questionnaire assessing SDH. Text messages were sent three times a week reinforcing the core components along with a link to short lessons Progress trackers and award badges were given for goals achieved. Progress was recorded via monthly surveys. Quantitative and qualitative data were analyzed. RESULTS:Results: 67% had a vaginal delivery and 32% a csection.65% gained more than 25 lb during pregnancy. 48.7% reached their pre-pregnancy weight by 8 weeks postpartum. Among overweight and obese moms 91% reported at least one SDH (60% income and 40% depression and anxiety). Breast feeding was the initiative adopted the least 256%. Water consumption was adopted the most 280.5%.CONCLUSION: CH LA MOMs has the potential to transform the delivery and outcomes of postpartum weight. The program provides support, education, and resources via text messages/web for activities already being done. LA MOMs goes to them via their mobile phone/ tablet/or internet.
Recently, there have been significant advancements in sonography in diagnosing cervical insufficiency and monitoring the effect of cerclage therapy. 1 These advantages have been driven by the increasing use of transvaginal sonography and the incidental diagnosis of a short cervix, which has been used as an indication for cerclage placement. 2-5 There are few data regarding the prediction of preterm versus term delivery after cerclage placement, despite studies demonstrating that transvaginal sonography is a precise method of serial evaluation of the cervix after cervical cerclage placement. 4-8 In cases of cervical insufficiency, there is a significant correlation of progressive cervical change, often as much as 5 mm per week, measured by transvaginal sonography and the likelihood of preterm birth. 3 Hedriana et al. 8 performed serial sonographic assessment of cervical lengths after cerclage. This study has two significant findings. First, there was a striking increase in overall cervical length after the McDonald procedure. This is similar to the increase in cervical length after cerclage described by other studies. 5-7 Second, it has been found that the length of the cervix left above the cerclage at 24 to 28 weeks was the best predictor of preterm delivery. 8 The study addressed another poorly understood issue of the outcomes of a cerclage procedure-the significance of the location of the stitch within the cervix. Materials and Methods The authors conducted a retrospective cohort study analyzing gestational ages at delivery in 72 consecutive patients who underwent placement of a cervical cerclage between June 2010 and January 2015. Patients' ages varied from 21 to 37 years, with a median of 26 years. The following inclusion criteria were used: (1) singleton gestation; (2) history-based cerclage due to cervical insufficiency (which includes two or more 728029J DMXXX10.
The contraction stress test (CST) is currently the only modality used to test for placental insufficiency. It is rarely used due to possible complications. We propose a new test to assess placental reserves by measuring fetal heart rate (FHR) fetal responses to maternal exercise (FRME). A cohort of 640 term patients underwent FRME for accepted clinical indications. There was a total of 1680 tests, performed using a motorized treadmill in a moderate exercise regimen. Monitoring was provided by using standard Philips equipment (Avalon CTS and FM40). FRME was interpreted as negative (absence of decelerations, possible presence of accelerations), positive (presence of late decelerations or sustained bradycardia), or inconclusive. The results demonstrated 1506 tests were negative, 58 were positive, and 312 were inconclusive. If the test was negative, only 2% of the fetuses experienced adverse outcomes, versus 14%, when the test was positive. Positive tests were associated with 29% of category III FHR tracing, 11.6% of 5-minute Apgar score of less than 7, 9.8% admissions to the intensive care nursery, 2.2% of growth restrictions, and 1.2% of fetal or early neonatal demises. FRME if positive is associated with adverse perinatal outcome and could be included into the armamentarium of fetal testing.
INTRODUCTION: FDA recently stated that "ultrasound can heat tissues and can also produce cavitation in some tissues. Long term effects of which are not known." The effects of ultrasound on the fetus depends on the length of the examination. This report deals with the analysis of the duration of different types of ultrasound examinations performed in the office of generalists and MFM specialists. Our computer assisted PubMed search failed to find any information on the topic. METHODS:All ultrasounds performed in generalists (6112 scans) and MFM office (3172 scans) were times by an observer using a wristwatch. Sonographer and MFM specialists performing the ultrasound were not aware that the procedures were timed. Only the time of actual scanning was recorded and included in statistical analysis. The duration of the following sonographic procedures were recorded: 1st trimester transvaginal scan, level II comprehensive scan, follow-up limited ultrasound examination and fetal endocardiography. RESULTS: Duration of the procedure in minutes (mean and range) 1st trimester 3-18 (11) 6-24 (16) Level II scan 16-46 (24) 12-66 (28) BPP excluding NST 4-21 (17) 6-36 (24) Follow up scan 1-16 (8) 6-22 (18) Fetal echo N/A 12-64 (22).CONCLUSION: A wide variety in duration of sonographic examinations had been observed. It appears that MFM specialist takes more time performing sonographic examinations. The reported data can be utilized to develop timing guidelines for obstetric sonography in the future.
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