Sunday, November 2, 2014

Collaboration, telemedicine save lives in rural Kentucky

Many rural women in Appalachia can now have their babies closer to home thanks to a partnership between Appalachian Regional HealthCare and UK HealthCare.

UK HealthCare women's health providers are now based at permanent community clinics in Morehead, Georgetown and Hazard, says a University of Kentucky news release. Prenatal emergencies are still transferred by air ambulance to the UK Chandler Hospital, but full-time obstetricians, telehealth and a partnership with ARH is allowing most women to deliver closer to home.

A Breathitt County mom, Elma Thorpe, shared her story about how Dr. James Dawson, one of two doctors based at the UK HealthCare Women's Clinic in Hazard saved her life and her newborn son's life in November 2012.

At 36 weeks pregnant, Thorpe had stomach pains and thought she was going into labor. She went immediately to the hospital and was admitted to the emergency department at Appalachian Regional HealthCare Medical Center in Hazard. Her regular doctor was on vacation, so the on-call obstetrician Dr. James Dawson, one of two doctors based at the women's clinic, stepped in to deliver Thorpe's baby.

While waiting to be taken to the labor and delivery department, Thorpe developed a placental abruption, which occurs when the placenta prematurely breaks away from the wall of the uterus and was causing bleeding from the womb. That cut off the baby's oxygen supply, and Dawson feared that the baby would die inside the womb before he was able to deliver. He also knew Thorpe was in danger from losing a high volume of blood.

"With some emergencies, you have several minutes or an hour, but this was one where we had only a few minutes," Dawson said. He and the ARH medical team performed an emergency Cesarean section to deliver baby Nicholas and then successfully worked to stop Thorpe's bleeding.

UK HealthCare's Women's Health in Hazard employs two full-time obstetricians with the intent to keep women closer to their home for prenatal care and delivery, even when emergencies arise, UKNow reports.

Dawson and colleague Dr. Misty Thompson live and work in the Appalachian community they serve. A partnership between UK and ARH allows them to be on-call for deliveries and emergencies, and provide women's health services at health departments in surrounding counties.

Obstetricians in Hazard also have access to the latest ultrasound technology and consultations with UK specialists in Lexington through telemedicine if they partner with UKHealthCare.

Dr. Wendy Hansen, chair of UK's Department of Obstetrics and Gynecology, said these collaborative resources and support "will improve the level of care for women in every part of Kentucky" and will also "help recruit doctors to an historically underserved area that struggles to attract providers."

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