Procedure Ready: Ob/Gyn

By Jennifer Doorey, MD, MSScience Medicine Health & Fitness Education Life Sciences

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Typical duration
21 min
per episode

Based on Podcast App listening data

Procedure Ready: Ob/Gyn episodes

June 09, 2023Operative Vaginal Deliveries
Operative vaginal delivery with forceps or vacuum is uncommon but high-stakes. This episode covers the current incidence, indications, consent considerations, preparation checklist, and contraindications – including what to say about forceps vs. vacuum success rates and laceration risk.
Show Outline:
Incidence – 3.3% as of 2013
Indications – Prolonged second stage, risk of fetal compromise, shortening 2nd stage for maternal benefit (e.g., cardiac conditions)
Consent – Comparison is typically c-section. Failure rate of OVD is ~3–6%. Forceps has a higher success rate over vacuum but also higher risk of 3rd/4th degree laceration. Risks to both mom and baby.
Preparation
Fetus at appropriate station/position
Anesthesia
Empty bladder
Assess pelvis/passenger sizes/fit
OR ready
Pediatrics available
Episiotomy – NO! (Not routinely indicated.)
Contraindications – Fetal conditions, known or suspected: bone disorders (OI), bleeding disorders. Maternal infections: Hep C, HIV, etc. Concern for shoulder dystocia or cephalopelvic disproportion.
About the Speaker:
Jennifer Doorey, MD, MS – Academic Ob/Gyn at The Johns Hopkins University School of Medicine. As the founder of MedReady, Dr. Doorey seeks to advance clinical medical education by developing resources for medical students and clinical educators.
Procedure Ready: Ob/Gyn is a podcast aimed at medical, PA, and NP students entering their clinical rotation in Ob/Gyn. The views expressed are the speaker's own and do not constitute medical advice.
14 min
June 09, 2023Induction of Labor
Induction of labor is one of the most common procedures on L&D. This episode covers the indications (including the landmark ARRIVE trial for 39-week elective induction), the Bishop score for determining readiness, cervical ripening options, pitocin protocols, and the criteria for failed induction.
Show Outline:
Indications – Post-dates (42+wks), late term (41+wks), elective 39+wks, diabetes, hypertension, and many more per ACOG
ARRIVE Trial – Multicenter RCT showing 39wk IOL in low-risk primips had a LOWER c-section rate vs. expectant management to ~41wks, with a trend toward fewer neonatal complications. Many pregnant people are now offered a 39wk IOL.
Evaluate and Prep – Full H&P, ultrasound for vertex position, cervical exam (dilation/effacement/station/position/consistency), calculate Bishop score
Options for IOL
If Bishop <8 (primip) or <6 (multip) → ripen first!
Mechanical cervical ripening (balloon)
Chemical cervical ripening (misoprostol or cervidil)
Best yet – both!
Contractions (Pitocin) – Primip: alone if Bishop ≥8. Multip: alone if Bishop ≥6.
Augmentation – AROM (amniotomy)
Failed IOL – Failure to reach active labor after 18+hrs ruptured on pitocin (definition varies 12–24hrs). If she reaches active labor (6+cm), it's no longer failed IOL – now it's arrest of dilation or descent.
Resources/Links:
ACOG – Medically Indicated Late-Preterm and Early-Term Deliveries
Links:
ACOG – Medically Indicated Delivery: https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2021/07/medically-indicated-late-preterm-and-early-term-deliveries
About the Speaker:
Jennifer Doorey, MD, MS – Academic Ob/Gyn at The Johns Hopkins University School of Medicine. As the founder of MedReady, Dr. Doorey seeks to advance clinical medical education by developing resources for medical students and clinical educators.
Procedure Ready: Ob/Gyn is a podcast aimed at medical, PA, and NP students entering their clinical rotation in Ob/Gyn. The views expressed are the speaker's own and do not constitute medical advice.
18 min
June 08, 2023Shoulder dystocia
Shoulder dystocia is an unpredictable obstetric emergency where seconds matter. This episode covers the definition, risk factors, prevention counseling, exactly what you'll see in the delivery room, and how you as a student can be most useful – including timekeeping and supporting the family.
Show Outline:
Definition – Failure to deliver fetal shoulders with normal downward traction
Why We Care – Baby hypoxia, brachial plexus injuries, maternal injuries
Risk Factors – Diabetes, excessive weight gain, S>D, large baby, history of shoulder dystocia (~10–15% recurrence), turtling while pushing
Prevention – Difficult to predict. Offer cesarean if EFW >5000g (no DM) or >4500g (with DM).
Your Role – Step back. Help minimize family interference with calm explanations. Offer to be the timekeeper – write down times and events, announce every 2 minutes.
What You'll See
Hypothesize shoulder orientation, suprapubic pressure, place stool
Announce the problem and call for help
Maneuvers: McRoberts, suprapubic pressure, posterior arm delivery, rotational (Wood's screw, Rubin), Gaskin's (all fours), episiotomy, Zavanelli (last resort)
About the Speaker:
Jennifer Doorey, MD, MS – Academic Ob/Gyn at The Johns Hopkins University School of Medicine. As the founder of MedReady, Dr. Doorey seeks to advance clinical medical education by developing resources for medical students and clinical educators.
Procedure Ready: Ob/Gyn is a podcast aimed at medical, PA, and NP students entering their clinical rotation in Ob/Gyn. The views expressed are the speaker's own and do not constitute medical advice.
17 min
August 15, 2018Cancer Screening and Vaccinations (HCM)
Cancer screening and vaccinations are essential components of health care maintenance in Ob/Gyn. This episode provides a quick-reference summary of current screening guidelines for cervical, breast, colon, and lung cancer, plus the key vaccination schedules every student should know.
Show Outline:
Cancer Screening
Cervical – Age 21–65, cytology q3yrs, co-testing q5yrs if normal. Follow ASCCP guidelines (there's an app!).
Breast – ACOG: 40–75, annual mammogram
Colon – Colonoscopy, FOBT, FIT. Begin at age 50 (or 40 / 10yrs prior to youngest first-degree relative's diagnosis, whichever is younger).
Lung – 55–80 with 30 pack-year history, annual low-dose CT
Vaccinations
HPV: 3-dose series, age 12–26
Influenza: annual
Pneumovax: 1 dose + 1 booster if risk factors (any age); after 65 if no risk factors
Shingles: 2-dose series, age 50+
Hep B: initial vaccination in youth; vaccinate anyone non-immune
MMR: if not immune
Varicella: if not immune
Tdap: booster every 10yrs, new parents
About the Speaker:
Jennifer Doorey, MD, MS – Academic Ob/Gyn at The Johns Hopkins University School of Medicine. As the founder of MedReady, Dr. Doorey seeks to advance clinical medical education by developing resources for medical students and clinical educators.
Procedure Ready: Ob/Gyn is a podcast aimed at medical, PA, and NP students entering their clinical rotation in Ob/Gyn. The views expressed are the speaker's own and do not constitute medical advice.
13 min
August 15, 2018STIs
Sexually transmitted infections are a core part of gynecologic care. This episode provides a rapid-fire review of the most common STIs organized by diagnostic method – swab/urine vs. serum vs. clinical diagnosis – covering screening recommendations, classic presentations, and first-line treatments.
Show Outline:
Swab/Urine STIs
Chlamydia – Usually asymptomatic. Screen routinely. Can cause infertility/PID and Fitz-Hugh-Curtis syndrome. Treat with Azithromycin ×1.
Gonorrhea – Often asymptomatic. Screen routinely. Can cause infertility/PID. Treat with Ceftriaxone + Azithromycin.
Trich – Frothy/watery discharge, “strawberry cervix.” Can see trich moving on wet mount. Treat Flagyl 2g PO once.
HPV – Cervical dysplasia/cancer and genital warts. Topical treatments as needed.
Serum STIs
Syphilis – Painless chancre → latent → secondary (palmar/plantar rash). If unsure of stage, treat as latent: PCN IM ×3.
HIV – Universal screening. PrEP if high risk. Referral to ID and counseling if positive.
Hep B – Treatable, not curable. Routine serum screening.
No Routine Screening (diagnose if lesion)
HSV – Antivirals for outbreaks; prophylaxis if frequent outbreaks or immunosuppressed. Valacyclovir or acyclovir most common.
About the Speaker:
Jennifer Doorey, MD, MS – Academic Ob/Gyn at The Johns Hopkins University School of Medicine. As the founder of MedReady, Dr. Doorey seeks to advance clinical medical education by developing resources for medical students and clinical educators.
Procedure Ready: Ob/Gyn is a podcast aimed at medical, PA, and NP students entering their clinical rotation in Ob/Gyn. The views expressed are the speaker's own and do not constitute medical advice.
20 min
August 10, 2018 STIs
Swab/Urine Chlamydia: usually asymptomatic. Screen routinely. Can cause infertility/PID and Fitz-hugh-curtis. Treat with Azithro x1 Gonorrhea: often asymptomatic. Screen routinely. Can cause infertility/PID. Treat with Ceftriaxone and Azithromycin Trich: frothy/watery discharge. “Strawberry cervix” Can see trich moving on wet mount. Treat Flagyl 2g PO once. HPV: Cervical dysplasia/cancer and Genital warts. Topical treatments as needed. […]
14 min
August 10, 2018 Cancer Screening and Vaccinations (HCM)
Cancer Screening Cervical: Age 21-65 Cytology q3yrs, co-test q5 if normal. ASCCP guidelines (there is an app! Or PDF: http://www.asccp.org/Assets/51b17a58-7af9-4667-879a-3ff48472d6dc/635912165077730000/asccp-management-guidelines-august-2014-pdf ) Breast: ACOG: 40-75 annual mammogram Colon: Colonoscopy, FOBT, FIT. Begin at age 50. If first degree relative with colon cancer begin screening at age 40 or 10yrs prior to youngest diagnosis, whichever is younger. […]
13 min
February 13, 2018Before Your First: Colposcopy and LEEP
Abnormal Pap? This episode covers the colposcopy and LEEP procedures from start to finish – why we do them (ASCCP guidelines), the histology and staining principles behind acetic acid and Lugol's iodine, what cervical dysplasia looks like through the colposcope, and how LEEP and cold-knife cone excisions differ.
Show Outline:
Why – ASCCP guidelines (there's an app!)
Cervical Dysplasia – Caused by HPV. CIN I → CIN III is a progression. Risk factors: smoking, other STIs including HIV, immunodeficiency.
Histology – Increased nuclear-to-cytoplasmic ratio in abnormal cells
Staining Principles
Acetic acid: higher N:C ratio cells reflect more light and appear white (acetowhite)
Lugol's iodine: reacts with glycogen in normal squamous cells (appear dark); non-staining cells are abnormal
Colposcopic Findings – Increased vascularity, punctations, mosaicism, surface contour changes
LEEP – Stain the abnormality, know where the abnormal biopsy was taken. Single pass is ideal – tag a side for orientation. +/- Top Hat depending on ECC result.
Cold-Knife Cone (CKC) – For pathology higher in the cervical canal; more complications. No electricity – okay if pregnant.
About the Speaker:
Jennifer Doorey, MD, MS – Academic Ob/Gyn at The Johns Hopkins University School of Medicine. As the founder of MedReady, Dr. Doorey seeks to advance clinical medical education by developing resources for medical students and clinical educators.
Procedure Ready: Ob/Gyn is a podcast aimed at medical, PA, and NP students entering their clinical rotation in Ob/Gyn. The views expressed are the speaker's own and do not constitute medical advice.
16 min
February 11, 2018Return OB Visits
What happens at every prenatal visit – and what changes as the pregnancy progresses? This episode covers the routine assessments performed at every appointment, plus the key milestones and screenings organized by gestational age from 20 weeks through delivery.
Show Outline:
Every Visit – Doptones, fundal height, vitals. Four questions: vaginal bleeding, contractions, leaking fluid, fetal movement.
By Gestational Age
20wks – Get and review anatomy ultrasound
24wks – Order glucola, CBC (check for anemia), discuss normal growing pains
28wks – Tdap and RhoGAM if needed, discuss kick counts
32wks – Discuss birth control method, sign tubal papers if needed, discuss TOLAC if needed
36wks – GBS screening, birth expectations, ultrasound for position
38–40wks – Vaginal exam, “sweep membranes”
About the Speaker:
Jennifer Doorey, MD, MS – Academic Ob/Gyn at The Johns Hopkins University School of Medicine. As the founder of MedReady, Dr. Doorey seeks to advance clinical medical education by developing resources for medical students and clinical educators.
Procedure Ready: Ob/Gyn is a podcast aimed at medical, PA, and NP students entering their clinical rotation in Ob/Gyn. The views expressed are the speaker's own and do not constitute medical advice.
13 min
February 08, 2018First Prenatal Visit
The first prenatal visit sets the tone for the entire pregnancy. This episode walks through everything you'll need to cover – from confirming the pregnancy and dating ultrasound, to screening options, weight gain targets by BMI, food and medication safety, and exercise recommendations.
Show Outline:
Initial Assessment – Planned/desired pregnancy, options counseling if needed, full exam/pelvic/Pap
Ultrasound – Dating scan
Screening Options – QUAD, Sequential, NIPS, invasive testing
Weight Gain Targets by BMI
BMI <18.5: gain 28–40 lbs
BMI 18.5–24.9: gain 25–35 lbs
BMI 25–29.9: gain 15–25 lbs
BMI ≥30: gain 11–20 lbs
Food Safety – Avoid unpasteurized dairy, large fish (swordfish, shark, king mackerel, tilefish, bigeye tuna, etc.), uncooked meat/seafood, uncooked deli meat, alcohol
Medications – Nothing unless cleared by MD. Tylenol okay if needed. PNV, Colace, FeSO4. NO NSAIDs!
Exercise – Nothing that could leave a bruise on your belly! Moderate exercise is great.
About the Speaker:
Jennifer Doorey, MD, MS – Academic Ob/Gyn at The Johns Hopkins University School of Medicine. As the founder of MedReady, Dr. Doorey seeks to advance clinical medical education by developing resources for medical students and clinical educators.
Procedure Ready: Ob/Gyn is a podcast aimed at medical, PA, and NP students entering their clinical rotation in Ob/Gyn. The views expressed are the speaker's own and do not constitute medical advice.
18 min

About Procedure Ready: Ob/Gyn

From the publisher's feed

Procedure Ready: Ob/Gyn (formerly called Pimped Ob/Gyn) is a podcast aimed at medical, PA, and NP students who are entering their clinical rotation in Ob/Gyn. It covers topics including Your Ob/Gyn Survival Guide-Tips and Tricks, Labor and Delivery, Vaginal deliveries, C-sections, Hysterectomies, and more.