gov/cmv/pregnancy.htmFor more information about parvovirus and pregnancy: Centers for Disease Control http://www.cdc.gov/ncidod/dvrd/revb/respiratory/B19&preg.htmFor more information about listeria and pregnancy: United States Department of Agriculture http://www.fsis.usda.gov/Fact_Sheets/Protect_Your_Baby/index.aspFor more information about herpes and pregnancy: National Institutes of Health http://www.nlm.nih.gov/medlineplus/ency/article/001368.htmFor more information about HIV and pregnancy Centers for Disease Control http://www.cdc.gov/hiv/topics/perinatal/index.htmNational Institutes of Health http://www.nlm.nih.gov/medlineplus/aidsandpregnancy.html
Dermatologic Disorders in Pregnancy The skin is affected by the changes in hormones and metabolism during pregnancy. Common normal changes in the skin seen during pregnancy include darkening of the skin (hyperpigmentation or melasma), changes in superficial blood vessels, stretch marks, and changes in the hair and nails. Pregnant women are at risk for the same skin disorders that nonpregnant women are; in addition, there are several skin conditions that are directly related to pregnancy. Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPS) is the most common skin condition associated with pregnancy. It primarily occurs in women having their first baby, and usually starts towards the end of pregnancy. Frequently, the first lesions are within the stretch marks on the abdomen. Lesions can look many different ways, and can spread over the chest and extremities, although usually not on the face. Though PUPPS can be uncomfortable, it does not increase the risk to the mother or the baby. Herpes gestationis an autoimmune disorder that is seen during the second or third trimester, usually starting with itchy lesions on the abdomen. Shortly after the initial itchy lesions, the skin forms bubbles or bullae (large blisters) all over the body. These lesions can increase at the time of delivery. Other than infection and discomfort, there is no significant risk to the mother, and it usually resolves after the baby is born. The baby may be at risk for being small, being born early, and having mild skin lesions at the time of birth. For more information on skin disorders during pregnancy: American College of Obstetricians and Gynecologists http://www.acog.org/publications/patient_education/bp169.cfm
Cholestasis of Pregnancy Cholestasis of pregnancy is a problem with the mother’s liver that increases risk for the fetus. The primary symptom of cholestasis of pregnancy is itching without a rash. Itching typically involves the palms and soles, the legs, or the whole body. The level of bile acids in the blood or the level of liver enzymes in the blood is elevated in cholestasis, so blood tests are helpful. The diagnosis of cholestasis is usually made by excluding other possible causes of the symptoms. The main effect of cholestasis on the mother is the symptom of itching, which can be intense. Medications can be used to help control the itching. Cholestasis carries an increased risk of stillbirth, early delivery, and meconium staining of the amniotic fluid. Once cholestasis is diagnosed, there is increased monitoring of the baby. To try and avoid stillbirth, women with cholestasis are often delivered before their due date; depending on how early the delivery is, the baby may have complications because of being born early. Cholestasis resolves after delivery. More links for general pregnancy information: National Institutes of Health http://www.nlm.nih.gov/medlineplus/pregnancy.htmlDepartment of Health and Human Services Healthy Pregnancy http://www.womenshealth.gov/pregnancy/March of Dimes- Pregnancy Toolkit http://www.marchofdimes.com/pnhec/28699.aspNutrition During Pregnancy Resource List for Consumers http://www.nal.usda.gov/fnic/pubs/bibs/topics/pregnancy/pregcon.htmlCenters for Disease Control http://www.cdc.gov/ncbddd/pregnancy_gateway/default.htmFor general information on high risk pregnancy: National Institute of Child health and Human Development http://www.nichd.nih.gov/health/topics/high_risk_pregnancy.cfmSidelines- a support network for women with high risk pregnancies and premature births http://www.sidelines.org
Conclusion Most women with high risk pregnancies can deliver safely, but they need specialty care that includes close surveillance of the mother and the fetus. Consideration should be given as to the location of the delivery, both to be sure that intensive care is available for the mother and the newborn, especially if delivered prematurely. A good social support system (family, friends, and childcare if needed) is often needed prior to the birth in these high risk pregnancies, to ensure that the pregnant women has the best chance to extend the pregnancy and deliver the healthiest and most mature baby possible. Breastfeeding is encouraged as long as any medication that the mother must take has been researched and found to be compatible with breastfeeding. The only exception to this is for women with HIV infection and for those who use illicit substances

noreply@blogger.com (mystero) — Sun, 16 Nov 2008 21:42:00 +0000

نظام التشغيل (Windows)

يتميز هذا النظام عن نظام (Ms-Dos) بما يلي:

سهولة الاستخدام.

سهولة التعامل مع الملفات.استخدام أكثر من تطبيق في آن واحد (Multitasking) .يستخدم القوائم (Menus) ويتم الاختيار عن طريق الماوس (Mouse).استخدام أشكال ورموز صغيرة تسمى الأيقونات ((Icons وهي تمثل تطبيقات معينة.عدد الأوامر التي يجب حفظها قليل جداً.

هاك رائع لشريط آخر المواضيع و اشتراك مجاني في خدمه

noreply@blogger.com (mystero) — Wed, 15 Oct 2008 18:27:00 +0000

هاك رائع لشريط آخر المواضيع و اشتراك مجاني في خدمه

Speculation vs investment

noreply@blogger.com (mystero) — Thu, 02 Oct 2008 12:53:00 +0000

It is very important that the individual wanting to trade foreign exchange be aware of the very marked difference between speculation and investment. Forex trading is by nature a speculative occupation. Foreign exchange markets are amongst the most volatile markets in the world. When traded on a margined basis they effectively become the most volatile in the world. Day trading in foreign exchange can be extremely profitable and high-risk profile traders can generate huge percentage returns even overnight. Day trading is however a mentally and psychologically challenging activity and is by no means meant for everyone. Day trading is essentially speculation and day traders essentially only do that: day trading. Most people who trade foreign exchange are not professional day traders however.
Often the contractors of foreign exchange brokerage services are professionals in some capacity or other. These people do not day trade but take the occasional position from time to time. This is also speculation and should not be confused with making an investment.
The conclusion here is that the nature of foreign exchange trading not lend itself as much to investment as it does to speculation and hedging (hedging may be performed in forward instruments). It is possible in a sense to make an investment in foreign exchange over a long-term period but this necessitates a large account value and low leveraging.

Market dynamics

noreply@blogger.com (mystero) — Thu, 02 Oct 2008 12:51:00 +0000

The breadth, depth, and liquidity of the market are truly impressive. It has been estimated that the world's most active exchange rates like EURUSD and USDJPY can change up to 18,000 times during a single day.
Somewhere on the planet, financial centers are open for business, and banks and other institutions are trading the dollar and other currencies, every hour of the day and night, aside from possible minor gaps on weekends. In financial centers around the world, business hours overlap; as some centers close, others open and begin to trade.
The foreign exchange market follows the sun around the earth. Each business day arrives first in the Asia-Pacific financial centers; first Wellington, New Zealand, then Sydney, Australia, followed by Tokyo, Hong Kong, and Singapore. A few hours later, while markets remain active in those Asian centers, trading begins in Bahrain and elsewhere in the Middle East. Later still, when it is late in the business day in Tokyo, markets in Europe open for business. Subsequently, when it is early afternoon in Europe, trading in New York and other U.S. centers starts. Finally, completing the circle, when it is middle or late afternoon in the United States, the next day has arrived in the Asia-Pacific area, the first markets there have opened, and the process begins again.
The graph underneath displays not only the currency trading time cycle but also the average 'depth' of trading at different times during the day in the various business hours.
1. Spot rate
A spot transaction is a straightforward (or outright) exchange of one currency for another. The spot rate is the current market price or 'cash' rate. Spot transactions do not require immediate settlement, or payment 'on the spot'. By convention, the settlement date, or value date, is the second business day after the deal date on which the transaction is made by the two parties.
2. Bid & ask
In the foreign exchange market (and essentially in all markets) there is a buying and selling price. It is important to perceive these prices as a reflection of market condition.
A market maker is expected to quote simultaneously for his customers both a price at which he is willing to buy (the bid) and a price at which he is willing to sell (the ask) standard amounts of any currency for which he is making a market.
ACM quotes very competitive spreads to customers, to site an example if a trader is interested in a transaction in EURUSD then he can trade on a bid/ask of say 0.9150 / 0.9153. This means that ACM is willing to buy from him a pre-determined amount at 0.9150 or inversely to sell to him at 0.9153.
Generally speaking the difference between the bid and ask rates reflect the level of liquidity in a certain instrument. On a normal trading day, the major currency pairs EURUSD, USDJPY, USDCHF and GBPUSD are traded by a multitude of market participant every few seconds. High liquidity means that there is always a seller for your buy and a buyer for your sell at actual prices.
3. Base currency and counter currency
Every foreign exchange transaction involves two currencies. It is important to keep straight which is the base currency and which is the counter currency. The counter currency is the numerator and the base currency is the denominator. When the counter currency increases, the base currency strengthens and becomes more expensive. When the counter currency decreases, the base currency weakens and becomes cheaper. In telephone trading communications, the base currency is always stated first. For example, a quotation for USDJPY means the US dollar is the base and the yen is the counter currency. In the case of GBPUSD (usually called 'cable') the British pound is the base and the US dollar is the counter currency.
4. Quotes in terms of base currency
Traders always think in terms of how much it costs to buy or sell the base currency. When a quote of 0.9150 / 53 is given that means that a trader can buy EUR against USD at 0.9153. If he is buying EURUSD for 1'000'000 at that rate he would have USD 915'300 in exchange for his million Euro. Of course traders are not actually interested in exchanging large amounts of different currency, their main focus is to buy at a low rate and sell at higher one.
5. Basis points or 'pips'
For most currencies, bid and offer quotes are carried down to the fourth decimal place. That represents one-hundredth of one percent, or 1/10,000th of the counter currency unit, usually called a 'pip'. However, for a few currency units that are relatively small in absolute value, such as the Japanese yen, quotes may be carried down to two decimal places and a 'pip' is 1/100th of the terms currency unit. In foreign exchange, a 'pip' is the smallest amount by which a price may fluctuate in that market.
6. Euro cross & cross rates
Euro cross rates are currency pairs that involve the Euro currency versus another currency. Examples of Euro crosses are EURJPY, EURCHF and GBPEUR. Currency pairs that involve neither the Euro nor the US dollar are called cross rates. Examples of cross rates are GBPJPY and CHFJPY. Of course hundreds of cross rates exist involving exotic currency pairs but they are often plagued by low liquidity. Ever since the Euro the number of liquid cross rates have decreased and have been replaced (to a certain extent) by Euro crosses.

Main forex markets

noreply@blogger.com (mystero) — Thu, 02 Oct 2008 12:50:00 +0000

Foreign exchange is traded essentially in two distinctive ways. Over an organized exchange and 'over the counter'. Exchange traded foreign exchange represents a very small portion of the total foreign exchange market the great majority of foreign exchange deals being traded between banks and other market participants 'over the counter'.
1. Exchange traded currencies
In the case of an organized exchange like the Chicago Mercantile exchange (CME) in the US, standardized currency contract sizes that represent a certain monetary value are traded in the International money market (IMM). A central clearing house organizes matching of transactions between counter-parties. There are various disadvantages to trading currency futures as outlined in the chapter Advantages of trading FX.
2. Forex market
In comparison the over the counter market is traded around the world by a multitude of participants and price quality, reputation and trading conditions determine who a participant wishes to trade with. It is probably the most competitive market in the world and brokers like ACM must insure they live up to the highest standards of service and be compliant with market standards and practices if they want to acquire new customers and retain their existing ones. In 1998 a survey under the auspices of the Bank for International Settlements (BIS), global turnover of reporting dealers was estimated at about USD 1.49 trillion per day. In comparison, currency futures turnover was estimated at USD 12 billion.
Among the various financial centers around the world, the largest amount of foreign exchange trading takes place in the United Kingdom, even though that nation's currency, the British pound is less widely traded in the market than several others. As shown in the graph underneath, the United Kingdom accounts for about 32 percent of the global total; the United States ranks a distant second with about 18 percent, and Japan is third with 8 percent

Market participants

noreply@blogger.com (mystero) — Thu, 02 Oct 2008 12:49:00 +0000

In the last years, the foreign exchange market has expanded from one where banks would execute transactions between themselves to one in which many other kinds of financial institutions like brokers and market-makers participate including non-financial corporations, investment firms, pension funds and hedge funds.
Its' focus has broadened from servicing importers and exporters to handling the vast amounts of overseas investment and other capital flows that currently take place. Lately foreign exchange day trading has become increasingly popular and various firms offer trading facilities to the small investor.
Foreign exchange is an 'over the counter' (OTC) market, that means that there is no central exchange and clearing house where orders are matched. Geographic trading 'centers' exist around the world however and are: (in order of importance) London, New York, Tokyo, Singapore, Frankfurt, Geneva & Zurich, Paris and Hong Kong. Essentially foreign exchange deals are made between participants on the basis of trust and reputation to deliver on an agreement. In the case of banks trading with one another, they do so solely on that basis. In the retail market, customers demand a written legally accepted contract between themselves and their broker in exchange of a deposit of funds on which basis the customer may trade.
Some market participants may be involved in the 'goods' market, conducting international transactions for the purchase or sale of merchandise. Some may be engaged in 'direct investment' in plant and equipment, or may be in the 'money market,' trading short-term debt instruments internationally. The various investors, hedgers, and speculators may be focused on any time period, from a few minutes to several years. But, whether official or private, and whether their motive be investing, hedging, speculating, arbitraging, paying for imports, or seeking to influence the rate, they are all part of the aggregate demand for and supply of the currencies involved, and they all play a role in determining the exchange rate at that moment.

Origins of foreign exchange

noreply@blogger.com (mystero) — Thu, 02 Oct 2008 12:48:00 +0000

In order to gain a complete understanding of what foreign exchange market is, it is useful to examine the reasons that lead to its existence in the first place. Exhaustively detailing the historical events that shaped the foreign exchange market into what it is today is of no great importance to the fx trader and therefore we happily will omit lengthy explanations of historical events such as the Bretton Woods accord in favor of a more specific insight into the reasoning behind foreign exchange as a medium of exchange of goods and services.
Originally our ancestors conducted trading of goods against other goods this system of bartering was of course quite inefficient and required lengthy negotiation and searching to be able to strike a deal. Eventually forms of metal like bronze, silver and gold came to be used in standardized sizes and later grades (purity) to facilitate the exchange of merchandise. The basis for these mediums of exchange was acceptance by the general public and practical variables like durability and storage. Eventually during the late middle ages, a variety of paper IOU started gaining popularity as an exchange medium.
The obvious advantage of carrying around 'precious' paper versus carrying around bags of precious metal was slowly recognized through the ages. Eventually stable governments adopted paper currency and backed the value of the paper with gold reserves. This came to be known as the gold standard. The Bretton Woods accord in July 1944 fixed the dollar to 35 USD per ounce and other currencies to the dollar. In 1971, president Nixon suspended the convertibility to gold and let the US dollar 'float' against other currencies.Since then the foreign exchange market has developed into the largest market in the world with a total daily turnover of about 1.5 trillion USD. Traditionally an institutional (inter-bank) market, the popularity of online currency trading offered to the private individual is democratising foreign exchange and widening the retail market.

Advantages of trading forex

noreply@blogger.com (mystero) — Thu, 02 Oct 2008 12:47:00 +0000

Although the forex market is by far the largest and most liquid in the world, day traders have up to now focused on seeking profits in mainly stock and futures markets. This is mainly due to the restrictive nature of bank-offered forex trading services.Advanced Currency Markets (ACM) offers both online and traditional phone forex trading services to the small investor with minimum account opening values starting at 5000 USD.There are many advantages to trading spot foreign exchange as opposed to trading stocks and futures. Below are listed those main advantages.
1. Bid/Ask Spread rates
Spread rates have tightened dramatically in the last years. Most online forex brokers offer a spread of 5 pips on EURUSD which is the most widely traded and liquid currency pair. ACM offers a 3 pip spread on EURUSD. In stock trading, only liquid stocks offer tight spreads. Those spreads often represent on average between 0.04% and 0.06% of the value of the stock. In comparison ACM offers a 3 pip spread on all major currencies, this equates to approximately between 0.02% and 0.03% on the underlying dollar value.
Exact percentages at current rates (May 2002)
EURUSD 3 pips 0.03%GBPUSD 3 pips 0.03%USDJPY 3 pips 0.023%USDCHF 3 pips 0.018%
In the futures market spreads can vary anywhere between 5 and 9 pips and can become even larger under illiquid market conditions (which tends to happen substantially more often in futures currencies).
2. Commissions
ACM offers foreign exchange trading commission free. This is in sharp contrast to (once again) what stock and futures brokers offer. A stock trade can cost anywhere between USD 5 and 30 per trade with online brokers and typically up to USD 150 with full service brokers. Futures brokers can charge commissions anywhere between USD 10 and 30 on a round turn basis.
3. Margins requirements
ACM offers a foreign exchange trading with a 1% margin. In layman's terms that means a trader can control a position of a value of USD 1'000'000 with a mere USD 10'000 in his account. By comparison, futures margins are not only constantly changing but are also often quite sizeable. Stocks are generally traded on a non-margined basis and when they are, it can be as restrictive as 50% or so.
4. 24 hour market
Foreign exchange market trading occurs over a 24 hour period picking up in Asia around 24:00 CET Sunday evening and coming to an end in the United States on Friday around 23:00 CET. Although ECNs (electronic communications networks) exist for stock markets and futures markets (like Globex) that supply after hours trading, liquidity is often low and prices offered can often be uncompetitive.
5. No Limit up / limit down
Futures markets contain certain constraints that limit the number and type of transactions a trader can make under certain price conditions. When the price of a certain currency rises or falls beyond a certain pre-determined daily level traders are restricted from initiating new positions and are limited only to liquidating existing positions if they so desire. This mechanism is meant to control daily price volatility but in effect since the futures currency market follows the spot market anyway, the following day the futures market may undergo what is called a 'gap' or in other words the futures price will re-adjust to the spot price the next day. In the OTC market no such trading constraints exist permitting the trader to truly implement his trading strategy to the fullest extent. Since a trader can protect his position from large unexpected price movements with stop-loss orders the high volatility in the spot market can be fully controlled.
6. Sell before you buy
Equity brokers offer very restrictive short-selling margin requirements to customers. This means that a customer does not possess the liquidity to be able to sell stock before he buys it. Margin wise, a trader has exactly the same capacity when initiating a selling or buying position in the spot market. In spot trading when you're selling one currency, you're necessarily buying another.

Forex Glossary

noreply@blogger.com (mystero) — Thu, 02 Oct 2008 12:45:00 +0000

Accrual The apportionment of premiums and discounts on forward exchange transactions that relate directly to deposit swap (Interest Arbitrage) deals, over the period of each deal.Actualize The underlying assets or instruments which are traded in the cash market.Adjustable Peg An exchange rate system where a country's exchange rate is "pegged" (i.e. fixed) in relation to another currency. The official rate may be changed from time to time.Adjustment Official action normally by either change in the internal economic policies to correct a payment imbalance or in the official currency rate or.Agent Bank A bank acting for a foreign bank. In the Euro market - the agent bank is the one appointed by the other banks in the syndicate to handle the administration of the loan.Aggregate Demand Total demand for goods and services in the economy. It includes private and public sector demand for goods and services within the country and the demand of consumers and and firms in other countries for good and services.Aggregate Risk Total amount of exposure a bank has with a customer for both spot and forward contracts.Aggregate Supply Total supply of goods and services in the economy from domestic sources (including imports) available to meet aggregate demand.Agio Difference in the value between currencies. Also used to describe percentage charges for conversion from paper money into cash, or from a weak into a strong currency.Aggressor A trader dealing on an existing price in the market.Appreciation A currency is said to 'appreciate' when it strengthens in price in response to market demand. Describes a currency strengthening in response to market demand rather than by official action.Arbitrage Profiting from differences in the price of a single currency pair that is traded on more than one market.Arbitrage Channel The range of prices within which there will be no possibility to arbitrage between the cash and futures market.Around Used in quoting forward "premium/discount". "Five-five around" would mean five points on either side of the present spot value.Ask Price Sometimes called the Offer Price, this is the market price for traders to buy currencies. Ask Prices are shown on the right side of a quote - e.g. EUR/USD 1.1965 / 68 - means that one euro can be bought for 1.1968 US dollars.Asset An item having commercial or exchange value.Asset Location Dividing instrument funds among markets to achieve diversification or maximum return.At Best An instruction given to a dealer to buy or sell at the best rate that is currently available in the market.At or Better An order to deal at a specific rate or better.Authorized Dealer A financial institution or bank authorized to deal in foreign exchange.Average Rate Option A contract where the exercise price is based on the difference between the strike price and the average spot rate over the contract period. Sometimes called an "Asian option".Back Office The office location, or department, where the processing of financial transactions takes place.Balance of Trade The value of a country's exports minus its imports.Bank Notes Paper issued by the central bank, redeemable as money and considered to be full legal tender.Bank Rate The rate at which a central bank is prepared to lend money to its domestic banking system.Bar Chart A type of chart used in Technical Analysis. Each time division on the chart is displayed as a vertical bar which show the following information - the top of the bar is the high price, the bottom of the bar is the low price, the horizontal line on the left of the bar shows the opening price and the horizontal line on the right of bar shows the closing price.Base Currency In terms of foreign exchange trading, currencies are quoted in terms of a currency pair. The first currency in the pair is the base currency. The base currency is the currency against which exchange rates are generally quoted in a given country. Examples: USD/JPY, the US Dollar is the base currency; EUR/USD, the EURO is the base currency. Bear Market An extended period of general price decline in an individual security, an asset, or a market.Bid Price is the price a trader can sell currencies. The Bid Price is shown on the left side of a quote - e.g. EUR/USD 1.1923 / 68 - means that one euro can be sold for 1.1923 US dollars.Bid/Ask Spread is the difference between the bid price and the ask price in any currency quotation. The spread represents the broker's fee, and varies from broker to broker.Big Figure The first two or three digits of a foreign exchange price or rate. Examples: USD/JPY rate of 108.05/10 the big figure is 108. EUR/USD price of .8325/28 the big figure is .83Bretton Woods The site of the conference which in 1944 led to the establishment of the post war foreign exchange system that remained intact until the early 1970s. The conference resulted in the formation of the IMF. The system fixed currencies in a fixed exchange rate system with 1% fluctuations of the currency to gold or the dollar.Broker An agent, who executes orders to buy and sell currencies and related instruments either for a commission or on a spread. Brokers are agents working on commission and not principals or agents acting on their own account. In the foreign exchange market brokers tend to act as intermediaries between banks bringing buyers and sellers together for a commission paid by the initiator or by both parties. There are four or five major global brokers operating through subsidiaries affiliates and partners in many countries.Bull Market A market which is on a consistent upward trend.Bundesbank Central Bank of Germany.Buy On Margin The process of buying a currency pair where a client pays cash for part of the overall value of the position. The word margin refers to the portion the investor puts up rather than the portion that is borrowed.Buy Limit Order An order to execute a transaction at a specified price (the limit) or lower.Candlestick Chart A chart that displays the daily trading price range (open, high, low and close). A form of Japanese charting that has become popular in the West. A narrow line (shadow) shows the day's price range. A wider body marks the area between the open and the close. If the close is above the open, the body is white (not filled); if the close is below the open, the body is black (filled).Central Bank A bank, administered by a national government, which regulates the behavior of financial institutions within its borders and carries out monetary policy.Chartist A person who attempts to predict prices by analyzing past price movements as recorded on a chart.Closing a Position The process of selling or buying a foreign exchange position resulting in the liquidation (squaring up) of the position.Commission The fee that a broker may charge clients for dealing on their behalf.Cross Currency A currency pair that does not include US dollars - e.g. EUR/GBP.Currency Money issued by a government. Coins and paper money. It is a form of money used as a unit of exchange within a country.Currency Pair Two currencies involved in a Forex transaction - e.g. EUR/USD.Currency Risk The risk that shifts in foreign exchange rates may undermine the dollar or any other foreign currency value of overseas investments.Day Trade A trade opened and closed on the same trading day.Day Trading Refers to a style or type of trading where trade positions are opened and closed during the same day.Day Trader A trader who buys and sells on the basis of small short-term price movements.Dealer An individual or firm that buys and sells assets from their portfolio, acting as a principal or counterpart to a transaction.Depreciation A fall in the value of a currency due to market forces.Desk Term referring to a group dealing with a specific currency or currencies.Devalution The act by a government to reduce the external value of its currency.Direct Quotation Quoting in fixed units of foreign currency against variable amounts of the domestic currency.Discretionary Account An account in which the customer permits a trading institution to act on the customer's behalf in buying and selling currency pairs. The institution has discretion as to the choice of currency pairs, prices, and timing-subject to any limitations specified in the agreement.Economic Indicator A statistical report issued by governments or academic institutions indicating economic conditions within a country.Euro (EUR) The single currency of the European Economic and Monetary Union (EMU) introduced in January 1999. This is the amalgamation of the following currencies, after Jan. 1, 2002 these currencies will be considered legacy currencies. Germany Deutsche Marks, Italy Lira, Austria Schillings, France Franc, Belgium Francs, Netherlands (Dutch) Guilders, Finland Markka, Portugal Escudo, Greece Drachmas, Ireland Punt, Luxembourg Francs, Spanish Pesetas.European Central Bank (ECU) The Central Bank for the new European Monetary Union.Execution The Process of completing an order or deal.First In First Out (FIFO) refers to the order open orders are liquidated. The first orders to be liquidated are the first that were opened.Foreign Exchange (Forex, FX) Simultaneously buying one currency and selling another.Fundamental Analysis Analysis of political and economic conditions that can affect currency prices.Leverage or Margin The ratio of the value of a transaction to the required deposit. A common margin for Forex trading is 100:1 - you can trade currency worth 100 times the amount of your deposit.Limit Order An order to buy or sell when the price reaches a specified level.Lot The size of a Forex transaction. Standard lots are worth about 100,000 US dollars.Major Currency The euro, German mark, Swiss franc, British pound, and the Japanese yen are the major currencies.Minor Currency The Canadian dollar, the Australian dollar, and the New Zealand dollar are the minor currencies.Offer (Ask) The rate at which a dealer is willing to sell a currency.Offsetting transaction A trade with which serves to cancel or offset some or all of the market risk of an open position.One Cancels the Other (OCO) Two orders placed simultaneously with instructions to cancel the second order on execution of the first. A designation for two orders whereby one part of the two orders is executed the other is automatically cancelled.Open Order An order that will be executed when a market moves to its designated price. Normally associated with Good 'til Cancelled Orders.Open Position An active trade that has not been closed. An active trade with corresponding unrealized Profit and Loss, which has not been offset by an equal and opposite deal.Order A customer's instructions to buy or sell currencies.Over the Counter (OTC) Used to describe any transaction that is not conducted over an exchange.Overnight Position Trader's long or short position in a currency at the end of a trading day.Pips or Points The smallest unit a currency can be traded in. The smallest unit of price for any foreign currency. Digits added to or subtracted from the fourth decimal place, i.e. 0.0001.Political Risk Exposure to changes in governmental policy which will have an adverse effect on an investor's position.Price The price at which the underlying currency can be bought or sold. Price Transparency The ability of all market participants to "see" or deal at the same price. Describes quotes to which every market participant has equal access.Principle Value The original amount invested by the client.Profit /Loss or "P/L" or Gain/Loss The actual "realized" gain or loss resulting fromtrading activities on Closed Positions, plus the theoretical "unrealized" gain or loss on Open Positions that have been Mark-to-Market.Quote Currency The second currency in a currency pair. In the currency pair USD/EUR the euro is the quote currency.Rally A recovery in price after a period of decline.Range The difference between the highest and lowest price of a future recorded during a given trading session.Rate Price at which a currency can be purchased or sold against another currency. The price of one currency in terms of another, typically used for dealing purposes.Resistance Price level at which technical analysts note persistent selling of a currency. A term used in technical analysis indicating a specific price level at which analysis concludes people will sell.Revaluation Daily calculation of potential profits or losses on open positions based on the difference between the settlement price of the previous trading day and the current trading day. An increase in the exchange rate for a currency as a result of central bank intervention. Opposite of "Devaluation".Risk (Forex Risk) The risk that the exchange rate on a foreign currency will move against the position held by an investor such that the value of the investment is reduced. Exposure to uncertain change, most often used with a negative connotation of adverse change.Risk Management The employment of financial analysis and use of trading techniques to reduce and/or control exposure to financial risk.Rollover (Roll-Over) The process of extending the settlement value date on an open position forward to the next valid value date.Settlement The process by which a trade is entered into the books and records of the counterparts to a transaction. The settlement of currency trades may or may not involve the actual physical exchange of one currency for another.Short Position An investment position that benefits from a decline in market price. When the base currency in the pair is sold, the position is said to be short.Spot Market Market where people buy and sell actual financial instruments (currencies) for two-day delivery.Spot Price The current market price of a currency that normally settles in 2 business days (1 day for Dollar/Canada). The current market price. Settlement of spot transactions usually occurs within two business days.Spread This point or pip difference between the bid and ask price of a currency pair.Square Purchase and sales are in balance and thus the dealer has no open position.Squawk Box A speaker connected to a phone often used in broker trading desks.Squeeze Action by a central bank to reduce supply in order to increase the price of money. The difference between the bid and offer prices.Stable Market An active market which can absorb large sale or purchases of currency without major moves.Standard A term referring to certain normal amounts and maturities for dealing.Sterilization Central Bank activity in the domestic money market to reduce the impact on money supply of its intervention activities in the FX market.Sterling (The Pound - GBP) Another term for the British currency, "The Pound".Stop An order to buy or to sell a currency when the currency's price reaches or passes a specified level.Stop Loss Order Order to buy or sell when a given price is reached or passed to liquidate part or all of an existing position. Order type whereby an open position is automatically liquidated at a specific price. Often used to minimize exposure to losses if the market moves against an investor's position. As an example, if an investor is long USD at 156.27, they might wish to put in a stop loss order for 155.49, which would limit losses should the dollar depreciate, possibly below 155.49.Support Levels A price at which a currency or the currency market will receive considerable buying pressure. A technique used in technical analysis that indicates a specific price ceiling and floor at which a given exchange rate will automatically correct itself. Opposite of "resistance".Swap A transaction which moves the maturity date of an open position to a future date. The simultaneous purchase and sale of the same amount of a given currency for two different dates, against the sale and purchase of another. A swap can be a swap against a forward. In essence, swapping is somewhat similar to borrowing one currency and lending another for the same period. However, any rate of return or cost of funds is expressed in the price differential between the two sides of the transaction.Swap Price A price as a differential between two dates of the swap.Swiss Market slang for Swiss Franc.Take Profit Order A customer's instructions to buy or sell a currency pair which, when executed, will result in the reduction in the size of the existing position and show a profit on said position.Technical Analysis Analysis of historical market data to predict future movements in the market.Technical Correction An adjustment to price not based on market sentiment but technical factors such as volume and charting.Thin Market A market in which trading volume is low and in which consequently bid and ask quotes are wide and the liquidity of the instrument traded is low.Thursday/Friday Dollars A US foreign exchange technicality. If a foreign bank buys dollars on Tuesday for Thursday delivery. If the bank leaves the funds overnight and transfers them on Friday by means of a clearing house cheque then clearance is not until Monday, the next working day. Higher interest rates for this period are thus available.Tick The smallest possible change in a price, either up or down.Today/Tomorrow Simultaneous buying of a currency for delivery the following day and selling for the spot day, or vice versa. Also referred to as overnight.Tomorrow Next (Tom Next) Simultaneous buying of a currency for delivery the following day and selling for the spot day or vice versa.Trade Date The date on which a trade occurs.Tradeable Amount Smallest transaction size acceptable.Transaction The buying or selling of currencies resulting from the execution of an order.Transaction Cost The cost of a Forex transaction - typically the spread between bid and ask prices.Transaction Date The date on which a trade occurs.Turnover The total volume of all executed transactions in a given time period.Two Tier Market A dual exchange rate system where normally only one rate is open to market pressure, e.g. South Africa.Two-Way Price A quote in the foreign exchange market that indicates a bid and an offer.Two-Way Quotation When a dealer quotes both buying and selling rates for foreign exchange transactions.Uncovered Open position.Under-Valuation An exchange rate is normally considered to be undervalued when it is below its purchasing power parity.Unrealized Gain/Loss The theoretical gain or loss on Open Positions valued at current market rates, as determined by the broker in its sole discretion. Unrealized Gains' Losses become Profits/Losses when position is closed.Uptick A new price quote at a price higher than the preceding quote. A transaction executed at a price greater than the previous transaction.Uptick Rule In the US, a regulation whereby a security may not be sold short unless the last trade prior to the short sale was at a price lower than the price at which the short sale is executed.US Prime Rate The interest rate at which US banks will lend to their prime corporate customers.US Treasury The United States Department of the Treasury is the government department responsible for issuing all Treasury bonds, notes, and bills.Value Data The maturity date of the currency for settlement, usually two business days (one day for Canada) after the trade has occurred.Value Date The date on which counterparts to a financial transaction agree to settle their respective obligations, i.e., exchanging payments. For spot currency transactions, the value date is normally two business days forward. Value Date is also known as "maturity" date. For a spot transaction it is two business banking days forward in the country of the bank providing quotations which determine the spot value date. The only exception to this general rule is the spot day in the quoting centre coinciding with a banking holiday in the country(ies) of the foreign currency(ies). The value date then moves forward a day.Value Spot Normally settlement for two working days from today. See value date.Variation Margin Funds, which are required to bring the equity in an account back up to the initial margin level, calculated on a day-to-day basis. Funds a broker must request from the client to have the required margin deposited. The term usually refers to additional funds that must be deposited as a result of unfavorable price movements.Volatility (VOL) Statistical measure of the change in price of a financial currency pair over a given time period. A statistical measure of a market's price movements over time. A measure of the amount by which an asset price is expected to fluctuate over a given period.Vostro Account A local currency account maintained with a bank by another bank. The term is normally applied to the counterparty's account from which funds may be paid into or withdrawn, as a result of a transaction.Wash Trade A matched deal which produces neither a gain nor a loss.Whipsaw Slang for a condition of a highly volatile market where a sharp price movement is quickly followed by a sharp reversal.Withholding Tax Income tax withheld from employees' wages and paid directly to the government by the employer.Working Day A day on which the banks in a currency's principal financial centre are open for business. For FX transactions, a working day only occurs if the bank in both financial centre's are open for business (all relevant currency centers in the case of a cross are open).Yard A slang word used in the currency industry meaning "billion".X A Nasdaq stock symbol specifying that it is a mutual fund.Z-Score A statistical measure that quantifies the distance (measured in standard deviations) a data point is from the mean of a data set. In a more financial sense, Z-score is the output from a credit-strength test that gauges the likelihood of bankruptcy.
at 9:16 AM 1 comments
FOREX Trading News
Forex Trading as commonly called stands for Foreign Exchange Trading. It is biggest financial trading market in the world having a daily turnover in excess of US$1 Trillion. The figure signifies a volume amounting to about 28 times the combined volume of all US equity trading markets.Forex Trading means buying of one foreign currency by paying in another. Each transaction involves a purchase and a sale of currency at the same time, since currency trading is always done in pairs for example USD/EUR or USD/GBP etc.Foreign Currency trading or Forex Trading is undertaken for two purposes. About 5-7% of the transactions are undertaken by institutions that do business in foreign lands or companies that have to convert their foreign currency earnings into domestic currency. The rest of the Forex Trading is done purely on speculative basis with profit objectives.For trading by speculation purposes, the best profit making opportunity lies in most traded currencies (obviously the currencies of most economically advanced countries) also called the "majors" in Forex Trading parlance. They consist of US Dollar, GB Pounds, Japanese Yen, European Unions EURO, Swiss Franc, Canadian Dollar, Australian Dollar etc

How To Choose a Forex Trading System That Works and Suits You

noreply@blogger.com (mystero) — Thu, 02 Oct 2008 12:44:00 +0000

There are so many different trading systems you could use to trade the forex market, some better suited to certain people than others. For example some people may find it easier to comprehend and take into account fundamental factors as opposed to looking at a screen covered in technical indicators, and vice-versa.
The first logical step in determining what type of trading system would best suit you is actually being aware and understand the widely known methods of analysis used in trading the currency market. Once you are aware of the tools that are available, you can generally tell what type of analysis suits you. For example some of the main technical analysis methods which are popular include:
Pivot points
Chart patterns
Fibonacci retracements
Candlestick patterns
And some fundamental factors which are widely used include analyzing:
Interest rates
Trade balances
Unemployment rates
Gross domestic product (GDP)
You may now actually be able to develop your own system by combining certain methods of analysis together, giving you a method which you are comfortable with. On the other hand you may decide that you would like to trade someone else’s system, either way, that brings us to the next step which is determining the profitability of a trading system.
Determining Profitability
Most people would think that back testing is the best way to determine a systems profitability. However back testing doesn’t always give you a true idea of how profitable a system is. The reason for this is because when you’re back testing your system on historical charts, you are only seeing the obvious setups which have occurred, and not always seeing the ones that are less obvious. These less obvious ones sometimes can produce losses, which is why back testing isn’t always the best method to implement.
A better method of determining profitability is by trading your system in real-time with a demo account. This would give you a true understanding of what your system is capable of. This would also allow you to familiarize yourself with your trading platform at the same time. When determining profitability you must look at it in terms of expectancy and opportunity.
Expectancy & Opportunity
These two factors together will be able to tell you what you could expect to make over a period of time. Expectancy is calculated with the following formula:
(Probability of winning × average win) – (Probability of losing × average loss)
This will give you a figure which is the average amount you can expect to make per trade. This shouldn’t be a negative amount, if it is you should look at some other method of trading since you cannot make money on a system that produces a negative expectancy. Obviously the higher this figure is the better. Now to the opportunity factor.
The opportunity factor is how often you are able to trade using your system. By multiplying your expectancy figure with your opportunity factor it will tell you how much you could expect to make over a period of time. The more opportunity you have to trade, the more money you should expect to make. This now brings us to the last component of a trading system, money management.
Money Management
Without proper money management you will end up as a statistic. In other words one of those 90%+ of traders who loose their money. Money management tells you how much of your account balance to risk per trade. The whole point of money management is to ensure your survival over the long term, and to preserve your capital.
The most common form of money management is the percent risk model which tells you not to risk more than x percent of your account balance on any one trade. A range between 1-3% is generally an accepted amount which has been a reliable percentage to use in order to make money in the long term.
Conclusion
By taking into consideration the above factors you will be able to determine if a trading system best suits you, and with some simple mathematical calculations you will be able to determine its profitability

About Forex

noreply@blogger.com (mystero) — Thu, 02 Oct 2008 12:43:00 +0000

To buy foreign goods or services, or to invest in other countries, companies and individuals may need to first buy the currency of the country with which they are doing business. Generally, exporters prefer to be paid in their country's currency or in U.S. dollars, which are accepted all over the world.
The foreign exchange market, or the "FX" market, is where the buying and selling of different currencies takes place. The price of one currency in terms of another is called an exchange rate.

The market itself is actually a worldwide network of traders, connected by telephone lines and computer screens there is no central headquarters. There are three main centers of trading, which handle the majority of all FX transactions United Kingdom, United States, and Japan .

Forex Resources

noreply@blogger.com (mystero) — Thu, 02 Oct 2008 12:42:00 +0000

The live forex charts can be used to track ten currency pairs in real time and click on forex rates for a pop-up window of ten currency pairs with live rates for the EUR/USD, USD/JPY, GBP/USD, USD/CHF, USD/CAD, AUD/USD, NZD/USD, EUR/JPY, EUR/GBP and EUR/CHF, including the daily highs and lows from 17:00 EST. For a selection of free ebooks, trial offers, calculators and tutorials, visit free downloads. For a current snapshot of the foreign exchange market, use the market monitor to display time zones for several key markets, as well as live forex rates, a sentiment indicator and an economic calendar in a detachable window. Use the online money management calculator to calculate the correct position size for your trade based on your risk profile. Browse the selection of forex books on offer in forex books which includes special sections on technical analysis and general trading. There is a great number of forex related resources to be found in the categorised forex directory to help you find a particular niche or service.

what is forex

noreply@blogger.com (mystero) — Thu, 02 Oct 2008 12:36:00 +0000

FOREX (FOReign EXchange market) is an international foreign exchange market, where money is sold and bought freely. In its present condition FOREX was launched in the 1970s, when free exchange rates were introduced, and only the participants of the market determine the price of one currency against the other proceeding from supply and demand.As far as the freedom from any external control and free competition are concerned, FOREX is a perfect market. It is also the biggest liquid financial market. According to various assessments, money masses in the market constitute from 1 to 1.5 trillion US dollars a day. (It is impossible to determine an absolutely exact number because trading is not centralized on an exchange.) Transactions are conducted all over the world via telecommunications 24 hours a day from 00:00 GMT on Monday to 10:00 pm GMT on Friday. Practically in every time zone (that is, in Frankfurt-on-Main, London, New York, Tokyo, Hong Kong, etc.) there are dealers who will quote currencies.FOREX is a more objective market, because if some of its participants would like to change prices, for some manipulative purpose, they would have to operate with tens of billions dollars. That is why any influence by a single participants in the market is practically out of the question. The superior liquidity allows the traders to open and/or close positions within a few seconds. The time of keeping a position is arbitrary and has no limits: from several seconds to many years. It depends only on your trading strategies. Although the daily fluctuations of currencies are rather insignificant, you may use the credit lines, that are accessible even to currency speculators with small capitals ($ 1,000 - 5,000), where the profit may be impressive. (You can learn more about it in the section: The main principles of trading.)The idea of marginal trading stems from the fact that in FOREX speculative interests can be satisfied without a real money supply. This decreases overhead expenses for transferring money and gives an opportunity to open positions with a small account in US dollars, buying and selling a lot of other currencies. That is, on can conduct transactions very quickly, getting a big profit, when the exchange rates go up or down. Many speculative transactions in the international financial markets are made on the principles of marginal trading.Margin trading is trading with a borrowed capital. Marginal trading in an exchange market uses lots. 1 lot equals approximately $100,000, but to open it it is necessary to have only from 0.5% to 4% of the sum.For example, you have analyzed the situation in the market and come to the conclusion that the pound will go up against the dollar. You open 1 lot for buying the pound (GBP) with the margin 1% (1:1000 leverage) at the price of 1.49889 and wait for the exchange rate to go up. Some time later your expectations become true. You close the position at 1.5050 and earn 61 pips (about $ 405). For the calculation of 1 pip click here.Everyday fluctuations of currencies constitute about 100 to 150 pips, giving FX traders an opportunity to make money on these changes.In FOREX, it's not obligatory to buy some currency first in order to sell it later. It's possible to open positions for buying and selling any currency without actually having it. Usually Internet-brokers establish the minimum deposit such as $ 2000, for working in the FOREX market, and grant a leverage of 1:100. That is, opening the position at $100,000, a trader invests $1,000 and receives $99.000 as a credit. The major currencies traded in FOREX, are Euro (EUR), Japanese yen (JPY), British Pound (GBP), and Swiss Franc (CHF). All of them are traded against the US dollar (USD).In order to assess the situation in the market a trader has to be able to use fundamental and/or technical analysis, as well as to make decisions in the constantly changing current of information about political and economic character. Most small and medium players in financial markets use technical analysis. Technical analysis presupposes that all the information about the market and its further fluctuations is contained in the price chain. Any factor, that has some influence on the price, be it economic, political or psychological, has already been considered by the market and included in the price. The initial data for a technical analysis are prices: the highest and the lowest prices, the price of opening and closing within a certain period of time, and the volume of transactions.A technical analysis is founded on three suppositions:Movement of the market considers everything;Movement of prices is purposeful;History repeats itself. That is, technical analysis is a statistical and mathematical analysis of previous quotes and a prognosis of coming prices.A number of technical indicators have been installed into the PRO-CHARTS trading system. Analyzing the indicators one can come to the conclusion about further movements of the quoted currencies. For a more detailed description of the indicators, analyzing price charts and volumes of trading, click here.Fundamental analysis is an analysis of current situations in the country of the currency, such as its economy, political events, and rumors. The country's economy depends on the rate of inflation and unemployment, on the interest rate of its Central Bank, and on tax policy. Political stability also influences the exchange rate. Policy of the Central Bank has a special role, as concentrated interventions or refusal from them greatly influence the exchange rate.At the same time one should not consider fundamental analysis just as an analysis of the economic situation in the country itself. A far bigger role in the FOREX market belongs to the expectations of the market participants and their assessment of these expectations. Various prognoses and bulletins, issued by the participants, have a strong influence on the expectations. Very often an effect of the so-called self-filfilling prophecy occurs when market players raise or lower the exchange rates according to the prognosis. But a deep and thorough fundamental analysis is available only for big banks with a staff of professional analysts and constant access to a wide field of information.In spite of these different approaches, both forms of analyses complement one another. Traders who act on the basis of a fundamental analysis, have to consider some technical characteristics of the market (the main rates of support, such as resistance and resale), and supporters of the technical approach to the market must track the main news (interest rates, important political events).

.::++ MyStErO ++::.

noreply@blogger.com (mystero) — Thu, 18 Sep 2008 21:58:00 +0000

.::+*+* MyStErO *+*+::.

Valentine Appeal

noreply@blogger.com (mystero) — Fri, 12 Sep 2008 00:26:00 +0000

I know this is one day late but I just became aware of a Valentine’s Day campaign in Britain for this year. Though it is a day after Valentine’s Day, I am sure you can still do something to help out this cause. So what is it all about?
Arena Flowers, one of Britain’s leading flower shop, has teamed up with the British Heart Foundation and came up with the concept of selling flowers for a cause. The idea is simple and has been around for years – for each Valentine’s tulips bouquet that the flower shop sells this year, they will be donating £1 to the BHF’s cause. By the way, there are four different types of tulips bouquets available. In addition to this, they will be donating 50p for each Heart of Chocolates and Large Heart of Chocolates products that they sell.
If you are not the type who buys and gives flowers on Valentine’s you might want to make a change this year and do so – for any other reason! More than that, you can actually go straight to the BHF’s web site and make a direct donation. A mere £24 can pay for one hour of a BHF Heart Nurse’s time. It may seem little to you but it will make a world of difference to someone else! There are also many other ways that you can help the BHF’s campaign. If you want to know more, I suggest that you visit their web site and do your part in this worthy cause.

Bath’s Heritage May Be In Danger

noreply@blogger.com (mystero) — Fri, 12 Sep 2008 00:24:00 +0000

I wrote something about visiting Bath, one of the most popular tourist spots in the UK, some time ago. If you remember, Bath is a World Heritage Site as designated by UNESCO and this is one reason that Bath is as popular as it is today.
Recent developments, however, might be putting this charming British town at risk. Apparently, there are some building developments in the city which might lead to the stripping of the designation by the UNESCO. The said developments are actually plans to construct homes – thousands of them – in the Western Riverside area, and this is only part of the whole picture.
The Guardian reports:
The development has been described by the Bath Heritage Watchdog as ’something akin to a massive Soviet-era housing project’.Deborah Aplin, managing director of Crest Nicholson Regeneration, which is behind the Western Riverside development, said that it had written support from the government and English Heritage. ‘This land has been derelict for more than 25 years and our scheme will help regenerate this part of an otherwise beautiful city,’ she added.
I think that it is understandable that some citizens of the city would want to push Bath forward by opening the city to development and progress. However, it is also understandable that the city’s stature as a World Heritage Site could be affected. After all, certain criteria must be met in order for a place to be designated as such.
The issue will be discussed during UNESCO’s annual conference. I guess we just have to wait and see what happens.

Cumbria: England’s Loveliest Walking Country

noreply@blogger.com (mystero) — Fri, 12 Sep 2008 00:20:00 +0000

Long rambling walks in the countryside, the unmistakable scent of fresh air, the peacefulness that one finds only outside of the city – these things and more are what you can expect from a visit to Cumbria. Cumbria is a shire county in Northwest England and is predominantly rural. It is actually considered to be one of the most beautiful places in the whole country.
Being predominantly rural, the Cumbria area is one of the best places – if not the best – to go walking in England. If going on leisurely walks is your idea of relaxation, then Cumbria should definitely be on your list of places to visit.
The two main footpaths in this area are the Cumbrian Way and the Dales Way. If you take the former route, you will start by the sea side and head on northward to experience some of the most spectacular sceneries. The latter route will take you west into Yorkshire. Either way, you will have a one of a kind walking experience.
Of course, there are other options for those who are not “heavy duty walkers.” There are countless other footpaths wherein you can take more leisurely and shorter walks. Cumbria Calling lists down some of them:
• Buttermere - a two hour walk takes you all the way round this lovely lake• Derwent Water Ferry - take the Derwent ferry from Keswick to Hawes End. Walk to Lodore Falls and take the ferry back to Keswick• Stiffer than a stroll, but possible without being a mountaineer is to climb Skiddaw from Keswick.• Ullswater ferry and walk. Take ferry from Glenridding pier to Howtown. It is then a three hour walk back along the lake shore to Howtown• Take the ferry from Bowness to Sawrey, walk along the lake shore to Bass Rock, return through the National Trust woods• Grizedale forest. There are a number of waymarked walks. Details from Forestry Commission• Round Grasmere. A pleasant walk all the way round the lake at Grasmere will take about two hours
So put on your walking shoes and head on over to Cumbria!
Photo courtesy of Pikaluk