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1,384 results on '"Srinivas, Sindhu"'

4. Oxytocin regimen used for induction of labor and pregnancy outcomes

Author

Reddy, Uma M., Sandoval, Grecio J., Tita, Alan T.N., Silver, Robert M., Mallett, Gail, Hill, Kim, El-Sayed, Yasser Y., Rice, Madeline Murguia, Wapner, Ronald J., Rouse, Dwight J., Saade, George R., Thorp, John M., Jr, Chauhan, Suneet P., Costantine, Maged M., Chien, Edward K., Casey, Brian M., Srinivas, Sindhu K., Swamy, Geeta K., Simhan, Hyagriv N., Macones, George A., and Grobman, William A.

Published
2024
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5. Universal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Testing for Obstetric Inpatient Units Across the United States

Author

Gilner, Jennifer, Kansal, Namita, Biggio, Joseph R, Delaney, Shani, Grotegut, Chad A, Hardy, Erica, Hirshberg, Adi, Kachikis, Alisa, LaCourse, Sylvia M, Martin, Jane, Metz, Torri D, Miller, Emily S, Norton, Mary E, Sinkey, Rachel, Sobhani, Nasim C, Son, Shannon L, Srinivas, Sindhu, Tita, Alan, Werner, Erika F, and Hughes, Brenna L

Subjects
Vaccine Related, Biodefense, Infectious Diseases, Pneumonia & Influenza, Prevention, Lung, Clinical Trials and Supportive Activities, Pneumonia, Health Services, Clinical Research, Emerging Infectious Diseases, Good Health and Well Being, COVID-19, COVID-19 Testing, Clinical Laboratory Techniques, Cross-Sectional Studies, Female, Humans, Inpatients, Pregnancy, Pregnancy Complications, Infectious, SARS-CoV-2, United States, pregnancy, testing, screening, Biological Sciences, Medical and Health Sciences, Microbiology
Abstract

BackgroundThe purpose of this study was to estimate prevalence of asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among patients admitted to obstetric inpatient units throughout the United States as detected by universal screening. We sought to describe the relationship between obstetric inpatient asymptomatic infection rates and publicly available surrounding community infection rates.MethodsA cross-sectional study in which medical centers reported rates of positive SARS-CoV-2 testing in asymptomatic pregnant and immediate postpartum patients over a 1-3-month time span in 2020. Publicly reported SARS-CoV-2 case rates from the relevant county and state for each center were collected from the COVID Act Now dashboard and the COVID Tracking Project for correlation analysis.ResultsData were collected from 9 health centers, encompassing 18 hospitals. Participating health centers were located in Alabama, California, Illinois, Louisiana, New Jersey, North Carolina, Pennsylvania, Rhode Island, Utah, and Washington State. Each hospital had an active policy for universal SARS-CoV-2 testing on obstetric inpatient units. A total of 10 147 SARS-CoV-2 tests were administered, of which 124 were positive (1.2%). Positivity rates varied by site, ranging from 0-3.2%. While SARS-CoV-2 infection rates were lower in asymptomatic obstetric inpatient groups than the surrounding communities, there was a positive correlation between positivity rates in obstetric inpatient units and their surrounding county (P=.003, r=.782) and state (P=.007, r=.708).ConclusionsGiven the correlation between community and obstetric inpatient rates, the necessity of SARS-CoV-2-related healthcare resource utilization in obstetric inpatient units may be best informed by surrounding community infection rates.

Published
2022

7. 2023 HRS expert consensus statement on the management of arrhythmias during pregnancy

Author

Joglar, José A., Kapa, Suraj, Saarel, Elizabeth V., Dubin, Anne M., Gorenek, Bulent, Hameed, Afshan B., Lara de Melo, Sissy, Leal, Miguel A., Mondésert, Blandine, Pacheco, Luis D., Robinson, Melissa R., Sarkozy, Andrea, Silversides, Candice K., Spears, Danna, Srinivas, Sindhu K., Strasburger, Janette F., Tedrow, Usha B., Wright, Jennifer M., Zelop, Carolyn M., and Zentner, Dominica

Published
2023
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9. COVID-19 Testing, Personal Protective Equipment, and Staffing Strategies Vary at Obstetrics Centers across the Country.

Author

Johnson, Jasmine D, Melvin, Emilie, Srinivas, Sindhu K, Louis, Judette M, Hughes, Brenna, Han, Christina Shih-Chi, Norton, Mary E, and Werner, Erika F

Subjects
Humans, Pregnancy Complications, Infectious, Pneumonia, Viral, Coronavirus Infections, Clinical Laboratory Techniques, Pregnancy, Female, Pandemics, Personal Protective Equipment, Betacoronavirus, COVID-19, SARS-CoV-2, COVID-19 Testing, Good Health and Well Being, Clinical Sciences, Paediatrics and Reproductive Medicine, Obstetrics & Reproductive Medicine
Published
2020

10. Community Obstetrical Units Less Likely than Academic Units to Have Universal COVID-19 Testing

Author

Werner, Erika F, Louis, Judette M, Hughes, Brenna, Han, Christina Shih-chi, Norton, Mary E, and Srinivas, Sindhu K

Subjects
Biomedical and Clinical Sciences, Midwifery, Health Sciences, Paediatrics, Reproductive Medicine, Academic Medical Centers, COVID-19, COVID-19 Testing, Clinical Laboratory Techniques, Coronavirus Infections, Female, Hospitals, Community, Humans, Needs Assessment, Obstetrics and Gynecology Department, Hospital, Pandemics, Pneumonia, Viral, Pregnancy, Surveys and Questionnaires, United States, Clinical Sciences, Paediatrics and Reproductive Medicine, Obstetrics & Reproductive Medicine, Reproductive medicine
Published
2020

15. Audit and feedback is an effective implementation strategy to increase fidelity to a multi-component labor induction protocol designed to reduce obstetric inequities.

Author

Hamm, Rebecca F., Pattipati, Sreya, Levine, Lisa D., Parry, Samuel, Srinivas, Sindhu K., and Beidas, Rinad S.

Subjects
INDUCED labor (Obstetrics), HEALTH equity, RACIAL inequality, PUBLIC health, MEDICAL sciences
Abstract

Background: Studies have demonstrated that standardizing labor induction (IOL), often with the use of protocols, may reduce racial inequities in obstetrics. IOL protocols are complex, multi-component interventions. To target identified implementation barriers, audit and feedback (A&F) was selected as an implementation strategy. Here, we aimed to understand the acceptability and effect of A&F on fidelity to this complex intervention through quantitative and qualitative approaches. Methods: This secondary analysis of a type I hybrid effectiveness-implementation trial (10/2018–12/2022) compared 2 years before (PRE) to 2 years after (POST) implementation of an IOL protocol at two sites. Fidelity to each of 8 specific protocol components was collected via chart review. During the POST period, unit-aggregated A&F reports were distributed via email every 3 months to site clinicians. Reports tracked fidelity to protocol components over time. For this analysis, we compared component fidelity PRE to POST-implementation. Additionally, during the POST period, we compared fidelity by month after each A&F (Month#1 v. Month#2/3) to evaluate the effect of A&F over time. Acceptability of A&F reports was evaluated using qualitative interviews. Results: 8509 labor inductions were included (PRE = 4214, POST = 4295). A&F reports were successfully distributed every 3 months for the 2-year POST period. PRE to POST-implementation, fidelity to 4 of the 8 components increased significantly (cervical Foley utilization, latent labor examination frequency, amniotomy timing, and intrauterine pressure catheter utilization), without change in the other 4 components. For 2 of those 4 components where improvement was noted, there was no difference in fidelity by month after A&F report; rather, there was sustained improvement across the POST-implementation period. On the other hand, for the remaining 2 components, fidelity peaked in the first month after each A&F report, with some decline in the following 2 months prior to the next A&F report. Qualitative analysis (n = 24) supported A&F acceptability, with A&F described as "motivating" and "helpful." Conclusions: A&F was an effective implementation strategy to promote fidelity to certain components of this labor induction protocol. With some decline in effect after the first month POST-A&F report, increased A&F frequency should be considered in future work targeting obstetric outcomes, as well as health inequities. [ABSTRACT FROM AUTHOR]

Published
2025
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18. Development and testing of a survey measure of organizational perinatal patient-centered care culture

Author

Handley, Sara C., Passarella, Molly, Martin, Ashley E., Lorch, Scott A., Srinivas, Sindhu K., and Nembhard, Ingrid M.

Subjects
United States. Agency for Healthcare Research and Quality -- Powers and duties, Patients -- Care and treatment, Maternal health services -- Forecasts and trends, Corporate culture -- Forecasts and trends, Employees -- Beliefs, opinions and attitudes, Market trend/market analysis, Business, Health care industry
Abstract

Objective: To develop and test a measure of patient-centered care (PCC) culture in hospital-based perinatal care. Data Sources: Data were obtained from US perinatal hospitals: one provided survey development data and 14 contributed data for survey testing. Study Design: We used qualitative and quantitative methods to develop the mother-infant centered care (MICC) culture survey. Qualitative methods included observation, focus group, interviews, and expert consultations to adapt items from other settings and create new items capturing dimensions of PCC articulated by The Commonwealth Fund. We quantitatively assessed survey psychometric properties using reliability (Cronbach's a and Pearson correlation coefficients) and validity (exploratory and confirmatory factor analysis [CFA]) statistics, and refined the survey. After confirming aggregation suitability (ICCs), we calculated 'MICC culture scores' at the individual, unit, and hospital level and assessed associations between scores and survey-collected, staff-reported outcomes to evaluate concurrent validity. Data Collection: Survey development included 12 site-visit observations, one semi-structured focus group (five participants), two semi-structured interviews, five cognitive interviews, and three expert consultations. Survey testing used online surveys administered to obstetric and neonatal unit staff (N = 316). Principal Findings: Using responses from 10 hospitals with [greater than or equal to] 4 responses from both units (n = 240), the 20-item MICC culture survey demonstrated reliability (Cronbach's [alpha] = 0.95) while capturing all PCC dimensions (subscale Cronbach's [alpha] = 0.72-0.87). CFA showed validity through goodness-of-fit (overall chisquare = 214 [p-value = 0.012], SRMR = 0.056, RMSEA = 0.041, CFI = 0.97, and TLI = 0.96). Aggregation statistics (ICCs < 0.05) justify unit- and hospital-level aggregation. Demonstrating preliminary validity, individual-, unit-, and hospital-level MICC culture scores were associated with all outcomes (satisfaction with care provided, within-unit team effectiveness, and relational coordination [RC] between units) (p-values < 0.05), except for neonatal unit scores and RC (p-value = 0.11). Conclusions: The MICC culture survey is a psychometrically sound measure of PCC culture for hospital-based perinatal care. Survey scores are associated with staff-reported outcomes. Future studies with patient outcomes will aid identification of improvement opportunities in perinatal care. KEYWORDS childbirth, hospitalization, inpatients, mother-infant, organizational culture, patient-centered care, perinatal care, surveys and questionnaires What is known on this topic * Patient-centered care (PCC) is associated with better in-hospital and post-discharge outcomes for patients who sought care for various conditions. * Organizational culture, the shared beliefs, perceptions, and values within an organization, has been linked to improved patient and staff outcomes in other health care settings. * There is no psychometrically sound measure of PCC culture for perinatal (obstetric and neonatal) care to facilitate identification of opportunities to improve care, which is needed given the health and economic burden of adverse perinatal outcomes. What this study adds * The mother-infant centered care (MICC) culture survey is a reliable and valid measure of PCC culture for the hospital setting. * The MICC culture survey can be used to assess PCC culture at the individual staff, unit, and hospital level. * MICC culture scores at the individual, unit, and hospital level are associated with multiple staff-reported outcomes including staff satisfaction with care provided, within-unit team effectiveness, and relational coordination between obstetric and neonatal units., 1 | INTRODUCTION Each year over 3.5 million women are hospitalized for childbirth in the United States, accounting for 23% of hospitalizations and $12 billion in hospitalization costs. (1, 2) [...]

Published
2022
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27. Clinical course of severe and critical coronavirus disease 2019 in hospitalized pregnancies: a United States cohort study

Author

Pierce-Williams, Rebecca A.M., Burd, Julia, Felder, Laura, Khoury, Rasha, Bernstein, Peter S., Avila, Karina, Penfield, Christina A., Roman, Ashley S., DeBolt, Chelsea A., Stone, Joanne L., Bianco, Angela, Kern-Goldberger, Adina R., Hirshberg, Adi, Srinivas, Sindhu K., Jayakumaran, Jenani S., Brandt, Justin S., Anastasio, Hannah, Birsner, Meredith, O’Brien, Devon S., Sedev, Harish M., Dolin, Cara D., Schnettler, William T., Suhag, Anju, Ahluwalia, Shabani, Navathe, Reshama S., Khalifeh, Adeeb, Anderson, Kathryn, and Berghella, Vincenzo

Published
2020
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34. Putting the “M” back in maternal-fetal medicine: A 5-year report card on a collaborative effort to address maternal morbidity and mortality in the United States

Author

D’Alton, Mary E., Friedman, Alexander M., Bernstein, Peter S., Brown, Haywood L., Callaghan, William M., Clark, Steven L., Grobman, William A., Kilpatrick, Sarah J., O’Keeffe, Daniel F., Montgomery, Douglas M., Srinivas, Sindhu K., Wendel, George D., Wenstrom, Katharine D., and Foley, Michael R.

Published
2019
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50. Lifetime Racism and Blood Pressure Changes During Pregnancy: Implications for Fetal Growth

Author

Hilmert, Clayton J, Dominguez, Tyan Parker, Schetter, Christine Dunkel, Srinivas, Sindhu K, Glynn, Laura M, Hobel, Calvin J, and Sandman, Curt A

Subjects
Health Sciences, Psychology, Minority Health, Preterm, Low Birth Weight and Health of the Newborn, Clinical Research, Perinatal Period - Conditions Originating in Perinatal Period, Pediatric, Social Determinants of Health, Pregnancy, Women's Health, Health Disparities, Cardiovascular, Reproductive health and childbirth, Good Health and Well Being, Adult, Black or African American, Birth Weight, Blood Pressure, Female, Fetal Development, Gestational Age, Health Status Disparities, Humans, Infant, Newborn, Qualitative Research, Racism, Surveys and Questionnaires, Time Factors, Young Adult, African American, blood pressure, fetal growth, racial disparities, racism, Medical and Health Sciences, Education, Psychology and Cognitive Sciences, Public Health, Health sciences
Abstract

ObjectiveResearch suggests that exposure to racism partially explains why African American women are 2 to 3 times more likely to deliver low birth weight and preterm infants. However, the physiological pathways by which racism exerts these effects are unclear. This study examined how lifetime exposure to racism, in combination with maternal blood pressure changes during pregnancy, was associated with fetal growth.MethodsAfrican American pregnant women (n = 39) reported exposure to childhood and adulthood racism in several life domains (e.g., at school, at work), which were experienced directly or indirectly, meaning vicariously experienced when someone close to them was treated unfairly. A research nurse measured maternal blood pressure at 18 to 20 and 30 to 32 weeks gestation. Standardized questionnaires and trained interviewers assessed maternal demographics. Neonatal length of gestation and birth weight data were collected from medical charts.ResultsChildhood racism interacted with diastolic blood pressure to predict birth weight. Specifically, women with two or more domains of indirect exposure to racism in childhood and increases in diastolic blood pressure between 18 and 32 weeks had lower gestational age adjusted birth weight than the other women. A similar pattern was found for direct exposure to racism in childhood.ConclusionsIncreases in diastolic blood pressure between the second and third trimesters predicted lower birth weight, but only when racism exposure in childhood (direct or indirect) was relatively high. Understanding pregnant African American women's lifetime direct and indirect experiences with racism in combination with prenatal blood pressure may improve identification of highest risk subgroups within this population.

Published
2014

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