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ForwardSeries Description:
This educational activity is designed to incorporate evidence-based pathophysiology, diagnosis, and/or treatment of surgical disorders into clinical practice. Speakers will utilize their personal, institutional, and evidence-based experience to address patient health care conditions requiring clinical and surgical treatment. Speakers will also utilize departmental quality improvement data, M&M data, and patient safety data to improve outcomes of surgical disease and other aspects of surgical patients’ general health. Evidence-based data regarding the changing aspects/newer approaches to surgical disease will be analyzed, and critical issues related to surgery within the broader scope of health care will be discussed. There are varying degrees to individuals’ knowledge regarding clinical and surgical treatments. While individuals may be aware of varied treatments within the surgeons’ armamentarium it is beneficial to address the topics from an evidence-based approach. Learners should both have the knowledge base and be able to apply this knowledge into their practice. Grand Rounds will address each of these shortcomings by utilizing experienced surgical experts in the field. Each month will provide diverse information pertaining to these issues.
Session Description:
This Grand Rounds session will explore current evidence and guidelines for managing appendicitis and biliary disease during pregnancy. Participants will review diagnostic pathways, operative and nonoperative treatment considerations, and strategies for supporting informed, patient-centered decisions.
Target Audience:
Physicians (MD or DO)
Other Healthcare Professionals
Session Learning Objectives:
Upon completing this session participants should be able to:
Describe at least five physiologic changes of pregnancy and the perioperative adjustment each one requires.
Apply ACOG and SAGES principles for timing, consultation, fetal monitoring, positioning and VTE prophylaxis in non-obstetric surgery.
Evaluate the evidence for and against the safety of laparoscopy in each trimester, including its limitations.
Apply an imaging and operative pathway for suspected appendicitis in pregnancy.
Apply evidence-based management to biliary colic, acute cholecystitis, choledocholithiasis and gallstone pancreatitis.
Counsel patients on maternal and fetal risks of operative and nonoperative management using published estimates.
Recognize social determinants of health and implicit bias that affect diagnosis, access, treatment and outcomes, and name three mitigation strategies.
Providing Culturally Appropriate Care which is Free of Implicit Biases (AB 1195 & 241):
Learners are strongly encouraged to engage in self-directed learning related to the impact of implicit biases in this clinical area via the references provided below:
Social Determinants of Health
Wang E, Glazer KB, Howell EA, Janevic TM. Social determinants of pregnancy-related mortality and morbidity in the United States: a systematic review. Obstet Gynecol. 2020;135(4):896-915. (LINK)
Petersen EE, Davis NL, Goodman D, et al. Racial/ethnic disparities in pregnancy-related deaths—United States, 2007–2016. MMWR Morb Mortal Wkly Rep. 2019;68(35):762-765. doi:10.15585/mmwr.mm6835a3
Implicit Bias:
Hoffman KM, Trawalter S, Axt JR, Oliver MN. Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites. Proc Natl Acad Sci U S A. 2016;113(16):4296-4301. doi:10.1073/pnas.1516047113
Saluja B, Bryant Z. How implicit bias contributes to racial disparities in maternal morbidity and mortality in the United States. J Womens Health (Larchmt). 2021;30(2):270-273. doi:10.1089/jwh.2020.8874
Disclosure of Financial or In-Kind Commercial Support & Conflict of Interest
No one involved in the planning or presentation of this educational activity have any relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. No financial or in-kind commercial support was received to produce or promote this educational activity.
– Provider Designee/Verification: Fozia Ferozali, Ed.D.
Faculty List:
Committee Member(s)
Ajay Upadhyay has no relevant financial relationships to disclose at this time.
Planner(s)
Ajay Upadhyay has no relevant financial relationships to disclose at this time.
- 1.00 ABS MOC
American Board of Surgery (ABS)
Successful completion of this CME activity, [which includes participation in the evaluation component], enables the learner to earn credit toward the CME [and Self-Assessment] requirement(s) of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit.
- 1.00 AMA PRA Category 1 Credit™
Physician Credit
Sutter Health designates this Live activity for a maximum of 1.00 AMA PRA Category 1 Credit™ for physicians. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
- 1.00 Non-Physician Participation Credit
Sutter Health designates this Live activity for a maximum of 1.00 Non-Physician Participation Credit. Non-Physicians should claim only the credit commensurate with the extent of their participation in the activity.
AMA PRA Category 1 Credits HOURS™ Continuing Medical Education is acceptable for meeting the continuing education requirements for Pharmacists, Physician Assistants, Psychologists, Registered Nurses, and Respiratory Care Practitioners. For other disciplines, please check with the regulatory board for your discipline to confirm what type of credits meet the continuing education requirements. Continuing education hours for nurses accredited by ANCC, via Joint Accreditation.