The Green Room: A Podcast from Obstetrics & Gynecology January 2025: Obstetrics
Dec 14, 2024
Dr. Asha N. Talati, an expert in maternal fetal medicine and genetic counseling at UNC, joins to discuss the latest advancements in pregnancy management for individuals with cystic fibrosis. They explore the impact of effective modulator therapies on fertility and reduced preterm birth risks. The conversation highlights innovations in prenatal care, including randomized trials on postpartum hemorrhage and the genetic considerations affecting maternal health. Critical ethical questions surrounding expensive treatments and the importance of informed counseling are also addressed.
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Modulators Transform Pregnancy Outcomes
- Highly effective CFTR modulators (like Trikafta) have transformed reproductive outcomes and pulmonary health for people with cystic fibrosis.
- Improved maternal health likely lowers preterm birth and increases fecundity, changing pregnancy expectations.
Review Modulator Eligibility Preconception
- Review CFTR modulator eligibility and mechanism (e.g., Trikafta) with reproductive-age patients before conception.
- Explain how eligibility now includes the majority of US reproductive-age people with CF.
Major Evidence Gaps Remain
- Evidence gaps exist: we lack clear pregnancy-specific guidelines and robust data on fetal or neonatal harms from modulators.
- The article calls for coordinated research and registry contributions to fill knowledge gaps.