Obgyno Wino Podcast
Obgyno Wino Podcast
Nathan Riley, MD
Summaries of ACOG's Practice Bulletins recorded while the host guzzles booze and speaks too closely to the microphone. Each episode accompanied by comprehensive show notes, wine recommendations, and unsolicited advice. Pour yourself a glass, and come along, friend. Help us remain the reigning #1 OBGYN Podcast Ever Made! #DoNoHarmTakeNoShit
Ep 49: Operative Vaginal Birth
Practice Bulletins #219 - Published April 2020 1. Episiotomies should never be performed routinely, even if you were trained to do it routinely to assist in operative vaginal delivery. If you think it's absolutely necessary, counsel the patient so that she can make an informed decision. 2. Overall, operative vaginal delivery carries low absolute risk for baby and mom w/ comparable relative risk compared to c-section 3. Vacuum-assisted delivery carries higher risks to the fetus when compared to forceps and lower risks to mom. 4. Major benefit to operative vaginal birth is decreased risk of hypoxic injury to the newborn in the event of successful expedited vaginal delivery through operative means (assuming there is concern for fetal acidemia) 5. Forceps, even in trained hands, carries significantly higher risk of severe perineal injury compared to vacuum. Show Notes **Visit our friends at www.intimatewellnessshop.com for bushels of sex positivity, including toys, massage oils, self-care products, and more! Use code MOREWINE at checkout for 15% off your purchase!** Wine pairing: 2018 Willamette Valley Pinot Noir from Inscription Wine Theme music by Evan Handyside Logo design by JD Dotson (jddotson1@gmail.com)
Nov 20
48 min
Ep 48: Chronic Pelvic Pain
Practice Bulletins #218 - Published March 2020 1. Up to 33% of women with chronic pelvic pain will also meet criteria for diagnosis of major depression 2. An interdisciplinary approach is the way go to: gynecologist, physical therapist, and psychologist in the very least. 3. The physical exam should be approached very carefully and systematically 4. Yoga, acupuncture, and other complementary and integrative therapies should absolutely be considered. 5. Don't prescribe opioids for chronic pelvic pain. Go with neuropathic agents, SNRIs, and tricyclic antidepressants. Show Notes **Visit our friends at www.intimatewellnessshop.com for bushels of sex positivity, including toys, massage oils, self-care products, and more! Use code MOREWINE at checkout for 15% off your purchase!** Wine pairing: 2017 Red Blend from Francis Coppola Theme music by Evan Handyside Logo design by JD Dotson (jddotson1@gmail.com)
Nov 13
1 hr 15 min
Ep 47: Prelabor Rupture of Membranes
Practice Bulletins #188 - Published January 2018 1. Management recommendations in PROM/PPROM is dependent on gestational age: >37 0/7 wga => induction/augmentation 34 0/7 - 36 6/7 wga => expectant management or induction/augmentation <34 0/7 wga => expectant management 2. Diagnosis of  PROM is based on history and physical: pooling of fluid, pH of vaginal fluid, and ferning on microscopy. 3. Indications for induction/augmentation for both PROM and PPROM include abnormal fetal testing, evidence of intra-amniotic infection, and vaginal bleeding suggestive of abruptio placentae. 4. For PPROM (24 0/7 - 33 6/7 wga) --> antibiotics and steroids should be offered, and magnesium sulfate should be offered at <32 wga 5. The diagnosis of periviable ROM is best followed up with careful counseling around the risks and benefits. It can be managed with induction or expectant management, which, after hospital assessment, can be provided via home care until viability Show Notes Wine pairing: 2019 Malbec from Espuela del Gaucho Theme music by Evan Handyside Logo design by JD Dotson (jddotson1@gmail.com)
Jul 2
51 min
Ep 46: Changing the Culture of Hospital-Based Birth
SPECIAL EPISODE - Interview w/ Hermine Hayes-Klein, JD, and Brad Bootstaylor, MD, FACOG In this episode, we'll be discussing the problematic culture of hospital-based birth. We explore the physician-patient relationship, the responsibilities that come with the rights to informed consent and refusal of treatment, and how supercomputers in the hands of our patients have enabled them to view us as the enemy, and vice-versa. Most importantly, we discuss ways in which we may all begin to mend the physician-patient relationship in order to redirect the culture of hospital-based birth. Show Notes Wine pairing: 2017 Sauvignon Blanc from Psyche Wines Theme music by Evan Handyside Logo design by JD Dotson (jddotson1@gmail.com)
Apr 29
1 hr 30 min
Ep 45: Nausea and Vomiting of Pregnancy
Practice Bulletins #189 - Published January 2018 Five pearls: 1. The decision to treat should be informed by the woman’s perception of the severity of symptoms, her desire for treatment, and the potential effect of treatment on her fetus 2. Use of prenatal vitamins 1 mo before fertilization may reduce incidence and treating nausea and vomiting of pregnancy (NVP) can prevent progression from NVP to hyperemesis gravidarum (HG) 3. After dietary and nonpharmacologic options (e.g. ginger) have been tried, first-line pharmacotherapy entails trying vitamin B6 alone or vitamin B6 plus doxylamine 4. Antithyroid drugs are not recommended for abnormal maternal thyroid tests attributable to gestational transient thyrotoxicosis or HG 5 .Hospitalization for evaluation and treatment of dehydration and electrolyte imbalance is indicated when a woman can’t tolerate liquids without vomiting and hasn’t responded to outpatient management Show Notes Wine pairing: 2018 Pinot Noir from Hedgeline Vineyards Theme music by Evan Handyside Logo design by JD Dotson (jddotson1@gmail.com)
Apr 18
42 min
Ep 44: Midwifery is Under Attack
SPECIAL EPISODE - Interview w/ Elizabeth Catlin, CPM, Melissa Carman, CPM, and Hermine Hayes-Klein, J.D.  In this special episode, I speak with two midwives about their recently being arrested and charged with the "unauthorized practice of a profession" in the state of New York. They have served the Amish and Mennonites communities for years, and these charges are just another piece in the government's and medical profession's efforts to control a woman's right to choice in pregnancy and childbirth. We are joined by an attorney who specializes in human rights in childbirth. Show Notes Wine pairing: 2017 Merlot from Chalkboard Wines Theme music by Evan Handyside Logo design by JD Dotson (jddotson1@gmail.com)
Apr 1
1 hr 13 min
Microdose F: On My Departure From Hospital-Based Birth
"Today is my final shift as an obstetrician. You'll find me breaking bread with the birth educators, doulas, witches, midwives, nurses, and other physicians who guide their patients to safety without failing to appreciate the beauty and majesty displayed by a birthing human." www.ObgynoWino.com
Mar 26
12 min
Ep 43: Prevention and Management of Alloimmunization in Pregnancy
Practice Bulletins #181 and #192 - Reaffirmed in 2019 Five pearls: 1. Risk of alloimmunization is around 15% after 2nd delivery of an Rh positive fetus to an Rh negative mother; this risk is decreased dramatically with administration of postpartum RhoGam 2. RhoGam is never indicated if both mom and dad are Rh negative or in women who are already sensitized (indirect coombs screen) 3. The KB test can used to determine if excessive feto-maternal hemorrhage has occurred in order to guide RhoGam administration in less obvious cases such as abdominal trauma in pregnancy 4. Alloimmunization can present as mild to severe anemia; if concerning antibodies are found, serial titers and/or peak systolic velocity of the middle cerebral artery ma be indicated 5. "Kell kills" Show Notes SIGN UP FOR LOUISVILLE BREECH WORKSHOP! Wine pairing: 2017 Pinot Noir from Longford Estate Wines Theme music by Evan Handyside Logo design by JD Dotson (jddotson1@gmail.com)
Feb 7
37 min
Microdose E: Senseless Acts of Sourdough
We need more senseless acts of kindness in our world, in feeding the masses, in home repair needs, and particularly in medicine. www.ObgynoWino.com
Jan 31
4 min
Ep 42: A Brief History of Midwifery w/ Rebecca Dekker, PhD
SPECIAL EPISODE - Interview w/ Rebecca Dekker, PhD (Instagram, Twitter, and Website).  Rebecca also wrote a book called Babies Are Not Pizzas...you may have heard of it. Show Notes SIGN UP FOR LOUISVILLE BREECH WORKSHOP! Wine pairing: 2017 Chardonnay from Montoya Vineyards Theme music by Evan Handyside Logo design by JD Dotson (jddotson1@gmail.com)
Jan 28
1 hr 8 min
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