Dr. Deemah Salem will be joining Genesis Perinatal Care Clinic in March!
Dr. Deemah was born in Chicago, Illinois, USA. She received her Bachelor’s degree from Saint Louis University in the USA in 1999 with the highest recognised honor, Summa Cum Laude. She then graduated from Saint Louis University School of Medicine with honors in 2003, after which she did her residency training in Obstetrics and Gynaecology at one of the top nationally ranked hospitals in the USA, William Beaumont Hospital in Michigan. She then joined a prestigious OBGYN medical center for seven years where she gained outstanding experience in general and high risk obstetrics and gynaecology.
She relocated to Dubai with her husband and children in 2014. She performs deliveries and surgeries at Mediclinic City Hospital in Dubai.
Dr. Deemah has a warm bedside manner and advocates women’s preventative healthcare. She speaks both English and Arabic fluently. She has a rich diverse background and caters to the cultural needs of patients.
Her passion is to educate and empower her female patients with information about their health and provide them with the best healthcare.
She is a fellow of the American College of Obstetrics and Gynecology and is board certified by the American Board of Obstetrics and Gynecology.
Martie Clayton is a qualified Registered Nurse and Midwife for the last 28 years, South African trained.
In 2006 she completed a honors degree in Nursing Education and administration.
Martie relocated to Dubai in 2008. She worked as Head Nurse – Maternity Manager at Mediclinic City Hospital for 9 years. During this period her team received numerous accolades and recommendations including passing the JCIA accreditation with excellent comments for the care given to parents and newborn babies.
In 2011 Martie completed International Breastfeeding Lactation Consultancy Course (IBCLC). She is a certified ALSO/NRP/BLS instructor and actively participates in giving lectures on breastfeeding, Obstetric Emergencies, Neonatal Resuscitation and Basic life Support. This keep her updated on International best practices in Obstetric.
“I am enjoying my new work experience as part of the Genesis Perinatal Care Clinic family with Dr. George and the team. We all have the same goal a healthy mom and healthy baby/babies and a family that know we care for them.
I am a reflective practitioner who enjoy and love what I do hence, I value the importance of having personal engagement with parent to share knowledge and ideas during their journey to parenthood and post delivery as a family.
As a midwife my role will be to provide Antenatal Classes in preparation for our parents to parenthood as well as Breastfeeding Education prior delivery as well as breastfeeding support after delivery.
Wishing all a blessed day and keep smiling!” – Martie says 🙂
16 Jun 2018
Carrier screening for genetic diseases Preconception, Early pregnancy test Genesis Perinatal Care Clinic
Carrier screening in early pregnancy.Advances in genotyping technology resulted in the fast and affordable sequencing of the human genome (genetic information). Conditions like cystic fibrosis (1/25 risk of being a carrier) and spinal muscular atrophy (1/47 -1/90 risk of being a carrier) thalassemias (almost 7% of women are carriers ) are relatively common conditions with a significant impact on the life of the affected individual. Expanded carrier screening can identify not only common recessive conditions but also rare ones. This was till recently offered only as a preconception test. However as Carrier screening can now be completed at a very fast pace it is an option to be considered as an early pregnancy test.
What is carrier screening?
Carrier screening is a type of genetic test that can tell you whether you carry a gene for certain genetic disorders. When it is done before or during pregnancy, it allows you to find out the chances of having a child with a genetic disorder
For some genetic disorders in order for the child to be affected, it needs to inherit the abnormal gene from both parents (autosomal recessive). Individuals who have one abnormal gene are most of the time asymptomatic meaning they do not have the disease or have a very mild form. However, they can pass the abnormal gene to their children. these individuals are called Carriers. For example, for Cystic fibrosis, the carrier is usually completely symptomatic while for B thallasemia the carrier might have mild anemia.
Who should have carrier screening?
It is currently recommended for women to consider having screening for cystic fibrosis, hemoglobinopathies and spinal muscular atrophy if they are planning to get pregnant
How is the testing done?
Usually, a sample of blood is required although some test uses saliva for swab taken from the mouth. The test comes as positive (you have an abnormal variant) or negative (you don’t). If you are found to be a carrier then your partner should be tested to determine his status
Normally you do not need to repeat the test in the future for the same mutation
Should everyone have carrier screening?
Carrier screening in most settings is a voluntary decision. The same applies to the extent of screening you will have. Meaning whether you will opt for a targeted screening or expanded
What is expanded carrier screening?
Current tests offer the option to test for more than 200 conditions. They usually focus on conditions that although rare are expected to have a major impact on the person’s quality of life
How accurate are the tests?
The tests are not perfect. There is a small risk of both false positive and false negative results. A negative – normal test does not guarantee that there no chance for genetic disorders because; 1 does not test for everything 2. there may be a variant mutation that is not detected by the test but still cause problems
What the test providers are trying to calculate for you is the residual risk; meaning the risk after you have a negative test
the following table gives an example for cystic fibrosis
Gregg et al Expanded Carrier Screening Obstet Gynecol Clin N Am 45 (2018) 103–112
At Genesis Perinatal Care Clinic we are offering the most comprehensive carrier screening tests; The test can be scaled from the relatively common diseases to an expanded test that covers more than 270 serious diseases. We have built the proper setting to discuss, counsel and perform both screening and follow up diagnostic tests for genetic conditions
Dr George Michailidis, MRCOG
Fetal &Maternal Medicine Consultant
Obstetrician & Gynaecologist
20 Sep 2017
We are happy to announce the ‘GENESIS’ was granted an Educational Permit by Dubai Healthcare Regulation, what gives us a great opportunity to organize medical events where we can talk about different topics related to:
- Maternal and Fetal Medicine
- Obstetrics and Gynecology
- Management of high risk pregnancies
- Basic and advanced prenatal ultrasound scans
- 3D/4D scans
- And many more…
25 Mar 2016
23 Jan 2016
Zika virus and pregnancy in Dubai
What is Zika virus ?
How is Zika virus transmitted ?
Zika virus is spread by the yellow fever mosquito Aedes aegypti . The specific mosquito can carry a number of other viruses as well like denque fever yellow fever. It is recognised by the white markings on its legs and a specific mark that resemble the music instrument lyra on it thorax . The mosquito has originated in Africa and now is spread in most subtropical regions throughout the word
How do I know if I am infected ?
Symptoms of Zika virus infection in pregnancy
- It is a self limiting infection that usually lasts a few days
- Only one in 5 people who are infected with the virus do actually become ill
Diagnosis of Zika virus infection
- Diagnosis is not easy and is based on a very high index of suspicion
- Symptoms are very similar to those from dengue fever or chinkungunya . Both these viruses are transmitted from the same species of mosquitoes as Zika
- Travel history during pregnancy in areas where zika virus is prevalent is important. CDC is regularly updating its travel information and this can be found online at http://wwwnc.cdc.gov/travel/notices/
- Blood tests can help the diagnosis
Treatment for the pregnant mother with Zika virus infection
- There is no specific medication or vaccine to treat or prevent Zika virus infection during pregnancy
- Ensure good hydration
- Paracetamol is safe to take during pregnancy in mothers with Zika virus infection to relieve some of the symptoms
- In pregnant mothers with laboratory evidence of zika virus disease during pregnancy follow up by a fetal medicine specialist is recommended. Ultrasound scans are performed in 3-4 weeks interval looking for specifically for evidence of microcephaly or cerebral calcifications
Pregnancy advice and Zika virus
Pregnant women considering travelling in an area affected by Zika virus
- Pregnant women should be advised against travelling to areas known to be affected by zika virus. There are no vaccines or medication that can be used in pregnancy to prevent Zika virus.
- The mosquitos responsible for transmitting Zika virus are most active during the day so appropriate measures to avoid mosquito bites should be taken . Wearing long sleeve shirts and long sleeve pants as well a appropriate use of insect repellants is strongly advised
Testing of pregnant women with a possible infection by Zika virus
- To date there is no commercially available test specific for Zika virus . Blood test utilising reverse transcription polymerase test can be used in symptomatic patients . In the US this is facilitated by the local health care departments
Effect of Zika virus to the baby
There is increasing evidence linking Zika virus infection during pregnancy and fetal microcephaly.
What is microcephaly? The term microcephaly is used to describe a fetal head size that is smaller than expected at a certain gestational age. Different cut of points are used but most will take 3 standard deviations from the mean. This means that the circumference of the fetal head is less than the 0.3 % expected for the gestation
The size of the fetal head is mostly dependent on the growth of the fetal brain. Most cases of microcephaly are due to genetic factors. However acquired microcephaly is well described due to infections like toxoplasmosis and rubella. Zika virus has been associated with the increased rate pregnancies affected by fetal micropcephaly in Brazil .
What is the treatment for microcephaly. There is no treatment for microcephaly as this is the result of the damage that has already happened to the fetal brain.
Fetal and Maternal Medicine Consultant
Genesis Perinatal Care Clinic Dubai
Further updated information
Interim Guidelines for Pregnant Women During a Zika Virus Outbreak — United States, 2016
“Aedes aegypti” by Muhammad Mahdi Karim (www.micro2macro.net) Facebook Youtube – Own work. Licensed under GFDL 1.2 via Commons – https://commons.wikimedia.org/wiki/File:Aedes_aegypti.jpg#/media/File:Aedes_aegypti.jpg
“Zika.Virus.Rash.Arm.2014” by FRED – Own work. Licensed under CC BY-SA 3.0 via Commons – https://commons.wikimedia.org/wiki/File:Zika.Virus.Rash.Arm.2014.jpg#/media/File:Zika.Virus.Rash.Arm.2014.jpg
08 Jan 2015
Gestational diabetes has a major impact in pregnancy care especially in Middle East. Lifestyle and diet interventions can help improve outcomes for baby and mother. Furthermore the set the foundations for a long term healthier lifestyle. The following is from the OBGYNnet referring to a recent publication from Diabetes Care ;
Best Diet for Gestational Diabetes | OBGYN.Net: Clinicians should prescribe a low glycemic index diet to women with gestational diabetes mellitus, according to new data from a meta-analysis.
The analysis found that a low glycemic index diet was associated not only with reducing insulin use but also with lower birth weights for the babies. Published in Diabetes Care, the analysis was based on data from nine randomized controlled trials.
– Physicians should recommend that women with gestational diabetes choose foods with a low glycemic index.
– Adhering to a low glycemic index diet will likely improve the health of women with gestational diabetes.
– Although associated with decreased need for insulin and reduced birth weight in infants, a low glycemic diet did not affect maternal weight gain or c-section rates.
A previous Cochrane review found no significant dietary benefit of a low glycemic index diet. However, this latest analysis included more trials that the Cochrane analysis, the authors said.
Total dietary restriction and low carbohydrate diets did not have similar impact on maternal or newborn health, the researchers found. However, a low glycemic index diet reduced the proportion of patients who needed insulin (relative risk, 0.767 [95% CI 0.597, 0.986]; P = 0.039).
“The less frequent use of insulin means that 13 out of 100 patients with GDM will not need to use insulin if they adopt a low GI diet during pregnancy,” the authors reported.
In addition, the average birth weight of babies born to pregnant women with gestational diabetes who consumed a low GI diet was 161.9 g less than that of babies born to women in the control diet group (95% CI: −246.4, −77.4; P = 0.000).
Using a glycemic index scale from 0 to 100 according to the extent to which a food raises blood glucose levels after eating, the authors categorized foods with a glycemic index of less than 55 as low glycemic index foods. Pumpernickel bread, oatmeal, muesli, sweet potato, corn, yam, lima beans, peas, lentils, most fruits, and carrots are among foods deemed to have a low glycemic index, according to the American Diabetes Association.
A low glycemic diet, however, did not affect maternal weight gain or c-section rates, the authors noted.
See more at: http://www.obgyn.net/gestational-diabetes/best-diet-gestational-diabetes
20 Jun 2014
Monochorionic twins (identical twins) present a real management challenge for the obstetric team. In addition to the common twin pregnancy complications like preterm delivery and growth retardation monochorionic twin pregnancies can be affected by twin to twin transfusion syndrome.
Twin to twin transfusion syndrome is a pregnancy complication unique to monochorionic twins. It affects up to 18% of monochorionic twins and if left untreated can lead to loss of both babies. Treatment of choice is laser ablation of the communicating placental vessels. This is not available in Dubai.
There are few centres of excellence around the word with a load of cases to get good level of expertise and good results. Most are in Western Europe and USA.
Given visa restrictions it is imperative that the parents have appropriate counselling and as much notice as possible in order to prepare for possible treatment interventions.
At Genesis we offer a comprehensive monochrorionic twin pregnancy surveillance program aiming to identify early major complications like TTTS and preterm labour.
- Certified Fetal Medicine Consultant supervision.
- First trimester screening, TTTS risk assessment. Documentation preparation for those parents who may need to travel.
- US review from 16 weeks and every 2 weeks till 24 weeks gestation and then 2-3 weeks till delivery.
You can always reach our team for more information and appointments on 044498446.
Dr George Michailidis, MRCOG
Fetal & Maternal Medicine ConsultantObstetrician & Gynaecologist