Deanna DiUlio, Certified Nurse Midwife

01/22/2026

https://www.contemporaryobgyn.net/view/fda-approves-5-year-use-for-etonogestrel-implant-68-mg-contraceptive

The extended approval and contracpetive efficacy during use from 3 to 5 years was based on a multicenter, single-arm, open-label study (NCT04626596) conducted in the United States.

12/24/2025

Super cute 🥰

https://www.facebook.com/share/r/1GfW3AF6KL/?mibextid=wwXIfr

12/19/2025

Medical News

Brain Tumor Warning Added to Birth Control Shot

Meningioma risk now included in Depo-Provera prescribing information

by Judy George, Deputy Managing Editor, MedPage Today
December 17, 2025 • 2 min read

The FDA approved a label change for the birth control shot depot medroxyprogesterone acetate (Depo-Provera), which now warns about the risk of meningioma, according to a letter posted on the agency website. The new drug label indicates that meningiomas have been reported after repeated administration of medroxyprogesterone acetate, primarily with long-term use. Patients using this form of birth control should be monitored for signs and symptoms of meningioma, and treatment should be discontinued if a meningioma is diagnosed.

The label change follows a study of 10 million U.S. women published in JAMA Neurology in September that showed meningioma was rare, but occurred more frequently among women who used depot medroxyprogesterone acetate versus other forms of contraception. Meningioma risk was limited to women with more than 4 years of exposure to depot medroxyprogesterone acetate, or those who started using it after age 31.

A 2024 case-control study in France suggested that injectable medroxyprogesterone acetate was tied to an increased risk of meningioma.

After the 2024 paper was published, the American College of Obstetricians and Gynecologists (ACOG) issued a guide to discussing the study findings with patients. About 2% of U.S. women use depot medroxyprogesterone acetate for contraception, according to the CDC.

Meningiomas are the most common primary brain tumor. They arise from the membranes surrounding the brain and spinal cord and are usually benign. They have a clear predominance in women, with increasing incidence after puberty, and may require surgery.

Since 2024, more than 1,000 people have filed lawsuits against Pfizer, the maker of depot medroxyprogesterone acetate, claiming the company failed to warn them about the risk of meningioma. Most were women who required surgery; some had ongoing neurologic problems, including vision loss and seizure disorders.

In August, Reuters reported that Pfizer urged a Florida federal judge to dismiss the lawsuits, saying regulators barred the company from including a warning about the tumors on the drug's label.

The company said it concluded in late 2023 that there was a potential causal association between an ingredient in the drug and the tumors and asked the FDA for permission to add a warning about meningiomas on all its medications with that ingredient. The FDA rejected Pfizer's request at the time, saying the data didn't support the warning, according to the filing.

In 2024, the European Medicines Agency issued recommendations to minimize the risk of meningioma with drugs containing medroxyprogesterone.

12/11/2025

How many ultrasounds should you have in pregnancy?

As most questions in pregnancy, this one is dependent on several factors.

In a healthy, low risk pregnancy, typically 2 ultrasounds will be performed. One ultrasound in early pregnancy (6-12 weeks), called a dating ultrasound and one at 20-22 weeks, called an anatomy ultrasound.

If your pregnancy has one (or more) complications more ultrasounds may be needed. Now, how many additional ultrasounds are needed with complicated pregnancies, depends on the complication.

Ultrasound visits do not replace to need to come for regular OB visits in the pregnancy. Ultrasound is a tool that allows us to have insights of assessments. Regular OB visits allow us to assess if there are complications developing and if additional ultrasounds are needed.

11/06/2025

Enroll your child now – Zero cost to families!

11/02/2025

https://www.health.harvard.edu/staying-healthy/the-dark-side-of-daylight-saving-time

Moving the clock ahead in the spring for daylight saving time can disrupt sleep and worsen conditions like depression, anxiety, and seasonal affective disorder. People can lessen the effect by adju...

10/02/2025

What are the risk factors for Breast Cancer?

-Family history of breast or ovarian cancer
-Hereditary breast or ovarian cancers, know as gene mutations (BRCA 1/2 mutations)
-Late menopause
-Nulliparity (never having been pregnant)
-Not having breastfed
-Certain ethnicities (Ashkenazi Jewish)
-Higher body mass index (BMI)
-Cigarette smoking
-Dense breast tissue

***The highest risk comes from family history and genetic mutations***

Most women (with average risk) should have a mammogram starting at age 40. If you have high risk factors, earlier mammogram may be recommended.

If you have high risk factors or are 40 years old, then come in to discuss having a mammogram.

October is Breast Cancer Awareness Month

09/30/2025

What is prenatal care and why is it important?

Prenatal care is essential for optimizing the mother and baby’s health. Consistent pregnancy care reduces pregnancy-associated illness and death, and improves mother/baby outcomes. Early initiation of prenatal care (ideally before 3 months) allows us to identify and manage medical and social concerns. As well as provide testing for diabetes, infection, and treat any conditions that may complicate the pregnancy.

Each mother’s medical and social conditions are unique to them. So, along with routine monitoring of blood pressure, weight, fetal heartbeat, screening for anxiety/depression, domestic violence, and substance abuse, other screenings may be recommended or needed to take excellent care of the woman and her growing baby. It is important to examine and treat conditions in the mother such as anemia (low iron), tooth decay, and urinary tract infections, to decrease the risk of pre-term (early) delivery and other complications to the baby. So, in addition to seeing a midwife or doctor for your pregnancy, you should also see a dentist regularly (before and during pregnancy).

Prenatal care provides education on pregnancy, birth, parenting, and gives access to support for many social concerns. Good prenatal care is associated with lower rates of pre-term birth, stillbirth (miscarriage), and maternal and infant death. Prenatal care is preventative medicine that directly impacts the short and long-term health of both the mother and child.

09/25/2025

~Early testing and timely treatment of Syphilis infections in pregnant women are the key to preventing Syphilis infections in newborns~

-> Sexually transmitted disease (STD) rates for U.S. adults fell last year, but syphilis in newborns continued to rise, according to new government data posted Wednesday.

The CDC provisional data for 2024 showed a third consecutive year of fewer gonorrhea cases, and the second year in a row of fewer adult cases of chlamydia and the most infectious forms of syphilis.

But congenital syphilis cases, in which infected moms pass the disease to their babies, aren't seeing the same improvements. Such infections in infants can lead to deaths or lifelong health problems such as deafness, blindness, and malformed bones.

The number and rate of newborn cases has been rising since 2012, when about 300 were reported, and last year rose to nearly 4,000. The 2024 increase was not as steep as in other years -- cases were up by less than 2%. But health experts say no cases should be happening, and any growth is worrisome.

"The continued rise in congenital syphilis is a distressing indication that we are not doing enough to protect pregnant women and newborns," said Elizabeth Finley, interim executive director of the National Coalition of STD Directors, in a statement.

About 1.5 million chlamydia cases, 543,000 of gonorrhea, and more than 190,000 of syphilis were diagnosed and reported last year. Each was lower than the year before, and the more than 2.2 million total cases represented a 9% decline from 2023.

Overall decreases in STDs in recent years have a lot to do with a general decline in young people having new partners, said Jeffrey Klausner, MD, MPH, an infectious diseases researcher at the University of Southern California.

STD Cases Fall, but Not Syphilis in Newborns
by Associated Press, September 24, 2025

09/24/2025

What is Brandt-Andrews maneuver?

Known as Active Management of 3rd Stage Labor

The Brandt-Andrews maneuver is an obstetric technique used during the third stage of labor to assist with placental delivery by applying gentle, controlled tension to the umbilical cord while simultaneously pushing the uterus upward with the other hand. This combined action helps prevent uterine inversion and promotes placental separation. Key steps include clamping the cord and applying gentle traction, while the other hand provides upward pressure on the lower abdomen.

Purpose
Prevent uterine inversion: The primary goal is to keep the uterus elevated and prevent it from inverting (turning inside out) as the placenta is delivered.

Facilitate placental separation: The maneuver helps to separate the placenta from the uterine wall.

Aid in placental delivery: It provides a controlled method for delivering the expelled placenta from the birth canal.

Facilitating delivery of the placenta following birth if the infant helps to decrease the risk of postpartum bleeding, also known as postpartum hemorrhage.

09/23/2025

Science, not speculation…excerpts taken from:

Autism Experts Rebuff HHS Report on Tylenol-Autism Link, New Indication for Leucovorin
Megan Brooks
September 23, 2025

…The Swedish study of 2.4 million children (1995-2019) that included sibling data to control for genetic and environmental factors found no relationship between exposure to acetaminophen in utero and subsequent occurrence of autism, ADHD, or intellectual disability. This suggests no causal effect of acetaminophen in autism.

…Those and other findings show that prenatal acetaminophen use is safe, the American Psychiatric Association (APA) said in a statement.

…“A strong base of evidence shows that acetaminophen, when taken as directed, is safe for use during pregnancy. Any decisions around a course of treatment should be determined by a patient and their doctor,” the APA said.

…Experts agree that autism is a complex neurodevelopmental condition influenced by many genetic and environmental factors, with no known single cause.

…Because autism is so complex, “the odds of identifying a single factor that causes autism, whether genetic or environmental, is zero,” Alexander Kolevzon, MD, clinical director of the Seaver Autism Center at Mount Sinai in New York City, noted in an interview with Medscape Medical News earlier this year.