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As up to 36 inches of snow blanketed central Virginia last month during a record-setting blizzard caused by Winter Storm Jonas, several Ob Hospital Group obstetricians scrambled to make sure there was coverage at area hospitals to serve any pregnant women who might experience labor during the storm. These physicians went beyond the call to ensure uninterrupted coverage during the storm, and their teamwork is noteworthy.
Continuing our blog series for International Prenatal Infection Prevention Month, this post discusses sexually transmitted diseases (STDs) along with Hepatitis B and C. Most STDs, including Syphilis, Genital Herpes, and Human Papilloma Virus (HPV), also can be passed to the baby. A very common sexually transmitted infection, Chlamydia trachomatis, targets a woman’s reproductive tract and can prompt pelvic inflammatory disease or other complications, including ectopic pregnancy, stillbirth, or even infertility.
Chlamydia can be passed to the newborn, increasing the risk of early labor and post-natal eye infection in the newborn, possibly even pneumonia at one to three months of age. Most women have no symptoms. If diagnosed, pregnant women can be treated with a number of safe antibiotics, and the infection can be eliminated before giving birth.
Findings from a study published recently by the New England Journal of Medicine (and widely shared online) cite OB/GYN as one of four top medical specialties targeted in medical malpractice claims. It’s true, but it doesn’t tell the whole story.
Approximately one out of every 10 OB/GYN physicians nationwide is named in a malpractice claim every year. 1 in 10! How healthcare facilities operate and utilize personnel can make all the difference in mitigating malpractice risk and delivering the best quality care possible to expectant mothers.
Mothers-to-be, especially first-timers, have many questions. Am I getting enough folic acid? Is drinking coffee OK? Should I get a flu shot? How much weight gain is normal? What is my risk for preeclampsia?
Because February is International Prenatal Infection Prevention Month, Ob Hospitalist Group (OBHG) wants women to be aware of both common and not-so-common prenatal infections, as well as actions that can prevent them. We will share information throughout the month about different infections.
Critics assert that healthcare in the United States, perhaps inadvertently, has become an example of “ready-fire-aim” thinking. For decades, our conventional model has been tweaked and refined to create necessary cost efficiencies that are palatable to the traditional fee-for-service, insurance-shaped marketplace. The old model — which industry experts dubbed the First Curve Paradigm — typically put urgent, episodic, acute care front and center.
In this First Curve culture, preventive, chronic, and longer-term care are relegated to a volume-based healthcare periphery where patients basically fend for themselves. This often involves navigating an uncoordinated network of independent providers operating as turf-protected islands unto themselves. There is little communication among providers, no strategy to sustain the patient’s health beyond isolated episodes, no forward-thinking plan for maintaining the wellness of the patient or even entire population groups.
As the Zika Virus continues to spread around the globe, particularly in South and Central America, pregnant women planning "babymoons" should take note of travel alerts from the Centers for Disease Control. Dr. Rakhi Dimino recently wrote a blog post for the Texas Medical Association aimed at alerting women in Texas to this advisory and what precautions they should take to protect themselves.
To read the full article, visit the Me & My Doctor blog.
Dr. Dimino is a Houston OB Hospitalist and Medical Director of Operations for OB Hospitalist Group.
Although the risk this winter for contracting the Zika Virus remains relatively low for pregnant women in the United States, the World Health Organization (WHO) this week declared Zika a global “public health emergency of international concern.” While that reference sounds frightening on the surface, the WHO declaration is intended less to be alarmist and more to coordinate funding and expertise among governments around the world to begin the long-term task of managing the epidemic. Any Zika outbreaks in the United States are projected to be both insignificant and localized.
Women who are pregnant or trying to conceive should be aware of a low-level risk in the United States of contracting the Zika virus, which has been observed in recent months in Brazil and several Caribbean and Latin American countries. About 12 cases of people in the United States being infected with the virus have been confirmed in Florida, Texas, Illinois, and Hawaii. All of the infected individuals recently had traveled to Latin American countries.
The virus is believed to be responsible for an escalation of congenital microcephaly in newborns and for stillborn births. Babies born with microcephaly have abnormally small heads and under-developed brains. Because of this, they suffer a number of medical complications and developmental issues requiring constant care. Most have a life expectancy of only 10 years, though some live into their 30s.
The United States is one of the few developed countries in the world where the rate of maternal mortality is increasing. More women are dying during pregnancy and delivery in the United States than before. This should raise shock and concern among our pregnant patients and the medical community caring for them. Although the overall numbers are low, in a country where access to excellent health care is becoming more achievable, we should be working harder to address this.
The major causes of maternal death are blood clots, postpartum hemorrhage, and pre-eclampsia (high blood pressure in pregnancy) complications. Many of these complications occur in the immediate hours or days after delivery while the new mom may still be in the hospital. Some of these deaths are prior to delivery but after the mom is emergently brought to the hospital.
One of the most successful ways to reduce the number of deaths is to reduce the time it takes an experienced obstetrician-gynecologist (OB-Gyn) to evaluate and treat the mother. Traditionally, a private OB-Gyn who takes care of a patient prenatally and during the delivery does not stay in the hospital 24 hours a day. This creates a lag time between the onset of the emergency and the arrival of the OB-Gyn coming to the hospital from home or elsewhere.
Across Texas today, more and more hospitals and maternity units are using obstetrical hospitalists who are experienced in obstetrical emergencies and are in the hospital 24/7 to react immediately to any emergency and assist a private OB-Gyn once he or she arrives. When an emergency arises, this removal of the lag time has greatly increased safety for mothers and newborns and improved overall outcomes. Talk to your OB-Gyn or your hospital about the availability of OB hospitalists in your area.
Rakhi Dimino, MD
Medical Director of Operations, OB Hospitalist Group
Member, TMA Council on Science and Public Health
View the original blog post Here
Since implementing our flagship OB/GYN hospitalist program in 2006, Ob Hospitalist Group (OBHG) has helped our partner hospitals realize many successes, not only in elevating the standard of women’s healthcare but also by improving patient satisfaction, reducing physician and nursing staff turnover and reducing hospital liability.
While we have as many success stories as we do hospital partners, it’s nice to know healthcare industry research confirms the positive impact hospitalists have on hospital medicine.
Recent research has been able to quantify the positive impact of hospitalist medicine in the following five main areas:
- Patient Safety and Quality of Care
- Economic Efficiency
- Access and Availability
- Leadership and Education
The patient safety and quality of care advantages OBHG hospitalists deliver are not only vast but vital.