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