Shannon M. Clark, MD, FACOG

You know who you are! #obgyn #obstetricalcare #ob #obsetetrician #gynecologist

Us Medicaid kids are the real ones 🙌 #mywhy #mylife #medicaid #medicaidkid #firstgeneration #medschool #obgynresidency #mfmfellow #physician #surgeon #academic #professor

OP @baileyeisman From UpToDate: Group B Streptococcus (GBS; or Streptococcus agalactiae) infection in neonates and young infants is classified by age at onset into early-onset (<7 days of age); late-onset (7 to 89 days); and late, late-onset infection (≥90 days). •Early-onset neonatal GBS infection is acquired in utero or during passage through the vagina. Late-onset GBS infection is acquired vertically at birth or horizontally in household and community settings. above.) •Universal antenatal screening of pregnant women for GBS colonization and widespread use of intrapartum chemoprophylaxis have resulted in a decline in early-onset GBS disease in the United States but have not reduced late-onset GBS infections. neonates".) •Important clinical risk factors for early-onset neonatal GBS infection include: -Maternal GBS colonization (ie, positive GBS vaginal or rectal screening culture or GBS bacteriuria during pregnancy) -Prior delivery of an infant with GBS disease -Delivery at <37 weeks of gestation -Prolonged rupture of membranes (≥18 hours) before delivery -Preterm prelabor rupture of membranes -Intraamniotic infection (also called chorioamnionitis) -Intrapartum fever (temperature ≥38°C [100.4°F]) •Early-onset – Early-onset GBS infection most commonly manifests as generalized sepsis and, less commonly, as pneumonia or meningitis. Clinical signs usually are apparent in the first 24 hours after birth. Signs of sepsis are nonspecific and include irritability, lethargy, respiratory symptoms (eg, tachypnea, grunting, hypoxia), temperature instability, poor perfusion, and hypotension. •Late-onset – Late-onset GBS disease most often presents as bacteremia without a focus or meningitis. Less common but well-described late-onset GBS focal infections include septic arthritis, osteomyelitis, and cellulitis-adenitis. Outcomes of neonatal GBS infection vary depending on the gestational age of the infant, timing of disease onset (early versus late onset), and severity of infection. Among term infants with GBS infection, mortality rates are approximately 2 to 3 percent for early-onset infection and 1 to 3 percent for late-onset infection; mortality is considerably higher among preterm infants (20 to 30 percent for early-onset, and 5 to 8 percent for late-onset). Morbidity from GBS meningitis is substantial. #gbs #gbsawareness #groupbstrep #pregnancy #birth #laboranddelivery #greenscreenvideo

RECOMMENDATIONS ●Prevalence – Umbilical cord prolapse is a rare event potentially associated with serious fetal/neonatal complications. ●Risk factors – Risk factors for cord prolapse include (1) fetomaternal factors that lead to inadequate filling of the maternal pelvis by the fetus and (2) iatrogenic obstetric interventions, but many prolapses occur without antecedent risk factors. Fetal and maternal factors that have been associated with cord prolapse include: ●Malpresentation (breech, transverse, oblique, or unstable lie) ●Unengaged presenting part ●Polyhydramnios ●Preterm gestational age ●Low birth weight ●Second twin ●Low lying placentation ●Pelvic deformities ●Uterine malformations/tumors ●External fetal anomalies ●Multiparity ●Long umbilical cord ●Prolonged labor ●Atypical placental cord insertions (velamentous and marginal) Obstetric interventions are associated with those that may elevate the fetal head out of the pelvis and include: ●Iatrogenic rupture of membranes,especially with an unengaged presenting part ●Manual rotation of the fetal head ●Amnioinfusion ●External cephalic version ●Internal podalic version ●Application of forceps or vacuum ●Clinical presentation – The first sign of cord prolapse is usually severe, prolonged fetal bradycardia or moderate to severe variable decelerations or late decelerations after a previously normal tracing. The prolapse may be overt or nonovert (occult). ●Management – Standard obstetric management of cord prolapse is prompt cesarean birth to avoid fetal compromise or death from compression of the cord. ●Intrauterine resuscitation – Intrauterine resuscitation using maneuvers to elevate the presenting part (eg, manually, or placing the patient in a knee-chest position or deep Trendelenburg, or retrofilling the bladder with at least 500 mL of saline) and administering a tocolytic may reduce pressure on the cord while preparations are being made for delivery. ●Outcome – Reported perinatal mortality related to cord prolapse varies widely, from 0 to 3 percent for events occurring among patients monitored on a labor and delivery unit. Asphyxia and complications related to prematurity and congenital anomalies are the major causes of poor outcome. The degree of cord compression, the interval between cord prolapse and delivery, and successful use of intrauterine resuscitation maneuvers all impact the risk of asphyxia. #cordprolapse #umbilicalcordprolapse #birth #childbirth #laboranddelivery

I was a wreck, but baby did beautifully! #obyn #mfm #pregnant #pregnancy #birth #birthtok #childbirth #laboranddelivery #shoulderdystocia

#emtala #obgyn #mfm #emergencyroom #emergencymedicine

I have seen thousands of brand new babies and they aint always cute! Some need time to ripen 😆 #ob #obstetrician #obgyn #newborn #neonate #laboranddelivery #birth #childbirth #snappingturtle

Test all the vitamins and supplements!! #naturemadevitamins #naturemadeprenatal #classactionlawsuits #prenatalvitamins

There is no delayed umbilcal cord clamping conspiracy. All these folk want to get on social media to act like a medical professional without actually doing the work. Right @alexandrakisitu.phd? #birth #childbirth #delayedumbilicalcordclamping #greenscreenvideo

#obgyn #influencer #obgyninfluencer

#obgyn #mfm #laboranddelivery

#birth #cesarean #cesareanbirth #cesareandelivery #cesareansection

OP @Mercedeslynnnn8 From Up To Date: The major non-anesthesia-related complications related to cesarean birth are surgical site infection (SSI), particularly superficial wound complications; hemorrhage; injury to pelvic organs; and thromboembolism. The risk of severe maternal morbidity is generally higher in after an unplanned cesarean birth during labor than after a scheduled prelabor cesarean birth. Cesarean birth in the second stage of labor is generally associated with higher maternal composite morbidity than cesarean birth in the first stage of labor. Previa and placenta accreta spectrum – In a meta-analysis of observational studies: •The incidence of placenta previa was 10/1000 deliveries in patients with one previous cesarean birth versus 28/1000 in those with ≥3 cesarean births, based on eight studies. •In patients with placenta previa undergoing cesarean birth, the incidence of placenta accreta spectrum was 3.3 to 4.0 percent in those with no previous cesarean births versus 50 to 67 percent in those with ≥4 previous cesarean births, based on two studies. The risk of placenta previa in the general obstetric population, after one cesarean birth, and after ≥3 cesarean births was 4 in 1000, 10 in 1000, and 28 in 1000 deliveries, respectively, in one review. Patients with a previa and ≥3 cesarean births were at significantly increased risk of placenta accreta spectrum (PAS), compared with those with a previa and no previous cesarean birth (PAS: 50 to 67 percent versus 3.3 to 4 percent). The risk of PAS increases with an increasing number of prior cesarean births, even in the absence of placenta previa. Uterine rupture in a subsequent pregnancy — The incidence of uterine rupture is higher in patients who undergo a trial of labor after cesarean birth (TOLAC) than in those who undergo planned repeat cesarean delivery (PRCD). The incidence varies depending on the type and location of the prior uterine incision, as well as other factors. Interpregnancy interval — Delaying conception for at least 18 months following a cesarean birth is important to allow for adequate healing of the hysterotomy. #cesarean #cesareansection #cesereansection #cesareandelivery

#headache #pregnancy #neurology #neurologist

#duet with @Dr. Z 🧠 Neurosurgery Thanks to @Megan for sharing her story ❤️ These major medical organizations recommend folic acid supplementation in pregnancy: ACOG: The American College of Obstetricians and Gynecologists SMFM: The Society of Maternal-Fetal Medicine USPSTF: US Preventive Services Task Force ACMG: American College of Medical Genetics CDC: Centers for Disease Control and Prevention FDA: Food and Drug Administration AAFP: American Academy of Family Physicians AAP: American Academy of Pediatrics AAN: American Academy of Neurology SOGC: The Society of Obstetricians and Gynaecologists of Canada RCOG: The Royal College of Obstetricians and Gynaecologists The Academy of Nutrition and Dietetics (FORMERLY the American Dietetics Association) The Food and Nutrition Board (FNB) of the National Academies of Sciences, Engineering, and Medicine, Health, and Medicine Division #anenchepaly #folicacid #neuraltubedefect #anencephaly

#teamwork #obgyn #mfm #birth #childbirth #laboranddelivery #epidural #epiduralbirth #anesthesia #obanesthesia

#preeclampsia #pres #intraventricularhemorrhage #neurosurgeon #neurosurgeryresident #obgyn #mfm

@Crystal Ann I hope whatever commission you earn is worth it. Ritual, allowing accounts to do this to sell your product is deceptive and misleading advertising targeting a very vulnerable population of people trying to get pregnant. Targeting the infertility community is just dirty…plain dirty. #prenatal #prenatalvitamin #folicacid #greenscreenvideo #greenscreen

#folicacid #mthfr #mthfrgene #mthfrgenevariant OP @Brittney

#stitch with @Audrey #diabetes #gestationaldiabetes #pregestationaldiabetes