Tuesday, October 16, 2012

Current Research Round-Up

I haven't done a link round-up in a while, mostly due to the fact that I can barely keep up with reading my google reader blogs, let alone blog about them! But I am always reading and always following the latest research. Here is some of what I've come across lately:

Robin Elise Weiss wrote about really interesting research that found that you can actually determine the gender of the fetus at 6 weeks! It's called the Ramzi's method. In using this data, Dr. Ramzi Ismail concluded that at six weeks gestation, 97.2% of the male fetuses had a placenta or chorionic villi on the right side of the uterus. When it came to female fetuses, there were 97.5% of the chorionic villi or placenta on the left side of the uterus. Robin writes,
"This is amazingly accurate and has nothing to do with actual visualization of the sex organs, which is impossible this early in pregnancy. Parents want to know the sex of their baby for many reasons, including to figure out how to manage a pregnancy when there may be certain sex linked diseases complicating it. Though the author encourages this to be used as a soft marker to be used between the physician and patient when earlier knowledge can help the team with decision making.
The biggest advantage here is that the use of 2D ultrasound does not pose the risks that other methods do to the pregnancy. It can also easily be incorporated into the first trimester screenings and the results are immediately available. This can also prevent the waiting times that can cause much anxiety for families.

Though this is not widely used anywhere currently, parents wishing to know the sex of their baby may be trying to figure this out any way. If you have an early ultrasound and are not trained, you may misinterpret the results, even if you can clearly see the screen. You would be better off asking the person doing the ultrasound which side the placenta is on, than trying to guess yourself."
But she cautions that "it would be wise not to make decisions that are irreparable because of this knowledge. I'm not even sure if I'd paint a nursery with this answer."
 Can't find the actual article for this, just the abstract.  What it says is that there were fewer prefeeding cues observed in infants who were exposed to Pitocin than those who weren't, especially hand-to-mouth cues. Pitocin-exposed infants also had what the authors called "a low level of prefeeding organization," as evidenced by frequency of 8 prefeeding cues.

Another article demonstrating that it's not patient-requested C-sections that is driving the increasing cesarean rate. Authors found that those judged to have selected an elective cesarean were significantly older and had babies with a lower gestational age than women with a nonelective cesarean section. No significant differences between the two groups were found with respect to maternal weight, length of stay for the mother or baby, newborn birthweight, or special care nursery days. Overall, the prevalence of nulliparous women judged to have had a patient-initiated elective cesarean was found to be low and is not likely to be substantially contributing to the rising proportion of cesarean births.

An article on outcomes of Inuit births in Canada. The authors' conclusions are:  The success of the Innulitsivik midwifery service rests on the knowledge and skills of the Inuit midwives, and support of an interprofessional health team. Our study points to the potential for safe, culturally competent local care in remote communities without cesarean section capacity. Our findings support recommendations for integration of midwifery services and Aboriginal midwifery education programs in remote communities.

Only 3% of babies were Baby Friendly in 2010. The researchers in this study basically called all maternity hospitals in the US and asked to be connected to the maternity service. Then the person answering the maternity service phone was asked: "Is your hospital a Baby-Friendly hospital?" They found that Although the Baby-Friendly Hospital Initiative was established over 20 years ago, most US maternity staff responding to a telephone survey either incorrectly believed their hospital to be Baby-Friendly certified or were unaware of the meaning of "Baby-Friendly hospital."

This research is begging for follow-up studies. What do the maternity staff thing Baby Friendly means? Why do they think they are or they aren't BF?  Why are IBCLC's only correct 89% of the time in knowing if their hospital is BF?

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