The ACOG released Clinical Consensus #4 in August 2023, covering Urinary Track Infections in Pregnancy. Urinary tract infection (UTI) is one of the more common perinatal complications, affecting approximately 8% of pregnancies. These infections represent a spectrum, from asymptomatic bacteriuria, to symptomatic acute cystitis, to the most serious, pyelonephritis. In this episode we will summarize some the key points from this monograph, and we will tackle 3 common myths/misperceptions related to OB Pyelonephritis. Are most people who claim a PCN allergy truly allergic? Can an anaphylactic PCN response decrease over time? What antibiotic is recommended for OB Pyelo if patients do have a real anaphylactic PCN history? Can OB Pyelo present without fever? Listen in and find out.

The age at which couples have children in the United States continues to increase. While it is well documented and known that maternal age directly impacts fetal and child outcomes, less attention has been given to advanced paternal age (APA). Medical and Genetic commentaries have stated that limited APA principles have been advocated for or disseminated into the medical communities and the general population. There may be considerations for the development and application of a couple-centered strategy counseling on age-related genetic risks. Is APA a real issue? What age defines that? And what has APA been associated with? Listen in and find out!

A quick clarification about Beyfortus neonatal protection against RSV. Thank you Katie for bringing this to my attention! What a wonderful podcast community we have. ❤️❤️❤️

We have been following this developing story on the Maternal RSV vaccine, Abrysvo. In the recent podcast, we stated that we would let you know when the ACOG releases its “Practice Advisory”, which is its clinical guidance update. This is now out! In this episode will provide the summary, high-yield points regarding this vaccine’s use in pregnancy. Can this be co-administered with other vaccines? What did ACOG say about the preterm birth “numerical imbalance” among study trial participants who received this vaccine? And which option provides a stronger and longer lasting immune response in the child: maternal vaccination, or newborn vaccination? Listen in and find out.

Low Dose Aspirin has been a routine aspect of preeclampsia prevention since first mentioned by the ACOG’s Hypertension in Pregnancy Task Force report, back in November 2013. Since that time, there has been several revisions of the criteria of who qualifies for low-dose aspirin in pregnancy. Nonetheless, there are calls and expert opinions challenging this “risk factor based” approach, favoring a more universal adoption. Additionally, the DOSE of low-dose aspirin has also come under recent critique. Is 81 mg the correct dose to use? Does aspirin have the potential to reduce preterm birth? In this episode, we will review a soon-to-be released clinical commentary from the AJOG (October 2023) which addresses these matters.

According to the CDC’s press release from September 2022, the leading underlying causes of pregnancy-related death include mental health conditions (including deaths to suicide and overdose/poisoning related to substance use disorder), accounting for 23% of cases. The top 2 perinatal, mental health conditions are anxiety and depression. And, although much more rare with an incidence of 1–2/1,000, postpartum psychosis is a major cause of self-harm an infant harm. In this episode, we will review “The College’s” recent clinical practice guidelines on mental health therapies in the perinatal interval. Do you know which 2 classes of medications are most preferred for treating anxiety/depression in the perinatal period? Are SSRIs a leading cause of PPHN? Is Lithium allowed in pregnancy? And what is “neonatal adaptation syndrome”? We will cover all these questions, and more, in this episode.

It’s pretty standard of an evaluation… TVUS for postmenopausal bleeding. It’s well accepted that an endometrial thickness of 4 mm (5 mm in some studies) should trigger further endometrial tissue analysis in women with postmenopausal bleeding. But is there a cut-off endometrial thickness at which endometrial tissue should be evaluated in a postmenopausal patient WITHOUT bleeding, where this was found incidentally? There is definitely an evidence-based recommendation, and we will cover that in this episode.(With a special guest host 😊…. “Anything for SELENAs”)

Welcome to our “OB Smorgasburg” episode, where we have a CORNUCOPIA of topics. Well, maybe not a full cornucopia… But a mini-cornucopia. In this episode, we will address 2 recent publications that really are my “pet peeves“ about medical data! One is from the US Preventive Service Task Force, and the other has to do with “timed intercourse”. You have to listen to this! Then we will get into new data regarding the association of 1 abnormal glucose value on the 3 hour GTT with adverse neonatal outcomes. And lastly, is there such a thing as “organic” 50 g glucose challenge? Let’s get into all this information…Now!

Universal, weekly (surveillance) laboratory screening for expectant management of Hypertensive Disorders in Pregnancy has been routine practice since the release of the ACOG’s Hypertension in Pregnancy executive summary in November of 2013. This plan of care was also recommended in the ACOG Practice Bulletin 222 focused on Gestational Hypertension and Preeclmapsia. But does this actually help prevent maternal morbidity? Does routine weekly lab surveillance, detect worsening disease over clinical presentation alone? In this episode, we will summarize a new study soon to be released in the Green Journal (Obstetrics & Gynecology) which seeks to determine the clinical utility of this outpatient, antepartum management option.

Trichomoniasis has been found in every continent and climate without showing any significant seasonal variability. According to the CDC, trichomoniasis is estimated to be the most prevalent nonviral STI worldwide, affecting approximately 2.6 million persons in the United States. Conditions shown to be associated with T vaginalis infection include: Increased risk of HIV acquisition and transmission, increased prevalence of other sexually transmitted infections, adverse outcomes of pregnancy (eg, preterm delivery, preterm prelabor ROM), pelvic inflammatory disease, and infertility. Nonetheless, despite this potential morbidity, T. Vaginalis remains a non-reportable communicable illness. Why is that? In this episode we will summarize the data and look into the CDC's rationale for that decision.