Parhaat Dr Pearl Podcastit (2024)

1
Take Aspirin to Prevent PP HTN? 42:41

6h ago42:41

42:41

Low-dose aspirin (LDA), typically prescribed at a dosage of 81 mg daily, is primarily used during pregnancy to prevent or delay the onset of preeclampsia. However, the question of whether to continue LDA postpartum is less clear and requires careful consideration of the benefits and risks associated with its use in the postpartum period. After all,…

1
The Controversy of Cerclage and PPROM 32:12

4d ago32:12

32:12

Somethings in medicine are pretty cut and dry. Others...not so much. Such is the case with obstetrical management of PPROM with a cervical cerclage in place. Should it be removed, or left in place? While the ACOG has some guidance from March 2020, there has been additional publications released, including one from SMFM. PLUS, a November 2024 review…

1
2025 SFP Statement on BC and Body Weight 32:15

8d ago32:15

32:15

In late 2024, the CDC updated their MEC on contraception in those with medical co-morbidities. Obesity (BMI >/= 30) was also referenced in that revision. NOW, coming out officially in 2025, The Society of Family Planning has released their committee statement on "contraception and body weight". Is there a certain BMI class where a type of BC is con…

1
Fetal RHD Positive, Yet RH Blood Type Negative at Birth? YEP. 36:07

10d ago36:07

36:07

We have made SIGNIFICANT progress in our ability to screen for fetal RH factor using cell free DNA from maternal blood. Cell-free DNA to determine the fetal RHD genotype from the maternal circulation was first described in 1993. We have come so far since them. In March 2024, the ACOG released a Practice Advisory stating, “the use of NIPT to priorit…

1
Best ASA Admin Time? YEP, there IS one. 36:36

13d ago36:36

36:36

The saying says, “The Devil is in the details”. This idiomatic phrase that means even the grandest project depends on the success of the smallest components. So is the case with low dose ASA for preeclampsia prevention. Currently, the ACOG states, “Low-dose aspirin (LDA) (81 mg/day) prophylaxis is recommended in women at high risk of preeclampsia a…

1
BRAND NEW USPSTF Recs (12/10/24) on HPV Screening 32:34

15d ago32:34

32:34

EVERYTHING CHANGES! So true. And now, the USPSTF has changed (UPDATED) their recommendations for cervical cancer screening in regards to HPV primary screening. This is BRAND NEW, within the last 24 hours. Primary HPV screening for cervical cancer has gained a lot of steam and is progressing quickly. The FDA approval of “dual stain” testing of hrHPV…

1
Episode: OB Sono “Issues”: 2 for 2. 48:06

18d ago48:06

48:06

Well, in this episode we have 2 very interesting andchallenging clinical situations. These come from real world clinical encounters so we thought we would share these with you because they are brain teasers and should be discussed. They both have to do with OB ultrasound. First, is there a“minimal” CRL to estimate gestational age? In other words, i…

1
NEW DATA: Acetaminophen in OB=ADHD & ASD! (Not So Much.) 27:08

21d ago27:08

27:08

Acetaminophen (Paracetamol) is a common over-the-counter medication that has gained substantial media attention regarding its use by pregnant women. Although estimates vary considerably, most studies and surveys report that around 40–65% of women take acetaminophen sometime during their pregnancy. Historically considered safe, concern was initially…

1
Another Nail in the 81mg ASA Coffin? Move to 162mg? 35:16

25d ago35:16

35:16

In November 2013, ACOG issued the Hypertension in Pregnancy Task Force Report recommending daily low-dose aspirin (81mg) beginning in the late 1st trimester for women with a history of early-onset preeclampsia and preterm delivery at less than 34 0/7 weeks, or for women with more than one prior pregnancy complicated by preeclampsia. The following y…

1
The Fertility Anxiety Panic: Freeze Eggs in 20s? 37:39

29d ago37:39

37:39

The first successful births from frozen eggs were twins, born in Australia in 1986. IVF serves a valuable role for those with persistent infertility issues or other conditions where natural conception is hindered. Although oocyte cryopreservation was initially used as a fertility preservation strategy for medical indications, currently, it is incre…

1
Avoiding Sex While Pregnant, To Avoid Pregnancy? And MORE! 9:50

1M ago9:50

9:50

Introducing one of our Senior Residents, Dr. Mauldin: Dr. Mauldin just told me of a real patient encounter she had just today, that I felt we HAD to share with everyone. This real encounter is WHY we are passionate about EVIDENCE-BASED medicine! PLUS, we will introduce our NEXT episode which will focus on "elective egg harvesting and freezing" for …

1
Chewing Gum to Prevent Preterm Birth! Maybe. 31:37

1M ago31:37

31:37

In the United States, more than 400,000 babies are bornprematurely each year, which is about 1 in 10 babies. Over the last several decades, multiple studies have shown a link between poor oral health and increased occurrence of preterm birth. Researchers have looked at various waysto improve dental health during pregnancy, including doing a “deep-t…

1
Understanding Dual Stain in HPV Triage (ASCCP 2024 Update) 30:58

1M ago30:58

30:58

The U.S. Preventive Services Task Force and the World Health Organization recommend primary HPV screening, starting at age 25, as an option (some as preferred) for cervical cancer screening. Although primary HPV screening is as effective as cotesting at detecting cervical cancer, primary HPV screening decreases the number of lifetime screenings nee…

1
New Data: Vaginal Estrogen Use in Breast CA Survivors 32:18

1M ago32:18

32:18

With an estimated 3.8 million breast cancer survivors in the United States, OBGYNs and other women's healthcare providers often are on the front lines of addressing survivorship issues, including the hypoestrogenic-related adverse effects of cancer therapies or early menopause in survivors. Although systemic and vaginal estrogen are used widely for…

1
Steroids & Studies & "Shared-Decisions": Oh My! 26:28

1M ago26:28

26:28

Yep! We have definitely covered the evolving saga and controversy regarding antenatal corticosteroids in the late preterm/early term interval. It's like Dorothy in the Wizard of Oz: "Lions and Tigers and Bears, Oh My!" More fitting for our discussion, its "Steroids, and Studies, and Shared-Decisions, Oh My!" In this episode we will highlight TWO pi…

1
A Mini-Plethora of ObGyn News 40:49

1M ago40:49

40:49

Well, in the last 4 weeks there have some interesting developments in the sphere of OBGYN medical news. In October 2024, out of the American Society of Anesthesiologists, came a study on the possibility of using serum FAR to predict preeclampsia with severe features in admitted patients (don’t worry, we’ll discuss what FAR is!). PLUS, some exciting…

1
Was the ARRIVE Trial an IOL Mandate? (New ACOG CPU) 29:45

2M ago29:45

29:45

The ARRIVE was published in the New England Journal of Medicine on August 8, 2018 1. This study was a large unmasked multicenter trial conducted from March 2014 to August randomized 6,106 nulliparous women to either IOL or expectant management at full term. The trial was conducted at 41 facilities across the United States. This validated that eIOL …

1
New Data for UTI in Women 41:22

2M ago41:22

41:22

Urinary tract infections (UTIs) are a leading cause of health care visits in the USA and around the world. In the US, they have a cost burden of $3.5 billion annually. Half of women experience at least one UTI in their lifetime, and approximately 25% of these women develop recurrent UTIs! On October 31, 2024, a study was published in Obstetrics Gyn…

1
Does OB Superficial Thrombophlebitis (SVT) Need LMWH? YES, and NO. 33:55

2M ago33:55

33:55

Everyone understands that VTE (DVT and/or VTE) requires life-saving anticoagulation. That's simple. No controversy there. But what about pregnancy-associated superficial thrombophlebitis (AKA superficial venous thrombosis) in an extremity? Does that need anticoagulation? We have been traditionally taught that superficial venous issues are benign an…

1
24-28 Hour Post-CS Discharge: New Data 29:04

2M ago29:04

29:04

According to the UK’s National Institute for Health and Care Excellence (NICE; 2024), women who are S/P scheduled CS and recovering well, who are afebrile, and do not have complications, should be discharged early (after 24 h) and followed at home because this is not related to the readmission of the baby or mother. However, the first 24 hours afte…

1
Q&A: ABRYSVO® Every Pregnancy? Clitoxin™? 41:51

2M ago41:51

41:51

Welcome Back to another episode of "You ask, We Answer"! As Abrysvo (RSV vaccine) now has some time on the market, some women may find themselves with a subsequent pregnancy after first receiving the injection in the prior pregnancy. Is another RSV vaccine recommended with each pregnancy, like TDap? The answer to that question depends on where you …

1
Can Placental Volume on Sono Predict IUFD? 51:03

2M ago51:03

51:03

Ultrasound assessment of placental volume has been proposed as an important aspect of prenatal care. It involves measuring the size and volume of the placenta, which may provide critical information regarding fetal health and development. Abnormal placental volume can be associated with various complications such as FGR, preeclampsia, and other pre…

1
New AHA/ASA 2024 Guidance: WH Focus 27:38

2M ago27:38

27:38

Stroke is also a leading cause of adult-onset disability; among individuals who survive 6 months, almost half are dependent in at least 1 activity of daily living. In October 2024, the AHA/ASA released their 2024 Primary Prevention of Stroke guidance. This document has a striking focus on women's health, namely adverse pregnancy outcomes and certai…

1
The Enigma of Endo and Early Birth 33:29

2M ago33:29

33:29

Several observational studies have suggested that women with endometriosis have a slightly increased risk for preterm birth. The cause seems to be related to factors associated with pathogenesis of endometriosis, such as inflammation, reactive oxygen species, progesterone resistance, and alterations in the junctional zone of uterus leading to the s…

1
Insulin Initiation Made Easy 47:00

2M ago47:00

47:00

In November's Green Journal, Drs Amy Valent and Linda Barbour will publish their Clinical Expert Series (CES) on insulin management in GDM and Type 2 DM in pregnancy. This is a FANTASTIC document and is our subject matter in this episode. Here, we will give clinical pearls for insulin initiation in pregnancy based on 3 regimens (NPH/Reg; NPH/RAAs; …

1
The OCP Makes You Gay? 24:10

2M ago24:10

24:10

The relationship between hormonal birth control and sexual orientation has been a topic on social media channels and threads; it is a discussion of controversy. It is essential to clarify that the hormonal birth control pill itself does not determine or change an individual's sexual orientation. While there is evidence to suggest that hormonal birt…

1
Miso for EPF With Prior CSs? 37:15

2M ago37:15

37:15

Early pregnancy failure (EPF), pregnancy loss in the first trimester, is a common pregnancy complication, with 15 to 20% of clinically recognized pregnancies ending in the first trimester. It is not uncommon for women with one or more cesarean sections, or myomectomies, to present with EPF. Options for treatment of early pregnancy failure include e…

1
RPL with APS: When to Start RX 34:02

2M ago34:02

34:02

The SMFM, ACOG and RCOG all recommend screening for Antiphospholipid Antibody Syndrome (APS) in women with Recurrent Pregnancy Loss (RPL). However, once identified, there has been controversy historically regarding the best TIME to initiate low dose aspirin and prophylactic LMWH. The main controversy regarding this is whether to begin treatment bef…

1
CHS in pregnancy (Updated Data) 40:34

3M ago40:34

40:34

Cannabinoid Hyperemesis Syndrome (CHS): Yep, this is definitely an issue and has been in recent print. This was just covered in an expert commentary in J Gastroenterology in May 2024, and CMS was featured as a JAMA Patient Page on October 10, 2024 in JAMA Network. PLUS, we actually covered this back in Feb 10th, 2020! Yep…M-O-R-E information just k…

1
Dehydration Causes OB Contractions? YES, and NO. 44:39

3M ago44:39

44:39

Proper hydration is important for physiology whether male or female, and if female… hydration in pregnancy is important for proper uterine blood flow and proper amniotic fluid production. Interestingly, water recommendations do not specify differential water needs or hydration status recommendations by pregnancy month or trimester, nor do they take…

1
Dupixent Use in Pregnancy: Sept 2024 Data 31:48

3M ago31:48

31:48

Eczema is also known as a form of Atopic Dermatitis (AD). Males and females are not equally affected by AD, and studies have shown that AD is more common among males during infancy and childhood. However, around puberty, there is a shift towards more females than males having AD and this female predominance continues into adulthood. Eczema can impa…

1
Pump the Brakes on "ROUTINE" IV Fluids in Labor (SMFM ALERT) 18:47

3M ago18:47

18:47

Hurricane Helene has caused massive devastation for a part of the US, and now we are bracing again for Milton, set to affect Florida within the next 24 hours. Baxter, one of the country's leading manufactures for IV fluid bags has closed its plant for an unknown amount of time as it was affected by Helene. On October 4, 2024, the SMFM released a ne…

1
The Pregnancy “One-Stop Shop”: Screen for BRCA1? HPV Vacc PP? 40:09

3M ago40:09

40:09

BRCA1 mutations dramatically increase the lifetime risk of breast, ovarian, pancreatic, and other cancers, yet most BRCA1-positive patients are not identified until after they have been diagnosed with cancer. At prenatal visits, women often undergo obstetrical prenatal carrier screening that can identify hundreds of genetic mutations which can be p…

1
'Lil Convo With the (ACOG) Prez! 12:51

3M ago12:51

12:51

Podcast family, this episode comes to you NOT FROM THE STUDI, but was recorded LIVE at the ACOG Annual District Meeting (District XI in Texas). This episode is a "lil convo" with Dr. Stella Dantas, our current ACOG President. This is a brief, light-hearted, yet POWERFUL message to encourage you, lighten your day, and make you smile. PLUS, Dr. Danta…

1
Bed Rest for FGR? Surprising 2024 Data 32:10

3M ago32:10

32:10

The ACOG defines Fetal Growth Restriction (FGR) as fetuses with an estimated fetal weight or abdominal circumference that is less than the 10th percentile for gestational age. Currently, the ACOG, SMFM, FIGO, and the ISUOG do not recommend maternal bed rest for this condition. However, a recent publication from the AJOG (May 2024) concluded that st…

1
Use 130/80 Cut-off in OB? Depends! (CHIP, CHAP, & CLIP). 52:30

3M ago52:30

52:30

In the ACOG practice bulletin 203, the ACOG states that, “Traditionally, the diagnosis of hypertension (HTN) in pregnancy has been 140/90, on 2 occasions at least 4 hrs apart“. The keyword there is… “Traditionally”. In 2017, the ACC/AHA redefined hypertension with Stage I HTN being 130/80. Do some societies recommend the use of this lowered blood p…

1
D-MER: Breastfeeding's Ugly Side 34:25

3M ago34:25

34:25

Dysphoric Milk Ejection Reflex (D-MER) is an abrupt emotional "drop" that occurs in some women just before milk release and continues for not more than a few minutes. Although research is still evolving, one study Published in 2019 (Breastfeeding Medicine) states that up to 9% of breastfeeding women may experience dysphoric milk ejection, although …

1
It's a Small World 17:21

3M ago17:21

17:21

Podcast Family, every once in a while we need a little reminder that we are all wired for community. Despite differences in geographic locations, cultures, and family history, we really do have a lot in common. In this episode, I'll share with you 3 examples which prove that we really do live in a very small world. I hope this brings a smile to you…

1
Does LNG-IUS Increase Breast CA? 37:34

3M ago37:34

37:34

The LNG-IUS has been on the U.S. market since 2001. Since 2005, there have been several studies examining the association (if any) of LNG-IUS users and the diagnosis of breast cancers. This is a controversial and conflicting story. In this episode, we will highlight a soon to be released publication (OCT 2024) from the AJOG looking into this relati…

1
Labor Hacks? Pit Breaks, Propranolol, & Calcium 42:38

3M ago42:38

42:38

We all what to win in life, right? That’s why we have life hacks…to beat the system. Sometimes those tricks are tremendously successful while some other random hack can be- well, just WACK. Such is the case for LABOR HACKS! We all want our inductions and augmentations of labor to be successful, and there have been some labor hacks promoted througho…

1
New Meta-Analysis on Immediate PP GTT (Sept 19, 2024) 31:58

3M ago31:58

31:58

On May 22, 2024, we summarized a then soon-to-be-released ACOG CPU on Screening for GDM in Pregnancy and Postpartum. That CPU was officially released July 2024. That update endorsed the possibility of immediate postpartum GTT testing with a 75-gram OGTT. Now, on September 19, 2024, authors from UT Houston have published a systematic review/meta-ana…

1
The "Tradition" of 24-Hrs PP MagSo4 46:04

3M ago46:04

46:04

Magnesium Sulfate for preeclampisa can be traced back to the work of Horn in 1906! Yet, despite such a long history of use, there are still questions about mag sulfate use that we just don’t have good answers for, and that’s indicative of the all the continued articles and commentaries on the subject that are still being released. For example, ther…

1
Alpha-Gal Syndrome in Pregnancy 44:57

3M ago44:57

44:57

Filet Mignon, Pork Loin, Rib-Eye….all delicious (unless you are vegetarian)! If you are a meat- eater, be aware of AGS. Alpha-gal syndrome (AGS), also known as Red Meat Allergy, is a potentially life-threatening allergic reaction that can occur after a tick bite from a Lone Star tick or other tick species. While clustering within the US, Alpha-gal …

1
NEW SPECIAL REPORT: FDA SAFETY NOTICE for Veozah 21:21

3M ago21:21

21:21

Today, 9/12/24, the FDA released a SAFETY COMMUNICATION regarding Veozah. As you may recall, we have been following this novel medication since March 2023. This episode is NOT our regularly planned episode- that topic will come out as scheduled tomorrow AM 9/13/24! This is a SPECIAL REPORT episode in response to the FDA's communication released tod…

1
New CPU from ACOG (9/10/24): RH IG Under 12 weeks 24:26

4M ago24:26

24:26

Back in January 2024, we summarized the SFP's position statement on RH IG use (or rather non-use) under 12 weeks IUP gestations. Then, in February 2024, we released an episode summarizing the more conservative stance from the SMFM. Well now, 7 months after that episode, we have a new Clinical Practice Update from the ACOG on this very issue. That i…

1
ONE MORE Random Question/Specific Answer: ABX with Bakri? 46:59

4M ago46:59

46:59

In our last episode we tackled random questions with specific answers. After that episode went live, one of our nurses asked about the value of antibiotics with a Bakri balloon in place. This conversation happened as we were placing the balloon for PPH in a patient on Mag-Sulfate for Preeclampsia with Severe Features. That's antibiotic question is …

1
Random Questions: Specific Answers! 37:01

4M ago37:01

37:01

Welcome to this episode of "Random Questions: Specific Answers"! In this episode we will (surprise) answer random questions- with specific answers- from our podcast family members: 1. Can administration of IV Calcium at intrapartum CS reduce QBL?, 2. What are the 4 classes of CS performance urgency? and 3. If a normal MVP for amniotic fluid is 2-8c…

1
The REFEREE: MORE SSRI and PTB Info (Sept 2024) 16:45

4M ago16:45

16:45

on 09/02/2024, we released an episode called, "Do SSRIs Raise PTB Risk?". In that episode, we highlighted a new publication from the AJOG (August 30. 2024) which indicated that SSRIs may raise PTB risk. This is in contrast to a separate cohort study released Feb 2024. This is a classic case of "He Said, She Said". But now we have a REFEREE on the f…

1
Failure Rates S/P Tubal Sterilization: NOT What we Thought. 34:59

4M ago34:59

34:59

Tubal sterilization goes back to the 1880s. The first collaborative review of sterilization effectiveness was the CREST study published in 1996 in the AJOG. But that was with prior sterilization techniques. As a way to update the data researchers looked at the national survey for family growth (NSFG) from 2002 to 2015 to determine failure rates aft…

1
Do SSRIs Raise PTB Risk? 40:17

4M ago40:17

40:17

Depressive disorders during pregnancy are common, with estimated prevalence ranging from 11% to 16%. Accordingly, antidepressant drugs, most commonly selective serotonin reuptake inhibitors (SSRI), are used by approximately 3–4% of pregnant women worldwide, with a higher prevalence in the United States compared to Europe. As antidepressants cross t…

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