Development and implementation of a quality improvement toolkit, iron deficiency in pregnancy with maternal iron optimization (IRON MOM): A before-and-after study

by Jameel Abdulrehman, Andrea Lausman, Grace H. Tang, Rosane Nisenbaum, Jessica Petrucci, Katerina Pavenski, Lisa K. Hicks, Michelle Sholzberg BackgroundIron deficiency (ID) in pregnancy is a common problem that can compromise both maternal and fetal health. Although daily iron supplementation is a simple and effective means of treating ID in pregnancy, ID and ID anemia (IDA) often go unrecognized and untreated due to lack of knowledge of their implications and competing clinical priorities. Methods and findingsIn order to enhance screening and management of ID and IDA in pregnancy, we developed a novel quality-improvement toolkit: ID in pregnancy with maternal iron optimization (IRON MOM), implemented at St. Michael ’s Hospital in Toronto, Canada. It included clinical pathways for diagnosis and management, educational resources for clinicians and patients, templated laboratory requisitions, and standardized oral iron prescriptions. To assess the impact of IRON MOM, we retrospectively extracted laboratory data of all women seen in both the obstetrics clinic and the inpatient delivery ward settings from the electronic patient record (EPR) to compare measures pre- and post-implementation of the toolkit: a process measure of the rates of ferritin testing, and outcome measures of the proportion of women with an antenatal (predelivery) hemoglobin value below 100 g/L (anemia), the proportion of women who received a red blood cell (RBC) transfusion during pregnancy, and the pr...
Source: PLoS Medicine - Category: Internal Medicine Authors: Source Type: research

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Conclusions: the frequencies of infections in maternal-fetal health were considered low, highlighting on syphilis and the presence for sickle cell trait.Resumo Objetivos: estimar a taxa de detec ção de patologias da TPN em papel de filtro nas regiões Sul e Sudoeste do Estado da Bahia, bem como delinear o perfil epidemiológico dessas gestantes, calcular e estimar a taxa de adesão e abrangência de cobertura do Programa. Métodos: estudo descritivo, de agosto 2013 a agosto de 2015, de d ados obtidos do Labimuno/ICS/UFBA. Resultados: foram incluídas 64.743 gestantes; as m&e...
Source: Revista Brasileira de Saude Materno Infantil - Category: Midwifery Source Type: research
This study was carried out at a tertiary care hospital in Haryana. The prevalence of anemia in females at the time pregnancy diagnosis during first trimester was studied. The study period was January 2018 to June 2019. Severity of anemia was categorized as mild (hemoglobin 10 –10.9 gm/dl), moderate (hemoglobin 7–9.9 gm/dl) and severe (hemoglobin 
Source: Indian Journal of Hematology and Blood Transfusion - Category: Hematology Source Type: research
Abstract BACKGROUND: Prenatal alcohol exposure (PAE) causes long-term growth and neurodevelopmental deficits that are worsened by maternal iron deficiency (ID). In our preclinical rat model, PAE causes fetal anemia, brain ID, and elevated hepatic iron via increased maternal and fetal hepcidin synthesis. These changes are normalized by a prenatal iron-fortified (IF) diet. Here, we hypothesize that iron status and PAE dysregulate the major upstream pathways that govern hepcidin production - EPO/BMP6/SMAD and IL-6/JAK2/STAT3. METHODS: Pregnant, Long-Evans rat dams consumed ID (2-6ppm iron), iron-sufficient (IS, ...
Source: Alcoholism, Clinical and Experimental Research - Category: Addiction Authors: Tags: Alcohol Clin Exp Res Source Type: research
Publication date: November 2019Source: Human Pathology: Case Reports, Volume 18Author(s): Yiqin Xiong, Michelle X. YangAbstractPrimary gastric choriocarcinoma (PGC) is a rare gastric malignancy that accounts for
Source: Human Pathology: Case Reports - Category: Pathology Source Type: research
TUESDAY, Sept. 10, 2019 -- A standardized iron deficiency (ID) toolkit increases detection and management of anemia during pregnancy, according to a study published Aug. 20 in PLOS Medicine. Jameel Abdulrehman, M.D., from University Health Network...
Source: Drugs.com - Pharma News - Category: Pharmaceuticals Source Type: news
Authors: Omer SA, Noureldein AN, Eisa H, Abdelrahim M, Idress HE, Abdelrazig AM, Adam I Abstract The aim of the present study was to investigate the prevalence of submicroscopic infections and to assess its impact on maternal anaemia and low birth weight. A cross-sectional study was carried out with 1149 consented pregnant women who delivered at 3 main hospitals in the Blue Nile State, between January 2012 and December 2015. From a matched maternal peripheral, placental maternal side, and cord blood sample, blood films and dried spots were prepared for microscopic examination and nested polymerase chain reaction (n...
Source: Journal of Tropical Medicine - Category: Tropical Medicine Tags: J Trop Med Source Type: research
Purpose of review Malaria threatens the lives of over 200 million individuals with the disease each year. Plasmodium falciparum is the predominant cause of severe malaria which may be lethal and result in neurocognitive sequelae despite appropriate treatment. We review recent advances regarding the pathophysiology of severe malaria and treatment recommendations for severe disease in the United States. Recent findings Infected red blood cell (iRBC) sequestration in microvascular beds is a critical factor in the development of severe malaria syndromes. Interactions between iRBC variant adhesive peptides and the endothel...
Source: Current Opinion in Infectious Diseases - Category: Infectious Diseases Tags: TROPICAL AND TRAVEL-ASSOCIATED DISEASES: Edited by Christina Coyle Source Type: research
Authors: Malakauskienė L, Nadišauskienė RJ, Ramašauskaitė D, Bartusevičienė E, Ramonienė G, Maleckienė L Abstract The optimal interval between bariatric surgery (BS) and pregnancy remains clearly undefined. The aim of this study was to assess pregnancy outcomes according to the interval from BS to conception. The nationwide study cohort consisted of 130 women with previous BS and postoperative singleton delivery during 2005-2015 in Lithuania. Women who conceived within the first 12 months after BS were included in the early conception (EC) group (n = 30); who became pregnant ...
Source: Journal of Obstetrics and Gynaecology - Category: OBGYN Tags: J Obstet Gynaecol Source Type: research
Authors: Tamaki S, Shinoda K, Matsumoto T, Morita S, Asanuma H, Yoshida T, Oya M PMID: 31478423 [PubMed - as supplied by publisher]
Source: Journal of Obstetrics and Gynaecology - Category: OBGYN Tags: J Obstet Gynaecol Source Type: research
The objective of this study was to describe the socio-demographic and unique morbidity characteristics of this community and their effect on HbA1c measurements. Consanguinity, especially among cousins in the Bedouin population, results in a high prevalence of autosomal recessive genetic diseases such as thalassemia (underestimate of HbA1c), hemoglobinopathies (underestimate and overestimate), Gilbert's disease, and glucose-6-phosphate dehydrogenase deficiency, an X-linked disorder, which can cause hyperbilirubinemia with an overestimate of HbA1c. Furthermore, nutritional deficiencies, autosomal recessive diseases, high bir...
Source: The Israel Medical Association Journal - Category: General Medicine Tags: Isr Med Assoc J Source Type: research
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