Perinatal Center of Iowa seek answers to reduce pre-term births
A National Institutes of Health study recently found that the hormone progesterone reduced the rate of preterm birth before week 33 of pregnancy by 45 percent among one category of at-risk women. The results were recently published online in “Ultrasound in Obstetrics and Gynecology.” Perinatal Center of Iowa—the medical staff led the only study location in Iowa.
The women studied each had a short cervix, which is known to increase the risk for preterm birth. The study included 458 healthy pregnant women with cervixes between 10-20 millimeters long. Each woman was assigned to use a progesterone gel that was administered daily beginning about midway through her pregnancy or a fake gel.
Of the women who were treated with the progesterone, 8.9 percent delivered before 33 weeks compared to 16.1 percent of women who were assigned the fake gel. Even though the medical community classifies deliveries before 37 weeks as being premature, the 33-week cutoff was used because babies born before that are more likely to experience health problems than those who are officially premature, but born closer to the normal gestational time of 40 weeks.
“The findings of this study means once a woman is determined to have a shortened cervix, she could receive this progesterone gel and ultimately give her baby a healthier start at life,” says Joseph Hwang, M.D., perinatologist with the Perinatal Center of Iowa.
According to the March of Dimes, one out of eight babies is born pre-term (considered before week 37 of pregnancy). Pre-term infants are at increased risk for death in the first year of life, breathing difficulties and life-long disabilities. The manufacturer of the gel plans to submit a new drug application to the Food and Drug Administration for the preventive use of the gel, which they will name Prochieve.
Dotzler Quads Turn One
If the happiness of a home can be measured with giggles, wiggles, smiles, and a few yawns, the Dotzler household of Bondurant is overflowing with joy. Within a matter of one minute on Nov. 18, 2009, Casey and James Dotzler´s world completely changed when they welcomed not one, not two, not three, but four tiny miracles — sons Max and Brady accompanied by daughters Emme and Sophie. As the new mom and dad of quadruplets work through the challenges and rewards of parenthood, they are quickly forgetting what life was ever like without their children.
“We were truly praying for one baby,” says Casey. “When the sonographer found four heart beats during our first ultrasound, we were shocked — and felt incredibly blessed at the same time.” Casey, a preschool teacher, and James, a park ranger, were referred to the Perinatal Center of Iowa (PCI) — perinatology (high risk obstetrics) practice — where Casey received prenatal care. In September 2009, Casey was ordered on to be on bed rest at home to help stave off premature labor. By mid-October, Casey had been admitted to Mercy’s Maternity Triage & Treatment Unit — central Iowa’s only dedicated high-risk pregnancy inpatient unit for close monitoring.
During the evening of Nov. 17, Casey’s water broke signaling the big moment was only hours away. On the morning of Nov. 18, more than 20 Mercy physicians, nurses and staff joined Casey and James in the in the delivery room as they waited to welcome the Dotzler babies. PCI Dr. Neil Mandsager and the medical staff oversaw the prenatal care of Casey and the babies, and a fellow doctor was the delivering physician Born at 30 weeks gestation, the babies received care in the Mercy Variety Neonatal Intensive Care Unit. Casey and James welcomed Emme home first on Dec. 26, followed by Brady and Max on Dec. 31, and finally Sophie on Feb. 13.
Despite being born 10 weeks premature, the babies are all doing well developmentally. “Sophie, Emme, Max, and Brady can thank their mom for their healthy start at life,” said Dr. Mandsager. “Casey was extremely dedicated to following our directions and endured several weeks of bed rest. Because of her perseverance, Casey and James have four healthy babies.”
“Each baby has had their own unique personality from birth — really even since before birth,” says Casey. “The girls are both very sweet. Emme is totally a daddy’s girl and Sophie loves to sleepa lot! Brady really enjoys playing pat-a-cake and Max has so much energy — which comes in handy since he just learned to crawl.”
The Dotzler home has changed a lot over the past year too. Casey’s father created one large U-shaped table with seats recessed in to use as a high chair. They have a few different strollers, one that can hold all four babies and two twin strollers. Casey and James also have had great assistance from friends and family since before the babies arrived. Grandparents rotate weekends to come visit, help out, and — most importantly — spoil the babies.
“We are so thankful for the care we received from the Perinatal Center of Iowa and Mercy,” says James. “We are quickly reminded of the outstanding care we received every time we look into the eyes of one of our children, when they reach out for us or when they giggle.”
The Dotzler family appeared on an episode of a new TLC series, “Make Room for Multiples.” The show followed the Dotzler family during their prenatal phase as well as when all the babies were at home. For the Dotzlers, life is perfect and they count their blessings every day — all four of them.
The Dotzler babies were the first set of quadruplets born at Mercy since 1999. The Dotzler quads helped Mercy set another record year for the number of babies born at a single Iowa hospital — Mercy welcomed more than 5,000 babies in 2009.
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