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All Posts in Category: Maternal Fetal Medicine

Twin to Twin Transfusion Syndrome: A Life-Saving Story

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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Women’s Telehealth Announces New Partnership with Envision Healthcare

Women’s Telehealth welcomes Envision Healthcare’s Women and Children’s Division as a strategic partner. Envision Healthcare is a preferred national medical group that partners with hospitals and healthcare systems to provide anesthesia, emergency medicine, hospitalists, radiology, surgical and women and children’s services. They have a national network of over 25,000 clinicians over 45 states.

“This partnership expands the capabilities of both companies,” says WT President, Tanya Mack. “Envision Healthcare will add to their telehealth capabilities and NICU continuity of care and Women’s Telehealth will expand their service area to provide improved and quick access to maternal-fetal medicine services.”

Both companies share the goal of improving the clinical outcomes of high risk OB women and their babies. The WT team looks forward to working with Envision Healthcare team members, Deidre Jordan, VP of Clinical Operations, Juli Stover, VP of Virtual Health and Dr. Meg Prado, President of Envision’s Women and Children’s Services.

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Mom’s Rare Birth Defect – An Unchartered Pregnancy Story

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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Addiction and Babies? Help Us Raise Awareness!

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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World Prematurity Day Highlights Education and Technology As Solutions

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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Women’s Telehealth Selected as a 2018 Atlanta Metro Export Challenge Winner

ATLANTA – November 5, 2018  Women’s Telehealth is a recipient of a $5,000 grant in the annual Atlanta Metro Export Challenge (Atlanta MEC), a grant program designed to engage small- and medium-sized businesses in metro Atlanta in the development of international sales plans.

Companies from all over the 29-county region, ranging in size from pre-revenue startups to small and established medium-sized businesses, applied to the program. Thirty companies were selected in the competition and will each receive a grant of $5,000 to apply towards the growth of their international business.

Women’s Telehealth is thrilled to be in receipt of The Atlanta MEC grant and plans to use this funding to make technology enhance to benefit the launch and relationships associated with Project Echo to decrease  maternal and infant mortality rates in our partner countries.

Women’s Telehelath provides high risk obstetric service  via telemedicine.

To see the full list of grant awardees, click here

The Atlanta MEC is one of many ways to engage small- and medium-sized companies in metro Atlanta in the development of their international business. Over the last two years, the program has given out more than $400,000 to metro Atlanta companies thanks to the generous sponsorship of JPMorgan Chase & Co, which again contributed $100,000 to this year’s program. Additional sponsorship came from the Metro Atlanta Chamber, UPS, Johnson Controls and Partnership Gwinnett.

“JPMorgan Chase is pleased to help metro Atlanta businesses grow in the international economy,” said David Balos, head of JPMorgan Chase’s Middle Market Banking group in Georgia. ‘’These grants will help companies spend time in their target markets to meet with distributors, partners, and potential customers. Seeing metro Atlanta companies grow their international business will consequently lead to job creation and growth of the metro Atlanta economy.”

The Atlanta MEC is being implemented by ORBATL, a regional partnership of metro Atlanta public and private leaders that enables businesses to grow in the global economy through trade and foreign direct investment.

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Dr. Dinsmoor Joins Women’s Telehealth

Women’s Telehealth welcomes Dr. Mara J. Dinsmoor to our telemedicine practice.  Dr. Dinsmoor earned her undergraduate degree from Dartmouth College in Hanover, NH and went on to earn her Medical Doctor’s degree from Indiana University. She completed her residency in Obstetrics and Gynecology at the Medical Center Hospital of Vermont and completed a fellowship in Obstetrics and Gynecology at the University of Texas Health Science Center in San Antonio, Texas. Dr. Dinsmoor also holds a Masters Degree in Public Health.  After completing her fellowship, she joined the faculty at the Medical College of Virginia (now Virginia Commonwealth University) where she worked for 12 years.  She became a tenured Associate Professor and was the Head of the Maternal Fetal Medicine Division.  Her research interests while there were HIV in pregnancy and group B streptococcus.  In 2001, Dr. Dinsmoor returned to the Midwest and has been with NorthShore University HealthSystem for the past 17 years, reaching the rank of Clinical Professor.  Her primary research focus at NorthShore has been the NICHD Maternal Fetal Medicine Unit Network studies. We are proud to have such an accomplished physician join Women’s Telehealth.

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Top Docs Radio Show About Women’s Health

Check out this week’s Top Docs Radio Show about women’s health with Women’s Telehealth President, Tanya Mack, and Dr. Hugo Ribot of Cartersville OB-GYN. The show show focuses on three areas: Laparoscopic Surgery, Maternal Fetal Telemedicine in the OB office and Zika virus recommendations for pregnant women. Click here to listen: http://businessradiox.com/podcast/topdocs/minimally-invasive-gynecologic-surgery/

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