Discover how cesarean hysterectomy, once a procedure shrouded in fear, has evolved into a life-saving operation with contributions from pioneering figures like Eduardo Porro and Lawson Tate. In this episode, we are joined by gynecologic oncologist Stuart Winkler, who shares invaluable insights into both unplanned and planned cesarean hysterectomies. Explore the primary indications for these critical surgeries, from uncontrollable bleeding in unplanned emergencies to managing known conditions like placenta accreta in planned scenarios. You'll gain a deep understanding of the strategic decision-making required, especially in resource-limited environments, to ensure the best outcomes for patients.

Navigate the complexities of performing cesarean hysterectomies under challenging circumstances, particularly when severe hemorrhage threatens patient safety. We delve into surgical tips and techniques, emphasizing the significance of early and careful bladder dissection, effective use of energy sealing devices, and confident decision-making. Our discussion highlights innovative strategies for uterine preservation in placenta accreta spectrum disorders, offering creative solutions when complete resection isn't feasible, and exploring new protocols that balance operative blood loss and patient fertility.

Finally, take a journey through the historical evolution of cesarean hysterectomy with us, as we trace its transformation from a fearful, last-resort measure to a cornerstone of modern obstetric care. Learn about the pivotal technological advancements that have shaped current practices, such as preoperative arterial occlusion techniques, equipping today's surgeons with a wide array of tools to tackle even the most complex cases. This episode promises a comprehensive blend of historical insights and practical advice, making it an essential listen for both seasoned professionals and those new to the field.

00:00:01 Cesarean Hysterectomy
00:09:14 Surgical Tips for Cesarean Hysterectomy
00:17:42 Advanced Techniques in C-Hysterectomy
00:23:56 Surgical Tips for Planned C-Hysterectomy
00:31:36 Surgical Techniques for Hemorrhage Control
00:41:38 Uterine Preservation in Spectrum Placenta
00:53:37 Evolution of Cesarean Hysterectomy

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Challenge preconceived notions in obstetrics and gynecology with our latest episode, where we dismantle myths that have long influenced medical practices, even in the absence of scientific backing. From unraveling the misunderstood reaction between alcohol and metronidazole to examining the overlooked risks of clindamycin cream, we'll look at how these misconceptions take root in medical culture. We continue with a critical analysis of intrapartum GBS prophylaxis, correcting widespread misunderstandings around its purpose and timing during labor and how it affects labor management.

We address the rise of dubious hormone tests, like the DUTCH Test, marketed to consumers, painting a cautionary picture of how social media amplifies these unvalidated products. We highlight the importance of consulting healthcare professionals while discussing the potential paradigm shift that self-collected HPV testing could bring to cervical screening, as recommended in the coming cervical cancer screening guiudelines. This new approach might revolutionize screening rates and quality of care, especially for underserved populations, all while realigning healthcare providers' focus on more pressing medical needs.

Prepare for an engaging conclusion as we scrutinize the comparative effectiveness of postpartum hemorrhage devices Jada and Bakri, emphasizing the ethical implications of cost versus efficacy. We'll take you on a historical journey through the concept of "quickening" in pregnancy, reflecting on its cultural significance and evolution with modern science.

Plus, changes for next season!

00:00:02 Metronidazole and Alcohol
00:13:03 Intrapartum GBS Prophylaxis Guidelines Clarified
00:24:54 Hormone Testing and Cervical Screening
00:31:07HPV Self-Collect Screening Implications
00:42:54 Comparative Efficacy of Postpartum Hemorrhage Devices
00:51:29 Historical Perspectives on Fetal Development

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In this episode, we give four simple tips for performing a Pap smear. Then we dive into the complicated problem of obstetric units closing across the United States and actions we need to take to stop this dangerous trend that threatens the safety of pregnant women and newborns. Also, we highlight the important of hospital based obstetric programs and the history of why births moved into the hospitals in the beginning of the 20th Century and the 99% decline in maternal and neonatal mortality that followed.

00:00:02 Cervical Cancer Screening Tips

00:14:13 Hospital Closures Affect Obstetric Care

00:37:27 Rural Obstetric Units Closing Challenges

00:44:53 Hospital vs. Home Birth Safety

00:49:40 Healthcare Disparities for Women and Children

00:55:08 Evolving Birth Settings in America

01:02:28 Email Advocacy for Healthcare Reform

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