In this podcast series, surgical experts, M. Andrew Davis, Traci E. Ito, and Meghan R. Lewis, answer your questions about optimizing the selection, preparation and application of topical hemostatic agents in the hospital outpatient department and ambulatory surgery center environment. Visit https://topical-hemostats-ambulatory-hospital.medicinematters.com/module/webcast/ to watch our webinar and earn CME credit.
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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.
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Blood, Sweat and Smears is a podcast focused on thrombosis and hemostasis and is hosted by Benign Hematologist, Dr. Brad Lewis. Dr. Lewis shares some of his knowledge built over decades of experience in hematology and laboratory testing.
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Episode 7.8 Osteopenia treatments, antenatal steroids, IOL methods, VBAC risk factors, and surgical hemostasis
1:01:19
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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 discus…
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Episode 7.7 Cord Prolapse, Radical Hysterectomy for Cervical Cancer
1:03:43
1:03:43
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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 L…
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Episode 7.6 Maternal Mortality Declining? Plus skin closures and listener questions
59:52
59:52
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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 Mate…
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Episode 7.5 Breech Delivery Tips, Laparoscopy Entry, and IVF Legality
1:08:20
1:08:20
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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 Deliveries 00:13:1…
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Episode 7.4 Oxygen for Decels, Interpreting Studies Part 2, Frozen Eggs
1:03:08
1:03:08
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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 que…
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Episode 7.3 Cephalic Version, Interpreting Studies Part 1, and Jackie Kennedy
1:01:17
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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 Version 00:17:10 Evaluating Clinical Studies 00:53:13 Jackie Kennedy's Impact on Cesarean Deliveries Follow us on Insta…
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Episode 7.2 Cesareans for Macrosomia, Yearly Pelvic Exams, Zuranolone, and more!
1:04:03
1:04:03
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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 a…
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Episode 7.1 New Mammography Guidelines, Four Tips for Fetal Tracings, and Pregnancy after Hysterectomy
1:05:57
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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 0…
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Episode 6.13 Hormone Replacement Myths Part 2
1:06:41
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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 00:22:44M…
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Episode 6.12 Hormone Replacement Therapy Myths Part 1
1:05:00
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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, 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 …
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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 o…
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Episode 6.10 Magnesium Sulfate for Neuroprotection for Preterm Infants
1:08:14
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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 Magnesiu…
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Episode 6.9 Male Circumcision: A Global, Historical, and Ethical Debate
1:02:03
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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 Hist…
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Episode 6.8 The (Near) Future of Obstetrics
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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? 00:00:0…
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Episode 6.7 Early GDM screening, repeat antibody testing, mayo and more
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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. …
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Episode 6.6 Overconsulting and Surgical Training
1:04:27
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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 Sodium 00:09:24 Appropriate Specialty Referrals in Gynecology 00:20:51 Considerations for EIN Management and Ref…
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Episode 6.5 How to Deliver A Baby (an evidence based approach)
1:01:42
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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…
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Episode 6:4 Frequency of Prenatal Visits and Eat, Sleep, Console
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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 Recommenda…
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In this podcast our Medical Director, Dr. Brad Lewis, discusses mixing studies- more specifically what a mixing study is and what it isn't, as well as a few quirks we see in some of the mixing studies. Click here ➡️ https://bit.ly/47wN5fN for information on all the different mixing studies that Machaon Diagnostics performs.…
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Episode 6.3 Rural vs Urban Obstetrics, Screening for BV, and Prophylactic Salpingectomy
59:32
59:32
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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 Bacteri…
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Diagnosing Heparin-Induced Thrombocytopenia (HIT) and the role of HIPA Testing
17:02
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In this podcast, our Medical Director, Dr. Brad Lewis, discusses heparin-induced thrombocytopenia, also known as HIT. Dr. Lewis addresses what HIT is, how to diagnose and interpret testing, and the role of functional testing like the HIPA (Heparin-Induced Platelet Antibody) test.By Dr. Brad Lewis, Machaon Diagnostics
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Episode 6.2 Surgical Restrictions, Probiotics for GBS, Stratafix and more
54:39
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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.By Antonia Roberts and Howard Herrell
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Episode 6.1 Antidepressants in Pregnancy and Cephalosporins in Patients with Penicillin Allergy
54:01
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In this episode, we discuss current evidence about potential cross-reactivity for patients with penicillin allergy who receive a cephalosporin. Then we discuss the safety of antidepressant medications in pregnancy. Follow us on Instagram @thinkingaboutobgyn.By Antonia Roberts and Howard Herrell
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Episode 6: Achieving Effective Hemostasis with THAs to Improve Patient Outcomes
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Dr. Traci Ito and Dr. Drew Davis conclude this podcast series with an informative discussion that offers practical strategies for utilizing THAs for maintaining surgical control of bleeding. Don't miss out on this insightful discussion, packed with practical clinical tips and expert recommendations! Interested in learning more? Visit https://topica…
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Episode 5: Role of Topical Hemostatic Agents in Minimially Invasive Surgery and Gynecological Surgery
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Can topical hemostatic agents be used during minimally invasive surgery? What is the role of THAs in gynecological surgeries? Tune in now to hear Dr. Megan Lewis and Dr. Traci Ito discuss the application of THAs in minimally invasive and robotic surgery, as well as how these agents are utilized during gyncological surgeries. Visit https://topical-h…
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Episode 4: Surgical Scenarios – Strategies for Achieving Hemostasis in Patients with Platelet Dysfunction
5:21
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Dr. Drew Davis and Dr. Megan Lewis address key considerations for achieving effective hemostasis and ensuring optimal patient outcomes in patients with platelet dysfunction. Don't miss out on this insightful discussion, packed with practical clinical tips and expert recommendations! Interested in learning more? Watch the webinar at https://topical-…
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Episode 3: Optimizing Topical Hemostatic Agents for Patients on Oral Anticoagulants – Insights for Surgeons
4:11
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In this podcast episode, Dr. Megan Lewis and Dr. Drew Davis discuss the best THA adjuncts for patients taking oral anticoagulants. Don't miss this informative conversation that explores the challenges and strategies for achieving optimal hemostasis in patients on oral anticoagulants. Tune in now! Visit https://topical-hemostats-ambulatory-hospital.…
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Episode 2: Navigating Topical Hemostatic Options for Patients with Specific Cultural and Religious Beliefs
5:31
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Join Dr. Drew Davis and Dr. Megan Lewis as they delve into the considerations and challenges of using topical hemostatic agents in patients with specific cultural and religious beliefs. In this enlightening podcast episode, they discuss the impact of religious beliefs, such as those of Jehovah's Witnesses, on the choice of hemostatic agents and the…
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Episode 1: Role of Topical Hemostatic Agents for Diabetic Patients
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6:15
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Are you ready to explore the role of topical hemostatic agents in patients with diabetes? Join Dr. Megan Lewis and Dr. Drew Davis as they delve into the commonly asked question regarding the use of THAs in this complex patient population. Listen now to gain valuable insights from leading experts in the field! Visit https://topical-hemostats-ambulat…
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Episode 5.13 Tori Bowie and Maternal Mortality
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In this episode, we discuss the death of Tori Bowie and new data about maternal mortality and the closing gap of black to white mortality in hospital birth. Plus, we discuss pelvic rest after childbirth. Follow us on Instagram @thinkingaboutobgyn.By Antonia Roberts and Howard Herrell
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Episode 5.12 The ARRIVE Trial, Hydration, Partograms, and more
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56:53
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In this episode, we discuss the practice of IV hydration for preterm contractions. Then we take a look at the ARRIVE trial and some recent studies about this controversial study. Plus, we look at several articles from the Labor and Delivery special edition of the Gray Journal. Follow us on Instagram @thinkingaboutobgyn.…
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In this episode, we discuss data about the methods of breech vaginal delivery, including new studies describing the forces with different maneuvers and the ideal position for maximizing pelvic side. Plus, can pregnant women eat sushi? Follow us on Instagram @thinkingaboutobgyn.By Antonia Roberts and Howard Herrell
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Episode 5.10 Ten Things We Wish ER Docs Knew About OB/GYN
1:03:51
1:03:51
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In this episode, we discuss ten things we wish ER docs knew. Also, the history of IUDS, new mammogram guidelines, over the counter birth control, and urine screening for pregnant women with sickle cell trait. Follow us on Instagram @thinkingaboutobgyn.By Antonia Roberts and Howard Herrell
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Episode 5.9 Cookies, Virgin Birth, Forceps, and the History of Handwashing
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41:58
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In this episode, we discuss several new articles, including evidence about operative delivery in obese women, lactation, cookies, propranolol for labor arrest. We also discuss virgin birth in America, whether to place IUD's early in women who have had chorioamnionitis, and the history of hand-washing. Featuring guest co-host Jamie Perry, MD. Follow…
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Episode 5.8 Medical and Surgical Management of Missed Abortion
1:02:33
1:02:33
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In this episode, we discuss a variety of commonly ordered prenatal labs that are unnecessary. We also discuss new studies that affect both surgical and medical management of miscarriage. Finally, we debunk a new study that claims that induction of labor leads to lower test performance in children. Follow us on Instagram @thinkingaboutobgyn.…
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Episode 5.7 In vitro fertilization (infertility Part 4)
1:03:49
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In this episode, we discuss routine labs for patients with a history of hypertension. Then, we take a deeper dive into in vitro fertilization (IVF). Follow us on Instagram @thinkingaboutobgyn.By Antonia Roberts and Howard Herrell
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Episode 5.6 COVID Update, Cystotomies, Scope, and More
1:03:41
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In this episode, we discuss the repair of cystotomies along with the scope of general OB/GYN. Plus, COVID and maternal mortality updates. Then some new literature including an update on Clomiphene vs Letrozole and Azithromycin for vaginal birth. Finally, the best female eponym ever and the removal of Makena from the market. Follow us on Instagram @…
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In this episode, we discuss Polycystic Ovary Syndrome and discover a couple of more female eponyms. Follow us on Instagram @thinkingaboutobgyn.By Antonia Roberts and Howard Herrell
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Diagnosing and treating Hemophagocytic lymphohistiocytosis (HLH)
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In this podcast, our Medical Director, Dr. Brad Lewis, talks with Dr. Scott Canna, from the Division of Rheumatology and the Immune Dysregulation Program at Children's Hospital of Philadelphia. Dr. Lewis and Dr. Canna discuss Hemophagocytic lymphohistiocytosis (HLH); what HLH is, treating and diagnosing HLH, and infections that make you particularl…
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Episode 5.4 Meds for IUD placement, some recent studies, and a poem!
1:02:47
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In this episode, we discover three more female eponyms, plus we review the utility of premedication for IUD placement. We review new literature about maximum dose of oxytocin in labor, surgery vs pessary for pelvic organ prolapse, buprenorphine vs methadone for management of addiction in pregnancy, new guidelines for male infertility evaluation, fa…
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Diagnosing and treating aHUS in a 40-day-old patient
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In this podcast, our Medical Director, Brad Lewis, discusses a pediatric case of aHUS with Dr. Amara Finch, a Pediatric Resident Physician at the University of Utah. Dr. Finch presents a fascinating case of atypical hemolytic uremic syndrome (aHUS) in a 40-day-old patient. Using Machaon Diagnostics' fast turnaround time, physicians were able to get…
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Episode 5.3 Eponyms! and some oncology
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In this episode, we have our new favorite guest Stuart Winkler, to discuss eponyms and also a touch of oncology, including the appropriate work up of unilocular ovarian cysts. Follow us on Instagram @thinkingaboutobgyn.By Antonia Roberts and Howard Herrell
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Episode 5.2 Baby Season (a listener question) and RhoGAM
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In this episode, we discuss the use of RhoGAM in the first trimester. Then we discuss the timing of birth and why babies are born more commonly in some months and days than others. Follow us on Instagram @thinkingaboutobgyn.By Antonia Roberts and Howard Herrell
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In this episode, we discuss caffeine and other supplements and breast pain, then we continue our discussion of management of obstetric emergencies, focusing on amniotic fluid embolism, shoulder dystocia, cesarean under local, and eclamptic seizure. Follow us on Instagram @thinkingaboutobgyn.By Antonia Roberts and Howard Herrell
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In this episode, we discuss the management of nuchal cords at the time of delivery. Then we begin part 1 of our review of obstetric emergencies, focusing on postpartum hemorrhage, uterine inversion, cord prolapse, breech deliveries, and other not so fun stuff. Follow us on Instagram @thinkingaboutobgyn.…
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Episode 4.12 Angle of Progression, Two Layer Closure, and Deliverance
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In this episode, we discuss the newest evidence for two layer closure at the time of Cesarean. Plus, delivery vs birth, a clarification from the prior episode about sexism. Finally, we take a deep dive into the angle of progression and how it can be used to reduces cesareans and promote safety during delivery. Follow us on Instagram @thinkingabouto…
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Episode 4.11: Amnioinfusions, Stat Cesareans, Braxton-Hicks, and TikTok
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In this episode, we discuss the utility of amnioinfusion for both variable decelerations and meconium stained fluid. Plus, how fast do we need to go when doing a Cesarean under general anesthesia. Then we talk about how Braxton-Hicks is still relevant today. Finally, new studies about TikTok and the placebo effect in menopause treatments. Follow us…
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Episode 4.10 Iron in pregnancy, Sexism in OB/GYN, and the Postpartum visit
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57:19
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In this episode, we discuss the pros and cons of iron supplementation during pregnancy. We take a big of a dangerous dive into chauvinism and sexism in OB/GYN. Then, we discuss rethinking the postpartum visit(s) to better serve patients. Follow us on Instagram @thinkingaboutobgyn.By Antonia Roberts and Howard Herrell
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Episode 4.9 Value Based Care Part 2: Vaginal Delivery (and some other stuff)
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In this episode, we discuss management of soft markers of aneuploidy on ultrasound. Also, on update on Makena's potential withdrawal by the FDA. And finally, we discuss value based care for vaginal induction and delivery, including methods of inductions, routine labs, methods of hemorrhage control, sterilization, etc. Follow us on Instagram @thinki…
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Episode 4.8 Fish, Maternity Deserts, and Value Based Care Part 1
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In this episode, we discuss the value of eating fish during pregnancy and the potential harm of warning women about fish. Plus, we discuss factors driving an increase in maternity deserts in the US and discuss value based care in obstetrics and how that may reverse this dangerous trend. In Part 1 of this discussion, we discuss value decisions at th…
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