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 unnecessary tests, and the disconnect many gynecologists have with guideline and evidence based care.

00:00:02 Ultrasound Use in Twin Pregnancies
00:14:06 Twin Growth and Fetal Growth Restriction
00:20:00 Fetal Growth Assessment in Twin Pregnancies
00:29:10 Overdiagnosis of Tongue Tie in Infants
00:38:05Breastfeeding and Tongue Tie Recommendations
00:45:43 Controversy Surrounding Pelvic Exams
00:58:21 Unnecessary Physical Exams and IUD Preferences

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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 Obstetrics

00:08:39 Anticoagulation Recommendations in Pregnancy

00:22:29 Assessing Anticoagulation Recommendations in Pregnancy

00:35:22 Evaluating Anticoagulation Protocols in Pregnancy

00:42:22 Debating Risks of Obstetric Anticoagulation

00:59:28 History of Heparin

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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 importance of personalized patient discussions regarding risks and treatment options.

Next, we discuss a new study about how surgical residents are treated during residency. From inadequate parental leave to cultural pressures, we highlight the urgent need for systematic changes to foster a supportive and equitable environment.

Then expose the deceptive practices in the umbilical cord blood banking industry, revealing the ethical issues and questioning the touted benefits.

Finally, we answer listener questions about use of sterile gloves for cervical exams and trials of labor after two cesareans.

00:00:02 Obsolete Physical Exam Maneuvers in Gynecology
00:14:25 Endometriosis and Ovarian Cancer Risk
00:20:47 Residency Challenges for Parents and Discrimination
00:33:10 Deceptive Practices in Cord Blood Banking
00:49:19 Debate on Mammography Guidelines
00:54:17 Listener Questions: Sterile Gloves and VBA2C

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