Howard Herrell and Antonia Roberts explore evidence-based practices in obstetrics and gynecology, examining both established protocols and emerging research with critical perspectives on medical misinformation.

• Serial cervical length monitoring after LEEP procedures lacks evidence for improving outcomes despite being common practice
• SMFM's 2016 recommendation explicitly advises against routine cervical length screening for patients with history of cervical procedures
• Retrospective studies on induction timing require careful interpretation due to inherent biases in methodology
• Understanding the difference between intent-to-treat and per-protocol analysis is crucial when evaluating medical research
• Pseudoscience and alternative medicine have gained mainstream acceptance over decades through celebrity endorsements and media platforms
• Reusable surgical instruments like stainless steel uterine manipulators offer both economic and environmental advantages over disposable options
• Plus, Learn the history of The Green Journal's distinctive color

Be sure to check out thinkingaboutobgyn.com for more information and follow us on Instagram. We'll be back in two weeks.

00:00:35 Monitoring Cervical Length After LEEP

00:10:30 Understanding Intent-to-Treat Analysis

00:28:54 MAHA Movement and Medical Misinformation

00:53:49 Carbon Footprint of Uterine Manipulators

00:57:30 History of the Green Journal

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Cervical cancer represents a success story in developed countries due to screening and vaccination, yet remains a significant global health problem with over 340,000 deaths annually worldwide. We explore the current state of cervical cancer prevention, screening, and treatment while discussing exciting advances that could eventually eliminate this disease.

• Different levels of prevention for cervical cancer: primordial, primary, secondary, tertiary, and quaternary
• HPV vaccination as the most effective primary prevention method, with Australia on track to make cervical cancer rare by 2035
• Evolution from Pap smears to primary HPV testing, with potential future urine-based screening options
• Less radical surgical approaches for early-stage disease, improving quality of life without compromising outcomes
• Immunotherapy advances showing 6-12 month survival benefits in metastatic disease
• Howard Kelly's pioneering work with radium in the early 1900s, establishing foundations for radiation therapy
• Importance of addressing healthcare disparities, as rural Americans are 25% more likely to develop cervical cancer and 42% more likely to die from it

Visit our website at thinkingaboutobgyn.com for more information and follow us on Instagram for updates.

00:00:00 Introduction to Cervical Cancer

00:08:10 Prevention Strategies Explained

00:18:02 HPV Screening Evolution

00:26:51Treatment of Early-Stage Disease

00:37:09Advances in Locally Advanced Disease

00:50:31 Radium and Howard Kelly's History

01:02:48 Final Thoughts on Prevention

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Howard and Antonia explore the evidence behind pit breaks in labor, cannabis use in pregnancy, and IUD options for hormone replacement therapy.

• Pit breaks in labor lack substantial evidence of benefit when used in active labor
• Current research suggests stopping oxytocin during active labor may slightly increase cesarean rates rather than decrease them
• Long pit breaks (up to 8 hours) in latent labor may be beneficial by allowing rest and promoting patience
• Recent systematic review shows prenatal cannabis use increases risk of low birth weight by 75%, preterm birth by 50%, and perinatal mortality by 29%
• Cannabis use during pregnancy (7.2% of pregnant women) now exceeds tobacco use
• Retrospective studies on doula care show association with better outcomes, but can't establish causation due to inherent differences in patients who seek doulas
• 52mg levonorgestrel IUDs (Mirena/Liletta) are suitable for endometrial protection during HRT, but evidence only supports use up to 5 years
• Most systematic reviews combine heterogeneous studies and shouldn't be considered level 1 evidence

We'd love to hear your questions! Send them to us through our Instagram or website thinkingaboutobgyn.com.

00:04:52 Pit Breaks in Labor

00:15:32 Examining Evidence on Oxytocin Discontinuation

00:26:08 Prenatal Cannabis Use and Adverse Outcomes

00:36:07 Doula Care Study Analysis

00:57:22 Levonorgestrel IUD Use in HRT

Follow us on Instagram @thinkingaboutobgyn.