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During Pregnancy CONTEMPORARY OB CONTEMPORARY / GYN FEBRUARY 2014, Vol. 59, No. 2 Expert Advice for Today’s Ob/Gyn For Doctors by Doctors ContemporaryOBGYN.net OPIATE ABUSE IN PREGNANCY OPIATE ABUSE DURING PREGNANCY SCREEN AND INTERVENE Mona Prasad, DO, MPH ◾ FUNDING FOR ACADEMIC MEDICINE MEDICINE ACADEMIC FOR FUNDING Why send placentas to pathology? ◾ PLACENTAL PATHOLOGY PATHOLOGY PLACENTAL SMFM CONSULT Risks of CVS and amnio MEDICAL SCHOOL Can it be done in 3 years? FEBRUARY 2014 | VOLUME 59, NUMBER 2 facebook.com/ContempOBGYN twitter.com/ContempOBGYN magentablackcyanyellow ES387450_obgyn0214_CV1.pgs 02.03.2014 21:12 ADV EDITOR IN CHIEF DEPUTY EDITOR Charles J Lockwood, MD, MHCM Jon I Einarsson, MD, PhD, MPH Dean of the College of Medicine Associate Professor of Obstetrics and Gynecology and Vice President for Health Sciences Harvard Medical School The Ohio State University Director, Division of Minimally Invasive Gynecologic Surgery COLUMBUS, OH Brigham and Women’s Hospital BOSTON, MA YOUR EDITORIAL BOARD Haywood L Brown, MD Paula J Adams Hillard, MD Sharon T Phelan, MD Roy T. Parker Professor and Chair, Professor, Department of Obstetrics Professor, Department of Obstetrics Division of Maternal Fetal Medicine and Gynecology, Chief, Division of and Gynecology Duke University Medical Center Gynecologic Specialties University of New Mexico DURHAM, NC Stanford University ALBUQUERQUE, NM School of Medicine STANFORD, CA Joshua A Copel, MD Sarah J Kilpatrick, MD, PhD Joe Leigh Simpson, MD Professor, Obstetrics, Helping Hand Endowed Chair, Executive Associate Dean for Academic Gynecology, and Reproductive Department of Obstetrics and Affairs, Professor of Obstetrics and Sciences, and Pediatrics Gynecology Gynecology, and Human and Molecular Yale University Cedars-Sinai Medical Center Genetics School of Medicine LOS ANGELES, CA Florida International University NEW HAVEN, CT College of Medicine MIAMI, FL John O DeLancey, MD Elliott K Main, MD FOUNDING EDITOR Norman F Miller Professor of Gynecology, Director, California Maternal Quality John T Queenan, MD Director, Pelvic Floor Research, Group Care Collaborative, Chair and Chief, Professor of Obstetrics and Gynecology Director, Fellowship in Female Pelvic Department of Obstetrics Medicine and Reconstructive Surgery and Gynecology Georgetown University School of Medicine University of Michigan California Pacific Medical Center WASHINGTON, DC Medical School SAN FRANCISCO, CA ANN ARBOR, MI Robin Farias-Eisner, MD, PhD Laurie J McKenzie,Mckenzie, MD Chief, Gynecology and Gynecologic Director of Oncofertility, Oncology, Department of Obstetrics and Houston IVF, Director Gynecology, Director of the Center for Houston Oncofertility Preservation Biomarker Discovery and Research and Education (H.O.P.E.) 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This advanced technology provides surgeons with enhanced visualization, precision and control. In fact, 100% of the top 50 cancer hospitals in the United States use the da Vinci Surgical System. Results Matter. See facts and clinical data Patients like Donielle Wiest are believers because results matter. at www.davincisurgery.com/facts All surgery presents risk, including da Vinci Surgery and other types of minimally invasive surgery. Serious complications may occur, up to and including death. Detailed information on indications, risks, benefi ts, considerations and alternatives, as well as a summary of key literature on da Vinci Surgery, is provided at www.davincisurgery.com. 100% of the top 50 cancer, urology and gynecology hospitals ranked by U.S. News & World Report 2013 use da Vinci Surgical Systems. Patients were not compensated for their participation in this advertisement. © 2014 Intuitive Surgical, Inc. All rights reserved. Product names are trademarks or registered trademarks of their respective holders. PN 1005819 Rev B 1/14 magentablackcyanyellow ES384730_OBGYN0214_005_FP.pgs 01.30.2014 00:01 ADV CONTEMPORARYOBGYN.NET FEBRUARY 2014 VOL. 59, NO. 2 GRAND ROUNDS 28 Opiate abuse in pregnancy MONA PRASAD, DO, MPH The most effective approach to screening for substance abuse during pregnancy may be through a series of nonjudgmental questions. SMFM CONSULT 24 Risks of CVS and amniocentesis SOCIETY FOR MATERNAL-FETAL MEDICINE WITH THE ASSISTANCE OF JOANNE STONE, MD Questions and answers about fetal loss and complications associated with chorionic villus sampling and amniocentesis. ONLINE EXCLUSIVE: PATIENT HANDOUT 41 The value of placental pathology RAYMOND W. REDLINE, MD Is it time to get serious about routinely sending placentas for pathologic examination? Clinicians and pathologists have different opinions. 28 About the cover: A close-up of the placental barrier at the cellular level, showing a fetal capillary with nucleated erythrocytes. The glowing dots represent transfer of opiates from mother to child. ACOG GUIDELINES AT A GLANCE 60 Considering the options for 10 EDITORIAL second-trimester abortion CHARLES J. LOCKWOOD, MD, MHCM SHARON T. PHELAN, MD Is the academic medicine bubble about to burst? A commentary on the recommendations in 18 EXPERT PERSPECTIVES ACOG Practice Bulletin No. 135. 23 LETTERS TO THE EDITOR 55 LEGALLY SPEAKING DAWN COLLINS, JD A patient is transferred to another hospital while in active labor and dies. What happened? 63 CALENDAR/AD INDEX 64 CLASSIFIEDS CONTEMPORARY OB/GYN (Print ISSN#0090-3159, DIGITAL ISSN#2150-6264), is published monthly by Advanstar Communications, Inc, 131 West First St, Duluth, MN 55806-2065. One-year subscription rates: $110.00 per year (USA and Possessions); $140.00 per year (elsewhere). Single copies (prepaid only) $12.00 in the USA; $18.00 per copy elsewhere. Include $6.50 per order plus $2.00 for US postage and handling. Periodicals postage paid at Duluth, MN 55806 and additional mailing offices. POSTMASTER: Please send address changes to Contemporary OB/GYN, PO Box 6084, Duluth, MN 55806-6084. Return Undeliverable Canadian Addresses to: IMEX Global Solutions, PO Box 25542, London, ON N6C 6B2, CANADA. Canadian GST number: R-124213133RT001. Publications Mail Agreement Number 40612608. Printed in USA. Subscription inquiries/address changes: toll-free 888-527-7008, or dial direct 218-740-6477. ©2014 Advanstar Communications Inc. All rights reserved. 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