List of Applicable Pregnancy Codes for Controlling High Blood Pressure - CMS / NQF #: 165 / 0018
Total Page：16
File Type：pdf, Size：1020Kb
Load more
Recommended publications
-
Spectrum of Benign Breast Diseases in Females- a 10 Years Study
Original Article Spectrum of Benign Breast Diseases in Females- a 10 years study Ahmed S1, Awal A2 Abstract their life time would have had the sign or symptom of benign breast disease2. Both the physical and specially the The study was conducted to determine the frequency of psychological sufferings of those females should not be various benign breast diseases in female patients, to underestimated and must be taken care of. In fact some analyze the percentage of incidence of benign breast benign breast lesions can be a predisposing risk factor for diseases, the age distribution and their different mode of developing malignancy in later part of life2,3. So it is presentation. This is a prospective cohort study of all female patients visiting a female surgeon with benign essential to recognize and study these lesions in detail to breast problems. The study was conducted at Chittagong identify the high risk group of patients and providing regular Metropolitn Hospital and CSCR hospital in Chittagong surveillance can lead to early detection and management. As over a period of 10 years starting from July 2007 to June the study includes a great number of patients, this may 2017. All female patients visiting with breast problems reflect the spectrum of breast diseases among females in were included in the study. Patients with obvious clinical Bangladesh. features of malignancy or those who on work up were Aims and Objectives diagnosed as carcinoma were excluded from the study. The findings were tabulated in excel sheet and analyzed The objective of the study was to determine the frequency of for the frequency of each lesion, their distribution in various breast diseases in female patients and to analyze the various age group. -
Breastfeeding Management in Primary Care-FINAL-Part 2.Pptx
Breastfeeding Management in Primary Care Pt 2 Heggie, Licari, Turner May 25 '17 5/15/17 Case 3 – Sore nipples • G3P3 mom with sore nipples, baby 5 days old, full term, Breaseeding Management in yellow stools, output normal per BF log, 5 % wt loss. Primary Care - Part 2 • Mother exam: both nipples with erythema, cracked and scabbed at p, areola mildly swollen, breasts engorged and moderately tender, mild diffuse erythema, no mass. • Baby exam: strong but “chompy” suck, thick ght frenulum aached to p of tongue, with restricted tongue movement- poor lateral tracking, unable to extend tongue past gum line or lower lip, minimal tongue elevaon. May 25, 2017, Duluth, MN • Breaseeding observaon: Baby has deep latch, mom Pamela Heggie MD, IBCLC, FAAP, FABM Addie Licari, MD, FAAFP with good posioning, swallows heard and also Lorraine Turner, MD, ABIHM intermient clicking. Mom reports pain during feeding. Sore cracked nipple Type 1 - Ankyloglossia Sore Nipples § “Normal” nipple soreness is very minimal and ok only if: ü Poor latch § Nipple “tugging” brief (< 30 sec) with latch-on then resolves ü LATCH, LATCH, LATCH § No pain throughout feeding or in between feeds ü Skin breakdown/cracks-staph colonizaon § No skin damage ü Engorgement § Some women are told “the latch looks ok”… but they are in pain and curling their toes ü Trauma from pumping ü § It doesn’t maer how it “looks” … if mom is uncomfortable Nipple Shields it’s a problem and baby not geng much milk…set up for low ü Vasospasm milk supply ü Blocked nipple pore/Nipple bleb § Nipple pain is -
Cracked Nipples
UNICEF UK BABY FRIENDLY INITIATIVE GUIDANCE FOR PROVIDING REMOTE CARE FOR MOTHERS AND BABIES DURING THE CORONAVIRUS ( COVID - 19) OUTBREAK GUIDANCE SHEET 5 B ( CHALLENGES ) : SORE , PAINFUL A N D / O R CRACKED NIPPLES Delivering Baby Friendly services at this time can be difficult. However, babies, their mothers and families deserve the very best care we can provide. This document on management of sore, painful and/or cracked nipples is part of a series of guidance sheets designed to help you provide care remotely. THE MOTHER HAS SORE, PAINFUL AND/OR CRACKED NIPPLES ▪ Sore, painful and/or cracked nipples are signs of ineffective positioning and attachment of the baby at the breast. Therefore, revisiting positioning and attachment are the top priorities. ▪ Other causes include restricted tongue movement in the baby (tongue tie) or infection of the breast, e.g. thrush. PREPARING FOR THE CONVERSATION ▪ Plan a mutually agreed appointment with the USEFUL RESOURCES mother and consider using video so that you can watch a feed and see the mother and baby ▪ Breastfeeding assessment tools ▪ Refer to Guidance Sheet 1 before you start (midwives, health visitors, neonatal or ▪ Be aware that parents may be feeling vulnerable and mothers) frightened because of Covid-19, so sensitivity and ▪ Unicef UK support for parents active listening are important overcoming breastfeeding problems ▪ Take the parent’s worries seriously as they can often ▪ Knitted breast and doll (if video call) sense when something is wrong. DURING THE CALL Introduce yourself and confirm consent for the call ▪ Ask the mother to describe her feeding journey so far. -
Benign Breast Diseases1
BENIGN BREAST DISEASES PROFFESOR.S.FLORET NORMAL STRUCTURE DEVELOPMENTAL/CONGENITAL • Polythelia • Polymastia • Athelia • Amastia ‐ poland syndrome • Nipple inversion • Nipple retraction • NON‐BREAST DISORDERS • Tietze disease • Sebaceous cyst & other skin disorders. • Monder’s disease BENIGN DISEASE OF BREAST • Fibroadenoma • Fibroadenosis‐ ANDI • Duct ectasia • Periductal papilloma • Infective conditions‐ Mastitis ‐ Breast abscess ‐ Antibioma ‐ Retromammary abscess Trauma –fat necrosis. NIPPLE INVERSION • Congenital abnormality • 20% of women • Bilateral • Creates problem during breast feeding • Cosmetic surgery does not yield normal protuberant nipple. NIPPLE INVERSION NIPPLE RETRACTION • Nipple retraction is a secondary phenomenon due to • Duct ectasia‐ bilateral nipple retarction. • Past surgery • Carcinoma‐ short history,unilateral,palpable mass. NIPPLE RETRACTION ABERRATIONS OF NORMAL DEVELOPMENT AND INVOLUTION (ANDI) • Breast : Physiological dynamic structure. ‐ changes seen throught the life. • They are ‐ developmental & involutional ‐ cyclical & associated with pregnancy and lactation. • The above changes are described under ANDI. PATHOLOGY • The five basic pathological features are: • Cyst formation • Adenosis:increase in glandular issue • Fibrosis • Epitheliosis:proliferation of epithelium lining the ducts & acini. • Papillomatosis:formation of papillomas due to extensive epithelial hyperplasia. ANDI & CARCINOMA • NO RISK: • Mild hyperplasia • Duct ectasia. • SLIGHT INCREASED RISK(1.5‐2TIMES): • Moderate hyperplasia • Papilloma -
Terminology for Describing Normally-Sited and Ectopic Pregnancies on Ultrasound: ESHRE Recommendations for Good Practice
Terminology for describing normally-sited and ectopic pregnancies on ultrasound: ESHRE recommendations for good practice Set-up The invitation to review was sent to the members of the SIG Implantation and early pregnancy (n=7443 email addresses). In addition, the invitation was mailed to the members of the ESHRE Executive Committee and the Committee of National Representatives (n=74). An announcement was also placed on the eshre.eu website. The stakeholder review started on 20th of April 2020, and was closed after 4 weeks, on the 18th of May 2020. Summary Thirty reviewers, representing nineteen countries, submitted a total of 212 comments (on average 7 comments per reviewer). All reviewers are listed on page 2. IMPACT OF THE COMMENTS 9% General comment or language correction 25% Comments resulting in a change Comments to which a reply 66% was formulated This report comprises the list of reviewers, and the overview of comments, with a reply from the working group. Page 1 of 40 List of reviewers Name Country Organization Masoud Kamrava Iran Steven Goldstein USA Ulrike Metzger France Grigorios Derdelis Greece Luca Savelli Italy Gangaraju Buvaneswari India Mridu Sinha India Onur Erol Turkey Aboubakr Mohamed Elnashar Egypt Jiuzhi Zeng China Carlos Calhaz-Jorge Portugal Dr. Nidaa Qatar Attilio Di Spiezio Sardo Italy Melinda Mitranovici Romania Ali Sami Gurbuz Turkey Philippe Merviel France Roy Farquharson UK Ilan Timor USA Alessandra Pipan United Arab Emirates Company, Taiwan IVF Wen Jui Yang Taiwan Group Center Lorenzo Abad de Velasco Spain Monica Varma India Kumaran Aswathy India Annick Geril Belgium Snezana Vidakovic Serbia Lukasz Polanski, Miriam Baumgarten, Rebecca McKay, Laura Rutherford, Ouma Pillay, Anita Jeyaraj, Kanna Jayaprakasan and Kamal Ojha UK organization Mohamed Shahin UK Mohsen M El-Sayed UK International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) ISUOG European Niche taskforce group of the ESGE and international Prof. -
ABSTRACT Background: the Benefits of Breast Milk Are Greatly Enhanced If Breastfeeding Starts Within One Hour After Birth
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by International Journal of Health and Biological Sciences International Journal of Health and Biological Sciences Vol. 2, No. 3; 2019:16-41 e-ISSN: 2590-3357; p-ISSN:2590-3365 DOI: https://doi.org/10.30750/ IJHBS.2.3.2 Breast Feeding Knowledge and Practices Among Primiparous Women with Caesarean Section: Impact on Breast Engorgement in Upper Egypt Hanan Elzeblawy Hassan 1* , Galal Ahmed EL-Kholy2, Aziza Ahmed Ateya3, Amal Ahmed Hassan4 1 Maternal and Newborn Health Nursing Department, Faculty of Nursing, Beni- Suef University, Egypt. 2 Professor of obstetrics & gynecology, Faculty of Medicine, Benha University, Egypt. 3Professor of Maternal and Newborn Health Nursing, Faculty of Nursing, Ain Shams University, Egypt. 4 Professor of Obstetrics and Women’s’ Health Nursing department, Benha University, Egypt. ABSTRACT Background: The benefits of breast milk are greatly enhanced if breastfeeding starts within one hour after birth. Hunan milk contains a host of dynamic and unique feeding properties. Breast engorgement is one of the most common minor discomforts confronting nursing women after delivery, especially Primiparous. The aim of the study was to investigate the breastfeeding knowledge and practices among primiparous women with a cesarean section and its impact on breast engorgement in Upper Egypt. The study was conducted in the postnatal unit of Beni-Suef University Hospital. The study design was a descriptive study. The type of sample was a simple random sample. The study comprised 90 Primiparous cesarean section mothers; suffer from breast engorgement. Tools of Data Collection were interview questionnaire sheet, knowledge assessment sheet, observational checklist, and engorgement assessment scale. -
Sonography in First Trimester Bleeding
Review Sonography in First Trimester Bleeding Manjiri Dighe, MD,1 Carlos Cuevas, MD,1 Mariam Moshiri, MD,1 Theodore Dubinsky, MD,1 Vikram S. Dogra, MD2 1 Department of Radiology, University of Washington Medical Center, Seattle, WA 98195 2 Department of Imaging Sciences, University of Rochester School of Medicine, 601 Elmwood Avenue, Box 648, Rochester, NY 14642 Received 19 April 2007; accepted 1 October 2007 ABSTRACT: Vaginal bleeding is the most common however, the most common cause of bleeding is cause of presentation to the emergency department spotting caused by implantation of the conceptus in the first trimester. Approximately half of patients into the endometrium. A complete assessment of with first trimester vaginal bleeding will lose the preg- the first trimester pregnancy requires correlation nancy. Clinical assessment is difficult, and sonogra- of serum b human chorionic gonadotropin (b- phy is necessary to determine if a normal fetus is hCG) levels with the appearance of the gesta- present and alive and to exclude other causes of bleeding (eg, ectopic or molar pregnancy). Diagnosis tional sac (GS) using sonography. of a normal intrauterine pregnancy not only helps the physician in terms of management but also gives psy- SPONTANEOUS ABORTION chologic relief to the patient. Improved ultrasound technology and high-frequency endovaginal trans- Spontaneous abortion is defined as the termina- ducers have enabled early diagnosis of abnormal and tion of a pregnancy before the twentieth completed ectopic pregnancies, decreasing maternal morbidity week of gestation. Sixty-five percent of spontane- and mortality. The main differential considerations of ous abortions occur in the first 16 weeks of preg- first trimester bleeding are spontaneous abortion, ec- nancy. -
Overcoming Difficulties (PDF)
Breastfeeding Overcoming Difficulties ® Only a phone call away! See your local telephone directory Breastfeeding is a gift only you can give to your baby. A healthy full-term baby is likely to know instinctively what to do at the breast. For many mothers and babies breastfeeding goes well right from the start, for others it can take a little longer to learn. Common problems can be minimized or avoided entirely if a mother has accurate and consistent breastfeeding information and support. “Breastfeeding is a long term commitment. In order to succeed, a mother needs the encouragement and companionship of other mothers. La Leche League succeeded in the beginning and continues to work well because it meets the dual need for sound practical information and loving support. Babies don’t change and neither do mothers, though the circumstances in which they find themselves differ from one generation to the next.” Mary Ann Cahill, Founder LLL Sore Nipples Many mothers experience some nipple tenderness at the beginning of a feed during the first two to three days of breastfeeding, however, breastfeeding should not hurt. If you have continued discomfort or pain while breastfeeding or have discomfort or pain between breastfeeds, some adjustment or treatment may be needed. Research shows that good positioning of the baby at the breast will help prevent and heal sore nipples. Positioning Baby at the Breast There are a number of ways to hold your baby while breastfeeding. Getting your baby started at the breast smoothly and easily will soon become second nature to you. Nursing a baby at the breast is actually much less involved than any description of the process. -
High Risk L&D
High Risk L&D, pg 1 of 12 Taking care of patients who have non-reasurring pattern • A non-reassuring pattern is: • no variability • less than 2 accelerations • decelerations • In antepartum setting, you are looking at variable and accelerations • Parameters for 28-32 weeks is different than 32 weeks or greater • What about in labor? • looking for late decels (these are bad) • variability is THE most important thing! • moderate variability shows the CNS is intact • absent variability is no bueno...this would be a big issue if it was moderate before and now has become absent. If pt had medication, then this may not be so much of a concern b/c the meds affects the baby. • minimal may be bad (probably is) • marked is also not good • Category 1: has variablity, maybe a random decel (but most likely none), has accelerations • Category 2: starting to get into a little gray area; physician can proceed forward with usual plan of care; moderate or minimal variability; may have recurring decels (of any type); • Category3 : absent or minimal variability with repetitive late decels; baby is not coping • What’s the first thing you would do if pt had repetitive variable decels? • reposition, increase IV, put Oxygen on mom, call doc (You will reposition b/c the variable decels are d/t cord compression). • You would give O2 if she had decreased variability (according to Dr. Ferguson) • Baby can get late decels from mom lying on her back (so position change), or from having low BP (so give IV bolus). Things you need for precipitous birth • IV • Oxygen • BOA kit (Birth on Arrival kit) What kind of risks are involved with precipitous birth? • Tearing at perineum • Hemorrhage d/t lacerations and such • Pneumothorax (not in boook!). -
Pregnant Woman with Circumvallate Placenta and Suspected Fetal Hypotrophy Caused by Placental Insufficiency: a Case Report
© Copyright by PMWSZ w Opolu e-ISSN 2544-1620 Medical Science Pulse 2020 (14) 4 Case reports Published online: 31 Dec 2020 DOI: 10.5604/01.3001.0014.6735 PREGNANT WOMAN with circumvALLATE PLACENTA AND suspEctED FETAL hypOtrOphy CAusED BY PLACENTAL INsuFFiciENcy: A CASE REPOrt Jadwiga Surówka1 A,B,D–F 1 SSG of Midwifery Care, Jagiellonian University Medical College, • ORCID: 0000-0003-0170-8820 Kraków, Poland 2 A,B,D–F 2 Institute of Nursing and Midwifery, Faculty of Health Sciences, Dorota Matuszyk Jagiellonian University Medical College, Kraków, Poland • ORCID: 0000-0002-3765-6869 A – study design, B – data collection, C – statistical analysis, D – interpretation of data, E – manuscript preparation, F – literature review, G – sourcing of funding ABSTRACT Background: The circumvallate placenta is a rare pathology of the human placenta that occurs in 1–2% of pregnancies. It is characterized by extrachorial placental development, resulting in a ring formation along the edges of the placenta, which leads to efficiency impairment. As a consequence, it causes an intrauter- ine fetal hypotrophy. The fetal hypotrophic pregnancies are classified as high-risk pregnancies, requiring not only intensive monitoring of fetal development but also maternal and fetal care by the highest reference clinical center. Aim of the study: The aim of this study was to analyze the case of a patient with circumvallate placenta and fetal hypotrophy suspicion. Material and methods: The study was based on the case study method. The data was obtained by analyzing medical documentation collected during hospitalization. The patient was interviewed and observed. All of the selected parameters were measured and scaled. -
OBGYN-Study-Guide-1.Pdf
OBSTETRICS PREGNANCY Physiology of Pregnancy: • CO input increases 30-50% (max 20-24 weeks) (mostly due to increase in stroke volume) • SVR anD arterial bp Decreases (likely due to increase in progesterone) o decrease in systolic blood pressure of 5 to 10 mm Hg and in diastolic blood pressure of 10 to 15 mm Hg that nadirs at week 24. • Increase tiDal volume 30-40% and total lung capacity decrease by 5% due to diaphragm • IncreaseD reD blooD cell mass • GI: nausea – due to elevations in estrogen, progesterone, hCG (resolve by 14-16 weeks) • Stomach – prolonged gastric emptying times and decreased GE sphincter tone à reflux • Kidneys increase in size anD ureters dilate during pregnancy à increaseD pyelonephritis • GFR increases by 50% in early pregnancy anD is maintaineD, RAAS increases = increase alDosterone, but no increaseD soDium bc GFR is also increaseD • RBC volume increases by 20-30%, plasma volume increases by 50% à decreased crit (dilutional anemia) • Labor can cause WBC to rise over 20 million • Pregnancy = hypercoagulable state (increase in fibrinogen anD factors VII-X); clotting and bleeding times do not change • Pregnancy = hyperestrogenic state • hCG double 48 hours during early pregnancy and reach peak at 10-12 weeks, decline to reach stead stage after week 15 • placenta produces hCG which maintains corpus luteum in early pregnancy • corpus luteum produces progesterone which maintains enDometrium • increaseD prolactin during pregnancy • elevation in T3 and T4, slight Decrease in TSH early on, but overall euthyroiD state • linea nigra, perineum, anD face skin (melasma) changes • increase carpal tunnel (median nerve compression) • increased caloric need 300cal/day during pregnancy and 500 during breastfeeding • shoulD gain 20-30 lb • increaseD caloric requirements: protein, iron, folate, calcium, other vitamins anD minerals Testing: In a patient with irregular menstrual cycles or unknown date of last menstruation, the last Date of intercourse shoulD be useD as the marker for repeating a urine pregnancy test. -
Coverkids Diagnosis Codes for Pregnancy and Complications of Pregnancy
CoverKids Diagnosis Codes for Pregnancy and Complications of Pregnancy This list is for informational purposes only and is not a binding or definitive list of covered conditions. It is not a guarantee of coverage; coverage depends on the available benefits and eligibility at the time services are rendered. It is for use only with the CoverKids program. When filing claims, providers should use the most accurate codes for the condition being treated – it is fraud against the State of Tennessee and BlueCross BlueShield of Tennessee to intentionally use a code for a covered condition when the treatment provided is for a non- covered condition.