Podcast family, as we have said on many previous occasions, we get episode suggestions from either real-world patient encounters, from things that are hot in press, and/or from podcasts family member suggestions. Recently, one of our podcast family members asked me about the utility of performing pelvic floor muscle therapy (PFMT) antepartum. Is this evidence-based? Does performing PFMT help with postpartum urinary incontinence? Not all PFMTs are kegel exercises! In this episode, we will review peripartum urinary incontinence and answer the question, “Is there value in teaching antepartum PFMT?”. We will summarize key concepts from the Oct 2025 Narrative Review on this subject from the Green Journal (Obstet Gynecol).

1. Siddique, Moiuri MD, MPH; Hickman, Lisa MD; Giugale, Lauren MD. Peripartum Urinary Incontinence and Overactive Bladder. Obstetrics & Gynecology 146(4):p 466-472, October 2025. | DOI: 10.1097/AOG.0000000000005993

2. Woodley SJ, Lawrenson P, Boyle R, et al. Pelvic Floor Muscle Training for Preventing and Treating Urinary and Faecal Incontinence in Antenatal and Postnatal Women.

The Cochrane Database of Systematic Reviews. 2020;5:CD007471. doi:10.1002/14651858.CD007471.pub4.

3. Pelvic Floor Muscle Training to Prevent and Treat Urinary and Fecal Incontinence in Antenatal and Postnatal Patients. American Academy of Family Physicians (2021). Practice Guideline

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In the 09/1/2018 Society for Academic Specialists in General Obstetrics and Gynecology’s (SASGOG’s) Pearls of Exxcellence publication, “Management of Preeclampsia at Term”, it states: “If hypertension management requires acute IV treatment, it is often prudent to initiate oral labetalol or EXTENDED-release nifedipine to maintain blood pressures below the severe range. Intrapartum blood pressure management and consultation should not delay progress towards delivery. Fetal monitoring should be continuous.” In the original ACOG CO 692 from 2017, oral nifedipine was first referenced as an alternative to IV meds GIVEN INTRAPARTUM, stating, “Although relatively less information currently exists for the use of calcium channel blockers for this clinical indication, the available evidence suggests that immediate release oral nifedipine also may be considered as a first-line therapy, particularly when intravenous access is not available.” This may be given orally as 10mg, 20mg, and 20 mg separated in time by 20 minutes per dose. Notice it says “immediate release oral nifedipine”. But what about EXTENDED release nifedipine intrapartum as stated by the SASGOG? Is that an option after immediate attentive and therapy has been given with IV anti-hypertensives? Listen in for details.

1. Emergent Therapy for Acute-Onset, Severe Hypertension During Pregnancy and the Postpartum Period: Committee Opinion, Number 692. Obstetrics & Gynecology 129(4):p e90-e95, April 2017. | DOI: 10.1097/AOG.0000000000002019

2. Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222. Obstet Gynecol. 2020 Jun;135(6):e237-e260. doi: 10.1097/AOG.0000000000003891. PMID: 32443079.

3. Cleary EM, Racchi NW, Patton KG, Kudrimoti M, Costantine MM, Rood KM. Trial of Intrapartum Extended-Release Nifedipine to Prevent Severe Hypertension Among Pregnant Individuals With Preeclampsia With Severe Features. Hypertension. 2023 Feb;80(2):335-342. doi: 10.1161/HYPERTENSIONAHA.122.19751. Epub 2022 Oct 3. PMID: 36189646.

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Fetal gastroschisis is a congenital defect of the abdominal wall, typically located to the right of a normally inserted umbilical cord, through which the fetal intestines and sometimes other abdominal organs herniate directly into the amniotic cavity. This condition is usually isolated, not associated with other major anomalies, and is reliably diagnosed prenatally by ultrasound. Does this require antenatal fetal surveillance? In this episode, we will cover the prevalence, diagnosis, classification, and management of this congenital anomaly.

1. Ferreira RG, Mendonça CR, Gonçalves Ramos LL, de Abreu Tacon FS, Naves do Amaral W, Ruano R. Gastroschisis: a systematic review of diagnosis, prognosis and treatment. J Matern Fetal Neonatal Med. 2022 Dec;35(25):6199-6212. doi: 10.1080/14767058.2021.1909563. Epub 2021 Apr 25. PMID: 33899664.

2. Pontes KFM, Muniz TD, Caldas JVJ, Acácio GL, Lapa DA, Rolo LC, Araujo Júnior E. Fetal Gastroschisis: Review From Diagnosis to Delivery. J Clin Ultrasound. 2025 Jun;53(5):1122-1130. doi: 10.1002/jcu.23976. Epub 2025 Mar 28. PMID: 40152061.

3. Muniz TD, Rolo LC, Araujo Júnior E. Gastroschisis: embriology, pathogenesis, risk factors, prognosis, and ultrasonographic markers for adverse neonatal outcomes. J Ultrasound. 2024 Jun;27(2):241-250. doi: 10.1007/s40477-024-00887-8. Epub 2024 Mar 29. PMID: 38553588; PMCID: PMC11178761.

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