Cesarean Delivery and Vaginal Birth After Cesarean Delivery Rates in a First Nations Community-Based Obstetrical Program in Northwestern Ontario.

Objective: To examine rates of cesarean delivery (CD) and vaginal birth after cesarean delivery (VBAC) and the patient profile in a community-based obstetrical practice.

Methods: Retrospective data from 2012 to 2017 for the Sioux Lookout Meno Ya Win Health Centre (SLMHC) were compared to data from the 30 hospitals providing the same level of services (Maternity 1b: maternity care by family physicians/midwives with CD and VBAC capacity) and Ontario. SLMHC VBAC patients were then compared to the general SLMC obstetrical population.

Maternal opioid use disorder and neonatal abstinence syndrome in northwest Ontario: a 7-year retrospective analysis.

Introduction: Opioid use in pregnancy is increasing globally. In northwest Ontario, rates of neonatal abstinence syndrome (NAS) are alarmingly high. We sought to document the increasing rates of opioid exposure during pregnancy and associated cases of NAS over a 7-year period in northwest Ontario.

Nonpharmacological management of neonatal abstinence syndrome: a review of the literature.

Background: Infants with neonatal abstinence syndrome (NAS) experience withdrawal that occurs as a result of termination of placental opioid supply following delivery. Common symptoms include restlessness, tremors, agitation and gastrointestinal disturbances. Severe NAS is often treated using opioids and/or sedatives.

Maternal-Fetal Monitoring of Opioid-Exposed Pregnancies: Analysis of a Pilot Community-Based Protocol and Review of the Literature.

Objectives: To describe/analyse a novel, community-based prenatal monitoring protocol for opioid-exposed pregnancies developed by our centre in 2014 to optimize prenatal care for this population. A literature review of published monitoring protocols for this population is also presented.

Methods: Retrospective comparison of pre-protocol (n = 215) and post-protocol (n = 251) cohorts.

Observational study of the safety of buprenorphine+naloxone in pregnancy in a rural and remote population.

Objectives: To describe the effect of in utero exposure to the buprenorphine+naloxone combination product in a rural and remote population.

Setting: A district hospital that services rural and remote, fly-in communities in Northwestern Ontario, Canada.

Participants: A retrospective cohort study was conducted of 855 mother infant dyads between 1 July 2013 and 30 June 2015.

Narcotic tapering in pregnancy using long-acting morphine: an 18-month prospective cohort study in northwestern Ontario.

Objective: To document the management of and outcomes for patients receiving narcotic replacement and tapering with long-acting morphine preparations during pregnancy.

Design: A prospective cohort study over 18 months.

Setting: Northwestern Ontario.

Incidence of narcotic abuse during pregnancy in northwestern Ontario: three-year prospective cohort study.

Objective: To document the incidence and outcomes of narcotic use during pregnancy in northwestern Ontario.

Design: Three-year prospective cohort study.

Setting: Sioux Lookout and surrounding communities in northwestern Ontario.