In this episode, we discuss prevention of thromboembolism during pregnancy and the postpartum period and the evidence for which patients should receive anticoagulation. Plus, the history of heparin and four tips for preventing embolism. 00:00:02 Four Tips for Preventing Thromboembolism in Obstetrics 00:08:39 Anticoagulation Recommendations in Pregnancy 00:22:29 Assessing Anticoagulation Recommendations in Pregnancy 00:35:22 Evaluating Anticoagulation Protocols in Pregnancy 00:42:22 Debating Risks of Obstetric Anticoagulation 00:59:28 History of Heparin Follow us on Instagram @thinkingaboutobgyn.

In this episode, we challenge the reliability of traditional tests like Homan's sign and cervical motion tenderness. Learn how understanding and applying likelihood ratios can vastly improve diagnostic accuracy, and why combining multiple findings is more reliable than putting faith in isolated tests. Then we discuss a new JAMA study linking advanced endometriosis with a heightened risk of ovarian cancer. The study brings to light the complexities and gaps in our knowledge, underscoring the importance of personalized patient discussions regarding risks and treatment options. Next, we discuss a new study about how surgical residents are treated during residency. From inadequate parental leave to cultural pressures, we highlight the urgent need for systematic changes to foster a supportive and equitable environment. Then expose the deceptive practices in the umbilical cord blood banking industry, revealing the ethical issues and questioning the touted benefits. Finally, we answer listener questions about use of sterile gloves for cervical exams and trials of labor after two cesareans. 00:00:02 Obsolete Physical Exam Maneuvers in Gynecology 00:14:25 Endometriosis and Ovarian Cancer Risk 00:20:47 Residency Challenges for Parents and Discrimination 00:33:10 Deceptive Practices in Cord Blood Banking 00:49:19 Debate on Mammography Guidelines 00:54:17 Listener Questions: Sterile Gloves and VBA2C Follow us on Instagram @thinkingaboutobgyn.

In this episode, we discuss four tips for Cesarean under local. Then we discuss some new literature including full versus empty bladder during gyn procedures and endometrial ablation vs IUD for abnormal uterine bleeding. We also discuss the inertia of old ideas in obstetric practice. Finally, we discuss the history of the diagnosis of preeclampsia and eclampsia. 00:00:02 Cesarean Delivery Under Local Anesthesia 00:07:04 Emergency Cesarean Delivery Procedure 00:19:47 Bladder Status in Gynecological Procedures 00:29:01 Endometrial Ablation vs IUD for Treatment 00:38:43 Inertia in Obstetrics Practice Trends 00:47:45 Historical Evolution of Eclampsia Diagnosis Follow us on Instagram @thinkingaboutobgyn.

In the season 8 premiere, we discuss over-utilization of serial quantitative HCGs. Then we discuss several famous or influential studies in obstetrics, including the WOMAN trial, the CLASP trial, the ARRIVE trial, MagPIE, and several more. Finally, we discuss the history of how magnesium sulfate came to be used in obstetrics. 00:00:02 Overuse of HCG 00:13:17 Aspirin for Preeclampsia Prevention Debate 00:18:51 Debate on the ARRIVE Trial 00:29:10 MagPIE 00:39:05 Fetal Fibronectin Trials 00:44:53 Induction at 41 Weeks Discussion 00:55:16 History of Magnesium Use in Obstetrics Follow us on Instagram @thinkingaboutobgyn.

In this episode, we discuss four tips for uterine inversion. Then, we discuss mistreatment and abuse of trainees in OB/GYN plus physician suicide. Finally, we answer a question about closure of peritoneum. 00:00:02 Managing Uterine Inversion in Obstetrics 00:13:39 Combatting Harassment in Medical Training 00:25:41 Addressing Mistreatment in Medical Training 00:31:13 Workplace Mobbing and Bystander Dynamics 00:37:29 Identifying and Addressing Workplace Abuse 00:59:30 Listener Question Follow us on Instagram @thinkingaboutobgyn.

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 Labor 00:12:28 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.

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 Management 00:23:04 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.

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 ECV Follow us on Instagram @thinkingaboutobgyn.

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 Cesarean 00:13:53 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 Follow us on Instagram @thinkingaboutobgyn.

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 Osteoporosis 00:14:40 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 Follow us on Instagram @thinkingaboutobgyn.

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 Labor 00:11:01 History and Evolution of Radical Surgery 00:25:03 Recent Trials on Cervical Cancer Surgery 00:48:33 Activity Restrictions in Surgical Practice Follow us on Instagram @thinkingaboutobgyn.

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 Policies Follow us on Instagram @thinkingaboutobgyn.

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 Deliveries 00:13:17 Alabama Supreme Court and IVF 00:29:15 Initial Laparoscopic Entry Follow us on Instagram @thinkingaboutobgyn.

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 Labor 00:11:00 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.

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 Version 00:17:10 Evaluating Clinical Studies 00:53:13 Jackie Kennedy's Impact on Cesarean Deliveries Follow us on Instagram @thinkingaboutobgyn.

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: Zuranolone Follow us on Instagram @thinkingaboutobgyn.

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 Hysterectomy Follow us on Instagram @thinkingaboutobgyn.

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 products Follow us on Instagram @thinkingaboutobgyn.

In this episode we debunk the first of five myths about menopausal hormone replacement therapy. 00:00:02 Hormone Replacement Therapy For Smokers, HTN 00:11:42 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.

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 Loss Follow us on Instagram @thinkingaboutobgyn.