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Use of complementary medicines and therapies among obstetric patients
Methods: Patients from the high-risk clinic at Saint Peter’s University Hospital from December 1997 to June 1999 with history of preterm delivery (PTD), preterm labor, secondtrimester loss, or fetal demise served as the study population. Cervical cultures for Ureaplasma (UR) were obtained at the first prenatal visit, and patients were divided into groups based on results. Patients with positive UR served as the study group and were compared with noncolonized patients. All patients with positive cultures were treated. Age, gravidity, parity, number of prenatal visits, gestational age (GA) at first visit, weight gain, drug use, smoking, antibiotic therapy, use of aspirin, use of aspirin and heparin, cerclage, and GA at delivery were the variables collected. The outcome variable was PTD, which was defined as delivery between 24 and 37 weeks of gestation. Significance was set as P less than 0.05. Results: A total of 100 patients met the inclusion criteria. Positive cultures were found in 69% (69/100) of the patients. UR cervical colonization was not significantly associated with PTD. There were no significant differences between groups for the maternal variables studied. Conclusion: In this high-risk clinic population, antibiotic therapy for UR cervical colonization at the first prenatal care visit did not reduce the risk for preterm delivery.
1,141 g. If diagnosis was made before 24 weeks of gestation, the survival rate was 50%; if it was made after 24 weeks of gestation, survival was 100%. If drainage was required, survival rate was 56%. If no drainage was required, survival was 100%. Conclusions: TTTS still is associated with significant morbidity and mortality. Other treatments, such as laser ablation, need to be investigated, particularly for the patients who present in the second trimester. Studies of long-term morbidity also are needed.
Use of Complementary Medicines and Therapies Among Obstetric Patients Angela Ranzini, MD UMDNJ–Robert Wood Johnson Medical School/Saint Peter’s University Hospital, New Brunswick, NJ
Adrienne Allen and Yu-Ling Lai, RNC, MSN
Twin-to-Twin Transfusion Syndrome: A Review of 27 Cases and the Relationship Between Gestational Age at Diagnosis and Serial Amniocentesis on Outcome Elisabet Joa, MD University of Alberta, Edmonton, Alberta Canada,
Rhada Chari, MD, Damon Mayes, MSc, N. Demianczuk, MD, and N. Okun, MD Objective: To review outcomes of twin-to-twin syndrome (TTTS) cases and to examine the relationship between gestational age at diagnosis and serial amniocentesis drainage on these outcomes. Methods: Charts were reviewed from a 5-year period. Charts with a diagnosis of TTTS and multiples with discordant growth, polyhydramnios, oligohydramnios, or intrauterine growth restriction were reviewed. Diagnosis of TTTS was confirmed by ultrasound and pathological examination. Cases with placental insufficiency or chromosomal, cardiac, or urinary tract abnormalities were excluded. Outcomes were: survival rates, gestational age at delivery, and birth weight. Results were analyzed using the 2 and t tests. Results: Overall survival rate was 71%. Mean gestational age at delivery was 27.8 weeks, and mean birth weight was
46S Tuesday Posters
Objectives: To assess how frequently complementary medicines and therapies (CMT) are used in pregnancy, the types used, and the reasons for use. Methods: From August 1999 to June 2000, 463 postpartum patients were surveyed by questionnaire about their use of CMT, including natural therapies (teas, herbs, oils, and foods used for medicinal purposes), alternative techniques (biofeedback, meditation, yoga, t’ai chi, mental healing, imagery, Reiki, therapeutic touch and polar, dance, reflex, art, and aroma therapies), chiropractic, acupuncture/pressure, and vitamin supplements (other than prenatal vitamins, iron, and calcium). Results: The median age was 28 (range 15–39). Of respondents, 57% were college graduates; 68% were born in the United States; 58% were white, 19% Asian, 10% Hispanic, and 9% black; and 145 (31.3%) used one or more form of CMT. Of those who used CMT, 112 (24.2%) used natural therapies, 27 (5.8%) alternative techniques, 24 (5.2%) a chiropractor, 13 (2.8%) acupuncture/pressure, and 13 (2.8%) vitamin supplements. The most frequent reasons for CMT use included lower GI problems (73 , 25.1%), anxiety (36, 12.6%), nausea/vomiting (34, 12.6%), and urinary tract problems (20, 7.0%). Before pregnancy only 19 (4.6%) reported use of CMT, and 12 of these discontinued use when they became pregnant. Fourteen patients (3.0%) used potentially harmful products based on published evidence. Only 13% of patients informed their physicians of CMT use. Conclusions: 1) Almost one third of pregnant women use CMT during pregnancy. 2) Physicians rarely are aware of these practices. 3) Some patients use potentially harmful CMT during pregnancy.
Obstetrics & Gynecology
1,141 g. If diagnosis was made before 24 weeks of gestation, the survival rate was 50%; if it was made after 24 weeks of gestation, survival was 100%. If drainage was required, survival rate was 56%. If no drainage was required, survival was 100%. Conclusions: TTTS still is associated with significant morbidity and mortality. Other treatments, such as laser ablation, need to be investigated, particularly for the patients who present in the second trimester. Studies of long-term morbidity also are needed.
Use of Complementary Medicines and Therapies Among Obstetric Patients Angela Ranzini, MD UMDNJ–Robert Wood Johnson Medical School/Saint Peter’s University Hospital, New Brunswick, NJ
Adrienne Allen and Yu-Ling Lai, RNC, MSN
Twin-to-Twin Transfusion Syndrome: A Review of 27 Cases and the Relationship Between Gestational Age at Diagnosis and Serial Amniocentesis on Outcome Elisabet Joa, MD University of Alberta, Edmonton, Alberta Canada,
Rhada Chari, MD, Damon Mayes, MSc, N. Demianczuk, MD, and N. Okun, MD Objective: To review outcomes of twin-to-twin syndrome (TTTS) cases and to examine the relationship between gestational age at diagnosis and serial amniocentesis drainage on these outcomes. Methods: Charts were reviewed from a 5-year period. Charts with a diagnosis of TTTS and multiples with discordant growth, polyhydramnios, oligohydramnios, or intrauterine growth restriction were reviewed. Diagnosis of TTTS was confirmed by ultrasound and pathological examination. Cases with placental insufficiency or chromosomal, cardiac, or urinary tract abnormalities were excluded. Outcomes were: survival rates, gestational age at delivery, and birth weight. Results were analyzed using the 2 and t tests. Results: Overall survival rate was 71%. Mean gestational age at delivery was 27.8 weeks, and mean birth weight was
46S Tuesday Posters
Objectives: To assess how frequently complementary medicines and therapies (CMT) are used in pregnancy, the types used, and the reasons for use. Methods: From August 1999 to June 2000, 463 postpartum patients were surveyed by questionnaire about their use of CMT, including natural therapies (teas, herbs, oils, and foods used for medicinal purposes), alternative techniques (biofeedback, meditation, yoga, t’ai chi, mental healing, imagery, Reiki, therapeutic touch and polar, dance, reflex, art, and aroma therapies), chiropractic, acupuncture/pressure, and vitamin supplements (other than prenatal vitamins, iron, and calcium). Results: The median age was 28 (range 15–39). Of respondents, 57% were college graduates; 68% were born in the United States; 58% were white, 19% Asian, 10% Hispanic, and 9% black; and 145 (31.3%) used one or more form of CMT. Of those who used CMT, 112 (24.2%) used natural therapies, 27 (5.8%) alternative techniques, 24 (5.2%) a chiropractor, 13 (2.8%) acupuncture/pressure, and 13 (2.8%) vitamin supplements. The most frequent reasons for CMT use included lower GI problems (73 , 25.1%), anxiety (36, 12.6%), nausea/vomiting (34, 12.6%), and urinary tract problems (20, 7.0%). Before pregnancy only 19 (4.6%) reported use of CMT, and 12 of these discontinued use when they became pregnant. Fourteen patients (3.0%) used potentially harmful products based on published evidence. Only 13% of patients informed their physicians of CMT use. Conclusions: 1) Almost one third of pregnant women use CMT during pregnancy. 2) Physicians rarely are aware of these practices. 3) Some patients use potentially harmful CMT during pregnancy.
Obstetrics & Gynecology