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ACOG Issues New Guidelines On Fetal Monitoring To Resolve Inconsistencies In Interpretation
The American College of Obstetrics and Gynecology recently published new guidelines on electronic fetal monitoring in an attempt to increase consistency in the way physicians interpret and act on the results, the New York Times reports. Electronic fetal monitoring, which was introduced in the 1970s, is used during labor for more than 85% of the four million infants born alive in the U.S. annually, the Times reports. According to the Times, use of fetal monitors became standard obstetrical practice before it was known if the benefits outweighed the risks. The new guidelines refine the meaning of various readings from fetal monitors and could help doctors make better decisions about whether to intervene during labor.According to experts, the widespread adoption of fetal monitoring has produced both negative and positive consequences, including significant increases in caesarean deliveries and the use of forceps during vaginal deliveries. Monitoring has not been found to reduce the risk of either cerebral palsy or fetal death resulting from inadequate oxygen to the fetal brain, as it was intended to do. Furthermore, lawyers commonly use monitoring results to support malpractice cases that might have little merit, which in turn has driven rising malpractice insurance costs and prompted some obstetricians to stop delivering infants.The new guidelines divide monitor readings into three categories to help doctors interpret readings more consistently. The old guidelines had two categories -- reassuring and non-reassuring -- and it was up to the obstetrician to determine whether a non-reassuring reading required intervention. Under the new guidelines, the first category applies when tracings of the fetal heart rate are normal and no specific action is required. The second category is for indeterminate tracings that require evaluation, continuous surveillance and re-evaluation. Obstetricians treating patients in this category should consider other clinical factors that could affect the fetus and whether the patient could be safely moved to category one, according to Catherine Spong of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, which produced recommendations on which the guidelines are based. The final category is for abnormal tracings that require immediate evaluation and efforts to reverse the abnormal heart rate. The Times reports that more refinements to the guidelines are expected to be released in 2010 (Brody, New York Times, 7/7).
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Rep. Schwartz Introduces Legislation To Establish AAMC-Proposed Health Care Innovation Zones
The AAMC (Association of American Medical Colleges) applauds Rep. Allyson Schwartz (D-Pa.) for introducing legislation (H.R. 3134) to establish pilot "health care innovation zones" (HIZs) building on the strengths of academic medical centers (AMCs). The legislation creates and tests these zones around the country with the goal of improving patient outcomes, while slowing the growth of health care costs.
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Fat Tissue Growth In Rodent Models Suppressed By Turmeric Extract
Curcumin, the major polyphenol found in turmeric, appears to reduce weight gain in mice and suppress the growth of fat tissue in mice and cell models. Researchers at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University (USDA HNRCA) studied mice fed high fat diets supplemented with curcumin and cell cultures incubated with curcumin.
Health Insurance

Oral Piercings Pose Potential Health Care Risks

Like clothing and hairstyles, oral piercings give teens and adults a way to express themselves. While trendy, this fashion statement poses a number of potential oral and overall health care risks. It"s also important to note that oral piercings most commonly involve the tongue, and also the lips, cheeks, uvula or a combination of sites. Oral piercings have been implicated in a number of adverse oral and systemic conditions. "Anyone considering an oral piercing should consult a dentist to discuss the possible adverse effects," says Dr. George Koumaras, DDS, dental director for Delta Dental of Virginia, "or if you already have an oral piercing, make sure to schedule routine dental exams so a dentist can check for potential problems." Known complications of oral piercings include: -- Pain - People who have oral piercings cite pain as the first thing they notice after the procedure. -- Swelling - Piercing may cause swelling of the tongue. According to the American Dental Association, in extreme cases, a severely swollen tongue can actually close off the airway and restrict breathing. --- Prolonged bleeding - A blood vessel punctured during piercing may cause severe bleeding. -- Damage to the sublingual salivary glands - An improperly placed tongue piercing may damage the sublingual salivary glands (salivary glands under the tongue), which produce five percent of saliva entering the oral cavity. -- Aspiration (choking) - Jewelry may become loose in the mouth, creating a choking hazard. -- Plaque buildup - Plaque may build up on piercings, requiring more frequent cleanings. -- Damage to the teeth and gums - Jewelry may come in contact with both the teeth and gums, causing chipped or cracked teeth or gingival (gum) recession. -- Allergic reaction - Jewelry containing certain metals may cause an allergic reaction. -- Nerve damage - A piercing that penetrates a nerve may cause nerve damage, leading to numbness or loss of sensation at the piercing site. -- Infection - The wound from the piercing, coupled with bacteria in the mouth, creates an increased risk of infection. "If you decide to get an oral piercing and complications arise, schedule an appointment with your dentist," says Dr. Koumaras. "Dentists are trained to monitor and manage oral health problems and will work with a physician to manage more serious conditions." Also, make sure to follow any home-care instructions, including cleaning, provided by your dentist or piercing specialist. This may help prevent immediate, short-term or long-term complications. Your dentist can prescribe an antimicrobial rinse to help keep the pierced site and jewelry clean. "Whether a piercing is through the cheek, lip or tongue, proper oral hygiene measures are critical," continues Dr. Koumaras, "and may help reduce the risk of some damaging adverse effects of oral piercing." About Delta Dental of Virginia Delta Dental of Virginia, headquartered in Roanoke, was created in 1964 by the Virginia Dental Association and chartered by the General Assembly, as a not-for-profit service corporation the same year. Delta Dental provides employee dental benefits through a variety of managed fee-for-service and PPO plans covering over 1.3 million enrollees in over 3,100 groups. Delta Dental of Virginia is a member company of the Delta Dental Plans Association, the nation"s largest, most experienced dental benefits carrier providing dental coverage to over 51.6 million people in over 93,000 groups across the nation. ProAct Public Relations LLC


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