OB-GYN To Go: Recent Episodes
Whitney Hoffman, CEO, Hoffman OmniMedia
Dr. Hoffman and Dr. Wasson discuss this important paper about the outcomes of patients delivered prior to 37 weeks, and the significant morbidity risk it poses. Over half of the babies delivered in this retrospective cohort study were delivered for non-evidence based reasons, leading to a higher rate of NICU admissions for these late pre-term birth babies.
Click here to listen to our latest episode where Dr. Hoffman discusses his important research.
Dr. Nima Patel joins us to discuss the June, 2011 new England Journal of medicine Article by Mozaffarian et. al. regarding Changes in diet and lifestyle and long term weight gain in women and men. (N Engl J Med 2011 (Jun); 364(25) 2392-404.) Surprisingly small changes- as little as 50 to 100 calories a day- in diet and exercise have large effects in long term weight management, and certain foods are linked both with long term weight gain or loss. Understanding these factors should help physicians counsel patients on the minor changes that will have the biggest impact on their long term health management based on these large, multi-year studies of healthcare providers.
Click here to listen to our discussion about these factors important to long term health
In this week's show, we discuss the Committee opinion about Tobacco use, and its continued adverse impact on women's health. Tobacco is no longer limited to cigarettes, but people are consuming tobacco and nicotine in other formats, ranging from gels to e-cigarettes, hookas, pouches, and more. The same adverse impacts to health remain regardless of the supposedly healthier ways to "smoke", and surprisingly, despite many efforts to reduce or eliminate smoking all together, tobacco use seems to remain at a relatively constant level. We discuss ways to counsel patients and offer support in their efforts to reduce and eliminate tobacco use, despite many patients worries about weight gain if they cease this habit.
Click here to listen to our discussion about Committee Report 53, Tobacco use and womens health outcomes
In today's show, we discuss with Dr. Jain and Dr. Rutstaller an article from the September, 2011 issue of the American Journal of Obstetrics and Gynecology, regarding the treatment of ologohydramnios before 37 weeks gestation and the implications in clinical care.
Melamed N, Pardo J, Milstein R, et al: Perinatal outcome in pregnancies complicated by isolated oligohydramnios diagnosed before 37 weeks ofgestation, Am J Obstet Gynecol 2011(Sep);205(3):241.e1-6
Click here to listen to the most recent episode!
We talk with Dr. Bobik Vakili about an articel from The October 2011 Green Journal, Obstetrics and Gynecology, entitled "Pelvic Floor Disorders 5 - 10 Years after Vaginal or Cesarean Child Birth" by Handa et. al. Our discussion includes covering clinical implications, what brings patients into the office, and balancing risks between damage to the pelvic floor from operative and spontaneous vaginal deliveries and the risks associated with cesarean section. It was a great talk, and I hope you enjoy it as much as I did.
Click here to download the latest episode with Dr. Vakili
OB GYN To Go #17 Reliability of Laproscopic compared to Hysteroscopic Sterilization at One Year
We sat down with Dr. Hy and Dr. Nima Patel to discuss "Reliability of Laproscopic Compared With Hysteroscopic sterilization at one year- a decision analysis" by Gariepy t al, from Obstetrics and Gynecology Vol. 188 #2 from August, 2011. This paper details the success rates between laproscopic and hysteroscopic sterilization techniques, performed both in the OR and hysteroscopic sterilization performed in the office setting. With 38.2 million US Women using contraceptives, 27% or approximately 10.3 million are using sterilization as their method of choice in preventing conception. With as much as a 10% difference in effectiveness, doctors and patients need to be aware of the relative risks when choosing a method that best suits their needs.
Click here to listen or download Ob Gyn To Go- Reliability of Laproscopic versus Hysteroscopic Sterilization at one year- a decision analysis
OB GYN To Go #16 Misoprostal in Operative Hysteroscopy with Dr. Nima Patel
We spoke with Dr. Nima Patel about the paper by Selk and Kroft- Misoprostal in Operative Hysteroscopy, A systematic Review and meta-analysis that appeared in Obstetrics and Gynecology Vol. 118 No. 4 in October, 2011. The paper reviews randomized controlled studies of patients undergoing operative hysteroscopy unsing misoprostal looking for effects of its use as a cervical dilation agent versus side effects and concluded that current evidence does not support routine use of pre-operative misoprostal in operative hysteroscopy.
Click here to listen to OB GYN To Go # 16 Misoprostal in Operative Hysteroscopy
OB GYN To Go #15 Adverse Health Outcomes in Women Exposed In Utereo to DES
In our most recent podcast, we sit down with Dr. Matthew Hoffman, MD, MPH, FACOG and Dr. Megan Wasson, discussing the recent article on adverse health outcomes in women exposed to Diethylstilbestrol in utereo, appearing in The New England Journal of Medicine, in October, 2011 (N Engl J Med 2011 (Oct); 365 (14): 1304-14). The important factors here include understanding the difference between hazard risk and attributable (cumulative) or absolute risk .
OB GYN To Go # 15 In Utereo DES exposure
In this show, Dr. Venitha Jain, Maternal Fetal Medicine specialist and Dr. Kelly Ruhstaller, OB-GYN 3rd year resident, discuss the clinical problem solving article from the New England Journal of Medicine in the September, 2011 issue, entitled A Problem in Gestation by Chamarthi et. al. (N Engl J Med 2011; 365:843-8), discussing a case of pancreatitis in pregnancy caused by hyperparathyroidism.
While hyperparathyroidism is rare, the testing and diagnostics of variations in calcium levels and the issues and roles of calcium during pregnancy and its role in fetal skeletal mineralization are discussed.
Click here to download and listen to A Problem in Gestation- Pancreatitis and Hyperparathyroidism in pregnancy
OB - GYN To Go- Show #13: Magnesium Sulfate and the Possible Protective Effects for Cerebral Palsy
Dr. Philip Schlossman and Dr. Jennifer Merriman discuss recent New Englad Journal of Medicine articles regarding the use of Magnesium Sulfate antenatally to provide possible protection for some cases of cerebral palsy.
Articles Discussed: A Randomized Controlled Trial of Magnesium Sulfate for the Prevention of Cerebral Palsy, New England Journal of Medicine, 2008; ASSK 2009 Comment Magnesium Sulfate for the Prevention of Cerebral Palsy
Cerebral Palsy (CP) is a non-progressive deficit in motor functioning and posture, typically diagnosed in childhood, with an unknown precise etiology. While its severity can vary, it can be quite debilitating for the child and family, adding significant additional medical costs to caring for CP affected individuals as well as negatively impacting their quality of life. About of a third of all cases of Cerebral Palsy are associated with pre-term birth. While general causes of pre-term birth and its prevention would certainly reduce over all the number of cases of CP, it has been thought that provision of magnesium sulfate antentally may provide some neuroprotection and help reduce the number of cases of CP seen in pre-term infants. Dr. Schlossman and Dr. Merriman discuss the studies, their design, strengths and weaknesses, and how this impacts treatment decisions in clinical practice.
Click here to listen to Magnemisum Sulfate and Cerebral Palsy, Show #13
In this show, Dr. Adrian Queseda and Dr. Matthew K. Hoffman discuss the Quantification of the Familial Contribution to Mullerian Anomolies, ( A. Hammoud et. al., Obstet Gynecol 2008, 111:378-384). This paper was published in Obstetrics and Gynecology in February, 2008 and reveals level II evidence of an increased risk of inheritance of mullerian anomilies, based on data from the Utah Population Database.
Click here to listen or download Mullerian Anomolies
Obesity is growing more and more common in the US and has many associated health risks. But what happens to women who have greater than normal Body Mass Index (BMI) during pregnancy, a time where additional weight gain is expected? Are there additional health risks posed?
In this show, Dr. Adrian Queseda and Dr. Matthew K. Hoffman discuss the association between obesity during pregnancy and the increased use of health care, based on the article of the same name, published in April, 2008 in the New England Journal of Medicine (S. Chu et al, N Engl J Med 358;14, www.NEJM.org).
Click here to listen or download Obesity in Pregnancy
In this program, Dr. Adrian Queseda, MD and Dr. Matthew K. Hoffman, MD, MPH, FACOG discuss the treatment of Asthma in during pregnancy. There is an increasing number of people in the United States who suffer from asthma, and it can be exacerbated during pregnancy. We discuss the latest American College of Obtetrics and Gynecology (ACOG's) practice bulletin outlining the management of asthma during pregnancy and the challenges it poses, and how sometimes "normal" results are not "normal" for the pregnant patient.Click here to listen or download Asthma In Pregnancy- ACOG Bulletin
In today's schow we discuss the new guidelines for cervical cancer screening and colposcopy recommendations, that came out in October, 2007. The changes reflect more conservative treatment, aimed at reducing the impact procedures such as colposcopy may have on fertility and pre-term birth, while maintaining effective screening for disease that will not self-clear. The age of the patient and their screening history impact the decisions made in treatment, and even veteran practioners will need to review the new guidelines in making recommendations for treatment of abnormal pap smears.
Click here to listen to Cervical cancer screening Guidelines
Preterm delivery causes substantial morbidity and mortality in newborns, and may be theleading cause of disability amoung adults. The economic and societal costs are huge, making the prevention of preterm delivery one of the most important issues confronting OB-GYN's. Dr. Schlossman and Dr. Hoffman discuss the latest studies involving the use of progesterone to prevent premature delivery, and the ongoing studies to look at dosage amounts and the mechanism of action.
Click here to download the podcast- OB GYN to go- progesterone and preterm delivery
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Ob-GYN To Go- Vaginal Agenesis
Dr. Matthew Hoffman discusses Vaginal Agenesis and its treatment based on the ACOG Committee Opinion #35 from December, 2006. Vaginal Agenesis occurs in approximately 1 in 4,000 to 1 in 10,000 women, and can be treated in several different ways, including surgical and non-surgical approaches.
Click here to download or listen to Vaginal Agenesis
Dr Matt Hoffman discusses the history of the pap smear as a diagnostic tool for cervical cancer, and the changes in the screening process following the ALTS trial. This podcast is a companion to a more in-depth discussion of the ALTS trial with Dr. Mark Borowsky.
Click here to listen to Show #4 Pap smears: The ALTS trial changes everything
In this episode, residents discuss the challenges to leanring to manage labor and delivery as a first year resident and provide pointers to make this easier for incoming residents.
Click here to listen to Show # 3- OB GYN 101- Labor & Delivery
This show discusses Post partum hemorrhage for OB Gyn residents
Click here to download Show #2
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