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PODCAST

Thinking About Ob/Gyn

Antonia Roberts and Howard Herrell

A fresh and evidence-based perspective of all things related to obstetrics and gynecology. Follow us on Instagram @thinkingaboutobgyn or visit thinkingaboutobgyn.com for show notes and more.

health & fitness medicine

All Episodes

52:19

Episode 9:3 Obstetric Life Support with Jacqueline...

Thinking About Ob/Gyn ·

2025/02/06

Join Howard with guest host Jacqueline Vidosh as we explore the challenges of maternal cardiac arrest. This episode emphasizes the urgent need for specialized training in obstetric life support. From discussing causes of maternal mortality to sharing practical tips for first responders, the insights presented aim to enhance awareness and preparedness in critical situations. • Discussing the alarming rise in maternal mortality rates • Identifying common causes of maternal cardiac arrest • The...

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60:56

Episode 9:2 Circumvallate Placenta, Pregnancy Apps,...

Thinking About Ob/Gyn ·

2025/01/23

In this episode, Howard and Antonia focuses on the evolving guidelines for HPV screening and the implications for women's health, highlighting its superior effectiveness over traditional Pap smear tests. Additionally, we explore the reliability of pregnancy apps for information and address a listener question about Group B Streptococcus screening and management. • Discusses the transition to HPV testing as primary cervical cancer screening • Reviews a recent study confirming HPV's effectivene...

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59:08

Episode 9:1 Cesarean Hysterectomy

Thinking About Ob/Gyn ·

2025/01/08

Discover how cesarean hysterectomy, once a procedure shrouded in fear, has evolved into a life-saving operation with contributions from pioneering figures like Eduardo Porro and Lawson Tate. In this episode, we are joined by gynecologic oncologist Stuart Winkler, who shares invaluable insights into both unplanned and planned cesarean hysterectomies. Explore the primary indications for these critical surgeries, from uncontrollable bleeding in unplanned emergencies to managing known conditions ...

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60:00

Episode 8.13: Flagyl, GBS, DUTCH, Jada, Quickening...

Thinking About Ob/Gyn ·

2024/12/25

Challenge preconceived notions in obstetrics and gynecology with our latest episode, where we dismantle myths that have long influenced medical practices, even in the absence of scientific backing. From unraveling the misunderstood reaction between alcohol and metronidazole to examining the overlooked risks of clindamycin cream, we'll look at how these misconceptions take root in medical culture. We continue with a critical analysis of intrapartum GBS prophylaxis, correcting widespread misund...

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63:10

Episode 8.12: Four Tips for Paps, OB Unit Closures,...

Thinking About Ob/Gyn ·

2024/12/12

In this episode, we give four simple tips for performing a Pap smear. Then we dive into the complicated problem of obstetric units closing across the United States and actions we need to take to stop this dangerous trend that threatens the safety of pregnant women and newborns. Also, we highlight the important of hospital based obstetric programs and the history of why births moved into the hospitals in the beginning of the 20th Century and the 99% decline in maternal and neonatal mortality t...

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62:18

Episode 8.11 Catheters in Labor, Occiput Posterior...

Thinking About Ob/Gyn ·

2024/11/28

Do patients in labor need continuous bladder drainage? We will review the literature comparing intermittent to continuous drainage. Next, we venture into the art and science of manual rotation for persistent posterior fetal presentations, a skillful maneuver that might just hold the key to lowering cesarean rates. Drawing from comprehensive reviews and trials, including the TURN-OUT trial and studies from UCSF, we debate the efficacy and applicability of manual rotation in various clinical se...

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65:08

Episode 8.10: Birth Control Counseling, MOC Article...

Thinking About Ob/Gyn ·

2024/11/14

In this episode, we discuss four tips for effective birth control counseling. By dissecting communication techniques, we highlight how striking a balance between relational and task-oriented approaches can maximize patient interactions and ensure comprehensive, evidence-based care regarding birth control choices.Then we delve into several studies from the recent ABOG MOC cycle that we found interesting or curious and point out several informative nuggets.Finally, we discuss the book "Feminine...

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56:15

Episode 8.9: Intrapartum Fentanyl, IUDs and Breast...

Thinking About Ob/Gyn ·

2024/10/30

Can IV fentanyl use during labor actually be safe for mothers and newborns beyond six centimeters of dilation? Join us as we unpack a pivotal 1989 study and question the stereotypes surrounding fentanyl use in labor.Our second segment tackles sensational claims about IUDs and breast cancer, as we dissect a Danish study recently published in JAMA. Listen as we unpack the methodological nuances and confounders that mainstream publications have overlooked, and explore the media's role in shaping...

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57:06

Episode 8.8: Finding Clinical Answers, Iron, Fetal...

Thinking About Ob/Gyn ·

2024/10/17

In this episode, we discuss four tips for finding evidence based answers quickly. Then we discuss some new literature about pap smears and new guidelines regarding iron supplementation in pregnancy. We also discuss the history of corticosteroids for fetal maturity and the hype cycle in medicine.00:00:02 Finding Evidence-Based Clinical Answers Quickly00:13:36 Understanding Evidence-Based Clinical Practice00:23:30 Cervical Cancer Screening During Pandemic00:33:51 Optimal Timing for Cervical Can...

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64:07

Episode 8.7: One Layer or Two? Endometrium or Serosa?...

Thinking About Ob/Gyn ·

2024/10/02

In this episode, we discuss the evidence behind one layer and two layer Cesarean closures with an emphasis on inclusion of the endometrium and the risk of cesarean scar ectopics and placenta accreta spectrum disorders. Plus, we define minimally invasive surgery and trace the origin of the term and it's introduce a new concept: less invasive vs minimally invasive surgery. 00:00:02 Hysterotomy Closure Techniques in Cesarean Deliveries00:14:46 Debunking Claims About Cesarean Techniques00:27:20 U...

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59:53

Episode 8.6 Cervical Catheters, SGA, Due Date Errors,...

Thinking About Ob/Gyn ·

2024/09/18

In this episode, we discuss four tips for placing and using catheters for induction of labor. Then we revisit the issue of small for gestational age versus fetal growth restriction. We also discuss the most common mistake made in calculating due dates and how this can have a negative impact on pregnancies. Finally, we discuss the history of postpartum depression and the literature and stories of Kate Chopin and Sylvia Plath. 00:00:35 Four Tips for Cervical Catheter Placement00:23:00 SGA vs FG...

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64:36

Episode 8.5 Ultrasounds of Twins, Tongue Ties, and...

Thinking About Ob/Gyn ·

2024/09/04

In this episode, we discuss the frequency of Pap smears for twin pregnancies as well as the need for using twin-based growth data for the diagnosis of fetal growth restriction in twins. We will poke the fire of controversy of the use of the terms "fetal growth restriction" and "small for gestational age" and discover how the terms might harm pregnancies. Next, we discuss the new AAP guidelines for diagnosis of tongue ties. Finally, we answer a listener question about pushy doctors, paying for...

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63:17

Episode 8.4 Anticoagulation Use In Pregnancy

Thinking About Ob/Gyn ·

2024/08/22

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 Obstetrics00:08:39 Anticoagulation Recommendations in Pregnancy00:22:29 Assessing Anticoagulation Recommendations in Pregnancy00:35:22 Evaluating Anticoagulation Protocols in Pregnancy00:42:22 Debating Risks...

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66:25

Episode 8.3 Antiquated Physical Exam Techniques, Cord...

Thinking About Ob/Gyn ·

2024/08/08

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 im...

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58:56

Episode 8.2: Cesarean Under Local, New Literature,...

Thinking About Ob/Gyn ·

2024/07/24

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 Anesthesia00:07:04 Emergency Cesarean Delivery Procedure00:19:47 Bladder Status in Gynec...

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63:52

Episode 8.1: Overuse of HCGs, Famous Studies in OB,...

Thinking About Ob/Gyn ·

2024/07/11

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 HCG00:13:17 Aspirin for Preeclampsia Prevention Debate00:18:51 Debate on the ARRIVE Trial00:29:10 MagPIE00:39:05 Fetal Fibronectin Trials00:44:53 Ind...

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66:44

Episode 7.13: Uterine inversion, Trainee Harassment...

Thinking About Ob/Gyn ·

2024/06/26

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 Obstetrics00:13:39 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 QuestionFollow us ...

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61:18

Episode 7.12: BV Screening, WHI, First Trimester...

Thinking About Ob/Gyn ·

2024/06/13

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 Vagino...

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57:31

Episode 7.11: IUD insertion, teaching residents and...

Thinking About Ob/Gyn ·

2024/05/29

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 Teacher00:35:16 The Benefits of Teaching in Medicine00:45:42 Teaching Strategies for Clinical Preceptors00:52:33 History of Blood Transfusion & ...

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71:04

Episode 7.10: Risks of multiple Cesareans, tips for...

Thinking About Ob/Gyn ·

2024/05/15

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 Deliveries00:08:13 Risks and Outcomes of Cesarean Hysterectomies00:16:09 Uterine Dehiscence and Vaginal Hysterectomy00:24:01 Tips for Vaginal Hysterectomy Assistants00:35:24 Masteri...

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