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Gestational diabetes is a condition where a pregnant woman develops high blood sugar levels, or diabetes, during pregnancy. As many as 1 in 25 women experience some degree of gestational diabetes as pregnancy hormones block the action of naturally produced insulin. Insulin is the chemical the body uses to break down sugar in the blood.

According to Syracuse New York gestational diabetes lawyers Bottar Law, PLLC, well-known blood sugar level benchmarks may soon be revised in order to better diagnose and treat women diagnosed with diabetes during pregnancy. Soon to be released revised guidelines will result in more women carrying the diagnosis of gestational diabetes, as well as better care for blood glucose levels which may pose a threat the health and safety of a mother and her unborn fetus.

Historically, a fasting blood sugar level of 92 mg/dL was considered “safe,” as was a one-hour level of 180 mg/dL and a two-hour level of 153 mg/dL. New standards will set the bar much lower. Medical intervention at lower maternal blood glucose levels should reduce the number of premature deliveries, shoulder dystocias due to big babies, and a high blood pressure condition called preeclampsia. A failure to diagnose preeclampsia can cause maternal heart failure, and death.

The failure to diagnose gestational diabetes can have serious consequences, including maternal or fetal death, maternal or fetal heart damage, Erb’s palsy, cerebral palsy, polycythemia, jaundice and hypocalcemia.
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Normal pregnancy lasts 40 weeks. A baby born before 37 weeks is considered a preterm delivery. A baby born before 32 weeks is considered very premature. According to Syracuse New York premature birth injury lawyers Bottar Law, PLLC, preterm deliveries are on the rise for women who conceive through in-vitro fertilization (IVF) or intracytoplsmic sperm injection (ICSI).

Danish researchers recently published the results of a study of births from 1989 through 2006. Of the 730 babies born to women who underwent IVF or ICSI, 8% were born premature and 1.5% were born very premature, compared to 5% and 0.06%, respectively, for women who conceived “naturally.”

There are many health risks for premature babies. Some premies are born with respiratory distress syndrome (RDS) and need to be on a mechanical ventilator for the first few weeks of life. Other premature baby diagnoses include intraventricular hemorrhaging (bleeding in a baby’s brain following birth), periventricular leukolamacia (baby brain damage), cerebral palsy, bronchopulmonary dysplasia (when a baby needs oxygen after 36 weeks), or retinopathy of prematurity (due to abnormal blood vessels in the eyes). In addition to any of the above problems, premature babies are also predisposed to learning disabilities, problems with their hearing and vision, blindness, deafness, and mental retardation. More often than not, however, premature babies grow up with no problems whatsoever.
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A recent study of Medicaid patients reveals that the better a patient follows a blood pressure medication prescription, the lower the patient’s risk of stroke and, ultimately death.

According to North Country medical malpractice lawyers Bottar Law, PLLC, patients who took just one more pill (a week) decreased their risk of stroke by nearly 10%, and their risk of death by around 7%. Most of the nearly 50,000 patients in the study were on two blood pressure medications; however, some were taking as many as six. Roughly 60% of the patients did not fill their prescriptions 80% of the time. These patients, known as non-adherent patients, were .5% more like to die over a five-year period.

There are many different types of blood pressure medications. Diuretics, such as Amiloride, Bumetanide, Chlorothiazide, Chlorthalidone, Furosemide, Indapamide and Spironolactone, decrease blood pressure by causing the body to purge excess fluids and sodium. Angiotensin Converting Enzymes (ACE) inhibitors, such as Benazepril, Captopril, Enalapril, Fosinopril, Lisinopril and Moexipril, decrease blood pressure by allowing blood to flow more freely, which makes the heart’s job easier. Beta blockers, such as Acebutolol, Atenolol, Betaxolol, Bisoprolol, Carteolol, Metaprolol, Nadolol and Sotaolol, decrease blood pressure by decreasing heart rate and cardiac output.
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A recent study of approximately 400,000 patients suggests that emergency room physicians treating chest pain are all too often ordering cardiac catheterizations, a relatively safe procedure commonly used to rule out a heart attack. Surprisingly, most of the patients who underwent the procedure did not have obstructive disease.

According to Central New York medical malpractice lawyers Bottar Law, PLLC, most unnecessary medical procedures are performed without incident. However, where a patient experiences a complication as a result of a contraindicated medical procedure, the physician who ordered the procedure may be liable for medical negligence.

Typically, interventional cardiologists perform cardiac catheterizations by threading a thin tube into a vein or artery in the groin and maneuvering the tube to the coronary arteries or heart. In most cases, the patient is awake and feels no pain. Soreness is to be expected in the blood vessel where the catheter was inserted. Known risks and complications associated with cardiac catheterization include: infection, damage to involved blood vessels, arrhythmias, low blood pressure (hypotension), blood clots, heart attack, congestive heart failure and allergic reactions to dye causing kidney damage.
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All too often, cerebral palsy caused by medical malpractice occurs in Syracuse, Utica, Oswego, Watertown and Binghamton, New York. As many as one-third of cerebral palsy cases are associated with an early labor and delivery resulting in a premature baby.

When OBGYNs or labor and delivery nurses correctly diagnose an impending preterm birth, a recent study suggests that magnesium sulfate should be prescribed to protect against cerebral palsy. According to Syracuse birth injury lawyers Bottar Law, PLLC, magnesium sulfate may strengthen fetal blood vessels and, in turn, increase oxygen transport despite swelling and inflammation associated with an early delivery.

While scientists have not identified exactly how magnesium sulfate may aid in protecting a premature baby from brain injury, and despite the fact that the therapy has not been approved by the FDA, many OBGYNS are recommending the chemical compound (which also goes by the name Epson salt) to pregnant mothers.

According to John Thorpe, co-author of one of the largest studies of cerebral palsy and magnesium sulfate, “[v]irtually every delivery room in the United States is already stocked with magnesium sulfate solutions that are given to pregnant women during childbirth for other reasons. [W]hat we have learned from this study is that we have a cheap, widely available treatment already in hand that cuts in half the risk of babies being born with an extremely disabling disorder. That is a tremendously exciting development.”
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Children’s Hospital researchers recently announced that a procalcitonin test may help identify serious bacterial infections in children without the need for hospitalization, invasive testing (such as a spinal tap), or medication.

According to Syracuse, New York infection lawyers Bottar Law, PLLC, one of the most significant signs of an ongoing disease process in children is a fever. Most infant visits to an emergency room are for fever. As many as 20% of fevers have no identifiable cause. While a fever may be a symptom of something as minor as a cold or the flu, a fever may also be a sign of a very serious infection, such as meningitis, bacteremia, pneumonia or urinary tract infection. The failure to diagnose meningitis can result in brain damage or death.

As many as 12% of “well-appearing” children in the emergency room are very ill. Emergency room doctors should not rely solely upon whether a child has a fever to determine whether a baby is sick, especially in children under the age of 3 months. In turn, most order a battery of tests, including analysis of blood, urine and spinal fluid. Performing a procalcitonin test may allow emergency room personnel to quickly identify whether a child is at low-risk for a serious bacterial infection.
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According to New York medical malpractice lawyers Bottar Law, PLLC, with offices in Syracuse and Albany, magnetic resonance imaging (MRI) may reduce a potentially lethal labor and delivery complication known as placenta acrete.

Placenta accrete is a condition occurring in 1 out of every 2,500 births. It involves the placenta attaching too deeply to the uterine wall – through the endometrium and into the myometrium. If undetected until the time of labor and delivery, either because an OBGYN failed to order an MRI to diagnose the complication, because and MRI was misread by a radiologist, or because the condition was occult, post-partum hemorrhaging may occur as the placenta is delivered during the third stage of labor.

A recent study suggests that an MRI may be more than 90% effective in diagnosing placenta accrete. Risk factors for placenta accrete include: a prior uterine surgery, prior cesarean section, myomectomy, advanced maternal age (over 35), D&C and, according to some literature, a female fetus.
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According to Syracuse New York birth injury lawyers Bottar Law, PLLC, children diagnosed with cerebral palsy are on the rise in the United States, especially in cases involving prematurity.

In a recent study of 222 preterm births, research reported that connective tissue may be the link between cerebral palsy and prematurity. More specifically, inflammation in the connective tissue in the umbilical cord may lead to cerebral palsy. There are many potential causes for inflammation in the connective tissue in the umbilical cord, including: premature birth from preterm labor, premature rupture of the amniotic sac, and infection.

The umbilical cord is the pathway for oxygen and nutrients to a fetus, and waste from a fetus. Where there is umbilical cord inflammation, the ability of the cord to pass oxygen to a fetus may be impaired. Likewise, the ability of the cord to pass waste from the fetus (contributing to acidosis) may be impaired. During labor and delivery, an OBGYN should monitor a pregnant mother and unborn fetus for problems with umbilical cord function. Often times, fetal distress visible on tracings created by an external fetal heart rate monitor (EFM) may suggest that an unborn baby’s lifeline is failing or is compromised and, in turn, the baby should be delivered by cesarean section as soon as possible.
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It is well-known that very sick patients, especially those in the intensive care units at Central New York hospitals, e.g., Crouse Hospital (Syracuse), St. Joseph’s Hospital Health Center (Syracuse), Community General Hospital (Syracuse), SUNY Upstate University Hospital (Syracuse), Faxton-St. Luke’s Healthcare (Utica), St. Elizabeth’s Medical Center (Utica), Oswego Hospital (Oswego), United Health Services Hospital (Binghamton), and Samaritan Medical Center (Watertown), require close monitoring. According to Dr. Phillip H. Factor, of Beth Israel Hospital in New York, “[r]elying on electronic monitors is not sufficient in the sickest of the sick; these patients require direct observation.”

A recent study suggests that very sick patients assigned to ICU rooms that could not be directly observed from a nursing station, were more likely to die while hospitalized. Data from the study is still being analyze to determine why deaths were more likely and what can be done to lessen the risk, such as increasing the nurse-to-patient ratios for remote ICU beds so that nurses spend more time at the bedside.
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According to the American Academy of Neurology and the Child Neurology Society, botulinum toxin type A (also known as Botox) may be an effective treatment for Central New York children diagnosed with cerebral palsy including, specifically, symptoms of cerebral palsy like muscle tightness and spasticity.

The intended effect of a Botox injection is to paralyze a spastic muscle. However, the benefits are not without risk. According to the FDA, there have been reports of “isolated cases of generalized weakness following use of botulinum toxin type A for spasticity.” These reports are under investigation. In addition to Botox, recent guidelines also propose the use of diazepam or tizanidine for suppression of spasticity. Each are associated with side effects, including liver toxicity.

Cerebral palsy is a condition, often caused by hypoxia in the womb or ischemia during child birth, affecting the brain and nervous system functions such as movement, hearing, vision, cognition and thought. While spastic quadriplegic cerebral palsy is the form most often associated with a birth injury or birth trauma, there are other forms, e.g., dyskinetic, ataxic, hypotonic and mixed.
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