Procedure Ready: Ob/Gyn

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

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Typical duration
21 min
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Based on Podcast App listening data

Procedure Ready: Ob/Gyn episodes

December 13, 2017Preterm Labor and PPROM
Preterm labor and preterm premature rupture of membranes (PPROM) are critical diagnoses on L&D. This episode reviews the evaluation approach – from sterile speculum exam to fetal fibronectin – and the management protocols including magnesium for neuroprotection, betamethasone, tocolysis, and latency antibiotics. Based on ACOG Practice Bulletin #171.
Show Outline:
PTL/TPTL – Preterm (<37wks) with cervical change
Evaluation – SSE first: collect GC/CT cultures, FFN (no gel, blood, or semen), GBS, evaluate for rupture if needed. SVE for dilation/effacement changes.
If tPTL
Magnesium for neuroprotection (<32wks to decrease CP rates)
Betamethasone for fetal lung development
PCN
Tocolysis for the steroid window (48hrs) if <34wks (indomethacin if <32wks, nifedipine if 32+wks)
IV fluids
NICU consult
PPROM – Preterm (<37wks) with ruptured membranes. Confirm with pooling, nitrazine, ferning.
If PPROM – Delivery at 34wks or at diagnosis if chorio/34+wks
Latency antibiotics (Erythromycin/Azithromycin + Ampicillin × 2 days, then PO Erythro/Amoxicillin × 5 days)
Magnesium, betamethasone, PCN
NO tocolysis
NICU consult
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.
21 min
December 12, 2017 Preterm Labor and PPROM
ACOG Practice bulletin: # 171 PTL or TPTL: Preterm <37wks, cervical change Evaluation: SSE first: Collect GC/CT cultures, FFN (no gel, blood or semen), GBS, eval for rupture if needed SVE: Cervical change–can dilation or effacement changes FFN: Fetal fibronectin If tPTL: Magnesium for neuroprotection if <32wks, decrease CP rates Betamethasone for fetal lung development […]
21 min
December 04, 2017 Birth Control
Resources: https://www.bedsider.org/methods Table: http://www.womenscommunityclinic.org/wp-content/uploads/Bedsider-Birth-Control-Effectiveness-Poster.jpg Spanish: http://s3.amazonaws.com/providers/images/images/000/000/032/center/Spanish_tiers_of_effectiveness.png?1464661802
20 min
December 03, 2017Indications for a c-section during labor
When does a laboring patient need a cesarean delivery? This episode covers the six key indications – from nonreassuring fetal heart tracings to cord prolapse – including the specific time criteria for arrest disorders and what fetal heart rate findings are the most concerning.
Show Outline:
Nonreassuring Fetal Heart Tracing – Category 2 remote from delivery; minimal/absent variability as the most significant predictor of fetal acidemia; Category 3 at any time is emergent delivery
Failed IOL – Most commonly defined as 12–24hrs ruptured membranes on pitocin without active labor
Arrest of Dilation – Must be in active labor (6cm+). Adequate contractions (IUPC with MVUs >200–250): no change over 4hrs. Inadequate or no IUPC: no change over 6hrs
Arrest of Descent – Primip with epidural: 3hrs; without: 2hrs. Multip with epidural: 2hrs; without: 1hr
Cord Prolapse – Emergency!
Malpresentation – Breech, transverse, compound
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
December 03, 2017Birth Control
Contraception counseling is one of the most common and impactful conversations in Ob/Gyn. This episode provides a comprehensive overview of birth control options – from LARCs to barrier methods – along with key resources and visual tools for patient-centered counseling, including in Spanish.
Resources/Links:
Bedsider – Birth Control Methods – Comprehensive patient-friendly resource for comparing options
Bedsider Birth Control Effectiveness Poster – Visual tiers-of-effectiveness chart for counseling
Spanish Tiers of Effectiveness – Same chart in Spanish
Links:
Bedsider – Birth Control Methods: https://www.bedsider.org/methods
Bedsider Birth Control Effectiveness Poster: http://www.womenscommunityclinic.org/wp-content/uploads/Bedsider-Birth-Control-Effectiveness-Poster.jpg
Spanish Tiers of Effectiveness: http://s3.amazonaws.com/providers/images/images/000/000/032/center/Spanish_tiers_of_effectiveness.png?1464661802
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.
21 min
November 20, 2017Before Your First: Hysterectomy
Hysterectomy is one of the most common major surgeries in gynecology. This episode reviews the different surgical approaches, the decision to take or leave the tubes and ovaries, the critical surgical steps – including the four sites of ureteral injury – and key anatomy like the IP ligament, uterine artery, and round ligament.
Show Outline:
Approach – Abdominal, laparoscopic, vaginal, or combination
Tubes and Ovaries – What benefit do they provide? Ovaries still benefit bones and cardiovascular health even after menopause (65yr old cut-off for removal).
Key Surgical Steps
Round Ligament – Sampson's artery runs inside
IP Ligament (formerly suspensory ligament of the ovary) – Conceals ovarian blood supply from the aorta. If transected before fully sealed, can hemorrhage while retracting into the retroperitoneum.
Four Levels of Ureteral Injury – (1) Pelvic brim, (2) medial to IP ligament, (3) under the uterine artery (“water under the bridge”), (4) lateral to vaginal cuff closure
Uterine Arteries – Ligate and transect; the uterus should blanch white
Colpotomy – Disconnecting the uterus from the vagina
Vaginal Cuff Closure – If total hysterectomy
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.
21 min
November 19, 2017Before Your First: Laparoscopy
Your first time in the OR for a laparoscopic case can feel high-stakes. This episode covers everything from how to be helpful during setup and patient positioning, to the anatomy you'll see on screen, entry techniques, port placement, common GYN procedures, and what to watch for in post-op recovery.
Show Outline:
Before the Case – Review anatomy, know the case and why, greet the patient, help set up stirrups/yellowfins, scrub in properly
Prep – Abx if entering uterus or vagina (i.e., hyst). Chloraprep or similar (EtOH-based – must evaporate before draping!). Vaginal prep with betadine or chlorhexidine.
Uterine Manipulators – Many sizes/shapes/types. Vagina is dirty – can't go from vagina to abdomen.
Abdominal Entry – Typically in the umbilicus. Options: direct visualization with Hasson, Visiport, Veress needle. Insufflate with CO2. Palmer's Point if needed.
Port Placement – Middle ⅓ between ASIS and umbilicus. Avoid superficial vessels and inferior epigastric arteries – watch from below.
Common Procedures – Diagnostic LSC (endometriosis, adhesions), tubal ligation or bilateral salpingectomy, cystectomy, BSO, hysterectomy
Closing – Close fascia on ports >5mm (hernia risk)
Post-Op – Many cases are same-day. Check nausea/vomiting, eating/drinking, voiding, flatus, ambulation, UOP, BPs.
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.
29 min
November 19, 2017Hypertension in Pregnancy
Hypertensive disorders of pregnancy exist on a spectrum – from chronic hypertension to eclamptic seizures. This episode breaks down the classifications, blood pressure thresholds, antihypertensive options, severe features to watch for, and the HELLP syndrome.
Show Outline:
The Spectrum – Hypertension in pregnancy as one large continuum
Blood Pressure Thresholds – Mild range: 140/90; Severe range: 160/110
Classifications – CHTN → SIPE (superimposed preeclampsia); gHTN → Pre-E (preeclampsia)
BP Medications – Methyldopa, labetalol, hydralazine, nifedipine
Severe Features – Severe-range BPs, neurologic symptoms, lab abnormalities
HELLP Syndrome – Hemolysis, Elevated Liver enzymes, Low Platelets
Eclampsia – Seizures in the setting of preeclampsia
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.
25 min
November 14, 2017Before Your First: Cesarean Section
Whether it's scheduled or called urgently during labor, the cesarean section is one of the most common surgeries you'll see on Ob/Gyn. This episode covers the indications, abdominal wall anatomy layer by layer, the key surgical steps from hysterotomy to closure, and how you can be the most helpful in the OR.
Show Outline:
Scheduled Indications – Repeat cesarean, hx of uterine surgery, abnormal placentation (placenta previa, vasa previa, accreta, etc.), malpresentation (not cephalic), multiple gestation
In-Labor Indications – Arrest of dilation, arrest of descent, nonreassuring fetal heart tones, elective
Anatomy – Layers of the anterior abdominal wall: skin, subcutaneous tissue, superficial fascia (Camper's, Scarpa's), external oblique, internal oblique, transversus abdominis, transversalis fascia, preperitoneal tissue, and peritoneum
Key Surgical Steps
Clear surgical field and adhesions, bladder flap
Hysterotomy in the lower uterine segment (avoid lateral uterine vessels)
Deliver baby with delayed cord clamping, deliver placenta
Manage atony with same meds as vaginal delivery
Possibly exteriorize uterus to see better – depends on scarring
How to Be Helpful – Visualization! Bladder blade, suction, and clean with laps between sutures
Closure
Two-layer hysterotomy if future labor desired
Peritoneum – optional, no evidence either way
Muscle – do NOT close (risk of hematoma)
Fascia – close! Key nerves: ilioinguinal, iliohypogastric
Subcutaneous fat – close if >2cm depth
Skin – staples, suture, or absorbable staples
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.
26 min
October 29, 2017Before Your First: Vaginal Delivery
Your first vaginal delivery can be exhilarating and nerve-wracking all at once. This episode walks you through the cardinal movements of labor, how to assist with pushing, delivering the baby and placenta, managing bleeding, and what to expect in the immediate postpartum period.
Show Outline:
Cardinal Movements of Labor – Engagement, descent, flexion, internal rotation, extension, external rotation, and expulsion
Complete Dilation – Station assessment, labor down vs. push
2nd Stage: Pushing – Offer to help with maternal positioning (holding ankle/leg)
Delivery – Downward traction on head, thumbs to nose, anterior shoulder, posterior shoulder, body. Skin to skin. Delayed cord clamping.
3rd Stage: Placenta – Active management, Pitocin, gentle cord traction. Three signs of placental detachment.
Bleeding – Atony and uterotonic medications
Lacerations – Degree classification and repair
Postpartum – Fundal tenderness, lochia, voiding, breastfeeding
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.
23 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.