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.

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 Reevaluated Follow us on Instagram @thinkingaboutobgyn.

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 Circumcision Follow us on Instagram @thinkingaboutobgyn.

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 Technology Follow us on Instagram @thinkingaboutobgyn.

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 Standards Follow us on Instagram @thinkingaboutobgyn.

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 Sodium 00:09:24 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.

In this episode we discuss the evolution and evidence behind vaginal delivery techniques. Plus, we discuss the importance of the golden hour after birth for the mother and baby. 00:00:02 Golden Hour Care After Birth 00:09:23 Traditional Practices in Vaginal Deliveries 00:20:54 Optimal Practices for Labor Management 00:26:10 Monitoring and Positions in Labor 00:30:52 Labor Positions and Pushing Techniques 00:36:30 Episiotomy and Preventing Perineal Tears 00:49:54 Third Stage and Cord Clamping Guidelines Follow us on Instagram @thinkingaboutobgyn.

In this episode, we discuss guidelines about bulb suctioning at the time of delivery. Then we discuss the nearly 100 year old schedule of prenatal visits and how these can be modernized. Finally, we discuss the next Eat, Sleep, Console approach for neonatal abstinence. 0:02 Neonatal Suctioning 11:33 Reforming Prenatal Visits and Outdated Recommendations 21:41 Streamlining Prenatal Visits and Remote Monitoring 28:47 The Controversy Surrounding Home Dopplers 33:36 Efficiency and Effectiveness of Prenatal Visits 40:48 Prenatal Care and Biomarkers for Preeclampsia 51:27 Comparing Methods of Diagnosing NAS Follow us on Instagram @thinkingaboutobgyn.

In this episode, we discuss screening for BV to prevent preterm birth. Then new data about the safety of obstetric care in rural vs urban hospitals of different sizes. Plus, new evidence that prophylactic salpingectomy is working and new data about vaginal cuff dehiscence and the analogy between clinical studies and lab tests. 0:02 Treating Bacterial Vaginosis in Pregnancy 10:12 Morbidity Rates in Rural and Urban Hospitals 20:43 Hospital Size and Patient Care Impact 32:56 Maternity Deserts 37:04 Salpingectomy for Ovarian Cancer Prevention 44:10 Analogy of Clinical Trials 49:53 Vaginal Cuff Dehiscence Follow us on Instagram @thinkingaboutobgyn.

In this episode, we discuss current evidence about post-surgical activity restrictions. Plus, we explore probiotics for GBS prevention, vaginal seeding, barbed sutures, disposable staples, and how to be faster during surgery. Follow us on Instagram @thinkingaboutobgyn.