Health: The Miscarriage Maze

By Karen Springen

Jon Cohen and his wife, Shannon, never thought much about fertility. Their first child, Erin, was conceived easily, and Shannon's pregnancy progressed without a hitch. But when the couple decided to try again four years later, when both were 37, they ran into trouble. First they had difficulty conceiving; then Shannon had four miscarriages. "We felt like failures," says Jon.

The experience prompted Jon to delve into the science of miscarriage, which he maps out in his new book, "Coming to Term." Despite the guilt and secrecy, miscarriage is far from uncommon. Anywhere from 30 to 50 percent of all pregnancies are lost before women are even aware they've conceived, and at least one in seven known pregnancies ends in miscarriage. Older women are especially vulnerable; as more fortysomethings launch into baby making, miscarriage could strike in even greater numbers. Researchers will never be able to treat the heartache, but they are beginning to unravel the biological triggers, and they're testing new approaches to prevention. Today "we have more technological tools," says Dr. Mary Stephenson, director of the University of Chicago's new Recurrent Pregnancy Loss Program.

Most miscarriages are caused by an abnormal number of chromosomes. Nature usually expels these pregnancies before the end of the first trimester. Sometimes the embryos are perfectly healthy, but women miscarry for other reasons: a misshapen or scarred uterus, insulin or hormonal imbalances, immunological problems or chronic infections in the uterus.

You can take steps to lessen the likelihood of pregnancy loss. Start by taking a multi-vitamin with folic acid, don't smoke and maintain a healthy body weight. About one in five women with recurrent miscarriage suffers from antiphospholipid syndrome, a clotting problem that can interfere with implantation. Doctors are testing the ideal dose and type of heparin, a blood thinner, as treatment. Progesterone suppositories may help strengthen the lining of the uterus in women with low hormone levels. Some researchers also believe that women with un-explained miscarriages after a healthy first child may experience an immune response to a subsequent pregnancy. Stephenson and her colleagues are now testing intravenous immunoglobulin therapy.

Losing a baby is as emotional as it is physical. Take time to grieve and, if you feel comfortable, talk to friends and family. Even after recurrent miscar--riages, you can still have a healthy pregnancy. An expert told Jon and Shannon Cohen that she had only a 3 percent chance of carrying a baby to term. "It was hokum," says Jon. After four miscarriages, Shannon delivered two healthy boys.

Travel: An Island Getaway

Looking to escape the cold? Try sunny southern Cyprus, the wealthiest of the new EU member states and a Mediterranean island rich in ancient Greek and Roman history. Our picks:

Stay at the five-star Anassa resort, with its luxury suites, private plunge pools and a Roman-style spa (from $240; www.thanoshotels.com).

Dine on farmhouse-style food like beef stew and feta salad at Araouzos (from $15; 357-266-32076).

Sip brandy sours, the island drink, in the picturesque fishing village of Ayia Napa, which has become a serious hot spot for clubbing.

See Roman mosaics in the town of Paphos ($1.90).

Shop for local arts and crafts in the Ktima morning market; the Kivotos boutique sells wonderful ceramics, jewelry and glassware by Greek and Cypriot artists (67 Agoras Street).

Life Of Luxury: Creme de la Creme

Nothing is better for your winter-worn skin than... Crisco. "Shortening products make great moisturizers," says Dr. Boni Elewski, president of the American Academy of Dermatology. But effectiveness is just a small part of a cosmetic's allure. Just ask the superluxury Japanese cosmetics maker Cle de Peau Beaute (Key to Skin Beauty), which sells its increasingly popular moisturizer--called simply La Creme--for $450 an ounce. Each jar (whose precise ingredients remain closely guarded) comes with a tiny caviar spoon so you can ladle out the precious balm drop by drop. Save the Crisco for cookies.

Uncorked: Barolo

Barolo, located in Italy's Piedmont region, is known for its rich, powerful red wines made from the Nebbiolo grape. The 2000 vintage was superb and received the first overall perfect score from Wine Spectator. Rarely produced in large quantities, these wines are well worth the hunt. 100 | $169 | Bruno Giacosa Barolo Le Rocche del Falletto Riserva 2000 The result of ideal weather and Giacosa's experience, it has amazing concentration and fabulous purity.

96 | $90 | Pira Barolo Cannubi 2000 Made by Chiara Boschis, one of the area's few female wine makers, it's silky and refined, with fantastic cherry, mineral and raspberry character.

95 | $58 | Elio Grasso Barolo Ginestra Vigna Casa Mate 2000 The wine shows the splendid structure and big fruity style of the Nebbiolo grape, named after the vineyards' rolling fog.

92 | $36 | Ca'Bianca Barolo 2000 This is a great value for a 2000 Barolo. It is full-bodied, jammy and rich, in a soft, fruity style, with flavors of plum and blackberry.

91 | $40 | Michele Chiarlo Barolo Tortoniano 2000 From vineyards located in the western half of the Barolo zone, this wine is fresh, polished and approachable.

Food: Munch 'N' Moseying

Take your taste buds on a culinary walking tour that'll burn calories while you binge:

Barcelona. A day tour of Catalan cuisine starts at the city's oldest granja cafe, followed by a visit to the Boqueria market, and tapas, cava and a final meal at Angel's, a local favorite (myft.net).

St. Petersburg. Russians consume more than just caviar and vodka, you know. On this day trip you'll sample Siberian pelmeni, Ukrainian borscht and Armenian lavash. And don't forget the blini (peterswalk.com/ food.html).

New York. Mixing gastronomy with history, Big Onion Walking Tours lets you nosh through the neighborhoods of the Jewish East Side, Little Italy and Chinatown (Bigonion.com).

Italy. Try the seven-day Culinary Walk in Emilia-Romagna and Cinque Terre, which includes a stop at a Parmesan cheese factory and a pasta-making demonstration (experienceplus.com/ walking/itw032.html).

Music: Beyond The Hula

For the first time in its 47-year history, last week's Grammys included a category for Hawaiian music. If you're picturing women in grass skirts, here are some top albums to get you better acquainted with the genre. No leis required.

"Ke'alaokamaile" (Punahele; $15.98). Grammy nominee Keili'i Reichel, Hawaii's top-selling artist, plays oli (chants) passed down through families.

Elvis soundtrack to "Blue Hawaii" (RCA; $17.98). Swoon to the King's dreamy island renditions from this classic 1961 film.

"Mohala Hou" (Ohe; $16.99). With a Hawaiian musical lineage tracing back to the 15th century, Keola Beamer mixes native instruments like the bamboo nose flute with contemporary sounds.

"Hawaii's Greatest Hits, Vol. II" (Hawaii Calls Inc.; $15.95). The perfect soundtrack to your next luau. Mix up a mai tai and sway to "Aloha Oe," written in 1878 by Liliuokalani, the last reigning queen of Hawaii.