Relevant, evidence based, and practical information for medical students, residents, and practicing healthcare providers regarding all things women’s healthcare...
Severe CHTN or Superimposed PreE w/Severe Features?
Yep, its an area of debate and confusion. Controversy surrounds the diagnosis of CHTN with severe BPs vs superimposed preeclampsia with severe features. Do you need “new onset proteinuria” for the diagnosis of superimposed preeclampsia over CHTN? What about “with severe features”? This is something that is very clear to understand, yet muddy; there is well defined guidance here which is grey! Yep, we will cover this controversy and give PRACTICAL insights for the care of CHTN with severe BPs in the third trimester.
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43:53
Eclampsia = Brain Scan?
According to the ACOG, eclampsia is a low frequency, high acuity emergent condition. The rate of an eclamptic seizure is 1/200 in those with preeclampsia without severe features but is 4 fold higher ( 4/200 ) in those with preeclampsia with severe features. Traditionally, “textbook eclampsia” management did not include cranial imaging. However, that consensus is changing! In this episode, we will review data making the case for a standardized approach to eclampsia, which includes universal non-contract cranial CT after eclampsia. We will highlight a Clinical Expert Series ACOG publication from July 2024 as well as an upcoming publication from Pregnancy Hypertension in March 2025 which makes the strong case for this radiological diagnostic tool. Listen in for details.
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38:19
“Sounds Reasonable”! 3 Things to Consider.
Well, in this episode we have a “3-in-1” subject review. Often in medicine, we find ourselves with some data to guide us, but definitely not a “predominance of evidence”. So in caring for our patients, we often come to the conclusion that doing a course of action can possibly help, and can't hurt... and therefore our plan “sounds reasonable”. That's the focus of our episode today! We're going to have fun with this one and cover three topics where we do have some data to guide us, but not our predominance of data that the dot leaving us to conclude that a plan of action “sounds reasonable”. 1. Can nitrous oxide be used for IUD/IUS insertion? 2. Should we follow total serum bile acids serially for ICP (new Jan 2025 data)? 3. And if IM Ceftriaxone is recommended as first-line RX for gonorrhea, can we give expedited partner therapy as an oral medication? Listen in for details!
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40:09
No Need for PP LMWH VTE Prophylaxis?
Venous thromboembolism (VTE), which includes deep vein thrombosis and pulmonary embolism, is responsible for 9–30% of pregnancy-related mortality in high resource countries and remains a significant, increasing cause of severe maternal morbidity. Peripartum, 50% of VTE events occur in the postpartum interval, which has a 6-fold higher risk compared to antepartum. There is wide variation in LMWH pharmacological postpartum prophylaxis guidance. The RCOG, for example, recommends 10 days of LMWH for all postop CS patients unless it was elective, and additional risk factors exist. The ACOG uses a more selective approach. However, on Jan 16, 2025, a new multicenter retrospective study from the US is raising questions about the efficacy of postpartum VTE pharmacologic therapy. Is there really no need for pp VTE pharmacologic therapy? Or does the answer lie in the reality of VTE as a “low frequency, high acuity” event? Listen in for details!
This- is-CNN. No, that THAT CNN...This is Chapa News Network! WE have late-breaking news developments on 2 fronts: 1. The ACOG has released a clinical update (ACOG ROUNDS) in response to a recent study associating the RSV vaccine and GBS (we covered this study in a past episode). 2. The FDA has EXPANDED the label for an intranasal therapy for Treatment Resistant depression (TRD). Listen in for details.
Relevant, evidence based, and practical information for medical students, residents, and practicing healthcare providers regarding all things women’s healthcare! This podcast is intended to be clinically relevant, engaging, and FUN, because medical education should NOT be boring! Welcome...to Clinical Pearls.
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