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Comments Off on Preventing HIV Transmission to Your Baby during Pregnancy

Preventing HIV Transmission to Your Baby during Pregnancy

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The US has estimated that 1 million Americans are living with HIV today – and 1 in 7 do not know they have HIV as they have no symptoms. June 27th is World HIV Testing Day and Women’s Telehealth is working to raise awareness about preventing HIV transmission during pregnancy. Prevention starts with HIV testing and knowing your status.

Since 1995, the CDC has recommended that all pregnant women be test for HIV and STD’s in their first and third trimesters and then receive treatment during pregnancy if they test positive for HIV. Yet, recent statistics estimate that in the US, 31% of pregnant women are still not tested for HIV. Concurrent testing for STD’s allows for specifically testing for syphilis (which is treatable) and the prevention of congenital syphilis in the newborn. HIV infection is more prevalent in Southern States, African Americans, and in young people. Testing can be completed in a doctor’s office, hospital, clinic or home.

If the mom’s HIV test is positive or the mom has known HIV infection, with treatment, the risk of transmitting the infection to the newborn can be reduced to approximately 1% through early testing and diagnosis and the use of anti-retroviral therapy (ART) with increasingly effective medicines. The sooner therapy is started the better. The medications work by preventing HIV from multiplying, keeping the viral load in the body low. This helps a pregnant mom stay healthier and significantly decreases the likelihood of transmission during pregnancy or birth. Some of these medications also pass through the placenta adding extra protection for the baby. Most of these ART meds are safe during pregnancy but the best treatment regimen should be determined by a high risk pregnancy specialist.

If pregnant women present to deliver and there are no records of HIV and STD testing, rapid testing prior to delivery can be done with the mother’s consent. If HIV positive moms have a high HIV viral load at the time of delivery, a C-section may be performed to decrease the chance of transmission during the birth process. Babies born to a mom with a known HIV infection will be treated for HIV for 4-6 weeks after birth. To further reduce risk of HIV transmission, HIV positive moms should not breastfeed their newborns.

We are moving in the right direction with preventing transmission during pregnancy through awareness, testing and treatment! From 2012-2016, diagnosed perinatal HIV infections have decrease by 41%! Many states have laws about HIV and STD testing in pregnancy and surveillance upon delivery. For example, Georgia has the HIV and Syphilis Screening Act that mandates all pregnant women be tested for HIV and STD’s in the 1st and 3rd trimester- unless the woman opts out. Also, the law states that if there is no evidence that testing was done prior to delivery when a woman presents for delivery that a rapid HIV screen be performed, unless the mother declines. Similarly, all babies born to an HIV positive mom are required to be reported to the health department within 7 days of birth in GA. Likewise, all babies born with congenital syphilis are to be reported within 24 hours of birth to the local health district officer in the state surveillance system.

HIV transmission to the baby during pregnancy, birth and breastfeeding can be greatly reduced through early testing, treatment and following some precautions. Women’s Telehealth provides high risk pregnancy care via telemedicine – including care of HIV positive moms and their babies – with great results!

Help us raise awareness on World HIV Testing Day by SHARING this blog or checking out further resources:
– For more info, call CDC 800-232-4636
– To schedule HIV testing in your local GA Health Dept., call 800-551-2728
– To find a testing provider nationally, visit: http://www.greaterthan.org or http://www.locator.hiv.gov

~Tanya Mack, President

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Comments Off on Twin to Twin Transfusion Syndrome: A Life-Saving Story

Twin to Twin Transfusion Syndrome: A Life-Saving Story

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A twin pregnancy comes with risks for mother and babies and this Women’s Telehealth patient story presents one such serious complication.

This Pregnancy’s Challenge: The ultrasound conducted by the patient’s local OB physician revealed that one twin was growing and the other was not. Preliminary tests indicated a suspected “Twin to Twin Transfusion Syndrome,” caused by a blood vessel defect. Left untreated, the survival rate for both twins would be less than 15%.  The mom-to-be needed immediate high-risk OB care and intervention. Because the closest MFM Specialist was two hours away and the patient would require consistent monitoring, she was referred to the OB/GYN’s MFM telemedicine partner in Atlanta, GA, Women’s Telehealth.

The Team’s Actions:

  • The initial MFM telemed consult and specialized ultrasound confirmed the “Twin to Twin Transfusion Syndrome” and identified the problematic blood vessels causing it. 
  • The MFM physician forwarded all images and notes immediately to the closest  fetal surgeon to see if he would take the case as there was a critical time window.
  • The surgery was performed in FL and the patient stayed in the hospital for a few days to monitor mom and babies before they were released to home.
  • WT continued to remotely monitor growth of both twins regularly until the OB and MFM doctors decided to deliver a little early via C-Section, to prevent loss and trauma.

The Results:

  • Two healthy baby girls were delivered slightly early by C-Section with no residual health problems.          
  • Cost savings were estimated to be > $12,000 in expenses.                                                                  
  • Travel savings of 2700 miles and 40 commuting hours were realized.                                               

Early identification and treatment of this often-fatal condition in a rural area, where there was no MFM specialist, led to the successful birth of these babies. Women’s Telehealth is pleased to have played a key role in arranging life-saving surgery through their network of high risk OB specialists and the use of continued monitoring via telemedicine!

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Multiple births are much more common today than in the past. According to the U.S. Dept. of Health and Human Services, the twin birth rate has increased by over 75% since 1980, and triplet, quadruplet and high-order multiple births have increased at an even higher rate.  To learn more, visit:

https://www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/documents/fact-sheets-and-info-booklets/multiple-pregnancy-and-birth-twins-triplets-and-high-order-multiples-booklet/

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Our goal in sharing patient case stories is to show the role and possibilities Women’s Telehealth plays in accessing and intervening in high risk pregnancies. We help turn patient and OB provider concern into the best possible care plans and outcomes for moms and their babies.
For more information, call our office at: 404.478.3017

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Comments Off on Keeping Safe While Pregnant

Keeping Safe While Pregnant

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The U.S. celebrates National Safety Month in June! Since Women’s Telehealth focuses on high risk pregnancy, we are motivated to pass along some tips to keep moms safe while pregnant from day one through delivery!

Injury is the leading cause of death in the US between the ages of 1 and 44, which includes those childbearing years. Research shows that most injuries are preventable and over half of falls occur in the home.

Pregnant women are bombarded with all kinds of do’s and don’ts during their pregnancy. Now that summer is here, there are some extra precautions for pregnant women during this season.

Here are our “Top 10 Tips” for Keeping Safe While Pregnant:

  1. Wear a seat belt (We are frequently sent pregnant women who have been in motor accidents.)
  2. Don’t text and drive (In some states, it’s the law!)
  3. Avoid falls, trips and slips (The body’s center of gravity changes during the 2nd and 3rd trimester.)
  4. Mind your food safety (Learn about diet during pregnancy. Steer clear of mercury-laden fish.)
  5. Learn first aid and CPR (You can save another or help them save you!)
  6. Avoid overheating in the summer (Drink fluids and avoid dehydration.)
  7. Skip the amusement park rides that jolt suddenly and have high impact (can tear the placenta).
  8. Add the Poison Control number to your phone for an emergency: 1-800-222-1222
  9. Wear sunblock
  10. Most importantly – KEEP all your prenatal care appointments!  That’s the best prevention! Follow doctor’s guidelines on no smoking, drugs, alcohol, CBD use and caffeine during pregnancy.

To help us raise awareness for Pregnant Women and Family Safety, check your local neighborhood resources for local events on Family Safety Day, June 8th. Visit your local parks, get out and take a safe walk! Keep your safety awareness keen and teach your family to do the same!

~ Tanya Mack, President

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Comments Off on Mom’s Rare Birth Defect – An Unchartered Pregnancy Story

Mom’s Rare Birth Defect – An Unchartered Pregnancy Story

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This Women’s Telehealth patient story is a twist on a birth defect – the mother’s rare birth defect, a diaphragmatic hernia at birth, now posed a pregnancy management challenge to mom and potentially baby.

The Pregnancy Challenge: A mom-to-be from middle Georgia was 26 weeks pregnant when she visited her local OB physician for the first time.  When her initial OB assessment revealed that she had been treated for a Bochdelek Hernia at birth, her doctor promptly referred her to Women’s Telehealth for high-risk MFM Specialist care.

A Bochdelek Hernia is a rare, life-threatening congenital birth defect in which an opening in the diaphragm allows the baby’s abdominal organs to shift into the chest.  The patient required surgery at birth to place the organs in the proper position and repair the opening in the diaphragm, and, a tissue graft was placed surgically during childhood.  Rarely does a woman who has had this condition become pregnant herself later in life.                          

Of primary concern was:  Would the growing baby in utero cause the graft to stretch or possibly break? How would the growing baby affect the patient’s health? Would she be able to push during delivery or would a C-section be required? These were the serious questions facing the patient and her obstetric team.

The Team’s Actions:

  • The initial, advanced MFM ultrasound via telemedicine revealed that the tissue graft was intact and functioning well.                
  • The fetus was found to have a two vessel umbilical cord with low blood flow and was in the 9th percentile for its gestational age, indicating Intrauterine Growth Retardation (IUGR).                 
  • An extensive literature search revealed no documented, similar cases.                                                    
  • WT collaborated with other MFM’s and a graft surgeon in San Francisco who places grafts in children, to discuss the situation and graft function with a pregnancy stress.
  • The patient was educated about immediate reasons to present to the ER.                               
  • Diagnostic genetic lab tests revealed the baby did not have any genetic or neural tube defects.
  • WT is now in the process of writing this case study for publication in a professional peer reviewed journal, with the family’s cooperation, so there will be a future resource for others.          

The Results: A healthy, > 5-pound baby girl was successfully delivered via C-Section at 35 weeks gestation!  WT is happy to report that the mom’s diaphragmatic graft functioned well throughout the pregnancy and required no medical or surgical intervention. 

Women’s Telehealth was pleased to be called on to help solve this rare pregnancy dilemma. It’s another example of how the advanced MFM technological services can be provided via telemedicine to treat complicated, high-risk prenatal cases often saving time and money as well.

Our goal in sharing patient stories is to show the role and possibilities Women’s Telehealth plays in accessing and intervening in high risk pregnancies. We help turn patient and OB provider concern into the best possible care plans and outcomes for moms and their babies.
For more information, call our office at: 404.478.3017

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Comments Off on Addiction and Babies? Help Us Raise Awareness!

Addiction and Babies? Help Us Raise Awareness!

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April is Alcohol Awareness Month in the U.S. and a perfect time to raise awareness around prenatal substance abuse and how this affects both the fetus and the newborn. The U.S. has seen a dramatic increase in the past ten years in babies exposed to drugs and alcohol in the womb before birth.  Babies that are born to an addicted mother can suffer from withdrawal once born. Babies can’t consciously abstain. We know this and see stories about this in the news every day. 

The effects are far reaching and for the baby in utero, may result in low birth weight, slow growth, altered development and in some, lifelong health problems.  After the baby is born, Fetal Alcohol Spectrum Disorder (FASD) and Neonatal Abstinence Syndrome (NAS) may require intense intervention in a hospital, perhaps even NICU setting.

Neonates may be exposed to a wide range of substances and it’s hard to know what they may be exposed to due to self-reporting, not knowing the exact components of illicit drugs and wide range of prescription drugs the mother may be taking during pregnancy. All babies do not have withdrawal depending on the length of exposure, the cumulative dose and the baby’s gestational age at birth. Full term babies are more likely to experience withdrawal than preemies.

Symptoms for babies who are experiencing withdrawal often show up within 72 hours of birth, but may not become apparent until a few weeks after delivery. Specific symptoms may vary but include:

  • Irritability 
  • Poor Feeding    
  • High Pitched Crying
  • Fever  
  • Diarrhea 
  • Vomiting
  • Seizures  
  • Chronic pain

Most babies get better initially in 5-30 days and treatments for these conditions include:

  • Environmental manipulation (swaddling, holding, low lighting, mother-baby bonding
  • Pharmacologic therapy to wean them off of the  addictive substance
  • Social service intervention as family situations may be complex
  • Providing empathy and support  
  • Close follow up post hospitalization and these substances may affect their development

As with many health care issues, prevention is preferred over later intervention. Early intervention is a critical path to mitigating problems.  Consider:

  • If you are pregnant and on prescriptive drugs that may affect the fetus, notify your provider.
  • If you are pregnant and using, do not quit cold turkey without the direction of your provider, as it may negatively affect the baby.  Ask about medically-assisted treatment.                                           

To help us raise awareness, SHARE THIS MESSAGE to get information into the hands of people dealing with pregnancy and substance abuse.
~Tanya Mack, President
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Comments Off on World Prematurity Day Highlights Education and Technology As Solutions

World Prematurity Day Highlights Education and Technology As Solutions

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World Prematurity Day is Saturday November 17, a day designed to draw attention to the more than 380,000 babies who are born too soon in the United States every year. Alabama’s pre-term birth rate is 12%, as published in the annual report from the March of Dimes, earning the state a grade of “F” which is unchanged from the previous year.  Baptist East Hospital in Montgomery, Women’s Telehealth and Dr. Anne Patterson have launched a new MFM Clinic to support expecting Moms in the prevention of premature births.  Please click the link below to view the WSFA news report.

http://www.wsfa.com/2018/11/15/world-prematurity-day-raises-awareness-education-about-babies-born-too-soon/

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Comments Off on Women’s Telehealth Opens Clinic in Montgomery Alabama

Women’s Telehealth Opens Clinic in Montgomery Alabama

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Women’s Telehealth has opened the first Telemedicine Maternal Fetal Medicine Clinic at Baptist Medical Center East in Montgomery, Alabama. An open house was held on October 30 to introduce the new clinic to the public and medical communities.  Click link below to view news coverage of the Open House.

Baptist Medical Center East Open House

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Comments Off on WT and Dr. Patterson Featured in The Wall Street Journal

WT and Dr. Patterson Featured in The Wall Street Journal

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Women’s Telehealth and Dr. Anne Patterson were featured in the Wall Street Journal on September 13, 2017 in the article, “Telemedicine Helps Pregnant Women At Risk.” The article explains how telemedicine appointments with Dr. Patterson helped save the baby of a high-risk pregnant patient who lived two hours away from an MFM specialist.

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Comments Off on Breastfeeding: Giving Your Baby Their Best Start in Life

Breastfeeding: Giving Your Baby Their Best Start in Life

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The decision to breastfeed is a personal choice for a mother and her baby, however, research shows many benefits of breastfeeding for both the mother and the baby. Breast milk is nutritious, rich in vitamins, and saves time and money. In support of National Breastfeeding Week, below are some of the reasons you may want to consider breastfeeding your baby.

Benefits to babies who breastfeed:

  • Breast milk provides the ideal amount of nutrients and vitamins for babies, and it’s provided in a more digestible form than formula.
  • Breast milk provides important antibodies to fight off viruses and bacteria.
  • The colostrum that is found in breast milk within the first few days of giving birth is rich in nutrients and antibodies to protect the baby from infections, as well as helps the baby’s digestive system function and grow.
  • Breastfed babies are less likely to develop asthma or allergies, and research shows that they have a lower risk of developing ear infections, respiratory illnesses, eczema, diarrhea and vomiting. According to the American Academy of Pediatrics, breastfeeding can also help prevent Sudden Infant Death Syndrome (SIDS), and it has been thought to lower the risk of developing obesity, diabetes, and certain cancers as a child.

Benefits to mothers who breastfeed:

  • Breastfeeding can help mothers lose their pregnancy weight faster since breastfeeding burns extra calories.
  • Breastfeeding helps the mother and baby bond due to skin to skin contact, the closeness of the mother’s body to the baby, and close eye contact to each other. This closeness is beneficial to both the baby and the mother.
  • Breastfeeding releases the hormone oxytocin which helps the mother’s uterus return to normal size and reduce bleeding after giving birth. It can also help calm the mother emotionally.
  • Breastfeeding may reduce the risk of developing osteoporosis as well as breast and ovarian cancer.
  • Breastfeeding saves time and money since there is no cost involved, nor time spent washing and sterilizing bottles and nipples.

Breastfeeding is a personal choice that a mother should make without being influenced by friends or family. There are many benefits, but there may also be some challenges, such as sore nipples, the baby not latching on, or not producing enough milk. Seek counsel from your health care provider, family members, or other mothers if these challenges arise. If breastfeeding is the right choice for you, it can help give your baby their best and healthiest start in life.

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