Authors

  1. Blackburn, Susan PhD, RN, FAAN
  2. Professor Emeritus

Article Content

This column is a part of an ongoing series on selected perinatal and neonatal focused Internet resources and mobile applications (apps) for clinical practice, teaching, or professional development. The focus for app recommendations is primarily on free or inexpensive apps. The Internet sites and apps covered in this column include an update on the March of Dimes PeriStats site, INTERGROWTH-21st Project, and a Placental Blood Draw Technique video and selected animations of embryologic development of various body systems.

 

The March of Dimes PeriStats site at http://www.marchofdimes.org/peristats/Peristats.aspx has added to its wealth of resources. PeriStats now includes 13 new PRAMS (Pregnancy Risk Assessment Monitoring System) indicators. These indicators are available through a cooperative agreement with the Centers for Disease Control and Prevention. The new indicators "largely encompass preconception and interconception care and include data on pregnancy intention and contraception use at time of conception, pre-pregnancy morbidities like diabetes and hypertension, and postpartum contraception use, checkups, and depressive symptoms, among others. Data for the new indicators are available for 2000-2011, depending on the state, and are available stratified by maternal race/ethnicity and age, household income, and Medicaid status."1 These data can be accessed by going to individual state(s) of interest and clicking on "View All Data." PRAMS data are labeled as such for quick reference.

 

The INTERGROWTH-21st Project (based at Oxford Maternal & Perinatal Health Institute at the University of Oxford, is "a multicentre, multi-ethnic, population-based study,"2 available at: http://www.intergrowth21.org.uk/default.aspx?lang=1). The original study took place at 8 sites: Pelotas (Brazil), Turin (Italy), Muscat (Oman), Oxford (United Kingdom), Seattle (United States); Beijing (China), Nagpur (India), and Nairobi (Kenya).3-5 Infants in the study are currently being followed for neurodevelopmental outcomes. The main purpose of this project was "to develop new 'prescriptive' standards describing normal fetal growth, preterm growth and newborn nutritional status in eight geographically diverse populations, and to relate these standards to neonatal health risk. The worldwide use of these tools should improve infants' healthcare and nutritional status.... The project aims to develop scientifically robust clinical tools to assess fetal growth and the nutritional status of newborn infants, as adjuncts to the recently produced WHO (World Health Organization) charts for children aged 0 to 5."2 (Information on the WHO growth charts and training tools are available at: http://www.cdc.gov/nccdphp/dnpao/growthcharts/who/index.htm.)

 

The INTERGROWTH-21st Project Web site includes links to the global fetal and newborn growth charts developed from the study (https://intergrowth21.tghn.org/global-perinatal-package), including global standards for crown-rump length estimation for gestational age; fetal head circumference, abdominal circumference, and femur length; newborn birth weight, length, and head circumference standards for males and females; preterm growth; maternal weight gain in pregnancy; and symphysiofundal height growth and developmental evaluation tools.2 Links to training tools for use of the various charts are also provided.

 

A video on Placental Blood Draw Technique is available on YouTube at https://www.youtube.com/watch?v=5niR8Y9XB_M. This 4-minute video demonstrates techniques for drawing blood from the placenta to use for newborn blood tests. The video was developed by Patrick Carroll, a neonatologist at Dixie Regional Medical Center in St George, Utah, in 2014.

 

There are many animations of embryologic development of different systems on YouTube. Examples that are based on Before We Are Born: Essentials of Embryology and Birth Defects by Moore et al6 include animations of development of the urinary system (https://www.youtube.com/watch?v=v3Tv86bITZ4), respiratory system (https://www.youtube.com/watch?v=Nvo8XGMSCwU); gastrointestinal tract (https://www.youtube.com/watch?v=cBSyOgjTGVU); face and palate (https://www.youtube.com/watch?v=4LQJIf0XLP0), pharyngeal area (http://www.youtube.com/watch?v=fp3Z_Y-0jo), nervous system (https://www.youtube.com/watch?v=Cu4lQYbOzzY), reproductive system (https://www;.youtube.com/watch?v=MureNA-RSZM), and heart (https://www.youtube.com/watch?v=-0N76gycPvo). These animations provide an excellent visual overview of embryologic development of the specific system. Unfortunately, there is no narration, so animations are most useful when used in conjunction with readings in this or other textbooks or courses.

 

-Susan Blackburn, PhD, RN, FAAN

 

Professor Emeritus

 

Department of Family and Child Nursing

 

University of Washington, Seattle

 

References

 

1. PeriStats (March of Dimes) http://www.marchofdimes.org/peristats/whatsnew.aspx?id=73. Accessed August 17, 2015. [Context Link]

 

2. Intergrowth-21st Project. http://www.intergrowth21.org.uk/about.aspx?lang=1. Accessed August 17, 2015. [Context Link]

 

3. Villar J, Cheikh IL, Victora CG, et al. International standards for newborn weight, length and head circumference by gestational age and sex: the Newborn Cross-Sectional Study of the INTERGROWTH-21st Project. Lancet. 2014;384(9946):857-868. doi:10.1016/S0140-6736(14)60932-6. [Context Link]

 

4. Cheikh IL, Knight HE, Ohuma EO, et al. International Fetal and Newborn Growth Consortium for the 21st Century. Anthropometric standardization and quality control protocols for the construction of new, international, fetal and newborn growth standards: the INTERGROWTH-21st Project. BJOG. 2013;120(suppl 2):48-55, v. doi:10.1111/1471-0528.12127. [Context Link]

 

5. Papageorghiou AT, Ohuma EO, Altman DG, et al. International standards for fetal growth based on serial ultrasound measurements: the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project [Erratum in: Lancet. 2014;384(9950):1264]. Lancet. 2014;384(9946):869-879. doi:10.1016/S0140-6736(14)61490-2. [Context Link]

 

6. Moore KL, Persaud TVN, Torchia MG. Before We Are Born: Essentials of Embryology and Birth Defects. 8th ed. Philadelphia, PA: Saunders Elsevier; 2012. [Context Link]