Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Ninety percent of term infants make a successful and uneventful transition from living within the womb to the outside world. About 10% will need some medical intervention and approximately 1% will require extensive resuscitation. A reproducible and rapidly determined rating system is necessary for evaluation the newborn infant. The Apgar score is a practical method for assessing a neonate.
How is the Apgar score done?
The Apgar score is a number calculated by scoring the heart rate, respiratory effort, muscle tone, skin color, and reflex irritability (response to a catheter in the nostril). Each of these objective signs can receive 0, 1, or 2 points.
What does a high or low Apgar score mean?
A perfect Apgar score of 10 means an infant is in the best possible
condition. An infant with an Apgar score of 0-3 needs immediate
resuscitation. It is important to note that diligent care of the newborn is an immediate response to the current status of the infant. It is inappropriate to wait until Apgar scores are obtained to begin or continue to address the needs of the neonate.
When is the Apgar scoring done?
The Apgar score is done routinely 60 seconds after the birth of the infant and then is repeated
five minutes after birth.
In the event of a difficult resuscitation, the Apgar score may
be done again at 10, 15, and 20 minutes.
Preeclampsia is related to increased blood pressure and protein in the mother's urine. Preeclampsia typically begins after the 20th week of pregnancy. When preeclampsia causes seizures, it is termed "eclampsia" and is the second leading cause of maternal death of in the US. Preeclampsia is the leading cause of fetal complications. Risk factors for preeclampsia include high blood pressure, obesity, multiple births, and women with preexisting medical conditions such as diabetes, kidney disease, rheumatoid arthritis, lupus, or scleroderma. Pregnancy planning and lifestyle changes may reduce the risk of preeclampsia during pregnancy.
Birth defects have many causes and currently, are the leading cause of death for infants in the first year of life. Some of the causes of birth defects include genetic or chromosome problems. Exposure of the mother to rubella or German measles during pregnancy, or using drugs or alcohol during pregnancy. The treatment for birth defects depends upon the condition of the effected child.
Pregnancy planning is important to help prevent exposure of the mother and fetus to potentially harmful medications and substances during the early days, and throughout the pregnancy. Nutritional planning, prevention of birth defects, conditions such as high blood pressure, heart disease, diabetes, and kidney disease need careful monitoring. Gestational diabetes, preeclampsia, and pregnancy induced hypertension are conditions that may arise during pregnancy. Immunizations, inherited disorders, exercise, air travel, intercourse, and birth control are important factors to consider when planning a pregnancy.
Women's health is an important topic area to guide a woman through the stages of her life, as well as knowing the conditions and diseases that may occur. Educating yourself so that the transitions into different phases of life is key to a healthy, happy, and productive life.
Taking prescription medications or over-the-counter drugs or supplements should be discussed with your doctor. There are some medications that have been found to cause no problems in pregnancy, however, medications such as Accutane for acne, should never be taken during pregnancy.
What is a newborn infant hearing screening program?
Newborn infant hearing screening programs are designed to identify hearing
loss in infants shortly after birth. All states have implemented these screening protocols within hospitals and birthing clinics.
About 95% of hearing screening tests are done prior to discharge from the hospital or birthing clinics.
Typically, nurses or medical assistants are trained extensively on how to
operate automated equipment for testing infants. Prior to discharge, each
newborn has his/her hearing tested. If, for some reason, the newborn does not
pass the screen, a rescreen is usually done. If the infant still does not pass
the second hearing test, he/she is referred to a specialist for further testing.
Specialists who are experts at testing hearing are called audiologists.
Audiologists have had training that emphasizes diagnostic hearing testing
techniques as well as hearing rehabilitation of children and adu...
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