Dr. Chapa’s Clinical Pearls.

Gyn surgery can be associated with iatrogenic nerve injury. Neuropathy can be classified into three types: neuropraxia, axonotmesis, and neurotmesis. The most severe form of injury is nerve transaction or complete nerve ligation (neurotmesis). In this session, we will review the mechanism of nerve injury during Gyn surgery, their presentations, and prevention tips. Material is taken from the AAGL and the Society of Gyn Surgeons.

In this podcast, we will review the ACOG updated guidelines regarding intra-amniotic infections. Three classifications have been given by the ACOG: 1. Isolated maternal fever in labor, 2. Suspected intra-amniotic infection, and 3. Confirmed intra-amniotic infection. We will review these three categories, their diagnosis, and treatment recommendations. Data taken from the ACOG committee opinion 712.

The ACOG, as well as the AAP, recommends delayed umbilical cord clamping in stable term as well as preterm neonates. While once considered necessary to keep the Neonate at or below the level of the placenta, new data shows that placental to child transfusion still occurs if the child is placed on the maternal chest for skin to skin contact. Additionally, the presence of meconium stained fluid – in vigorous neonates – is not a contraindication to delayed umbilical cord clamping. In this podcast, we will review the ACOG committee opinion on delayed umbilical cord clamping.

Ovarian cancer is the most deadly of all gynecological malignancies. Most cases present an advanced stage. Epithelial ovarian cancer is the most common histological class at diagnosis. In this session, we will cover the SGO data on presentation, staging, and treatment of epithelial ovarian malignancies. Avastin and PARP therapy will also be reviewed.

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Persistence of high-grade oncogenic HPV is the key risk factor for the development of cervical carcinoma. In this session, we will review the pathophysiology, clinical staging, and treatment regimens for cervical carcinoma. Additionally, we will review the 2014 approved medication (Avastin) for the treatment of advanced, metastatic, recurrent cervical cancer. (Data taken from the Society of Gynecologic Oncology and the American Cancer Society.

Explore the intricacies of endometrial carcinoma, the leading gynecologic cancer. Learn about its risk factors and staging, along with vital distinctions between type 1 and type 2 cancers. Discover how Lynch syndrome plays a role in diagnosis and treatment. The podcast also covers diagnostic procedures and addresses management strategies for fertility and menopausal symptoms. A must-listen for those interested in the latest insights on this critical health issue.

EIN Represents a true antecedent lesion in the endometrial cavity with the potential to develop into endometrial adenocarcinoma. This podcast will review the joint committee opinion released by the SGO and the ACOG (#631) covering pre-malignant endometrial pathology.

In this session, we will cover emergency contraception: levonorgestrel, Ullipristal, and the copper IUD. Data for this podcast comes from the ACOG practice bulletin 152.

MRI offers some advantages over ultrasound as a diagnostic tool in pregnancy. In this session, we were review the ACOG committee opinion on MRI use in pregnancy with a focus on gadolinium contrast agent.