May 4, 2020

When Kirsti Clifford found out she was pregnant with her second child, she was excited beyond belief. She was grateful to be giving her daughter a sibling and she was looking forward to pregnancy and delivery more so than with her first child because she knew what to expect. Then the pandemic happened and Clifford’s anxiety rose right along with it.

“There is so much unknown.” Clifford said. “I have felt much more uneasy this time and am trying to be really careful. I am limiting my exposure, social distancing and not going out unless I have to.”

To reduce the anxiety of expectant moms like Clifford, and to lower their risk of COVID-19 exposure and infection, Texas Children’s Pavilion for Women has opened a drive-through prenatal clinic at our Medical Center Campus.

A group of Texas Children’s obstetrics and gynecology physicians in consultation with the American College of Obstetrician Gynecologists (ACOG) came up with the idea while discussing how to adequately care for pregnant mothers while reducing their risk of contracting COVID-19 while traveling to hospitals or clinics for a prenatal exam.

“Providing access to prenatal health care while limiting exposure of both obstetric health care professionals and patients to COVID-19 is challenging,” said Dr. Mark Turrentine, a Texas Children’s obstetrician and gynecologist. “Although reductions in the frequency of prenatal visits and implementation of telehealth interventions provide some options, there still remains a need for patient–health care professional visits.”

The drive-through prenatal care clinic at Texas Children’s allows pregnant women who do not need to be seen in the clinic to remain in their vehicles while being assessed by a health care professional, thus reducing potential patient, health care professional, and staff exposure to COVID-19.

View photos of the drive-through clinic below.

The drive-through visits include key elements of a prenatal exam such as blood pressure measurements for evaluation for hypertensive disorders of pregnancy, fetal heart rate assessment, and selected ultrasound-based measurements or observations, as well as face-to-face patient–health care professional interaction.

“Patients using the drive-through clinic feel reassured that they can actually see a health care provider and hear their baby’s heartbeat without having to come into our facility and risk being exposed to the virus,” Turrentine said. “Our providers like it as well. They enjoy being able to provide patients with an option that might better suit their needs during these unprecedented times.”

Clifford said she used the drive-through clinic at the Medical Center Campus for her 30-week appointment because she didn’t want to take any unnecessary risks, and that it turned out to be a great decision. She said she got her blood pressure taken and that, more importantly, she got to hear her baby’s heartbeat.

“I appreciated the setup because we can still get some of the important monitoring that we need to feel reassured,” Clifford said. “It’s a creative solution that I would opt to use again.”

In conjunction with Turrentine and other Texas Children’s obstetrics and gynecology physician, Obstetrician and Gynecologist-in-Chief Dr. Michael A. Belfort recently published a paper about the drive-through prenatal clinic in Obstetrics & Gynecology, the official publication of ACOG. In that paper, Belfort said the drive-through model is projected to reduce the number of in-person clinic visits by 33 percent per patient compared with the traditional prenatal care paradigm, using equipment and supplies that most obstetric clinics in the United States can access.

“What we have seen so far at Texas Children’s is that the concept of a drive-through prenatal clinic works,” Belfort said. “They are reducing patient anxiety without compromising quality of care. It’s a win-win for everyone involved.”

Texas Children’s is also using drive-through capabilities for a variety of services including per-operative COVID-19 testing at all three of our hospital campuses and will expand these options as we continue to refine how we care for our patients.

January 28, 2019

Drs. Jimmy Espinoza and Alex Vidaeff were recently honored by the American College of Obstetricians and Gynecologist (ACOG) for preparing new guidelines for the management and prevention of complications of pregnancy including preeclampsia and gestational hypertension as well as chronic hypertension during pregnancy.

These pregnancy complications are among the leading causes of maternal death in the United States and abroad. The new guidelines on how to manage and prevent these complications were published in Obstetrics and Gynecology the official journal of the ACOG.

“Your contributions to the medical literature on hypertensive disorders in pregnancy were paramount in helping the Practice Bulletin Committee – Obstetrics develop and implement these two critical documents,” said Dr. Mark Turrentine, chair of the ACOG Bulletin Committee – Obstetrics. “While ACOG does not state its guidelines should be considered the standard of care, I suspect these documents will be utilized to guide clinician’s management of hypertensive disorders of pregnancy not only in the United States, but worldwide.”

Turrentine also said the appropriate treatment of hypertensive diseases in pregnancy may be the most important focus of our attempts to improve maternal mortality and morbidity in the United States, and that the new guidelines will focus clinicians on providing the right and the best care based on the latest and soundest available evidence.

Espinoza’s clinical interests include the pregnancy complications listed above; in addition, his clinical and research interest include prenatal diagnosis of congenital defects with emphasis of congenital heart defects as well as fetal interventions including laser photocoagulation of placental anastomoses in twin-to-twin transfusion syndrome, fetoscopic tracheal occlusion in cases of severe congenital diaphragmatic hernia and open/fetoscopic repair of spina bifida among other interventions. He is board certified in Obstetrics and Gynecology and serves as co-director of the Fetal Center and in the Division of Fetal Intervention and Therapy at Baylor College of Medicine. Espinoza earned his medical degree at San Fernando Faculty of Medicine, University of San Marcos in Lima, Peru. He completed his residency in Obstetrics and Gynecology at William Beaumont Hospital, Royal Oak, MI. Espinoza earned his Master in Science in Reproductive Health at the University of Cardiff, Wales, where he graduate with distinction, followed by a Diploma in Fetal Medicine under the auspices of the Fetal Medicine Foundation in London, UK.

Vidaeff has extensive experience in the management of multiple pregnancies, preterm labor, and preeclampsia. He specializes in the management of medical complications in pregnancy. Vidaeff is board certified in Obstetrics and Gynecology and in Maternal-Fetal Medicine. He completed his residency at Temple University in Philadelphia. He completed his fellowship training in Maternal-Fetal Medicine at The University of Texas Medical School at Houston. Vidaeff also holds a Masters in Public Health from The University of Texas School of Public Health at Houston. He is the chairman of the steering committee of the World Organization Gestosis, international organization for the study of pathophysiology of pregnancy.