The Curbsiders Internal Medicine Podcast

#472 DIGEST: cfDNA & cancer in Pregnancy, Vitamin K2 for Leg Cramps, PRN anti-hypertensives, GLP-1 Agonists for AUD, Short-Course Antibiotics

Feb 24, 2025
Delve into the innovative world of non-invasive prenatal testing and its potential for early cancer detection in pregnant women. Discover the promising effects of Vitamin K2 for alleviating leg cramps and the dangers associated with as-needed antihypertensives in hospitals. Explore the use of GLP-1 agonists for treating alcohol use disorder and the effectiveness of short-course antibiotics for bacteremia. The discussion also highlights advancements in patient-collected HPV testing for cervical cancer screening, bringing attention to the future of accessible health care.
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INSIGHT

Incidental Cancer Detection in NIPT

  • Non-invasive prenatal testing (NIPT) can incidentally detect maternal cancers through cell-free DNA analysis.
  • Current guidelines lack recommendations on managing non-reportable NIPT results.
INSIGHT

Cancers Found in IDENTIFY Study

  • The IDENTIFY study found cancers in almost 50% of pregnant women with non-reportable NIPT results.
  • These included lymphomas (mostly Hodgkin's) and solid tumors (colorectal, breast).
ADVICE

Whole-Body MRI in Pregnancy

  • Whole-body MRI is useful for detecting cancers in pregnant women due to its lack of radiation.
  • Consider this approach when non-reportable NIPT results raise cancer suspicion.
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