Episode 11.8 MTHFR, Bed Rest, and More!

We take on four stubborn myths in modern obstetrics and follow the evidence instead of the vibes, from thrombophilia testing to bed rest to seizure prophylaxis. We also spotlight a patient-empowering insulin strategy that may improve gestational diabetes outcomes faster than usual care. 
• distinguishing recurrent pregnancy loss evaluation from venous thromboembolism testing 
• focusing thrombophilia workups on antiphospholipid antibody syndrome when criteria are met 
• explaining why MTHFR variants and PAI-1 polymorphisms do not belong in routine panels 
• unpacking how social media and narrative fallacies keep low-value tests alive 
• reviewing the AWARE trial and why activity restriction lacks benefit and carries harms 
• clarifying reasonable pregnancy activity modifications versus false labor prevention claims 
• assessing late preterm antenatal corticosteroids for twins and the hypoglycemia signal 
• discussing inertia of practice and why weak evidence becomes hard to undo 
• breaking down patient-led insulin titration for gestational diabetes and why it may reduce macrosomia 
• evaluating laboring down and long-term pelvic floor outcomes plus statistical pitfalls 
• answering a listener question on Keppra alternatives to magnesium for preeclampsia seizures 
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0:00 Welcome And What We’re Reviewing

0:28 Thrombophilia Testing After Miscarriage

3:51 What Belongs In A VTE Panel

5:55 MTHFR And PAI1 Myth Busting

13:36 Activity Restriction And The AWARE Trial

23:27 Practical Counseling Without False Promises

27:08 Late Preterm Steroids For Twins

32:53 Patient-Led Insulin Titration In GDM

38:38 Laboring Down And Pelvic Floor Outcomes

47:51 Keppra Versus Magnesium For Preeclampsia

1:00:25 Wrap Up And Where To Follow

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