“New” Data: CS Skin Incision To Delivery Interval (AJOG-MFM)

“New” Data: CS Skin Incision To Delivery Interval (AJOG-MFM)

If you practice obstetrics, you already know that our entire world is ruled by a stopwatch. Think about it: we are obsessed with time. We wait exactly 60 or 120 minutes for a gestational diabetes challenge. We stare at a monitor for a strict 30 minutes timing a biophysical profile. The entire pregnancy is dictated by an Estimated Date of Delivery that has us counting down the literal days. But what happens when we step into the OR? Once that scalpel hits the skin for a cesarean section, does the clock matter just as much? There are two separate intervals which have generated data: the skin incision to delivery interval, and the uterine incision to delivery interval. In today's episode, we are CUTTING INTO the data. First, we are summarizing a hot-off-the-press study from AJOG-MFM (Pink) that takes a hard look at the macro clock—the skin incision-to-delivery interval. Then, we are going to contrast those findings with the recent Bart 2026 study published in the AJOG (Grey) Journal, which tracked over 5,800 routine deliveries to see exactly what happens to a baby's pH and clinical outcome when that uterine extraction takes longer than 120 seconds. These two are somewhat at odds. Listen in for details. Strong Coffee Company - Protein Coffee PLUS MORE; Get 20% OFF | Promo Code: CHAPANOSPINOBG https://promocode.to/strong-coffee-company/chapanospinobg-hbv [https://promocode.to/strong-coffee-company/chapanospinobg-hbv] 1. Zayat N, Bertozzi-Villa C, Cavallino A, et al. Skin incision-to-delivery interval and neonatal outcomes: A retrospective cohort study. Am J Obstet Gynecol MFM2026;00:101980. 2. Bart Y, Sibai BM, Fishel Bartal M, Mazaki-Tovi S, Yoeli R. Uterine incision-to-delivery interval and neonatal outcomes among nonurgent, term, cesarean deliveries. Am J Obstet Gynecol. 2026 May;234(5):1459-1469. doi: 10.1016/j.ajog.2025.12.059. Epub 2025 Dec 30. PMID: 41478544.

More Steroid Stuff (July 2026)

Think about the last time you had to time something perfectly. Maybe it taking that perfect swing at the baseball, or catching a flight after a commute, or making a high-stakes decision. In the world of high-risk pregnancy, clinicians play a constant game of high-stakes timing with a usual medication called antenatal corticosteroids. Given to moms at risk of giving birth early, these steroids are a gamechanger for a preterm neonate. But there’s a catch. If you give them too early, the benefits fade. If you give them too late and she delivers very quickly, they don't have time to work. A brand-new study published in the journal Obstetrics & Gynecology by Mark Clapp et al reveals just how incredibly difficult this balancing act is. This data shows that nearly 26% of pregnant individuals who received these steroids actually went on to deliver completely full-term, exposing babies to medications they might not have needed. So how do we as clinicians solve this OB Goldilocks problem where the stakes are a newborn baby's health? On today's episode, we break down the data behind 'maximizing benefit while avoiding overuse' and what it means for real world practice. Strong Coffee Company - Protein Coffee PLUS MORE; Get 20% OFF | Promo Code: CHAPANOSPINOBG https://promocode.to/strong-coffee-company/chapanospinobg-hbv [https://promocode.to/strong-coffee-company/chapanospinobg-hbv] 1. Clapp, Mark A. MD, MPH; Li, Siguo MS; Melamed, Alexander MD, MPH; Reiff, Emily MD; Gyamfi-Bannerman, Cynthia MD, MS; Kaimal, Anjali J. MD, MAS. Maximizing Benefit From Antenatal Steroid Use While Avoiding Overuse. Obstetrics & Gynecology 148(1):p e33-e42, July 2026 2. FIGO good practice recommendations on the use of prenatal corticosteroids to improve outcomes and minimize harm in babies born preterm. Int J Gynaecol Obstet. 2021 Oct;155(1):26-30 3. Society for Maternal-Fetal Medicine Special Statement: Quality metrics for optimal timing of antenatal corticosteroid administration; 2022

MOPP & PP BP Control

More than 60% of maternal deaths occur during the postpartum period, and hypertensive disorders of pregnancy are a major, preventable driver of that statistic. For too long, the transition from labor and delivery to home has been a vulnerable blind spot—leading to high rates of avoidable readmissions. But the landscape has shifting. In this episode, we are diving deep into why OB providers must optimize blood pressure control before and after postpartum discharge. We’ll be breaking down the landmark 2025 MOPP study, which shook up our traditional targets by examining tight versus standard blood pressure control, alongside the recently released May 2026 ACC Expert Consensus Decision Pathway.What is the actual "goal BP" for a safe postpartum discharge? When should we initiate outpatient tight control, and how do we prevent these patients from bouncing back to the ED? Grab your coffee and pull up a chair. Let’s look at the evidence. 20% DISCOUNT: https://strongcoffeecompany.com/discount/CHAPANOSPINOBG [https://strongcoffeecompany.com/discount/CHAPANOSPINOBG] 1. Gibson K, Hameed A. Society for Maternal-Fetal Medicine Special Statement: Checklist for postpartum discharge of women with hypertensive disorders. AJOG, 2020. 2. Farahi N, Oluyadi F, Dotson AB. Hypertensive Disorders of Pregnancy. American Family Physician. 2024. 4. Lindley KJ, Bello NA, Berlacher KL, et al. Optimization of Postpartum Care for Patients With and at Risk for Premature and Long-Term Cardiovascular Disease: 2026 ACC Expert Consensus. Journal of the American College of Cardiology. May 2026. 5. ACOG Task Force on Hypertension in Pregnancy, 2013 6. Rosenfeld EB, Sagaram D, Lee R, et al. Management of Postpartum Preeclampsia and Hypertensive Disorders (MOPP): Postpartum Tight vs Standard Blood Pressure Control. JACC. Advances. 2025.

Peripartum Cardiomyopathy (PPCM): When the Left Heart Falters

Welcome back to the show, everybody! Today, we are diving deep into the intersection of maternal-fetal medicine and cardiology. We’re tackling a condition that keeps every OB/GYN, MFM, and cardiologist up at night: Peripartum Cardiomyopathy, or PPCM. And to keep our clinical gears turning, we are framing this discussion squarely through the lens of Society for Maternal-Fetal Medicine (SMFM) Consult Series #73, which focuses on right and left heart failure in pregnancy, alongside the foundational data from ACOG Practice Bulletin #212. PPCM presents fundamentally as acute left heart failure with reduced ejection fraction. Think of the left ventricle as the primary engine pump of the systemic circulation. When it stalls, everything upstream gets backed up. While this was traditionally called IDIOPATHIC, newer data says otherwise. We are going to cover presentation, eval, care and prognosis. So, get your palpitations in check- here we go. 16% OFF TONA ACTIVE WEAR PROMO: https://tonaactive.com/discount/CHAPANOSPINOBG [https://tonaactive.com/discount/CHAPANOSPINOBG] 1. SMFM CS 73; 2025 2. ACOG PB 212; 2019 3. Arany Z. Peripartum Cardiomyopathy. The NEJM. 2024. 4. Sliwa K, Hilfiker-Kleiner D, Damasceno A, Al Farhan H, Goland S, Johnson MR, Bauersachs J. Peripartum cardiomyopathy. Lancet. 2025 Nov 22;406(10518):2483-2493. doi: 10.1016/S0140-6736(25)01451-5. Epub 2025 Oct 28. PMID: 41173010.

The “20-minute” Rule for VAVD: 2026 Data

Podcast Family, in this episode we will focus on the “20-minute rule” for vacuum assisted vaginal delivery. This is an important aspect of neonatal safety and is a vital part of procedure documentation. Documentation for vacuum assisted vaginal delivery should include station at application, number of tractions, number of pop-offs and the total traction time and the vacuum trackable time (time from first application to delivery). This has historical roots as well as new data to validate it (March 2026). Listen in for details. 1. ACOG PB 219; 2020 2. Preuss E, Porto A, Sheiman V, Bitton M, Tovbin J, Kedem HI, Barzilay E. When to stop? A single center experience on vacuum-assisted deliveries. Eur J Obstet Gynecol Reprod Biol. 2026 Mar 25;320:114983. 2. Teng FY, Sayre JW. Vacuum Extraction: Does Duration Predict Scalp Injury? Obstetrics and Gynecology. 1997. 4. Tsakiridis I, Giouleka S, Mamopoulos A, et al.Operative Vaginal Delivery: A Review of Four National Guidelines. Journal of Perinatal Medicine. 2020. 16% OFF TONA ACTIVE WEAR PROMO: https://tonaactive.com/discount/CHAPANOSPINOBG [https://tonaactive.com/discount/CHAPANOSPINOBG]