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I’ve been working in obstetrics for over twenty-five years, so very little takes me by surprise. However, the photos illustrating a recent article in The Sun, definitely gave me pause for thought. The item reported the difficult story of a mother who is now covered from head to toe with tumours, after her second pregnancy triggered a flare-up of her pre-existing genetic disorder.

Neurofibromatosis

Charmaine Sahadeo is affected by neurofibromatosis, an inherited condition that is characterised by tumours growing over the body. A genetic mutation causes the swellings to develop along nerves within the skin, the brain and in other parts of the body. The growths aren’t cancerous, but they can be distressing and disfiguring.

Neurofibromatosis (NF) is one of the world’s more common genetic disorders, affecting around of 1 in 3,000 people. Charlotte was born with the condition and like others affected she may have noticed a number of different abnormalities on her skin and elsewhere. People with NF may have café au lait spots, which are flat brown birthmarks, freckles in the armpits or elsewhere, and lumpy neurofibromas over the body. Some people may also have learning difficulties, high blood pressure and problems with the eyes and bones.

The Neuro Foundation says,
‘NF varies from one person to another even in the same family. Some people will be mildly affected with very few health problems. Others will have some serious health problems that mean that daily life is difficult and it restricts what they can do.’

Charmaine, from Trinidad, says that her condition changed around the time of the birth of her second son, Osiris. Now, 15 years later, she has an enormous number of tumours that in the pictures appear to be engulfing her body. She said ‘In all I think I have thousands of lumps. On my face and head alone there are probably three thousand or more. It looks like my skin is a strange bubble wrap’.

What happened in pregnancy to make the difference?

Pregnancy didn’t cause Charmaine’s neurofibromatosis, but it does appear to have made her condition much worse. Although we can’t know all about her health and wellbeing from a short item in a newspaper, scientists have reported that around half of all women with neurofibromatosis notice increased growth in size and number of their tumours during pregnancy. We’re not sure why, but it could be linked to the changing hormone levels and the fact that women’s immune systems alter during pregnancy. It’s nature’s way of protecting the baby from attack by their mother’s own defences against disease. The problem is, maintaining this delicate balance can disrupt the systems that usually suppress the growth of tumours and keep the neurofibromatosis in check.
Sadly, for Charmaine, neurofibromatosis is incurable and the surgery she has had to remove larger tumours has been unsuccessful. She is now hoping for further symptomatic treatment in the UK, America or Australia.

Preconception Care
I’m not commenting on this story to shock or scare anyone, or to draw gratuitous attention to Charmaine’s plight. Instead, it’s a way of demonstrating how much pregnancy can affect the body. Anyone who has a pre-existing chronic condition should see their doctor for assessment and advice, ideally prior to conception. That way, you will be supported to have as healthy a pregnancy as possible.

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