Increasing Prenatal Care Compliance in At-Risk Black Women: Findings from a RCT of Patient Navigation and Behavioral Incentives.

Background: In the USA, infant mortality remains a major public health concern, particularly for Black women and their infants who continue to experience disproportionately high mortality rates. Prenatal care is a key determinant of infant health, with inadequate prenatal care increasing risk for prematurity, stillbirth, neonatal loss, and infant death. The aim of the present study was to determine if concurrent delivery of patient navigation and behavioral incentives to at-risk Black pregnant women could improve prenatal care attendance and associated maternal and infant outcomes.

Study protocol for a multisite randomized controlled trial of an internet and mobile-based intervention for preventing and reducing perinatal depressive symptoms.

Nearly 20% of women in the United States experience clinically significant depressive symptoms during pregnancy or the postpartum period. These women may benefit from easily accessible, nonpharmacologic, and inexpensive self-management approaches, such as via internet and mobile-based interventions, to prevent development of symptoms and/or intervene with current symptoms. This paper summarizes the research protocol of a nationally-funded large-scale randomized controlled study to evaluate "Mamma Mia," a self-guided program with 44 modules that women use throughout pregnancy to 6 months postpartum.

Management of fetal ductus arteriosus constriction with Digoxin and oxygen therapy.

Constriction of the fetal ductus arteriosus is rare and usually attributed to medications or CHD. We describe a 24-year-old multigravida at 33 weeks 5 days gestation with echocardiographic findings of severe ductal constriction, a dilated, hypertrophied and hypocontractile right ventricle, and severe tricuspid regurgitation following BC powder® use. Treatment with Digoxin and oxygen resulted in a progressive 71% reduction in peak systolic ductal gradient, improved right ventricular function, and decreased tricuspid regurgitation.

Pre- and postnatal MR imaging of an asymptomatic giant hypothalamic hamartoma.

Hypothalamic hamartomas are rare tumors that are most often diagnosed in early childhood. These lesions are classified as giant hypothalamic hamartomas when they exceed 4 cm in any 1 dimension. The most common presenting symptoms associated with these lesions are precocious puberty, gelastic seizures, and (less commonly) syndromic conditions such as Pallister-Hall syndrome.

Standardized severe maternal morbidity review: rationale and process.

Severe maternal morbidity and mortality have been rising in the United States. To begin a national effort to reduce morbidity, a specific call to identify all pregnant and postpartum women experiencing admission to an intensive care unit or receipt of four or more units of blood for routine review has been made. While advocating for review of these cases, no specific guidance for the review process was provided.

Standardized severe maternal morbidity review: rationale and process.

Severe maternal morbidity and mortality have been rising in the United States. To begin a national effort to reduce morbidity, a specific call to identify all pregnant and postpartum women experiencing admission to an intensive care unit or receipt of 4 or more units of blood for routine review has been made. While advocating for review of these cases, no specific guidance for the review process was provided.

Oral health care for the pregnant patient.

Pregnancy is a unique time in a woman's life, accompanied by a variety of physiologic, anatomic and hormonal changes that can affect how oral health care is provided. However, these patients are not medically compromised and should not be denied dental treatment simply because they are pregnant. This article discusses the normal changes associated with pregnancy, general considerations in the care of pregnant patients, and possible dental complications of pregnancy and their management.

Oral health care for the pregnant patient.

Pregnancy is a unique time in a women's life, accompanied by a variety of physiologic, anatomic and hormonal changes that can affect how oral health care is provided. However, these patients are not medically compromised and should not be denied dental treatment simply because they are pregnant. This article discusses the normal changes associated with pregnant general considerations in the care of pregnant patients, and possible dental complications of pregnancy and their management.

Oral health care for the pregnant patient.

Pregnancy is a unique time in a woman's life, accompanied by a variety of physiologic, anatomic and hormonal changes that can affect how oral health care is provided. However, these patients are not medically compromised and should not be denied dental treatment simply because they are pregnant. This article discusses the normal changes associated with pregnancy, general considerations in the care of pregnant patients, and possible dental complications of pregnancy and their management.

Oral health care for the pregnant patient.

Pregnancy is a unique time in a woman's life, accompanied by a variety of physiologic, anatomic, and hormonal changes that can affect how oral health care is provided. However, these patients are not medically compromised and should not be denied dental treatment simply because they are pregnant. This article discusses the normal changes associated with pregnancy, general considerations in the care of pregnant patients, and possible dental complications of pregnancy and their management.

Oral health care for the pregnant patient.

Pregnancy is a unique time in a woman"s life, accompanied by a variety of physiologic, anatomic and hormonal changes that can affect how oral health care is provided. However, these patients are not medically compromised and should not be denied dental treatment simply because they are pregnant. This article discusses the normal changes associated with pregnancy, general considerations in the care of pregnant patients, and possible dental complications of pregnancy and their management.

Smoking and illicit drug use during pregnancy: impact on neonatal outcome.

Objective: To examine the effects of maternal substance use on neonatal outcomes in 212 pregnant cocaine/opiate dependent women who delivered while in active drug treatment.

Study Design: Using urine toxicology data at delivery, subjects were classified drug positive (+TOX) (n = 53) or negative (-TOX) (n = 159).

Results: Toxicology status was not associated with maternal or neonatal demographic or drug use variables.

The predictive value of the 1-h 50-g glucose screen for diagnosing gestational diabetes mellitus in a high-risk population.

Objective: To determine a value, for a gestational diabetes mellitus (GDM) screening test, above which the glucose tolerance test is obviated.

Methods: A database search of patients delivered at the Medical College of Virginia Hospital (MCV) between April 1991 and April 2002 was undertaken. Subjects were screened using standard methodology: blood glucose level 1 h after a 50-g oral glucose load (1OGT).

Hemodynamic changes and baroreflex gain in the supine hypotensive syndrome.

Objective: The purpose of this study was to determine whether supine hypotensive syndrome is caused by a decreased baroreflex gain that results in inadequate compensatory responses to restore cardiac output.

Study Design: Ten third-trimester gravid women with symptoms that were suggestive of supine hypotensive syndrome and 10 control subjects without symptoms were studied. Patients were studied initially for 30 minutes in the lateral recumbent position with continuous heart rate, blood pressure, external cardiotocography, and cardiac output determinations every 5 minutes.