A metanalysis published in Obstetrics and Gynecology, Vol 135, NO.5 May 2020 shows that patients with high grade Cervical Intraepithelial Neoplasia (CIN), a pre-cancerous lesion, may benefit from an HPV vaccine after the surgical diagnosis is made. Recurrent disease was decreased by more than 50% in the vaccinated group in the first 6-18 months after treatment.

Pregnant patients are more likely to be admitted to an ICU, require assisted ventilation and die, compared to pregnant women. Severe complications for mom usually means severe complications for baby. There is limited data to weigh the risks and benefits of the vaccine in pregnancy. The Center for Disease Control, the American College of Obstetricians and Gynecologists, and the Society for Maternal-Fetal Medicine all support the offering of COVID-19 vaccines to pregnant women. I do too.

There is a new one-size-fits-most diaphragm on the market called Caya.  It is non-hormonal and is inserted prior to sex by the user.  Caya needs to be used with contraceptive gel and remain in for 6 hours after coitus.  If you are interested I have some test fit samples in the office.

I now have a patient portal; a secure web site where you can access your visit summaries and laboratory results. You can also send me questions or concerns and I will answer you via this link. The portal site website is https://health.eclinicalworks.com/nathanfujitamd.

You will get your user name and password when you come into the office for your next visit. If you need your password reset, give the office a call (808-538-3787)

With the recent Costco recall for peaches due to Listeria, I thought it would be a good time to blog about this organism. Listeria is a bacterium that can grow in many unusual environments, including normal refrigerator temperatures; freezing has little effect on this microbe as well. Pasteurization temperatures can kill Listeria, but there can be cross contamination if foods are not well handled. Pregnant women are 20 times more likely to come down with Listeria, which can result in spontaneous abortion, preterm delivery or stillbirth. Initial symptoms are flu-like illness, nausea, vomiting and diarrhea. Listeria can cross thru the placenta to infect the baby. A neonate that comes down with Listeria has up to a 50% mortality rate. Proper preparation, storage and handling of food can minimize your risk. Avoid hotdogs or deli meats unless it’s steaming hot; avoid soft cheeses like feta and brie; do not eat refrigerated pate or meat spreads.

I recently learned a new technique for the Davinci Robotic surgeries, the single site approach. This technique leaves a single scar in the belly button, where 4 trocars are placed together. This leaves a cosmetic, almost invisible scar for appropriate surgical candidates. Please ask me about it if you are contemplating surgery.

I posted a youtube video for you to see. http://youtu.be/Ia9KtXuCLYA.

Cases of whooping cough have been on the rise in recent years, and in 2012, the number of U.S. illnesses soared to more than 48,000 — more than any other year since 1955; infants are at particular risk. The formulation for the whooping cough vaccine was changed in 1997. The new formulation causes less of a reaction, but it may also wear off sooner. To maximize protection for an infant, optimal timing for Tdap administration is between 27 and 36 weeks gestation for the pregnant mother to allow passive antibody transfer to the infant. On October 24, 2012, the Advisory Committee on Immunization Practices voted to recommend use of Tdap vaccine during every pregnancy.

Medical technology has gotten to the point where fetal DNA can be detected in the maternal blood stream. This test is not for everyone, but can be considered instead of amniocentesis for maternal age greater than 35, an abnormal fetal ultrasound, previous abnormal baby, abnormal downs screening test, and parental chromosomal translocation. ACOG Committee Opinion 545, December 2012.

In the June 2011 issue of the Journal of the American Medical Association, the Prostate, Lung, Colon, and Ovary (PLCO) Cancer Screening Randomized Trial published their findings in over 78,000 women. Screening women with CA-125 and ultrasound did NOT reduce ovarian cancer mortality. Surgical procedures done for false positive results was associated with complications.