Medical Monday: Breaking News from the World of Obstetrics and Gynecology 

Congress has gone for a two and half week recess without coming to agreement on a budget to combat the Zika Virus. The CDC (Centers for Disease Control) plans on drawing from the emergency public health fund which will affect patient care all around the country. Florida is severely at risk

Medicaid has chipped in. The Department of Health and Human Services has announced that Medicaid funds can bet used to pay for mosquito repellant in the effort to control the spread of Zika.This will require a prescription. Medicaid will also cover all forms of birth control. 

One hundred and fifty health experts from several countries have called for the cancellation of the Summer Olympics in Rio De Janeiro this year. The CDC and the WHO (World Health Organization) have not taken this view and have made statements indicating it should go on. I am completely unsure of their reasoning. Zika virus acquired in Rio could spread to all the participating countries of the world, causing microcephaly and Guilaine Barre far and wide. 

Newer evidence is showing that sexual transmission of Zika is more common than previous thought. Moreover, Zika is now known to last longer in the body than previously thought. Because of this, people in a Zika affected area, but practice safe sex for 8 weeks, not 4, as previously recommended. Men with Zika must wait 6 months after clearing it before trying to conceive. A letter published in the New England Journal of Medicine presents a case where Zika seems to have been transmitted by a kiss and or oral sex.

ACOG (American College of Obstetricians and Gynecologists) has started talking about the fourth trimester. This is, of course, the postpartum period. They are calling for physicians and patients to jointly craft a “ Postpartum care plan”. This is to include identification of the members of her postpartum care “team”, i.e. friends, family, and health professionals who will be able to help out. 

It’s true. There is “ mom brain”. But, it’s not what you think it is. New research out of the University of Colorado at Denver has shown that during pregnancy and the postpartum, the prefrontal cortex of the maternal brain reorganizes and increases it activity. This appears to translate into improved concentration. 

The WHO has come out with statements and guidelines in support of breastfeeding. They also issued controversial new recommendations to governments to restrict advertising of formula for children under three years of age. 

Maine legislature has approached new rules requiring lay midwives to meet certain minimal l education requirements and to be licensed by the state. This represents a step forward in the free for all that is home birth in this country. 

Menstrual migraines are real and we are beginning to crack their code. Researchers have discovered that estrogen levels fall unusually quickly right before the period in those who experience menstrual - timed migraine. This may point to effective therapies. 

The sale tax on tampons has been repealed by law in both Illinois and New York. The “ tampon tax” has been judged unfair to women, since that are the only gender who pays it. 

Teen pregnancy rates have fallen again to 22.3 live birth per 1000 teens ages 15-19. The CDC has identified the following likely reasons for the drop: "less sex, more contraceptive, and positive peer influence". 

I am starting to think that we each ought to contact our legislators about funding the fight against Zika. This thing may break open after these misbegotten Summer Olympics. 


Stay tuned next week, for more news from the world of Obstetrics and Gynecology.