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Our obstetrical service provides medical students with a unique learning opportunity that few schools can mirror. During their third year, students from The University of Texas Southwestern School of Medicine spend 3 weeks learning the fundamentals of prenatal care, pregnancy complications, and delivery skills.
Our patient volume allows students to actively participate in patient care and deliveries under direct physician supervision.
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The division also continues its commitment to resident training. Residents spend 4-6 months during each year of training on services which deal with L&D skills, with comprehensive routine obstetrics, with high-risk obstetrics, or with ultrasound and prenatal genetics.
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Residents have faculty available in house to serve as instructors and consultants around-the-clock. At night, no less than four faculty remain within the hospital for this sole purpose. Our dedication to teaching is evidenced in part by our division members consistently winning the department's resident-teaching and medical student teaching awards.
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This academic year marks the 31st year of our division's fellowship in maternal-fetal medicine. Currently accredited to train 6 fellows, our 3-year program offers extensive training in pregnancy complications from the simple to the extreme.
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Fellows gain experience with ultrasonography, amniocentesis, percutaneous umbilical sampling (PUBS), and operative obstetrical skills.
Additionally, fellows spend 18 months of the fellowship involved in research activities directed toward a graduating thesis.
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Because our obstetrical patients and newborns often require services from other medical specialties, our division has several faculty members who share joint appointments with other departments such as radiology, anesthesiology, and neonatology.
These physicians allow us to provide superior patient care and comprehensive medical professional training.
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Patient Care:
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Despite the division's successes in research and education, patient care remains the committed focus of our residents, fellows, nursing staff, and faculty members. The "Parkland Way" of patient care delivery is a nationally-recognized and award-winning philosophy which has resulted in measurable success.
This year the divisions of Maternal-Fetal Medicine and Gynecology were applauded again as U.S. News and World Report named Parkland Hospital's gynecologic and maternity services as among the nation's best.
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Other clinical accomplishments include almost 16,000 infants delivered under the division's umbrella of care and rates of stillbirth, very-low-birth-weight infants born, and cesarean deliveries all below the national average. |
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Our patient care achievements stem in part from our ability to effectively assess and match patients to the medical professionals able to provide the necessary level of care. Management of the nation's largest maternity volume begins in our triage unit where each pregnant woman who presents to L&D is individually evaluated.
From triage, laboring women are transferred to 1 of 3 L&D units, each designated to care for a specific level of medical acuity. Our L&D with the highest acuity level is staffed by faculty and residents; the lower acuity units by faculty, residents, and certified nurse midwives.
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Certified nurse midwives (CNMs) play an integral role in managing our volume of obstetrical patients. CNMs in conjunction with managing physicians perform approximately 40% of our deliveries.
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Similarly, postpartum recovery care is triaged. Medical staff members provide immediate postpartum care in two recovery rooms, each staffed to manage different levels of problem severity.
Altogether our Parkland facilities provide a total resource of 36 labor beds, 7 delivery rooms, 7 operating rooms, 7-bed recovery room, and 5-bed critical care unit.
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Although sound obstetrical fundamentals drive our care, our division has additional services such as 24-hour in house language translation, LDR rooms, rooming-in option for mothers and their newborns, in hospital lactation counselors, community-based prenatal classes, and electronic centralized fetal monitoring.
Our well-developed bereavement program extends one-on-one case management to parents from the moment that a fetal death has been identified, through the medical search for the cause of their loss, to assimilation back into the Parkland women's health care clinic system.
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A second component to our patient care achievements comes from our ability to cast a broad health care net out into the Dallas community. We strive to reach out and to remove many of the barriers to early prenatal care such as geography and language.
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Faculty members, residents, and nurse practitioners staff 8 community clinics that offer daily prenatal care. Translators and bilingual health care workers bridge language and cultural barriers. In addition to the neighborhood-based clinic concept, our "MomMobile" provides pregnant patients free transportation to their clinic appointments.
As a result, 97% of women delivering at Parkland Hospital have received antenatal care prior to giving birth.
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Our triage philosophy carries over into prenatal care. Women identified as having a pregnancy complication are appointed to one of several specialty clinics that our maternal-fetal faculty and residents staff. Individual clinics, each specialized to manage a specific pregnacy complication meet weekly.
These clinics manage problems such as diabetes, multiple fetuses, genetic abnormalities, hypertension, infectious disease, preterm labor, and postterm gestation.
In addition to our specialty clinics, the 29-bed High Risk Pregnancy Unit within Parkland Hospital is dedicated to the care of maternity patients who require hospitalization and treatment for complications such as preterm labor, pregnancy induced hypertension, preterm rupture of membranes, and placenta previa. Patient volume from this ward and clinics feeds our thriving clinical research projects.
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| Our division serves not only Dallas county, but also serves as a referral source for complicated obstetrical cases for a surrounding 30 county area. Several maternity patients are transported by ambulance or care-flight helicopter annually. |
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Research:
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Our patient volume affords our division an unmatched research resource. Specialty antenatal clinics which deal with pregnancy complications serve as research clinics in addition to providing focused patient care. Maternal-Fetal experts in diabetes, hypertension, preterm labor, infectious disease, and prenatal genetics use data from these clinics for their research efforts.
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This same patient data also adds to the understanding of antenatal disorders on a national scale. The Division of Maternal-Fetal Medicine and Parkland Hospital together serve as one of 14 NIH-funded centers in the United States collaborating in a clinical obstetrics research network. Our center has participated in the research network for 10 years.
One of our division members acts as the primary investigator for one such network study which deals with fetal pulse oximetry. Another is the primary investigator for a randomized trial of thyroxine therapy in pregnant women with subclinical hypothyroidism.
Much of this research is made possible by a computerized database, begun in 1982, and managed by the division's own statistician.
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