OB/GYN Newsletter Summer 2021

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Adapting to Change
retirement. He has played a significant role in the education and mentoring of our
residents and his contributions to the field are beyond measure. He will be greatly
missed. I would also like to offer a heartfelt congratulations to our graduating
residents. We wish you the best in your future fellowships and careers and ask
you to please stay in touch. You’ll always be welcomed as a member of our
Einstein family.
Warmly,
David Jaspan, DO, FACOOG
Chair, Department of Obstetrics and Gynecology
Einstein Healthcare Network
215-456-8438 | JaspanD@Einstein.edu
Editor’s Note: Graduating
residents can stay in touch by
registering with Einstein Alumni
Connect – Einstein’s new alumni
networking tool. Visit the site at
alumni.einstein.edu
2
Medication-Assisted Treatment Improving
Outcomes for Moms and Babies
Supported by state grant funding, the Department of
Obstetrics and Gynecology at Einstein has been advancing
plans to launch a medication-assisted treatment program
designed to address the specialized needs of pregnant
women since the beginning of 2021.
“There’s good evidence showing patients who receive
medication-assisted treatment do better in pregnancy,” says
Carlene Quashie, MD, who, along with Amanda Schieler, MD,
is leading the charge to get the program up and running.
“Patients are more likely to keep prenatal appointments, less
likely to overdose, and are better able to care for themselves.
It also helps the developing fetus.”
The program was developed to address the growing problem
of opioid use disorder in the general population, including
pregnant patients. The Department of Pediatrics was also
seeing an increase in the number of newborns experiencing
withdraw symptoms without the OB providers having any prior
knowledge of maternal opioid use during the pregnancy.
“We backtracked and realized we could help reduce or
prevent the incidence of neonatal abstinence syndrome
if we provided intervention for pregnant women prior to
delivery,” explains Dr. Quashie. “In addition, there is a direct
relationship with maternal opioid use and maternal mortality
in the post-partum period.”
To ensure the program’s success, Drs. Quashie and Schieler
set out to develop training guidelines for clinicians and get
input from other departments before launching the program.
“We had a number of attending physicians get trained and
certified to write prescriptions for buprenorphine, the drug
used to treat opioid addiction,” says Dr. Schieler. “We’ve also
reached out to departments already doing this type of work
for feedback and buy-in.”
Patients who admit to opioid use during prenatal care
visits are informed about the program. For those who are
interested, a consultation is scheduled with Dr. Quashie or
Dr. Schieler and a social worker is brought in to initiate the
patient’s medical and drug use history.
“We provide interested patients with the education they
need to take the next step,” says Dr. Quashie. “Initiation
of medication can’t take place until the patient has been
off opioids for at least 12-24 hours. If they decide to
participate, we bring them back the following day, provide
training on taking their medication and schedule a follow-up
appointment one week later.”
“When a patient has their baby, we schedule them for a
post-partum appointment and help them with insurance
clearance before discharging them from the hospital,” adds
Dr. Schieler. “The post-partum period can get hectic and
it’s a time when patients may be more likely to drop out of
the program. Once they’re released from our care, we also
refer them to the outpatient medicine service where they can
continue medication assisted therapy.”
The medication assisted treatment program is currently in
its infancy and is offered at Einstein Philadelphia, as well
as the Rising Sun practice location. Patient outcomes are
being tracked and the program is hoping to expand to other
locations by the end of the year.
A program led by Dr. Schieler (left) and Dr. Quashie (right), is
working to improve outcomes for mothers and their babies.