Dr. Chapa’s Clinical Pearls.

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.

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.

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.

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.

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.

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.

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).

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.

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!

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.