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Show Zero-Base Budgeting, Sunset Laws Studies For Possibilities in Utah A concept in total medical care for mothers and potential offspring from conception to birth and beyond is receiving increased attention at the University of Utah Medical Center. This concept, which involves university hospital's obstetrical and newborn intensive care services, is directed toward pregnancies singled out as potentially high risk. "By high risk, we mean mothers who are extremely young or who become pregnant late in life," according to Dr. Margaret Watkins, assistant professor of pediatrics and a specialist in the care of newborn infants In addition, the high risk category includes mothers who may be drug addicts, have incompatible blood types with their offspring, have a history of miscarriages or who have genetic disorders that can be passed on to offspring. "The Intermountain Newborn Intensive Care Center (1NICC) at the university has long been known for its medical care of infants who suffer from medical problems associated with birth defects or prematurity," Dr Watkins said. "This will continue to be the case, but now we hope to decrease the numbers of those kinds of births by a total care approach involving mothers identified as high risk," She added that parents whose families possess genetic defects that might be passed on to offspring can be counseled prior to conception to decrease ihe chances of producing affected or unhealthy babies. "Because of the medical center's expertise in genetic counseling and testing methods, we are seeing more and more high risk mothers here," Dr Watkins said, "Years ago. probably more than two-thirds of the deliveries here were routine ones; now, that trend it reversing." She said more high risk mothers are delivering in university hospital because of the close proximity of the newborn intensive care center. "It's much better to have the birth here where we merely have to take an ill newborn from the delivery room to UV INICC three floors below rather than transport the child many miles over many hours. "If the mother and father are here rather than at a distant point in the region, they can be more involved with what we are doing for their baby," the U pediatrician noted. Highly sophisticated tests not generally available at smaller, more remote hospitals give physicians a better idea of what to expect with a birth, and steps can be taken to minimize problem pregnancies, Dr. Watkins said. For example, doctors are able to utilize a process known as amniocentesis, where a sample of the amniotic fluid surrounding the baby in the womb can be extracted and tested. "From this, we can diagnose as many as two dozen hereditary disorders, Dr. Watkins pointed out. "Counseling is also available to advise parents what options are open to them in problems are anticipated. "Oftentimes we can prescribe a course of therapy that may correct potential problems by the time of birth once we have a solid idea of what those problems are," One of the more critical problems often associated with premature newborns is hyaline membrane disease, a respiratory disorder. Through amniocentesis, physicians can analyze the lipid (fatty) levels of the amniotic fluid to deter mine the degree of maturity of the infant's lungs. "If we can develop a course of therapy and thereby decrease the chances for a premature birth, the baby will have a better chance for full development before the delivery," Dr Watkins said. With this total care concept in mind, Dr. Watkins and her colleagues are working toward establishing a perinatal care center in university hospital as the facility is expanded over the next few years. Such an expansion would include space for the existing intensive care nursery, an intermediate care unit for less than critically ill newborns and space nearby to care for high risk mothers. "In such an expanded facility, we could, for example, deal with women suffering from infertility problems, and then follow them through the birth and through postnatal care," she said. The key, she emphasized, "rests in how early the problem mother gets to us. If we can begin management early in pregnancy, fewer problem births will occur. And those that do occur can more easily be handled when mother and infant are close to a specialized intensive care unit." |