Prone positioning has been used for decades to improve oxygenation in patients with acute respiratory distress syndrome. With the COVID-19 pandemic there has been a growing emphasis on the utilization of prone positioning for non-intubated patients as a means of preventing invasive ventilation and improving outcomes. In this case report, a patient is presented with acute hypoxemic respiratory failure in late pregnancy who experienced significant improvements in oxygenation with prone positioning. Additionally, the physiology of prone positioning is reviewed, as well as its mechanism and safety in pregnancy.
per week and 91 were in the top 90th percentile (High ASB), consuming >21 ounces per week. Sixty percent of the cohort consumed no ASB. Demographic characteristics were similar between groups. No significant differences were found for primary or secondary outcomes after adjusting for potential confounding variables. CONCLUSION: Most patients consumed some SSB, no ASB, and there were no differences in pregnancy outcomes between the highest consumers in both groups. Beverage consumption is an important aspect of maternal dietary quality and evidence-based recommendations are needed to guide consumption in pregnancy.
INTRODUCTION:
Doula support for socially disadvantaged women during pregnancy, childbirth and postpartum period is associated with improved outcomes, including lower rates of cesarean section, higher rates of breastfeeding initiation, and decreased maternal and perinatal complications. The purpose of our study is to report rates of primary cesarean section rate, breastfeeding initiation, and maternal and perinatal complications among socially or economically disadvantaged pregnant patients enrolled in a doula program in a large inner city setting.
METHODS:
Retrospective chart review of birth outcomes included primary cesarean section rate, breast feeding initiations, maternal and perinatal complications of patients enrolled in a certified doula support program in a large inner city setting. Outcomes were compared to local states percentages.
RESULTS:
Three hundred twenty two patients enrolled in the doula support program, 248 delivered vaginally and 74 required a cesarean section (cesarean section rate 22%), breast feeding initiation was reported in 269 patient (83% rate breast feeding initiations) and no maternal or perinatal loss was reported.
CONCLUSION:
Patients enrolled in a certified doula support programs in an inner city setting have improved cesarean section rates (22% vs 27%), breast feeding initiation rate (83% vs 80%) and improved maternal and perinatal outcomes compared to local state percentages. Our study confirms that pregnancy support by doulas are associated with improved outcomes in socially disadvantaged mothers because of racial disparities and psychosocial factors. Given these benefits certified doula support programs should be an available option during prenatal and postpartum care.
ratios (aOR) and 95% confidence intervals (CI) were calculated and stratified by race (Black versus non-Black). RESULTS: Of 11,863 deliveries, 111 (1.7%) had a 30-day postpartum readmission and 502 (4.2%) had SMM. Readmission was associated with age, race, multiple gestation, preterm delivery, hypertensive disorders, longer delivery hospitalization, and presence of SMM (Table ). Hypertension was the most common reason for readmission (Figure). Black women had a higher odds of hypertension-related readmission compared to non-Black women (70% versus 46%, aOR 4.7, 95% CI 2.0-11.1). Overall, women with any SMM had higher odds of readmission than women without SMM; this finding persisted with adjustment for maternal age and insurance status (aOR 3.5, 95% CI 2.3-5.3). When stratified by race, Black women with SMM had an increased odds of readmission (aOR 6.8, 95% CI 3.1-14.8) compared to non-Black women with SMM (aOR 2.9, 95% CI 1.7-4.9). CONCLUSION: SMM is a clear risk factor for 30-day postpartum readmission among all women, but especially for Black women. Black women are most likely to be readmitted for hypertension. These findings may help to identify women who are at increased risk for postpartum readmission, which might then lead to preventive strategies.
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