OBG in a Minute by Dr. Anita

ENDOMETRIOSIS: ACOG 2026 UPDATE in 60 SECONDS!”

“ACOG has changed the way we diagnose AND treat endometriosis in 2026. Here are the updates every OBG must know!”

**1️⃣ Diagnosis is now CLINICAL FIRST — laparoscopy NOT needed
“2026 update is clear:
👉 If symptoms + exam + imaging fit → treat as endometriosis
👉 Laparoscopy is NOT required to ‘confirm’ diagnosis.”
**2️⃣ Non-invasive Diagnostics Upgraded
“ACOG endorses:
✔️ Transvaginal US (first-line)
✔️ MRI for DIE mapping
✔️ Biomarkers: CA-125 is NOT a diagnostic test
✔️ ‘Endometriosis symptom score’ added for tracking response.”
**3️⃣ First-line Treatment SHIFT
“Medical therapy BEFORE surgery unless red flags.
First-line meds:
✔️ Combined OCPs
✔️ Progestins (Dienogest strongest evidence 2026)
✔️ LNG-IUS
✔️ GnRH antagonists (Elagolix/Relugolix) early use allowed.”
**4️⃣ Surgery — Narrower Indications
“Surgery now recommended ONLY for:
🔸 Endometriomas > 4–5 cm causing pain/infertility
🔸 DIE causing bowel/ureteric compromise
🔸 Failure of optimal medical therapy
🔸 Infertility needing access for ART”
**5️⃣ Infertility Management Streamlined
“If endometriosis + infertility:
➡️ Treat pain medically
➡️ Do NOT delay ART
➡️ Surgery only if required for access, not routinely.”
**6️⃣ Adolescents Update
“ACOG emphasises early recognition:
✔️ Treat clinically
✔️ Avoid repeated laparoscopies
✔️ Use progestins + LNG-IUS as first-line.”

“Endometriosis is now a clinical diagnosis, with medical therapy FIRST. Update your practice — ACOG 2026 changes everything!”

Contact : 9908384060
[email protected]

“ENDOMETRIOSIS: ACOG 2026 UPDATE in 60 SECONDS!”

“ACOG has changed the way we diagnose AND treat endometriosis in 2026. Here are the updates every OBG must know!”

**1️⃣ Diagnosis is now CLINICAL FIRST — laparoscopy NOT needed
“2026 update is clear:
👉 If symptoms + exam + imaging fit → treat as endometriosis
👉 Laparoscopy is NOT required to ‘confirm’ diagnosis.”
**2️⃣ Non-invasive Diagnostics Upgraded
“ACOG endorses:
✔️ Transvaginal US (first-line)
✔️ MRI for DIE mapping
✔️ Biomarkers: CA-125 is NOT a diagnostic test
✔️ ‘Endometriosis symptom score’ added for tracking response.”
**3️⃣ First-line Treatment SHIFT
“Medical therapy BEFORE surgery unless red flags.
First-line meds:
✔️ Combined OCPs
✔️ Progestins (Dienogest strongest evidence 2026)
✔️ LNG-IUS
✔️ GnRH antagonists (Elagolix/Relugolix) early use allowed.”
**4️⃣ Surgery — Narrower Indications
“Surgery now recommended ONLY for:
🔸 Endometriomas > 4–5 cm causing pain/infertility
🔸 DIE causing bowel/ureteric compromise
🔸 Failure of optimal medical therapy
🔸 Infertility needing access for ART”
**5️⃣ Infertility Management Streamlined
“If endometriosis + infertility:
➡️ Treat pain medically
➡️ Do NOT delay ART
➡️ Surgery only if required for access, not routinely.”
**6️⃣ Adolescents Update
“ACOG emphasises early recognition:
✔️ Treat clinically
✔️ Avoid repeated laparoscopies
✔️ Use progestins + LNG-IUS as first-line.”

“Endometriosis is now a clinical diagnosis, with medical therapy FIRST. Update your practice — ACOG 2026 changes everything!

Contact : 9908384060
[email protected]

ENDOMETRIOSIS: ACOG 2026 UPDATE in 60 SECONDS!
“ACOG has changed the way we diagnose AND treat endometriosis in 2026. Here are the updates every OBG must know!”

**1️⃣ Diagnosis is now CLINICAL FIRST — laparoscopy NOT needed
“2026 update is clear:
👉 If symptoms + exam + imaging fit → treat as endometriosis
👉 Laparoscopy is NOT required to ‘confirm’ diagnosis.”
**2️⃣ Non-invasive Diagnostics Upgraded
“ACOG endorses:
✔️ Transvaginal US (first-line)
✔️ MRI for DIE mapping
✔️ Biomarkers: CA-125 is NOT a diagnostic test
✔️ ‘Endometriosis symptom score’ added for tracking response.”
**3️⃣ First-line Treatment SHIFT
“Medical therapy BEFORE surgery unless red flags.
First-line meds:
✔️ Combined OCPs
✔️ Progestins (Dienogest strongest evidence 2026)
✔️ LNG-IUS
✔️ GnRH antagonists (Elagolix/Relugolix) early use allowed.”
**4️⃣ Surgery — Narrower Indications
“Surgery now recommended ONLY for:
🔸 Endometriomas > 4–5 cm causing pain/infertility
🔸 DIE causing bowel/ureteric compromise
🔸 Failure of optimal medical therapy
🔸 Infertility needing access for ART”
**5️⃣ Infertility Management Streamlined
“If endometriosis + infertility:
➡️ Treat pain medically
➡️ Do NOT delay ART
➡️ Surgery only if required for access, not routinely.”
**6️⃣ Adolescents Update
“ACOG emphasises early recognition:
✔️ Treat clinically
✔️ Avoid repeated laparoscopies
✔️ Use progestins + LNG-IUS as first-line.”

“Endometriosis is now a clinical diagnosis, with medical therapy FIRST. Update your practice — ACOG 2026 changes everything!”

Contact : 9908384060
[email protected]

NEW 2026 Alignment:
Early screening now strongly recommended for ALL high-risk women at booking.
High-risk = obesity, PCOS, prior GDM, family Hx DM, macrosomia, steroid use, ART pregnancy.
Universal screening still at 24–28 weeks.
Key update:
Single-step OGTT is preferred where feasible (ACOG & ADA support consistency of method).
2️⃣ Diagnostic Criteria – Small Tweaks, BIG clarity (10 sec)
A. Single-step 75 g OGTT
FPG ≥ 92 mg/dL
1 hr ≥ 180 mg/dL
2 hr ≥ 153 mg/dL
→ Any ONE abnormal = GDM
B. DIPSI (India)
Still acceptable for mass-screening in high-load OPDs
2-hr PP ≥ 140 mg/dL = GDM
NEW 2026 emphasis:
If DIPSI positive → confirm with OGTT if possible for classification.
3️⃣ Management Updates (15 sec)
A. Glycemic Targets
(Same targets, stronger evidence support)
Fasting < 95 mg/dL
1 hr PP < 140 mg/dL
2 hr PP < 120 mg/dL
B. Medical Nutrition Therapy
Low GI diet more strongly recommended
Balanced carb distribution (40–45% carbs, monitored)
15–20 min post-meal walking – strongly endorsed
C. Pharmacotherapy
Insulin is still first-line
Metformin use continues as acceptable but:
2026 update stresses counselling on placental transfer
Use when insulin not feasible / patient declines
4️⃣ Antenatal Care Changes (10 sec)
Growth scan + AC / EFW mapping at 28–32 weeks mandatory
More vigilance for polyhydramnios, LGA, and reduced movements
Twice-weekly NST from 34 weeks if poor control / insulin use
5️⃣ Timing of Delivery (8 sec)
Diet-controlled: 39–40 weeks
Well-controlled on insulin: 38–39 weeks
Poor control / complications: 37 weeks or earlier if indicated
6️⃣ Postpartum Updates (8 sec)
75 g OGTT at 6–12 weeks (strong recommendation)
If normal → check HbA1c/FBG every 1–3 years
Breastfeeding improves maternal glycemic outcomes – emphasized more in 2026

Contact : 9908384060
[email protected]

“OBESITY UPDATE 2026 (FOGSI)

“Obesity is now classified as a chronic, relapsing disease. The 2026 FOGSI guidelines just changed our entire approach!”

1️⃣ NEW BMI CUT-OFFS FOR INDIAN WOMEN
“Use Asian-Indian cut-offs:
Overweight = BMI ≥ 23
Obesity = BMI ≥ 25
Why? South Asians have higher visceral fat at lower BMI.”
2️⃣ WHEN TO INTERVENE
“Intervention MUST begin if the woman has:
BMI ≥ 23 + PCOS
BMI ≥ 23 + infertility
BMI ≥ 25 any woman planning pregnancy
BMI ≥ 27.5 in pregnancy (high-risk ANC)”
3️⃣ LIFESTYLE FIRST — BUT STRUCTURED
“Not general advice.
2026 update recommends:
✔️ 500–750 kcal/day deficit
✔️ 150–300 min/week activity
✔️ Strength training 2–3/week
✔️ Screen EVERY woman for binge/emotional eating.

Contact : 9908384060
[email protected]

Thalassemia 2025: Every OBG Must Know This
“India’s carrier rate is 5–7%. This is NOT rare.”
When to Screen :
“Screen early: Pre-conception / First ANC ≤12w”
“Don’t wait for anemia — screen at first contact.”
16–30 sec — Tests & Interpretation.
CBC low MCV/MCH
Mentzer 3.5 → β-thal trait
Alpha thal → normal HPLC
“These are classic viva traps.”
“FOGSI 2025 → Universal Screening = Zero-Thal Births”
“This guideline must land in every ANC room.

Contact : 9908384060
[email protected]

“THALASSEMIA SCREENING — MUKTA UPDATE 2025”
HOOK (0–5 sec)
“Every pregnant woman MUST be screened for thalassemia — and the 2025 MUKTA-FOGSI guidelines tell us exactly how!”
BODY (5–50 sec)
1️⃣ Who to Screen? (MUST)
“All pregnant women, ideally at first ANC visit, must get:
✔️ CBC
✔️ HPLC or CE (Capillary Electrophoresis)
This is universal screening, not selective.”
2️⃣ When is a woman a POSITIVE Screen?
“If MCV < 80 or MCH < 27, PROMPTLY do:
➡️ HPLC / CE
➡️ Serum ferritin if needed (iron deficiency can mask thalassemia).”
3️⃣ Partner Testing Rule
“If mother is a carrier, ALWAYS test the partner.
If both are carriers → 25% risk of major disease.”
4️⃣ Confirmatory Testing
“For couples at risk:
➡️ Offer diagnostic testing
– CVS at 11–13 weeks
– Amniocentesis after 16 weeks
➡️ Genetic counseling is MANDATORY.”
5️⃣ Management in Pregnancy
“If mother is thalassemia major/intermedia:
✔️ Folic acid 5 mg
✔️ Maintain Hb > 10
✔️ Monitor iron overload (ferritin)
✔️ Deferoxamine can be used in 2nd–3rd trimester if needed.”
OUTRO (50–60 sec)
“Universal screening saves lives — ONE test at the first visit can prevent severe disease in the next generation.

Contact : 9908384060
[email protected]

Maternal Sepsis: The FAST-M Bundle for OBG (WHO 2025/26)
Style: Clean, algorithmic, academic
HOOK
“Every labor room in 2026 MUST know FAST-M.”
BODY
FAST-M =
F — Fluids
Balanced crystalloids. Go slower than adult sepsis protocols.
A — Antibiotics
Start within 1 hour.
Choose obstetric-specific regimens:
Piperacillin-tazobactam
Ceftriaxone + Metronidazole
Carbapenem for severe cases
S — Source Control
Uterine source → evacuation/delivery
Wound/abscess → drainage
RPOCs → surgical removal
T — Transfer
“All unstable women must move to a higher level of care ASAP.”
M — Monitoring
Urine output
MAP ≥ 65
Lactate repeat
Fetal monitoring (if viable fetus)
OUTRO
“Maternal sepsis is preventable. FAST-M is how you save 2 lives at once.

Contact : 9908384060
[email protected]

“Pregnancy + Infection? Check these 3 red flags BEFORE it becomes septic shock!”
1️⃣ RED FLAG: The Lactate Leap
“Lactate ≥ 2 mmol/L — be alert.
Lactate ≥ 4 mmol/L — immediate escalation.
This is now NON-NEGOTIABLE in 2026.”
Text overlay: Lactate 4 = RED.
2️⃣ RED FLAG: The MAP Gap
“MAP < 65 mmHg after fluids?
Don’t drown pregnant patients with over-resuscitation.
Go EARLY to Norepinephrine.”
Text overlay: Pressors > Overhydration.
3️⃣ RED FLAG: The Source Rule
“Infection inside the uterus →
Delivery IS source control.
Infection outside the uterus →
Stabilize the mother FIRST.”
Text overlay: Uterine = Deliver.
Extra-uterine = Stabilize.
OUTRO
“Sepsis kills fast. 2026 guidelines demand that YOU move faster.”

Contact : 9908384060
[email protected]

The Surviving Sepsis Campaign (SSC) 2026 Guidelines were officially released on March 23, 2026. These updates significantly refine how clinicians identify and manage sepsis, including critical shifts for obstetric practice.
ESICMESICM +2
🚨 The "New" Definition & Screening (2026)

Term Shift: Sepsis is now defined by the Phoenix Criteria as life-threatening organ dysfunction caused by a dysregulated host response to infection.

Screening Tools: qSOFA is no longer preferred for primary screening.

The Recommendation: Use NEWS/NEWS2 or MEWS (Modified Early Warning Scores).

The Obstetric Twist: Always use an Obstetric-modified Early Warning System (MEWS), as normal pregnancy physiology (like higher heart rates) can trigger false positives on standard adult tools.

Are you measuring blood pressure correctly during pregnancy? 🤰🩺
Proper BP monitoring is crucial to detect high blood pressure, preeclampsia, and pregnancy-related complications at the right time.

In this video, Dr. Anita from OBG in a Minute explains the precautions to follow while recording blood pressure in pregnant women, including the right posture, timing, and common mistakes to avoid.

Watch the video to ensure accurate blood pressure monitoring during pregnancy and safeguard both mother and baby’s health.

Contact : 9908384060
[email protected]