ObG Project Podcasts – Details, episodes & analysis

Health disparities in the United States are not a foregone conclusion and all of us can be part of the solution! We talk to Ebony Carter today and discuss the drivers of health disparities in the United States and explain the impact of implicit bias and racism on health outcomes. We discuss evidence for group prenatal care as a potential solution and review potential mechanisms for why group prenatal care may promote health equity. As always, our med-ed enthusiast Dr. Ashley Comfort joins us to moderate the discussion. 

Today we feature Tamar Goldwaser and the New ACMG Guidelines for Prenatal and Preconception Carrier Screening. Genetic testing is expensive! Until now it has been reserved for a few populations that are known to be at higher risk. But we have missed many carriers this way. Many families continue to be unprepared for the news that their child has a severe inherited genetic condition that was passed on from the parents. 

What about everyone else? The time is now! With advanced technology making testing for hundreds of genes all at once, faster and cheaper, we can finally envision a reality where all patients can be tested before they start to build a family. If a couple finds out that they are carriers, they can use this information to take advantage of various reproductive options. 

This is genetic testing for all! This is one step towards equity in reproductive medicine. I am proud to be an author on a Practice Resource published by the American College of Medical Genetics and Genomics (ACMG) entitled “Screening for autosomal recessive and X-linked conditions during pregnancy and preconception,” which recommends a uniform set of conditions for carrier screening panels for all individuals, regardless of ethnicity, race or population. It is my hope that this leads to increased awareness, familiarity and clarity among doctors and genetics professionals and also puts pressure on insurance companies to cover testing. 

HIV pre-exposure prophylaxis (PrEP) has been a proven HIV prevention modality for almost a decade, yet women, who make up 20% of new HIV cases annually, have not been prioritized in these efforts. Join us as we discuss the basics of PrEP, which medications are available now, what patients would get the most benefit from it, and how to conduct a good sexual history, initiate, and conduct follow-up visits for PrEP.

Today we talk to Dr. David Malebranche and Ariel Watriss on how to integrate the latest CDC HIV prevention guidelines into your practice. We discuss the science and effectiveness of PrEP,  the patients who may benefit the most from PrEP, and describe the baseline and follow-up labs needed to administer PrEP to patients. We also discuss how you can integrate PrEP into your current clinical practice and how to design a clinical flow template to assess needs and indications for PrEP

Multiple responsibilities, systemic discrimination, poor societal support, and a pandemic to boot - it's no secret that American women are experiencing record levels of stress, and they're bringing it to your office.

Do you want to be more effective at helping women in their moments of distress? Join Dr. Lulu Zhao, MD, a board-certified ObGyn fellowship trained in women's mental health to discuss practical tips for managing mental health disorders common in the ObGyn office, top medication prescribing mistakes to avoid, and strategies to help your patients connect to the information and care they need.

We discuss how to practice using validated screening tools to identify perinatal mood disorders, recognizing how mood disorders may present in marginalized or traumatized populations, how to counsel patients about common concerns in the use of psychotropic medications, how to choose medications that effectively treat common mental health conditions, and how to integrate existing resources into your clinical toolbox to optimize time management

Today with talk with Dr. Margaret Dow on shoulder dystocia and the latest on emerging strategies. In this episode we describe classic algorithms for managing shoulder dystocia, explain how emerging techniques augment classic approaches used to manage shoulder dystocia, demonstrate the steps of a posterior sling technique and shrug technique for shoulder dystocia, identify low- and high fidelity options for shoulder dystocia simulation, and summarize the patient care benefits of shoulder dystocia simulation.

Dr. Dow also shows her very own very patent protected simulation tool!

Today we chat with Dr. Carrie Sopata about the Lichens! Lichen Sclerosis, Lichen Planus and Lichen Simplex Chronicus the Diagnosis of Skin Disorders and Vulvodynia. We discuss how to Identify features of lichen sclerosis, lichen Planus, and lichen simplex chronicus and make a diagnosis based on physical exam findings, the list of treatment options for refractory lichen sclerosis and recognize the benefits of long-term management. We state the current knowledge of the benefits of fractional laser in the treatment of lichen sclerosis, how to perform a tailored vulvar exam in patients complaining of vulvar pain, and create a management plan for patients with Vulvodynia that addresses their psychological and physical complaints.

Vulvar skin disorders are common and can be frustrating to treat because they often are chronic and patients have tried multiple therapies without success. for the physician, high potency steroids are the mainstay of treatment, but some patients are non-responsive and/or non-compliant with this medication. When patients do not respond to steroids, what should be the next step? And how should patients be managed long term?

Today we talked to Dr. Sarah Petruska about Vaginal Birth After Cesarean (VBAC). We covered how to Assess factors that impact risks and benefits of a trial of labor after cesarean, describe the role of maternal autonomy in the decision for cesarean, how to assess the patient’s chance for a successful trial of labor, and how to identify factors that patients may weigh when deciding the value successful VBAC holds for them.

Supporting patients in their choice for Trial of Labor after Cesarean is an important part of reducing the cesarean delivery rate. In addition, thinking about how we counsel patients about this topic gives us an opportunity to examine the language we use in all of the counseling we do, to make sure we communicate with patients in a way that respects autonomy. Historical data on factors that affected patients' chances for successful VBAC give us a window on racial and ethnic disparities in obstetrical practice.

Today we talked to Dr. Ashley Fuller to discuss Low Libido and Sexual Dysfunction. We covered how to screen patients for sexual dysfunction including how to approach the topic with patients, describe how to approach the common concern of low libido from a practical and evidence-based perspective, manage a treatment plan for hypoactive sexual desire disorder, and apply key principles to be a resource for women struggling with sexual dysfunction. See below resources discussed during the talk!

• A Tired Woman’s Guide to Passionate Sex by Laurie B. Mintz, PhD
• Becoming Cliterate by Laurie B. Mintz, PhD
• Girls & Sex: Navigating the complicated new landscape by Peggy Orenstein
• Boys & Sex: Young Men on Hookups, Love, Porn, Consent, and Navigating the New Masculinity by Peggy Orenstein

• The North American Menopause Society: journals, resources, seminars, and patient resources
• Gennev: Empowering women to take control of their health in the second half of life starting with menopause
• International Society for the Study of Women’s Sexual Health

• Lelo: Sona Cruise Clitoral sonic stimulator
• Womanizer: Womanizer Premium Suction clitoral massager
• Dipsea: audio stories that spark your imagination and get you in the mood
• Rosy: Sexual Wellness (Solutions) Woman Deserve (also an app)
• Omgyes.com: honest, practical resource about women’s pleasure.

OBG CORExchange a podcast featuring regular discussions with renowned researchers (and the resident researchers, too!) to discuss practical advice, mentorship, and resources for any academically inclined physician.

This episode features Dr. Jocelyn Fitzgerald, Assistant Professor in the Department of Obstetrics, Gynecology & Reproductive Sciences, Division of Urogynecology & Reconstructive Pelvic Surgery. Dr. Fitzgerald is a life-long Pittsburgher with research expertise in a myriad of topics including patient-centered outcomes in pelvic reconstructive surgery, surgical innovation in pelvic reconstructive surgery, equity in medicine, the role of social media in medicine.

OBG CORExchange a podcast featuring regular discussions with renowned researchers (and the resident researchers, too!) to discuss practical advice, mentorship, and resources for any academically inclined physician. 

Switching gears to gynecology, come join us for a discussion with Gyn Oncologist Dr. Haley Moss, MD, MBA (@haleyarden1) and clinical fellow Dr. Benjamin Albright (@benalbrightmd) on how states’ rights to adopt Medicaid expansion inadvertently lent itself to a public health experiment as well as their motivation and passion for research centered on public policy.