Women’s and Children’s

For more than 30 years, we have been a leading provider of outsourced women's and children's services, specializing in acute inpatient care and treatment of infants and children. We continue to expand our services into pediatric intensive care, pediatric hospitalist programs and pediatric emergency medicine.

Through our demonstrated commitment to clinical excellence, we are also motivated to be an integral part of your community. We develop collaborative working relationships with community obstetricians, pediatricians, hospital nursing staffs and administration.

PremiEHR™, our proprietary EMR, captures medical information relevant to care provided in the NICU, nursery and delivery room. We also offer a turnkey, universal newborn hearing screening program called Healthy Hearing™.

Led by our dedicated on-site medical director, our locally based teams are comprised of full-time, board-certified or board-eligible physicians and ARNPs. Learn more about our women's and children's services management.

Read our posts related to women's and children's:

26 April2017

Doctors Recommend a Pause Before Cutting the Umbilical Cord

In the first moments of a newborn’s life, obstetricians make multiple crucial decisions to provide optimal medical care. One of those decisions is the right time to cut the umbilical cord. While it has traditionally been cut immediately after birth to quickly clean and deliver the newborn to its expecting parents, the health care community has started to rethink this age-old practice. The latest official change in thinking has come from the American College of Obstetricians and Gynecologists (ACOG), which recently recommended that obstetricians wait at least 30 to 60 seconds before cutting the umbilical cord, as reported by The New York Times.

Even before the ACOG released the new recommendations, many medical professionals extolled the neonatal benefits of delayed cutting. According to researchers, the umbilical cord is rich with oxygenated blood from the placenta that, if the cord is not immediately cut, can passively transfer to the newborn within the first minute after birth. This blood provides additional reservoirs of iron that greatly benefit infants’ short- and long-term development. 

The most obvious benefit is the prevention of iron deficiency and subsequent anemia, which can hinder important aspects of an infant’s physical and cognitive development. In a Swedish clinical trial, delayed cutting reduced the prevalence of neonatal anemia and iron deficiency in full-term babies at four months old. Additionally, since umbilical cord blood contains immunoglobulins and stem cells, researchers believe that delayed cutting may strengthen a newborn’s immune system and aid in tissue healing.

For preterm infants, delayed cord cutting can be particularly lifesaving. British researchers discovered that preterm infants experience lower incidents of after birth complications such as intraventricular hemorrhage and necrotizing enterocolitis infection when given access to the supplementary iron from their umbilical cords. 

The ACOG’s recommended cutting delay follows previous endorsements made by other prominent medical organizations, including the World Health Organization, which recommends a full 60-second wait, and the American College of Nurse-Midwives, which recommends a two- to five-minute wait. While the medical community continues to debate the potential adverse effects of a too-long delay, such as the development of polycythemia or respiratory distress for the newborn, the increasingly known benefits are undoubtedly changing the conversation on the optimal time to cut the umbilical cord.

19 April2017

Google’s AI Could Help Pathologists Identify Breast Cancer Better, Faster

According to the CDC, there are more than 230,000 people diagnosed with breast cancer in the U.S. each year.  For these patients, determination of whether cancer cells have metastasized to other parts of the body significantly influences decisions about treatment.

While a pathologist’s report is generally considered the gold standard in the diagnosis of cancer, reviewing diagnostic slides is an extremely complicated task, even for specialists with years of training and experience. Different pathologists can arrive at variable diagnoses for the same patient, which can result in misdiagnoses. Diagnostic agreement for some forms of breast cancer can be as low as 48%. That number is unsurprising, considering the massive volume of information that must be reviewed in order to make an accurate diagnosis. 

Dr. Martin Stumpe, Technical Lead, and Dr. Lily Peng, Product Manager at Google Research, wrote in a recent blog post that “There can be many slides per patient, each of which is 10+ gigapixels when digitized at 40X magnification. Imagine having to go through a thousand 10 megapixel (MP) photos, and having to be responsible for every pixel.” Reviewing that much information per slide is time-consuming.  Stumpe and Peng worked with a team of Google researchers to address two of the critical issues in the battle against breast cancer: diagnostic variability and pathologists’ time constraints.

The Google research team used pathology images to train machine learning algorithms which have been optimized to detect metastasized breast cancer cells. Imaging analytics driven by machine learning algorithms can identify metastasized breast cancer with higher sensitivity rates than other automated methods and can even rival detection by human pathologists, according to a recent Google research paper.

A HealthITAnalytics article reports that Stumpe and Peng worked with a team of researchers from Google Inc., Google Brain and Alphabet’s Verily Life Sciences (formerly Google Life Sciences) “to apply convolutional neural network (CNN) architecture to a set of training and validation images, surveying the data on a pixel-by-pixel basis. The algorithm produced “heat maps” that predicted the likelihood of tumor cells in a given sample.”

Stumpe and Peng wrote that after customizing “off-the-shelf” deep learning approaches, “including training networks to examine the image at different magnifications (much like what a pathologist does),” Google successfully demonstrated that “it was possible to train a model that either matched or exceeded the performance of a pathologist who had unlimited time to examine the slides.” The improved heatmaps produced by the algorithm reached 89 percent accuracy, compared to 73 percent accuracy from a pathologist with no time constraints who scrutinized 130 slides for 30 hours. Diagnostic accuracy was measured using a localization score (FROC). 

Additionally, Stumpe and Peng noted that “These algorithms perform well for the tasks for which they are trained, but lack the breadth of knowledge and experience of human pathologists — for example, being able to detect other abnormalities that the model has not been explicitly trained to classify (e.g. inflammatory process, autoimmune disease, or other types of cancer).” The algorithms should complement the pathologist’s workflow to ensure the best clinical outcome for patients, they explained.

The researchers envision that machine learning algorithms will increase pathologists’ efficiency and diagnostic consistency. They offered examples such as the ability for clinicians to “reduce their false negative rates (percentage of undetected tumors) by reviewing the top ranked predicted tumor regions including up to 8 false positive regions per slide,” and to “easily and accurately measure tumor size, a factor that is associated with prognosis.”

11 April2017

Pediatric Vaccine Recommendations Updated for 2017

In a recent joint report, the Centers for Disease Control and Prevention (CDC) and American Academy of Pediatrics (AAP) have released the recommended childhood and adolescent immunization schedules for 2017. While immunization schedules are typically updated annually, medical professionals view some of the recent schedule updates as significant changes for pediatricians. Influenced by new trends in nationwide adolescent health, notable changes to the recommendations include:

1. Adolescents should no longer be given the live attenuated influenza vaccine. Flu-related hospitalizations and deaths have spiked nationwide since the start of the 2016–2017 flu season. Children younger than 4 years old have been especially vulnerable; according to the CDC, as of March 11, 2017, 53 children had died from influenza.

In an analysis of currently used vaccination strains, researchers from the CDC’s Advisory Committee on Immunization Practices found that the live attenuated influenza vaccine, given to children as a nasal spray, has an effectiveness rate of only 3 percent. Due to the vaccine’s significantly low rate of protection against the flu, the updated vaccination schedule no longer recommends this type of vaccine for pediatric care.

2. HPV vaccines can now be given to adolescents as young as 9 and 10 years old. Previously, routine vaccination for human papillomavirus (HPV) was recommended for adolescents once they were 11 or 12 years old. However, HPV rates continue to remain high for teens and young adults. As a result, the joint report recommends immunization for younger populations to prevent them from acquiring this sexually transmitted disease (STD) in their teenage years.

The new two-dose vaccination schedule will be used for all adolescents starting the HPV vaccination series before age 15. Additional updates to current HPV recommendations include the removal of the vaccine strain 2vHPV, as it is no longer available in the United States. 

3. Meningococcal boosters should be given to teens at 16 years old. Meningococcal meningitis is rare, thanks to readily available and effective antibiotic therapies. However, if not treated promptly, it poses an elevated risk for mortality and long-term neurological defects in infected children and adolescents. To lower the infection rate nationwide, the updated schedule now emphasizes the necessity of the one-time booster at 16 years old.

Specifically, the joint report recommends that adolescents ages 11 to 18 years old receive the serogroup B vaccine to prevent against the most common cause of meningitis for children in the U.S. Other updates to the pediatric meningococcal vaccination schedule include new vaccination recommendations for children with HIV infection.

The CDC and AAP report also provides resources, including easy-to-read immunization schedules and educational materials, to aid in the successful implementation of the vaccination schedule updates and to help providers communicate changes to parents and families. 

28 March2017

Northside Team Saves Mother, Baby in Complicated Delivery

Air Force major Jerry Gay and his pregnant wife, Mary, were looking forward to the expected February 9 arrival of their new daughter. Mary was at home in Georgia and Jerry was deployed in Qatar, in the Middle East. But the couple’s joy became tempered with fear when Mary’s ob-gyn, Dr. Alex Eaccarino, noticed a spot that didn’t look quite normal during Mary’s 30-week checkup, per a recent story on Fox 5 Atlanta

The spot turned out to be uterine scarring from Mary’s prior cesarean-section deliveries. The scarring increased her risk for a placenta accreta, a potentially life-threatening obstetric condition that occurs when part or all of the placenta invades the uterine wall and is inseparable from it, preventing the placenta from detaching as it should during birth. "The biggest risk factor to the mom would be the risk of post-partum hemorrhage or uncontrollable bleeding," Dr. Eaccarino told Fox 5 Atlanta. Mary was told that she would need a C-section and that it was likely she also would need a hysterectomy to remove all or part of her uterus. Jerry immediately rushed home from the Middle East on emergency leave and was with Mary at Northside Hospital’s Forsyth campus on January 4 for her surgery.

Mary’s three surgeons and the anesthesia team from Sheridan practice Northside Anesthesiology Consultants (NAC) were extremely experienced in dealing with this type of complicated, high-risk delivery. Northside has the busiest obstetric practice in the country, delivering more than 25,000 babies and performing roughly 7,000–8,000 C-sections each year, according to John Kimbell, CAA, MMSC, NAC’s administrative chief anesthetist. 

Anticipating the possibility of hemorrhage, the anesthesia team placed invasive monitoring lines pre-operatively, and a large supply of blood products had already been cross-matched and were available, if needed—preparations that helped saved Mary’s and her unborn daughter’s lives.

The C-section went better than expected, with minimal bleeding, and it appeared that the placenta accreta was not as extensive as the surgeons had originally thought, Dr. Eaccarino told Fox 5. At that point, he said, they agreed it would be best to preserve Mary’s uterus and decided against performing a hysterectomy. Jerry told the reporter that while he was in the NICU with newborn daughter Sinclair, he was ecstatic to receive a call from Mary's surgical nurse, who told him that she was doing well and was being moved to the recovery area.

Unfortunately, this best-case scenario didn’t last long. When Mary woke up from the anesthesia, she was in severe pain and her nurse quickly realized Mary was bleeding excessively. The nurse "got my doctor back in there really quickly and the anesthesiologist back into the OR,” she recalled to the reporter. By then, Mary was hemorrhaging and needed more than 30 units of blood to replace the blood she was losing.

The anesthesia team, which included Stephen Grice, MD, Jeff Mims, CAA, Jeff Thomas, CAA and Patty Flaherty, CAA, among others, activated its Massive Transfusion Protocol that allows quick coordination with the blood bank and enables predetermined packages of different blood products to be delivered quickly and constantly. Thanks to that team’s prior preparations and the Massive Transfusion Protocol, the surgeons were able to stop the bleeding and remove part of Mary's uterus. Jerry told Fox 5 that it "the longest hour and a half of my life." 

When Mary woke up in the ICU, on a ventilator, she immediately asked to see her baby, Sinclair. "I don't think you can go through things like that and have it not change you,” she told the reporter. “I appreciate things a lot more."

In their interview with Fox 5 Atlanta, Mary and Jerry expressed their gratitude for Dr. Eaccarino and the entire Northside team, whose skill and alertness helped save both Mary’s and Sinclair’s lives, and for the dozens of strangers whose blood donations helped make the life-saving surgery possible.

21 March2017

Three Breakthrough Technologies That Will Change Medicine

The Massachusetts Institute of Technology (MIT) publishes an annual list of 10 Breakthrough Technologies. Three innovations from this year’s list promise to have a dramatic impact on the future of medicine.

Brain Implants that Reverse the Effects of Paralysis

In recent years, brain implants have enabled lab animals and even a few people to use thoughts to control computer cursors or robotic arms. According to the 2017 MIT report,  researchers are “taking a significant next step toward reversing paralysis once and for all” using what French neuroscientist Grégoire Courtine calls a “neural bypass.” Wireless implants transmit electrical impulses from brain to spinal cord, bypassing damaged parts of the central nervous system and enabling movement of limbs once paralyzed due to spinal cord injuries. Courtine and a team of researchers at a Swiss university have used the implanted electronics to restore mobility of a partially paralyzed macaque monkey in hopes of future applications with humans.

A team at Cleveland’s Case Western Reserve University placed two of the same type of implants used in the Swiss experiment in the brain of a middle-aged quadriplegic volunteer who, on his own, could not move any part of his body other than his head and a shoulder. The implants are smaller than a postage stamp and “bristle with a hundred hair-size metal probes that can ‘listen’ as neurons fire off commands.” The Case team also inserted more than 16 fine electrodes into the muscles of the volunteer’s arm and hand. According to the MIT report, in videos of the experiment, “the volunteer can be seen slowly raising his arm with the help of a spring-loaded arm rest, and willing his hand to open and close. He even raises a cup with a straw to his lips.” This transformational technology is expected to be available in 10 to 15 years.

Next-generation Gene Therapy

For decades, researchers have been pursuing the idea of gene therapy—what the MIT report calls the use of “an engineered virus to deliver healthy copies of a gene into patients with defective versions”—with mostly disappointing results. Now, researchers have solved some of the puzzles that caused many earlier gene therapies to fail. Scientists are “using viruses that are more efficient at transporting new genetic material into cells” to develop the next generation of gene therapies—or “gene therapy 2.0”—to treat patients with rare hereditary diseases. 

European regulators have approved two of the treatments. One is Strimvelis, for treating children with severe combined immunodeficiency due to adenosine deaminase deficiency (ADA-SCID). The other is Glybera, for treating patients with lipoprotein lipase deficiency (LPLD), a rare disease that causes fat to accumulate in the blood and increases the risk of acute and recurrent pancreatitis. 

In the United States, one of Spark Therapeutics’ gene therapies for inherited retinal diseases (IRDs) is in phase III clinical trials. The company’s hemophilia B therapy, SPK-9001, is currently in an ongoing phase i/ii clinical trial and recently received breakthrough therapy and orphan product designations from the U.S. Food and Drug Administration. Another promising gene therapy in development could lead to a cure for hemophilia and enhance healing in patients suffering from epidermolysis bullosa, an excruciatingly painful and sometimes fatal hereditary skin disease. 

According to the MIT report, researchers are conducting clinical trials for gene therapies for some 40 to 50 diseases. “Fixing rare diseases, impressive in its own right, could be just the start.” 

The Human Cell Atlas

An international consortium of scientists is being assembled to develop the first comprehensive map of human cells. Biologists, clinicians, technologists, physicists, computational scientists, software engineers and mathematicians from the U.S., U.K., Sweden, Israel, the Netherlands, and Japan will be collaborating on the construction of what the MIT report calls “biology’s next mega-project”—a “cell atlas” that catalogs and maps the 37.2 trillion cells of the human body. 

The Human Cell Atlas website explains the significance of this massive, ambitious and unprecedented undertaking. “A complete Human Cell Atlas would give us a unique ID card for each cell type, a three-dimensional map of how cell types work together to form tissues, knowledge of how all body systems are connected, and insights into how changes in the map underlie health and disease. It would allow us to identify which genes associated with disease are active in our bodies and where, and analyze the regulatory mechanisms that govern the production of different cell types.”

The MIT report calls the future genomic reference map “a technological marvel that should comprehensively reveal, for the first time, what human bodies are actually made of and provide scientists a sophisticated new model of biology that could speed the search for drugs.”

According to the report, this new type of mapping is possible thanks to the confluence of three technologies: 

  • Drop-Seq—described in the abstract of a 2015 Cell article by Evan Z. Macosko and his colleagues as “a strategy for quickly profiling thousands of individual cells by separating them into nanoliter-sized aqueous droplets, associating a different barcode with each cell’s RNAs, and sequencing them all together.” 

  • Ultra-fast, extremely efficient sequencing machines that can decode and identify the genes active in single cells “at a cost of just a few cents per cell. One scientist can now process 10,000 cells in a single day.”

  • Innovative labeling and staining techniques that “can locate each type of cell—on the basis of its gene activity—at a specific zip code in a human organ or tissue.”

Among the key supporters of this project are the U.K.’s Wellcome Trust Sanger Institute, the Broad Institute of MIT and Harvard in Massachusetts, and the new Chan Zuckerberg Biohub in California funded by Facebook CEO Mark Zuckerberg and his wife, Priscilla Chan. Zuckerberg and Chan made the Human Cell Atlas project “the inaugural target of a $3 billion donation to medical research,” according to the MIT report. The human cell atlas should be available in five years.

14 March2017

Newly ID’d Genomic Features of Cervical Cancer May Allow Targeted Therapies

Once known as the leading cause of cancer deaths for women in the United States, cervical cancer has been on the decline due to advances in detection technology and medical treatments over the last four decades. The latest example of this trend is a recent study by investigators with The Cancer Genome Atlas (TCGA) Research Network, which has identified novel genomic and molecular characteristics of cervical cancer that may aid in the creation of more targeted, effective drug therapies.

Through an analysis of the genomes of 178 primary cervical cancers, TCGA researchers found that more than 70 percent of cervical tumors had genomic alterations in one or both of two important cell signaling pathway. Further, researchers identified a unique set of eight cervical cancer tumors that demonstrated molecular similarities with endometrial cancers and had high frequencies of mutations in the KRAS, ARID1A and PTEN genes. Researchers unexpectedly discovered that all the tumors with genomic alterations and most of the endometrial-like tumors did not show evidence of human papillomavirus (HPV) infection, the leading cause of nearly all cervical cancer incidents.

The discovery of HPV-negative tumors with endometrial characteristics is significant in the pursuit of effective cervical cancer treatments. While current preventive vaccines are effective against the most oncogenic forms of HPV, most women who will develop cervical cancer are older than the recommended age for vaccination and will not be protected. The TCGA findings confirm that a notable portion of cervical cancers are formed from other factors not related to HPV. This signals the need for new cervical cancer treatments that specifically target genomic alterations and are effective for women regardless of age.  

TCGA researchers have already begun looking at the potential applications of the research for cervical cancer treatment. During the same study, researchers examined the tumors with genomic alterations to discover whether any alterations were particularly amplified. Amplification can predict genetic responsiveness to immunotherapy, a treatment which is becoming an increasingly important component of general cancer treatments. Ultimately, several of the alterations were amplified enough to be considered effective potential immunotherapy agents, including some alterations involving the gene BCAR4, which has been shown to respond to certain breast cancer immunotherapies

9 March2017

NICU Clinical Trial Studies Probiotics Use to Prevent NEC

Sheridan Clinical Research is participating in a multicentered, randomized, double-blind clinical trial using an Investigational probiotic for the prevention of necrotizing enterocolitis (NEC) in premature infants. The research is sponsored by Sigma-Tau Pharmaceuticals, Inc.  Sheridan’s NICU Medical Director Mitchell Stern, MD, is the Principal Investigator for the Phase Ib/IIa trial being conducted at Plantation General Hospital in Plantation, Florida, to study the safety and efficacy of once-daily dosing of STP206 in premature very low birth weight (VLBW) and extremely low birth weight (ELBW) neonates to decrease the incidence of NEC.

NEC is the most common serious acquired disease of the gastrointestinal tract in preterm infants. The majority of NEC occurs in infants weighing less than 1500 g at birth. It affects the bowel of premature infants in the first few weeks of life and has been reported to occur in approximately 10 percent of VLBW infants, although the incidence varies among countries and neonatal centers. The mortality rate of VLBW infants with NEC is approximately 20 percent. In addition, infants with NEC often require surgical intervention, have an increased rate of complications related to total parenteral nutrition (TPN) and require extended hospitalizations. In a study by National Institute of Child Health and Human Development Network (NICHD) published in JAMA in 2004, researchers also found an increase in neurodevelopmental impairment rates among infants with NEC and sepsis.

A 2010 analysis of previous clinical trials, published in Evidence-Based Child Health, found that the use of probiotics, dietary supplements containing potentially beneficial bacteria or yeast, reduces the occurrence of NEC and death in VLBW premature infants, but that there was insufficient data on the benefits and potential adverse effects in ELBW neonates.

The four-year Phase Ib/IIa clinical trial is intended primarily to assess the safety and tolerability of once-daily dosing of two dose levels of an investigational probiotic versus control in four different birth weight strata in premature neonates. Plantation General Hospital’s NICU has historically been involved in multiple trials with Dr. Stern as the Principal Investigator. For the current probiotic trial, Dr. Stern has had the highest enrollment for cohort 3b, which closed in May 2016, and was one of the highest enrollers for newly closed cohort 4a.

As Jessy Tharakan, NNP, knows very well, obtaining informed consent for clinical trials in the NICU setting is particularly challenging, because the patient population is both delicate and vulnerable. As the authors of the 2014 Pediatrics Perspectives article “Honesty, Trust and Respect During Consent Discussions in Neonatal Clinical Trials” wrote, “Participation in neonatal clinical trials is often viewed as risky, ethically challenging, burdensome for parents, and a favor that altruistic families are performing for future generations of babies.” But they pointed out that the consent process also can empower and reassure families, as long as certain conditions are met. For example, the investigators and clinicians must believe that the research is both safe and important and must agree that participation in the proposed research would be meaningful and safe for each prospective participant. And the research team should strive for an open, trusting relationship with the parents and enable them to make an informed decision about what is best for their baby, rather than focusing on getting the consent form signed. 

 

 

 

 

 

 

 

 

 

Kochuthresia (Jessy) Tharakan, NNP with Mitchell Stern, MD 

 

21 February2017

Research Recommends Continued Breast Cancer Screening Mammography for Older Women

New research about the appropriate age limit for breast cancer mammography screenings, presented at the Radiological Society of North America’s annual meeting late last year, challenges current conventional recommendations. While the U.S. Preventive Services Task Force (USPSTF) recommends that women undergo screenings every two years until age 74, researchers from the University of California at San Francisco assert this age limit may be arbitrary after finding that the precision of breast cancer mammography screening, and thus the rate of cancer detection, increases significantly as women age.

Pulling from the American College of Radiology National Mammography Database, the research team examined 5.7 million mammography screenings from 2.6 million women 40 years or older. The team found the average national cancer detection rate to be 3.74 per 1000 screenings, while the average recall rate of screenings leading to a call-back for additional workup was 10 percent. Further, the rate of cancers found in cases recommended for biopsy was 20 percent, and the rate of cancers found in women who underwent biopsy was 29 percent.

Next, researchers stratified the data into five-year age groups to identify any trends. They found that the recall rate decreased progressively every decade and that detection rates increased progressively with age. The team concluded that doctors should continue to recommend mammography screenings for women 75 years and older if it is medically appropriate based on preexisting conditions and life expectancy.

This conclusion coincides with growing evidence of high breast cancer incidents in older women. A similar study published in the May 2015 edition of the American Journal of Roentgenology found a significant detection of carcinomic and invasive breast cancer tumors in women 75 years and older at a rate of 5.9 per 1000 screenings. While detection rates for older women seem to have recently decreased, as the American Cancer Society states in its 2015-2016 report, almost 58 percent of all breast cancer deaths occur in women older than 65. Within this same group, women 80 years or older make up 46 percent of all deaths. 
 
Ultimately, at a time when the medical community is questioning the effectiveness of screening mammography, research still supports the necessity of continued, quality preemptive care for all – and especially older – women.

16 February2017

No Link Between Maternal Influenza and Increased Autism Risk for Children

Current research by the Center for Disease Control and Prevention estimates that autism spectrum disorder (ASD) affects about 1 in 68 children in the United States. While the exact causes for ASD are not yet known, previous and now widely discredited scientific research contributed to the popular belief that vaccinations can cause the disorder. Despite new research that increasingly disproves any potential link, this belief continues to linger. To further investigate a possible connection, a recent study published in JAMA Pediatrics examined the association between maternal influenza vaccination during pregnancy and an increased risk of ASD for children.

For this cohort study, researchers from Kaiser Permanente Northern California examined the mothers of 196,929 children born at Kaiser Permanente between Jan. 1, 2000 and Dec. 31, 2010. Influenza was diagnosed in 0.7 percent of the women with a gestational age of at least 24 weeks, and 23 percent of these women received an influenza vaccination during the remainder of their pregnancy. After adjusting for covariates, the team found there to be no substantial link between a mother’s vaccination for influenza during her pregnancy and the subsequent development of autism in her child. 

Overall, only 1.6 percent of children in the study were diagnosed with ASD. However, in a trimester-specific analysis, there was a slight correlation between first trimester influenza vaccination and an increased risk of ASD for children. While the researchers ultimately determined that this correlation could be due to chance, the possible increased risk in the first trimester suggests additional research is needed. 

Based on their findings, the research team has not called for any changes to influenza vaccine policy or practice for pregnant women. Their research supports current medical recommendations that all women receive the influenza vaccine when pregnant, as the weakened state of a pregnant woman’s immune system increases a child’s susceptibility to short- and long-term risks such as premature birth, low birth weight and illness in early life. Further, studies show that maternal infections that occur and are not treated during pregnancy can increase the risk of ASD for children. 

7 February2017

Grand Strand Medical Center Adds Neonatology Program

Grand Stand Medical Center in Myrtle Beach, South Carolina has launched a new neonatology program that has been in the works for about a year. The hospital is working to recruit two permanent, local neonatologists. Until those positions can be filled, neonatologists from other counties in South Carolina are working at the hospital, making Grand Stand Medical Center the only hospital in Horry County to have a neonatologist either in the hospital or on-call at all times.

Dr. Art Shepard, the Sheridan neonatologist who worked on staff at the hospital during the first week of the new program, told local ABC News affiliate WPDE that the hospital delivers about 1,000 babies a year, and that 8-10 percent of all babies need specialty neonatal care. “If babies need respiratory support or prolonged tube feeding, for example, because they're early those babies would ordinarily have to go to [a NICU in] Charleston or Florence, and so that's about a hundred babies a year that have to leave just for those reasons," Shepard said. Because Grand Strand has a level II nursery and not a NICU, he explained, some seriously ill babies will still need to be transported to either the Florence or Charleston NICUs.

"We can take care of babies as young as 32 weeks gestational, so about 8 weeks early, we can take babies that are as small as 1500 grams at birth, which is about 3 1/2 pounds, and we can maintain babies on mechanical ventilation for as long as 24 hours,” he continued. “If babies are smaller than that, less mature than that, or require more respiratory therapy than that, they still need to go to the regional perinatal center."

Both Shepard and OB/GYN Dr. Tracey Golden are excited that more babies will be able to be treated locally, near their mothers and families. "We are looking forward to the opportunity to keep those babies here. Keeping babies and moms together is so important. It's important to facilitate breast feeding, we want to encourage that. And keeping families together is the best way to get a family off to a healthy start," Shepard said. Golden added, "It's priceless, because unfortunately the NICUS are at least an hour and a half to two hours from this local region, and for many families that means they're taken away from their other children or their support network."

Emerald Rabon, who has a high-risk, complicated pregnancy, is comforted by the availability of a neonatologist at the hospital. “I'm going to be delivering really early, and she's going to be super small and not as developed, so that's even more scary," she told WPDE. After meeting with Dr. Shepard, she was reassured to learn that even if her baby girl arrives weeks early, there’s a good change she will be able to remain in Myrtle Beach. "You think of a pregnancy and the baby just pops out and they're doing great and mine is going to be hooked up to machine and tubes going in and out of her. It's scary," she said. 

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