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Demystifying Recurrent Pregnancy Loss (RECORDING)


Demystifying Recurrent Pregnancy Loss (RECORDING) Banner

  • Overview
  • Faculty
  • Begin


Date & Location
Tuesday, October 29, 2024, 12:00 AM - Thursday, October 28, 2027, 11:59 PM, On Demand

Overview
Miscarriage is the most common complication of early pregnancy, occurring in 10-40% of all pregnancies. Recurrent pregnancy loss (RPL) is a disease distinct from infertility, defined as the spontaneous loss of two or more pregnancies and affects as many as 5% of couples attempting to build their families. There are many known causes of miscarriage including genetic, uterine, and circulatory disorders, however the majority of patients with RPL remain without definite answers as to the cause of their pregnancy losses. Watch as our faculty discuss potentially novel causes of RPL and individualized approaches to each unique patient. Understanding the physical and psychological consequences of miscarriage are also a central focus of our team at Stanford Medicine - we strive for a holistic approach to miscarriage care. This recorded webinar will introduce you to the newest research and skills needed to address RPL.

Registration

     Release Date: October 28, 2024
     Expiration Date: October 27, 2027
     Estimated Time to Complete: 2 hours, 49 minutes
     Registration Fee: FREE 

*Originally recorded on 10/11/2024. 

Click the Begin tab to launch this course. 


Credits
AMA PRA Category 1 Credits™ (2.75 hours), ANCC Contact Hours (2.75 hours), CA BRN - California Board of Registered Nurses Contact Hours (2.75 hours), Non-Physician Participation Credit (2.75 hours)

Target Audience
Specialties - Family Medicine & Community Health, Maternal-Child Health, Maternal-Fetal Medicine, Midwifery, Obstetrics & Gynecology, Reproductive Endocrinology and Infertility
Professions - Advance Practice Nurse (APN), Fellow/Resident, Non-Physician, Nurse, Physician, Registered Nurse (RN), Student

Objectives
At the conclusion of this activity, learners should be able to:

  1. Identify new guidelines in recurrent pregnancy loss (RPL).
  2. Describe the orders for and interpretation of laboratory tests and imaging studies.
  3. Discuss the importance of communicating effectively with patients and their families in their language of preference, providing compassionate care and counseling guided by culture humility.
  4. Explain the basis for a comprehensive care plan based on the personalized needs and preferences of patients.

Accreditation

In support of improving patient care, Stanford Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Credit Designation 
American Medical Association (AMA) 
Stanford Medicine designates this Enduring Material for a maximum of 2.75 AMA PRA Category 1 CreditsTM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

American Nurses Credentialing Center (ANCC) 
Stanford Medicine designates this live activity for a maximum of 2.75 ANCC contact hours.  

California Board of Registered Nursing (CA BRN)
Stanford Medicine Provider approved by the California Board of Registered Nursing, Provider Number 17874, for 2.75 contact hours. 


Additional Information

Accessibility Statement
 Stanford University School of Medicine is committed to ensuring that its programs, services, goods and facilities are accessible to individuals with disabilities as specified under Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Amendments Act of 2008.  If you have needs that require special accommodations, please contact the coordinator.

Cultural and Linguistic Competency
The planners and speakers of this CME activity have been encouraged to address cultural issues relevant to their topic area for the purpose of complying with California Assembly Bill 1195. Moreover, the Stanford University School of Medicine Multicultural Health Portal contains many useful cultural and linguistic competency tools including culture guides, language access information and pertinent state and federal laws.  You are encouraged to visit the Multicultural Health Portal: https://laneguides.stanford.edu/multicultural-health

References/Bibliography

Demystifying Recurrent Pregnancy Loss - Ruth Lathi, MD

de Assis, V., Giugni, C. S., & Ros, S. T. (2024). Evaluation of Recurrent Pregnancy Loss. Obstetrics and gynecology, 143(5), 645–659. https://doi.org/10.1097/AOG.0000000000005498

Brigham, S. A., Conlon, C., & Farquharson, R. G. (1999). A longitudinal study of pregnancy outcome following idiopathic recurrent miscarriage. Human reproduction (Oxford, England), 14(11), 2868–2871. https://doi.org/10.1093/humrep/14.11.2868

ESHRE Guideline Group on RPL, Bender Atik, R., Christiansen, O. B., Elson, J., Kolte, A. M., Lewis, S., Middeldorp, S., Nelen, W., Peramo, B., Quenby, S., Vermeulen, N., & Goddijn, M. (2018). ESHRE guideline: recurrent pregnancy loss. Human reproduction open, 2018(2), hoy004. https://doi.org/10.1093/hropen/hoy004

HOPE Study. (n.d.). Uncovering the Causes of Pregnancy Loss. HOPE Team, Stanford University School of Medicine, University of California San Francisco, University of Pittsburgh, Oregon Health & Science University. https://www.pregnancylossanswers.org/

Kasman, A. M., Zhang, C. A., Li, S., Lu, Y., Lathi, R. B., Stevenson, D. K., Shaw, G. M., & Eisenberg, M. L. (2021). Association between preconception paternal health and pregnancy loss in the USA: an analysis of US claims data. Human reproduction (Oxford, England), 36(3), 785–793. https://doi.org/10.1093/humrep/deaa332

Khoury, M. J., & Erickson, J. D. (1993). Recurrent pregnancy loss as an indicator for increased risk of birth defects: a population-based case-control study. Paediatric and perinatal epidemiology, 7(4), 404–416. https://doi.org/10.1111/j.1365-3016.1993.tb00422.x

Macklon, N. S., Geraedts, J. P., & Fauser, B. C. (2002). Conception to ongoing pregnancy: the 'black box' of early pregnancy loss. Human reproduction update, 8(4), 333–343. https://doi.org/10.1093/humupd/8.4.333

McNally, L., Huynh, D., Keller, J., Dikan, J., Rabinowitz, M., & Lathi, R. B. (2016). Patient Experience with Karyotyping After First Trimester Miscarriage: A National Survey. The Journal of reproductive medicine, 61(3-4), 128–132.

Ogasawara, M., Aoki, K., Okada, S., & Suzumori, K. (2000). Embryonic karyotype of abortuses in relation to the number of previous miscarriages. Fertility and sterility, 73(2), 300–304. https://doi.org/10.1016/s0015-0282(99)00495-1

Papas, R. S., & Kutteh, W. H. (2020). A new algorithm for the evaluation of recurrent pregnancy loss redefining unexplained miscarriage: review of current guidelines. Current opinion in obstetrics & gynecology, 32(5), 371–379. https://doi.org/10.1097/GCO.0000000000000647

Philipp, T., Feichtinger, W., Van Allen, M. I., Separovic, E., Reiner, A., & Kalousek, D. K. (2004). Abnormal embryonic development diagnosed embryoscopically in early intrauterine deaths after in vitro fertilization: a preliminary report of 23 cases. Fertility and sterility, 82(5), 1337–1342. https://doi.org/10.1016/j.fertnstert.2004.04.057

Philipp, T., & Kalousek, D. K. (2002). Generalized abnormal embryonic development in missed abortion: embryoscopic and cytogenetic findings. American journal of medical genetics, 111(1), 43–47. https://doi.org/10.1002/ajmg.10476

Practice Committee of the American Society for Reproductive Medicine. Electronic address: [email protected] (2020). Definitions of infertility and recurrent pregnancy loss: a committee opinion. Fertility and sterility, 113(3), 533–535. https://doi.org/10.1016/j.fertnstert.2019.11.025

Practice Committee of the American Society for Reproductive Medicine (2012). Evaluation and treatment of recurrent pregnancy loss: a committee opinion. Fertility and sterility, 98(5), 1103–1111. https://doi.org/10.1016/j.fertnstert.2012.06.048

Stanford Medicine. (n.d.). Recurrent Pregnancy Loss. Stanford Medicine Children’s Health. https://www.stanfordchildrens.org/en/services/fertility-and-reproductive-health/recurrent-pregnancy-loss.html

Stephenson, M. D., Awartani, K. A., & Robinson, W. P. (2002). Cytogenetic analysis of miscarriages from couples with recurrent miscarriage: a case-control study. Human reproduction (Oxford, England), 17(2), 446–451. https://doi.org/10.1093/humrep/17.2.446

The Lancet (2021). Miscarriage: worldwide reform of care is needed. Lancet (London, England), 397(10285), 1597. https://doi.org/10.1016/S0140-6736(21)00954-5

Youssef, A., Vermeulen, N., Lashley, E. E. L. O., Goddijn, M., & van der Hoorn, M. L. P. (2019). Comparison and appraisal of (inter)national recurrent pregnancy loss guidelines. Reproductive biomedicine online, 39(3), 497–503. https://doi.org/10.1016/j.rbmo.2019.04.008

Bridging the Health Disparity Gap: Cultural Humility & Language of Preference - Katherine Bianco, MD

American College of Obstetricians and Gynecologists. (2020). Joint Statement: Collective Action Addressing Racism. The American College of Obstetricians and Gynecologists. https://www.acog.org/news/news-articles/2020/08/joint-statement-obstetrics-and-gynecology-collective-action-addressing-racism

Anaya, Y. B. M., Hsu, P., Greenwood, S. S., & Hayes-Bautista, D. (2023). Improvement Needed in Latina Physician Representation: Implications for Medical Education, Training, and Policy. UCLA, Latino Policy & Politics Institute. https://latino.ucla.edu/research/improvement-needed-in-latina-physician-representation/

Churchwell, K., Elkind, M. S. V., Benjamin, R. M., Carson, A. P., Chang, E. K., Lawrence, W., Mills, A., Odom, T. M., Rodriguez, C. J., Rodriguez, F., Sanchez, E., Sharrief, A. Z., Sims, M., Williams, O., & American Heart Association (2020). Call to Action: Structural Racism as a Fundamental Driver of Health Disparities: A Presidential Advisory From the American Heart Association. Circulation, 142(24), e454–e468. https://doi.org/10.1161/CIR.0000000000000936

Eliaz, A., Blair, A. H., Chen, Y. H., Fernandez, A., Ernst, A., Mirjahangir, J., Celentano, J., Sachdev, D., Enanoria, W., & Reid, M. J. A. (2021). Evaluating the Impact of Language Concordance on Coronavirus Disease 2019 Contact Tracing Outcomes Among Spanish-Speaking Adults in San Francisco Between June and November 2020. Open forum infectious diseases, 9(1), ofab612. https://doi.org/10.1093/ofid/ofab612

Hameed, A. B., Morton, C. H., & Moore, A. (2017). Improving Health Care Response to Cardiovascular Disease in Pregnancy and Postpartum. Cardiovascular Disease in Pregnancy Task Force, California Maternal Quality Care Collaborative (CMQCC). https://www.cmqcc.org/resource/improving-health-care-response-cardiovascular-disease-pregnancy-and-postpartum

Leonard, S. A., Main, E. K., Scott, K. A., Profit, J., & Carmichael, S. L. (2019). Racial and ethnic disparities in severe maternal morbidity prevalence and trends. Annals of epidemiology, 33, 30–36. https://doi.org/10.1016/j.annepidem.2019.02.007

Lopez, M. H., Krogstad, J. M., & Passel, J. S. (2024). Who is Hispanic?. Pew Research Center. https://www.pewresearch.org/short-reads/2024/09/12/who-is-hispanic/

Mazumdar, T. (2021). Miscarriage rates over 40% higher in black women, study suggests. BBC News. https://www.bbc.com/news/health-56889861

Moaddab, A., Dildy, G. A., Brown, H. L., Bateni, Z. H., Belfort, M. A., Sangi-Haghpeykar, H., & Clark, S. L. (2018). Health Care Disparity and Pregnancy-Related Mortality in the United States, 2005-2014. Obstetrics and gynecology, 131(4), 707–712. https://doi.org/10.1097/AOG.0000000000002534

Mogekwu, O., Kapoor, S., Carmichael, M., & Egbase, E. (2023). Racial disparities in early pregnancy: a narrative review. Current opinion in obstetrics & gynecology, 35(5), 446–452. https://doi.org/10.1097/GCO.0000000000000900

Steinberg, J. R., Turner, B. E., DiTosto, J. D., Weeks, B. T., Young, A. M. P., Lu, C. F., Wolgemuth, T., Holder, K., Laasiri, N., Squires, N., Zhang, N., Richardson, M. T., Magnani, C. J., Anderson, J. N., Roque, D. R., & Yee, L. M. (2023). Race and Ethnicity Reporting and Representation in Obstetrics and Gynecology Clinical Trials and Publications From 2007-2020. JAMA surgery, 158(2), 181–190. https://doi.org/10.1001/jamasurg.2022.6600

Steinberg, J. R., Weeks, B. T., Reyes, G. A., Conway Fitzgerald, A., Zhang, W. Y., Lindsay, S. E., Anderson, J. N., Chan, K., Richardson, M. T., Magnani, C. J., Igbinosa, I., Girsen, A., El-Sayed, Y. Y., Turner, B. E., & Lyell, D. J. (2021). The obstetrical research landscape: a cross-sectional analysis of clinical trials from 2007-2020. American journal of obstetrics & gynecology MFM, 3(1), 100253. https://doi.org/10.1016/j.ajogmf.2020.100253

The Lancet (2021). Miscarriage: worldwide reform of care is needed. Lancet (London, England), 397(10285), 1597. https://doi.org/10.1016/S0140-6736(21)00954-5

Victory, J., John, S., Wang, L. Q., Koegl, J., Richter, L. L., Bayrampour, H., Joseph, K. S., & Lisonkova, S. (2024). Racial/ethnic disparity in severe maternal morbidity among women who conceived by in vitro fertilization. AJOG global reports, 4(3), 100367. https://doi.org/10.1016/j.xagr.2024.100367

Vyas, D. A., Eisenstein, L. G., & Jones, D. S. (2020). Hidden in Plain Sight - Reconsidering the Use of Race Correction in Clinical Algorithms. The New England journal of medicine, 383(9), 874–882. https://doi.org/10.1056/NEJMms2004740

Wang, E., Glazer, K. B., Sofaer, S., Balbierz, A., & Howell, E. A. (2021). Racial and Ethnic Disparities in Severe Maternal Morbidity: A Qualitative Study of Women's Experiences of Peripartum Care. Women's health issues : official publication of the Jacobs Institute of Women's Health, 31(1), 75–81. https://doi.org/10.1016/j.whi.2020.09.002

Recurrent Pregnancy Loss Lived Experiences - Erica Freeman

Miller, C. C., Kliff, S., & Buchannan, L. (2023). Childbirth is Deadlier for Black Families Even When They’re Rich, Expansive Study Finds. New York Times. https://www.nytimes.com/interactive/2023/02/12/upshot/child-maternal-mortality-rich-poor.html

Treisman, R. (2022). A nonprofit says preterm births are up in the U.S. — and it’s not a partisan issue. NPR, Health. https://www.npr.org/2022/11/15/1136169727/pre-term-births-march-of-dimes-report-card

For activity related questions, please contact
     Name: Holly Meyer
     Title: Compliance Coordinator
     Email: [email protected]

For CME general questions, please contact 
 
   Email: [email protected]



Mitigation of Relevant Financial Relationships


Stanford Medicine adheres to the Standards for Integrity and Independence in Accredited Continuing Education.

There are no relevant financial relationships with ACCME-defined ineligible companies for anyone who was in control of the content of this activity.



Member Information
Role in activity
Nature of Relationship(s) / Name of Ineligible Company(s)
Faculty Photos
Y. Katherine Bianco, MD
Clinical Professor, Obstetrics & Gynecology - Maternal Fetal Medicine
Stanford University
Course Director, Faculty
Nothing to disclose
Faculty Photos
Ruth Bunker Lathi, MD
Professor of Obstetrics and Gynecology - Reproductive Endocrinology and Infertility
Stanford University
Course Director, Faculty
Nothing to disclose
Faculty Photos
Carla M Avalos, LCSW, PMH-C
Nuevos Caminos Therapy
Faculty
Nothing to disclose
Faculty Photos
Erica Freeman, Other
Founder of Sisters in Loss
Sisters in Loss
Faculty
Nothing to disclose
Faculty Photos
Nkemka O Egbuho, MPH
Program and Navigation Services Manager
Roots Community Health
Faculty, Planner
Nothing to disclose
Faculty Photos
Christina M Oldini, RN
Associate Director of Programs
CMQCC, Mid-Coastal California Perinatal Outreach Program
Stanford University
Faculty, Planner
Nothing to disclose
Faculty Photos
Nancy L Peterson, MSN, RNC-OB, PNNP
Perinatal Consultant
Stanford University
Planner
Nothing to disclose
Faculty Photos
Marci Treadwell, BA
CMQCC, Mid-Coastal California Perinatal Outreach Program
Stanford University
Planner
Nothing to disclose

Demystifying Recurrent Pregnancy Loss Recording Module
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