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Please join me for a discussion of the patient side of fertility treatment with author and journalist Amy Klein about her book "The Trying Game: Get Through Fertility Treatment and Get Pregnant Without Losing Your Mind".

In this episode we dive into the world of insulins and the management of preexisting diabetes in pregnancy.   feedback@obgyn.fm Uteroplacental blood flow in diabetic pregnancy: Measurements with iridium 113m and a computer-linked gamma camera. L. Nylund et al. AJOG. 1982 Pre-existing diabetes, maternal glycated haemoglobin, and the risks of fetal and infant death: a population-based study . P. Tennant et al. Diabetologia. 2014 Large for Gestational Age Neonates: Antrhopometric Reasons for Shoulder Dystocia. H. Mondanlou et al. Obset & Gynecology 1982 Shoulder Dystocia: Incidence and Risk Factors. Clinical Obstetrics & Gynecology. 2016 History of Insulin. C. Quianzon et al. Journal of Community Hospital Internal Medicine Perspectives 2012  Insulin Analogues. I. Hirsch. NEJM. 2005 Insulin requirements during labor: a reappraisal. AJOG. 1982 Insulin and glucose requirements during the first stage of labor in insulin-dependent diabetic women. AJM. 1983 The use of continuous insulin infusion for the peripartum management of pregnant diabetic women. AJOG. 1978 Peripartum metabolic control in gestational diabetes. AJOG 2010 Constant intravenous insulin infusion during labor and delivery in diabetes mellitus. Diabetes Care. 1982 Labor Insulin Drip Protocol

Drs. Jillian Kurtz & Vai Umesh join me to discuss fertility equality.   Drs. Jillian Kurtz & Vai Umesh join me to discuss fertility equality. feedback@obgyn.fm Discord Server The Fight for Fertility Equality - NYT How Much does IVF Really Cost? CNY Fertility West Coast Surrogacy

Join us as we discuss "Intra-abdominal Irrigation at Cesarean Delivery" from a the Green Journal in 2012.   Guests: Dr. Jerry Ballas & Dr. Heather Link feedback@obgyn.fm

Dr. Jillian Kurtz walks us through an evidence-based approach to infertility.

Join myself and Dr. Jerry Ballas to discuss what life has been like for us as Ob/Gyn's in the last 6 months. We delve into what COVID has done to our units and give some tips on how to protect ourselves.   OB Leadership - CoVID Response

Dr. Heather Link joins me to discuss maternal mortality in Lousiana. Racial Inequities in Preventable Pregnancy-Related Deaths in Louisiana, 2011–2016 louisiana maternal mortality review report 2011-2016  

Drs. Jillian Kurtz and Caiyun Liao join me to discuss "Association Between Fertility Treatment and Cancer RIsk in Children" published 12/19 in JAMA  

Dr. Ballas joins me to discuss the PROLONG trial and discuss the role of progesterone in the prevention of preterm birth.   PROLONG Trial

Join us to discuss the changes in postpartum care and how we can help better support women.   ACOG Bulletin

Drs. Sara Kim & Vai Umesh join me to dicuss stillbirth rates and medical treatment of uterine fibroids.

Join me while we discuss the history of diabetes in pregnancy in the first part of our tour de force!

Dr. Umesh joins me to discuss Umbilical Cord Clamp Milking in preterm neonates. Delayed clamping vs milking of umbilical cord in preterm infants: a randomized controlled trial   feedback@obgyn.fm  

Dr. Mariel Gross joins me to discuss the ethics of breastfeeding with HIV.   Breastfeeding with HIV: An Evidence-Based Case for New Policy   Contact Dr. Gross

Dr. Heather Link joins me to discuss US health policy around maternal mortality.   Alliance for Innovation on Maternal Health E. Warren Op ed in Essence   CDC MMWR Maternal Mortality 5/10     California Maternal Quality Collaborative  

Greg Kirschen takes us through the treatment of postpartum depression and psychosis. feedback@obgyn.fm American Psychiatric Association. (2013). In Diagnostic and statistical manual of mental disorders (5th ed.). doi:10.1176/appi.books.9780890425596.744053 Tate G. 1830. “A Treatise on Hysteria.” London: S. Highley, 174 Fleet St & Webb St, Maze Pond, Borough. Smith TN. 1830. “Observations on hysteria.” The Boston Medical and Surgical Journal. 3(34): 540. Louden, I. 1988. Puerperal insanity in the 19thCentury. Journal of the Royal Society of Medicine. 81, p 76-79. Griffen W, Griffen D. 1829. Observations on Functional Disorders of the Spinal Cord, and Their Connexion with Hysterical, Nervous, and Other Diseases. Illustrated by Cases, Selected Chiefly from the Reports of the Pallas, Kenry, and Currah Dispensaries. London Medical and Physical Journal. 7(42) 477-489. Reid, J. 1848. Dr. Reid on Puerperal Insanity. Journal of Psychological and Medical Mental Pathology. 1(1): 128-151. Clark AC. 1887. Aetiology, Pathology, and Treatment of Puerperal Insanity. Journal of Mental Science. 33(142): 169-189. Donkin, AS. 1863. The Pathological Relation between Albuminuria and Puerperal Mania. Journal of Mental Science. 9(47): 401-405. Barkin V. 1929. Protein therapy in insanity of puerperal origin. British Medical Journal. 1(3549): 67. Earle P. 1854. Bloodletting in Mental Disorders. American Journal of Insanity. 10(4): 287-405. Mackenzie FW. 1851. Puerperal Insanity: Especially in Reference to Anaemia. London Journal of Medicine. 3(30): 504-521. Gordon HL. 1897. Sir James Young Simpson and Chloroform (1811-1870). Masters of Medicine. T. Fisher Unwin, for Great Britain and Longmans Green & Co. for the United States of America. Dunn, PM. 2002. Sir James Young Simpson (1811-1870) and obstetric anesthesia. Archives of Disease in Childhood-Fetal and Neonatal edition. 86(3): F207-F209. Koppanyi T, Dille JM, Linegar CR. 1936. Studies on Barbiturates: XVII. The Effect of Prolonged Chloroform Anesthesia on the Duration of Action of Barbiturates. The Journal of Pharmacology and Experimental Therapeutics. 119-127. Waters ATH. 1857. On the use of chloroform in the treatment of puerperal insanity. American Journal of Psychiatry. 13(4): 341-353. Ramachandran CT, Subramanyam N, Baker G, et al. 2011. Antidepressants: From MAOIs to SSRIs and more. Indian Journal of Psychiatry. 53(2): 180-182. Agin HV. 1963. Phenelzine in the treatment of depression. American Journal of Psychiatry. 119(12): 1173-1174. Blacker KH, Weinstein BJ, Ellman GL. 1962. Mother’s Milk and Chlorpromazine. 119(2): 178-179. Whalley LJ, Eagles JM, Bowler GMR, et al. 1987. Selective effects of ECT on hypothalamic-pituitary activity. Psychological Medicine. 17(2): 319-328. Williams RL, Barrera SE. 1950. Observations and opinions concerning complications and contraindications in electric convulsive therapy. Psychiatric Quarterly. 24(4): 800-809. Matthew JR, Constan E. 1964. Complications following ECT over a three year period in a state institution. American Journal of Psychiatry. 120(11)-1119-1120.  Sobel DE. 1960. Fetal Damage Due to ECT, Insulin Coma, Chlorpromazine, or Reserpine. AMA Archives of General Psychiatry. 2(6): 606-611. Langan RC, Goodbred AJ. 2016. Identification and Management of Peripartum Depression.American Family Physician. 93(10): 852-858.  Information from your family doctor: Postpartum depression. 2010. American Family Physician. 82(8): 939-940. Schiller CE, Schmidt PJ, Rubinow D. 2014. Allopregnanolone as a Mediator of Affective Switching in Reproductive Mood Disorders. Psychopharmacology. 231(17): 3557-3567. Bitran D, Hilvers RJ, Kellogg CK. 1991.Anxiolytic effects of 3α-hydroxy-5α[β]-pregnan-20-one:endogenous metabolites of progesterone that are active at the GABAA receptor. Brain Research. 561:157–161. Ottander U, Poromaa IS, Bjurulf E, et al. 2005. Allopregnanolone and pregnanolone are produced by the human corpus luteum. Molecular and Cellular Endocrinology. 239(1-2): 37-44. Meltzer-Brody S, Colquhoun H. Reisenberg R, et al. 2018. Brexanolone injection in post-partum depression: two multicentre, double-blind, randomised, placebo-controlled, phase 3 trials. The Lancet. 392(10152): 1058-1070.

Medical Student Gregory Kirschen takes us through the history of postpartum depression from hippocrates to present day.   References American Psychiatric Association. (2013). Cautionary statement for forensic use of DSM-5. In Diagnostic and statistical manual of mental disorders (5th ed.). doi:10.1176/appi.books.9780890425596.744053 King, H. 1998. Hippocrates’ Woman: Reading the Female Body in Ancient Greece. London: Routledge, 1st ed. https://doi.org/10.4324/9780203025994   Adams, H. (1984). Comprehensive Handbook of Psychopathology. New York: Springer Science + Business Media. P. 319. ISBN 97814615668.   Louden, I. 1988. Puerperal insanity in the 19th Century. Journal of the Royal Society of Medicine. 81, p 76-79.   Reid, J. 1848. Dr. Reid on Puerperal Insanity. Journal ofPsychological and Medical Mental Pathology. 1(1): 128-151.   Meltzer HY, Stahl SM. 1976. The dopamine hypothesis of schizophrenia: a review. Schizophrenia Bulletin. 2(1): 19-76.   Hirschfeld, R. 2000. History and evolution of the monoamine hypothesis of depression. The Journal of Clinical Psychiatry. 61(Suppl6), 4-6.   Winn, JM. 1855. On the Treatment of Puerperal Mania. Journal of Psychological and Medical Mental Pathology.. 8(30): 309-313.   MacLeod, MD. 1886. An address on puerperal insanity. British Medical Journal. 2(1336): 239-242.   Theriot, N. 1989. Diagnosing Unnatrual Motherhood: Nineteenth-century Physicians and ‘Puerperal Insanity.’ American Studies. 30(2): 69-88.   Henry, WO. 1907. To what extent can the gynecologist prevent and cure insanity in women? JAMA. XLVIII(12): 997-1002.   Boyd, R. 1870. Observations on puerperal insanity. Journal of Mental Science. 16(74): 153-165.   Clark, AC. 1887. Aetiology, Pathology, and Treatment of Puerperal Insanity. Journal of Mental Science. 33(142): 169-189.   Dunn, PM. 2002. Sir James Young Simpson (1811-1870) and obstetric anesthesia. Archies of Disease in Childhood-Fetal and Neonatal edition. 86(3): F207-F209.   Tuke, JB. 1867. Cases illustrataive of insanity of pregnancy, puerperal mania, and insanity of lactation. Edinburgh Medical Journal. 12(12): 1083-1101.   Donkin, AS. 1863. The Pathological Relation between Albuminuria and Puerperal Mania. Journal of Mental Science. 9(47): 401-405.   Miller GE, Cohen S, Ritchey AK. 2002. Chronic psychological stress and the regulation of pro-inflammatory cytokines: a glucocorticoid-resistance model. Health Psychology. 21(6): 531-541.   Cassidy-Bushrow AE, Peters RM, Johnson DA, et al. 2012. Association between depressive symptoms with inflammatory biomarkers among pregnant African-American women. Journal of Reproductive Immunology. 94(2): 202-209.   O’Mahony SM, Myint AM, van der Hove D, et al. 2006. Gestational stress leads to depressive-like behavioural and immunological changes in the rat. Neuroimmunomodulation. 13: 82-88.   Bamford, CB. 1934. An analytical review of a series of cases of insanity with pregnancy. Journal of Mental Science. 80(328): 58-63.   Ballantyne, JW. 1892. A series of thirteen cases of alleged maternal impression. Edinburgh Medical Journal. 37(11): 1025-1034.   Fisher GJ. 1870. Does Maternal Mental Influence Have any Constructive or Destructive Power in the Production of Malformations or Monstrosities at any Stage of Embryonic Development? American Journal of Insanity. XXVI(III): 241-295.   Pohlman AG. 1911. Maternal impression. Proceedings of the Indiana Academy of Science. 65-70.   Kundakovic M, Gudsnuk K, Herbstman JB, et al. 2015. DNA methylation of BNDF as a biomarker of early-life adversity.PNAS. 112(22): 6807-6813.   Boersma GJ., Lee RS, Cordner ZA, et al. 2014. Prenatal stress decreases Bdnf expression and increases methylation of Bdnf exon IV in rats. Epigenetics. 9(3): 437-447.   Zajicek-Farber ML. 2009. Postnatal depression and infant health practices among high-risk women. Journal of Child and Family Studies. 18:236.   Ban L, Gibson JE, West J, et al. 2010. Association between perinatal depression in mothers and the risk of childhood infections in offspring: a population-based cohort study. BMC Public Health. 10:799.   Ertel KA, Koenen KC, Rich-Edwards JW, et al. 2010. Antenatal and postpartum depressive symptoms are differentially associated with early childhood weight and adiposity. Paediatric and Perinatal Epidemiology. 24: 179-189.   Beck CT. 1998. The effects of postpartum depression on child development: A meta-analysis. Archives of Psychiatric Nursing. 12(1): 12-20.   Tuovinen S, Lahti-Pulkkinen M, Girchenko P, et al. 2018. Maternal depressive symptoms during and after pregnancy and child developmental milestones. Depression and Anxiety. 35(8): 732-741.   Foundeur M, Fixsen C, Tribel WA, et al. 1957. Postpartum Mental Illness: A Controlled Study. AMA Archives of Neurology and Psychiatry. 77(5): 503-512.  

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Dr. Bergoy walks us through the risks and benefits of elective cesarean delivery. www.obgyn.fm feedback@obgyn.fm neonatal and maternal mortality https://www.acog.org/Clinical-Guidance-and-Publications/Obstetric-Care-Consensus-Series/Safe-Prevention-of-the-Primary-Cesarean-Delivery https://www.ncbi.nlm.nih.gov/pubmed/?term=24631705%5Buid%5D https://www.uptodate.com/contents/cesarean-delivery-on-maternal-request?search=cesarean%20section%20complications&source=search_result&selectedTitle=6~150&usage_type=default&display_rank=6#H16 Primary cs vs trial of labor Visco et al’s review https://www.ncbi.nlm.nih.gov/pubmed/?term=visco+cesarean+delivery+on+maternal+request+obstetrics+and+gynecology+2006 Declercq et al’s study https://www.ncbi.nlm.nih.gov/pubmed/?term=Declercq+et+al%2C+green+journal%2C+109(3)%2C+2007+%C2%ABMaternal+Outcomes+Associated+With+Planned+Primary+Cesarean+Births+Compared+With+Planned+Vaginal+Births%C2%BB Allen et al https://www.ncbi.nlm.nih.gov/pubmed/16880297 Liu et al, AJOG, vol 212 issue 6 2015. “Cesarean delivery on maternal request in China: what are the risks and benefits?” https://www.ncbi.nlm.nih.gov/pubmed/?term=25640048 Liu et al, CMAJ, vol 176, issue 4 2007 “Maternal mortality and severe morbidity associated with low-risk planned cesarean delivery versus planned vaginal delivery at term” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1800583/ TOLAC vs secondary elective cesarean Guise et al, Obstet gynecol, june 2010 vol 115, no 6, “Vaginal birth after cesarean: new insights on maternal and neonatal outcomes.” https://www.ncbi.nlm.nih.gov/pubmed/?term=20502300 Crowther et al, PLoS med, 2012, 9(3). «Planned Vaginal Birth or Elective Repeat Caesarean: Patient Preference Restricted Cohort with Nested Randomised Trial« RDS Hansen et al BMJ 2008 “Risk of respiratory morbidity in term infants delivered by elective caesarean section: cohort study” https://www.bmj.com/content/336/7635/85 Long term complications Marshall et al «Impact of multiple cesarean deliveries on maternal morbidity: a systematic review» Am J Obstet Gynecol2011;205:262.e1-8. https://www.ncbi.nlm.nih.gov/pubmed/22071057 Keag et al systematic review and metaanalysis of long term risks and benefits of cs vs vag delivery for mother and child from jan 18 in PLoS med https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002494 editorial in the green journal from 2011 on the evidence of CS as protective of pelvic floor damage https://www.ncbi.nlm.nih.gov/pubmed/21934440 composite outcomes Freemantle et al Jama 2003 https://jamanetwork.com/journals/jama/fullarticle/196588 Cordoba et al BMJ 2010 https://www.bmj.com/content/341/bmj.c3920 Various An article on how to counsel a patient on risks and benefits woth cesarean on maternal request from Jama 2013 https://jamanetwork.com/journals/jama/fullarticle/1685873 NNT https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4524406/

Dr. David Gagnon leads us through the origins of the National Perinatal Association.