Archive for October, 2009

Podcasts remastered for improved audio quality

Hello Friends!

I have been aware that some of the podcast episodes did not have great audio quality.  This was all  my fault, not being an audio engineer and lacking experience with this.

Over time I have learned how to do this stuff better, and audio quality in the podcasts has improved in general, and should continue to improve.

I have gone back through the old podcasts, and in most cases have substantially improved their audio quality, including increasing volume on the ones that were too quiet (including the recent Episode 7 which was way too quiet.)   So if you downloaded them before and chose not to listen because of objectionable audio quality, I invite you to delete what you have and redownload the improved versions.  The content is great and worth listening to!


Nicholas Fogelson, MD

Academic OB/GYN


PS. Episode 3, it seems, is beyond repair.  But Dr Robinson is still worth listening to if you can stand the static.

Amniotic Fluid Ferns at ANY gestational age

October 26, 2009 6 comments

Throughout my career heard so many reasons why the fern slide didn’t fern in the apparently ruptured patient.

“She’s only 19 weeks, they don’t fern this early.”

“There’s blood in the sample, that makes it not fern.”

“She has chorio, that makes it not fern.”

Over the years, this has driven me a bit crazy, because the real reason that the slide is not ferned is not any of these reasons.  The reason there is no fern on the slide is because the fluid on the slide is not amniotic fluid.

Read more…

Academic OB/GYN Podcast Episode 9 – Web 2.0 and You

October 25, 2009 1 comment

Dr Jeff Livingston (Twitter:@macobgyn) and I(@academicobgyn) discuss the role of Web 2.0 and Social Networking in modern OB/GYN practice.   Hear about how we use Facebook, Twitter, and other upcoming social networks to connect with our patients and the community at large.

Academic OB/GYN Episode 9 – Web 2.0 and YOU!

Academic OB/GYN is sponsored by Due Dater, iPhone and iPod Touch software for calculating gestational ages and due dates for obstetrics professionals.  Available at the Apple App Store.

Evidence Based Use of Misoprostol in Second Trimester Induction

October 24, 2009 11 comments

I was recently on call and we had 2 patients on our board having second trimester inductions, one for ruptured membranes at 17 weeks and another for fetal anomaly.  Both patients were being treated with what seemed like a strange regimen of misoprostol, 400 mcg miso vaginally _and_ 400 mcg orally, every 4 hours.  I had never heard of this regimen, and was wondering where it came from. None of the residents seemed to know, only that it had been passed down through some route to them.

It struck me as odd that people are using misoprostol in all kinds of different ways,  despite the large amount of available evidence in the literature.  In fact, it may be one of the most thoroughly studied topics in obstetrics, having been the subject of many randomized trials, a standard of research rarely achieved in our field.  Studies have included both pharmacokinetic and clinical data.  For better or for worse, abortion is the single most common procedure performed for women worldwide, and the patient population tends to be appreciative and willing to participate in research.  Sadly, the mammoth amount of data available seems overlooked by the majority of practicing obstetricians, given the wide variation in practice I have observed.  As such, I want to review a few of the major articles here.

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Surgical Video – Minilaparotomy Technique for Postpartum Tubal Ligation

October 20, 2009 9 comments

This video demonstrates an effective and efficient technique for getting into the abdomen for a postpartum tubal ligation or open laparoscopy in any patient, big or small, in no time at all.


Categories: Surgical Videos
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