Episódios
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In this episode, we discuss routine bacterial vaginosis screening in patients with preterm labor symptoms. Then, we discuss some dietary and other less-discussed findings from the Women's Health Initiative. We also discuss a new review article about first trimester anatomic ultrasounds. Finally, we answer a listener question about implementing postpartum sterilization routinely into unsupportive hospitals.
00:00:02 Testing for BV in Preterm Labor00:12:28 Clinical Diagnosis of Bacterial Vaginosis
00:21:14 First Trimester Ultrasound in Women's Health
00:34:12 First Trimester Ultrasound Anomalies and Costs
00:38:29 The Cost-Effectiveness of Early Ultrasounds
00:46:32 Improving Postpartum Sterilization Access
00:55:32 Strategies for Postpartum Sterilization Procedures
Follow us on Instagram @thinkingaboutobgyn.
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In this episode, we discuss four tips for IUD insertion. Then we discuss the qualities of good teachers and the important of teaching students and residents, with some practical advice thrown in as well. Finally, we discuss the history of blood transfusion.
00:00:02 IUD Insertion Techniques and Anxiety Management00:23:04 Qualities of a Great Teacher
00:35:16 The Benefits of Teaching in Medicine
00:45:42 Teaching Strategies for Clinical Preceptors
00:52:33 History of Blood Transfusion & Obstetrics
Follow us on Instagram @thinkingaboutobgyn.
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In this episode, we discuss the risks and counseling related to higher numbers of Cesareans. Then, we finish our discussion about vaginal hysterectomy with tips and tricks for some common problems. Finally, we answer a listener question about external cephalic version.
00:00:02 Considerations for Multiple Cesarean Deliveries
00:08:13 Risks and Outcomes of Cesarean Hysterectomies
00:16:09 Uterine Dehiscence and Vaginal Hysterectomy
00:24:01 Tips for Vaginal Hysterectomy Assistants
00:35:24 Mastering the Anterior Colpotomy Technique
00:44:01 Vaginal Hysterectomy Tips and Techniques
00:55:36 Teaching Vaginal Hysterectomy Techniques
00:57:55 Listener Question about ECVFollow us on Instagram @thinkingaboutobgyn.
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In this episode, we discuss four tips for managing the deeply impacted fetal head at the time of Cesarean. Then we discuss the optimal route of hysterectomy (hint: its a vaginal hysterectomy). Finally, we discuss the obstetric history of the Taj Mahal.
00:00:02 Four Tips For Deeply Impacted Head at Cesarean00:13:53 Advantages of Vaginal Hysterectomy
00:25:16 Optimizing Vaginal Hysterectomy Techniques
00:31:53 Advancing Skills in Minimally Invasive Surgery
00:40:24 Advancements in Vaginal Hysterectomy Technique
00:49:20 Debating the Merits of v-Notes
00:58:06 Taj Mahal and Maternal Mortality
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In this episode, we discuss the latest recommendations for treatments for osteopenia and osteoporosis, including vitamin D and calcium, as well as bisphophonates and other medications.
Then we discuss new literature about best methods for induction of labor and risks factors for uterine rupture during a trial of labor after Cesarean. We also discuss a new trial about late preterm antenatal steroids.
Also we talk about a new article about mammalian menopause the evolutionary rolls of menopause and concealed ovulation (fun people, we know!)
Finally, we answer a listener question about bleeding during surgery.
00:00:02 Treatment of Osteopenia and Osteoporosis00:14:40 Vaginal Birth After Cesarean Recommendations
00:24:05 Effectiveness of Late Preterm Steroids
00:35:49 Menopause and Evolution in Mammals
00:41:05 Concealed Estrus and Weight Gain Recommendations
00:47:56 Managing Surgical Hemostasis and Bleeding
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In this episode, Dr. Stuart Winkler returns to discuss new evidence about the risks and benefits of radical hysterectomy for cervical cancers. Also, for fun, we torture a Gyn-Onc with a four tips for managing cord prolapse. Also, we discuss a new commentary on activity restriction after gynecologic surgery.
00:00:02 Management of Cord Prolapse in Labor00:11:01 History and Evolution of Radical Surgery
00:25:03 Recent Trials on Cervical Cancer Surgery
00:48:33 Activity Restrictions in Surgical Practice
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In this episode, we discuss which laparoscopic ports need to be closed and how. Plus, we discuss more evidence that the current narrative about maternal mortality in the US is false. Finally, we answer listener questions about oxytocin protocols and the history and utility of the Bishop's Score.
00:00:02 Closing Laparoscopic Ports
00:13:32 The Maternal Mortality Rate Debate
00:21:04 Maternal Mortality Misconceptions and Progress
00:30:30 Maternal Mortality Misconceptions and Data Accuracy
00:39:27 The Bishop's Score
00:45:41 Debating Oxytocin and Labor PoliciesFollow us on Instagram @thinkingaboutobgyn.
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In this episode, we discuss four tips for breech vaginal delivery. Then, we respond to the Alabama Supreme Court's decisions about embryos and the impact on IVF and reproductive rights. Finally, we discuss the best methods for initial laparoscopic entry and discuss the history of laparoscopy.
00:00:02 Four Tips for Vaginal Breech Deliveries00:13:17 Alabama Supreme Court and IVF
00:29:15 Initial Laparoscopic Entry
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In this episode, we discuss the use of supplemental oxygen for fetal decelerations. Then we get into part 2 of our discussion of interpreting clinical studies and when to adopt new interventions into practice, including a discussion of intranasal metoclopramide, elagolix, and a new study about an app based doula service. Finally, we answer user questions about surprise billing at the time of annual exams and the pros and cons of egg freezing.
00:00:02 Oxygen Supplementation in Labor00:11:00 Interpreting studies part 2: intranasal metoclopramide
00:22:07 Evaluating Efficacy of Elagolix for Endometriosis
00:38:23 Doulas and Birth Outcomes
00:44:32 Listener Question: Surprise Billing
00:51:30 Listener Question: Egg Preservation
Follow us on Instagram @thinkingaboutobgyn.
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In this episode, we discuss four tips for external cephalic version. Then we dive into the basics of interpreting scientific studies. Finally, we discuss the pregnancy history of Jackie Kennedy.
00:00:20 Tips for External Cephalic Version00:17:10 Evaluating Clinical Studies
00:53:13 Jackie Kennedy's Impact on Cesarean Deliveries
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In this episode, we discuss performing Cesarean for fetal weights at lower thresholds than currently recommended. Then we discuss new literature regarding utility of pelvic exams or screening asymptomatic women and early rupture of membranes after cervical ripening with a Foley bulb. Then we discuss an editorial discussing selecting the best test and hysteroscopy for miscarriage after embryo transfer. Plus, a new RCT that examines stopping oxytocin once a patient is in active labor. Finally, we answer listener questions about harms of yearly pap smears and whether we plan to use Zuranolone for treatment of postpartum depression. Buckle up!
00:01:00 Cesarean for Fetal Weight > 4000 g
00:13:20 Pelvic Exams in Asymptomatic Women
00:30:10 Early Amniotomy After Foley Bulbs
00:33:43 The Best Test: Hysteroscopy for Miscarriage
00:40:59 Stopping Oxytocin in Active Labor
00:45:00 Listener Question: Harms Of Yearly Paps
00:55:26 Listener Question: ZuranoloneFollow us on Instagram @thinkingaboutobgyn.
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In the first episode of our new season, we introduce a new segment with Four Tips for managing fetal heart tracings. Then we discuss the new mammography guidelines. And finally we discuss a case of a viable pregnancy in a woman who had had a hysterectomy.
00:20:45 Mammography Guidelines
00:30:12 Debating the Effectiveness of Mammography Screening
00:41:01 Breast Cancer Screening and Overdiagnosis
00:55:50 Pregnancy After HysterectomyFollow us on Instagram @thinkingaboutobgyn.
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In this episode, we discuss five more myths about hormone replacement therapy. Also, we discuss the utility of cervical exams at later pregnancy visits and the history of synthetic hormones.
00:00:02 Intro and Routine Cervical Exams
00:07:51 Myth #6: Lowest dose, shortest duration
00:17:27 Myth #7: Women without a uterus need progesterone
00:22:44Myth #8: Transdermal estrogen is safer than oral
00:36:25 Myth #9: All menopausal women should also be on Testosterone replacement
00:39:50 Myth #10: Ineffective alternative treatments
00:53:04 History of hormone productsFollow us on Instagram @thinkingaboutobgyn.
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In this episode we debunk the first of five myths about menopausal hormone replacement therapy.
00:00:02 Hormone Replacement Therapy For Smokers, HTN00:11:42 Misinformation from Women's Health Initiative
00:17:18 Myth 1: Estrogen and Breast Cancer
00:28:06 Myth 2: HRT and BRCA Patients
00:33:17 Myth 3: Estrogen and Cardiovascular Disease
00:39:14 Myth 4: Bioidentical Hormones
00:51:00 Myth 5: Checking Hormone Levels
Follow us on Instagram @thinkingaboutobgyn.
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In this episode, we discuss several new articles related to treatment of vaginal atrophy or genitourinary syndrome of menopause, including literature that clarifies the role of vaginal estrogen cream. Plus, we discuss the role of washings at the time of management of adnexal masses. We also discuss new literature about the true impact of oxytocin on postpartum hemorrhage risk and examine a paper that claim that female gynecologists receive lower patient satisfaction scores than males. Finally, we discuss the true rate of pregnancy loss.
00:00:02 Peritoneal Washings in OBGYN Surgery
00:21:16 Oxytocin and Postpartum Hemorrhage Connection
00:28:23 Comparing Therapies for Menopausal Symptoms
00:42:54 Female Gynecologists and Patient Satisfaction
00:52:11 The True Rate of Pregnancy LossFollow us on Instagram @thinkingaboutobgyn.
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In this episode, we review the literature regarding the use of magnesium sulfate for neuroprotection to prevent CP in preterm infants.
00:00:02 Magnesium Sulfate for Neuroprotection
00:11:00 The Controversy Surrounding Magnesium Sulfate
00:36:37 Research Study Mistakes and Bias
00:46:33 Magnesium Sulfate's Effects on Preterm Birth
00:52:24 Magnesium for Fetal Neuroprotection ReevaluatedFollow us on Instagram @thinkingaboutobgyn.
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In this episode, we discuss neonatal circumcision and the pros, cons, and ethics. Prepare for controversy. We also discuss the utility of labs for fetal growth restriction.
00:00:02 Circumcision Controversy
00:05:00 Labs for Fetal Growth Restriction
00:15:31 Global Perspectives on Male Circumcision
00:26:17 Significance of Male Circumcision in History
00:33:52 The Arguments for and Against Circumcision
00:53:44 Ethical Considerations of CircumcisionFollow us on Instagram @thinkingaboutobgyn.
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In this episode, we speculate about the near future of advancement of obstetrics, including new vaccines, new uses for cell-free DNA screening, advancement in diabetes monitoring, the use of artificial intelligence and remote monitoring in obstetrics, and artificial womb technology. Also, do you need to stick the GBS swab in you know where?
00:00:02 GBS Swab Technique
00:10:09 Emerging Innovations in Obstetrics
00:18:35 Advancements in Vaccines and Prenatal Care
00:27:49 Diabetes Management and Assisted Birth Advances
00:39:06 AI, Prenatal Care and Fetal Monitoring Advances
00:53:20 Advancements in Artificial Womb TechnologyFollow us on Instagram @thinkingaboutobgyn.
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In this episode, we discuss the utility of repeat antibody testing at 28 weeks. Plus, new evidence about early screening for GDM, the concept of tension in the pelvic floor, the evidence about vaginal prep at the time of unplanned Cesarean, new literature about interventions for preterm birth, and the safety of Mayo (or raw eggs) during pregnancy.
00:00:02 Repeating Type and Screen for RH-Negative Pregnant Women
00:13:54 Evaluating Early Screening for Gestational Diabetes
00:19:24 Discussing Outcomes of Gestational Diabetes Study
00:27:17 Pelvic Therapy and Vaginal Cleansing
00:37:30 The Controversy Surrounding Preterm Birth Interventions
00:50:58 UK and US Egg Safety StandardsFollow us on Instagram @thinkingaboutobgyn.
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In this episode we welcome back Stuart Winkler to discuss over-consulting in OB/GYN and how to improve surgical eduction in our training programs and how to balance generalists vs subspecialists. Plus, colace!
00:00:02 Misuse of Docusate Sodium00:09:24 Appropriate Specialty Referrals in Gynecology
00:20:51 Considerations for EIN Management and Referrals
00:33:57 Endometrial Ablation in Gynecologic Surgery
00:41:53 Practice, Mentorship, Surgical Coaching Importance
00:51:04 Speed and Surgical Competence
00:57:59 Teaching and Expectations in OBGYN
Follow us on Instagram @thinkingaboutobgyn.
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