• Site Map
• What's New
• FAQs
• UpToDate

• Nurse Midwives
• MCH Coordinators

Maternal Child Topics

• Maternal Child Home
• Breastfeeding
• Family Planning
• Child Health Notes
• OB/GYN CCC Corner
• Perinatologist Corner
• Pregnancy

Contact Us

MCH Website Administrator

Required Plugins

These plug-ins may be required for the content on this page:  Acrobat  MS Word  PowerPoint IHS Plug-in Page Use site contact if unable to view a particular file

Maternal Child

Pregnancy

Welcome! To the newly reorganized Pregnancy page. Please take a few moments to familiarize yourself with the new sections in alphabetic order, followed by a Miscellaneous section

Hot Topics

Monthly Online MCH and Women's Health Newsletter, CCC Corner

• See Hot Topics featured each month

Access to Care

Do all hospitals need cesarean delivery capability?

• Leeman(s): Outcome based study: Zuni, New Mexico

Native American Community with a 7% Cesarean Delivery Rate

• Leeman(s): What explains the low rate in Zuni?

Medicaid Coverage of Perinatal Services: Results of a National Survey

• See the survey results on-line

Prenatal care

• Barriers to Medi-Cal lead to inadequate prenatal care

Homelessness

• Increased preterm birth

Advanced Life Support in Obstetrics

• The ALSO® course: manage emergencies obstetrics

Return to top of page

Alaska Native, American Indian, Ethnic & Minority Women

Aberdeen Area Infant Mortality Study (AAIMS): Leslie Randall, et al

• Audio and Powerpoint Conference Archive

Low Birthweight in Minority and High-Risk Women

• Effective ways to deliver services to Minority Women

Perinatal Study at Keams 1979, Charles North M.D.

• Interesting information for historical comparison (PowerPoint Presentation in 5 parts)

Racial and Ethnic Disparities in Infant Mortality Rates

• Demonstrate the need to decrease infant mortality in U.S. cities

Targeted interventions to address maternal needs of minority women

• Higher pregnancy-related deaths than non-Hispanic white women

Return to top of page

Beta Strep 

CDC: Revised Group B Streptococcal Disease Guidelines

• Screen all women at 35-37 weeks, among other changes

Group B Streptococcus in Alaska Native pregnant women and neonates

• Montse Soriano-Gabarro's Abstract for the ICAAC
• Power point (.PPT) presentation - 1.9 MB

Return to top of page

Birth Trends

Births: Preliminary Data for 2001

• CDC report presents preliminary data for 2001 on births in U.S.

Births: Data for 2000

• This CDC report presents data for 2000 on births in the United States

Prevalence of Selected Maternal Behaviors and Experiences, Pregnancy Risk Assessment Monitoring System (P.R.A.M.S.), 1999

• A wide range of pregnancy behaviors are reported: prenatal care to breastfeeding.

Births to Teenagers in the United States, 1940-2000

• This report tracks teen birth rates for more than half a century

Return to top of page

Cystic Fibrosis

Ob-Gyns offering large-scale cystic fibrosis screening

• A.C.O.G. recommends screening for cystic fibrosis to all couples

Cystic Fibrosis Carrier Testing: The Decision is Yours

• A.C.O.G. Patient education brochure.

Cystic Fibrosis Testing: What Happens If Both My Partner and I Are Carriers?

• A.C.O.G. Patient education brochure.

Preconception and Prenatal Carrier Screening for Cystic Fibrosis

• Publication at A.C.O.G. store.

Cystic Fibrosis Foundation publications

• Visit the on-line store.

Return to top of page

Diabetes in Pregnancy

Diabetes in Pregnancy Management Guidelines

• Diabetes in Pregnancy Guidelines (Word 190 KB)

Case Management - Diabetes in Pregnancy

• RPMS, CMS (PPT 201k) and Hard Copy: Shelley Thorkelson
• Gestational Diabetes Mellitus Tracking Sheet  (Word 325k) (q-man)

American Diabetes Association Offerings

• General information
• Information for health professionals
• Clinical practice guidelines
• Patient education for gestational diabetes

Children of moms who smoked during pregnancy at greater risk for diabetes

• Montgomery SM ,Ekbom A. Smoking during pregnancy and diabetes mellitus in a British longitudinal birth cohort. BMJ 2002;324:26-27.

Breastfeeding as a type 2 diabetes prevention intervention

• Suzan Murphy and Charlton Wilson, from the Phoenix Diabetes Center (Word)

Sansum Diabetes Research Institute

• Increasing healthy babies born to women with diabetes, and type 2 diabetes in children

Adverse outcome with one elevated OGTT value

• Kim HS, Chang KH, Yang JI, Yang SC, Lee HJ, Ryu HS . Int J Gynaecol Obstet 2002 Aug;78(2):131-8

Indian Health Programs and Practices: Diabetes in Pregnancy (PDF)

IHS National Diabetes Program

• Public health effort to prevent and control diabetes

Return to top of page

Evidence Based Information from A.H.R.Q.

• A -Z: AHRQ - Evidence Based practice
• Clinical Preventive Services, 2nd Ed. (Sroll down to: Congenital Disorders or Prenatal Disorders)
• Congenital Disorders or Prenatal Disorders
• Cesarean delivery: increased death compared to vaginal delivery
• Chronic hypertension associated with 11-fold increase in preeclampsia risk
• Down syndrome: risk a procedure-related miscarriage
• First-time mothers who have unassisted deliveries fare better
• Improving maternity care

• Homelessness: increased preterm birth
• Low Birthweight: 1992-98 Patient Outcomes
• Management of chronic hypertension during pregnancy
• Management of preterm labor
• Management of prolonged pregnancy
• Maternal fever during labor is predictor of infection-related infant death
• Prenatal care: lack of effect on low birth weight
• Prenatal care: Barriers to Medi-Cal lead to inadequate prenatal care
• Postpartum hospital stays: Reduce readmission of newborns
• Risk of uterine rupture during labor is higher for women with a prior cesarean
• Screening Bacterial Vaginosis in Pregnancy
• Screening Diabetes Mellitus, Adult Type II
• Social stressors increase preterm births
• Venous Thromboembolism

Return to top of page

H.I.V. in Pregnancy

HIV AND SYPHILIS EPIDEMIOLOGY: Navajo Nation

• PUBLIC HEALTH EMERGENCY! 2001 - 2003

HIV Testing Among Pregnant Women

• United States and Canada, 1998-2001

H.I.V. tests for all pregnant women

• Universal screening with patient notification

What is the latest in H.I.V. treatment and management?

• Resource for approved treatment guidelines for H.I.V. and AIDS.

Return to top of page

Infectious Disease

Clinical practice improvement on Chlamydial screening in adolescent girls

Maternal fever during labor is predictor of infection-related infant death

Pregnant women are 20 times more likely to get listeriosis

• Newborns suffer the serious effects of infection

Prevention and Control of Influenza Recommendations of ACIP

Sexually Transmitted Diseases Treatment Guidelines 2002, C.D.C.

• CDC Division of Sexually Transmitted Diseases Updates, CDC

Team approach boosts chlamydia screening of teenage girls from 5% to 65%

Web based Epidemiology in the IHS: Track Chlamydia and get CME

Midwives

What is a nurse midwife?

• What does a nurse midwife do? Want to talk to a midwife? Here is a great site to get introduced to nurse midwives that care for American Indians and Alaska Natives

Return to top of page

Mercury and Fish Consumption

Mercury Levels in Young Children and Women of Childbearing Age

• Methyl mercury exposures strategy to reduce Hg exposure

What is a safe amount of fish to eat during pregnancy?

• The F.D.A. recommends women can safely eat 12 ounces per week
  
• F.D.A. Consumer Advisory
  
• F.D.A. Center for Food Safety and Applied Nutrition

Return to top of page

Perinatology

Perinatology Corner

• Indian Health Oriented CME/CEUs: Graded recommendations and references

Harbor U.C.L.A. perinatology conferences

• Variety of subjects: Amniotic fluid embolism, I.U.G.R.

Return to top of page

Preterm Labor

Management of preterm labor

Preterm Labor: EBM Recommendations from ACOG

• Synopsis: Practice Bulletin on Preterm Labor, No. 43, May 2003

Social stressors increase preterm births

Oral Disease in Preterm Labor and Low Birthweight (PPT 2MB)

• Dr. Todd Smith, Periodontist at Phoenix Indian Medical Center

Antenatal corticosteroids revisited: Repeat courses, N.I.H. Consensus

• Data are insufficient to support repeat courses of antenatal corticosteroids

Measurement of uterine contraction frequency does NOT predict preterm delivery

• NEJM January 24, 2002 (346:250-255 ) Iams JD, et al

Return to top of page

Providers Partnership Project: A.C.O.G. / M.C.H.B. / H.R.S.A.

• About the project
• The Providers Partnership addresses health promotion/risk reduction behaviors
• Key issues. HIV, psychosocial screening and providing technical assistance
• Building Public/Private Partnerships to Address Perinatal HIV: A Case Study in Connecticut. Determining how to increase rates of HIV counseling and testing of pregnant women in the state
• Getting involved
• Publications
• New funding available for adolescent health efforts
• Maternal and Child Health Bureau, H.R.S.A. / H.H.S

Return to top of page

Safe Motherhood

C.D.C.'s Safe Motherhood

• Safe Motherhood strategies to decrease morbidity and mortality

Shortened interval to avoid pregnancy after receipt of rubella-containing vaccine

• now recommends shortening the interval from 3 months to 28 days

• Prenatal exposure to alcohol is one of the leading preventable causes of birth defects and mental retardation

Return to top of page

Smoking in Pregnancy

Active and Passive Tobacco Exposure

• A serious pediatric health problem

Smoke Free Families

• Helping pregnant smokers quit takes a team. Join ours.

Smoking Cessation Makes Cents

• The Cost-Effectiveness of Tobacco Interventions

Smoking During Pregnancy in the 1990s

• The rate of smoking during pregnancy dropped 33 percent between 1990 and 1999

Substance Abuse

Defining the National Agenda for Fetal Alcohol Syndrome

• And Other Prenatal Alcohol-Related Effects

Return to top of page

Vaginal Birth After Cesarean Delivery (VBAC)

Vaginal birth after cesarean birth

• California, 1996-2000

Vaginal birth after cesarean delivery: immediate availability recommended

• Recommendation Level C (A.C.O.G. Practice Bulletin Number 5, July 1999)

Trends in Cesarean Birth and Vaginal Birth After Previous Cesarean, 1991-99

• Cesareans are now on the rise

AHRQ: Risk of Uterine Rupture

• Uterine rupture is higher for women with a prior cesarean delivery

Return to top of page

Violence Against Pregnant Women

Violence against Native women, Indian Health web site

Pregnancy-associated assault hospitalizations

Pregnancy-associated injury deaths

Violence, substance abuse, and motor vehicle collisions, 1990-1999

Pregnant women with stressful events more likely to be physically abused

• Usually by their partners. September 2001 Mat Child Hlth J 5(3), pp. 145-152

Return to top of page

Miscellaneous

Albuquerque Service Unit: Medical Record - Prenatal and Pregnancy Flow sheet

• Albuquerque Area prenatal history, intake, lab, and maternity flow sheet. Word: Page 1 (WORD 98k) | Page 2 (WORD 57k)

CDC: Who should not get the smallpox vaccine?

• Pregnant women and other FAQs

Health Canada: Pregnancy

• Health Canada presents many pregnancy-related subjects

OBGYN.net

• Physician-reviewed network for pregnancy, women's health and index

Medical Evaluation in Cases of Fetal Demise

• Pregnancy loss, support, and protocols

Selective photocoagulation of communicating vessels in the treatment of monochorionic twins with selective growth retardation

• Unlinking the circulations renders the pregnancy "functionally" dichorionic, which results in decreased neonatal morbidity

Women with Smallpox Vaccine Exposure During Pregnancy

• United States, 2003

Return to top of page

This file last modified: Monday June 16, 2008  11:10 AM