 |
|
 |
|
Perinatal Post | January 2009 Issue | 
|
Perinatal Outreach Coordination
Section on Maternal-Fetal Medicine
Department of Obstetrics and Gynecology
Wake Forest University School of Medicine | Mona Brown Ketner RN, MSN, C-EFM
Perinatal Outreach Coordinator
mketner@wfubmc.edu
(336) 716-7981 | Lisa A. Canada
Secretary
lcanada@wfubmc.edu
(336) 716-3662 | Supported by the March of Dimes. |
| Change in Perinatal Post Distribution |
January 2009 Issue – U.S. Mail and posted on this website
July 2009 Issue – Posted on our Obstetrics and Gynecology website only
| The link/web address to access the Perinatal Post is: http://www1.wfubmc.edu/obgyn. If you would like to be added to Lisa’s “E-mail Update List” to receive program brochures, etc., call (336) 716-3662 or e-mail Lisa Canada at lcanada@wfubmc.edu. |
Region 2 Perinatal Meeting, Tuesday, April 14, 2009
Forsyth County Health Department, Winston-Salem, North Carolina | | 10:00 a.m. | Registration | 10:30 a.m. | Meeting | 11:30 a.m. | Lunch – Fee $15.00 | 12:00 Noon | Speaker: | Peggy Berry, MS | | | Certified Genetic Counselor | | | Wake Forest University School of Medicine | | Program: | “THE QUAD SCREEN IN PREGNANCY” | | 1.0 Northwest AHEC Contact Hour | 1:00 p.m. | Adjourn |
Limit: 40 People. Register early.
Please call Mona Brown Ketner, RN, MSN at (336) 716-7981 for questions
A registration form for this activity will be sent via e-mail. If you would like to receive
one, but did not, please contact Lisa A. Canada at (336) 716-3662 or lcanada@wfubmc.edu.
|
MODIFICATION OF STD TESTING RULE FOR PREGNANT WOMEN | A technical rule change of 10A NCAC 41A. 0204 (Control Measures - Sexually Transmitted Diseases) has been published in the NC Register (Vol. 22, Issue 12, pp. 1170-1171). The change clarifies the testing requirements for pregnant women with regard to chlamydia and gonorrhea testing. The requested change is in 10A NCAC 41A. 0204(e) and will now read “Pregnant women 25 years of age and younger shall be tested for chlamydia and gonorrhea in the third trimester or at delivery if the woman was not tested in the third trimester.”
Please make a note of this change. For questions or information, contact Maria Valentine-Welch, CNM, MPH, Maternal Health Nurse Consultant, Raleigh, North Carolina at (919) 707-5689. |
* * * * * * * * * * * * * * * * * * * * * *
PREVENTING RECURRING PRETERM BIRTH:
THE NORTH CAROLINA 17P PROJECT | Preterm birth is a serious and growing problem. The rate of preterm birth has increased 27% since 1982. In North Carolina, one out of every seven babies is born too soon. The risk is even higher for some mothers as one out of every five African American babies is born preterm. Prematurity causes over 70% of perinatal morbidity and mortality. Unfortunately, premature birth is also a complex issue with multiple causal pathways and many unanswered questions. While there are many possible risk factors for early birth, mothers who have had a previous preterm birth are at the greatest risk for having another preterm infant.
Fortunately, there is now hope for mothers with a history of preterm birth. Research has shown that 17 alpha hydroxyprogesterone caproate (17P) has the potential to reduce a woman’s risk of recurring preterm birth by up to 33%. Women for whom 17P has been shown to be effective have a history of a previous singleton spontaneous preterm birth (200 to 366 weeks). These mothers need to be pregnant with a singleton pregnancy. Treatment is initiated between 160 and 216 weeks gestation with injections given weekly until 366 weeks gestation or until she delivers. For women at risk who begin prenatal care late, it is possible to initiate treatment up to 236 weeks gestation. Studies show no serious side effects for mother or baby, no increase in the rate of birth defects for infants whose mothers use 17P, and no observed increase in health problems among children whose mothers used 17P.
In North Carolina, Medicaid has agreed to reimburse providers for 17P injections. Mothers who are low-income and uninsured may receive 17P free of charge through a special fund established by the General Assembly. Information about how to order 17P as well as billing details, patient resources, provider materials, and a description of the 17P project is available at www.mombaby.org, click on 17P. While 17P is not a silver bullet for preterm birth prevention, it is an important option for a group of high-risk women. It should be a part of every prenatal care provider’s list of intervention resources. For more information please contact Sarah Verbiest at (919) 843-7865 or sarahv@med.unc.edu.
Sarah Verbiest, DrPH, MSW, MPH
Executive Director, UNC Center for Maternal and Infant Health
& 17P Project Coordinator |
* * * * * * * * * * * * * * * * * * * * * * * * *
PLUS+1 – MANAGEMENT OF OBESITY IN PREGNANCY | I want to update you on the status of the Plus+1 clinic here at Wake Forest University. Since January 2007, we have consulted over 100 patients and recruited over 75 participants to our observational study on pregnancy outcomes. Our success includes two accepted abstracts to next year’s Society of Maternal-Fetal Medicine Annual Meeting, as well as two submitted abstracts to the Society for Gynecologic Investigation International Meeting. These successes are only the beginning and much credit goes to you, the referring clinician.
However, the epidemic grows and you may have seen televised reports on the association of obesity with increase in structural fetal malformations, pregnancy complications including stillbirth, etc… Other reports continue to be published at an increasing rate that link obesity to maternal and neonatal morbidities. Practically speaking, you may have had conversations with our anesthesia colleagues, as well as labor and delivery staff, who voice concerns in caring for the obese gravida. It is challenging, at best, to adequately assess whether your 250+ pound gravid patient has underlying cardiac or respiratory disease, sleep apnea syndrome, etc.
Our goal at the Plus+1 clinic is to serve the Central and Western North Carolina obstetrical community and address this epidemic of OBESITY as it relates to pregnancy. Working with collaborators like yourself, we are implementing management guidelines for this truly high-risk group. Our consultation includes antenatal strategies focusing on making lifestyle changes to improve the obese gravidas quality of life, as well as addressing issues of psychologic and physiologic stress. Observational and prospective studies are underway to answer some of these questions systematically.
We would gladly see your patients for consultation at either our Winston-Salem office at 336‑716‑4039 or our Greensboro office at 336-832-6986 and request Plus+1 consultation. Please contact me directly (cell: 336-403-4726) if you have any questions regarding the Plus+1 clinic or any of our ongoing studies.
Saju D. Joy, M.D., MS, Assistant Professor, Department of Obstetrics and Gynecology
Section on Maternal-Fetal Medicine, Wake Forest University School of Medicine |
* * * * * * * * * * * * * * * * * * * * * * * * *
* * * * * * * * * * * * * * * * * * * * * * * * *
Upcoming Programs | February 10, 2009
“Basic Fetal Monitoring”
Winston-Salem, North Carolina
Information: Mona Brown Ketner (336) 716-7981
| April 23-27, 2009
“38th Annual AWHONN NC Section Conference”
Information: Mona Brown Ketner (336) 716-7981
| February 18, 2009
“Advanced Fetal Monitoring”
Wilkes Regional Medical Center
North Wilkesboro, North Carolina
Information: Mona Brown Ketner (336) 716-7981
| May 28, 2009
“Counseling Women Who Smoke”
Winston-Salem, North Carolina
Information: Debbie Gordon (336) 716-2530
| *February 26-27, 2009
“Lamaze Teacher Education Seminar”
Burlington, North Carolina
Information: Tara Owens Shuler (919) 684-2648 tara.owens@duke.edu | June 2, 2009
“Global Health: Individual Perspectives”
Winston-Salem, North Carolina
Information: Mona Brown Ketner (336) 716-7981 | March 5, 2009
“Fetal Monitoring Update”
Winston-Salem, North Carolina
Information: Mona Brown Ketner (336) 716-7981
| November 16-17, 2009
“27th Annual Gravidas at Risk
Hickory, North Carolina
Information: Mona Brown Ketner (336) 716-7981 | March 20 & 27, 2009
“OB/Neonatal Review”
Winston-Salem, North Carolina
Information: Mona Brown Ketner (336) 716-7981 | | *For Candidates in the Lamaze Childbirth Education Certification Program |
|
|
|
|
|