Fetal Monitoring

Prenatal adenovirus vascular endothelial growth factor gene therapy: a promising new treatment for fetal growth restriction. By - Dr David J Carr, Raymond P Aitken, John S Milne, Vedanta Mehta, Don...

Obesity is increasing in the child-bearing population as are the rates of gestational diabetes. Gestational diabetes is associated with higher rates of Cesarean Section for the mother and increased risks of macrosomia, higher body fat mass, respiratory distress and hypoglycemia for the infant. Prevention of gestational diabetes through life style intervention has proven to be difficult. A Finnish study showed that ingestion of specific probiotics altered the composition of the gut microbiome and thereby m

AbstractObjective To investigate the incidence of preterm delivery in the Belgian population after implementation of smoke-free legislation in three phases (in public places and most workplaces January 2006, in restaurants January 2007, and in bars serving food January 2010). Design Logistic regression analyses on routinely collected birth data from January 2002 to December 2011.Setting Flanders, Belgium.Population All live born singleton births delivered at 2444 weeks of gestation (n=606877, with n=

PLOS ONE: an inclusive, peer-reviewed, open-access resource from the PUBLIC LIBRARY OF SCIENCE. Reports of well-performed scientific studies from all disciplines freely available to the whole world.

AbstractObjective To assess the main risk factors associated with stillbirth in a multiethnic English maternity population.Design Cohort study. Setting National Health Service region in England.Population 92218 normally formed singletons including 389 stillbirths from 24 weeks of gestation, delivered during 2009-11.Main outcome measure Risk of stillbirth.Results Multivariable analysis identified a significant risk of stillbirth for parity (para 0 and para 3), ethnicity (African, African-Caribbean, I

Full Text View. Use of Intrapartum Biophysical Profile When Fetal Heart Rate Monitoring is Non-reassuring in Labor. ... EndpointClassification: SafetyStudy. InterventionModel: SingleGroupAssignment. Masking: OpenLabel. PrimaryPurpose:

The decision to proceed to operative delivery was made by the obstetric team for maternal or fetal indications. ... All participants had continuous external electronic fetal heart rate ( FHR) monitoring and tocodynamometry.

Exclusion Criteria:. dBP consistently < 85mmHg by home BP monitoring; severe systolic hypertension; proteinuria; contraindication to either arm of the trial or to prolongation of pregnancy; or known lethal/major fetal anomaly.

Full Text View. Human Fetal Liver Cell Transplantation in Chronic Liver Failure. ... Primary Outcome Measures:. Assess the therapeutic efficacy of human fetal liver progenitor cell transplantation by monitoring standard and specific liver function

In this study, cardiac output and blood pressure will be measured by transthoracic bioimpedance, which is a new technique of noninvasive continuous cardiac output monitoring. ... Preexisting or pregnancy-induced hypertension. Cardiovascular or

This background report describes the process used to identify, evaluate, and select children's health care quality measures to be recommended for addition to the initial core set of 24 measures.

Topic page summarizing evidence report on screening for gestational diabetes.

Respiratory distress syndrome (RDS) is a breathing disorder that affects newborns. The disorder is more common in premature infants.

Treatment for respiratory distress syndrome (RDS) usually begins as soon as an infant is born, sometimes in the delivery room.

placebo. The FEM-PrEP trial and the oral TDF portion of the VOICE trial were stopped early by their data safety monitoring boards when they concluded that no evidence of efficacy ... Second, women who became pregnant during the PrEP trials described in

Intrapartum fetal heart rate monitoring: nomenclature, interpretation, and general management principles.

ACR Appropriateness Criteria multiple gestations.

Management of alloimmunization during pregnancy.

Preterm prelabour rupture of membranes.

It could, therefore, include induction, augmentation, electronic fetal monitoring, regional anaesthesia, and com- plications of pregnancy ( hypertension, antepartum hemor- rhage etc). ... 221, December 2008. Forceps or vacuum assistance Caesarean

Had a case the other day with the above finding on a pap. She was age 36 and had a Mirena in place. How do people feel about the idea of trying to do an EMB with an IUD in place? If not, how do we proceed?

Hello,

Has anyone tried FetalGrowth app (App Store for iPhone/iPad) ? I'm interested in using a simple and handy tool to calculate fetal percentiles, and I came across this app, which seems it does the job (plots growth charts, as well). I haven't seen anything else, besides this app, so I was wondering if there are people who have already tried it.

Thanks !

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I helped another physician with removal of a retained placenta last night, we were unsuccessful in removing it vaginally, her cervix was too closed to allow manual removal and we could only get a few pieces out with ring forceps and a large curette, so we did a laparotomy/hysterotomy and were able to preserve the uterus. The placenta turned out not to be an accreta and it was easily removed via that route through a low vertical incision on the uterus. Any thoughts on the appropriate CPT code would be appreciated. The patient came in through the ER five days after home delivery by her husband. She was severely anemic, rcvd 7 units of blood and is still quite ill and in the ICU but improving.

Ronald E. Ainsworth, MD, FACOG

Recently, I had the occasion to review a case of a term primigravida with PROM in a private hospital (no housestaff or in house obstetricians). She was seen by an obstetrician soon after arrival, evaluated, and pitocin induction begun.

She did not deliver for around 29 hours after admission, and the delivering obstetrician (a different physician) was physically present during the last 2 hours of labor prior to delivery.

Simply put, while the two involved obstetricians were in communication by phone with the nursing staff throughout labor (separately as their "shifts" did not overlap), no one actually came to the bedside and wrote a note) from admission until around 2 hours before delivery.

Medical staff bylaws call for a daily progress note; this bylaw was easily met.

In reviewing the case, it did not "feel good" that no one came to the bedside.

My questions:

1. Does anyone have or know of any guidelines to mandate such bedside attendance? Of course, we all hope that the involved physicians would not need said guidelines.
2. Does anyone have a suggestion of hospital/nursing protocols? Simply, in this case I would like to have had a charge nurse or bedside nurse simply say, "Hey, no one has been by for a while. What's up?"

Garry

Hey, what textbooks would you advise for my son who is beginning residency this summer?

Post here or email privately if better.

Thanks,

Garry

<p>Hello  friends ,

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Hello,

I really need help from OB/GYNs and I'm having a hard time getting it. I find your opinions really valuable. I'm researching recommendations for cosleeping. This is for my dissertation, so your time is truly appreciated! Please complete the full survey. It will help me tremendously.

The study takes about 5 to 10 minutes to complete. Please don't hesitate to contact me at bhamel@pacificu.edu with any questions.

If you are interested in participating, please follow the link provided below:

https://www.surveymonkey.com/s/Cosleeping

Thank you in advance for your time. If possible, please forward this to other OB/GYNs you know.

Sorry if this an innappropriate use of the forum. But it seems like the right place to find the participants I need.

.

Our hospital bought an electronic medical record (EMR) system for the clinics. There is a large hosptial group practice including pediatrics, medicine, FP, OB/GYN, and other specialities and sub-specialities. Furthermore, the hospitalists and the ER doctors are also employed in the same hosptial group practice.

The hospital spent millions of dollars on an EMR. As best I can tell there are only two useful things that the EMR does. One is to automatically calcualte the BMI, which it does very well. THe other is to make records available on any patient to any doctor anywhere in the practice. It does not do this well -- it requires lots of mouse movements and clicks and different documents come up in different formats, making it labor intenisve. But, with enough time, effort, and frustration, one can obtain copies of every document in the sustem, either on a computer screen or on paper.

Swith to the ER now. A paitnet whom I had seen the previous week in consultatio comes into the ER for a non-pregnancy problem. They call me on the telephone in the evening. "No problem", I say. I did a torough evaluation and wrote a detailed note on the patient and her OB and non-OB problems only a few days ago. "Just go to the EMR and you can print out my note with all the details."

Seems, however, that for some reason the EMR is not available in the ER (or on the wards for that matter). When I asked the hosptial administrator about it the next morning, he said that he and the hosptial lawyers were working on the problem.

Apparently the government thinks that the ER doctors and hospitalists have nothing better to do with their time than to print out copies of patients' medical records from the EMR and sell them on the black market. Therefore, we cannot let those nasty doctors have access to the EMR records. Nevermind that the ER doctors are in the same group practice as all the other doctors. Never mind that the patient is willing to sign a release so that the doctor who is taking care of her can see the records of the practice. We have to protect the patient even if it means that vital information is rendered unavailable and that things are made more difficult, complicated, and expensive. It reminds me of the Army in Viet Nam where they would have to "destroy a village in order to save it!" Apparently the EMR makes us destroy a patient in order to save her.

Thank GOD for the EMR. Three million dollars and the only benefit is that we can get a BMI 10 seconds faster.

I think the NEJM got it correct last month when they said in an atricle that the only ones who truly benefit from electronic medical record systems are the people who make and sell them.



Dean Huffman

Decline in Semen Concentration and Morphology in a Sample of 26,609 Men Close to General Population Between 1989 and 2005 in France


http://www.medscape....22498EV&spon=16