Village Obstetrics News

Happy Holidays!

2011-12-26T11:47:00.001-08:00

Everyone at Village Obstetrics wishes you & yours a happy and healthy holiday season!

Workshop for Couples!

2011-09-27T17:01:00.000-07:00

Are You a Pregnant Couple Considering Birthing Without a Doula? Need just a few more Secrets for Success before the Big Day arrives?

Join two of NYC's seasoned childbirth doulas, in an extraordinary workshop, where you will learn:

*the keys to working in partnership during labor/birth
*the 5 tools for getting the birth you want
*our top 3 comfort techniques
*expert advice in navigating the hospital system
*how to walk into labor with ease and curiosity

We know you believe in each other. And we want to help. Let us prepare and inspire you even further for the adventure that lies ahead.

Included in the workshop:

*holistic birth gifts for pregnancy and postpartum
*written materials for home study
*two 30 minute phone consultations after the workshop
*email support as you create your birth preferences
*discount on future sessions and services

Workshop dates:
every week through the end of the year
Manhattan and Brooklyn locations
private meetings available

Please inquiry with Erica for more info!!!!

--
Honoring Women * Humanizing Birth * Nurturing Families
~a heart-centered, referral-based business~

www.EricaShaneChildbirth.com
http://twitter.com/nycbirthdoula
http://www.facebook.com/nycdoula

Mom Prep Class

2011-09-15T09:01:00.001-07:00

Dr. Worth and Dr. Mussalli will be conducting a Mom Prep class at Rosie Pope Maternity on November 1st! Find out more about "Two Doctors' Perspectives on Birthing Options" at http://www.rosiepopematernity.com/momprep/classDetail.cfm?classID=133

Dr. Worth and family on holiday!

2011-08-24T08:32:00.001-07:00

Who's having a baby?!

2011-08-06T06:50:00.001-07:00

Join Erica Shane for a very special talk on the role of the birth doula in the pregnancy, birth and postpartum journey. She will speak about her own role as a childbirth doula and her experience of families receiving her unique all-inclusive doula support, here in NYC. She will share the various reasons couples choose and benefit from doula support, plus she'll be giving away the 5 tools that can help couples have a more meaningful birth experience, in the hospital or at home. She's got goodies to share for sure.

Register now!

August 14, 6-7:30pm at Brooklyn Acupuncture Project, 6-7:30pm
August 17, 6-7:30pm at Laughing Sage Wellness of Manhattan, 6-7:30pm

Email Erica to register for this event: ericashane@gmail.com

our new office!

2011-07-27T09:00:00.000-07:00

The 95th and Park location is up and running! Here are some pics of the new space, open every weekday except Thursdays when we're downtown on West 12th Street. You can see the rest of the pics on our Facebook page, http://www.facebook.com/pages/Village-Obstetrics-LLC/200542129995874?sk=wall

Office hours now at 1225 Park (95th St.) every day except Thursdays. Thursdays stay at West 12th Street

2011-03-13T16:03:00.000-07:00

ALL PATIENT APPOINTMENTS NOW AT 95th STREET EXCEPT THURSDAYS. PLEASE CONFIRM LOCATION BEFORE YOU COME!

WE ARE IN TEMPORARY SPACE NEXT DOOR TO OUR NEW OFFICE. TEMPORARY SPACE IS #1E. OUR FABULOUS NEW OFFICE (STILL UNDER RENOVATION) IS #1D.

WE CAN'T WAIT TO MOVE NEXT DOOR. IT WILL BE BEAUTIFUL! ESTIMATED MOVE IN DATE IS APRIL 15.

Dr. M and Dr. W

VOB renovation continues. Almost done!

2011-03-01T19:58:00.000-08:00

The renovation of our wonderful 95th street office is almost done.

VOb will be moving to temporary space next week (March 7, 2011) so call Leanne to confirm the location of your next appointment.

Some pictures from a few weeks ago to show our progress.

Dr. Mussalli and Dr. Worth

Dr. Bernadith Russell will share our West 12th Street Office

2011-02-14T18:37:00.001-08:00

We are pleased to announce that once VOb moves uptown (approximately 3/1/11) Dr.Bernadith Russell will practice out of our of our West 12th Street Office. She has a busy ob/gyn practice and will be in the office Mondays/Tuesdays/Wednesdays/Fridays and alternate Saturdays. Her contact phone is 212-941-0011.

We are thrilled to welcome Dr. Russell to VOb's downtown office.

office construction update

2011-02-14T18:32:00.000-08:00

Every day we make progress. Construction always takes longer than expected. Rest assured the new office will be beautiful and happy and filled with the voices of children. We can't wait! We hope to be there by March.

new office update

2010-12-11T18:41:00.000-08:00

We are still seeing patients every day at West 12th Street, but we are making progress on the renovation of our new East 95th Street office as quickly as possible. Once the removation is done we will be at West 12th street every Thursday and at 95th street the rest of the week.

This is Roman, our new doorman. He is looking forward to helping our VOb patients in and out.

These ground floor windows along 95th street will be ours. It is a sunny happy spot in which we hope to guide many tiny new lives into the world.

Dr. M and Dr. W

Village Obstetrics now at 1225 Park Avenue at 95th Street

2010-11-07T12:46:00.000-08:00

We are pleased to announce that we will soon open a second office at 95th Street and Park Avenue. We will continue to see patients once or twice a week at West 12th Street. Details to follow!

George Mussalli, MD
Jaqueline Worth, MD

vob patients love lenox hill hospital

2010-08-05T10:11:00.000-07:00

The reviews are in and our patients have given Lenox Hill Hospital a big thumbs up. The facility has been very responsive to couples desires and needs under the nursing leadership of Mia Patunas and Laura Shahim. If rooming in is what you want, just let them know. If nursery care is for you, no problem. Breastfeeding? - great, there's a class every day at 7:30am with tremendous lactation consultants. Want to bottlefeed? - you got it. The Lenox Hill Hospital maternity unit has no agenda. Regardless if you want all natural, all medical or somewhere in between the staff has been capable and competent. In over fifty deliveries so far, the plans we have made with our patients regarding food, drink, monitoring, ambulation, IV lines, medications etc have all been respected. Doulas have been welcomed. The anesthesia service is very strong and if an epidural is what you ask for it is in fast and easy. No doubt like every hospital these days, Lenox Hill is busy, but the staff is professional and efficient. The facility has a long tradition of excellence and elegance. All in all, Lenox Hill is a great place to have a baby!

Dr. M and Dr. W

rescue cerclage

2010-08-03T03:14:00.000-07:00

Pregnancy loss is one of the most devastating things a couple may have to endure. One possible cause of pregnancy loss or preterm delivery is a cervix which is unable to remain closed and hold the pregnancy in the uterus. This condition is known as incompetent or insufficient cervix. In the classic presentation of insufficent cervix, the cervix painlessly opens. The bag of waters sometimes breaks or labor may start as a result. We have developed an expertise in management of insufficient cervix including the placement of a stitch in the cervix known as a cerclage. A cerclage helps to keep the cervix closed so a pregnancy won't be lost. We also are uniquely qualified for the most difficult cerclage procedure known as rescue cerclage where the cervix may already be open several centimeters and even when the bag of waters has bulged out through the cervix.

midwife nancey rosensweig will be available for routine gyn care at village ob office

2010-08-02T18:57:00.000-07:00

Midwife Nancey Rosensweig is an experienced practitioner of well-woman gynecology based at the Village Obstetrics office. She sees clients for their yearly gynecological examinations throughout the life cycle, including Pap smears, testing for sexually transmitted infections, as well as diet, nutrition, physical conditioning, and perimenopause counseling.

Nancey provides family planning counseling and can prescribe birth control pills, Nuvaring, Depo-Provera, as well as the insertion of IUDs (intrauterine devices). Typical gynecologic services also include diagnosis and treatment of urinary tract infections and vaginal infections, such as those caused by yeast or bacteria.

With her background as a dancer, Pilates instructor and Alexander Technique instructor, Nancey works with women post-partum to assist them in strengthening abdominal muscles and pelvic muscles and dealing with common muscle aches and pain. Nancey is also an excellent resource for breastfeeding issues and concerns, and can give referrals to other practitioners as appropriate.

Appointments can be made with Nancey by calling or visiting the office. To contact Nancy, email at nbr@villageob.com.

Village Obstetrics Finds Great New Home at Lenox Hill Hospital!

2010-06-06T15:13:00.000-07:00

A dozen deliveries in our first week at Lenox Hill and the reviews are in! Lenox Hill is a great place to have a baby. The nurses are knowledgable and attentive. The anesthesia service is first class and the Neonatal/Pediatric team is terrific.

We have been impressed with how progressive the leadership is and genuinely interested in meeting the needs and desires of our patients. Lenox Hill is capable and elegant we are very pleased to have to affliate Village Obstetrics at this fabled institution. We look forward to helping lead the way on innovative new services for you in the coming weeks.

George Mussalli, MD
Jaqueline Worth, MD

Village Ob staff in New York Times artricle about loss of St. Vincent's Hospital

2010-04-10T09:42:00.001-07:00

Click here to read story by Susan Dominus "With the Closing of a Hospital, Women’s Childbirth Options Diminish", The New York Times, 4/10/10

Photos by Hiroko Masuike for The New York Times

Village Obstetrics moving to New York Downtown Hospital for now

2010-04-07T10:53:00.000-07:00

Dear Patients,

As probably many of you have heard our beloved St. Vincent’s Hospital is expected to close likely within the next 30 days. St. Vincent’s has been the best place for us to practice our brand of unhurried obstetrics. Obviously however, we must move to a new hospital location. We have been invited to join at many different hospitals but we have had to consider what best serves you, our patients. Many of you have an interest in a downtown location with uncrowded labor rooms. We too have to ensure that appropriate medical and pediatric services are in place at the hospital we choose.

We have been impressed lately at the rebirth of New York Downtown Hospital (170 William Street NY, NY 10038) in the financial district. It is now an affiliate of New York Presbyterian Medical Center and so has the referral resources of Cornell and Columbia. They also have the most capacity for obstetrics of any of the private hospitals in New York City. We have decided to give this hospital a trial and will begin to transition our work to this site in the next several days. For those who wish to deliver at St. Vincent’s while it remains open we are happy to do so. We are also in discussions with NYU/Bellevue and Presbyterian hospitals as possible sites for our practice.

While we are sure to miss St. Vincent’s, the magic of Village Obstetrics is our relationship with you and our commitment to practice obstetrics in the way it should be. That recipe we can recreate together in a new location. We remain at your faithful service. Please feel free to e-mail us back (info@vobsv.com) with any opinions or preferences you may have as we make a final decision on for our delivery hospital.

George Mussalli, MD
Jaqueline Worth, MD

March 18 labor talk cancelled

2010-03-08T19:36:00.000-08:00

We are so sorry but we must cancel the March 18 labor talk. Upcoming dates: 4/15/10, 5/27/10, 6/24/10, 7/15/10, 8/26/10

save st. vincent's hospital

2010-02-04T20:30:00.001-08:00

We love St Vincent's and have no plans to deliver anywhere else.

We are completely confident that the policians and investment bankers who are working feverishly to help us will find a solution. We hope for a financial restructuring plan and new clincal partner that returns St Vincent's to its place as one of the most compassionate and clinically excellent medical centers in the city.

Village Obstetrics will be fine. We will be among the very last to leave St Vincent's. But if the hospital closes have no doubt we will find a new home.

We hope you stay with us and St Vincent's.

hospital update

2010-01-31T10:25:00.000-08:00

Dr. Mussalli and Dr. Worth want to assure our patients that Village Obstetrics will continue to provide the finest maternity care regardless of the rapidly unfolding events at our hospital. We are fully committed to St. Vincent's and we will keep you informed of all developments. Please email us directly with any questions or concerns: drW@vobsv.com, drM@vobsv.com.

New Year's week coverage

2009-12-29T14:43:00.001-08:00

Mon 12/28: Worth
Tues 12/29: Mussalli
Wed 12/30: Worth
Thurs 12/31: Mussalli until 2pm, Dr. Beiter after 2pm
Friday 1/1: Worth
Sat 1/2: Worth
Sunday 1/3: CNM Barri with backup from Dr. Pena until 10pm, Worth after 10pm

Christmas week coverage

2009-12-19T07:08:00.000-08:00

Mon 12/21: Worth
Tues 12/22: Mussalli
Wed 12/23: Worth
Thurs 12/24: Mussalli until 2pm, Dr. Fridel after 2pm
Friday 12/25: Dr. Fridel until 7pm, Worth after 7pm
Sat 12/26: Dr. Fridel 7am - 7 pm, Worth after 7pm
Sunday 12/27: Mussalli

H1N1 shots now available in VOb office

2009-12-15T09:24:00.000-08:00

We now have H1N1 vaccine available in our office. Please call Leanne to schedule your vaccination.

call schedule week of Dec 14

2009-12-13T12:22:00.000-08:00

Worth: Mon/Wed/Fri/Sat
Mussalli: Tues/Thurs/Sun

call schedule week of December 7

2009-12-09T12:05:00.000-08:00

Worth: Mon/Wed/Sat
Mussalli: Tues/Thurs/Fri/Sun

call schedule week of Nov 30

2009-11-30T17:16:00.000-08:00

Worth: Mon/Wed/Fri/Sun
Mussalli: Tues/Thurs/Sat

Thanksgiving coverage

2009-11-25T18:52:00.000-08:00

Wed 11/25: Dr. Mussalli
Thurs 11/26: Dr. Beiter (faculty practice) until 7 pm, Dr. Worth after 7pm
Fri 11/27: Dr. Mussalli
Sat 11/28: Dr. Worth
Sun 11/29: Dr. Mussalli

swine flu shot info

2009-11-13T11:06:00.000-08:00

Click here for link to your designated NYC weekend vaccination site by zip code

November 10, 2009 – The Health Department announced today that it is further expanding its weekend H1N1 vaccination clinics to cover a broader range of New Yorkers. Starting this weekend – November 14th and 15th – vaccine will be available at temporary centers in all five boroughs for anyone 4 to 24 years old, anyone who is pregnant, anyone in close contact with newborns, and people age 25 to 64 with a medical condition that makes influenza more dangerous.

The weekend clinics, launched on November 7th in all five boroughs, are designed primarily to vaccinate middle and high school students, along with elementary school students who have not been vaccinated by private providers or in their schools. Because the first weekend’s clinics did not reach capacity, the City is opening the weekend clinics to adults with underlying health conditions as well. The expansion means that the following groups will now be able to receive vaccine at the weekend clinics:

Pregnant women
Anyone 4 years through 24 years of age
Persons 25 through 64 years of age who have underlying health conditions that increases risk of severe illness or complications*
Anyone who lives with or cares for children less than 6 months old
*These conditions include asthma, diabetes, chronic heart and lung conditions, kidney failure, or a weakened immune system.

The weekend vaccination clinics will continue over four weekends in November and December. Each weekend vaccination center is designed to accommodate up to 500 people per hour and will be open from 9 AM to 6 PM on Saturdays and from 9 AM to 5 PM on Sundays, but lines are possible. Anyone under 18 must present a signed parental consent form and anyone under 16 must be accompanied by a parent or guardian.

To prevent overcrowding and long lines, City officials are asking eligible New Yorkers to find the date and location of the vaccination center nearest their home, and report to that site on the appropriate weekend. People with computer access can find their designated weekend site by typing their zip code into the locator at nyc.gov/flu. Schedules and locations are also available through 311.

swine flu shot info

2009-11-12T12:48:00.000-08:00

Dear Dr. Worth and Dr. Mussalli,

I just spoke with a colleague who confirmed that the Chelsea District Public Health Office also has the H1N1 vaccination. She was able to get the vaccination there this afternoon. This location is closer to your offices than some that I sent info on earlier. Again, I would have patients call to confirm that they are able to accommodate them before they show up.

Here is the information:

Chelsea Health Center
303 Ninth Avenue - 1st Floor
Manhattan, New York 10001
Between: 27th & 28th Streets

Telephone: 212-594-1351

Adults and Children 4 years of age and over
Monday, Tuesday, Thursday and Friday
8:30 AM to - 2:30 PM

Directions: C or E train to West 23rd Street or #1 train to West 28th Street

Take care, J

swine flu shot info

2009-11-12T11:21:00.000-08:00

Hello-

Barri asked me to let you know if I found H1N1 vaccines available.

I learned that this weekend, there will be free vaccine clinics all over the city. There's one right on 17th Street between 8th & 9th Avenues. I'm not sure if they offer a mercury-free version, but they are offering to vaccinate pregnant women.

Thanks. A

#########################################

The Health Department's first weekend of H1N1 vaccine clinics weren't very well attended, prompting officials to open up the clinics—originally just for students—to people in other priority groups on Sunday. This weekend, the Health Department will continue its program offering the free vaccine in the five boroughs to people in these groups:

Pregnant women;
Anyone 4 years through 24 years of age;
Persons 25 through 64 years of age who have underlying health conditions that increases risk of severe illness or complications*; (*These conditions include asthma, diabetes, chronic heart and lung conditions, kidney failure, or a weakened immune system)"
Anyone who lives with or cares for children less than 6 months old
And here's a list of the locations:

Locations, followed by dates and hours of operations and the priority zip codes, below:

Bronx

H.S. 166 Roberto Clemente (X166)
250 East 164th Street
Saturday, November 14, 9:00am-6:00pm
Sunday, November 15, 9:00am-5:00pm
10032, 10451, 10452, 10454, 10455, 10456, 10474

J.H.S. Mosholu Parkway (X080)
149 East Mosholu Parkway North
Saturday, November 21, 9:00am-6:00pm
Sunday, November 22, 9:00am-5:00pm
10458, 10463, 10466, 10467, 10468, 10470, 10471

Christopher Columbus High School (X415)
925 Astor Avenue
Saturday, December 5, 9:00am-6:00pm
Sunday, December 6, 9:00am-5:00pm
10469, 10475

I.S. 127 Castle Hill (X127)
1560 Purdy Street
Saturday, December 12, 9:00am-6:00pm
Sunday, December 13, 9:00am-5:00pm
10461, 10462, 10464, 10465, 10472, 10473, 10499

Brooklyn
Sheepshead Bay H.S.(K495)
3000 Avenue X
Saturday, November 14, 9:00am-6:00pm
Sunday, November 15, 9:00am-5:00pm
11234, 11235, 11693, 11694, 11697

P.S. 196 (K196)
207 Bushwick Avenue
Saturday, November 14, 9:00am-6:00pm
Sunday, November 15, 9:00am-5:00pm
11205, 11206, 11211, 11222

J.H.S. 234 Arthur W. Cunningham (K234)
1875 East 17th Street
Saturday, November 21, 9:00am-6:00pm
Sunday, November 22, 9:00am-5:00pm
11210, 11223, 11229, 11230

George Wingate Educational Campus (K470)
600 Kingston Avenue
Saturday, December 5, 9:00am-6:00pm
Sunday, December 6, 9:00am-5:00pm
11203, 11213, 11215, 11216, 11217, 11218, 11225, 11226, 11238, 11247

P.S. 186 Dr. Irving Gladstone (K186)
7601 19th Avenue
Saturday, December 12, 9:00am-6:00pm
Sunday, December 13, 9:00am-5:00pm
11204, 11214, 11224, 11228, 11252

Manhattan
P.S. 290 Manhattan New School (M190)
311 East 82nd Street
Saturday, November 14, 9:00am-6:00pm
Sunday, November 15, 9:00am-5:00pm
10021, 10022, 10023, 10024, 10025, 10028, 10029, 10044, 10065, 10069, 10075, 10082, 10103, 10104, 10105, 10106, 10107, 10124, 10126, 10128, 10131, 10132, 10133, 10150, 10151, 10152, 10153, 10154, 10155, 10162, 10171, 10197, 11102, 11105

P.S. 92 Mary McLeod Bethune (M092)
222 West 134th St
Saturday, November 21, 9:00am-6:00pm
Sunday, November 22, 9:00am-5:00pm
10026, 10027, 10030, 10031, 10035, 10037, 10039, 10115, 10116

NYC Lab Middle School for Collaborative Studies (M070)
333 West 17th Street
Saturday, December 5, 9:00am-6:00pm
Sunday, December 6, 9:00am-5:00pm
10001, 10010, 10011, 10014, 10016, 10017, 10018, 10019, 10020, 10036, 10072, 10087, 10095, 10101, 10102, 10108, 10109, 10110, 10111, 10112, 10113, 10114, 10117, 10118, 10119, 10120, 10121, 10122, 10123, 10125, 10129, 10130, 10138, 10149, 10156, 10157, 10158, 10159, 10160, 10161, 10163, 10164, 10165, 10166, 10167, 10168, 10169, 10170, 10172, 10173, 10174, 10175, 10176, 10177, 10178, 10179, 10185, 10199, 10259, 10261

George Washington High School (M465)
549 Audubon Avenue
Saturday, December 12, 9:00am-6:00pm
Sunday, December 13, 9:00am-5:00pm
10033, 10034, 10040

Queens
I.S. 77 (Q077)
976 Seneca Avenue
Saturday, November 14, 9:00am-6:00pm
Sunday, November 15, 9:00am-5:00pm
11221, 11237, 11381, 11385, 11386

P.S. 19 Marino Jeantet (Q019)
98-02 Roosevelt Avenue
Saturday, November 14, 9:00am-6:00pm
Sunday, November 15, 9:00am-5:00pm
11352, 11356, 11368, 11369, 11370, 11371, 11372, 11373, 11374, 11380

I.S. 125 Thomas J. McCann Woodside (Q125)
46-02 47th Avenue
Saturday, November 21, 9:00am-6:00pm
Sunday, November 22, 9:00am-5:00pm
11101, 11103, 11104, 11106, 11109, 11377

I.S. 210 Elizabeth Blackwell (Q210)
93-11 101st Avenue
Saturday, December 5, 9:00am-6:00pm
Sunday, December 6, 9:00am-5:00pm
11208, 11256, 11414, 11416, 11417, 11418, 11419, 11420, 11421, 11430, 11690, 11691, 11692, 11695

I.S. 25 Adrien Block (Q025)
34-65 192nd Street
Saturday, December 12, 9:00am-6:00pm
Sunday, December 13, 9:00am-5:00pm
11004, 11005, 11351, 11354, 11355, 11357, 11358, 11359, 11360, 11361, 11362, 11363, 11364, 11365, 11426, 11427

Staten Island
I.S. 51 Edwin Markham (R051)
20 Houston Street
Saturday, November 14, 9:00am-6:00pm
Sunday, November 15, 9:00am-5:00pm
10302, 10303, 10311

P.S. 6 Corporal Allen Kivlehan (R006)
555 Page Avenue
Saturday, November 21, 9:00am-6:00pm
Sunday, November 22, 9:00am-5:00pm
10307, 10309

P.S. 58 Space Shuttle Columbia School (R058)
77 Marsh Avenue
Saturday, December 5, 9:00am-6:00pm
Sunday, December 6, 9:00am-5:00pm
10314

I.S. 24 Myra Barnes (R024)
225 Cleveland Avenue
Saturday, December 12, 9:00am-6:00pmSunday, December 13, 9:00am-5:00pm
10306, 10308, 10312

H1N1 vaccine update

2009-11-10T11:58:00.000-08:00

We do not yet have H1N1 vaccine in our office. We will post a note as soon as we do.

H1N1 vaccine update

2009-11-05T13:54:00.000-08:00

Below please see the information we have received from St. Vincents about prioritization of the H1N1 vaccine at our hospital.

As soon as we have the vaccine in our office we will make it available to our pregnant patients.

++++++++++++++++++++++++++++++++++++++++++++

Novel H1N1 vaccine is in very short supply at St. Vincent’s as it is throughout the country. An H1N1 preparedness committee of clinicians meets regularly to be sure that we make the most equitable use of this scarce resource. The committee has recommended that, as long as the vaccine is in short supply, St. Vincent’s will follow the attached priority protocol.

Prioritization of H1N1 Vaccine Distribution

During the shortage of H1N1 vaccine, the following groups will be given priority for
vaccination as follows:

First Week Availability
1. Pregnant staff
2. Staff who are caretakers of infants under the age of 6 months
3. Pregnant patients
4. Parents of newborns at Saint Vincent's
5. Healthcare workers with direct patient care in highest risk areas such as NICU,
Maternal and Child Health, Emergency Department
6. Cystic fibrosis patients
7. Staff under age 60 with serious pulmonary disease such as asthma (on daily
medications), COPD, emphysema
Starting Monday Nov 17, 2009
8. Healthcare workers with direct patient care in intermediate risk areas, such as medical
units and clinics
9. Patients under age 60 with serious pulmonary disease such as asthma (on daily
medications), COPD, emphysema
10. Children 6 months to 24 years of age (if not available through their school system)

Starting Monday Nov 24, 2009
11. Healthcare workers with direct patient care in lower risk areas
12. Immunosuppressed [such as: HIV, cancer -on chemotherapy, on high dose steroids]
13. Ischemic cardiovascular disease or history of CHF
14. End Stage or severe renal or hepatic impairment
15. Hematologic or metabolic disorders [including diabetes]
16. Neurologic, neuromuscular disorders or cognitive impairment
17. Residents of Shelters
18. Healthcare workers who have contact with those in direct patient care
19. Adults ages 24-65 without any of the above conditions
20. Adults 65 years of age and older

Approved 11/04/09 by:
William Mandell, MD - Infection Control Officer, Chairman, Infection Control Committee
Eric Legome, MD - Chairman, Department of Emergency Medicine
Ruth Smith, MD - Director, Personnel Health Services

H1N1 vaccine

2009-11-02T20:39:00.000-08:00

Check this blog for updates on when the H1N1 vaccine is available in our office. To date St. Vincent's has not received the vaccine.

pregnancy and swine flu

2009-10-20T15:18:00.000-07:00

Click here to read story from today's New York Times about a pregnant woman struggling with swine flu

First Shipments of H1N1 Vaccine Arrive in New York City

2009-10-07T09:34:00.000-07:00

Click here to link to press release, 10/6/09, from the NYC Department of Health and Mental Hygiene

10/6/09: City-wide vaccination effort starts by targeting children and health care workers. Hospitals and health care providers receive initial doses of the nasal mist vaccine. (Vaccine not yet available at Village Obstetrics. This form of the vaccine not appropriate for pregnant women.)

pregnancy and swine flu

2009-10-02T05:31:00.001-07:00

Click here to link to article from today's New York Times about pregnancy and swine flu

danger of H1N1 influenza

2009-10-01T17:41:00.000-07:00

We are posting an excerpt from this weeks Obstetrics and Gynecology to educate our patients about the potential seriousness of the H1N1 virus. When the vaccine becomes available we recommend it for all our pregnant patients.

H1N1 Influenza in Pregnancy
Cause for Concern
Erin Saleeby, MD, MPH, Jocelyn Chapman, MD, Jessica Morse, MD, MPH, and Allison Bryant, MD, MPH
Obstetrics and Gynecology, October 2009

CASE 1

A39-year-old multigravida at 32 weeks of gestation
presented to Labor and Delivery triage with a
chief complaint of headache for 2 days. Her temperature
was 38.6°C, blood pressure 114/61 mm Hg,
heart rate 121 beats per minute (bpm), and respiratory
rate 22 per minute. Her oxygen saturation was 96%
on room air. She reported a sore throat the day prior
and, on presentation, a mild cough and fatigue. Past
medical history was remarkable for obesity and current
tobacco use. On auscultation her chest was clear,
and fetal monitoring was reassuring. Laboratory studies
were notable for a white blood cell count of
5.8103/microliters, and rapid antigen tests for influenza
A and B were negative. Her fever resolved with
acetaminophen, so she was discharged to home. Given
her negative rapid influenza testing and mild symptoms,
her presentation was felt to be consistent with a viral
upper respiratory infection. Recommendations at that
time regarding treatment of symptomatic patients with
negative test results were vague, and she was managed
expectantly.

Less than 24 hours later, she presented to triage
again with severe worsening of her symptoms, complaining
of increased work of breathing and generalized
malaise. On initial examination she was febrile to
38.5°C, tachycardic (126 bpm), hypotensive (93/46
mm Hg), and tachypneic (40 per minute), and her
oxygen saturation was 74% on room air (Table 1 for
additional findings on admission). Initial fetal monitoring
was reassuring. She was transferred to the
intensive care unit (ICU) where she was intubated
within 40 minutes of arriving at the hospital. She
required a norepinephrine drip for blood pressure
support after intubation. Empiric therapy of ceftriaxone,
azithromycin, and oseltamivir (Tamiflu; Roche
Pharmaceuticals, Nutley, NJ) was also initiated. Although
external fetal monitoring in the ICU was
initially reassuring, 15 minutes after intubation a
terminal bradycardia to the 80s (bpm) was noted on
the fetal heart rate tracing, which was confirmed by
ultrasonography. Given this nonreassuring fetal status,
she was delivered by emergency cesarean in the
ICU. She delivered a female neonate with Apgar
scores of 2, 3, and 5 (at 1, 5, and 10 minutes of life,
respectively) and a weight of 1,500 g.

After delivery, the patient remained acutely ill
and was treated with prostacyclin and prone bed
positioning for alveolar recruitment. Oxygenation
was extremely challenging, with ventilator settings
reaching values of 100% FIO2 and positive end expiratory
pressure of 37. Her course was complicated by
acute renal failure and massive fluid retention requiring
a bumetanide drip. On hospital day 13, she
developed femoral deep vein thromboses, despite
enoxaparin prophylaxis, and a transthoracic echocardiogram
revealed right ventricular enlargement, with
elevated pulmonary artery pressures consistent with
pulmonary embolism. She was too unstable for evaluation
with computed tomography, so she was treated
empirically with intravenous unfractionated heparin
as anticoagulant. She continued to demonstrate profound
hypoxia, with arterial oxygen tension ranging
from 30–56 mm Hg, despite clot lysis with tissue-type
plasminogen activator. On hospital day 19, she be-came
acutely unstable and died. Given her prolonged hypoxia,
no resuscitation was attempted at both the
request of her family and recommendation of her
physicians.

come to vob office for your flu shot

2009-09-20T16:26:00.000-07:00

Traditional flu shots now available in our office. We recommend all pregnant patients get a flu shot as soon as possible.

H1N1 vaccine is not yet available. We will post information as soon as this vaccine arrives.

2009-10 flu season

2009-09-20T07:43:00.000-07:00

We are posting the following excerpt from Dr. Worth's subscription to Journal Watch to continue to share information about H1N1 influenza with our patients. We recommend annual flu vaccine plus H1N1 vaccine when it is available.

By Anna Wald, MD, MPH
Published in Journal Watch Women's Health August 6, 2009

Mortality among pregnant women was relatively high during the 1918 and 1957 influenza pandemics. Now, CDC investigators have reported hospital admission rates among pregnant women with confirmed or probable pandemic H1N1 ("swine") flu. Of 34 pregnant women with H1N1 influenza infection, 11 (32%) were admitted to the hospital for 2 to 15 days; of these women, 3 were admitted to the intensive care unit, and 1 died. This hospital admission rate is four times higher than that in the general population. Moreover, of 45 people who died from pandemic H1N1 influenza from April 15 to June 16, 2009, 6 (13%) were pregnant women (age range, 20–33) who were otherwise healthy. Five of these women had viable pregnancies and underwent cesarean deliveries; no infants had evidence of influenza infection.

Seasonal influenza also takes its toll on pregnant women (especially during the third trimester), although the proportional increase in morbidity is not as great as with pandemic H1N1. Seasonal influenza vaccination is recommended by the CDC and the American College of Obstetricians and Gynecologists for all pregnant women. However, only 15% of pregnant women receive the vaccine. Key barriers to more-widespread vaccination are general hesitance of pregnant women to receive medical products and difficulties associated with administering vaccines in obstetricians' offices. When the seasonal influenza vaccine becomes available this fall, it should be administered to pregnant women according to routine recommendations.

A vaccine against pandemic H1N1 influenza is not yet available. Because preexisting immunity is lacking, two doses will be required. The CDC's recommended order of priority for pandemic H1N1 vaccination is as follows: (1) pregnant women; (2) household contacts and caregivers of children younger than 6 months; (3) healthcare and emergency service workers; (4) all children, adolescents, and young adults (age range, 6 months–24 years); and (5) adults (age range, 25–64) who have underlying medical conditions (such as heart disease, respiratory illness, or diabetes) or who are immunocompromised.

vbac and cesarean hysterectomy

2009-09-19T11:30:00.001-07:00

We are posting below a very moving letter from our patient. She reminds us all that even under the best of circumstances a trail of labor after cesarean section can have life-threatening complications.

She is bravely sharing the story of her cesarean hysterectomy in the hope that women who want a vaginal birth after cesarean section (vbac) will choose to labor in the hospital rather than at home. Her doctors strongly agree and were so grateful that day for the equipment, blood, and support from colleagues that helped keep mother and baby healthy.

++++++++++++++++++++

I am the patient who suffered severe bleeding and needed a hysterectomy.

I would like to thank Drs. Worth and Mussalli, who did a great job during my pregnancy follow-up and handled perfectly an unexpected complication during my attempted VBAC: although I had a perfectly healthy pregnancy, no inducing, and everything seemed good for a natural birth, a bleeding occurred.

I am so glad to have chosen to deliver at the hospital (and not at home), where there was everything to take care of me: medical equipment, blood, qualified people.

Drs Worth and Mussalli, even if they prone a delivery as much natural as possible, are great doctors who can perfectly handle life-threatening situations when they occur. They operated me and did what was necessary to keep me and my baby healthy.

I am also very grateful to the teams of the hospital: both teams at the Intensive Care and Maternity Units were great. The nurses of the Maternity also took great care of my newborn (and of my husband!) when I could not because I was in ICU, and then of me when I came back to the Maternity unit. Special thanks to Sue.

I'm really glad that I chose Saint Vincent Hospital and Village Obstetrics.

I'm nursing little Martin and he's doing very well, putting on weight very quickly. My recovery has been fast and I enjoy more than ever life and the joys of taking care of my two sons. Martin is 2 weeks on the enclosed picture, his brother Simon is 3 years old.

A

henry amoroso, st. vincent's ceo, discusses h1n1 swine flu

2009-09-15T15:33:00.000-07:00

9/2/2009: I was in Washington for meetings this week, and one of the most important topics discussed was our national response to a potential H1N1 influenza pandemic. It is clear that vaccinations will be our first and best defense against the virus, originally called "the swine flu." A presidential advisory panel report that up to half the population of the country could be infected with H1N1 in the coming flu season. The report said that a "plausible scenario" for the United States later this year could include 30,000 to 90,000 deaths, mostly among young children and young adults, with perhaps as many as 300,000 Americans sick enough to require intensive care unit treatment at hospitals. And while the Centers for Disease Control suggests that these are "worst-case" predictions, the fact remains that H1N1 is a new and unknown disease, that it is spreading widely in the southern hemisphere, and that it is expected to affect many more people in the coming flu season than it did last year.

The vaccine that is being developed against H1N1 will require us to get two injections in addition to the regular seasonal flu inoculation for the more common variety of the illness, for a total of three shots. The NY State Hospital Review and Planning Council this week approved an emergency regulation to require influenza vaccinations for healthcare personnel (except those who have a medical contraindication or who have no contact with patients). The regulation applies to the regular seasonal flu vaccination, and the NYS Department of Health has said that it could also apply to the H1N1 vaccine as it becomes available.

The message for us is that the 2009-2010 flu season is not going to be a typical flu season. H1N1 has deadly potential, and has been compared to the 1918 Spanish flu pandemic that killed between 50 and 100 million people worldwide. Fortunately, with vaccines and infinitely better treatment options, we have the means to prevent such a horror from happening again. Here at Saint Vincent's, in cooperation with all stakeholders, we are developing a plan to safeguard our staff, our patients, and our
capacity to continue to deliver high quality medical care to our communities, even in the face of a possible flu pandemic.

Our priority in this, of course, is patient safety; I know that we all agree that it is our obligation to protect our patients. Vaccination will be our best ally in the fight against this flu – and failing to be vaccinated will put our patients in harm’s way. I will share the complete plan with you as soon as it is finalized. In the interim, as always, many thanks for your dedication to the mission, and to the health of the people we serve.

Henry Amoroso
President and Chief Executive Officer
St. Vincent's Hospital Manhattan