Detailed
Compact
Art
Reverse
July 10, 2020
Did you know that silver wire helped to dramatically reduce maternal mortality at cesarean section? And what does the Goodyear Rubber Company have to do with surgical techniques? In this episode we will wrap up our walk through history reviewing CS’s AMAZING History. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
July 9, 2020
What does a pig gelder, a woman dressed as a man, and the Queen of England all have in common? The answer: ALL CONTRIBUTED TO CS’s history! The history of C-section has been called the combination of “death, deceit, and germs“. In this historical review (Part 1), we will take a look at the origin of this all too frequent abdominal surgery. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
July 5, 2020
Prone positioning during invasive mechanical ventilation improves oxygenation, as shown in large randomized clinical trials of patients with ARDS. In an RCT that included 466 patients with moderate and severe ARDS, prone positioning for at least 16 hours per day with protective mechanical ventilation reduced 90-day mortality. Is prone positioning for respiratory support possible in pregnancy? In this session we will cover the beneficial effect of probe positioning and summarize an article (EPUB) soon to be in print in Obstetrics & Gynecology regarding prone therapy in pregnancy (Tolcher et al). --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
July 2, 2020
Gastroschisis occurs in about 1 in 1800 births in the US. Does this abdominal wall herniation usually occur to the right or left of the umbilical cord? Is this condition tied to chromosomal/genetic syndrome? What about antepartum fetal surveillance? Is a cesarean birth required? In this episode, we will review the SMFM and CDC data regarding management of gastroschisis. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
July 2, 2020
Female genital mutilation (FGM) is also known as female circumcision. The ACOG and the World Health Organization have issued public statements condemning the practice. What is this procedure? What are the 4 different types of female genital cutting? In this session we will review these answers as well as the immediate and long-term complications of FGM. We will also review the WHO international response to this unnecessary medical practice. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
June 28, 2020
Is labor affected by polyhydramnios? What is the suggested manner of performing artificial rupture of membranes in this setting? In this session, we will wrap up our discussion of polyhydramnios with a quick summary on intrapartum care. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
June 26, 2020
Polyhydramnios can be mild, moderate, or severe. Is deepest vertical pocket (DVP) or AFI preferred for amniotic fluid assessment? Is antepartum Indocin a valid treatment option? What about antepartum fetal surveillance? In this session, which is Part 1, we will review the SMFM guidance regarding polyhydramnios. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
June 22, 2020
Placenta accreta spectrum, formally known as morbidly adherent placenta, refers to a range of pathologic adherence of the placenta (accreta, increta, and percreta). There is significant risk of maternal morbidity and mortality including risk of blood transfusion, life-threatening hemorrhage, and hysterectomy. In this session, we will review the obstetric care consensus by the ACOG and SMFM regarding this condition (obstetric care consensus # 7). --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
June 20, 2020
On May 29, 2020, the U.S. FDA approved an novel oral drug, Oriahnn, for HMB use to fibroids. This medication (elagolix, estradiol, and norethindrone acetate) is the first oral medication designed specifically for Fibroid HMB. In this session, we will review this new medication. (No financial disclosures to report). --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
June 15, 2020
In this session, we will conclude our summary of the new ACOG clinical expert series, “Female Sexual Dysfunction“. This episode will focus on specific treatments of each of the 4 different DSM5 categories of female sexual dysfunction. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
June 13, 2020
Human sexual response is a highly individual and emotional process. Sexual dysfunction is common among women and leads to personal distress. The ACOG has released a new “clinical expert series“ which currently is published ahead of print. In this session (Part 1), we will review the prevalence, risk factors, and DSM5 categories of female sexual dysfunction. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
June 10, 2020
Unlike fetal thrombocytopenia resulting from maternal ITP, fetal- neonatal alloimmune thrombocytopenia may occur earlier in gestation and can lead to in-utero fetal intracranial hemorrhage. The condition can be severe. In this podcast, we will review the presentation, diagnosis, and management of this potentially lethal fetal acquired condition. (ACOG Data 2019). --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
June 7, 2020
On June 1, 2020, the American Journal of Obstetrics and Gynecology released a new publication with surprising results related to maternal oxygen use in labor for Category II fetal heart rate tracings. Although we have covered this in some form in previous episodes, we will provide new up-to-date information on this subject. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
June 3, 2020
Medical information moves fast. Although the increased morbidity with fetal macrosomia has long been known, the ACOG has revised his practice bulletin on the subject (January 2020). In this session, we will review this updated practice bulletin. What’s the new data on exercise and fetal birthweight? Is operative vaginal delivery contraindicated in macrosomic infants? What about TOLAC with a suspected macrosomic infant? Let’s cover these topics, and more, in this session. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
May 29, 2020
According to the ACOG, “Given approximately 40% of postpartum hemorrhage occurs in low risk women, every woman giving birth is at risk for obstetric hemorrhage“. The ABOG has released the MOC list for May 2020. This includes the ACOG committee opinion 794. In this podcast, we will summarize and highlight the sentinel components of this committee opinion. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
May 28, 2020
Multiple societies and experts have weighed in on whether 2nd stage of labor warrants universal use of respirators (e.g., N95 masks) vs surgical masks. The ACOG/SMFM has petitioned the CDC for clarity on this issue. In May 2020, the AJOG published a new “clinical perspective“ in MFM which is pushing for use of 1 mask over the other. We will highlight this new development in this session. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
May 25, 2020
Some experts have called for universal screening of all patients admitted to labor and delivery. The foundation of this opinion is to decrease exposure to healthcare workers and identification of asymptomatic women for the prevention of horizontal newborn transmission. However, there are some potential negative implications of this proposal. In this podcast, we will review a soon to be released editorial (Torri Metz, MD) from Obstetrics & Gynecology (the Green Journal) on the pros/cons of universal testing in Labor & Delivery. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
May 24, 2020
Examination (macroscopic and microscopic) of the placenta can give valuable insights into the intrauterine environment. The College of American Pathologists has issued guidelines about when to submit a placenta for histological examination. In this session, we will review the “what, when, and whys“ of histological placental referral. We will also review abnormal umbilical cord insertion and it’s link to adverse obstetrical/neonatal outcomes. SHOUTOUT TO LAUREN (our podcast listener) for the podcast topic! --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
May 22, 2020
Does the ACOG endorse universal screening for thyroid disease in pregnancy? What about treating subclinical hyperthyroidism or subclinical hypothyroidism? And what about those pesky anti-thyroid autoantibodies? In this podcast, we will highlight the June 2020 ACOG Practice Bulletin (223) covering thyroid disease in pregnancy.
May 20, 2020
The benefit of antenatal corticosteroids in preterm infants was first reported in 1972, but it took 20 years for widespread adoption. Now, antenatal steroids are recommended by the ACOG up to 36 weeks and 6 days. However, a new study (JAMA May 2020) has raised concerns about steroid exposure in utero and possible behavioral and mental diagnoses in children up to age 5. These outcomes were significant for infants who were born full term. In this podcast, we will highlight this new study and summarize the editorial perspective in JAMA regarding this study. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
May 17, 2020
Information can be confusing regarding COVID-19. The WHO, CDC, ACOG, AAP all have slightly different recommendations based upon what topic you’re looking at. Is a patient with COVID-19 allowed to breast-feed? In this episode, we will review the CDC/AAP recommendations for breast-feeding regarding a patient under investigation or confirmed positive case. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
May 11, 2020
Sexual assault/rape is a devastating occurrence for all victims. Post exposure infectious disease prophylaxis has been expanded to include hepatitis B and HPV vaccinations. In this session, we will review the medical/vaccine regimens as post exposure prophylaxis after assault. We will also cover HIV prophylaxis. Are 3 anti-retroviral medications more effective than 2 for HIV prevention? The answer is in this podcast! --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
May 9, 2020
The ACOG/SMFM does not recommend bedrest in pregnancy for the prevention of preterm birth for women at risk, nor in multiple gestation, or management of hypertensive disorders. Does bedrest actually RAISE PTB risk? In this session, we will summarize updated information about the real physiological, psychological, and possibly OB adverse effects of bedrest in pregnancy. (NEW SMFM Consult Series #50). --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
May 5, 2020
Advances in 1st trimester aneuploidy screening have increased the need for early prenatal diagnostic testing. There are only 2 prenatal diagnostic tests : CVS and amniocentesis. In this podcast, we will review these procedures and rates of potential complications. We will also summarize the difference between microarray chromosomal analysis and conventional karyotype. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
May 3, 2020
On May 1, 2020, the FDA authorized the emergency use of Remdesivir for COVID-19. This was based on a preliminary analysis of an NIH clinical trial. However, information is still lacking on safety and efficacy in a larger study population. In this session, we will review the known mechanism of action of this novel antiviral medication and limitations of data. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
April 27, 2020
In May 2020, the ACOG will release a new committee opinion regarding tobacco/nicotine use during pregnancy. What are the risks of nicotine use during pregnancy? Are medications to assist smoking cessation in pregnancy endorsed by the ACOG? In this session, we will highlight and summarize this new committee opinion. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
April 25, 2020
In 2018, the ACOG stated that screening for bacterial vaginosis before gynecological procedures “can be considered“ as a way to reduce infection. However, in March 2020, a new expert review was published in the AJOG making a much stronger recommendation. In this session, we will review the publication from March 2020 from the American Journal of ObGyn highlighting this stronger recommendation to screen for bacterial vaginosis before gynecological procedures. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
April 24, 2020
Women with seizure disorders often have altered menstrual function, with or without anti-seizure medications. One anti-seizure medication has even been linked to the development of PCOS. Seizure disorders in reproductive age women can also influence contraceptive choice. Do you know what makes Lamotrigine unique? In this session, we will summarize the upcoming May 2020 ACOG committee opinion (806) focusing on gynecological care of reproductive age women with seizure disorders. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
April 19, 2020
Data on exercise during pregnancy and the postpartum period has evolved. For example, once considered relatively contraindicated, jogging during pregnancy is not prohibited. Does exercise cause preterm birth? What about exercise in women with pre-existing diabetes or hypertension? In this session we will cover the April 2020 committee opinion clarifying myths/misperceptions regarding exercise in the pregnant and postpartum patient. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
April 16, 2020
Maternal oxygen administration in labor has been used as a traditional tool for intrauterine fetal resuscitation. However, excluding times of maternal hypoxemia, the practice could actually be detrimental to fetal well-being. In this session, we will review data from the SMFM annual meeting from February 2020. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
April 14, 2020
Being deaf and blind in the late 1800s (and a female!) was a prime recipe for failure and poverty. However, one young woman beat incredible odds to change American history. During these uncertain times of COVID19, we can still learn from Ms. Helen Keller, and her proven formula for overcoming life’s challenges: self-motivation, and personal encouragement. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
April 12, 2020
Elmiron (pentosan polysulfate sodium) is the only oral FDA approved medication for interstitial cystitis/painful bladder syndrome. Initially approved in the late 1990s, recent evidence (within two years) has described a new medication associated ocular pathology: retinal maculopathy. In the journal Obstetrics and Gynecology, a new commentary will soon be released on this topic. In this podcast, we will review the data to date regarding this newfound medication concern. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
April 9, 2020
The AAGL and the RCOG have released position statements regarding the use of laparoscopy during this viral pandemic. Can surgical plume from energy devices transmit infection? Is laparotomy safer for the OR team? In this podcast we will highlight and summarize the position statements of these professional societies regarding non-elective surgical procedures during this viral pandemic. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
April 9, 2020
ARDS in pregnancy carries an increased rate of maternal and perinatal mortality. Specific respiratory physiological changes make care of the pregnant ARDS patient more complex than in the non-pregnant individual. Is temporary hypocapnia or hypercapnia more favorable? What about ventilation pressures? We will review maternal respiratory changes and ARDS care in this session (Source: SMFM Critical Care in Obstetrics). --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
April 2, 2020
The SMFM has just released new labor guidelines for SARS-CoV2 patients under investigation/confirmed COVID-19. This new practice guideline addresses oxygen use for fetal decelerations, amniotomy, labor epidural, HCW protection during 2nd stage of labor, as well as antenatal corticosteroids and magnesium sulfate. We will review these points in this session. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
March 30, 2020
COVID-19 MEMEs are plentiful across social media platforms. Cynical medical humor has been around for decades. This phenomenon was made public in the late 1970s with a book called, “The House of God“. What does the literature say about the pros/cons of dark medical humor? Is this helpful or detrimental? And, what does dark humor have to do with “mind medicine”? We will dive into these questions in this session! --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
March 29, 2020
Phenylketonuria is better known as Phenylalanine Hydroxylase Deficiency (PAH-D). This genetic condition can have significant implications for the reproductive age woman including adverse pregnancy outcomes and congenital fetal malformations. In April 2020, the ACOG will release a new committee opinion (802) on the management of women with PAH-D. What Maternal serum levels are optimal to prevent adverse obstetrical outcomes? Do these pregnancies require specific fetal evaluation? What are the other health implications of elevated phenylalanine levels? We will answer these questions more in this session. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
March 27, 2020
In April 2020, the ACOG will release a new committee opinion (803) on adolescent confidentiality and ObGyn. What is the difference between a “mature minor” and an “emancipated” minor? Can minors receive contraception without parental consent? What about emergency care? In this podcast we will highlight (and expand upon) very important points made in this new committee opinion. We will also address potential breaches of adolescent confidentiality due to the use of electronic health records. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
March 26, 2020
It doesn’t matter who you are, what your title/position is, or how physically strong you are, times of social distancing and quarantine can take a mental toll on everyone. Nonetheless, we have a non-prescription, powerful anti-depressant at our disposable. Medical science has proven that the act of gratitude can physically affect not only our mindset, but can physically alter our brain, and impact our overall health as well. In this podcast, will take a look at the data. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
March 24, 2020
On March 23, 2020, the SMFM released new guidance on OB ultrasound performance during COVID-19. This “suggested best practice” includes new information on logistics, repeat ultrasound examinations, antepartum surveillance, and cervical length determinations. In this episode, we will review this recent guidance release. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
March 24, 2020
The AHA has just released interim guidance for healthcare providers performing CPR on suspected or known COVID-19 patients. This guidance include the restriction on procedures that can generate aerosols (bag-valve masks, nebulizers, non-invasive positive pressure ventilation). This guidance is divided into pre-hospital/transport care, and hospital care. In this podcast we will summarize the AHA guidance adopted from the CDC. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
March 22, 2020
This current global viral pandemic has shed light on the value of telemedicine. The ACOG endorses the use of telemedicine for pregnancy care as a way to “enhance“ prenatal/antepartum services. In this podcast we will review an effective model for prenatal telemedicine services, review its implementation, and discuss barriers to use. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
March 20, 2020
March 20, 2020: Currently, we are in desperate need of some encouraging news. Social distancing, times of quarantine, and a viral pandemic can easily overwhelm the strongest of individuals. So, this is our inaugural podcast for MIND MEDICINE. In this episode we will cover 2 incredible stories of 2 physicians who overcame incredible odds by the power of their will to survive: Dr. Leo Rogozov and Dr. Viktor Frankl. Let the true accounts of these two remarkable individuals inspire you, encourage you, and prove to you that uncertain times can still be an opportunity for extraordinary survival. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
March 18, 2020
Anti-Mullerian Hormone is a useful predictor of ovarian reserve in women with infertility and may help gauge ovarian stimulation. However, are levels of AMH helpful in prediction of time to next pregnancy, future pregnancy loss, or PCOS diagnosis? In this session, we will highlight the ACOG committee opinion 773. This information is also part of the Q1 MOC article list distribution. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
March 18, 2020
Stay encouraged, focused, and passionate.
March 16, 2020
Even though we have covered this topic in a prior podcast, the urgent need for Hepatitis C screening in pregnant women still leads the medical literature. In the journal Obstetrics and Gynecology, a new current commentary will soon be released titled, “A call to action: the urgent need for hepatitis C screening in pregnant women“. In this podcast, we will summarize the key aspects of this current commentary, proving that despite the ACOG recommendation of using a risk-based model, that ACOG recommendation is now outdated. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
March 13, 2020
On March 12, 2020, the SMFM released a new statement and guideline concerning COVID-19 in pregnancy. This was to supplement, and expand the information previously released by ACOG (and covered in our earlier podcast). Does this infection cause a miscarriage? What about congenital anomalies? Do these patients require antepartum surveillance? And what about breast-feeding? We will cover these important questions in this session. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
March 12, 2020
Welcome back! In this session, we will cover the echogenic cardiac focus, short humerus and femur length, fetal pyelectasis, and single umbilical artery! --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
March 11, 2020
In this session, Part 1, we will review soft markers of aneuploidy and their management. Soft markers of aneuploidy can be isolated or multiple. They can be associated with chromosomal, genetic, infectious causes, or they can be normal variants. In this session we will cover: ventriculomegaly, choroid plexus cysts, absent/hypoplastic nasal bone, nuchal folds, and echogenic bowel. Data for this podcast comes from SMFM and AIUM. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
March 9, 2020
In the ACOG committee opinion (743) on low-dose aspirin in pregnancy, the College states that more data is necessary before low-dose aspirin can be recommended for the prevention of spontaneous preterm birth. However, that was in 2018. Data since then (including data from January 2020 from the NIH) is supportive of aspirin use for the prevention of preterm birth. What does this data look like? In this episode we will review the possible indication of low-dose aspirin for the prevention of spontaneous preterm birth.
March 7, 2020
Virtual reality is well-established in the gaming community, but data is expanding regarding its utility and effectiveness for a variety of medical conditions. In February 2020, at the annual meeting of SMFM, researchers released their findings on a randomized controlled trial using VR headsets for labor pain. In this podcast we will briefly review VR technology and its application for medical pain conditions including labor. (NOTE: No financial disclosures or other commercial interests in any VR device exist or were implied in the generation of this podcast).
February 28, 2020
Worried about airline travel amid global health concerns? Well, you’re not alone. What does the CDC say about airline infectious disease precautions? And what about air travel during pregnancy in general? In this podcast, we will review the CDC recommendations regarding viral precautions and highlight some key points from the ACOG committee opinion, 746, regarding air travel in pregnancy. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
February 25, 2020
Vulvar pain (vulvodynia) is subdivided into generalized or local. The symptoms can either be spontaneous or provoked. Vulvodynia can result in painful intercourse, and affect other quality-of-life measures. In this session we will review the diagnosis, subcategories, and management of vulvodynia. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
February 23, 2020
Pre-labor rupture of membranes should be diagnosed based on clinical assessment. In March 2020, the ACOG will release a new practice bulletin (217) on PROM. This bulletin highlights the potential hazards of over reliance on lab tests for the diagnosis, and offers a new management option for PROM in the late preterm interval. Are steroids contraindicated in the presence of suspected intraamniotic infection? We will take a look at the data in this session. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
February 21, 2020
Chronic pelvic pain has been redefined by the ACOG and includes a broader range of etiologies. There are 3 main categories of potential etiologies for chronic pelvic pain. In this episode, we will review the March 2020 practice bulletin ( 218) on the subject. What is the Carnett test? Do trigger point injections work? What is the role of SNRI medications in treating chronic pelvic pain? What about lysis of adhesions? We will address these questions and more in this episode! --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
February 16, 2020
On February 14, 2020, the ABOG released a “double credit“ article for MOC credit, on the global alert of the novel viral outbreak. Originally called 2019-nCoV, the 2019 Novel,Chinese Coronavirus is now called COVID-19. In this session, we will highlight/summarize the CDC current update and clinical guidance as released by the ABOG. We will also summarize the February 12, 2020 Lancet retrospective review of nine pregnant patients with COVID-19 pneumonia. Although this brief retrospective review has several obvious limitations, it adds to the ever evolving data on the subject. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
February 11, 2020
Cannabinoid Hyperemesis Syndrome: Although widely recognized in the gastroenterology and psychiatry literature, its occurrence in pregnancy is well known. The pathophysiology of this condition is not well known but potential MOAs have been published. How does this present? And what do “hot baths“/“hot showers“ have to do with his condition? In this podcast we will review this interesting and intriguing condition specifically as it relates to pregnancy. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
February 5, 2020
In 2013, actor Michael Douglas blamed frequent oral sex with his wife as a cause of his throat cancer. In the 17 years from 1999 through 2015, the mouth and throat replaced the cervix as the most common site of cancer associated with human papillomavirus (HPV) infection in the United States. What is a data show about vaginal to oral HPV transmission, and even oral to oral transmission? Does Gardasil have a role in prevention here as well? In this podcast, we were review published data on oral HPV transmission and trends of acquisition. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
February 3, 2020
Non-obstetric surgery during pregnancy happens. Historically, general surgical procedures were avoided in the first trimester because of fear of pregnancy loss; General surgery was avoided in the 3rd trimester because of fear of preterm birth. But are these fears real? New data say, “no“! Is external fetal monitoring recommended during these procedures? In this session, we will summarize and highlight one of the February 2020 MOC review articles on non-obstetric surgery during pregnancy. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
January 31, 2020
Malignant GTD includes choriocarcinoma, invasive mole, and placental site trophoblastic tumor. When is single agent chemotherapy indicated? What about multiagent care? What is the classification system for malignant GTD? In this episode we will review the diagnosis, work up, and management of this condition. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
January 30, 2020
Gestational Trophoblastic Neoplasia is a complex condition with various histological and clinical distinct entities. In this episode, we will review the benign variants of GTN, hydatidiform moles (complete and partial). We will review their clinical presentations, diagnosis, management, and follow up. Data for this podcast comes from the ACOG practice bulletin 53 as well as the SGO. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
January 27, 2020
Currently, the CDC does not recommend “routine screening” for extragenital gonorrhea or chlamydia in women, although it does make a recommendation for MSM or bisexual males. However, as most extragenital infections are asymptomatic, this is potentially missing a large reservoir of infection. In this episode, we will review the USPSTF and CDC screening guidelines and compared that to evolving prevalence data of extragenital STIs. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
January 24, 2020
Opioid use disorder (OUD) Is a national crisis. Pregnancy is not immune to OUD. Traditionally, methadone and buprenorphine have been used as medical treatments for this condition in pregnancy, with concerns about naltrexone (an opioid antagonist) use. In January 2020, a new prospective cohort study (AJOH) adds reassuring data on the safety and effectiveness of this medication option. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
January 18, 2020
Up to 30% of initial BV diagnoses will have a recurrence. Does partner therapy (male or female) help reduce recurrence? Most of the original data which stated “No”, is now outdated. Additionally, what is the data on vaginal Vit C for recurrence prevention? Does that actually work? Let’s examine both of these questions...now. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
January 16, 2020
Vaginismus is the involuntary tightening of pelvic floor muscles that surround the vagina; this can make penetration very painful, if not impossible. The DSM5 reclassified female sexual dysfunction into 4 main categories, with vaginismus fitting in the “penetration disorder“ group. What role does medical therapy play with this condition? Does physical therapy have a role? In this session, we will review the July 2019 practice bulletin from the ACOG (213) focusing specifically on vaginismus. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
January 13, 2020
In 2018, the Lancet released the AFFIRM trial. They reported a NONsignificant decrease in the stillbirth rate from 4.40/1,000 births in the control group to 4.06/1,000 births in the fetal movement counting intervention group. In February 2020, a new systematic review and meta-analysis reveals additional information on the clinical utility of maternal perception of fetal movement. Let’s review that data now. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
January 12, 2020
Currently, the ACOG and SMFM recommend a “risk-based” approach to HCV screening in pregnancy. HOWEVER, a soon to be published original article (February 2020) in Obstet Gynecol confirms that “The reported prevalence of maternal HCV infection has increased 161% from 2009 to 2017”. The IDSA has called for UNIVERSAL screening of HCV. In the session, we will review the Nov 2019 IDSA HCV screening recommendations and provide key points from the Rossi et al Feb 2020 Green Journal publication. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
January 9, 2020
Most studies on the risks of post menopausal hormone therapy have focused on the oral route of administration. Does the transdermal route of estrogen delivery reduce the risk of VTE? In this episode, we will review the ACOG committee opinion (556) and ASRM guidelines on the use of transdermal estrogen vs oral estrogen therapy.
January 7, 2020
Is vaginal E2 therapy safe in women with a history of breast cancer? What is the data regarding systemic absorption levels? Are you familiar with the recently FDA approved medication IMVEXXY? In the session, we will review the data behind the use of vaginal estrogen and vaginal, non-estrogen therapy for persistent genital atrophy symptoms in women with a current or past history of breast cancer. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
January 5, 2020
In North America, the median age of menopause is 51 years. Among women reporting menopausal symptoms, vasomotor and vaginal symptoms are the most closely associated with these hormonal changes. Can progesterone use alone relieve vasomotor symptoms? What about the use of testosterone? What is Intrarosa vaginal therapy? Does ospemifene increase endometrial a risk? In this session, we will answer these questions and review the medical management of menopause according to the ACOG practice bulletin 141. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
January 3, 2020
Up to 30% to 50% of infertile women have endometriosis, based on laparoscopic diagnosis. Endometriosis affects fertility through a variety of mechanisms. In this session, we will review the ASRM position statement on endometriosis related infertility: work-up and patient management. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
January 1, 2020
Infertility can affect up to 15% of all couples. Male factor infertility can account for up to 40 to 50% of cases, while in 30% of couples there may no identifiable etiology (unexplained infertility). This session, we will review the ASR M guidelines for the infertility evaluation. Is postcoital testing still recommended? What role does laparoscopy play in the infertility evaluation? We will answer these questions and more in this session.(ACOG CO 781). --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
December 30, 2019
BRCA1 & BRCA2 are tumor suppressor genes; mutations in either are transmitted in an autosomal dominant pattern. Loss of both copies of either BRCA1 or BRCA2 is just the 1st step in the process of potential carcinogenesis. In this session, we will review the pathophysiology of BRCA mutations and review the NCCN guidelines for breast and ovarian cancer screening. We will also review the surgical & chemoprophylactic management of the BRCA positive patient. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
December 28, 2019
Once considered pathognomonic for gonorrhea or chlamydia, Bartholin’s gland abscesses are now recognized to be polymicrobial. Is I&D alone 1st line therapy for a Bartholin’s abscess? What about Word Catheter use? Are there any alternatives to Marsupialization for recurrent cases? In this session, we will review the data behind diagnosis and management of this common gynecological condition. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
December 25, 2019
There are 4 types of single umbilical artery (SUA), based on pathogenesis. The incidence of SUA is up to 1% of all singleton fetuses, and up to 4.6% of twins. SUA can occur either as an isolated finding or as part of a congenital anomaly syndrome. In this session we will review the pathogenesis, identification of, fetal work-up, and patient management of SUA. Data from the SMFM, and ACOG. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
December 22, 2019
Methamphetamine and amphetamine use has greatly increased all throughout the United States. While similar to cocaine, it’s mechanism of action is quite unique and dangerous. In this session we will cover the pharmacology of amphetamines/meth and its affects on pregnancy. We will also cover some common every day medications which can actually test false positive for meth/amphetamines on toxicology screening. Data for this podcast come from the ACOG, SMFM, and the CDC. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
December 20, 2019
Interest in, and performance of, female cosmetic genital surgery increased 50% from 2014 to 2018. As close to 80% of US females have some degree of pubic hair removal, self awareness of vulvar variation is increasing. Although labial hypertrophy can be a true functional/medical concern requiring labial reduction, what about elective cosmetic genital procedures? In January 2020, the ACOG will release its updated committee opinion on this topic. These are important points to review as patients often seek “designer labioplasty“ or “vaginal rejuvenation“ from their gynecologist. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
December 17, 2019
Pregnancy-related venous thromboembolism is the most common cause of maternal death and a significant cause of maternal morbidity. The factor V Leiden (FVL) mutation is the most common known genetic factor that predisposes to thrombosis. How does obstetric management differ regarding a heterozygous or homozygous carrier? When should anticoagulation be used, and at what dose? In this session we will review data from the SMFM, RCOG, and the ACOG practice bulletin 197. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
December 12, 2019
The initial gynecological visit for an early teen/adolescent is crucial in establishing patient trust, education of gynecological health, and establishment of healthy personal and sexual behaviors. At what years should the first visit occur? What about patient confidentiality when dealing with minors? Is a clinical breast exam part of the adolescent screening exam? In this session, we will review the ACOG committee opinion (598) on the first gynecological visit. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
December 10, 2019
Commercial laboratories offering cell free DNA for fetal prenatal screening are offering microdeletion testing. Is this valid? Microdeletions are varied and include 22q and 15q syndromes. In this session, we will review the pathophysiology of microdeletions and review 22q and 15q conditions. What does the SMFM have to say about cell free DNA screening for these conditions? How is Angelman syndrome related to Prader –Willi condition? Let’s cover this now. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
December 7, 2019
The “ideal“ interpregnancy interval depends on the outcome of the immediate, prior pregnancy. For example, the recommended interpregnancy interval following a 1st trimester miscarriage is different compared to a live, term birth. But what about the interpregnancy interval after a stillbirth? Are the recommendations the same? In this podcast will review updated data from 2019 regarding interpregnancy interval following stillbirth. The reference for this podcast summary is Regan AK, et al; Lancet, April 2019. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
December 3, 2019
You find that there is a medical indication for a cesarean birth- yet the patient refuses! What are your next steps? Should you seek a court order to intervene? “Informed refusal” encompasses a complex, multifaceted, ethical dilemma. In this session, we will review some clear guidelines from the American Academy of Pediatrics, the ACOG, and the AMA regarding the management of this difficult situation. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
December 1, 2019
No! Julius Caesar was not born by cesarean birth. What does a pig-gelder in 1500 have to do with CS History? From Jacob Nufer to Munroe Kerr, we will walk down the path of the cesarean’s incredible history. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
November 29, 2019
Medicine: it’s an incredibly rewarding profession. The opportunity and ability to comfort and heal the sick is an absolute privilege. BUT...if you are not careful, that wonderful of all professions can consume you, and may devour you. Two theories have been proposed to explain this: Burnout, and Moral Injury. But are these 2 separate conditions? How does the issue of mindset (fixed or growth) apply? In the session, we will review the latest (as of December 2019) on this ever evolving issue. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
November 25, 2019
In December 2019, the ACOG will release committee opinion 794 covering quantitative blood loss in obstetrics. Does QBL use ALONE improve clinical outcomes? The answer may surprise you! Nonetheless, there is great value in utilizing obstetric hemorrhage toolkits/bundles such as the California Maternal Quality Care collaborative strategy. In the session, we will review the use of QBL in practice in why having it as part of a larger toolkit helps reduce maternal morbidity and mortality. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
November 22, 2019
Breast-feeding mastitis is a common occurrence and a source of disruption of breast-feeding and negatively affects quality-of-life. In this session, we will review the Academy of Breastfeeding Medicine’s treatment protocol for the condition. When is abscess identification required? What about drainage? We will answer these questions and more in this episode! --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
November 20, 2019
Obesity is a known modifiable risk factor for complications of pregnancy- both antepartum and intrapartum. Data has confirmed a direct link/risk of stillbirth with obesity. In this session, we will review the data on this link as well as the effect of gestational age on the risk of stillbirth. We will also briefly review the ACOG practice bulletin on gestational diabetes and how this may relate to obesity’s risk of stillbirth. This podcast will also summarize the (conflicting) data on elective induction of labor at term as an attempt to reduce the risk of stillbirth in the obese population. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
November 17, 2019
Periviable birth is defined as delivery occurring from 20 0/7 weeks to 25 6/7 weeks of gestation. When is the earliest time to consider antenatal steroids for fetal lung maturation, and what about magnesium sulfate for neuroprotection? When should tocolytics be utilized? And when is the earliest just stational age to consider a C-section for fetal benefit? In this session, we will cover these questions according to the ACOG consensus statement #6. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
November 14, 2019
MTHFR... Yep, it gets blamed for a variety of health and pregnancy concerns. But does the data actually confirm the presence of adverse pregnancy and adverse health issues with MTHFR variants? In this session, we will review the difference between the 2 most common variants (C677T, A1298C) and true MUTATIONS. We will also review statements from the ACOG, ACMG, SMFM, as well as the Canadian Guidelines regarding MTHFR screening. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
November 7, 2019
Persistent cough, congestion, low-grade fever… Yep, typical symptoms of acute bronchitis! The CDC and the American College of Physicians have published guidelines on antibiotic stewardship regarding acute bronchitis. When are antibiotics indicated? What about beta-agonist therapy? Do mucolytics work? In this podcast we will review the presentation, etiology, and treatment algorithm of this common clinical diagnosis. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
November 3, 2019
“Never events“, “Sentinel events”, and “Near misses”. These terms strike fear in any healthcare provider! The National Quality Forum, the Agency for Healthcare Quality and Research, and the Joint Commission, all have stressed the importance of patient safety in the operating room and medical wards. In this podcast we will review alarming statistics regarding preventable medical errors, and remind ourselves of ways to keep patient safe. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
October 31, 2019
That’s right… We’re talking about vaginal lubricants! In general, there are 3 main categories: water-based, silicone based, and oil based. Each has their own advantages and disadvantages. Some lubes can actually place the patient at risk of pregnancy if used with a latex condom! In this podcast, we will cover the “lube library“ so that we can better inform our patients since education is key! --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
October 28, 2019
Mirror syndrome (first described in 1892) is another term for what is also known as Ballantyne Syndrome or triple edema. Maternal mirror syndrome is a rare consequence of fetal hydrops. By convention, delivery is recommended in pregnancies complicated by mirror syndrome due to grave fetal prognosis. Severe maternal morbidity has also been described. In this session, we will review the clinical presentation, similarities to preeclampsia, and management of this grave complication. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
October 25, 2019
On October 25, 2019, the American Journal of Perinatology published the results of the PROLONG Trial. This study demonstrated no statistical difference in the co-primary outcome of preterm birth less than 35 0/7 weeks of gestation (P = 0.72) and neonatal composite index (P = 0.73) with 17-OHP use. Similarly, the rate of preterm birth less than 37 weeks and less than 32 weeks were not different. On October 25, 2019, the ACOG released a practice advisory about this. Let’s summarize this now. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
October 25, 2019
The rate of sepsis appears to be increasing. Maternal sepsis is a significant cause of maternal morbidity and mortality. Sepsis is not a specific illness, but a syndrome that includes Oregon dysfunction caused by this regulated host response to infection. In this session we will review the SOFA score and it’s utilization. Is fever necessary for a diagnosis of sepsis? Which antibiotics should be used? What is the rate of IV fluid resuscitation? Are steroids contraindicated in the septic patient? We will answer these questions and more in this episode which summarizes the SMFM expert series #47, sepsis in pregnancy. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
October 22, 2019
N2O is a nonflammable, tasteless, odorless gas. It was first synthesized by the English scientist and theologian Joseph Priestly in 1772, and was first used as a labor analgesic by Stanislav Klikovich in Poland in 1881. Although much more frequently used in the UK and Canada, interest in nitrous oxide for labor pain management is increasing in the USA. What is its mechanism of action? Is it effective? What are the contraindications? Let’s review this topic...NOW. --- This episode is sponsored by · Techathlon Podcast: The Techathlon podcast is a weekly podcast that catches you up on the latest tech news through games, trivia, and (usually) friendly competitions. https://open.spotify.com/show/1HRe3KlPaYUVgs1zTcsztO?si=7f0rYgqhQ5WUmFbpwdKXZw · Anchor: The easiest way to make a podcast. https://anchor.fm/app
October 20, 2019
Universal thyroid screening in pregnancy is a key debate in endocrinology and obstetrics. While some countries advocate universal screening, the UK and USA adopt a “high-risk” based strategy. ACOG’s Practice Bulletin 148 (April 2015) keeps its recommendation to NOT perform routine screening for thyroid disease in pregnancy. BUT, should we screen for thyroid abnormalities universally? This podcast will review the pros and cons and make a push for once stance over the other. --- This episode is sponsored by · Techathlon Podcast: The Techathlon podcast is a weekly podcast that catches you up on the latest tech news through games, trivia, and (usually) friendly competitions. https://open.spotify.com/show/1HRe3KlPaYUVgs1zTcsztO?si=7f0rYgqhQ5WUmFbpwdKXZw · Anchor: The easiest way to make a podcast. https://anchor.fm/app
October 18, 2019
Fetal Tachycardia (FT) is described as increase in baseline fetal heart rate (FHR) above 160bpm, for longer than 10 minutes. In clinical daily practice, management of mild-moderate uncomplicated tachycardia can be challenging because clinicians do not have clear guidelines for intervention in cases of uncomplicated fetal tachycardia (in the absence of maternal pyrexia or decelerations) in cases where tachycardia has not resolved with conservative measures like left lateral tilt, hydration and pain control have been explored. In this session, we will review the etiology of fetal heart rate tachycardia and review intrapartum management. --- This episode is sponsored by · Techathlon Podcast: The Techathlon podcast is a weekly podcast that catches you up on the latest tech news through games, trivia, and (usually) friendly competitions. https://open.spotify.com/show/1HRe3KlPaYUVgs1zTcsztO?si=7f0rYgqhQ5WUmFbpwdKXZw · Anchor: The easiest way to make a podcast. https://anchor.fm/app
October 15, 2019
With normal pregnancy, blood volume increases, which results in a concomitant hemodilution. Although red blood cell (RBC) mass increases during pregnancy, plasma volume increases more, resulting in a relative anemia. This results in a physiologically lowered hemoglobin (Hb) level, hematocrit (Hct) value, and RBC count, but it has no effect on the mean corpuscular volume (MCV). However, in women who are iron deficient, this problem is exacerbated due to low iron stores affecting the body’s ability to increase red blood cell production. Iron deficiency is the most common pathologic cause of anemia in pregnancy. Does IDA result in adverse maternal or neonatal outcomes? The data is more controversial than you would suspect. In this session, we will review the data regarding the impact of iron deficiency anemia on maternal neonatal outcomes. --- This episode is sponsored by · Techathlon Podcast: The Techathlon podcast is a weekly podcast that catches you up on the latest tech news through games, trivia, and (usually) friendly competitions. https://open.spotify.com/show/1HRe3KlPaYUVgs1zTcsztO?si=7f0rYgqhQ5WUmFbpwdKXZw · Anchor: The easiest way to make a podcast. https://anchor.fm/app
Loading earlier episodes...
    15
    15
      0:00:00 / 0:00:00