Welcome to Project ECHO South Carolina Pregnancy Wellness

Project ECHO SC Pregnancy Wellness is a resource for South Carolina healthcare providers working in the field of obstetrics who are interested in learning more to address preterm birth. Our goal is to create a network of obstetrical health care professionals collaborating to support each other in treating high-risk pregnancy patients within their own respective communities.

What Topics Will Experts Discuss in the ECHO Sessions?

Sessions are held on the first and third Wednesday of each month from 12:15 p.m. to 1:00 p.m.

SC Pregnancy Wellness is leveraging the ECHO model to provide telementoring support to providers across the state of South Carolina. Our ECHO clinics feature brief, user-driven didactic content delivered by national experts in the treatment of high-risk pregnancies and case presentations from members of our ECHO community.

To access presentations from past ECHO Sessions, please visit our Pregnancy Wellness presentation archives.

Current Presentation Series:

January 2023 – December 2023
Date	Topic
1/18	Twins Part 1
2/1	Twins Part 2
2/15	Macrosomia
3/1	Shoulder dystocia
3/15	Fetal Growth Restriction Part 1
4/5	Fetal Growth Restriction Part 2
4/19	Labor induction
5/3	Perinatal Substance Use Disorder
5/17	Deeper Dive: e.g., Perinatal Opioid Use Disorders (OUD)
6/7	Management of Chronic Hepatitis in Pregnancy
6/21	Herpes
7/5	Derm 1
7/19	Derm 2

Past Presentation Series

January 2022 – December 2022
Date	Topic
7/20	Pre-labor ROM
8/3	Management of Pre-term Labor
8/17	Group B Strep Management
9/7	Iron, Folate, and B-12 Anemia
9/21	Vaccinations in Pregnancy
10/5	Maternal Mental Health Mortality First Aid
10/19	Effective Screening, Brief Intervention and Referral to Treatment
11/2	Perinatal Mood & Anxiety Disorders
11/16	Deeper Dive: Perinatal Mood & Anxiety Disorders
12/7	Deeper Dive: Postpartum Psychosis
12/21	Community Choice

July 2021 – December 2021
Date	Topic
7/21	Sepsis Part I
8/4	Emergency Update: Covid-19 Surge in Pregnancy
8/18	Sepsis Part II
9/1	Sepsis Bundle of Care
9/15	Fetal Heart Rate Tracings
10/6	COVID-19 Treatment in Pregnancy
10/20	Isoimmunization
11/3	Hemoglobinopathies
11/17	Thyroid Disease
12/1	Emergency Care Postpartum
12/15	ACOG Committee Opinion on Late Preterm Birth/Early Term Delivery

Safety Bundles Recognition, Differential Diagnosis, and Appropriate Treatment for Pregnancy Postpartum Hemorrhage – April 2021 to June 2021
Date	Topic
5/5	Postpartum Hemorrhage Assessing Etiology & Management
5/19	Morbidly Adherent Placenta
6/2	Assessing Blood Loss & Management
6/16	Safety Bundles for Postpartum Hemorrhage & Hypertension
7/7	Diagnosis and Management of Abruptio Placenta & Previa

Hypertension (HTN) – December 2, 2020 to April 7, 2021
Date	Topic
12/2/20	Chronic Hypertension Treatment & Goals
12/16/20	Standardized Treatment of Severe Hypertension
1/20/21	Diagnosis and Management of Chronic HTN with Superimposed Pre-Eclampsia
2/17/21	Pre-Eclampsia With & Without Severe Features
3/3/21	Inpatient vs. Outpatient Management of Pre-Eclampsia
3/17/21	Conservative Management of Early Onset Severe Pre-Eclampsia
4/7/21	Postpartum Management of HTN & Implications for Future Health

Special Focus: Pregnancy Wellness During the Coronavirus Public Health Emergency – June 17, 2020 to August 5, 2020
Date	Topic
6/17/20	Practical Office-Based Management in COVID-19
7/1/20	SMFM Updates, Guidelines, & Regulations During COVID-19
7/15/20	Infectious Diseases & Pregnancy Wellness During COVID-19
8/5/20	Panel Discussion – Pregnancy Wellness During the Coronavirus Public Health Emergency: Lessons Learned & Looking Forward

Substance Abuse Disorder in Pregnancy – August 19, 2020 to October 21, 2020
Date	Topic	Presenter
8/19/20	Subutex, Methadone, or Subozone: Which is Better for Baby?	Dr. Lisa Boyers
9/2/20	Can a Professional Wean Opioids During a Pregnancy?	Dr. Connie Guille
9/16/20	Pain Management After Delivery in OUD Patients on Medical Maintenance Therapy	Dr. Berry Campbell
10/7/20	How Do I Get Patients into Treatment?	Dr. Claire Smith
10/21/20	What To Do When a Patient is Admitted on OB with Recent Illicit Drug Use	Dr. Rubin Aujla

Diabetes – December 4, 2019 to February 19, 2020
Date	Topic
12/4/19	Help Me! I Need to Start Insulin
12/18/19	Pre-Gestational Diabetes P:C Ratio or 24-Hour Urine
1/15/20	Checking Blood Sugars & Adjusting Insulin
2/5/20	Managing Insulin for Intrapartum & Postpartum Care
2/19/20	Delivery Plans: Route & Timing of Delivery

How Can I Sign Up to Join the SC Pregnancy Wellness Community?

If you are interested in joining our SC Pregnancy Wellness ECHO Community, please reach out to us by either completing our Contact Us form or emailing our Program Coordinator, Rachel Grater at grater@musc.edu for more information. We're excited to work with you!

The South Carolina Maternal Morbidity and Mortality Review (MMMR) Committee, established by state law in 2016, investigates the death of mothers associated with pregnancy to determine which ones can be prevented. A pregnancy-related death occurs when a woman dies while pregnant or within 1 year of pregnancy. The cause is related to or made worse by her pregnancy or its management. This does not include accidental or incidental causes.

Between 2015 and 2019, 75 South Carolina women died within six weeks of giving birth, a rate of 26.2 deaths per 100,000 live births. The maternal mortality rate was 2.4 times higher for Black and Other women versus White women (42.3. vs. 18.0 maternal deaths per 100,000 live births, respectively).

Between 2016 and 2020, there were 63 maternal deaths reviewed. Of which, 60 were within the scope of case review. The Committee findings are summarized below.

Racial Disparities in Pregnancy-Related Deaths

Black maternal deaths accounted for 43% of all pregnancy-related deaths reviewed between 2016 and 2020 (White, 27%; Other, 8%, Unknown, 22%).
Disparate causes of death were observed by race - hemorrhage was the most common cause of Black maternal deaths, while infection and cardiomyopathy were tied as the leading cause of White maternal deaths.
The immediate postpartum period is the most vulnerable period for women of all races.

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Citations:

Berg, C., Danel, I., Atrash, H., Zane, S., & Bartlett, L. (2001). Strategies to reduce pregnancy-related deaths. from identification and review to action, 2001.
Petersen, E. E., Davis, N. L., Goodman, D., Cox, S., Mayes, N., Johnston, E., ... & Barfield, W. (2019). Vital signs: pregnancy-related deaths, United States, 2011–2015, and strategies for prevention, 13 states, 2013–2017. Morbidity and Mortality Weekly Report, 68(18), 423.
South Carolina Vital and Morbidity Statistics 2019. (2020, November). Retrieved from https://scdhec.gov/sites/default/files/media/document/Vital-Morbidity-Statistics_2019.pdf. Building U.S.
Capacity to Review and Prevent Maternal Deaths. (2018). Report from nine maternal mortality review committees. Retrieved from
http://reviewtoaction.org/Report_from_Nine_MMRCs