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Academic OB/GYN Podcast Episode 26 – Journals for October 2010

Hosts Nicholas Fogelson and Paul Browne discuss articles from the Green and Grey journals for October 2010.  Topics include – Two vessel cords, ablation techniques, tranexamic acid, high vs dose pitocin and more listener questions answered!

Academic OB/GYN Podcast Episode 26 – Journals for October 2010

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  1. QoB
    October 21, 2010 at 12:53 pm | #1

    be careful about your assumptions re: race and genetic homogeneity. It’s dangerous and potentially racist to assume that Zimbabwe and Iran are more genetically homogeneous just because the population might be the same ‘race’, without any relevant evidence.

    • October 21, 2010 at 2:36 pm | #2

      Fair point, though I think the underlying idea was that the very different populations studied in the particular paper may hurt applicability to patients in our communities.

      • QoB
        October 25, 2010 at 11:56 pm | #3

        Indeed, and that’s a fair point to make. I think you should be careful not to stretch it too far as Paul Browne does below: race =/= genetic homogeneity.

  2. Paul Browne
    October 24, 2010 at 2:09 pm | #4

    I have listed a site below that confirms the racial homogeniety of Zimbabwe (98% African). As you comment, Iran is more complicated with a variety of Arab ethnic groups of which there is no majority. Healthcare statistics for countries with significant racial minorities such as the U.S., U.K., Germany, France, etc are diificult to evaluate. Conclusions made from studies where there is an overwhelming majority of a single race may not be applicable in more diverse countries, if the issue studied is racially biased.
    http://www.nationmaster.com/graph/peo_eth_gro-people-ethnic-groups
    Amer J Public Health 2000;11(90):1690-1693

  3. October 24, 2010 at 11:47 pm | #6

    Good content and discussion.

    (1) Pitocin regimens. You exceed the maximum, recorded work of a nulliparous uterus in spontaneous labour at 12 mU per minute. Some nulliparous uteri have disordered innervation as a consequence of previous bowel problems and will need pitocin. Hyperstimulation may cause attenuation of uterosacral ligaments and nerves that result in subsequent gynecological pain. Good point about selective evidence (2.5% of papers) – key problem in ob/gyn.

    (2) Pushing is banned in most East European countries. Prolonged pushing (>2 hours) leads to serious gynaecologic symptoms at 4 years postpartum. Forceps are x10 more likely to avulse the obturator origin of LA than normal delivery. They also injure medially located, autonomic nerves resulting in subsequent gynecology. Most important contributory factor is angle of scissors at episiotomy when it is difficult given the assymmetric distension of the perineum to place them in a horizontal plane to achieve an RML incision. Settlements in UK for faecal incontinence now running at $500k plus.

    Predict forceps to be banned within next ten years because of detailed MR Studies and subsequent gynecologic problems owing to avulsion of autonomic nerves.

    • October 25, 2010 at 8:01 am | #7

      Interesting ideas. I took a look at your website, which offers some alternate ideas on the origins of endometriosis. What is your background?

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