scholarly journals Universal screening for SARS-CoV-2 infection among pregnant women at Elmhurst Hospital Center, Queens, New York

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0238409
Author(s):  
Sheela Maru ◽  
Uday Patil ◽  
Rachel Carroll-Bennett ◽  
Aaron Baum ◽  
Tracy Bohn-Hemmerdinger ◽  
...  
Keyword(s):  
New York ◽  
Pregnant Women ◽  
Universal Screening ◽  
Screening Program ◽  
Safety Net ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Percentage Points ◽  
Safety Net Hospital

Background Universal screening for SARS-CoV-2 infection on Labor and Delivery (L&D) units is a critical strategy to manage patient and health worker safety, especially in a vulnerable high-prevalence community. We describe the results of a SARS-CoV-2 universal screening program at the L&D Unit at Elmhurst Hospital in Queens, NY, a 545-bed public hospital serving a diverse, largely immigrant and low-income patient population and an epicenter of the global pandemic. Methods and findings We conducted a retrospective cross-sectional study. All pregnant women admitted to the L&D Unit of Elmhurst Hospital from March 29, 2020 to April 22, 2020 were included for analysis. The primary outcomes of the study were: (1) SARS-CoV-2 positivity among universally screened pregnant women, stratified by demographic characteristics, maternal comorbidities, and delivery outcomes; and (2) Symptomatic or asymptomatic presentation at the time of testing among SARS-CoV-2 positive women. A total of 126 obstetric patients were screened for SARS-CoV-2 between March 29 and April 22. Of these, 37% were positive. Of the women who tested positive, 72% were asymptomatic at the time of testing. Patients who tested positive for SARS-CoV-2 were more likely to be of Hispanic ethnicity (unadjusted difference 24.4 percentage points, CI 7.9, 41.0) and report their primary language as Spanish (unadjusted difference 32.9 percentage points, CI 15.8, 49.9) than patients who tested negative. Conclusions In this retrospective cross-sectional study of data from a universal SARS-Cov-2 screening program implemented in the L&D unit of a safety-net hospital in Queens, New York, we found over one-third of pregnant women testing positive, the majority of those asymptomatic. The rationale for universal screening at the L&D Unit at Elmhurst Hospital was to ensure safety of patients and staff during an acute surge in SARS-Cov-2 infections through appropriate identification and isolation of pregnant women with positive test results. Women were roomed by their SARS-CoV-2 status given increasing space limitations. In addition, postpartum counseling was tailored to infection status. We quickly established discharge counseling and follow-up protocols tailored to their specific social needs. The experience at Elmhurst Hospital is instructive for other L&D units serving vulnerable populations and for pandemic preparedness.

scholarly journals Universal screening for SARS-CoV-2 infection among pregnant women at Elmhurst Hospital Center, Queens, New York

2020 ◽  
Author(s):  
Sheela Maru ◽  
Uday Patil ◽  
Rachel Carroll-Bennett ◽  
Aaron Baum ◽  
Tracy Bohn-Hemmerdinger ◽  
...  
Keyword(s):  
New York ◽  
Pregnant Women ◽  
Universal Screening ◽  
Screening Program ◽  
Safety Net ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Percentage Points ◽  
Safety Net Hospital

Background Universal screening for SARS-CoV-2 infection on Labor and Delivery (L&D) units is a critical strategy to manage patient and health worker safety, especially in a vulnerable high-prevalence community. We describe the results of a SARS-CoV-2 universal screening program at the L&D Unit at Elmhurst Hospital in Queens, NY, a 545-bed public hospital serving a diverse, largely immigrant and low-income patient population and an epicenter of the global pandemic. Methods and findings We conducted a retrospective cross-sectional study. All pregnant women admitted to the L&D Unit of Elmhurst Hospital from March 29, 2020 to April 22, 2020 were included for analysis. The primary outcomes of the study were: (1) SARS-CoV-2 positivity among universally screened pregnant women, stratified by demographic characteristics, maternal comorbidities, and delivery outcomes; and (2) Symptomatic or asymptomatic presentation at the time of testing among SARS-CoV-2 positive women. A total of 126 obstetric patients were screened for SARS-CoV-2 between March 29 and April 22. Of these, 37% were positive. Of the women who tested positive, 72% were asymptomatic at the time of testing. Patients who tested positive for SARS-CoV-2 were more likely to be of Hispanic ethnicity (unadjusted difference 24.4 percentage points, CI 7.9, 41.0) and report their primary language as Spanish (unadjusted difference 32.9 percentage points, CI 15.8, 49.9) than patients who tested negative. Conclusions In this retrospective cross-sectional study of data from a universal SARS-Cov-2 screening program implemented in the L&D unit of a safety-net hospital in Queens, New York, we found over one-third of pregnant women testing positive, the majority of those asymptomatic. The rationale for universal screening at the L&D Unit at Elmhurst Hospital was to ensure safety of patients and staff during an acute surge in SARS-Cov-2 infections through appropriate identification and isolation of pregnant women with positive test results. Women were roomed by their SARS-CoV-2 status given increasing space limitations. In addition, postpartum counseling was tailored to infection status. We quickly established discharge counseling and follow-up protocols tailored to their specific social needs. The experience at Elmhurst Hospital is instructive for other L&D units serving vulnerable populations and for pandemic preparedness.

scholarly journals Do we need to screen and treat pregnant women for subclinical hypothyroidism? A cross sectional study in a rural tertiary centre in Kerala, India

2017 ◽  
Vol 6 (3) ◽  
pp. 781
Author(s):  
Radha K. R. ◽  
Nishu Sugunan ◽  
Resmy C. R.
Keyword(s):  
Pregnant Women ◽  
Subclinical Hypothyroidism ◽  
Universal Screening ◽  
Cross Sectional Study ◽  
P Value ◽  
Sectional Study ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Neonatal Hypothyroidism ◽  
In Pregnancy

Background: Hypothyroidism (HT) is associated with maternal and perinatal morbidity. Subclinical HT rather than overt occur in pregnancy, because overt HT causes infertility. Treatment of overt HT was beneficial in reducing the fetal and maternal complications, Usefulness of correcting subclinical hypothyroidism was doubtful, hence Universal screening of pregnant women was not recommended.Methods: Cross sectional study, conducted in the department of obstetrics and gynecology, Government Medical College, Thrissur, Kerala, India. 50 consecutive cases of subclinical hypothyroidism in pregnancy were analyzed for Thyroid function, antenatal, natal, postnatal complications. Perinatal complications, including neonatal hypothyroidism also noted. Statistical analysis done using computer software Epi info3.4. Data expressed in its frequency and percentage, continuous data in mean.Results: All women in the study group received levothyroxine during pregnancy from time of diagnosis. At the time of delivery 84% women were euthyroid and 16% hypothyroid. Complications like anemia 36%, abruption 4%, and postpartum hemorrhage 6% showed a statistically significant association, while pre-eclampsia 20%, preterm labor 22% had no statistically significant association. Comparing the women who are euthyroid as a result of levothyroxine supplementation to women inadequately treated, complications like anemia (33% versus 50%, p value 0.042), abruption (0% versus 4%, p value0.023), PPH (2% versus 6%, p value 0.014) were significantly less in well controlled.Conclusions: Significant association was noted between inadequately treated hypothyroidism and maternal complications like anaemia, placental abruption, placenta previa, PPH, preterm delivery, and caesarean section rate for foetal distress. Universal screening of pregnant women for thyroid status is recommended.

scholarly journals Long-term benefit of hepatitis C therapy in a safety net hospital system: a cross-sectional study with median 5-year follow-up

BMJ Open ◽  
2013 ◽  
Vol 3 (9) ◽  
pp. e003231 ◽  
Author(s):  
Amit G Singal ◽  
Tushar D Dharia ◽  
Peter F Malet ◽  
Saleh Alqahtani ◽  
Song Zhang ◽  
...  
Keyword(s):  
Safety Net ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Hospital System ◽  
System A ◽  
Safety Net Hospital ◽  
Term Benefit

ChemoPalRx—A Mobile App That Enhances Chemotherapy Prescription Accuracy: A Cross-Sectional Study

2021 ◽  
pp. 897-903
Author(s):  
Tony K. W. Hung ◽  
Serene Tareen ◽  
Sharvina Ziyeh ◽  
Gilad J. Kuperman ◽  
Jun J. Mao ◽  
...  
Keyword(s):  
Los Angeles ◽  
Hospital Setting ◽  
Safety Net ◽  
Cross Sectional Study ◽  
Mobile App ◽  
Sectional Study ◽  
Cross Sectional ◽  
Error Type ◽  
Safety Net Hospital ◽  
Provider Experience

PURPOSE ChemoPalRx is a novel provider order entry mobile application for chemotherapy. This study aims to evaluate the accuracy of prescribing chemotherapy using ChemoPalRx versus handwritten orders at a safety-net hospital in Los Angeles. METHODS In a cross-sectional study from October 2019 to December 2019, we evaluated all outpatient chemotherapy orders for accuracy. Our primary predictor was type of prescription, dichotomized as handwritten or ChemoPalRx. Primary outcome was accuracy, dichotomized as accurate if no error was made on an order and as inaccurate if any error was made. Preplanned subgroup analyses were performed with covariates including provider experience, complexity of order, and day of order submission. We characterized error type and analyzed our data using univariate and multivariate logistic regression models. RESULTS Among 288 orders (78.5% handwritten; 21.5% ChemoPalRx), prescription accuracy was higher among ChemoPalRx (93.5%) compared with handwritten orders (81.4%; P = .012). In multivariate analysis, prescription accuracy remained superior for ChemoPalRx after adjusting for provider experience, complexity of order, and day of order submission (adjusted odds ratio, 1.82; P = .012). Compared with handwritten orders, ChemoPalRx orders had less missing or incorrect information (1.6% v 13.7%; P = .0016). ChemoPalRx orders were also more accurate on prescriptions that contained two or fewer medications (92.2% v 80.2%; P = .032), submitted on the highest patient-volume clinic day of the week (96.7% v 83.2%; P = .035), and generated by a senior fellow or an attending (97.3% v 76.9%; P = .001). CONCLUSION ChemoPalRx is associated with improved chemotherapy prescription accuracy over handwritten orders in the safety-net hospital setting and may serve as an alternative prescribing tool for oncology practices.

scholarly journals Some characteristics of hyperglycaemic crisis differ between patients with and without COVID-19 at a safety-net hospital in a cross-sectional study

2021 ◽  
Vol 53 (1) ◽  
pp. 1642-1645
Author(s):  
Arnav Shah ◽  
Andrew Deak ◽  
Shaneisha Allen ◽  
Elayna Silfani ◽  
Christina Koppin ◽  
...  
Keyword(s):  
Safety Net ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Safety Net Hospital

scholarly journals Productive Safety Net Program and Dietary Practice Among Pregnant Women in Kacha Birra District, Southwest Ethiopia: Comparative Cross-Sectional Study

2020 ◽  
Author(s):  
LEMLEM DANIEL BAFFA ◽  
TEREFE DERSO ◽  
ESMAEL ALI MUHAMMAD
Keyword(s):  
Pregnant Women ◽  
Low Income ◽  
Safety Net ◽  
Cross Sectional Study ◽  
Nutrition Information ◽  
Sectional Study ◽  
Cross Sectional ◽  
Dietary Practice ◽  
Dietary Knowledge ◽  
Significant Difference

Abstract Background: Morbidity and mortality associated with poor dietary practice among pregnant women are a common public health burdens especially in low income countries like Ethiopia, for which, household food insecurity can be a determinant factor. Productive safety net program (PSNP) is implemented in Ethiopia to alleviate this problem with emphasis on pregnant and lactating mothers even though little is known about the dietary practice among pregnant women in the program user and non-user households. Therefore, this study is aimed to compare the proportion of good dietary practice and associated factors among pregnant women in productive safety net program user and non-user households in Kacha Birra District. Method: A Community based comparative cross sectional study was conducted in Kacha Birra District from March 12 to April 20, 2019. A total of 715 pregnant women were included by simple random sampling technique. A pretested and structured interviewer administered questionnaire was used to collect the data. Data was entered into EpiData version 3.1 and transferred to Stata version 14 for analysis. Binary logistic regression model was fitted to identify factors associated with dietary practice. Crude odds ratio and adjusted odds ratios with 95% confidence intervals were calculated to assess the strength of associations and significance of the identified factors with dietary practice. Result: The overall proportion of good dietary practice among pregnant women was 14.97% (95%CI: 12.3-17.6), while it was 11.17% (95%CI: 6.5-15.8) and 16.23% (95%CI: 13.09-19.36) among pregnant women in PSNP user and non PSNP user households respectively. Dietary knowledge (AOR=2.64, 95%CI:1.67-4.18), nutrition information (AOR=2.36, 95%CI:1.41-3.95) and husband occupation (AOR=3.51, 95%CI:1.02-12.08) were significantly associated with dietary practice of the pregnant women. Conclusion: The proportion of good dietary practice of the pregnant women in the study area was low with no significant difference among the comparative groups. Dietary knowledge, nutrition information and husband occupation were significantly associated with the dietary practice. So, giving due attention to the improvement of knowledge of the pregnant mothers about nutrition during pregnancy and enhancing their exposure to nutrition information is crucial. Also, strengthening the PSNP is important.

scholarly journals Physical Activity Patterns of Women with a Twin Pregnancy—A Cross-Sectional Study

2021 ◽  
Vol 18 (15) ◽  
pp. 7724
Author(s):  
Katarzyna Kwiatkowska ◽  
Katarzyna Kosińska-Kaczyńska ◽  
Izabela Walasik ◽  
Agnieszka Osińska ◽  
Iwona Szymusik
Keyword(s):  
Physical Activity ◽  
Pregnant Women ◽  
Twin Pregnancy ◽  
Activity Patterns ◽  
Multiple Pregnancy ◽  
Cross Sectional Study ◽  
Sources Of Information ◽  
Sectional Study ◽  
Cross Sectional ◽  
Physically Active

Background: No specific physical activity guidelines are available for women in multiple pregnancy. Aim of the study was to assess the knowledge and experience of women regarding physical activity during their latest twin pregnancy. Methods: A cross-sectional study including women after a twin delivery was conducted in Poland. A questionnaire was distributed in 2018 via web pages and Facebook groups designed for pregnant women. Results: 652 women filled out the questionnaire completely. Only 25% of women performed any physical exercises during twin gestation. The frequency of preterm delivery was similar in physically active and non-active participants. 35% of the respondents claimed to have gained information on proper activity from obstetricians during antenatal counselling while 11% claimed to be unable to identify the reliable sources of information. 7% of women admitted to feel discriminated by social opinion on exercising during a twin pregnancy. Conclusions: The population of women with a twin gestation is not sufficiently physically active and is often discouraged from performing exercises during gestation. Therefore, it is crucial to inform obstetricians to recommend active lifestyle during a twin gestation and to provide reliable information on physical activity to pregnant women. Further research on this topic is necessary in order for obstetric providers to counsel women on appropriate exercise with a twin pregnancy.

scholarly journals Knowledge and understanding of obstetric danger signs among pregnant women attending the antenatal clinic at the National Referral Hospital in Thimphu, Bhutan: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saran Tenzin Tamang ◽  
Thinley Dorji ◽  
Sonam Yoezer ◽  
Thinley Phuntsho ◽  
Phurb Dorji
Keyword(s):  
Pregnant Women ◽  
Knowledge Score ◽  
Antenatal Clinic ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Obstetric Danger Signs ◽  
Danger Signs ◽  
Obstetric Emergencies ◽  
Level Of Knowledge

Abstract Background The third Sustainable Development Goal for 2030 development agenda aims to reduce maternal and newborn deaths. Pregnant women’s understanding of danger signs is an important factor in seeking timely care during emergencies. We assessed knowledge of obstetric danger signs using both recall and understanding of appropriate action required during obstetric emergencies. Methods This was a cross-sectional study among pregnant women attending antenatal clinic at Bhutan’s largest hospital in Thimphu. Recall was assessed against seven obstetric danger signs outlined in the Mother and Child Health Handbook (7 points). Understanding of danger signs was tested using 13 multiple choice questions (13 points). Knowledge was scored out of 20 points and reported as ‘good’ (≥80%), ‘satisfactory’ (60–79%) and ‘poor’ (< 60%). Correlation between participant characteristics and knowledge score as well as number of danger signs recalled was tested using Pearson’s correlation coefficient. Association between knowledge score and participant characteristics was tested using t-tests (and Kruskal-Wallis test) for numeric variables. Socio-demographic and clinical characteristics associated with the level of knowledge ('good’ versus ‘satisfactory’ and ‘poor’ combined) were assessed with odds ratios using a log-binomial regression model. All results with p < 0.05 were considered significant. Results Four hundred and twenty-two women responded to the survey (response rate = 96.0%). Mean (±SD) knowledge score was 12 (±2.5). Twenty women (4.7%) had ‘good’ knowledge, 245 (58.1%) had ‘satisfactory’ knowledge and 157 (37.2%) had ‘poor’ knowledge. The median number of danger signs recalled was 2 (IQR 1, 3) while 68 women (20.3%) could not recall any danger signs. Most women were knowledgeable about pre-labour rupture of membranes (96.0%) while very few women were knowledgeable about spotting during pregnancy (19.9%). Both knowledge score and number of danger signs recalled had significant correlation with the period of gestation. Women with previous surgery on the reproductive tract had higher odds of having ‘good’ level of knowledge. Conclusions Most pregnant women had ‘satisfactory’ knowledge score with poor explicit recall of danger signs. However, women recognized obstetric emergencies and identified the appropriate action warranted.

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